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Cengiz T, Öncel M, Toka Özer T, Selimoğlu R, Kıyıcı A, Yılmaz H. Association of Leptin with Glucose Intolerance and Gestational Diabetes Mellitus in Pregnant Women: Prospective Analytical Case-Control Study. Reprod Sci 2024; 31:773-778. [PMID: 37816990 DOI: 10.1007/s43032-023-01354-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/09/2023] [Indexed: 10/12/2023]
Abstract
This study aimed to investigate the use of leptin as a marker for gestational diabetes by analyzing any correlation between serum leptin levels versus oral glucose tolerance tests (at 24 to 28 weeks of pregnancy) and increased body weight (during pregnancy). A total of 110 female cases (81 pregnant and 29 non-pregnant) were included in the study. The 81 pregnant cases were divided into 3 groups according to their oral glucose tolerance test results. A chi-square test was used for categorical variables. The distribution of numerical variables was tested with the Shapiro-Wilk test. ANOVA and a post-hoc Bonferroni test was used for parametric data. Kruskal-Wallis variance analysis was used for non-parametric data. The Mann-Whitney U-test was used for pairwise comparisons. Spearman correlation analysis and multivariate regression analysis were performed for the evaluation of the correlation analysis between the parameters. Oral glucose tolerance test results were compared with leptin levels with a cut-off value of 11.43 for leptin. The ROC curve demonstrated an 83.3% sensitivity and 72.1% specificity for leptin. Leptin may play a role in the pathophysiology of gestational diabetes mellitus. However, the relationship between leptin levels and maternal weight gain during pregnancy is still unknown.
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Affiliation(s)
- Türkan Cengiz
- Department of Obstetrics and Gynecology, Medical Park Hospital, Adana, Turkey
| | - Müfide Öncel
- Department of Medical Biochemistry, Konya Public Health Laboratory, Konya, Turkey
| | - Türkan Toka Özer
- Department of Medical Microbiology, Ankara Training and Research Hospital, Hacettepe Mh. Ulucanlar Cd. No:89 Altındağ, Ankara, 06230, Turkey.
| | - Refika Selimoğlu
- Department of Obstetrics and Gynecology, Farabi Hospital, Konya, Turkey
| | - Aysel Kıyıcı
- Department of Medical Biochemistry, Konya, Turkey
| | - Handan Yılmaz
- Department of Gynecological Oncology, Queen Elizabeth Hospital, Gateshead, UK
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Mantri N, Goel AD, Patel M, Baskaran P, Dutta G, Gupta MK, Yadav V, Mittal M, Shekhar S, Bhardwaj P. National and regional prevalence of gestational diabetes mellitus in India: a systematic review and Meta-analysis. BMC Public Health 2024; 24:527. [PMID: 38378536 PMCID: PMC10877914 DOI: 10.1186/s12889-024-18024-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 02/06/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is frequently misdiagnosed during pregnancy. There is an abundance of evidence, but little is known regarding the regional prevalence estimates of GDM in India. This systematic review and meta-analysis aims to provide valuable insights into the national and regional prevalence of GDM among pregnant women in India. METHODS We conducted an initial article search on PubMed, Scopus, Google Scholar, and ShodhGanga searches to identify quantitative research papers (database inception till 15th June,2022). This review included prevalence studies that estimated the occurrence of GDM across different states in India. RESULTS Two independent reviewers completed the screening of 2393 articles, resulting in the identification of 110 articles that met the inclusion criteria, which collectively provided 117 prevalence estimates. Using a pooled estimate calculation (with an Inverse square heterogeneity model), the pooled prevalence of GDM in pregnant women was estimated to be 13%, with a 95% confidence interval (CI) ranging from 9 to 16%.. In India, Diabetes in Pregnancy Study of India (DIPSI) was the most common diagnostic criteria used, followed by International Association of Diabetes and Pregnancy Study Groups (IADPSG) and World Health Organization (WHO) 1999. It was observed that the rural population has slightly less prevalence of GDM at 10.0% [6.0-13.0%, I2=96%] when compared to the urban population where the prevalence of GDM was 12.0% [9.0-16.0%, I2 = 99%]. CONCLUSIONS This review emphasizes the lack of consensus in screening and diagnosing gestational diabetes mellitus (GDM), leading to varied prevalence rates across Indian states. It thoroughly examines the controversies regarding GDM screening by analyzing population characteristics, geographic variations, diagnostic criteria agreement, screening timing, fasting vs. non-fasting approaches, cost-effectiveness, and feasibility, offering valuable recommendations for policy makers. By fostering the implementation of state-wise screening programs, it can contribute to improving maternal and neonatal outcomes and promoting healthier pregnancies across the country.
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Affiliation(s)
- Neha Mantri
- School of Public Health, AIIMS, Jodhpur, India
| | - Akhil Dhanesh Goel
- Department of Community Medicine & Family Medicine, AIIMS, Jodhpur, India.
| | - Mamta Patel
- School of Public Health, AIIMS, Jodhpur, India
| | - Pritish Baskaran
- Department of Community Medicine & Family Medicine, AIIMS, Jodhpur, India
| | - Gitashree Dutta
- Department of Community Medicine & Family Medicine, AIIMS, Jodhpur, India
| | - Manoj Kumar Gupta
- Department of Community Medicine & Family Medicine, AIIMS, Jodhpur, India
| | | | - Madhukar Mittal
- Department of Endocrinology and Metabolism, AIIMS, Jodhpur, India
| | | | - Pankaj Bhardwaj
- Department of Community Medicine & Family Medicine, Academic Head, School of Public Health, AIIMS, Jodhpur, India
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Shahriari M, Shahriari A, Khooshideh M, Dehghaninezhad A, Maleki-Hajiagha A, Karimi R. Maternal and fetal outcomes of pregnancies associated with single versus double abnormal values in 100 gr glucose tolerance test. J Diabetes Metab Disord 2023; 22:1347-1353. [PMID: 37975110 PMCID: PMC10638114 DOI: 10.1007/s40200-023-01253-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 06/13/2023] [Indexed: 11/19/2023]
Abstract
Purpose of the study Comparing maternal and fetal outcomes in pregnancies associated with single versus double abnormal values in 100 gr oral glucose tolerance test (OGTT). Methods This cohort study was performed in Arash women's Hospital, Tehran, Iran from 2019 to 2020. Patients with normal fasting blood sugar (FBS) tests were divided into two groups according to their OGTT results. The first group had a single abnormal value in their OGTT and the second group showed two abnormal values. Both groups were followed regularly until the end of pregnancy. Results Our results showed higher rates of macrosomia (birth of newborns weighed over 4 kg) and the need for pharmacological treatment for the management of GDM in the second group (P = 0.05). There were no differences between the two groups in terms of other maternal (polyhydramnios, shoulder dystocia, operative vaginal delivery, atony, postpartum bleeding, cesarean delivery, preeclampsia, and IUFD) and fetal outcomes (Apgar score, seizure, NICU admission, and hypoglycemia in the first 24 h). Conclusion We found no significant differences between pregnant women with single and double abnormal values in 100 gr OGTT regarding maternal and neonatal outcomes, except for macrosomia and need for pharmaceutical treatment.
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Affiliation(s)
| | - Ali Shahriari
- Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Khooshideh
- Department of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Dehghaninezhad
- Department of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezoo Maleki-Hajiagha
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Research Development Center, Arash Women’s Hospital, Tehran University of Medical Sciences, Rashid Ave, Resalat Highway, Tehranpars, Tehran, P.O Box: 1653915981, Iran
| | - Rana Karimi
- Department of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Research Development Center, Arash Women’s Hospital, Tehran University of Medical Sciences, Rashid Ave, Resalat Highway, Tehranpars, Tehran, P.O Box: 1653915981, Iran
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Rubio WB, Cortopassi MD, Ramachandran D, Walker SJ, Balough EM, Wang J, Banks AS. Not so fast: Paradoxically increased variability in the glucose tolerance test due to food withdrawal in continuous glucose-monitored mice. Mol Metab 2023; 77:101795. [PMID: 37640144 PMCID: PMC10493264 DOI: 10.1016/j.molmet.2023.101795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/16/2023] [Accepted: 08/23/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVE This study was performed to determine the effect of fasting on reproducibility of the glucose tolerance test. Due to individual variation in animal feeding behaviors, fasting animals prior to metabolic and behavioral experiments is widely held to reduce inter-subject variation in glucose and metabolic parameters of preclinical rodent models. Reducing variability is especially important for studies where initial metabolite levels can influence the magnitude of experimental interventions, but fasting also imposes stress that may distort the variables of interest. One such intervention is the glucose tolerance test (GTT) which measures the maximum response and recovery following a bolus of exogenous glucose. We sought to investigate how fasting affects the response of individual mice to a GTT. METHODS Using simultaneous continuous glucose monitoring (CGM) and indirect calorimetry, we quantified blood glucose, physical activity, body temperature, metabolic rates, and food consumption levels on a minute-to-minute basis in adult male mice for 4 weeks. We tested the effects of a 4-h or 18-h fast on the GTT to examine the effect of food withdrawal in light or dark photoperiods. Studies were also performed with 4-h fasting in additional mice without implanted CGM probes. RESULTS Contrary to our expectations, a 4-h fast during the light photoperiod promotes a paradoxical increase in inter-animal variation in metabolic rate, physical activity, body temperature, glycemia, and glucose tolerance. This hyperglycemic and hyper-metabolic phenotype promotes increased corticosterone levels and is consistent with a behavioral stress response to food deprivation, even in well-fed mice. We find that mice undergoing an 18-h fast entered torpor, a hibernation-like state. In addition to low body temperature and metabolic rate, torpor is also associated with glucose levels 56 mg/dl lower than those seen in mice with ad libitum access to food. Moreover, the time spent in torpor affects the response to a GTT. CONCLUSION Our results suggest fasting mice before glucose tolerance testing, and perhaps other experiments, can have the opposite of the intended effect where fasting can increase, rather than decrease, experimental variability.
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Affiliation(s)
- William B Rubio
- Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Marissa D Cortopassi
- Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Deepti Ramachandran
- Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Samuel J Walker
- Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Elizabeth M Balough
- Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Jiefu Wang
- Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Alexander S Banks
- Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
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Karasawa T, Koike A, Terada S. A very high-carbohydrate diet differentially affects whole-body glucose tolerance and hepatic insulin resistance in rats. Nutrition 2023; 114:112113. [PMID: 37441826 DOI: 10.1016/j.nut.2023.112113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/20/2023] [Accepted: 05/30/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVES This study was performed to assess the effects of long-term intake of a very high carbohydrate (VHCHO) diet (76% of total energy from carbohydrate [CHO]) on whole-body glucose tolerance and hepatic insulin resistance. METHODS AND MATERIALS Male Sprague Dawley rats were fed either a control high-CHO diet (59% total energy from CHO; n = 8) or a VHCHO diet (76% total energy from CHO; n = 8) for 17 wk. At 4, 8, 12, and 16 wk of the dietary intervention, oral glucose tolerance test and homeostasis model assessment of insulin resistance (HOMA-IR) measurements were taken to assess whole-body glucose tolerance and hepatic insulin resistance, respectively. The triacylglycerol concentration in the liver was measured at the end of the 17-wk intervention period. RESULTS The VHCHO diet group showed significantly higher muscle glucose transporter 4 content and a smaller area under the curve for plasma glucose, but not insulin, in the oral glucose tolerance test compared with the control group. On the other hand, the VHCHO diet group had a significantly higher hepatic triacylglycerol concentration and HOMA-IR measurement compared with the control group. The hepatic triacylglycerol concentration was significantly and positively correlated with HOMA-IR. CONCLUSIONS The results of the present study suggest that long-term intake of a VHCHO diet exerts differential effects on whole-body glucose tolerance and hepatic insulin resistance.
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Affiliation(s)
- Takuya Karasawa
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan; Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan.
| | - Atsuko Koike
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - Shin Terada
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
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de Los Reyes S, Dude A, Doll J, Plunkett BA. The association between a single abnormal glucose and fetal c-peptide. Acta Diabetol 2023; 60:1359-1363. [PMID: 37347447 DOI: 10.1007/s00592-023-02123-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/28/2023] [Indexed: 06/23/2023]
Abstract
AIM We aimed to evaluated if fetuses of subjects with one elevated value on the 3-h GTT had a measurable physiologic difference in fetal C-peptide levels as compared to those with no elevated values on the GTT. METHODS We performed a prospective cohort study to evaluate insulin levels in singleton non-anomalous fetuses of subjects with one elevated value on the GTT as compared to subjects with no elevated values on their GTT. Fetal insulin levels were measured by fetal C-peptide in cord blood. Distribution of data was assessed and outliers representing values > the 99th and < the 1st percentiles were excluded. Data were log transformed to achieve normal distribution and univariable analyses were performed to compare fetal C-peptide levels, baseline maternal characteristics and perinatal outcomes in subjects with one elevated value as compared those with no elevated values. RESULTS Our analysis included 99 subjects, with 49 subjects in the one elevated value group and 50 subjects in the no elevated values group. Fetal C-peptide levels (picomoles per liters, pmol/L), were significantly higher in the elevated value group as compared to the no elevated value group (mean ± SD; 4.6 ± 0.8 vs. 4.3 ± 0.7, P = 0.046, respectively). In univariable analysis, there was no significant difference in maternal characteristics or adverse composite perinatal outcomes. CONCLUSION Fetuses of subjects who had one elevated value on their GTT had a measurable physiologic difference in C-peptide levels as compared to fetuses of subjects with no elevated values on the GTT.
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Affiliation(s)
- Samantha de Los Reyes
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, NorthShore University HealthSystem/University of Chicago, 2650 Ridge Ave., Walgreen Building, Evanston, IL, 60201, USA.
| | - Annie Dude
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina - Chapel Hill, 3010 Old Clinic Building, CB 7570, Chapel Hill, NC, 27599, USA
| | - Jennifer Doll
- Department of Biomedical Sciences, University of Wisconsin Milwaukee, Enderis Hall 417, Milwaukee, USA
| | - Beth A Plunkett
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, NorthShore University HealthSystem, 2650 Ridge Ave, Walgreen Building, Evanston, IL, 60201, USA
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Luo J, Geng X, Zhou J, Liang S, Zheng W, Li G. Characteristics of the oral glucose tolerance test in women with different pre-pregnancy body mass index and the effect of gestational diabetes mellitus on twin pregnancy outcomes. Clinics (Sao Paulo) 2023; 78:100272. [PMID: 37604047 PMCID: PMC10445444 DOI: 10.1016/j.clinsp.2023.100272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/23/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the mid-pregnancy blood glucose levels of women with singleton or twin pregnancies. METHOD The relationship between blood glucose levels and Gestational Diabetes Mellitus (GDM) was studied in women with different pre-pregnancy Body Mass Index (BMI), and the effect of GDM on twin pregnancy outcomes was analyzed. Women with twin (n = 1,985) and singleton (n = 1,985) pregnancies were categorized into underweight (BMI < 18.5 kg/m2, n = 597), normal weight (BMI: 18.5-23.9 kg/m2, n = 2,575), and overweight/obese (BMI ≥ 24 kg/m2, n = 798) groups. RESULTS The incidence of GDM was 21.01% in women with twin pregnancies. Among the women with GDM in twin pregnancies, 38.37% had at least two abnormal blood glucose levels. The incidence of these parameters increased with preconception BMI, and the incidence of twin pregnancies was higher than that of singleton pregnancies (p < 0.001). In the normal weight and overweight/obese group, the oral glucose tolerance test glucose level and incidence of GDM were higher in women with twin than singleton pregnancies (p < 0.05). For twin pregnancies, the prevalence of selective fetal growth restriction was higher and anemia was lower in the GDM group than in the non-GDM group (all p < 0.05). CONCLUSION Therefore, a greater emphasis should be placed on BMI before conception, and well-controlled GDM does not increase adverse pregnancy outcomes for twin pregnancies.
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Affiliation(s)
- Jinying Luo
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, PR China; Beijing Maternal and Child Health Care Hospital, PR China; Department of Obstetrics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, PR China
| | - Xiaoyan Geng
- Department of Obstetrics and Gynecology, Xicheng Women and Children's Health Hospital, PR China
| | - Jinfu Zhou
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, PR China
| | - Shengnan Liang
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, PR China; Beijing Maternal and Child Health Care Hospital, PR China
| | - Wei Zheng
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, PR China; Beijing Maternal and Child Health Care Hospital, PR China
| | - Guanghui Li
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, PR China; Beijing Maternal and Child Health Care Hospital, PR China.
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Ma H, Sukonina V, Zhang W, Meng F, Subhash S, Palmgren H, Alexandersson I, Han H, Zhou S, Bartesaghi S, Kanduri C, Enerbäck S. The transcription factor Foxp1 regulates aerobic glycolysis in adipocytes and myocytes. J Biol Chem 2023:104795. [PMID: 37150320 DOI: 10.1016/j.jbc.2023.104795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/09/2023] Open
Abstract
In recent years, lactate has been recognized as an important circulating energy substrate rather than only a dead-end metabolic waste product generated during glucose oxidation at low levels of oxygen. The term "aerobic glycolysis" has been coined to denote increased glucose uptake and lactate production despite normal oxygen levels and functional mitochondria. Hence, in "aerobic glycolysis" lactate production is a metabolic choice, whereas in "anaerobic glycolysis" it is a metabolic necessity based on inadequate levels of oxygen. Interestingly, lactate can be taken up by cells and oxidized to pyruvate and thus constitutes a source of pyruvate that is independent of insulin. Here, we show that the transcription factor Foxp1 regulates glucose uptake and lactate production in adipocytes and myocytes. Over-expression of Foxp1 leads to increased glucose uptake and lactate production. In addition, protein levels of several enzymes in the glycolytic pathway are upregulated, such as hexokinase 2, phosphofructokinase, aldolase, and lactate dehydrogenase. Using chromatin immunoprecipitation and real-time quantitative PCR (ChIP-qPCR) assays, we demonstrate that Foxp1 directly interacts with promoter consensus cis-elements that regulate expression of several of these target genes. Conversely, knock-down of Foxp1 suppresses these enzyme levels and lowers glucose uptake and lactate production. Moreover, mice with a targeted deletion of Foxp1 in muscle display systemic glucose intolerance with decreased muscle glucose uptake. In primary human adipocytes with induced expression of Foxp1, we find increased glycolysis and glycolytic capacity. Our results indicate Foxp1 may play an important role as a regulator of aerobic glycolysis in adipose tissue and muscle.
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Affiliation(s)
- Haixia Ma
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, University of Gothenburg, SE405 30 Gothenburg, Sweden
| | - Valentina Sukonina
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, University of Gothenburg, SE405 30 Gothenburg, Sweden
| | - Wei Zhang
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, University of Gothenburg, SE405 30 Gothenburg, Sweden
| | - Fang Meng
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, University of Gothenburg, SE405 30 Gothenburg, Sweden; Institute of Systems Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005, China; Suzhou Institute of Systems Medicine, Suzhou 215123, Jiangsu, China
| | - Santhilal Subhash
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, University of Gothenburg, SE405 30 Gothenburg, Sweden; Karolinska Institutet, Department of Bioscience and Nutrition, Center for Innovative Medicine, Huddinge, Sweden
| | - Henrik Palmgren
- Bioscience Metabolism, Research and Early Development, Cardiovascular, Renal and metabolism (CVRM), BioPharmaceuticals R&D AstraZeneca, Gothenburg, Sweden
| | - Ida Alexandersson
- Bioscience Metabolism, Research and Early Development, Cardiovascular, Renal and metabolism (CVRM), BioPharmaceuticals R&D AstraZeneca, Gothenburg, Sweden
| | - Huiming Han
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, University of Gothenburg, SE405 30 Gothenburg, Sweden; Department of Pathogen Biology, School of Basic Medical Sciences, Beihua University, Jilin, Jilin Province, 132013, China
| | - Shuping Zhou
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, University of Gothenburg, SE405 30 Gothenburg, Sweden; School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Stefano Bartesaghi
- Translational Science and Experimental Medicine, Research and Early Development, Cardiovascular, Renal and metabolism (CVRM), BioPharmaceuticals R&D AstraZeneca, Gothenburg, Sweden
| | - Chandrasekhar Kanduri
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, University of Gothenburg, SE405 30 Gothenburg, Sweden
| | - Sven Enerbäck
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, University of Gothenburg, SE405 30 Gothenburg, Sweden.
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Liang R, Panelli DM, Stevenson DK, Rehkopf DH, Shaw GM. Associations between pregnancy glucose measurements and risk of preterm birth: a retrospective cohort study of commercially insured women in the United States from 2003 to 2021. Ann Epidemiol 2023; 81:31-39.e19. [PMID: 36905977 PMCID: PMC10195092 DOI: 10.1016/j.annepidem.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 02/16/2023] [Accepted: 03/05/2023] [Indexed: 03/12/2023]
Abstract
PURPOSE To investigate associations between glucose measurements during pregnancy and risk of preterm birth (PTB). METHODS Retrospective cohort study of commercially insured women with singleton live births in the United States from 2003 to 2021 using longitudinal medical claims, socioeconomic data, and eight glucose results from different fasting and post-load tests performed between 24 and 28 weeks of gestation for gestational diabetes screening. Risk ratios of PTB (<37 weeks) were estimated via Poisson regression for z-standardized glucose measures. Non-linear relationships for continuous glucose measures were examined via generalized additive models. RESULTS Elevations in all eight glucose measures were associated with increased risk (adjusted risk ratio point estimates: 1.05-1.19) of PTB for 196,377 women with non-fasting 50-g glucose challenge test (one glucose result), 31,522 women with complete 100-g, 3-hour fasting oral glucose tolerance test (OGTT) results (four glucose results), and 10,978 women with complete 75-g, 2-hour fasting OGTT results (three glucose results). Associations were consistent after adjusting for and stratifying by sociodemographic and clinical factors. Substantial non-linear relationships (U-, J-, and S-shaped) were observed between several glucose measurements and PTB. CONCLUSIONS Elevations in various glucose measures were linearly and non-linearly associated with increased PTB risk, even before diagnostic thresholds for gestational diabetes.
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Affiliation(s)
- Richard Liang
- Stanford University School of Medicine, Department of Epidemiology and Population Health, Alway Building, Stanford, CA.
| | - Danielle M Panelli
- Stanford University School of Medicine, Division of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Palo Alto, CA
| | - David K Stevenson
- Stanford University School of Medicine, Department of Pediatrics, Division of Neonatal and Developmental Medicine, March of Dimes Prematurity Research Center at Stanford University School of Medicine, Palo Alto, CA
| | - David H Rehkopf
- Stanford University School of Medicine, Department of Epidemiology and Population Health, Alway Building, Stanford, CA; Stanford University School of Medicine, Division of Primary Care and Population Health, Stanford, CA; Stanford University, Department of Sociology, Stanford, CA; Stanford University, Center for Population Health Sciences, Palo Alto, CA.
| | - Gary M Shaw
- Stanford University School of Medicine, Department of Pediatrics, Division of Neonatal and Developmental Medicine, March of Dimes Prematurity Research Center at Stanford University School of Medicine, Palo Alto, CA.
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Habibe JJ, Clemente-Olivo MP, Scheithauer TPM, Rampanelli E, Herrema H, Vos M, Mieremet A, Nieuwdorp M, van Raalte DH, Eringa EC, de Vries CJM. Glucose-mediated insulin secretion is improved in FHL2-deficient mice and elevated FHL2 expression in humans is associated with type 2 diabetes. Diabetologia 2022; 65:1721-1733. [PMID: 35802167 PMCID: PMC9477948 DOI: 10.1007/s00125-022-05750-1] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/09/2022] [Indexed: 02/05/2023]
Abstract
AIMS/HYPOTHESIS The general population is ageing, involving an enhanced incidence of chronic diseases such as type 2 diabetes. With ageing, DNA methylation of FHL2 increases, as well as expression of the four and a half LIM domains 2 (FHL2) protein in human pancreatic islets. We hypothesised that FHL2 is actively involved in glucose metabolism. METHODS Publicly available microarray datasets from human pancreatic islets were analysed for FHL2 expression. In FHL2-deficient mice, we studied glucose clearance and insulin secretion. Gene expression analysis and glucose-stimulated insulin secretion (GSIS) were determined in isolated murine FHL2-deficient islets to evaluate insulin-secretory capacity. Moreover, knockdown and overexpression of FHL2 were accomplished in MIN6 cells to delineate the underlying mechanism of FHL2 function. RESULTS Transcriptomics of human pancreatic islets revealed that individuals with elevated levels of HbA1c displayed increased FHL2 expression, which correlated negatively with insulin secretion pathways. In line with this observation, FHL2-deficient mice cleared glucose more efficiently than wild-type littermates through increased plasma insulin levels. Insulin sensitivity was comparable between these genotypes. Interestingly, pancreatic islets isolated from FHL2-deficient mice secreted more insulin in GSIS assays than wild-type mouse islets even though insulin content and islet size was similar. To support this observation, we demonstrated increased expression of the transcription factor crucial in insulin secretion, MAF BZIP transcription factor A (MafA), higher expression of GLUT2 and reduced expression of the adverse factor c-Jun in FHL2-deficient islets. The underlying mechanism of FHL2 was further delineated in MIN6 cells. FHL2-knockdown led to enhanced activation of forkhead box protein O1 (FOXO1) and its downstream genes such as Mafa and Pdx1 (encoding pancreatic and duodenal homeobox 1), as well as increased glucose uptake. On the other hand, FHL2 overexpression in MIN6 cells blocked GSIS, increased the formation of reactive oxygen species and increased c-Jun activity. CONCLUSIONS/INTERPRETATION Our data demonstrate that FHL2 deficiency improves insulin secretion from beta cells and improves glucose tolerance in mice. Given that FHL2 expression in humans increases with age and that high expression levels of FHL2 are associated with beta cell dysfunction, we propose that enhanced FHL2 expression in elderly individuals contributes to glucose intolerance and the development of type 2 diabetes. DATA AVAILABILITY The human islet microarray datasets used are publicly available and can be found on https://www.ncbi.nlm.nih.gov/geo/ .
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Affiliation(s)
- Jayron J Habibe
- Department of Medical Biochemistry, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Cardiovascular Sciences, Diabetes and Metabolism, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology, Endocrinology and Metabolism, University of Amsterdam, Amsterdam, the Netherlands
- Department of Physiology, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Maria P Clemente-Olivo
- Department of Medical Biochemistry, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Cardiovascular Sciences, Diabetes and Metabolism, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology, Endocrinology and Metabolism, University of Amsterdam, Amsterdam, the Netherlands
| | - Torsten P M Scheithauer
- Department of Experimental Vascular Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
| | - Elena Rampanelli
- Department of Experimental Vascular Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
| | - Hilde Herrema
- Department of Experimental Vascular Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
| | - Mariska Vos
- Department of Medical Biochemistry, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Cardiovascular Sciences, Diabetes and Metabolism, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology, Endocrinology and Metabolism, University of Amsterdam, Amsterdam, the Netherlands
| | - Arnout Mieremet
- Department of Medical Biochemistry, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Cardiovascular Sciences, Diabetes and Metabolism, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology, Endocrinology and Metabolism, University of Amsterdam, Amsterdam, the Netherlands
| | - Max Nieuwdorp
- Department of Experimental Vascular Medicine, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
| | - Daniel H van Raalte
- Department of Internal Medicine, Diabetes Center, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Etto C Eringa
- Department of Physiology, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Physiology, Cardiovascular Institute Maastricht, Maastricht, the Netherlands
| | - Carlie J M de Vries
- Department of Medical Biochemistry, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands.
- Amsterdam Cardiovascular Sciences, Diabetes and Metabolism, University of Amsterdam, Amsterdam, the Netherlands.
- Amsterdam Gastroenterology, Endocrinology and Metabolism, University of Amsterdam, Amsterdam, the Netherlands.
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11
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Ghavipanje N, Fathi Nasri MH, Farhangfar SH, Ghiasi SE, Vargas-Bello-Pérez E. Berberine supplementation modulates the somatotropic axis and ameliorates glucose tolerance in dairy goats during late gestation and early lactation. BMC Vet Res 2022; 18:357. [PMID: 36153497 PMCID: PMC9508731 DOI: 10.1186/s12917-022-03452-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pregnancy, parturition, and the onset of lactation represent an enormous physiological and hormonal challenge to the homeostasis of dairy animals, being a risk for their health and reproduction. Thus, as a part of the homothetic changes in preparturition period, goats undergo a period of IR as well as uncoupled GH/IGF-1 axis. The objective for this study was to determine the effect of berberine (BBR) during the peripartal period on hormonal alteration and somatotropic axis in dairy goats as well as glucose and insulin kinetics during an intravenous glucose tolerance test (IVGTT). At 21 days before the expected kidding date, 24 primiparous Saanen goats were assigned randomly to 4 dietary treatments. Goats were fed a basal diet from wk. 3 antepartum (AP) until wk. 3 postpartum (PP) supplemented with 0 (CTRL), 1 (BBR1), 2 (BBR2), and 4 (BBR4) g/d BBR. Blood samples were collected on days - 21, - 14, - 7, 0, 7, 14, and 21 relative to the expected kidding date. An IVGTT was also performed on day 22 PP. RESULTS Compared with CTRL, supplementation with either BBR2 or BBR4 increased DMI at kidding day and PP, as well as body conditional score (BCS) and milk production (p ≤ 0.05). On d 7 and 14 PP plasma glucose was higher in BBR2- and BBR4-treated than in CTRL. The glucagon concentration was not affected by BBR during the experimental period. However, supplemental BBR indicated a tendency to decrease in cortisol concentration on days 7 (p = 0.093) and 14 (p = 0.100) PP. Lower plasma GH was observed in BBR than in non-BBR goats (p ≤ 0.05). Plasma IGF-1 concentration was enhanced in both BBR2 and BBR4 at kidding and day 7 PP (p ≤ 0.05). During the IVGTT, glucose area under the curve (AUC), clearance rate (CR), T1/2, and Tbasal was lower (p ≤ 0.05) in both BBR2 and BBR4 goats as compared with CTRL. Likewise, the insulin CR was higher (p ≤ 0.05) in goats receiving either BBR2 or BBR4 which was accompanied by a lower insulin T1/2 and AUC. CONCLUSIONS Altogether, our results indicated an improved glucose and insulin status along with the modulation of the somatotropic axis and glucose and insulin response to IVGTT in dairy goats supplemented with 2 and 4 g/d BBR.
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Affiliation(s)
- Navid Ghavipanje
- Department of Animal Science, Faculty of Agriculture, University of Birjand, Birjand, 97175-331, Iran.
| | | | | | - Seyyed Ehsan Ghiasi
- Department of Animal Science, Faculty of Agriculture, University of Birjand, Birjand, 97175-331, Iran
| | - Einar Vargas-Bello-Pérez
- Department of Animal Sciences, School of Agriculture, Policy and Development, University of Reading, P.O. Box 237, Earley Gate, Reading, RG6 6EU, UK.
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12
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Alecrim MDJ, Mattar R, Torloni MR. Pregnant women's experience of undergoing an oral glucose tolerance test: A cross-sectional study. Diabetes Res Clin Pract 2022; 189:109941. [PMID: 35690268 DOI: 10.1016/j.diabres.2022.109941] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/25/2022] [Accepted: 06/02/2022] [Indexed: 11/22/2022]
Abstract
AIMS The oral glucose tolerance test (OGTT) is routinely performed in most pregnancies; however, there are few studies which document the experience of taking this test. We assessed the experience of pregnant women during an OGTT. METHODS This cross-sectional study included 152 women (24-32 weeks' gestation) and assessed their knowledge, anxiety (Spielberg anxiety inventory test-STAI), and physical pain (0-10 visual analog scale) during the OGTT. The Friedman test was used to compare pain scores over time. RESULTS 61 (40%) participants did not know why they were doing the OGTT and 73 (48%) women had high state-anxiety levels (STAI ≥ 41 points, 20-80 scale). Participants had mild to moderate pain scores immediately after the first and second blood draws (3.9 ± 2.7 and 3.8 ± 2.3, respectively) that decreased significantly after the third blood draw (2.8 ± 2.4, P < 0.001). Nearly half (n = 71, 47%) of the participants were very or extremely bothered with having to drink the glucose solution. CONCLUSIONS The OGTT was associated with high levels of anxiety and mild to moderate physical pain. Ingestion of the glucose solution was perceived as the most difficult part of the test. Good strategies can help to mitigate some of these negative experiences while undergoing an OGTT.
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Affiliation(s)
- Maria de J Alecrim
- Department of Obstetrics, São Paulo Federal University, Rua Napoleão de Barros, 875, São Paulo, SP 04024-002, Brazil.
| | - Rosiane Mattar
- Department of Obstetrics, São Paulo Federal University, Rua Napoleão de Barros, 875, São Paulo, SP 04024-002, Brazil.
| | - Maria R Torloni
- Department of Obstetrics, São Paulo Federal University, Rua Napoleão de Barros, 875, São Paulo, SP 04024-002, Brazil; Evidence Based Health Care Post-Graduate Program, Department of Medicine, São Paulo Federal University, Rua Botucatu 740, 3° andar, São Paulo, SP 04023-900, Brazil.
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13
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Ford HL, Champion I, Wan A, Reddy M, Mol BW, Rolnik DL. Predictors for insulin use in gestational diabetes mellitus. Eur J Obstet Gynecol Reprod Biol 2022; 272:177-181. [PMID: 35339075 DOI: 10.1016/j.ejogrb.2022.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 03/04/2022] [Accepted: 03/11/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Gestational diabetes mellitus (GDM) affects about 15% of pregnancies in Australia, with approximately 30% of those diagnosed with GDM requiring insulin therapy. There are several established risk factors for developing GDM, however limited studies show how these can be used to predict need for insulin treatment. The aim of this study is to identify predictors of insulin therapy in women diagnosed with GDM once an oral glucose tolerance test (OGTT) is performed during pregnancy. STUDY DESIGN This is a retrospective cohort study of women with singleton pregnancies complicated by GDM between 2016 and 2017 at a single, large health network in Melbourne, Australia. Data were obtained from hospital record and pathology result systems. Univariable and multivariable logistic regression models were fit to the data to obtain crude and adjusted odds ratios. RESULTS Of 2,048 women diagnosed with GDM, 647 (31.6%) required insulin therapy. Positive predictors included in the final multivariable model after backwards, stepwise elimination were an elevated fasting result on an OGTT (adjusted odds ratio (AOR) 2.93 [95% CI 2.34-3.66]), previous birth weight greater than 90th% (AOR 2.04 [95% CI 1.412.94]), previous diagnosis of GDM (AOR 1.68 [95% CI 1.28-2.21]), being born in the South Asian region (AOR 1.58 [95% CI 1.27-1.98]), the 2hr OGTT result (AOR 1.14 [95% CI 1.05-1.24]), body mass index (BMI; AOR 1.13 [95% CI 1.04-1.23]) and age (AOR 1.03 [95% CI 1.00-1.05]) The final predictive model had an area under the receiver-operating characteristics (ROC) curve of 0.744 (95% CI 0.720-0.767). CONCLUSIONS This study highlights the possible predictors of insulin use, informing counselling for women who are newly diagnosed with gestational diabetes.
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Affiliation(s)
- Heather Louise Ford
- Monash Health, Department of Obstetrics and Gynaecology, Melbourne, Australia; Monash University, Department of Obstetrics and Gynaecology, Melbourne, Australia.
| | - Isabella Champion
- Monash Health, Department of Obstetrics and Gynaecology, Melbourne, Australia
| | - Anna Wan
- Monash University, Department of Obstetrics and Gynaecology, Melbourne, Australia
| | - Maya Reddy
- Monash Health, Department of Obstetrics and Gynaecology, Melbourne, Australia; Monash University, Department of Obstetrics and Gynaecology, Melbourne, Australia
| | - Ben Willem Mol
- Monash Health, Department of Obstetrics and Gynaecology, Melbourne, Australia; Monash University, Department of Obstetrics and Gynaecology, Melbourne, Australia; Aberdeen Centre for Women's Health Research, School of Medicine, University of Aberdeen, Aberdeen, UK
| | - Daniel Lorber Rolnik
- Monash Health, Department of Obstetrics and Gynaecology, Melbourne, Australia; Monash University, Department of Obstetrics and Gynaecology, Melbourne, Australia
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14
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Kim M, Hur KY, Choi SJ, Oh SY, Roh CR. Influence of Pre-Pregnancy Underweight Body Mass Index on Fetal Abdominal Circumference, Estimated Weight, and Pregnancy Outcomes in Gestational Diabetes Mellitus. Diabetes Metab J 2022; 46:499-505. [PMID: 35067010 PMCID: PMC9171156 DOI: 10.4093/dmj.2021.0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/14/2021] [Indexed: 11/08/2022] Open
Abstract
This study aimed to determine the influence of pre-pregnancy body mass index on pregnancy outcomes in gestational diabetes mellitus (GDM), comparing underweight patients with GDM with normal weight patients with GDM. Maternal baseline characteristics, ultrasonographic results, and pregnancy and neonatal outcomes were reviewed in 946 women with GDM with singleton pregnancies. Underweight patients with GDM showed a benign course in most aspects during pregnancy, except for developing a higher risk of giving birth to small for gestational age neonates. Underweight women with GDM required less insulin treatment, had a higher rate of vaginal delivery, and had a lower rate of cesarean delivery. In addition, their neonates were more likely to have fetal abdominal circumference and estimated fetal weight below the 10th percentile both at the time of GDM diagnosis and before delivery. Notably, their risk for preeclampsia and macrosomia were lower. Collectively, our data suggest that underweight women with GDM may require a different approach in terms of diagnosis and management throughout their pregnancy.
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Affiliation(s)
- Minji Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyu-Yeon Hur
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Suk-Joo Choi
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo-Young Oh
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Cheong-Rae Roh
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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15
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French SS, Hudson SB, Webb AC, Knapp CR, Virgin EE, Smith GD, Lewis EL, Iverson JB, DeNardo DF. Glucose tolerance of iguanas is affected by high-sugar diets in the lab and supplemental feeding by ecotourists in the wild. J Exp Biol 2022; 225:274936. [PMID: 35448902 DOI: 10.1242/jeb.243932] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/17/2022] [Indexed: 12/28/2022]
Abstract
There is great interspecific variation in the nutritional composition of natural diets, and the varied nutritional content is physiologically tolerated because of evolutionarily based balances between diet composition and processing ability. However, as a result of landscape change and human exposure, unnatural diets are becoming widespread among wildlife without the necessary time for evolutionary matching between the diet and its processing. We tested how a controlled, unnatural high glucose diet affects glucose tolerance using captive green iguanas, and we performed similar glucose tolerance tests on wild Northern Bahamian rock iguanas that are either frequently fed grapes by tourists or experience no such supplementation. We evaluated both short and longer-term blood glucose responses and corticosterone (CORT) concentrations as changes have been associated with altered diets. Experimental glucose supplementation in the laboratory and tourist feeding in the wild both significantly affected glucose metabolism. When iguanas received a glucose-rich diet, we found greater acute increases in blood glucose following a glucose challenge. Relative to unfed iguanas, tourist-fed iguanas had significantly lower baseline CORT, higher baseline blood glucose, and slower returns to baseline glucose levels following a glucose challenge. Therefore, unnatural consumption of high amounts of glucose alters glucose metabolism in laboratory iguanas with short-term glucose treatment and free-living iguanas exposed to long-term feeding by tourists. Based on these results and the increasing prevalence of anthropogenically altered wildlife diets, the consequences of dietary changes on glucose metabolism should be further investigated across species, as such changes in glucose metabolism have health consequences in humans (e.g. diabetes).
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Affiliation(s)
- Susannah S French
- Department of Biology, Utah State University, Logan, UT 84322, USA.,Ecology Center, Utah State University, Logan, UT 84322, USA
| | - Spencer B Hudson
- Department of Biology, Utah State University, Logan, UT 84322, USA.,Ecology Center, Utah State University, Logan, UT 84322, USA
| | - Alison C Webb
- Department of Biology, Utah State University, Logan, UT 84322, USA.,Ecology Center, Utah State University, Logan, UT 84322, USA
| | - Charles R Knapp
- Daniel P. Haerther Center for Conservation and Research, John G. Shedd Aquarium, Chicago, IL 60605, USA
| | - Emily E Virgin
- Department of Biology, Utah State University, Logan, UT 84322, USA.,Ecology Center, Utah State University, Logan, UT 84322, USA
| | - Geoffrey D Smith
- Biology Department, Dixie State University, Saint George, UT 84770, USA
| | - Erin L Lewis
- Department of Biology, Utah State University, Logan, UT 84322, USA.,Ecology Center, Utah State University, Logan, UT 84322, USA
| | - John B Iverson
- Department of Biology, Earlham College, Richmond, IN 47374, USA
| | - Dale F DeNardo
- School of Life Sciences, Arizona State University, Tempe, AZ 85281, USA
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16
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Doi SAR, Bashir M, Sheehan MT, Onitilo AA, Chivese T, Ibrahim IM, Beer SF, Furuya-Kanamori L, Abou-Samra AB, McIntyre HD. Unifying the diagnosis of gestational diabetes mellitus: Introducing the NPRP criteria. Prim Care Diabetes 2022; 16:96-101. [PMID: 34419366 DOI: 10.1016/j.pcd.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/08/2021] [Accepted: 08/09/2021] [Indexed: 11/23/2022]
Abstract
AIMS Disagreement about the appropriate criteria for the diagnosis of gestational diabetes mellitus (GDM) persists. This study examines an alternative approach which combines information from all time-points on the glucose tolerance test (GTT) into a single index and expands the GDM spectrum into four categories using data from three geographically and ethnically distinct populations. METHODS A retrospective observational study design was used. Data from Wisconsin, USA (723 women) was used in derivation of the criterion and data from Doha, Qatar (1284 women) and Cape Town, South Africa (220 women) for confirmation. Pregnant women without pre-existing diabetes with a GTT done between 23 and 30 weeks gestation were included. A novel index was derived from the GTT termed the weighted average glucose (wAG). This was categorized into four pre-defined groups (henceforth National Priorities Research Program (NPRP) criterion); i) normal gestational glycemia (NGG), ii) impaired gestational glycemia (IGG), iii) GDM and iv) high risk GDM (hGDM). RESULTS In the Doha cohort, compared to the NGG group, the odds of large for gestational age babies increased 1.33 fold (P = 0.432), 2.86 fold (P < 0.001) and 3.35 fold (P < 0.001) in the IGG, GDM and hGDM groups respectively. The odds of pregnancy induced hypertension increased 2.10 fold (P = 0.024) in GDM & hGDM groups compared to the IGG and NGG groups. In the Cape Town cohort, a third of women in the GDM group and two-thirds in the hGDM group progressed to T2DM at 5 years. CONCLUSIONS The NPRP categorization identifies four distinct risk clusters of glycemia in pregnancy which may aid better decision making in routine management, avoid potential over-diagnosis of women at lower risk of complications and assist with diabetes prevention in women at high-risk after an index pregnancy with GDM.
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Affiliation(s)
- Suhail A R Doi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar.
| | - Mohammed Bashir
- Division of Endocrinology and Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar.
| | - Michael T Sheehan
- Department of Endocrinology, Marshfield Clinic Health System -Weston Center, Weston, WI, USA
| | | | - Tawanda Chivese
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Ibrahim M Ibrahim
- Endocrinology and Diabetes Services Division, Sidra Medicine, Qatar Foundation, Doha, Qatar
| | - Stephen F Beer
- Division of Endocrinology and Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Abdul-Badi Abou-Samra
- Division of Endocrinology and Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | - H David McIntyre
- Mater Research and The University of Queensland, Brisbane, Queensland, Australia
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17
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Abstract
Gestational diabetes mellitus (GDM) is the most common complication during pregnancy and is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. GDM is associated with adverse pregnancy outcomes and long-term offspring and maternal complications. For GDM screening and diagnosis, a two-step approach (1-hour 50 g glucose challenge test followed by 3-hour 100 g oral glucose tolerance test) has been widely used. After the Hyperglycemia and Adverse Pregnancy Outcome study implemented a 75 g oral glucose tolerance test in all pregnant women, a one-step approach was recommended as an option for the diagnosis of GDM after 2010. The one-step approach has more than doubled the incidence of GDM, but its clinical benefit in reducing adverse pregnancy outcomes remains controversial. Long-term complications of mothers with GDM include type 2 diabetes mellitus and cardiovascular disease, and complications of their offspring include childhood obesity and glucose intolerance. The diagnostic criteria of GDM should properly classify women at risk for adverse pregnancy outcomes and long-term complications. The present review summarizes the strengths and weaknesses of the one-step and two-step approaches for the diagnosis of GDM based on recent randomized controlled trials and observational studies. We also describe the long-term maternal and offspring complications of GDM.
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Affiliation(s)
- Joon Ho Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Corresponding author: Hak Chul Jang https://orcid.org/0000-0002-4188-6536 Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea E-mail:
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18
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Kim KJ, Kim NH, Choi J, Kim SG, Lee KJ. How Can We Adopt the Glucose Tolerance Test to Facilitate Predicting Pregnancy Outcome in Gestational Diabetes Mellitus? Endocrinol Metab (Seoul) 2021; 36:988-996. [PMID: 34649416 PMCID: PMC8566126 DOI: 10.3803/enm.2021.1107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We investigated how 100-g oral glucose tolerance test (OGTT) results can be used to predict adverse pregnancy outcomes in gestational diabetes mellitus (GDM) patients. METHODS We analyzed 1,059 pregnant women who completed the 100-g OGTT between 24 and 28 weeks of gestation. We compared the risk of adverse pregnancy outcomes according to OGTT patterns by latent profile analysis (LPA), numbers to meet the OGTT criteria, and area under the curve (AUC) of the OGTT graph. Adverse pregnancy outcomes were defined as a composite of preterm birth, macrosomia, large for gestational age, low APGAR score at 1 minute, and pregnancy-induced hypertension. RESULTS Overall, 257 participants were diagnosed with GDM, with a median age of 34 years. An LPA led to three different clusters of OGTT patterns; however, there were no significant associations between the clusters and adverse pregnancy outcomes after adjusting for confounders. Notwithstanding, the risk of adverse pregnancy outcome increased with an increase in number to meet the OGTT criteria (P for trend=0.011); odds ratios in a full adjustment model were 1.27 (95% confidence interval [CI], 0.72 to 2.23), 2.16 (95% CI, 1.21 to 3.85), and 2.32 (95% CI, 0.66 to 8.15) in those meeting the 2, 3, and 4 criteria, respectively. The AUCs of the OGTT curves also distinguished the patients at risk of adverse pregnancy outcomes; the larger the AUC, the higher the risk (P for trend=0.007). CONCLUSION The total number of abnormal values and calculated AUCs for the 100-g OGTT may facilitate tailored management of patients with GDM by predicting adverse pregnancy outcomes.
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Affiliation(s)
- Kyeong Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul,
Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul,
Korea
| | - Jimi Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul,
Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul,
Korea
| | - Kyung Ju Lee
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul,
Korea
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19
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Çetin C, Güngör ND, Yavuz M. First trimester glycosylated hemoglobin for gestational diabetes mellitus screening. Taiwan J Obstet Gynecol 2021; 60:899-902. [PMID: 34507669 DOI: 10.1016/j.tjog.2021.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Our aim in this study is to evaluate the efficacy of HbA1c in screening for GDM during the first trimester of pregnancy. MATERIALS AND METHODS In this retrospective cohort study, we evaluated the first trimester HbA1c (ft-HbA1c) levels of 195 pregnant women who attended our university hospital's obstetrics clinic. Blood samples were drawn from patients during 11-14 weeks of gestation. After that, all patients were screened using standardized one-step 75gr OGTT between 24 and 28 weeks of pregnancy. RESULTS In this study, 195 pregnant women were included. Thirty-two (16.4%) of the women included in this study were diagnosed with GDM. The mean ft-HbA1c level was 5.52% in those who developed GDM and 5.21% in those who did not develop GDM (p = 0.000). Only seven (3.6%) of the women included in this study had an ft-HbA1c level above the prediabetes limit of 5.7%. All these women with prediabetes developed GDM. The cut-off value for ft-HbA1c to distinguish GDM was 5,33%. For this cut-off value, the sensitivity was 71.9%, and the specificity was 82.8%. CONCLUSION The findings suggest that ft-HbA1c level is a promising biomarker for GDM screening. Especially, patients with ft-HbA1c level ≥5.33% are at increased risk for developing GDM.
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Affiliation(s)
- Cihan Çetin
- Bahçeşehir University, School of Medicine, Medical Park Göztepe Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey.
| | - Nur Dokuzeylül Güngör
- Medical Park Göztepe Hospital, Obstetrics and Gynecology, IVF Center, Istanbul, Turkey
| | - Melike Yavuz
- Bahçeşehir University, School of Medicine, Department of Public Health, Istanbul, Turkey
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20
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Chu AHY, Yuan WL, Loy SL, Soh SE, Bernard JY, Tint MT, Ho-Lim SST, Goh H, Ramasamy A, Kumar M, Goh C, Ang LT, Shek LPC, Chong YS, Tan KH, Su LL, Biswas A, Yap F, Lee YS, Chi C, Godfrey KM, Eriksson JG, Chan SY. Maternal height, gestational diabetes mellitus and pregnancy complications. Diabetes Res Clin Pract 2021; 178:108978. [PMID: 34303772 PMCID: PMC7611603 DOI: 10.1016/j.diabres.2021.108978] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/30/2021] [Accepted: 07/19/2021] [Indexed: 11/17/2022]
Abstract
AIMS To explore the glucose-overload hypothesis of artefactual gestational diabetes (GDM) diagnosis in shorter women during oral glucose tolerance testing (OGTT), by investigating associations between height and maternal glycemia; and GDM and pregnancy complications in height-groups. METHODS Women from GUSTO (n = 1100, 2009-2010) and NUH (n = 4068, 2017-2018) cohorts underwent a mid-gestation two and three time-point 75 g 2-hour OGTT, respectively. GDM-related complications (hypertensive disorders of pregnancy, preterm delivery, emergency cesarean section, neonatal intensive care unit admission, macrosomia, birthweight) were compared within shorter and taller groups, dichotomized by ethnic-specific median height. RESULTS Using WHO-1999 criteria, 18.8% (GUSTO) to 22.9% (NUH) of women were diagnosed with GDM-1999; and by WHO-2013 criteria, 21.9% (NUH) had GDM-2013. Each 5-cm height increment was inversely associated with GDM-1999 (adjusted odds ratio [aOR, 95% CI] = 0.81 [0.76-0.87], 2-h glycemia (adjusted β [aβ, 95% CI] = -0.171 mmol/L [-0.208, -0.135]) and 1-h glycemia (aβ = -0.160 mmol/L [-0.207, -0.112]). The inverse association between height and 2-h glycemia was most marked in "Other" ethnicities (Eurasians/Caucasians/mixed/other Asians) and Indians, followed by Chinese, then Malays. Compared with non-GDM, GDM-1999 was associated with preterm delivery (aOR = 1.76 [1.19-2.61]) and higher birthweight (aβ = 57.16 g [20.95, 93.38]) only among taller but not shorter women. CONCLUSIONS Only taller women had an increased odds of GDM-related pregnancy complications. An artefactual GDM diagnosis due to glucose-overload among shorter women is plausible.
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Affiliation(s)
- Anne H Y Chu
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Wen Lun Yuan
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - See Ling Loy
- Department of Reproductive Medicine, KK Women's and Children Hospital, Singapore; Duke-NUS Medical School, Singapore
| | - Shu E Soh
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jonathan Y Bernard
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Centre for Research in Epidemiology and StatisticS (CRESS), Université de Paris, Inserm, INRAE, Paris, France
| | - Mya-Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Huecin Goh
- Department of Nursing, National University Hospital, Singapore
| | - Adaikalavan Ramasamy
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Mukkesh Kumar
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Claire Goh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Li Ting Ang
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Lynette Pei-Chi Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kok Hian Tan
- Duke-NUS Medical School, Singapore; Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - Lin Lin Su
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Arijit Biswas
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Fabian Yap
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Claudia Chi
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, UK
| | - Johan Gunnar Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of General Practice and Primary Health Care, University of Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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21
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Tan Y, Liu J, Qin Y, Liang B, Gu Y, Liang L, Liu L, Liu Y, Su H. Glucose Homeostasis Is Dysregulated in Ducks Infected with Duck Hepatitis B Virus. Intervirology 2021; 64:185-193. [PMID: 34167117 DOI: 10.1159/000516766] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 04/21/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The association between hepatitis B virus (HBV) infection and the development of diabetes remains controversial. This study examined the effect of HBV infection on glucose homeostasis using a duck HBV (DHBV) model. METHODS Plasma DHBV DNA was detected by quantitative polymerase chain reaction (PCR). Tissue infection of DHBV was determined by detecting DHBV covalently closed circular DNA (cccDNA) with a method of rolling circle amplification combined with cross-gap PCR, and verified by fluorescence in situ hybridization assay. An intravenous injection glucose tolerance test (GTT) was used to analyze the effect of DHBV infection on glucose tolerance. RESULTS Of the finally included 97 domestic ducks, 53 (54.6%) were congenitally infected by DHBV. The positive rate of DHBV cccDNA in the liver, kidney, pancreas, and skeletal muscle of the infected ducks was 100, 75.5, 67.9, and 47.2%, respectively. The DHBV-infected ducks had higher blood glucose levels at 15 and 30 min post-load glucose (p < 0.01 and p < 0.001, respectively) in the GTT, much more individuals with greater glucose area under curve (p < 0.01), and a 57% impaired glucose tolerance (IGT) rate, as compared with noninfected controls. In addition, the subgroups of the infected ducks with DHBV cccDNA positive in skeletal muscle maintained the higher blood glucose level up to 2 h post-load glucose during the GTT and had a 76% IGT rate. CONCLUSION These results suggest that DHBV intrahepatic and extrahepatic infection impairs glucose tolerance, and thus evidence the association of DHBV infection with the dysregulation of glucose metabolism.
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Affiliation(s)
- Yanlian Tan
- Department of Biochemistry and Molecular Biology, Guilin Medical University, Guilin, China
| | - Jianxiang Liu
- Department of Biochemistry and Molecular Biology, Guilin Medical University, Guilin, China
| | - Yingjian Qin
- Division of Medical Laboratory Science, Guilin Maternal and Child Health Care Hospital, Guilin, China
| | - Bin Liang
- Department of Biochemistry and Molecular Biology, Guilin Medical University, Guilin, China
| | - Yunyan Gu
- Department of Biochemistry and Molecular Biology, Guilin Medical University, Guilin, China
| | - Lilan Liang
- Department of Biochemistry and Molecular Biology, Guilin Medical University, Guilin, China
| | - Lili Liu
- Department of Biochemistry and Molecular Biology, Guilin Medical University, Guilin, China
| | - Yongming Liu
- Department of Biochemistry and Molecular Biology, Guilin Medical University, Guilin, China
| | - Heling Su
- Department of Biochemistry and Molecular Biology, Guilin Medical University, Guilin, China
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22
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de Wit L, Zijlmans AB, Rademaker D, Naaktgeboren CA, DeVries JH, Franx A, Painter RC, van Rijn BB. Estimated impact of introduction of new diagnostic criteria for gestational diabetes mellitus. World J Diabetes 2021; 12:868-882. [PMID: 34168734 PMCID: PMC8192254 DOI: 10.4239/wjd.v12.i6.868] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/12/2021] [Accepted: 04/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Implementation of new diagnostic criteria for gestational diabetes mellitus (GDM) are still a subject of debate, mostly due to concerns regarding the effects on the number of women diagnosed with GDM and the risk profile of the women newly diagnosed.
AIM To estimate the impact of the World Health Organization (WHO) 2013 criteria compared with the WHO 1999 criteria on the incidence of gestational diabetes mellitus as well as to determine the diagnostic accuracy for detecting adverse pregnancy outcomes.
METHODS We retrospectively analyzed a single center Dutch cohort of 3338 women undergoing a 75 g oral glucose tolerance test where the WHO 1999 criteria to diagnose GDM were clinically applied. Women were categorized into four groups: non-GDM by both criteria, GDM by WHO 1999 only (excluded from GDM), GDM by WHO 2013 only (newly diagnosed) and GDM by both criteria. We compared maternal characteristics, pregnancy outcomes and likelihood ratios for adverse pregnancy outcomes.
RESULTS Retrospectively applying the WHO 2013 criteria increased the cohort incidence by 13.1%, from 19.3% to 32.4%. Discordant diagnoses occurred in 21.3%; 4.1% would no longer be labelled as GDM, and 17.2% were newly diagnosed. Compared to the non-GDM group, women newly diagnosed were older, had higher rates of obesity, higher diastolic blood pressure and higher rates of caesarean deliveries. Their infants were more often delivered preterm, large-for-gestational-age and were at higher risk of a 5 min Apgar score < 7. Women excluded from GDM were older and had similar pregnancy outcomes compared to the non-GDM group, except for higher rates of shoulder dystocia (4.3% vs 1.3%, P = 0.015). Positive likelihood ratios for adverse outcomes in all groups were generally low, ranging from 0.54 to 2.95.
CONCLUSION Applying the WHO 2013 criteria would result in a substantial increase in GDM diagnoses. Newly diagnosed women are at increased risk for pregnancy adverse outcomes. This risk, however, seems to be lower than those identified by the WHO 1999 criteria. This could potentially influence the treatment effect that can be achieved in this group. Evidence on treatment effects in newly diagnosed women is urgently needed.
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Affiliation(s)
- Leon de Wit
- Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht 3584 EA, Netherlands
| | - Anna B Zijlmans
- Department of Obstetrics and Gynaecology, Gelderse Vallei Hospital, Ede 6716 RP, Netherlands
| | - Doortje Rademaker
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centers- Location AMC, Amsterdam 1105 AZ, Netherlands
| | - Christiana A Naaktgeboren
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centers–Location AMC, Amsterdam 1105 AZ, Netherlands
| | - J Hans DeVries
- Department of Endocrinology, Amsterdam University Medical Centers–Location AMC, Amsterdam 1105 AZ, Netherlands
| | - Arie Franx
- Department of Obstetrics and Fetal Medicine, Erasmus MC Sophia Children Hospital, Rotterdam 3015 GD, Netherlands
| | - Rebecca C Painter
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centers–Location AMC, Amsterdam 1105 AZ, Netherlands
| | - Bas B van Rijn
- Department of Obstetrics and Fetal Medicine, Erasmus MC Sophia Children Hospital, Rotterdam 3015 GD, Netherlands
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23
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Chun S. Predictive capability of fasting-state glucose and insulin measurements for abnormal glucose tolerance in women with polycystic ovary syndrome. Clin Exp Reprod Med 2021; 48:156-162. [PMID: 34078009 PMCID: PMC8176159 DOI: 10.5653/cerm.2020.04308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 12/10/2020] [Accepted: 02/26/2021] [Indexed: 11/21/2022] Open
Abstract
Objective The aim of the present study was to evaluate the predictive capability of fasting-state measurements of glucose and insulin levels alone for abnormal glucose tolerance in women with polycystic ovary syndrome (PCOS). Methods In total, 153 Korean women with PCOS were included in this study. The correlations between the 2-hour postload glucose (2-hr PG) level during the 75-g oral glucose tolerance test (OGTT) and other parameters were evaluated using Pearson correlation coefficients and linear regression analysis. The predictive accuracy of fasting glucose and insulin levels and other fasting-state indices for assessing insulin sensitivity derived from glucose and insulin levels for abnormal glucose tolerance was evaluated using receiver operating characteristic (ROC) curve analysis. Results Significant correlations were observed between the 2-hr PG level and most fasting-state parameters in women with PCOS. However, the area under the ROC curve values for each fasting-state parameter for predicting abnormal glucose tolerance were all between 0.5 and 0.7 in the study participants, which falls into the “less accurate” category for prediction. Conclusion Fasting-state measurements of glucose and insulin alone are not enough to predict abnormal glucose tolerance in women with PCOS. A standard OGTT is needed to screen for impaired glucose tolerance and type 2 diabetes mellitus in women with PCOS.
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Affiliation(s)
- Sungwook Chun
- Department of Obstetrics and Gynecology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
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24
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Zhu S, Meehan T, Veerasingham M, Sivanesan K. COVID-19 pandemic gestational diabetes screening guidelines: A retrospective study in Australian women. Diabetes Metab Syndr 2021; 15:391-395. [PMID: 33571889 DOI: 10.1016/j.dsx.2021.01.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS Gestational diabetes (GDM) is one of the most common medical complications of pregnancy and associated with significant perinatal and long-term morbidity. Temporary changes to the diagnostic testing for GDM have been recommended for the COVID-19 pandemic. This study aims to identify what proportion of women with GDM would be missed by the COVID-19 GDM screening criteria. Secondly an analysis of the relationship between HbA1c, fasting blood glucose (FBG) and pregnancy outcomes will be completed. METHODS This was a retrospective analysis of all GDM patients at an Australian secondary hospital between January 2019 and February 2020. The proportion of women with GDM who would have been missed using the COVID-19 guidelines was assessed. Patients were divided into groups according to how their GDM was managed during the pregnancy: Diet, Metformin (MF), Insulin and MF + Insulin groups. Differences between the groups were compared using one-way ANOVA and post-hoc analysis was completed using the Bonferroni test. Logistic regression was employed to further compare the differences between the groups. RESULTS The study group comprised 237 patients. Sixty patients (25.3%) would not have had GDM detected in their pregnancy using the COVID-19 guidelines. FBG was the most significant predictor for intervention with medication for GDM (p = 0.001). CONCLUSION HbA1c and FBG are poor screening tests for GDM. During the COVID-19 pandemic, the OGTT should be given clinical priority in high risk patients. Elevated FBG is a significant predictor for needing medical management and could be used in the future to better enable individualised treatment.
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Affiliation(s)
- Stephanie Zhu
- Ipswich Hospital, Chelmsford Avenue, Ipswich, QLD, 4305, Australia.
| | - Tom Meehan
- The Park for Mental Health, Wolston Park Road, Wacol, QLD, 4076, Australia.
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Zaniqueli D, de Oliveira Alvim R, Griep RH, Benseñor IM, Barreto SM, Lotufo PA, Mill JG. Insulin resistance may be misdiagnosed by HOMA-IR in adults with greater fat-free mass: the ELSA-Brasil Study. Acta Diabetol 2021; 58:73-80. [PMID: 32860145 DOI: 10.1007/s00592-020-01594-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/07/2020] [Indexed: 11/24/2022]
Abstract
AIMS Conflicting results have been reported on the association of fat-free mass (FFM) and insulin resistance (IR). This study sought to test the association of FFM and IR by indexing FFM to avoid collinearity with fat mass. METHODS This cross-sectional study comprised 11,284 volunteers, aged 38-79 years. Body composition was assessed by multi-frequency bioelectrical impedance. FFM indexed to body surface area (FFMbsa) was calculated. IR and impaired glucose tolerance (IGT) were estimated with homeostatic model assessment of insulin resistance index (HOMA-IR) and 2-h oral glucose tolerance test (2h-OGTT), respectively. RESULTS Percent body fat decreased from the 1st to the 5th quintile of FFMbsa in both women (Eta2 = 0.166) and men (Eta2 = 0.133). In women, fasting insulin (Eta2 = 0.002), glucose (Eta2 = 0.006), and HOMA-IR (Eta2 = 0.007) increased slightly, but 2-h plasma glucose (2-h PG) was similar across the quintiles of FFMbsa. In men, fasting insulin and HOMA-IR were similar across the quintiles of FFMbsa, whereas fasting glucose increased slightly (Eta2 = 0.002) and 2-h PG decreased (Eta2 = 0.005) toward the highest quintile of FFMbsa. The higher the odds ratio for IR, the greater the FFMbsa in both sexes. Differently, FFMbsa did not affect the odds of IGT in women, while in men the odds ratio for IGT was lower in the 5th quintile compared with the 1st quintile of FFMbsa. CONCLUSIONS Higher odds of IR associated with greater FFMbsa contrasted with lower odds of IGT associated with greater FFMbsa. IR may be misdiagnosed by HOMA-IR in adults with greater fat-free mass.
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Affiliation(s)
- Divanei Zaniqueli
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Rafael de Oliveira Alvim
- Department of Physiological Sciences, Federal University of Amazonas, Av. General Rodrigo Octavio Jordão Ramos 1200, Coroado I, Manaus, AM, 69067-005, Brazil.
| | - Rosane Harter Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Isabela Martins Benseñor
- Center for Clinical and Epidemiological Research, Medical School, University of São Paulo, São Paulo, SP, Brazil
| | - Sandhi Maria Barreto
- School of Medicine and Clinical Hospital, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Paulo Andrade Lotufo
- Department of Internal Medicine, Medical School, University of São Paulo, São Paulo, SP, Brazil
| | - José Geraldo Mill
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
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Bang JB, Oh CK, Kim YS, Kim SH, Yu HC, Kim CD, Ju MK, So BJ, Lee SH, Han SY, Jung CW, Kim JK, Lee SH, Jeon JY. Insulin Secretion and Insulin Resistance Trajectories over 1 Year after Kidney Transplantation: A Multicenter Prospective Cohort Study. Endocrinol Metab (Seoul) 2020; 35:820-829. [PMID: 33202516 PMCID: PMC7803593 DOI: 10.3803/enm.2020.743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/22/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND We investigated the changing patterns of insulin secretion and resistance and risk factors contributing to the development of post-transplant diabetes mellitus (PTDM) in kidney recipients under tacrolimus-based immunosuppression regimen during 1 year after transplantation. METHODS This was a multicenter prospective cohort study. Of the 168 subjects enrolled in this study, we analyzed a total 87 kidney transplant recipients without diabetes which was assessed by oral glucose tolerance test before transplantation. We evaluated the incidence of PTDM and followed up the index of insulin secretion (insulinogenic index [IGI]) and resistance (homeostatic model assessment for insulin resistance [HOMA-IR]) at 3, 6, 9 months, and 1 year after transplantation by oral glucose tolerance test and diabetes treatment. We also assessed the risk factors for incident PTDM. RESULTS PTDM developed in 23 of 87 subjects (26.4%) during 1 year after transplantation. More than half of total PTDM (56.5%) occurred in the first 3 months after transplantation. During 1 year after transplantation, insulin resistance (HOMA-IR) was increased in both PTDM and no PTDM group. In no PTDM group, the increase in insulin secretory function to overcome insulin resistance was also observed. However, PTDM group showed no increase in insulin secretion function (IGI). Old age, status of prediabetes and episode of acute rejection were significantly associated with the development of PTDM. CONCLUSION In tacrolimus-based immunosuppressive drugs regimen, impaired insulin secretory function for reduced insulin sensitivity contributed to the development of PTDM than insulin resistance during 1 year after transplantation.
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Affiliation(s)
- Jun Bae Bang
- Department of Surgery, Ajou University School of Medicine, Suwon, Seoul, Korea
| | - Chang-Kwon Oh
- Department of Surgery, Ajou University School of Medicine, Suwon, Seoul, Korea
| | - Yu Seun Kim
- Department of Transplantation Surgery and Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Hoon Kim
- Department of Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Seoul, Korea
| | - Hee Chul Yu
- Department of Surgery, Jeonbuk National University Medical School, Jeonju, Seoul, Korea
| | - Chan-Duck Kim
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Seoul, Korea
| | - Man Ki Ju
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Byung Jun So
- Department of Surgery, Wonkwang University Hospital, Iksan, Seoul, Korea
| | - Sang Ho Lee
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sang Youb Han
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Seoul, Korea
| | - Cheol Woong Jung
- Department of Surgery, Korea University College of Medicine, Seoul, Korea
| | - Joong Kyung Kim
- Department of Internal Medicine, Bong Seng Memorial Hospital, Busan, Korea
| | - Su Hyung Lee
- Department of Surgery, Ajou University School of Medicine, Suwon, Seoul, Korea
- Su Hyung Lee, Department of Surgery, Ajou University School of Medicine, 164 World cup-ro, Yeongtong-gu, Suwon 16499, Korea, Tel: +82-31-219-5760, Fax: +82-31-219-4438, E-mail:
| | - Ja Young Jeon
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
- Corresponding authors: Ja Young Jeon, Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164 World cup-ro, Yeongtong-gu, Suwon 16499, Korea, Tel: +82-31-219-7459, Fax: +82-31-219-4497, E-mail:
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Yoo S, Jung J, Kim H, Kim KY, Kim SK, Jung J, Hahm JR, Baek JH. Predictive Performance of Glycated Hemoglobin for Incident Diabetes Compared with Glucose Tolerance Test According to Central Obesity. Endocrinol Metab (Seoul) 2020; 35:873-881. [PMID: 33397041 PMCID: PMC7803600 DOI: 10.3803/enm.2020.798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/08/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND To examine whether glycated hemoglobin (HbA1c) test would be a suitable screening tool for detecting high-risk subjects for diabetes compared to oral glucose tolerance test (OGTT) according to accompanied central obesity. METHODS In this prospective population-based cohort study, both OGTT and HbA1c tests were performed and continued every 2 years up to 12 years among individuals with non-diabetic state at baseline (aged 40 to 69 years, n=7,512). Incident diabetes was established by a doctor, HbA1c ≥6.5%, and/or fasting plasma glucose (FPG) ≥126 mg/dL, and/or 2-hour postprandial glucose (2hPG) level based on OGTT ≥200 mg/dL. Discriminative capacities of high HbA1c (≥5.7%) versus high 2hPG (≥140 mg/dL) for predicting incident diabetes were compared using Cox-proportional hazard regression and C-index. RESULTS During the median 11.5 years of follow-up period, 1,341 (17.6%) developed diabetes corresponding to an incidence of 22.1 per 1,000 person-years. Isolated high 2hPG was associated with higher risk for incident diabetes (hazard ratio [HR], 4.29; 95% confidence interval [CI], 3.56 to 5.17) than isolated high HbA1c (HR, 2.79; 95% CI, 2.40 to 3.26; P<0.05). In addition, high 2hPG provided better discriminatory capacity than high HbA1c (C-index 0.79 vs. 0.75, P<0.05). Meanwhile, in subjects with central obesity, the HR (3.95 [95% CI, 3.01 to 5.18] vs. 2.82 [95% CI, 2.30 to 3.46]) and discriminatory capacity of incident diabetes (C-index 0.75 vs. 0.75) between two subgroups became comparable. CONCLUSION Even though the overall inferior predictive capacity of HbA1c test than OGTT, HbA1c test might plays a complementary role in identifying high risk for diabetes especially in subjects with central obesity with increased sensitivity.
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Affiliation(s)
- Suji Yoo
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon,
Korea
| | - Jaehoon Jung
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon,
Korea
- Institute of Health Science, Gyeongsang National University, Jinju,
Korea
| | - Hosu Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon,
Korea
- Institute of Health Science, Gyeongsang National University, Jinju,
Korea
| | - Kyoung Young Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon,
Korea
- Institute of Health Science, Gyeongsang National University, Jinju,
Korea
| | - Soo Kyoung Kim
- Institute of Health Science, Gyeongsang National University, Jinju,
Korea
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju,
Korea
| | - Jungwha Jung
- Institute of Health Science, Gyeongsang National University, Jinju,
Korea
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju,
Korea
| | - Jong Ryeal Hahm
- Institute of Health Science, Gyeongsang National University, Jinju,
Korea
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju,
Korea
| | - Jong Ha Baek
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon,
Korea
- Institute of Health Science, Gyeongsang National University, Jinju,
Korea
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Sylvester E, Yi W, Han M, Deng C. Exercise intervention for preventing risperidone-induced dyslipidemia and gluco-metabolic disorders in female juvenile rats. Pharmacol Biochem Behav 2020; 199:173064. [PMID: 33127383 DOI: 10.1016/j.pbb.2020.173064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/30/2020] [Accepted: 10/23/2020] [Indexed: 01/02/2023]
Abstract
Risperidone use in children and adolescents is associated with the development of metabolic disorders including increased accumulation of body fat, dyslipidemia, and glucose and insulin metabolism dysregulation. As pharmacological interventions are often limited in their ability to treat a range of side-effects, this study aimed to evaluate the effectiveness of daily voluntary exercise intervention to prevent metabolic side-effects induced by risperidone in juveniles. Thirty-two juvenile female Sprague Dawley rats were treated with risperidone (0.9 mg/kg; b.i.d; n = 16) or vehicle (0.3 g cookie dough pellet; n = 16). These rats were then assigned to a sedentary or voluntary exercise intervention (three hours daily access to running wheels) group (n = 8/group) for a period of four weeks. An intra-peritoneal glucose tolerance test was performed after three weeks of risperidone treatment and exercise intervention to assess glucose tolerance. During the exercise intervention, risperidone-treated rats ran significantly less than vehicle-treated rats. Risperidone treatment of sedentary rats resulted in significantly increased white adipose tissue, fasting triglyceride and fasting insulin compared to vehicle-treated sedentary rats. Exercise intervention of risperidone-treated rats prevented significant increases in these metabolic parameters compared to risperidone-treated sedentary rats. These results support voluntary exercise as an effective mitigator of metabolic side-effects associated with risperidone treatment in juvenile rats. Dyslipidemia and dysregulation of glucose and insulin metabolism are significant risk factors for morbidities and mortality later in life, therefore a focus on strategies to mitigate these adverse effects is critical. Our findings support clinical trials in exercise intervention to prevent metabolic disorders associated with antipsychotic medication in children and adolescents.
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Affiliation(s)
- Emma Sylvester
- Antipsychotic Research Laboratory, Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; School of Medicine and Molecular Horizons, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Weijie Yi
- Antipsychotic Research Laboratory, Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; School of Medicine and Molecular Horizons, University of Wollongong, Wollongong, NSW 2522, Australia; Department of Nutrition and Food Hygiene, School of Public Health and Management, Binzhou Medical University, Yantai, Shandong 264003, China
| | - Mei Han
- Antipsychotic Research Laboratory, Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; School of Medicine and Molecular Horizons, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Chao Deng
- Antipsychotic Research Laboratory, Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; School of Medicine and Molecular Horizons, University of Wollongong, Wollongong, NSW 2522, Australia.
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Kira S, Ito C, Fujikawa R, Misumi M. Increased cancer mortality among Japanese individuals with hyperinsulinemia. Metabol Open 2020; 7:100048. [PMID: 32812908 PMCID: PMC7424784 DOI: 10.1016/j.metop.2020.100048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/25/2020] [Accepted: 07/28/2020] [Indexed: 11/19/2022] Open
Abstract
AIMS To evaluate the effect of hyperinsulinemia on cancer death, we clarified the association between hyperinsulinemia and cancer mortality among Japanese individuals. METHODS All the participants (5586 men and 6652 women) lived in Hiroshima City, underwent a 75 g oral glucose tolerance test between 1994 and 2012, and were followed for mortality until August 2013. A systematic review of death certificates was used to confirm the cause of death. RESULTS During the follow-up period (median, 10.0 years), 587 participants died of cancer. Lung cancer was the most common cause of organ-specific death. We divided the participants into 3 groups according to the tertiles of fasting immunoreactive insulin (FIRI) levels (low, middle, and high groups). The high group had the highest mortality rate (5.5 per 1000 person-years). The hazard ratio (HR) for cancer mortality of the high group after adjustment for possible confounders, such as age, sex, body mass index, smoking status, alcohol intake, and radiation effects (model 1), was significantly higher than that of the low group (HR, 1.55; 95% confidence interval (CI), 1.23-1.95). In model 2 (model 1 plus fasting plasma glucose) and model 3 (model 1 plus HbA1c), the multivariate HRs for cancer mortality were 1.46 (95% CI, 1.15-1.85) and 1.48 (95% CI, 1.17-1.87), respectively.The HR for cancer death at high FIRI levels (per 1 μU/mL) was 1.04 (95% CI, 1.02-1.05) in all participants after adjusting for fasting plasma glucose level and other confounders. In the subgroup analysis, the HRs were 1.03 (95% CI, 0.98-1.09), 1.05 (95% CI, 1.02-1.08), and 1.04 (95% CI, 1.02-1.06) in the normal, prediabetes, and diabetes group, respectively. CONCLUSIONS Hyperinsulinemia was associated with a high risk of cancer mortality and may be an important link between cancer mortality and diabetes or prediabetes.
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Affiliation(s)
- Sakurako Kira
- Grand Tower Medical Court, Hiroshima, Japan
- Hiroshima Atomic Bomb Casualty Council Health Management & Promotion Center, Japan
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Montoya B, Briga M, Jimeno B, Verhulst S. Glucose regulation is a repeatable trait affected by successive handling in zebra finches. J Comp Physiol B 2020; 190:455-464. [PMID: 32424441 DOI: 10.1007/s00360-020-01283-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/16/2020] [Accepted: 05/03/2020] [Indexed: 11/29/2022]
Abstract
The capacity to adequately respond to (physiological) perturbations is a fundamental aspect of physiology, and may affect health and thereby Darwinian fitness. However, little is known of the degree of individual variation in this capacity in non-model organisms. The glucose tolerance test evaluates the individual's ability to regulate circulating glucose levels, and is a widely used tool in medicine and biomedical research, because glucose regulation is thought to play a role in the ageing process, among other reasons. Here, we developed an application of the intraperitoneal glucose tolerance test (IP-GTT) to be used in small birds, to test whether individuals can be characterized by their regulation of glucose levels and the effect of successive handling on such regulation. Since the IP-injection (intraperitoneal glucose injection), repeated handling and blood sampling may trigger a stress response, which involves a rise in glucose levels, we also evaluated the effects of handling protocols on glucose response. Blood glucose levels decreased immediately following an IP-injection, either vehicle or glucose loaded, and increased with successive blood sampling. Blood glucose levels peaked, on average, at 20 min post-injection (PI) and had not yet returned back to initial levels at 120 min PI. Glucose measurements taken during the IP-GTT were integrated to estimate magnitude of changes in glucose levels over time using the incremental area under the curve (AUC) up to 40 min PI. Glucose levels integrated in the AUC were significantly repeatable within individuals over months (r = 50%; 95% CI 30-79%), showing that the ability to regulate glucose differs consistently between individuals.
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Affiliation(s)
- Bibiana Montoya
- Laboratorio de Conducta Animal, Departamento de Ecología Evolutiva, Instituto de Ecología, Universidad Nacional Autónoma de México, Mexico City, Mexico. .,Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, The Netherlands. .,Centro Tlaxcala de Biología de la Conducta (CTBC), Universidad Autónoma de Tlaxcala, Tlaxcala, México.
| | - Michael Briga
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, The Netherlands.,Department of Biology, University of Turku, Turku, Finland
| | - Blanca Jimeno
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, The Netherlands.,Division of Biological Sciences, University of Montana, Missoula, MT, USA
| | - Simon Verhulst
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, The Netherlands.
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Morettini M, Castriota C, Göbl C, Kautzky-Willer A, Pacini G, Burattini L, Tura A. Glucose Effectiveness from Short Insulin-Modified IVGTT and Its Application to the Study of Women with Previous Gestational Diabetes Mellitus. Diabetes Metab J 2020; 44:286-294. [PMID: 31950770 PMCID: PMC7188979 DOI: 10.4093/dmj.2019.0016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/24/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND This study aimed to design a simple surrogate marker (i.e., predictor) of the minimal model glucose effectiveness (SG), namely calculated SG (CSG), from a short insulin-modified intravenous glucose tolerance test (IM-IVGTT), and then to apply it to study women with previous gestational diabetes mellitus (pGDM). METHODS CSG was designed using the stepwise model selection approach on a population of subjects (n=181) ranging from normal tolerance to type 2 diabetes mellitus (T2DM). CSG was then tested on a population of women with pGDM (n=57). Each subject underwent a 3-hour IM-IVGTT; women with pGDM were observed early postpartum and after a follow-up period of up to 7 years and classified as progressors (PROG) or non-progressors (NONPROG) to T2DM. The minimal model analysis provided a reference SG. RESULTS CSG was described as CSG=1.06×10⁻²+5.71×10⁻²×KG/Gpeak, KG being the mean slope (absolute value) of loge glucose in 10-25- and 25-50-minute intervals, and Gpeak being the maximum of the glucose curve. Good agreement between CSG and SG in the general population and in the pGDM group, both at baseline and follow-up (even in PROG and NONPROG subgroups), was shown by the Bland-Altman plots (<5% observations outside limits of agreement), and by the test for equivalence (equivalence margin not higher than one standard deviation). At baseline, the PROG subgroup showed significantly lower SG and CSG values compared to the NONPROG subgroup (P<0.03). CONCLUSION CSG is a valid SG predictor. In the pGDM group, glucose effectiveness appeared to be impaired in women progressing to T2DM.
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Affiliation(s)
- Micaela Morettini
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Carlo Castriota
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Christian Göbl
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Alexandra Kautzky-Willer
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Giovanni Pacini
- Metabolic Unit, CNR Institute of Neuroscience, Padova, Italy
| | - Laura Burattini
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Andrea Tura
- Metabolic Unit, CNR Institute of Neuroscience, Padova, Italy.
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Tsuboi A, Kitaoka K, Yano M, Takeuchi M, Minato S, Kurata M, Yoshino G, Wu B, Kazumi T, Fukuo K. Higher circulating orosomucoid and lower early-phase insulin secretion in midlife Japanese with slower glucose disposal during oral glucose tolerance tests. Diabetol Int 2020; 11:27-32. [PMID: 31950001 DOI: 10.1007/s13340-019-00398-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/25/2019] [Indexed: 12/22/2022]
Abstract
Objective We examined whether serum orosomucoid, an acute phase protein as with C-reactive protein, in addition to insulin resistance and beta-cell dysfunction, was involved in glucose disposal during oral glucose tolerance tests. Research design and methods 124 midlife Japanese (65 women, 66% with normal glucose tolerance) received dual-energy X-ray absorptiometry and 75 g oral glucose tolerance tests with multiple postload glucose and insulin measurements. Subjects were divided based on the relationship between postload and fasting glucose. Obesity measures, insulin resistance, insulin secretion, serum orosomucoid and adiponectin were cross-sectionally analyzed by analysis of variance and then Bonferroni's multiple comparison procedure. Results In 10 subjects (group A) and 19 subjects (group B), postload glucose fell below fasting glucose at 1 h and 2 h, respectively. In the remaining 95 subjects (group C), postload glucose never fell below fasting glucose. The insulinogenic index was lower and area under the glucose curve was higher in groups B and C as compared to group A (both p<0.05), whereas the Matsuda index, the homeostasis model assessment of insulin resistance, adipose insulin resistance (the product of fasting free fatty acid and insulin) and area under the insulin curve did not differ. Although there was no difference in fat mass index, trunk/leg fat ratio and adiponectin, orosomucoid was higher in group C as compared to group A (p<0.05). Conclusions Lower early-phase insulin secretion and low-grade inflammation were associated with slower glucose disposal during an oral glucose tolerance test in midlife Japanese. The rate of glucose disposal was not related to adiposity and insulin resistance.
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Affiliation(s)
- Ayaka Tsuboi
- 1Research Institute for Nutrition Sciences, Mukogawa Women's University, 6-46, Ikebiraki-cho, NishinomiyaNishinomiya, 663-8558 Hyogo Japan.,Department of Nutrition, Osaka City Juso Hospital, Osaka, Japan
| | - Kaori Kitaoka
- 1Research Institute for Nutrition Sciences, Mukogawa Women's University, 6-46, Ikebiraki-cho, NishinomiyaNishinomiya, 663-8558 Hyogo Japan.,3Department of Nutritional Sciences for Well-Being, Faculty of Health Sciences for Welfare, Kansai University of Welfare Sciences, Kashiwara, Osaka Japan
| | - Megumu Yano
- 1Research Institute for Nutrition Sciences, Mukogawa Women's University, 6-46, Ikebiraki-cho, NishinomiyaNishinomiya, 663-8558 Hyogo Japan
| | - Mika Takeuchi
- 1Research Institute for Nutrition Sciences, Mukogawa Women's University, 6-46, Ikebiraki-cho, NishinomiyaNishinomiya, 663-8558 Hyogo Japan.,4Department of Food Sciences and Nutrition, Faculty of Human Life and Environmental Sciences, Nagoya Women's University, Nagoya, Japan
| | - Satomi Minato
- 1Research Institute for Nutrition Sciences, Mukogawa Women's University, 6-46, Ikebiraki-cho, NishinomiyaNishinomiya, 663-8558 Hyogo Japan.,5Graduate School of Human Science and Environment, University of Hyogo, Himeji, Hyogo Japan
| | - Miki Kurata
- 1Research Institute for Nutrition Sciences, Mukogawa Women's University, 6-46, Ikebiraki-cho, NishinomiyaNishinomiya, 663-8558 Hyogo Japan.,6Department of Food Sciences and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University, Nishinomiya, Hyogo Japan
| | - Gen Yoshino
- Diabetes Center, Shinsuma Hospital, Kobe, Hyogo Japan
| | - Bin Wu
- 8Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Japan.,9Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan China
| | - Tsutomu Kazumi
- 1Research Institute for Nutrition Sciences, Mukogawa Women's University, 6-46, Ikebiraki-cho, NishinomiyaNishinomiya, 663-8558 Hyogo Japan.,Department of Medicine, Kohnan Kakogawa Hospital, Kakogawa, Hyogo Japan
| | - Keisuke Fukuo
- 1Research Institute for Nutrition Sciences, Mukogawa Women's University, 6-46, Ikebiraki-cho, NishinomiyaNishinomiya, 663-8558 Hyogo Japan.,6Department of Food Sciences and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University, Nishinomiya, Hyogo Japan
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Kim MH, Kwak SH, Kim SH, Hong JS, Chung HR, Choi SH, Kim MY, Jang HC. Pregnancy Outcomes of Women Additionally Diagnosed as Gestational Diabetes by the International Association of the Diabetes and Pregnancy Study Groups Criteria. Diabetes Metab J 2019; 43:766-775. [PMID: 30877713 PMCID: PMC6943275 DOI: 10.4093/dmj.2018.0192] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 10/30/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND We investigated the pregnancy outcomes in women who were diagnosed with gestational diabetes mellitus (GDM) by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria but not by the Carpenter-Coustan (CC) criteria. METHODS A total of 8,735 Korean pregnant women were identified at two hospitals between 2014 and 2016. Among them, 2,038 women participated in the prospective cohort to investigate pregnancy outcomes. Diagnosis of GDM was made via two-step approach with 50-g glucose challenge test for screening followed by diagnostic 2-hour 75-g oral glucose tolerance test. Women were divided into three groups: non-GDM, GDM diagnosed exclusively by the IADPSG criteria, and GDM diagnosed by the CC criteria. RESULTS The incidence of GDM was 2.1% according to the CC criteria, and 4.1% by the IADPSG criteria. Women diagnosed with GDM by the IADPSG criteria had a higher body mass index (22.0±3.1 kg/m² vs. 21.0±2.8 kg/m², P<0.001) and an increased risk of preeclampsia (odds ratio [OR], 6.90; 95% confidence interval [CI], 1.84 to 25.87; P=0.004) compared to non-GDM women. Compared to neonates of the non-GDM group, those of the IADPSG GDM group had an increased risk of being large for gestational age (OR, 2.39; 95% CI, 1.50 to 3.81; P<0.001), macrosomia (OR, 2.53; 95% CI, 1.26 to 5.10; P=0.009), and neonatal hypoglycemia (OR, 3.84; 95% CI, 1.01 to 14.74; P=0.049); they were also at an increased risk of requiring phototherapy (OR, 1.57; 95% CI, 1.07 to 2.31; P=0.022) compared to the non-GDM group. CONCLUSION The IADPSG criteria increased the incidence of GDM by nearly three-fold, and women diagnosed with GDM by the IADPSG criteria had an increased risk of adverse pregnancy outcomes in Korea.
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Affiliation(s)
- Min Hyoung Kim
- Department of Obstetrics and Gynecology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Soo Heon Kwak
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Hoon Kim
- Department of Internal Medicine, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Joon Seok Hong
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hye Rim Chung
- Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Moon Young Kim
- Department of Obstetrics and Gynecology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Hak C Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
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Kang S, Kim MH, Kim MY, Hong JS, Kwak SH, Choi SH, Lim S, Park KS, Jang HC. Progression to Gestational Diabetes Mellitus in Pregnant Women with One Abnormal Value in Repeated Oral Glucose Tolerance Tests. Diabetes Metab J 2019; 43:607-614. [PMID: 30877710 PMCID: PMC6834832 DOI: 10.4093/dmj.2018.0159] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 11/23/2018] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Women with one abnormal value (OAV) in a 100 g oral glucose tolerance test (OGTT) during pregnancy are reported to have an increased risk of adverse pregnancy outcomes. However, there is limited data about whether women with OAV will progress to gestational diabetes mellitus (GDM) when the OGTT is repeated. METHODS To identify clinical and metabolic predictors for GDM in women with OAV, we conducted a retrospective study and identified women with OAV in the OGTT done at 24 to 30 weeks gestational age (GA) and repeated the second OGTT between 32 and 34 weeks of GA. RESULTS Among 137 women with OAV in the initial OGTT, 58 (42.3%) had normal, 40 (29.2%) had OAV and 39 (28.5%) had GDM in the second OGTT. Maternal age, prepregnancy body mass index, weight gain from prepregnancy to the second OGTT, GA at the time of the OGTT, and parity were similar among normal, OAV, and GDM groups. Plasma glucose levels in screening tests were different (151.8±15.7, 155.8±14.6, 162.5±20.3 mg/dL, P<0.05), but fasting, 1-, 2-, and 3-hour glucose levels in the initial OGTT were not. Compared to women with screen negative, women with untreated OAV had a higher frequency of macrosomia. CONCLUSION We demonstrated that women with OAV in the initial OGTT significantly progressed to GDM in the second OGTT. Clinical parameters predicting progression to GDM were not found. Repeating the OGTT in women with OAV in the initial test may be helpful to detect GDM progression.
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Affiliation(s)
- Sunyoung Kang
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Min Hyoung Kim
- Department of Obstetrics and Gynecology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Moon Young Kim
- Department of Obstetrics and Gynecology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea.
| | - Joon Seok Hong
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Soo Heon Kwak
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Soo Lim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Kyong Soo Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hak C Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
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Yuen JWY, Wu C, Wang CK, Kim DD, Procyshyn RM, Honer WG, Barr AM. A comparison of the effects of clozapine and its metabolite norclozapine on metabolic dysregulation in rodent models. Neuropharmacology 2020; 175:107717. [PMID: 31348941 DOI: 10.1016/j.neuropharm.2019.107717] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/13/2019] [Accepted: 07/22/2019] [Indexed: 01/11/2023]
Abstract
RATIONALE The second generation antipsychotic drug clozapine is a psychotherapeutic agent with superior efficacy for treatment-resistant schizophrenia. Clozapine is associated with a low likelihood of neurological side-effects, but a high propensity to induce weight gain and metabolic dysregulation. The primary metabolite of clozapine is norclozapine (N-Desmethylclozapine), which has psychoactive properties itself, but its effects on metabolic function remains unknown. The goal of the present study was to determine whether directly administered norclozapine could cause metabolic dysregulation, similar to clozapine. METHODS Adult female rats were treated with a range of doses of clozapine and norclozapine (0.5, 2, 8 & 20 mg/kg, i.p.) and then subjected to the intraperitoneal glucose tolerance test (IGTT), where glucose levels were recorded for 2 h following a glucose challenge. In parallel, rats were tested with two doses of clozapine and norclozapine (2 & 20 mg/kg, i.p.) in the hyperinsulinemic-euglycemic clamp (HIEC), to measure whole body insulin resistance. RESULTS In the IGTT, clozapine demonstrated dose-dependent effects on fasting glucose levels and total glucose area-under-the-curve following the glucose challenge, with the two highest doses strongly increasing glucose levels. Only the highest dose of norclozapine increased fasting glucose levels, and caused a non-significant increase in glucose levels following the challenge. By contrast, both doses of clozapine and norclozapine caused a potent and long-lasting decrease in the glucose infusion rate in the HIEC, indicating that both compounds cause whole body insulin resistance. ABSTRACT While not as potent as its parent compound, norclozapine clearly exerts acute metabolic effects, particularly on insulin resistance. This article is part of the issue entitled 'Special Issue on Antipsychotics'.
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Edmunds SJ, Liébana-García R, Nilsson O, Domingo-Espín J, Grönberg C, Stenkula KG, Lagerstedt JO. ApoAI-derived peptide increases glucose tolerance and prevents formation of atherosclerosis in mice. Diabetologia 2019; 62:1257-1267. [PMID: 31069401 PMCID: PMC6560211 DOI: 10.1007/s00125-019-4877-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 03/13/2019] [Indexed: 01/03/2023]
Abstract
AIMS/HYPOTHESIS Finding new treatment alternatives for individuals with diabetes with severe insulin resistance is highly desired. To identify novel mechanisms that improve glucose uptake in skeletal muscle, independently from insulin levels and signalling, we have explored the therapeutic potential of a short peptide sequence, RG54, derived from apolipoprotein A-I (ApoA-I). METHODS INS-1E rat clonal beta cells, C2C12 rat muscle myotubes and J774 mouse macrophages were used to study the impact of RG54 peptide on glucose-stimulated insulin secretion, glucose uptake and cholesterol efflux, respectively. GTTs were carried out on diet-induced insulin-resistant and Leprdb diabetic mouse models treated with RG54 peptide, and the impact of RG54 peptide on atherosclerosis was evaluated in Apoe-/- mice. Control mice received ApoA-I protein, liraglutide or NaCl. RESULTS The synthetic RG54 peptide induced glucose uptake in cultured muscle myotubes by a similar amount as insulin, and also primed pancreatic beta cells for improved glucose-stimulated insulin secretion. The findings were verified in diet-induced insulin-resistant and Leprdb diabetic mice, jointly confirming the physiological effect. The RG54 peptide also efficiently catalysed cholesterol efflux from macrophages and prevented the formation of atherosclerotic plaques in Apoe-/- mice. CONCLUSIONS/INTERPRETATION The RG54 peptide exhibits good prospects for providing glucose control and reducing the risk of cardiovascular disease in individuals with severe insulin resistance.
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Affiliation(s)
- Shelley J Edmunds
- Department of Experimental Medical Science, Biomedical Center Floor C13, Lund University, Tornavagen 10, 221 84, Lund, Sweden
| | - Rebeca Liébana-García
- Department of Experimental Medical Science, Biomedical Center Floor C13, Lund University, Tornavagen 10, 221 84, Lund, Sweden
| | - Oktawia Nilsson
- Department of Experimental Medical Science, Biomedical Center Floor C13, Lund University, Tornavagen 10, 221 84, Lund, Sweden
| | - Joan Domingo-Espín
- Department of Experimental Medical Science, Biomedical Center Floor C13, Lund University, Tornavagen 10, 221 84, Lund, Sweden
| | - Caitriona Grönberg
- Department of Experimental Medical Science, Biomedical Center Floor C13, Lund University, Tornavagen 10, 221 84, Lund, Sweden
| | - Karin G Stenkula
- Department of Experimental Medical Science, Biomedical Center Floor C13, Lund University, Tornavagen 10, 221 84, Lund, Sweden
| | - Jens O Lagerstedt
- Department of Experimental Medical Science, Biomedical Center Floor C13, Lund University, Tornavagen 10, 221 84, Lund, Sweden.
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Oh TJ, Kim YG, Kang S, Moon JH, Kwak SH, Choi SH, Lim S, Park KS, Jang HC, Hong JS, Cho NH. Oral Glucose Tolerance Testing Allows Better Prediction of Diabetes in Women with a History of Gestational Diabetes Mellitus. Diabetes Metab J 2019; 43:342-349. [PMID: 30604595 PMCID: PMC6581542 DOI: 10.4093/dmj.2018.0086] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 08/09/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND We aimed to identify the postpartum metabolic factors that were associated with the development of diabetes in women with a history of gestational diabetes mellitus (GDM). In addition, we examined the role of the oral glucose tolerance test (OGTT) in the prediction of future diabetes. METHODS We conducted a prospective study of 179 subjects who previously had GDM but did not have diabetes at 2 months postpartum. The initial postpartum examination including a 75-g OGTT and the frequently sampled intravenous glucose tolerance test (FSIVGTT) was performed 12 months after delivery, and annual follow-up visits were made thereafter. RESULTS The insulinogenic index (IGI30) obtained from the OGTT was significantly correlated with the acute insulin response to glucose (AIRg) obtained from the FSIVGTT. The disposition indices obtained from the OGTT and FSIVGTT were also significantly correlated. Women who progressed to diabetes had a lower insulin secretory capacity including IGI30, AIRg, and disposition indices obtained from the FSIVGTT and OGTT compared with those who did not. However, the insulin sensitivity indices obtained from the OGTT and FSIVGTT did not differ between the two groups. Multivariate logistic regression analysis showed that the 2-hour glucose and disposition index obtained from the FSIVGTT were significant postpartum metabolic risk factors for the development of diabetes. CONCLUSION We identified a crucial role of β-cell dysfunction in the development of diabetes in Korean women with previous GDM. The 2-hour glucose result from the OGTT is an independent predictor of future diabetes. Therefore, the OGTT is crucial for better prediction of future diabetes in Korean women with previous GDM.
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Affiliation(s)
- Tae Jung Oh
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yeong Gi Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sunyoung Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Joon Ho Moon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Soo Heon Kwak
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Soo Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kyong Soo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hak C Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
| | - Joon Seok Hong
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Nam H Cho
- Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Korea
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Nayak AU, Vijay AMA, Indusekhar R, Kalidindi S, Katreddy VM, Varadhan L. Association of hypoglycaemia in screening oral glucose tolerance test in pregnancy with low birth weight fetus. World J Diabetes 2019; 10:304-310. [PMID: 31139317 PMCID: PMC6522759 DOI: 10.4239/wjd.v10.i5.304] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 04/18/2019] [Accepted: 05/01/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a common metabolic derangement in pregnant women. In the women identified to be at high risk of GDM, a 75 g oral glucose tolerance test (OGTT) at 24-28 wk gestation is the recommended screening test in the United Kingdom as per National Institute for Health and Care Excellence (NICE). Hypoglycaemia following the glucose load is often encountered and the implication of this finding for the pregnancy, fetus and clinical care is unclear.
AIM To determine the prevalence of hypoglycaemia at any time during the screening OGTT and explore its association with birth weight.
METHODS All deliveries between 2009 and 2013 at the local maternity unit of the University hospital were reviewed. Of the total number of 24,154 women without pre-existing diabetes, those who had an OGTT for GDM screening based on NICE recommended risk stratification, who had a singleton delivery and had complete clinical and demographic data for analysis, were included for this study (n = 3537). Blood samples for fasting plasma glucose (FPG), 2-hour plasma glucose (2-h PG) and HbA1c had been obtained. Birth weight was categorised as low (≤ 2500 g), normal or Macrosomia (≥ 4500 g) and blood glucose ≤ 3.5 mmol/L was used to define hypoglycaemia. Binary logistic regression was used to determine the association of various independent factors with dichotomized variables; the differences between frequencies/proportions by χ2 test and comparison between group means was by one-way ANOVA.
RESULTS Amongst the study cohort (3537 deliveries), 96 (2.7%) women had babies with LBW (< 2500 g). Women who delivered a LBW baby had significantly lower FPG (4.3 ± 0.6 mmol/L, P = 0.001). The proportion of women who had a 2-h PG ≤ 3.5 mmol/L in the LBW cohort was significantly higher compared to the cohorts with normal and macrosomic babies (8.3% vs 2.8% vs 4.2%; P = 0.007). The factors which predicted LBW were FPG, Asian ethnicity and 2-h PG ≤ 3.5 mmol/L, whereas maternal age, 2-h PG ≥ 7.8 mmol/L and HbA1c were not significant predictors.
CONCLUSION A low FPG and 2-h PG ≤ 3.5 mmol/L on 75-gram OGTT are significantly associated with low birth weight in women identified as high risk for GDM. Women of ethnic backgrounds (Asians) appear to be more susceptible to this increased risk and may serve as a separate cohort in whom we should offer more intensive follow up and screening for complications. Cost implications and resources for follow up would need to be looked at in further detail to support these findings.
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Affiliation(s)
- Ananth U Nayak
- Combined Antenatal Diabetes Clinic, University Hospital of North Midlands NHS Trust, Stoke on Trent ST4 6QG, Staffordshire, United Kingdom
| | - Arun M A Vijay
- Combined Antenatal Diabetes Clinic, University Hospital of North Midlands NHS Trust, Stoke on Trent ST4 6QG, Staffordshire, United Kingdom
| | - Radha Indusekhar
- Combined Antenatal Diabetes Clinic, University Hospital of North Midlands NHS Trust, Stoke on Trent ST4 6QG, Staffordshire, United Kingdom
| | - Sushuma Kalidindi
- Combined Antenatal Diabetes Clinic, University Hospital of North Midlands NHS Trust, Stoke on Trent ST4 6QG, Staffordshire, United Kingdom
| | - Venkata M Katreddy
- Combined Antenatal Diabetes Clinic, University Hospital of North Midlands NHS Trust, Stoke on Trent ST4 6QG, Staffordshire, United Kingdom
| | - Lakshminarayanan Varadhan
- Combined Antenatal Diabetes Clinic, University Hospital of North Midlands NHS Trust, Stoke on Trent ST4 6QG, Staffordshire, United Kingdom
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Kasuga Y, Miyakoshi K, Tajima A, Saisho Y, Ikenoue S, Ochiai D, Matsumoto T, Arata N, Hata K, Tanaka M. Clinical and genetic characteristics of abnormal glucose tolerance in Japanese women in the first year after gestational diabetes mellitus. J Diabetes Investig 2019; 10:817-826. [PMID: 30239167 PMCID: PMC6497595 DOI: 10.1111/jdi.12935] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 07/20/2018] [Accepted: 09/17/2018] [Indexed: 12/12/2022] Open
Abstract
AIMS/INTRODUCTION Risk factors of type 2 diabetes mellitus in Japanese women with recent gestational diabetes mellitus are unknown. The objective of the present study was to investigate the clinical and genetic characteristics associated with postpartum abnormal glucose tolerance in Japanese women with gestational diabetes mellitus. MATERIALS AND METHODS A total of 213 Japanese women with recent gestational diabetes mellitus who underwent a postpartum 2-h oral glucose tolerance test were investigated. The association between antepartum clinical characteristics and postpartum abnormal glucose tolerance (diabetes or prediabetes based on the Japan Diabetes Society criteria) was examined. Frequencies of 45 known type 2 diabetes mellitus-associated genetic variants were also compared between women with and without postpartum abnormal glucose tolerance. RESULTS A total of 59 women showed postpartum abnormal glucose tolerance (prediabetes, n = 51; diabetes, n = 8). Plasma glucose levels at 1 or 2 h, the insulinogenic index and the insulin secretion-sensitivity index-2 of the antepartum oral glucose tolerance test were independent of postpartum abnormal glucose tolerance risk factors (P = 0.006, P = 0.00002, P = 0.01 and P = 0.006, respectively). Four genetic variants (rs266729 [ADIPOQ], rs6017317 [HNF4A], rs5215 [KCNJ11] and rs7177055 [HMG20A]) showed a nominally significant association with postpartum abnormal glucose tolerance (P < 0.05, respectively). Among these, three were related to insulin secretion. Postpartum abnormal glucose tolerance risk significantly increased with increasing risk-allele number (P = 0.0005; odds ratio 1.91). CONCLUSIONS Clinical features and genetic variants related to impaired insulin secretion are risk factors of postpartum abnormal glucose tolerance in Japanese women with recent gestational diabetes mellitus.
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Affiliation(s)
- Yoshifumi Kasuga
- Department of Obstetrics and GynecologyKeio University School of MedicineTokyoJapan
- Department of Maternal‐Fetal BiologyNational Research Institute for Child Health and DevelopmentTokyoJapan
| | - Kei Miyakoshi
- Department of Obstetrics and GynecologyKeio University School of MedicineTokyoJapan
| | - Atsushi Tajima
- Department of Bioinformatics and GenomicsGraduate School of Advanced Preventive Medical SciencesKanazawa UniversityIshikawaJapan
| | - Yoshifumi Saisho
- Department of Internal MedicineKeio University School of MedicineTokyoJapan
| | - Satoru Ikenoue
- Department of Obstetrics and GynecologyKeio University School of MedicineTokyoJapan
| | - Daigo Ochiai
- Department of Obstetrics and GynecologyKeio University School of MedicineTokyoJapan
| | - Tadashi Matsumoto
- Department of Obstetrics and GynecologyKeio University School of MedicineTokyoJapan
| | - Naoko Arata
- Department of Women's HealthNational Center for Child Health and DevelopmentTokyoJapan
| | - Kenichiro Hata
- Department of Maternal‐Fetal BiologyNational Research Institute for Child Health and DevelopmentTokyoJapan
| | - Mamoru Tanaka
- Department of Obstetrics and GynecologyKeio University School of MedicineTokyoJapan
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Moradi A, Morovati HR, Teimourpour A, Nematollahi S, Faghir Ganji M. Determine the prevalence of gestational diabetes in Ardakan and its related factors. MethodsX 2019; 6:409-416. [PMID: 30899677 PMCID: PMC6406171 DOI: 10.1016/j.mex.2019.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 01/25/2019] [Accepted: 02/19/2019] [Indexed: 12/07/2022] Open
Abstract
Gestational Diabetes (GD) is amongst the most common metabolic disorders. Due to the important complications of GD on maternal and fetal health and in order to identify the prevalence of GD in various climate and cultures, the present studies aimed to determine the prevalence of GD in Ardakan and its related factors in 2014–2015. This cross-sectional study was conducted in 3808 pregnant women referring to rural and urban health centers in Ardakan city in 2013–14. Demographic, clinical, and obstetrics history of the subjects was gathered. GD was defined based on Glucose Tolerance Test (GTT). Descriptive and Logistic regression models were applied. The prevalence of GD was estimated to be 7.5% (286) which was higher in 35–39 age group, urban residents, obese mothers, and pregnancies ended with macrosome babies. The odds of GD was higher in obese mothers by 1.62 times (95%CI: 1.18–2.24), in mothers above ages of 40 by 10.53 (95%CI: 3.8–29.3), in mothers with a history of GD by 3.86 (95%CI:1.65–8.93), and in pregnancies ended with a macro some baby by 2.2 (95%CI: 0.97–5.1). The prevalence of GD in Ardakan was similar to other studies in the area. It seems that improvement of GD screening in older mothers and those with a history of GD could be a priority of surveillance system in Yazd Province.
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Affiliation(s)
- Ahmad Moradi
- Department of Public Health, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Hamid Reza Morovati
- Department of Epidemiology and Biostatistics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amir Teimourpour
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrzad Nematollahi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Monireh Faghir Ganji
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Hormay E, László B, Szabó I, Ollmann T, Nagy B, Péczely L, Mintál K, Karádi Z. The effect of loss of the glucose-monitoring neurons in the anterior cingulate cortex: Physiologic challenges induce complex feeding-metabolic alterations after local streptozotocin microinjection in rats. Neurosci Res 2019; 149:50-60. [PMID: 30685493 DOI: 10.1016/j.neures.2019.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/14/2019] [Accepted: 01/21/2019] [Indexed: 10/27/2022]
Abstract
The anterior cingulate cortex (ACC) is interrelated to limbic structures, parts of the central glucose-monitoring (GM) network. GM neurons, postulated to exist here, are hypothesised to participate in regulatory functions, such as the central control of feeding and metabolism. In the present experiments, GM neurons were identified and examined in the ACC by means of the multibarreled microelectrophoretic technique. After bilateral ACC microinjection of streptozotocin (STZ), glucose tolerance tests (GTTs), and determination of relevant plasma metabolite concentrations were performed. Body weights were measured at regular time points during the GTT experiment. Ten percent of the neurons - 30 of 282 recorded cells - responded to the administration of D-glucose, thus, declared to be the GM units. The peak values and dynamics of the GTT blood glucose curves, the plasma metabolite concentrations, and the weight gain were pathologically altered in the STZ treated animals. Our recording experiments revealed the existence of GM neurons in the anterior cingulate cortex. STZ induced selective destruction of these chemosensory cells resulted in feeding and metabolic alterations. The present findings indicate distinguished significance of the cingulate cortical GM neurons in adaptive processes of maintenance of the homeostatic balance.
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Affiliation(s)
- Edina Hormay
- Institute of Physiology, Pécs University, Medical School, Pécs, Hungary; Neuroscience Centre, Pécs University, Pécs, Hungary.
| | - Bettina László
- Institute of Physiology, Pécs University, Medical School, Pécs, Hungary; Neuroscience Centre, Pécs University, Pécs, Hungary
| | - István Szabó
- Institute of Physiology, Pécs University, Medical School, Pécs, Hungary; Neuroscience Centre, Pécs University, Pécs, Hungary
| | - Tamás Ollmann
- Institute of Physiology, Pécs University, Medical School, Pécs, Hungary; Neuroscience Centre, Pécs University, Pécs, Hungary
| | - Bernadett Nagy
- Institute of Physiology, Pécs University, Medical School, Pécs, Hungary; Neuroscience Centre, Pécs University, Pécs, Hungary
| | - László Péczely
- Institute of Physiology, Pécs University, Medical School, Pécs, Hungary; Neuroscience Centre, Pécs University, Pécs, Hungary
| | - Kitti Mintál
- Institute of Physiology, Pécs University, Medical School, Pécs, Hungary; Neuroscience Centre, Pécs University, Pécs, Hungary
| | - Zoltán Karádi
- Institute of Physiology, Pécs University, Medical School, Pécs, Hungary; Neuroscience Centre, Pécs University, Pécs, Hungary; Molecular Neuroendocrinology and Neurophysiology Research Group, Szentágothai Research Center, Pécs University, Pécs, Hungary
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González-Grajales LA, Pieper L, Görner P, Görner S, Staufenbiel R. Effects of auditory and visual stimuli on glucose metabolism in Holstein dairy cattle. Acta Vet Scand 2019; 61:2. [PMID: 30611290 PMCID: PMC6321703 DOI: 10.1186/s13028-018-0436-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 12/23/2018] [Indexed: 11/30/2022] Open
Abstract
Background Standardization of the intravenous glucose tolerance test (ivGTT) in cattle has received little attention despite its widespread use to monitor glucose metabolism. The impact of management practices including several sensorial stimuli on test responses has not yet been described in young cattle. The objective of this study was to analyze the effects of noise exposure, and visual food stimuli in combination with physical restraint on ivGTT and insulin traits in Holstein cattle. A total of 108 ivGTT (6 tests per animal) were performed in bulls (n = 6), steers (n = 6), and heifers (n = 6) aged 312 to 344 days. The main parameters analyzed for glucose and insulin included: basal concentration (G0, Ins0), maximum concentration (GMAX, InsMAX), and final concentration at 63 min (G63, Ins63), glucose and insulin area under the curve (GAUC, InsAUC), and glucose half-life time (GHLT). Noise stimuli were induced by playing rock music at approximately 90 dB either before (NI) or immediately after glucose injection (NII). Visual food stimuli were induced by feeding the neighboring animals while the tested animal was restrained in a headlock. Results Almost all glucose and insulin traits were affected by gender (P< 0.05) whereas the factor with least impact on ivGTT was NI. InsMAX and InsAUC were affected (P < 0.002) by all factors analyzed. GHLT and G63 were affected by gender and noise with higher values in bulls when compared to steers and heifers. Furthermore, InsAUC and InsMAX values derived from NII significantly differed in bulls when compared to steers and heifers. Significantly higher values for G0 (P < 0.001), InsMAX (P < 0.001) and InsAUC (P = 0.001) were observed when exposed to the visual food stimulus whereas GMAX (P = 0.02) and GAUC (P = 0.04) decreased. Higher Ins63 values were observed in bulls exposed to the visual food stimulus when compared to heifers. Conclusions Short-term exposure to noise and visual food stimuli might lead to variations in glucose metabolism and insulin secretion which emphasizes the necessity to avoid practices involving auditory or visual stimuli prior to or during the conduction of an ivGTT.
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Urrunaga-Pastor D, Guarnizo-Poma M, Macollunco-Flores P, Lazaro-Alcantara H, Paico-Palacios S, Pantoja-Torres B, Benites-Zapata VA. Association between vitamin D deficiency and insulin resistance markers in euthyroid non-diabetic individuals. Diabetes Metab Syndr 2019; 13:258-263. [PMID: 30641708 DOI: 10.1016/j.dsx.2018.09.008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 09/07/2018] [Indexed: 01/17/2023]
Abstract
AIM To evaluate the association between vitamin D deficiency and insulin resistance (IR) or hyperinsulinemia after oral glucose tolerance test (OGTT) in euthyroid non-diabetic individuals. MATERIALS AND METHODS We carried out an analytical cross-sectional study in euthyroid non-diabetic adults of both sexes, who attended the outpatient service of a private clinic in Lima-Peru during the 2012-2016 period. Participants were categorized in two groups according to their serum vitamin D levels: normal vitamin D levels (serum vitamin D values ≥ 20 ng/dL) and vitamin D deficiency (serum vitamin D values < 20 ng/dL). IR was defined as a Homeostasis Model Assessment (HOMA-IR) value ≥ 3.8 and hyperinsulinemia after OGTT was defined as a serum insulin value ≥ 80μU/mL after 120 min of 75-g glucose intake. We elaborated crude and adjusted Poisson regression models to assess the association between serum vitamin D levels and IR or hyperinsulinemia after OGTT. The reported association measure was the prevalence ratio (PR) with their respective 95% confidence intervals (95%CI). RESULTS We analyzed 204 participants, the average age was 38.5 ± 10.6 (SD) years, 40 (19.6%) were males and the vitamin D median was 25.0 (IQR: 19.0-33.3) ng/dL. The prevalence of vitamin D deficiency, IR and hyperinsulinemia after OGTT was 29.4% (n = 60), 29.9% (n = 61) and 25.0% (n = 51). In the adjusted Poisson regression models, the prevalence of hyperinsulinemia after OGTT was higher among the vitamin D deficient group (aPR=1.75; 95%CI: 1.06-2.90); however, we did not find statistically significant association between vitamin D deficiency and IR (aPR=0.99; 95%CI: 0.61-1.63). CONCLUSIONS We found an association between vitamin D deficiency and hyperinsulinemia after OGTT in euthyroid people with no T2DM.Our findings are consistent with previous reports; providing evidence that serum vitamin D deficiency could be an IR marker.
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Affiliation(s)
- Diego Urrunaga-Pastor
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru.
| | | | | | | | | | | | - Vicente A Benites-Zapata
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru.
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Toro-Huamanchumo CJ, Urrunaga-Pastor D, Guarnizo-Poma M, Lazaro-Alcantara H, Paico-Palacios S, Pantoja-Torres B, Ranilla-Seguin VDC, Benites-Zapata VA. Triglycerides and glucose index as an insulin resistance marker in a sample of healthy adults. Diabetes Metab Syndr 2019; 13:272-277. [PMID: 30641711 DOI: 10.1016/j.dsx.2018.09.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 09/11/2018] [Indexed: 12/12/2022]
Abstract
AIM To assess the association between elevated triglycerides/glucose index (TGI) and insulin resistance (IR) or hyperinsulinemia after oral glucose tolerance test (OGTT) in a sample of healthy adults. METHODS We conducted an analytical cross-sectional study in euthyroid non-diabetic adults, who attended the outpatient service of a private clinic in Lima-Peru during the 2012-2016 period. Participants were categorized in two groups according to the presence or absence of elevated TGI, IR or hyperinsulinemia after OGTT. A TGI value ≥ 8.65 was considered as elevated. We defined IR as a Homeostasis Model Assessment (HOMA-IR) value ≥ 2.28 and hyperinsulinemia after OGTT as a serum insulin value ≥ 80μU/mL after 120 min of 75-g glucose intake. We elaborated crude and adjusted Poisson regression models to assess the association between elevated TGI and IR or hyperinsulinemia after OGTT. The reported association measure was the prevalence ratio (PR) with their respective 95% confidence intervals (95%CI). RESULTS We analyzed 118 individuals, the average age was 37.5 ± 11.3 years, 21 (17.8%) were males and the median BMI was 22.7 ± 1.6 kg/m2. The prevalence of elevated TGI was 25.4% (n=30) while the prevalence of IR and hyperinsulinemia after OGTT was 24.6% (n=29) and 17.0% (n=20) respectively. In the adjusted model, elevated TGI was associated with both IR (aPR=6.36; 95%CI: 3.41-11.86) and hyperinsulinemia after OGTT (aPR=4.19; 95%CI: 1.81-9.70). CONCLUSIONS We found that elevated TGI was associated with both IR markers in a sample of euthyroid adults without T2DM and with a normal BMI. The simplicity of the TGI calculation makes it the first-choice alternative when the hyperinsulinemic-euglycemic clamp or HOMA-IR are not available.
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Affiliation(s)
- Carlos J Toro-Huamanchumo
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru.
| | - Diego Urrunaga-Pastor
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru.
| | | | | | | | | | | | - Vicente A Benites-Zapata
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru.
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Benites-Zapata VA, Toro-Huamanchumo CJ, Urrunaga-Pastor D, Guarnizo-Poma M, Lazaro-Alcantara H, Paico-Palacios S, Pantoja-Torres B, Ranilla-Seguin VDC. High waist-to-hip ratio levels are associated with insulin resistance markers in normal-weight women. Diabetes Metab Syndr 2019; 13:636-642. [PMID: 30641781 DOI: 10.1016/j.dsx.2018.11.043] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 11/13/2018] [Indexed: 02/07/2023]
Abstract
AIM To assess the association between high waist-to-hip ratio (WHR) levels and insulin resistance (IR) or hyperinsulinemia after oral glucose tolerance test (OGTT) in a sample of normal-weight women. METHODS We conducted an analytical cross-sectional study in euthyroid non-diabetic women, who attended the outpatient service of a private clinic in Lima-Peru from 2012 to 2016. Participants were divided in two groups according to the presence or absence of high WHR levels, IR or hyperinsulinemia after OGTT. We considered WHR values > 0.85 as high levels. IR was defined as a Homeostasis Model Assessment (HOMA-IR) value > 2.39 and hyperinsulinemia after OGTT as a serum insulin value ≥ 80μU/mL after 120 min of 75-g glucose intake. We elaborated crude and adjusted Poisson generalized linear models to evaluate the association between high WHR levels and IR or hyperinsulinemia after OGTT and reported the prevalence ratio (PR) with their respective 95% confidence intervals (95%CI). RESULTS We analyzed the data of 248 euthyroid, non-diabetic and normal-weight women. The prevalence of high WHR levels was 68.9% (n = 171) while the prevalence of IR and hyperinsulinemia after OGTT was 25% (n = 62) and 15.3% (n = 38), respectively. WHR values were positively correlated with HOMA-IR (r = 0.307; p < 0.001) and serum insulin after OGTT (r = 0.260; p < 0.001). In the adjusted model, high WHR levels were associated with both IR (aPR = 2.63; 95%CI: 1.39-5.01) and hyperinsulinemia after OGTT (aPR = 2.35; 95%CI: 1.03-5.38). CONCLUSION High WHR levels were associated with both IR markers used in our study, appearing to be a useful anthropometric indicator to assess IR in euthyroid normal-weight women without type 2 diabetes mellitus.
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Affiliation(s)
| | - Carlos J Toro-Huamanchumo
- Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru.
| | - Diego Urrunaga-Pastor
- Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru.
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de Alencar Silva BS, Lira FS, Rossi FE, de Freitas MC, Freire APCF, Dos Santos VR, Gobbo LA. Elastic resistance training improved glycemic homeostasis, strength, and functionality in sarcopenic older adults: a pilot study. J Exerc Rehabil 2018; 14:1085-1091. [PMID: 30656174 PMCID: PMC6323338 DOI: 10.12965/jer.1836412.206] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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] [Received: 08/16/2018] [Accepted: 11/08/2018] [Indexed: 12/20/2022] Open
Abstract
The purpose of this study was to verify the effects of 12 weeks of elastic resistance training on the glucose homeostasis, strength and functionally in sarcopenic older adults. Seven sarcopenic subjects (age, 70.71± 8.0 years; body mass index, 22.75±3.1 kg/m2) participated of training protocol with 12 weeks of elastic resistance training. The oral glucose tolerance test, handgrip strength, sit-to-stand test, 4-m walk test, and coordination test were measured at baseline and after training. According to the results, baseline values of area under the curve of glucose and homeostatic model assessment-insulin resistance were significantly lower than after 12 weeks, respectively (808.2±185.0 mmol/L vs. 706.6±114.8 mmol/L, P=0.049; 1.44±0.48 vs. 0.73±0.32, P=0.040). There were a significant improve of HGS (24.3±5.7 kg vs. 27.3±7.3 kg, P=0.01), 4-m walking test (3.64±0.4 sec vs. 3.23±0.3 sec, P=0.04), and STS (10.2±2.3 sec vs. 9.0±1.9 sec, P=0.04) compared with baseline. In conclusion, these findings suggest that elastic resistance training improved glucose homeostasis, strength, and functionality in sarcopenic older adults.
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Affiliation(s)
- Bruna Spolador de Alencar Silva
- Skeletal Muscle Assessment Laboratory, Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Fábio Santos Lira
- Exercise and Immunometabolism Research Group, Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Fabrício Eduardo Rossi
- Immunometabolism of Skeletal Muscle and Exercise Research Group, Department of Physical Education, Federal University of Piaui (UFPI), Teresina, Brazil
| | - Marcelo Conrado de Freitas
- Skeletal Muscle Assessment Laboratory, Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Ana Paula Coelho Figueira Freire
- Department of Physical Therapy, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Vanessa Ribeiro Dos Santos
- Skeletal Muscle Assessment Laboratory, Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Luis Alberto Gobbo
- Skeletal Muscle Assessment Laboratory, Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
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Bernabe-Ortiz A, Perel P, Miranda JJ, Smeeth L. Diagnostic accuracy of the Finnish Diabetes Risk Score (FINDRISC) for undiagnosed T2DM in Peruvian population. Prim Care Diabetes 2018; 12:517-525. [PMID: 30131300 PMCID: PMC6249987 DOI: 10.1016/j.pcd.2018.07.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/23/2018] [Accepted: 07/29/2018] [Indexed: 12/18/2022]
Abstract
AIMS To assess the diagnostic accuracy of the Finnish Diabetes Risk Score (FINDRISC) for undiagnosed T2DM and to compare its performance with the Latin-American FINDRISC (LA-FINDRISC) and the Peruvian Risk Score. MATERIALS AND METHODS A population-based study was conducted. T2DM and undiagnosed T2DM were defined using oral glucose tolerance test (OGTT). Risk scores assessed were FINDRISC, LA-FINDRISC and Peruvian Risk Score. Diagnostic accuracy of risk scores was estimated using the c-statistic and the area under the ROC curve (aROC). A simplified version of FINDRISC was also derived. RESULTS Data from 1609 individuals, mean age 48.2 (SD: 10.6), 810 (50.3%) women, were collected. A total of 176 (11.0%; 95%CI: 9.4%-12.5%) were classified as having T2DM, and 71 (4.7%; 95%CI: 3.7%-5.8%) were classified as having undiagnosed T2DM. Diagnostic accuracy of the FINDRISC (aROC=0.69), LA-FINDRISC (aROC=0.68), and Peruvian Risk Score (aROC=0.64) was similar (p=0.15). The simplified FINDRISC, with 4 variables, had a slightly better performance (aROC=0.71) than the other scores. CONCLUSION The performance of FINDRISC, LA-FINDRISC and Peruvian Risk Score for undiagnosed T2DM was similar. A simplified FINDRISC can perform as well or better for undiagnosed T2DM. The FINDRISC may be useful to detect cases of undiagnosed T2DM in resource-constrained settings.
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Affiliation(s)
- Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima 18, Peru; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
| | - Pablo Perel
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
| | - Juan Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima 18, Peru; Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima 31, Peru.
| | - Liam Smeeth
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
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Xiao X, Li J, Yu T, Zhou L, Fan X, Xiao H, Wang Y, Yang L, Lv J, Jia X, Zhang Z. Bisphenol AP is anti-estrogenic and may cause adverse effects at low doses relevant to human exposure. Environ Pollut 2018; 242:1625-1632. [PMID: 30077407 DOI: 10.1016/j.envpol.2018.07.115] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 05/29/2018] [Revised: 07/07/2018] [Accepted: 07/24/2018] [Indexed: 05/25/2023]
Abstract
A recent increase in the use of bisphenol A (BPA) alternatives to manufacture plastics has led to safety concerns. Here, we evaluated the estrogenic and anti-estrogenic activities of bisphenol AP (BPAP), a poorly studied BPA alternative, using in vitro, in vivo and in silico tools. BPAP exhibited weak estrogenicity but strong anti-estrogenicity (IC50 = 2.35 μM) in a GeneBLAzer™ β-lactamase reporter gene assay. BPAP, when administered alone or in combination with E2 (50 μg kg-1 bw d-1) for 3 d, significantly decreased the uterine weights of post-weaning CD-1 mice at doses of 10 mg kg-1 bw d-1 and higher. When administered alone to prepubertal CD-1 mice for 10 d, BPAP significantly decreased the uterine weights at doses of 80 μg kg-1 bw d-1 and higher. Toxicogenomic analysis showed that BPAP regulated an opposite patterns of gene expression than that of E2 in mouse uteri. In a glucose tolerance test using male mice, BPAP was found to disrupt the blood glucose homeostasis at low doses relevant to human exposure (1 and 100 μg kg-1 bw d-1). Our results suggest that BPAP should be of great concern which might affect the sexual development in immature feminine and disrupt the blood glucose homeostasis at very low doses.
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Affiliation(s)
- Xuan Xiao
- College of Urban and Environmental Sciences, MOE Laboratory for Earth Surface Process, Peking University, Beijing, 100871, China
| | - Junyu Li
- College of Urban and Environmental Sciences, MOE Laboratory for Earth Surface Process, Peking University, Beijing, 100871, China
| | - Tong Yu
- College of Urban and Environmental Sciences, MOE Laboratory for Earth Surface Process, Peking University, Beijing, 100871, China
| | - Lei Zhou
- College of Urban and Environmental Sciences, MOE Laboratory for Earth Surface Process, Peking University, Beijing, 100871, China
| | - Xiaolin Fan
- College of Urban and Environmental Sciences, MOE Laboratory for Earth Surface Process, Peking University, Beijing, 100871, China
| | - Han Xiao
- College of Urban and Environmental Sciences, MOE Laboratory for Earth Surface Process, Peking University, Beijing, 100871, China
| | - Yue Wang
- College of Urban and Environmental Sciences, MOE Laboratory for Earth Surface Process, Peking University, Beijing, 100871, China
| | - Lei Yang
- College of Urban and Environmental Sciences, MOE Laboratory for Earth Surface Process, Peking University, Beijing, 100871, China
| | - Junhui Lv
- College of Urban and Environmental Sciences, MOE Laboratory for Earth Surface Process, Peking University, Beijing, 100871, China
| | - Xiaojing Jia
- College of Urban and Environmental Sciences, MOE Laboratory for Earth Surface Process, Peking University, Beijing, 100871, China
| | - Zhaobin Zhang
- College of Urban and Environmental Sciences, MOE Laboratory for Earth Surface Process, Peking University, Beijing, 100871, China.
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Åström MJ, von Bonsdorff MB, Perälä MM, Salonen MK, Rantanen T, Kajantie E, Simonen M, Pohjolainen P, Osmond C, Eriksson JG. Glucose regulation and physical performance among older people: the Helsinki Birth Cohort Study. Acta Diabetol 2018; 55:1051-1058. [PMID: 30032324 PMCID: PMC6150438 DOI: 10.1007/s00592-018-1192-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 07/11/2018] [Indexed: 12/25/2022]
Abstract
AIMS To assess whether disturbances in glucose regulation are associated with impairment in physical performance during a 10-year follow-up. METHODS 475 Men and 603 women from the Helsinki Birth Cohort Study were studied. Glucose regulation was evaluated with a 2-h 75-g oral glucose tolerance test (OGTT) in 2001-2004. Subjects were categorised as having either impaired fasting glucose (IFG), impaired glucose tolerance (IGT), newly diagnosed diabetes or previously known diabetes. Physical performance was assessed approximately 10 years later using the validated senior fitness test (SFT). The relationship between glucose regulation and the overall SFT score was estimated using multiple linear regression models. RESULTS The mean age was 70.8 years for men and 71.0 years for women when physical performance was assessed. The mean SFT score for the whole population was 45.0 (SD 17.5) points. The SFT score decreased gradually with increased impairment in glucose regulation. Individuals with previously known diabetes had the lowest overall SFT score in the fully adjusted model (mean difference compared to normoglycaemic individuals - 11.56 points, 95% CI - 16.15 to - 6.98, p < 0.001). Both individuals with newly diagnosed diabetes and individuals with IGT had significantly poorer physical performance compared to those with normoglycaemia. No significant difference in physical performance was found between those with IFG and those with normoglycaemia. CONCLUSIONS Among older people, impaired glucose regulation is strongly related with poor physical performance. More severe disturbances in glucose regulation are associated with a greater decrease in physical function, indicating the importance of diagnosing these disturbances at an early stage.
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Affiliation(s)
- Max J Åström
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, PO Box 20, 00014, Helsinki, Finland.
- Folkhälsan Research Center, Helsinki, Finland.
| | - Mikaela B von Bonsdorff
- Folkhälsan Research Center, Helsinki, Finland
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Mia M Perälä
- Folkhälsan Research Center, Helsinki, Finland
- Public Health Promotion Unit, Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Minna K Salonen
- Folkhälsan Research Center, Helsinki, Finland
- Public Health Promotion Unit, Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Taina Rantanen
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Eero Kajantie
- Public Health Promotion Unit, Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
- Hospital for Children and Adolescents, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Mika Simonen
- Finnish Centre of Excellence in Intersubjectivity and Interaction, University of Helsinki, Helsinki, Finland
| | | | - Clive Osmond
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, PO Box 20, 00014, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Public Health Promotion Unit, Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
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Schmid A, Albrecht J, Brock J, Koukou M, Arapogianni E, Schäffler A, Karrasch T. Regulation of natriuretic peptides postprandially in vivo and of their receptors in adipocytes by fatty acids in vitro. Mol Cell Endocrinol 2018; 473:225-234. [PMID: 29409758 DOI: 10.1016/j.mce.2018.01.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 01/29/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIM Natriuretic peptides (NPs) and their receptors gain attention regarding adipocyte function. It was the aim to investigate the expression of natriuretic peptide receptors NPR-A, NPR-B and NPR-C during adipocyte differentiation (AD), upon stimulation with fatty acids (FA), and in murine and human adipose tissue depots (AT) of patients undergoing bariatric surgery (n = 44). PATIENTS, MATERIAL AND METHODS The postprandial regulation of NT-proANP and NT-proBNP levels was measured by ELISA and was studied in two cohorts of healthy individuals undergoing an oral glucose tolerance test (OGTT) (n = 100) and an oral lipid tolerance test (OLTT) (n = 100). Adipocyte mRNA expression was investigated by quantitative real-time PCR. RESULTS During AD, an early expression pattern could be described for NPR-C, a bimodal expression for NPR-B and a late expression pattern for NPR-A. NPR-A and NPR-B expression was high in epididymal and subcutaneous AT but low in peri-renal AT of mice. NPR-C showed a differential expression profile. FA stimulation caused a significant and differential regulation of NPRs in adipocytes. Serum NT-proANP and NT-proBNP concentrations did not change during OGTT, whereas NT-proANP significantly declined during OLTT. Basal NT-proANP and NT-proBNP concentrations were positively correlated with each other and with FGF-19 and FGF-21 levels. CONCLUSION Adipocytes and AT show a characteristic expression of NPRs. FA are able to regulate NPR expression differentially. There is a postprandial and negative regulation of serum NT-proANP concentrations after OLTT and of NPR-A after FA stimulation. Both effects could represent a novel hypothetical negative feedback mechanism on adipocyte lipolysis.
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Affiliation(s)
- Andreas Schmid
- Department of Internal Medicine III, Giessen University Hospital, Germany.
| | - Jens Albrecht
- Department of Surgery, Giessen University Hospital, Germany
| | - Judith Brock
- Department of Internal Medicine III, Giessen University Hospital, Germany
| | - Maria Koukou
- Department of Internal Medicine III, Giessen University Hospital, Germany
| | | | - Andreas Schäffler
- Department of Internal Medicine III, Giessen University Hospital, Germany
| | - Thomas Karrasch
- Department of Internal Medicine III, Giessen University Hospital, Germany
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