Association between anorexia nervosa and type 2 diabetes in Sweden: Etiological clue for the primary prevention of type 2 diabetes

Adaptive Effects of Endocrine Hormones on Metabolism of Macronutrients during Fasting and Starvation: A Scoping Review

Food deprivation can occur for different reasons. Fasting (<24 h duration) occurs to meet religious or well-being goals. Starvation (>1-day duration) occurs when there is intentional (hunger strike or treatment of a medical condition) or unintentional (anorexia nervosa, drought, epidemic famine, war, or natural disaster) food deprivation. A scoping review was undertaken using the PubMed database to explore 1805 abstracts and review 88 eligible full-text articles to explore the adaptive relationships that emerge between cortisol, insulin, glucagon, and thyroid hormones on the metabolic pathways of macronutrients in humans during fasting and starvation. The collected data indicate that fasting and starvation prime the human body to increase cortisol levels and decrease the insulin/glucagon ratio and triiodothyronine (T3) levels. During fasting, increased levels of cortisol and a decreased insulin/glucagon ratio enhance glycogenolysis and reduce the peripheral uptake of glucose and glycogenesis, whereas decreased T3 levels potentially reduce glycogenolysis. During starvation, increased levels of cortisol and a decreased insulin/glucagon ratio enhance lipolysis, proteolysis, fatty acid and amino acid oxidation, ketogenesis, and ureagenesis, and decreased T3 levels reduce thermogenesis. We present a potential crosstalk between T3 and the above hormones, including between T3 and leptin, to extend their adaptive roles in the metabolism of endogenous macronutrients during food deprivation.

Shared genetics of psychiatric disorders and type 2 diabetes:a large-scale genome-wide cross-trait analysis

BACKGROUND

Individuals with psychiatric disorders have elevated rates of type 2 diabetes comorbidity. Although little is known about the shared genetics and causality of this association. Thus, we aimed to investigate shared genetics and causal link between different type 2 diabetes and psychiatric disorders.

METHODS

We conducted a large-scale genome-wide cross-trait association study(GWAS) to investigate genetic overlap between type 2 diabetes and anorexia nervosa, attention deficit/hyperactivity disorder, autism spectrum disorder, bipolar disorder, major depressive disorder, obsessive-compulsive disorder, schizophrenia, anxiety disorders and Tourette syndrome. By post-GWAS functional analysis, we identify variants genes expression in various tissues. Enrichment pathways, potential protein interaction and mendelian randomization also provided to research the relationship between type 2 diabetes and psychiatric disorders.

RESULTS

We discovered that type 2 diabetes and psychiatric disorders had a significant correlation. We identified 138 related loci, 32 were novel loci. Post-GWAS analysis revealed that 86 differentially expressed genes were located in different brain regions and peripheral blood in type 2 diabetes and related psychiatric disorders. MAPK signaling pathway plays an important role in neural development and insulin signaling. In addition, there is a causal relationship between T2D and mental disorders. In PPI analysis, the central genes of the DEG PPI network were FTO and TCF7L2.

CONCLUSION

This large-scale genome-wide cross-trait analysis identified shared genetics andpotential causal links between type 2 diabetes and related psychiatric disorders, suggesting potential new biological functions in common among them.

Association of postnatal severe acute malnutrition with pancreatic exocrine and endocrine function in children and adults: a systematic review

Severe acute malnutrition may lead both concurrently and subsequently to malabsorption and impaired glucose metabolism from pancreatic dysfunction. We conducted a systematic review to investigate the associations of current and prior postnatal wasting malnutrition with pancreatic endocrine and exocrine functions in humans. We searched PubMed, Google Scholar, Web of Science and reference lists of retrieved articles, limited to articles in English published before 1 February 2022. We included sixty-eight articles, mostly cross-sectional or cohort studies from twenty-nine countries including 592 530 participants, of which 325 998 were from a single study. Many were small clinical studies from decades ago and rated poor quality. Exocrine pancreas function, indicated by duodenal fluid or serum enzymes, or faecal elastase, was generally impaired in malnutrition. Insulin production was usually low in malnourished children and adults. Glucose disappearance during oral and intravenous glucose tolerance tests was variable. Upon treatment of malnutrition, most abnormalities improved but frequently not to control levels. Famine survivors studied decades later showed ongoing impaired glucose tolerance with some evidence of sex differences. The similar findings from anorexia nervosa, famine survivors and poverty- or infection-associated malnutrition in low- and middle-income countries (LMIC) lend credence to results being due to malnutrition itself. Research using large, well-documented cohorts and considering sexes separately, is needed to improve prevention and treatment of exocrine and endocrine pancreas abnormalities in LMIC with a high burden of malnutrition and diabetes.

THE CHALLENGES OF METABOLIC SYNDROME IN EATING DISORDERS

A number of studies have examined the association of the three major eating disorders - anorexia nervosa, bulimia nervosa, and binge-eating disorder - with metabolic syndrome, or with individual components of metabolic syndrome, such as obesity, type 2 diabetes, hypertension, and dyslipidemia. Present evidence suggests that anorexia nervosa confers no excess risk of metabolic syndrome and may be associated with lower risk of certain metabolic syndrome components, including obesity and type 2 diabetes. Bulimia nervosa shows associations with increased risk for metabolic syndrome components in some studies, but not in others. Binge-eating disorder, however, is strongly associated with increased risk for both metabolic syndrome and its components - and these associations appear to be mediated not only through elevated body weight, but also possible body-weight-independent factors. Given that binge-eating disorder is the most common eating disorder, treatment and prevention of metabolic syndrome in this group represents a significant clinical and public health challenge.

A Ten-Year Longitudinal Study of Prevalence of Eating Disorders in the General Polish Type 2 Diabetes Population

BACKGROUND Little has been reported regarding the epidemiology of eating disorders (EDs) in type 2 diabetes (T2DM). We examined the Polish National Health Fund-NFZ database estimates of all medical visits from 2008 to 2017 to determine the trend and the epidemiology of EDs in T2DM patients. MATERIAL AND METHODS The NFZ database were used. We defined the T2DM group diagnosed with both T2DM and EDs according to the ICD-10 codes. Demographic data were collected from the webpage of Statistics Poland (GUS). The annual prevalence of EDs was estimated according to the T2DM diagnosis status, and the age groups were stratified into 8 groups. RESULTS The prevalence of EDs in T2DM patients in the whole patient population with diagnosed T2DM ranged from 0.059% (in 2017) to 0.086% patients (in 2010). Differences in subcategories of EDs were noted. In the case of anorexia nervosa, a decreasing trend of coexistence with T2DM was noted. However, in the case of atypical anorexia nervosa, an increasing trend was observed. Both in the case of bulimia nervosa and atypical bulimia nervosa, an increasing trend of coexistence with T2DM was noted. As patients with T2DM age, the prevalence of EDs in T2DM decreased. CONCLUSIONS A relatively stable trend of prevalence of EDs in T2DM patients benefiting from state medical care indicated the need to develop effective screening methods and adequate procedures for therapeutic interventions with this group of patients using a multidisciplinary therapeutic team.

Are Eating Disorders Risk Factors for Type 2 Diabetes? A Systematic Review and Meta-analysis

RECENT FINDINGS

Eating disorders (ED) affect energy intake modifying body fat depots. Prior evidence suggests that binge eating disorder (BED) and bulimia nervosa (BN) could increase the risk for type 2 diabetes (T2D), while anorexia nervosa (AN) could reduce it.

PURPOSE OF REVIEW

A systematic review and meta-analysis were conducted to evaluate if ED are risk factors for T2D. Ten studies were selected out of 1057 screened. Meta-analysis of six studies with T2D as outcome is reported. Among cross-sectional studies, both BED (OR 3.69, 95% CI [1.12-12.12]) and BN (OR 3.45 [1.92-6.1]) increased the risk of T2D, while AN was not associated with lower risk (OR 0.87 [0.40-1.88]). Cohort studies showed increased risk of T2D with BN (RR 1.7 [1.2-2.5]), and decreased risk with AN (RR 0.71 [0.52-0.98]), but for BED the association was less clear (OR 3.34 [0.85-13.12]). Limitations of studies and recommendations for future research are presented.