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Chang X, Bian H, Xia M, Zhu X, Sun X, Yang X, Gao J, Lin H, Yan H, Gao X. Postprandial glucose is correlated with an increasing risk of liver fibrosis in Chinese patients with nonalcoholic fatty liver disease. Diabetes Metab 2022; 48:101377. [PMID: 35858659 DOI: 10.1016/j.diabet.2022.101377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
AIM Type 2 diabetes (T2DM) is closely related to nonalcoholic fatty liver disease (NAFLD) and is an important risk factor for the progression of liver fibrosis, but the role of 2-h postprandial blood glucose (PPG) as a biomarker in this process remains unclear. This study was designed to investigate the relationship between PPG and liver fibrosis in Chinese NAFLD populations with or without T2DM. METHODS This study included three independent NAFLD populations: 1) 618 inpatients with T2DM or pre-diabetes, 2) 255 patients with T2DM or pre-diabetes who underwent liver biopsy, and 3) a prospective community-based cohort without diabetes who completed a median of 4.22 years follow-up. The degree of liver fibrosis was assessed by liver fibrosis stage in subjects with a liver biopsy, and by NAFLD fibrosis score (NFS) in subjects without liver biopsy. RESULTS In the first population, PPG {OR 0.02, [95% CI (0.01-0.03)], P< 0.001} was positively correlated with NFS. In the second population, an increasing PPG was associated with increase in the proportion of advanced liver fibrosis (P = 0.012). Multivariate line regression revealed that PPG {OR 0.03 [95% CI (0.00-0.06)], P = 0.049}was positively associated with liver fibrosis stages. In the third population, PPG {OR 0.103, [95% CI (0.011-0.194) P = 0.028} at baseline was positively associated with NFS at follow-up. Furthermore, changes in PPG were significantly associated with NFS change after follow-up. We did not find a similar association between fasting glucose or HbA1c and liver fibrosis. CONCLUSIONS PPG was independently associated with the severity of liver fibrosis in the Chinese NAFLD population.
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Affiliation(s)
- Xinxia Chang
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Fudan Institute for Metabolic Diseases, Fudan University, Shanghai 200032, China
| | - Hua Bian
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Fudan Institute for Metabolic Diseases, Fudan University, Shanghai 200032, China
| | - Mingfeng Xia
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Fudan Institute for Metabolic Diseases, Fudan University, Shanghai 200032, China
| | - Xiaopeng Zhu
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Fudan Institute for Metabolic Diseases, Fudan University, Shanghai 200032, China
| | - Xiaoyang Sun
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Fudan Institute for Metabolic Diseases, Fudan University, Shanghai 200032, China
| | - Xinyu Yang
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Fudan Institute for Metabolic Diseases, Fudan University, Shanghai 200032, China
| | - Jian Gao
- Center of Clinical Epidemiology and Evidence-based Medicine, Fudan University, Shanghai 200032, China; Department of Nutrition, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
| | - Huandong Lin
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Fudan Institute for Metabolic Diseases, Fudan University, Shanghai 200032, China.
| | - Hongmei Yan
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Fudan Institute for Metabolic Diseases, Fudan University, Shanghai 200032, China.
| | - Xin Gao
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Fudan Institute for Metabolic Diseases, Fudan University, Shanghai 200032, China
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Liu J, Hou D, Gao Y, Wu J. No Association between Elevated 2-h Postprandial Blood Glucose Levels and Functional Outcomes of Small-Artery Occlusion in Patients with Diabetes. Front Neurol 2018. [PMID: 29535677 PMCID: PMC5834660 DOI: 10.3389/fneur.2018.00093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Background The association between 2-h postprandial blood glucose level (2hPBG) and functional outcomes in patients with small-artery occlusion (SAO) is poorly understood. We aimed to explore the relationship between 2hPBG levels and functional outcomes in SAO patients with diabetes. Methods We retrospectively analyzed 174 diabetic patients diagnosed with SAO, and 2hPBG values were classified into four groups according to quartiles (<8.90, 8.90 to <12.16, 12.16 to <15.14, and ≥15.14 mmol/L), or according to clinical glycemic recommendations for adults with diabetes (<10 and ≥10 mmol/L, respectively). The relationship between 2hPBG levels and modified Rankin Scale (mRS) scores was assessed using univariate and multivariate analyses. Results Among all patients with SAO, there were 139 patients with favorable outcomes and 35 patients with poor outcomes. National Institutes of Health Stroke Scale scores were significantly different according to mRS scores (P < 0.001) in both the univariate and multivariate analyses. The binary logistic regression analyses showed that compared with the lowest quartile (<8.90 mmol/L), elevated 2hPBG levels (8.90 to <12.16, 12.16 to <15.14, and ≥15.14 mmol/L) were not associated with mRS scores after adjusting for multiple confounding factors. Compared with patients with 2hPBG levels <10 mmol/L, those with 2hPBG levels ≥10 mmol/L did not have a significant risk of poor outcome after adjusting for confounders. Meanwhile, the negative results appeared in the ordinal logistic regression of 2hPBG levels and 3-month functional outcomes. Conclusion Elevated 2hPBG levels were not associated with unfavorable functional outcomes 3 months after stroke onset in SAO patients with diabetes.
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Affiliation(s)
- Ji Liu
- Department of Medicine, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, China
| | - Dongzhe Hou
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, China.,Department of Neurorehabilitation, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, China
| | - Yuan Gao
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, China.,Department of Neurorehabilitation, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, China
| | - Jialing Wu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, China.,Department of Neurorehabilitation, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, China
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