Association of glycosylated hemoglobin (HbA1c) levels with Iinsulin resistance in obese children

Glycated hemoglobin (HbA1c) is independently associated with the bioelectrical impedance phase angle in junior sumo wrestlers: A pilot study

The study explores the relationship between phase angle (PhA), an indicator of cellular health, and metabolic health parameters among junior sumo wrestlers in Japan. Given the demanding lifestyle and high-energy diets of sumo wrestlers that predispose them to metabolic syndrome post-retirement, this study focuses on a younger cohort. The primary aim is to evaluate if PhA could serve as an early indicator of metabolic health issues within this unique demographic. A total of 14 sumo wrestlers aged 9-17 years were assessed to determine the relationship between PhA and various metabolic markers, including glycated hemoglobin (HbA1c), using a TANITA MC-780A-N body composition analyzer and standard blood tests. Bivariate regression analysis and Pearson's correlation revealed a negative relationship between PhA and HbA1c even after adjusting for age and weight (ß = -0.496, r2 = 0.776, r = -0.756, p = 0.004). The results indicate a significant negative relationship between PhA and HbA1c levels, suggesting that lower PhA values, which indicate poorer cellular integrity, are associated with higher HbA1c levels, signifying impaired glycemic control. These findings underscore the potential of PhA as a valuable biomarker for monitoring metabolic health in young sumo wrestlers, with implications for early intervention and management strategies.

Dietary Supplement, Containing the Dry Extract of Curcumin, Emblica and Cassia, Counteracts Intestinal Inflammation and Enteric Dysmotility Associated with Obesity

Intestinal epithelial barrier (IEB) impairment and enteric inflammation are involved in the onset of obesity and gut-related dysmotility. Dietary supplementation with natural plant extracts represents a useful strategy for the management of body weight gain and systemic inflammation associated with obesity. Here, we evaluate the efficacy of a food supplement containing the dry extract of Curcumin, Emblica and Cassia in counteracting enteric inflammation and motor abnormalities in a mouse model of obesity, induced by a high-fat diet (HFD). Male C57BL/6 mice, fed with standard diet (SD) or HFD, were treated with a natural mixture (Curcumin, Emblica and Cassia). After 8 weeks, body weight, BMI, liver and spleen weight, along with metabolic parameters and colonic motor activity were evaluated. Additionally, plasma LBP, fecal calprotectin, colonic levels of MPO and IL-1β, as well as the expression of occludin, TLR-4, MYD88 and NF-κB were investigated. Plant-based food supplement administration (1) counteracted the increase in body weight, BMI and metabolic parameters, along with a reduction in spleen and liver weight; (2) showed strengthening effects on the IEB integrity; and (3) reduced enteric inflammation and oxidative stress, as well as ameliorated the colonic contractile dysfunctions. Natural mixture administration reduced intestinal inflammation and counteracted the intestinal motor dysfunction associated with obesity.

Oral administration of processed Cassia obtusifolia L. seed powder May reduce body weight and cholesterol in overweight patients with schizophrenia: A 36-week randomized, double-blind, controlled trial of high and low doses

ETHNOPHARMACOLOGICAL RELEVANCE

Obesity in patients with schizophrenia is related to antipsychotic drug use, hypertension, diabetes, and dyslipidemia, which are critical risk factors for cardiovascular disease. Cassia seed is a traditional Chinese medicine that can be used to treat various eye disorders. Anthraquinone-containing Cassia seed were used to lower serum levels of fat and cholesterol.

AIM OF STUDY

The effects of Cassia seed powder on body weight and lipids were investigated in overweight or obese patients with schizophrenia.

METHODS

The present study was designed as a double-blind, randomized, controlled trial. Ninety-four patients with schizophrenia who were overweight or obese were assigned to a control group (CG, 47 patients) and treatment group (TG, 47 patients) that received low dose Cassia seed power (0.3 g once daily) and Cassia seed powder (3.0 g once daily), respectively, for 36 weeks. The main outcome was the change in body mass index and waist circumference (WC). The secondary outcome was the change in serum lipids, C-reactive protein, interleukin-6, and glycated hemoglobin.

RESULTS

Seventy-four patients completed the study (n = 36, CG; n = 38, TG). WC was significantly lower at the second (24 weeks, 98.63 ± 9.44 vs 95.80 ± 10.26 cm, p = 0.023), third (36 weeks, 98.35 ± 9.46 vs 95.05 ± 10.07 cm, p = 0.002), and fourth (48 weeks, 98.78 ± 9.48 vs 93.73 ± 10.28 cm, p < 0.001) follow-ups than at baseline in the TG, but only significantly lower than baseline at the fourth follow-up (100.78 ± 13.98 vs 94.03 ± 9.74 cm, p = 0.006); no significant difference in CG was observed at both the second (101.03 ± 13.62 vs 97.35 ± 8,29 cm, p = 0.08) and third (100.55 ± 13.69 vs 96.55 ± 8.29 cm, p = 0.066) follow-up. The difference in serum total cholesterol and low-density lipoprotein levels between the baseline and the third follow-up was greater in the TG than in the CG (149.68 ± 34.85 vs 179.08 ± 75.87 mg/dL, p = 0.033; 84.40 ± 28.06 vs102.08 ± 34.12 mg/dL, p = 0.015, respectively).

CONCLUSION

In patients with schizophrenia who were overweight or obese, oral administration of Cassia seed powder (3.0 g) for 24 weeks and 36 weeks reduced WC, and oral administration of Cassia seed powder for 36 weeks reduced total cholesterol and low-density lipoprotein levels, suggesting that Cassia seed powder aids the management of patients with schizophrenia who are overweight or obese. However, these results are preliminary, and future studies should use larger sample sizes, multiple testing centers, and multiple dosing.

Potential relation between non-alcoholic fatty liver disease and glycemic and metabolic parameters in subjects without diabetes

Background

Nonalcoholic fatty liver disease (NAFLD) is proved to be related to insulin resistance and type 2 diabetes, and it is also not rare in individuals without diabetes. The present study attempts to identify the metabolic risk factors of NAFLD among those individuals.

Results

ALT and HbA1c levels were independently associated with NAFLD development in individuals without diabetes. Receiver operating characteristic (ROC) analysis identified the optimal cutoff point of ALT (> 19 IU/ml) with AUC = 0.731, 95% CI 0.653–0.809. On the other hand, the optimal cutoff point of HbA1c was identified to be > 5.1% with AUC = 0.665, 95% CI 0.581–0.750.

Conclusions

Early identification of NAFLD among subjects without diabetes is crucial. In this study, ALT and HbA1c cutoff values had been identified, so we suggest that inclusion of both HbA1c and ALT levels may have significant implications for prediction of NAFLD among individuals without diabetes.

HbA1c may contribute to the development of non-alcoholic fatty liver disease even at normal-range levels

Previous clinical studies highlighted nonalcoholic fatty liver disease (NAFLD) as a hepatic facet of metabolic syndrome, which progresses toward Type 2 diabetes along with an elevation of HbA1c in the blood. Longitudinal observations were performed in a cohort of 2811 participants with no liver disease at inception. The rate of the conversion into NAFLD was 15.7% (440/2811), with a steady increase in prevalence observed in sub-cohorts with increasing HbA1c levels. Moreover, regression analysis indicated that HbA1c levels serve as the risk factors for NAFLD after multiple adjustments (odds ratio: 1.58, P-value < 0.004). When HbA1c-related molecular networks were investigated using natural language programming algorithms, multiple genetic/small molecular (SM) pathways were highlighted as connectors between the HbA1c levels and the development of NAFLD, including ones for nitric oxide, hypoxia and receptor for advanced glycation end products (RAGE). Our results suggest that increased levels of HbA1c may contribute to the progression of NAFLD either directly, by stimulating RAGE or indirectly, through the promotion of hypoxia and suppression of the release of NO. Further studies are needed to test the impact of HbA1c on the development of the chronic liver disease.

Association of Prenatal and Perinatal Exposures to Particulate Matter With Changes in Hemoglobin A1c Levels in Children Aged 4 to 6 Years

IMPORTANCE

Environmental risk factors for childhood type 2 diabetes, an increasing global problem, are understudied. Air pollution exposure has been reported to be a risk factor for this condition.

OBJECTIVE

To examine the association between prenatal and perinatal exposures to fine particulate matter with a diameter less than 2.5 μm (PM2.5) and changes in hemoglobin A1c (HbA1c), a measure of glycated hemoglobin and marker of glucose dysregulation, in children aged 4 to 7 years.

DESIGN, SETTING, AND PARTICIPANTS

The Programming Research in Obesity, Growth, Environment, and Social Stressors (PROGRESS) study, a birth cohort study conducted in Mexico City, Mexico, recruited pregnant women from July 3, 2007, to February 21, 2011, through public health maternity clinics. The present analysis includes 365 mother-child pairs followed up until the child was approximately 7 years of age. This study included data from only study visits at approximately 4 to 5 years (visit 1) and 6 to 7 years (visit 2) post partum because HbA1c levels were not measured in earlier visits. The data were analyzed from March 11, 2018, to May 3, 2019.

EXPOSURES

Daily PM2.5 exposure estimates at participants' home addresses from 4 weeks prior to mothers' date of last menstrual period (LMP), a marker of the beginning of pregnancy, to 12 weeks after the due date. Exposure was estimated from satellite measurements and calibrated against ground PM2.5 measurements, land use, and meteorological variables.

MAIN OUTCOMES AND MEASURES

Outcomes included HbA1c levels at 4 to 5 years and 6 to 7 years of age, and the change in the level from the former age group to the latter.

RESULTS

The sample included 365 children, of whom 184 (50.4%) were girls. The mean (range) age of the children was 4.8 (4.0-6.4) years at visit 1, and 6.7 (6.0-9.7) years at visit 2. At the time of delivery, the mean (range) age of the mothers was 27.7 (18.3-44.4) years, with a mean (range) prepregnancy body mass index of 26.4 (18.5-43.5). The mean (SD) prenatal PM2.5 exposure (22.4 μg/m3 [2.7 μg/m3]) was associated with an annual increase in HbA1c levels of 0.25% (95% CI, 0.004%-0.50%) from age 4 to 5 years to 6 to 7 years compared with exposure at 12 μg/m3, the national regulatory standard in Mexico. Sex-specific effect estimates were statistically significant for girls (β = 0.21%; 95% CI, 0.10% to 0.32%) but not for boys (β = 0.31%; 95% CI, -0.09% to 0.72%). The statistically significant windows of exposure were from week 28 to 50.6 after the mother's LMP for the overall cohort and from week 11 to the end of the study period for girls. Lower HbA1c levels were observed at age 4 to 5 years in girls (β = -0.72%; 95% CI, -1.31% to -0.13%, exposure window from week 16 to 37.3) and boys (β = -0.98%; 95% CI, -1.70% to -0.26%, exposure window from the beginning of the study period to week 32.7), but no significant association was found in the overall cohort (β = -0.13%; 95% CI, -1.27% to 1.01%). There was no significant association between PM2.5 exposure and HbA1c level at age 6 to 7 years in any group.

CONCLUSIONS AND RELEVANCE

The findings of this study suggest that prenatal and perinatal exposures to PM2.5 are associated with changes in HbA1c, which are indicative of glucose dysregulation, in early childhood. Further research is needed because this finding may represent a risk factor for childhood or adolescent diabetes.

Honokiol Improves Insulin Resistance, Hepatic Steatosis, and Inflammation in Type 2 Diabetic db/db Mice

This study focuses on the effect of honokiol (HON) on glucose homeostasis, insulin resistance, dyslipidemia, hepatic steatosis, and inflammation in type 2 diabetic db/db mice. Male C57BL/KsJ-db/db mice were fed a normal diet with or without HON (0.02%, w/w) or pioglitazone (PIO, anti-diabetic agent, 0.01%, w/w) for 5 weeks. Blood biomarker, tissue morphology and enzymatic and genetic parameters were determined. PIO significantly decreased food intake, fasting blood glucose, and glycosylated hemoglobin (HbA1c) levels, but markedly increased body weight, adipose tissue weight, and plasma leptin levels. HON did not significantly affect food intake, body weight, or levels of plasma leptin and blood glucose. However, HON led to significant decreases in adipose tissue weight, plasma insulin, blood HbA1c and HOMA-IR levels and improved glucose tolerance. The anti-diabetic and anti-adiposity effects of HON were partially related to the inhibition of gluconeogenic enzymes and their mRNA expression in the liver; and the inhibition of lipogenic enzymes in adipose tissue, respectively. Unlike PIO, HON did not affect dyslipidemia, but ameliorated hepatic steatosis by inhibiting hepatic lipogenic enzymes activity. Moreover, HON exhibited anti-inflammatory effects similar to PIO. These results suggest that HON can protect against type 2 diabetes by improving insulin resistance, glucose and lipid metabolism, and inflammation.

Metabolic Profiles in Obese Children and Adolescents with Insulin Resistance

BACKGROUND:

In the past several decades, the increasing frequency of overweight and obese children and adolescents in the world has become a public health problem. It has contributed significantly to the already high tide of diabetes, cardiovascular and cerebrovascular diseases.

AIM:

To investigate the frequency of insulin resistance and to evaluate the metabolic profile of insulin resistant and non-insulin resistant obese children and adolescents.

SUBJECTS AND METHODS:

The study included 96 (45 boys, 51 girls) obese children and adolescents aged 4-17 years old (10.50 ± 2.87 years). Only participants with Body Mass Index ≥ 95 percentile were included. We analysed sera for fasting insulin levels (FI), fasting serum triglycerides (TG), total serum cholesterol (TC), fasting plasma glucose (FPG) and plasma glucose 2 hours after the performance of the oral glucose tolerance test (2-h G). Homeostatic model assessment for insulin resistance (HOMA-IR) index was calculated as fasting insulin concentration (microunits per millilitre) x fasting glucose concentration (millimolar)/22.5. The value of HOMA-IR above 3.16 was used as a cut-off value for both genders.

RESULTS:

Insulin resistance was determined in 58.33% of study participants. Insulin resistant participants had significantly higher level of 2-h G (p = 0.02), FI level (p = 0.000) as well as TG levels (p = 0.01), compared to non-insulin resistant group. Strikingly, 70.73% of the pubertal adolescents were insulin resistant in comparison to 49.09% of the preadolescents (p = 0.03). Significantly higher percentage of insulin-resistant participants were girls (p = 0.009). Moreover, a higher percentage of the girls (70.59%) than boys (44.44%) had HOMA-IR above 3.16 and had elevated FI levels (70.59% vs 48.89%). The difference in the frequency of insulin resistance among obese versus severely obese children and adolescents was not significant (p = 0.73, p > 0.05). Our study results also showed positive, but weak, correlation of HOMA-IR with age, FPG, TG and BMI of the participants (p < 0.05).

CONCLUSION:

Higher percentage of insulin-resistant participants was of female gender and was adolescents. In general, insulin resistant obese children and adolescents tend to have a worse metabolic profile in comparison to individuals without insulin resistance. It is of note that the highest insulin resistance was also linked with the highest concentrations of triglycerides.

Positive correlation of plasma PCSK9 levels with HbA1c in patients with type 2 diabetes

BACKGROUND

Proprotein convertase subtilisin/kexin type 9 (PCSK9) has been demonstrated to be involved in not only lipid metabolism but also glucose homeostasis. Glycated haemoglobin (HbA1c ) is a 'gold standard' for monitoring long-term glycaemic control. However, the correlation of plasma PCSK9 levels with HbA1c remains undetermined.

METHODS

We consecutively enrolled 805 subjects undergoing coronary angiography, including 176 patients with type 2 diabetes mellitus (T2DM) and 629 non-diabetic patients. The baseline characteristics were collected, and serum PCSK9 level was assessed by ELISA. Univariable regression analysis and multiple-variable regression analysis were used to examine the associations of PCSK9 with HbA1c . Furthermore, the HbA1c was compared across the tertiles of PCSK9 levels. And also, PCSK9 levels were compared in poorly controlled (HbA1c  ≥ 7.0%) and well-controlled (HbA1c  < 7.0%) patients with T2DM.

RESULTS

PCSK9 levels were positively correlated with low-density lipoprotein cholesterol in both T2DM and non-T2DM. Univariable regression analysis revealed a positive association between PCSK9 and HbA1c in patients with T2DM (β = 0.255, p = 0.001) but not in patients without diabetes (β = 0.061, p = 0.128). Multiple-variable regression analysis exhibited that PCSK9 was independently correlated with HbA1c in T2DM after adjustment for traditional atherosclerotic risk factors (β = 0.197, p = 0.020). Moreover, HbA1c level was higher in patients with the highest tertile of PCSK9 than that in the lowest tertile (p = 0.042). Additionally, higher levels of PCSK9 were found in poorly controlled group compared with the well-controlled group (p = 0.029).

CONCLUSIONS

Data suggest a positive correlation of PCSK9 levels with HbA1c in patients with T2DM but not in patients without T2DM, indicating a potential role of PCSK9 in T2DM. Copyright © 2015 John Wiley & Sons, Ltd.