1
|
Wang S, Niu Y, Zhang H, Zhao Z, Zhang X. Metabolomic alterations in healthy adults traveling to low-pollution areas: A natural experiment with ozone exposure. Sci Total Environ 2023; 897:165501. [PMID: 37442463 DOI: 10.1016/j.scitotenv.2023.165501] [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] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 07/15/2023]
Abstract
Numerous epidemiological studies have demonstrated links between short-term ozone exposure to various adverse health outcomes, but some ozone-induced pathological mechanisms remain unclear. To fill this knowledge gap, we enrolled 36 healthy young adults living in high-ozone areas and performed an untargeted metabolomic analysis in serum collected before, during, and after their travel to a low-ozone scenic area. Reviewing the literature, we found 16 metabolites significantly associated with ozone, pointing to neurological health, type 2 diabetes (T2D) risk, and cardiovascular health. Notably, we observed significant changes in these 16 metabolites from the ozone reduction when participants traveled from the campus to the scenic area (adjusted p-value < 0.05). However, when ozone increased after participants returned to campus from the scenic area, we observed that T2D risk and cardiovascular health-related metabolites returned to their original state (adjusted p-value < 0.05), but neurological health-related metabolites did not change significantly with ozone exposure. Our study showed that ozone exposure was linked to prompt alterations in serum metabolites related to cardiovascular health and T2D risk but less sensitive changes in neurological health-related metabolites. Among many lipids, free fatty acids and acylcarnitines were the most sensitive compounds positively associated with changes in ozone exposure.
Collapse
Affiliation(s)
- Shengchun Wang
- Institute of Environmental Science, Shanxi University, Taiyuan 030006, China
| | - Yue Niu
- Department of Environmental Health, School of Public Health, Fudan University, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Shanghai 200032, China
| | - Huilin Zhang
- Institute of Environmental Science, Shanxi University, Taiyuan 030006, China
| | - Zhuohui Zhao
- Department of Environmental Health, School of Public Health, Fudan University, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Shanghai 200032, China.
| | - Xin Zhang
- Institute of Environmental Science, Shanxi University, Taiyuan 030006, China.
| |
Collapse
|
2
|
Huffman KM, Parker DC, Bhapkar M, Racette SB, Martin CK, Redman LM, Das SK, Connelly MA, Pieper CF, Orenduff M, Ross LM, Ramaker ME, Dorling JL, Rosen CJ, Shalaurova I, Otvos JD, Kraus VB, Kraus WE. Calorie restriction improves lipid-related emerging cardiometabolic risk factors in healthy adults without obesity: Distinct influences of BMI and sex from CALERIE™ a multicentre, phase 2, randomised controlled trial. EClinicalMedicine 2022; 43:101261. [PMID: 35028547 PMCID: PMC8741476 DOI: 10.1016/j.eclinm.2021.101261] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/06/2021] [Accepted: 12/17/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND For many cardiovascular risk factors there is no lower limit to which further reduction will result in decreased disease risk; this includes values within ranges considered normal for healthy adults. This seems to be true for new emerging metabolic risk factors identified by innovative technological advances. Further, there seems to be ever evolving evidence of differential responses to lifestyle interventions by sex and body compositions in the normal range. In this secondary analysis, we had the opportunity to test these principles for newly identified molecular biomarkers of cardiometabolic risk in a young (21-50 years), normal weight healthy population undergoing calorie restriction for two years. METHODS The Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE™) was a 24-month, multicenter, randomized controlled trial (May 2007-November 2012) in healthy, adults without obesity to evaluate the potential for calorie restriction (CR) to promote anti-aging adaptations, including those associated with disease risk. 218 participants (age 37.9 ± 7.2 years and body mass index (BMI) 25.1 ± 1.7 kg/m2, mean±SD) were randomized 2:1 to 24 months of CR (prescribed as 25% reduction from baseline calorie intake) versus ad libitum (AL). Fasting plasma from baseline, 12, and 24 months was used for assessments of lipoproteins, metabolites, and inflammatory markers using nuclear magnetic resonance spectroscopy. FINDINGS Averaging 11.9% CR, the CR group had reductions at 12 and 24 months in the cardiovascular disease risk markers, apolipoprotein B and GlycA, and risks for insulin resistance and type 2 diabetes-Lipoprotein Insulin Resistance Index and Diabetes Risk Index (all PCRvsAL ≤0.0009). Insulin resistance and diabetes risk improvements resulted from CR-induced alterations in lipoproteins, specifically reductions in triglyceride-rich lipoprotein particles and low-density lipoprotein particles, a shift to larger high-density lipoprotein particles (more effective cholesterol transporters), and reductions in branched chain amino acids (BCAAs) (all PCRvsAL ≤0.004). These CR responses were more pronounced in overweight than normal weight participants and greater in men than women. INTERPRETATION In normal to slightly overweight adults without overt risk factors or disease, 12 months of ∼12% CR improved newly identified risk markers for atherosclerotic cardiovascular disease, insulin resistance and type 2 diabetes. These markers suggest that CR improves risks by reducing inflammation and BCAAs and shifting lipoproteins from atherogenic to cholesterol transporting. Additionally, these improvements are greater for men and for those with greater BMIs indicating sex and BMI-influences merit attention in future investigations of lifestyle-mediated improvements in disease risk factors. FUNDING The CALERIE™ trial design and implementation were supported by a National Institutes of Health (NIH) U-grant provided to four institutions, the three intervention sites and a coordinating center (U01 AG022132, U01 AG020478, U01 AG020487 U01 AG020480). For this secondary analysis including sample acquisition and processing, data analysis and interpretation, additional funding was provided by the NIH to authors as follows: R01 AG054840 (MO, VBK); R33 AG070455 (KMH, DCP, MB, SBR, CKM, LMR, SKD, CFP, CJR, WEK); P30 DK072476 (CKM, LMR); and U54 GM104940 (CKM, LMR).
Collapse
Affiliation(s)
- Kim M. Huffman
- Divisions of Rheumatology and Immunology, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Corresponding author.
| | - Daniel C. Parker
- Geriatrics, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Manjushri Bhapkar
- Duke Clinical Research Institute, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Susan B. Racette
- Program in Physical Therapy and Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | | | | | - Sai Krupa Das
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | | | - Carl F. Pieper
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - Melissa Orenduff
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Leanna M. Ross
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Megan E. Ramaker
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - James L. Dorling
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Clifford J Rosen
- Maine Medical Center Research Institute 81 Research Drive Scarborough, Maine 04074 USA
| | - Irina Shalaurova
- Laboratory Corporation of America Holdings (Labcorp), Morrisville, NC, USA
| | - James D. Otvos
- Laboratory Corporation of America Holdings (Labcorp), Morrisville, NC, USA
| | - Virginia B. Kraus
- Divisions of Rheumatology and Immunology, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - William E. Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Division of Cardiology, Duke University School of Medicine, Durham, NC, USA
| | | |
Collapse
|
3
|
Zhang Z, Lai M, Piro AL, Alexeeff SE, Allalou A, Röst HL, Dai FF, Wheeler MB, Gunderson EP. Intensive lactation among women with recent gestational diabetes significantly alters the early postpartum circulating lipid profile: the SWIFT study. BMC Med 2021; 19:241. [PMID: 34620173 PMCID: PMC8499506 DOI: 10.1186/s12916-021-02095-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 05/10/2021] [Accepted: 08/12/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Women with a history of gestational diabetes mellitus (GDM) have a 7-fold higher risk of developing type 2 diabetes (T2D). It is estimated that 20-50% of women with GDM history will progress to T2D within 10 years after delivery. Intensive lactation could be negatively associated with this risk, but the mechanisms behind a protective effect remain unknown. METHODS In this study, we utilized a prospective GDM cohort of 1010 women without T2D at 6-9 weeks postpartum (study baseline) and tested for T2D onset up to 8 years post-baseline (n=980). Targeted metabolic profiling was performed on fasting plasma samples collected at both baseline and follow-up (1-2 years post-baseline) during research exams in a subset of 350 women (216 intensive breastfeeding, IBF vs. 134 intensive formula feeding or mixed feeding, IFF/Mixed). The relationship between lactation intensity and circulating metabolites at both baseline and follow-up were evaluated to discover underlying metabolic responses of lactation and to explore the link between these metabolites and T2D risk. RESULTS We observed that lactation intensity was strongly associated with decreased glycerolipids (TAGs/DAGs) and increased phospholipids/sphingolipids at baseline. This lipid profile suggested decreased lipogenesis caused by a shift away from the glycerolipid metabolism pathway towards the phospholipid/sphingolipid metabolism pathway as a component of the mechanism underlying the benefits of lactation. Longitudinal analysis demonstrated that this favorable lipid profile was transient and diminished at 1-2 years postpartum, coinciding with the cessation of lactation. Importantly, when stratifying these 350 women by future T2D status during the follow-up (171 future T2D vs. 179 no T2D), we discovered that lactation induced robust lipid changes only in women who did not develop incident T2D. Subsequently, we identified a cluster of metabolites that strongly associated with future T2D risk from which we developed a predictive metabolic signature with a discriminating power (AUC) of 0.78, superior to common clinical variables (i.e., fasting glucose, AUC 0.56 or 2-h glucose, AUC 0.62). CONCLUSIONS In this study, we show that intensive lactation significantly alters the circulating lipid profile at early postpartum and that women who do not respond metabolically to lactation are more likely to develop T2D. We also discovered a 10-analyte metabolic signature capable of predicting future onset of T2D in IBF women. Our findings provide novel insight into how lactation affects maternal metabolism and its link to future diabetes onset. TRIAL REGISTRATION ClinicalTrials.gov NCT01967030 .
Collapse
Affiliation(s)
- Ziyi Zhang
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Endocrinology, Sir Run Run Shaw Hospital, Zhejiang University, Zhejiang, Hangzhou, China
| | - Mi Lai
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Anthony L Piro
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stacey E Alexeeff
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Amina Allalou
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Hannes L Röst
- Donnelly Centre for Cellular and Biomolecular Research, University of Toronto, Toronto, Ontario, Canada
| | - Feihan F Dai
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - Michael B Wheeler
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
- Metabolism Research Group, Division of Advanced Diagnostics, Toronto General Research Institute, Toronto, Ontario, Canada.
| | - Erica P Gunderson
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.
- Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, USA.
| |
Collapse
|
4
|
Abstract
PURPOSE OF REVIEW The aim of this study is to summarize anthropometric and advanced methods used to assess body composition in adults diagnosed with type 2 diabetes (T2D) or at risk for T2D that provide clinically relevant information about T2D disease-related complications or risk factors. RECENT FINDINGS Anthropometry is commonly used in clinical settings; however, provides unreliable estimates of fat mass, fat-free mass, and body fat distribution for metabolic health assessments compared to advanced techniques such as bioelectrical impedance analysis (BIA), dual-energy x-ray absorptiometry (DXA), computerized tomography (CT), and magnetic resonance imaging (MRI). Few studies report the clinical use of anthropometric and advanced body composition methods that identify T2D disease-related complications or T2D risk factors. Anthropometry, BIA, DXA, CT, and MRI were used to estimate body adiposity and distribution, visceral and subcutaneous adipose tissue depots, and skeletal muscle mass. Review findings indicate that these methods were capable of identifying clinically relevant T2D disease-related complications such as sarcopenia and T2D risk factors such as obesity or regional adiposity. However, estimates were often sex and race/ethnicity specific warranting cross-validation of these methods in broader populations with T2D or risk for T2D prior to clinical implementation.
Collapse
Affiliation(s)
- Nadia Markie Sneed
- School of Nursing, Office of Research and Scholarship, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Shannon A Morrison
- School of Nursing, Department of Family, Community Health, and Systems, University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
5
|
Wu IH, Heredia N, Dong Q, McNeill LH, Balachandran DD, Lu Q, Chang S. Sleep duration and type 2 diabetes risk: A prospective study in a population-based Mexican American cohort. Sleep Health 2021; 7:168-176. [PMID: 33582048 DOI: 10.1016/j.sleh.2020.12.003] [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] [Received: 04/14/2020] [Revised: 12/03/2020] [Accepted: 12/09/2020] [Indexed: 12/20/2022]
Abstract
STUDY OBJECTIVES The primary aim of the study was to estimate the effect of sleep duration on prospective type 2 diabetes (T2D) risk across demographic characteristics and follow-up periods, and test body mass index (BMI) as a mediator and moderator. METHODS Data included adults (Mage = 39.0 ± 12.7 years) born in the United States or Mexico recruited from 2001 to 2012 in a Mexican American cohort study conducted in Houston, TX (n = 15,779). Participants completed self-reported questionnaires at baseline related to health, health behaviors (sleep duration, physical activity, smoking, drinking), and sociocultural factors and were followed up annually. RESULTS Cox proportional hazard models estimated hazard ratios (HR) for the effect of sleep duration on T2D diagnosis at follow-up. Of the participants, 10.3% were diagnosed with T2D. Self-reported ≤5 hours of sleep, compared to 7-8 hours, at baseline predicted greater risk for T2D (HR = 1.32, P = .001), yet was no longer significant after adjusting for sociodemographic characteristics and BMI. Notably, those with BMI <25 kg/m2 reporting ≤5 hours of sleep were at significant risk for T2D at 3 (HR = 4.13, P = .024) and 5-year follow-up (HR = 3.73, P = .008) compared to 7-8 hours. Obesity status accounted for 31.6% and 27.3% of the variance in the association between ≤5 and 6 hours of sleep and increased T2D risk, respectively. CONCLUSIONS Results highlighted the mediating and moderating role of BMI, and its effect on T2D risk at earlier follow-up among those without obesity. T2D prevention and control for Mexican American adults should consider the role of chronic sleep loss.
Collapse
Affiliation(s)
- Ivan Hc Wu
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
| | - Natalia Heredia
- Department of Health Promotion & Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas, USA
| | - Qiong Dong
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lorna H McNeill
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Diwakar D Balachandran
- Department of Pulmonary Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Qian Lu
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Shine Chang
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
6
|
Abstract
Social support and strain have been linked with many health outcomes. However, less is known about whether these psychosocial factors are associated with Type 2 diabetes risk. This study uses the Midlife in the United States (MIDUS) dataset to examine the relationship between social support and strain from friends, family members, and spouse/partners and blood hemoglobin A1c levels in married/cohabiting adults who have not been diagnosed with diabetes. In addition, health locus of control is examined as a possible mediator. The study's findings suggest that support from friends is negatively associated with HbA1c levels, indicating a relationship between better glycemic control and social support from friends, and an indirect association for spouse/partner support. A direct effect for internal health locus of control was also found.
Collapse
|
7
|
Mellor DD, Georgousopoulou EN, D'Cunha NM, Naumovski N, Chrysohoou C, Tousoulis D, Pitsavos C, Panagiotakos DB. Association between lipids and apolipoproteins on type 2 diabetes risk; moderating effects of gender and polymorphisms; the ATTICA study. Nutr Metab Cardiovasc Dis 2020; 30:788-795. [PMID: 32127339 DOI: 10.1016/j.numecd.2020.01.008] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/14/2019] [Accepted: 01/07/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Type 2 diabetes mellitus (T2DM) is a condition defined by hyperglycaemia, but also often presents with dyslipidaemia and suppressed HDL cholesterol. Mendelian randomization studies have suggested a causal link between low HDL cholesterol and T2DM. However, influences of gender, polymorphisms and lifestyle, all known to influence HDL cholesterol, have not been fully explored in a prospective cohort. METHODS AND RESULTS In 2001-2002, a random sample of 1514 males (18-87 years old) and 1528 females (18-89 years old) were recruited in the ATTICA study. The 10-year follow-up (2011-2012) included 1485 participants. Lipids and lipoproteins levels, glucose and insulin levels were measured together with apolipoprotein A1 (apoA1) 75 G/A genotype, which is known to influence HDL-cholesterol. In total, 12.9% of the study sample developed T2DM within the 10-year follow-up period. In multivariable models, for each mg/dL increase in apoA1 levels in males, 10-year T2DM risk decreased 1.02%; while every unit increase in apoB/LDL-cholesterol ratio increased risk 4-fold. Finally, for every unit increase in triglycerides/apoA1 ratio, the risk increased 85%. HOMA-IR independently predicted T2DM 10-year incidence only for carriers of GG polymorphism (all, p < 0.05), but not in carriers of the GA polymorphism (all, p > 0.05). CONCLUSION ApoA1 was associated with decreased T2DM risk and TG/ApoA1 and apoB/LDL were associated with increased risk of T2DM, only in males. ApoA1 polymorphism, which is associated with lower HDL cholesterol, influenced the predictive effects of HOMA-IR on T2DM incidence, which appeared to be moderated by physical activity, suggesting potential scope for more targeted preventative strategies.
Collapse
Affiliation(s)
- Duane D Mellor
- Aston Medical School, Aston University, Birmingham, B4 7ET, United Kingdom
| | - Ekavi N Georgousopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Medical School, Australian National University, Canberra, Australia; School of Medicine, The University of Notre Dame Australia, Sydney, Australia
| | | | - Nenad Naumovski
- Faculty of Health, University of Canberra, Canberra, Australia
| | - Christina Chrysohoou
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Dimitrios Tousoulis
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Faculty of Health, University of Canberra, Canberra, Australia; Department of Kinesiology and Health, Rutgers University, New Jersey, USA.
| |
Collapse
|
8
|
Adolf C, Berends AMA, Connelly MA, Reincke M, Dullaart RPF. Lipoprotein insulin resistance score and branched-chain amino acids increase after adrenalectomy for unilateral aldosterone-producing adenoma: a preliminary study. Endocrine 2020; 68:420-426. [PMID: 32133607 PMCID: PMC7266834 DOI: 10.1007/s12020-020-02235-2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 02/18/2020] [Indexed: 12/02/2022]
Abstract
BACKGROUND AND AIMS Primary aldosteronism (PA) due to unilateral aldosterone-producing adenoma (APA) is preferentially treated by unilateral adrenalectomy (ADX), but little is known about the changes in lipid and glucose metabolism that may occur after ADX. METHODS We studied 19 non-diabetic patients who did not use lipid-lowering drugs with PA due to APA before and 6 months after unilateral ADX. Fasting plasma lipids, lipoprotein subfractions, branched-chain amino acids (BCAA), and GlycA, a pro-inflammatory glycoprotein biomarker, were measured by nuclear magnetic resonance (NMR) spectroscopy. The Lipoprotein Insulin Resistance (LP-IR) score, which is based on six lipoprotein variables, was calculated. RESULTS In all patients, hyperaldosteronism was resolved after ADX. Body mass index and fasting plasma glucose were unchanged, but HbA1c increased (p = 0.002). Plasma triglycerides, large triglyceride-rich lipoprotein (TRL) cholesterol, and large TRL particles were increased (p < 0.01), resulting in an increase in TRL size (p = 0.027). High-density lipoprotein size was decreased (p = 0.015). LP-IR scores (p = 0.001) and total BCAA (p = 0.017) were increased, but GlycA remained unaltered. CONCLUSIONS Based on increases in LP-IR scores and BCAA, which each have been shown to predict new onset type 2 diabetes mellitus independent of conventional risk factors in the general population, this preliminary study suggests that diabetes risk is not improved but may even be increased after ADX for APA despite remission of PA.
Collapse
Affiliation(s)
- Christian Adolf
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, 80336, Munich, Germany
| | - Annika M A Berends
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Margery A Connelly
- Laboratory Corporation of America Holdings (LabCorp), Morrisville, NC, USA
| | - Martin Reincke
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, 80336, Munich, Germany
| | - Robin P F Dullaart
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
9
|
Følling IS, Solbjør M, Midthjell K, Kulseng B, Helvik AS. Exploring lifestyle and risk in preventing type 2 diabetes-a nested qualitative study of older participants in a lifestyle intervention program (VEND-RISK). BMC Public Health 2016; 16:876. [PMID: 27557801 PMCID: PMC4997726 DOI: 10.1186/s12889-016-3559-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 02/25/2016] [Accepted: 08/19/2016] [Indexed: 11/25/2022] Open
Abstract
Background Lifestyle intervention may reduce the development of type 2 diabetes among high-risk individuals. The aim of this study was to explore how older adults perceived their own lifestyle and being at increased risk for type 2 diabetes while they participated in a lifestyle intervention programme. Methods A nested qualitative study was performed with 26 participants (mean age 68 years) in the VEND-RISK Study. Participants had previously participated in the HUNT3 Study and the HUNT DE-PLAN Study, where their risk for developing type 2 diabetes (FIND-RISC ≥ 15) had been identified. The data were analysed using systematic text condensation. Results Two main themes were identified. The first theme was having resources available for an active lifestyle, which included having a family and being part of a social network, having a positive attitude toward life, and maintaining established habits from childhood to the present. The second theme was being at increased risk for type 2 diabetes, which included varied reactions to the information on increased risk, how lifestyle intervention raised awareness about risk behaviour, and health-related worries and ambitions as type 2 diabetes prevention. Conclusions Assessing a participant’s resources could improve the outcomes of lifestyle intervention programmes. Both family history and risk perception could be used in preventive strategies to enhance changes in lifestyle. Trial registration The VEND-RISK Study was registered in ClinicalTrials.gov on April 26, 2010, with the registration number NCT01135901.
Collapse
Affiliation(s)
- Ingrid S Følling
- Department of Health Sciences, Nord University, Røstad, N-7600, Levanger, Norway. .,Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Postboks 8905, MTFS, 7491, Trondheim, Norway.
| | - Marit Solbjør
- St. Olavs University Hospital, Trondheim, Norway.,Department of Social Work and Health Science, Faculty of Social Sciences and Technology Management, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Kristian Midthjell
- Department of Community Health and General Practice, HUNT Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bård Kulseng
- Obesity Research Centre, St. Olavs University Hospital, Forsyningssenteret, 7006, Trondheim, Norway.,Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Postboks 8905, N-7491, Trondheim, Norway
| | - Anne-S Helvik
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Postboks 8905, MTFS, 7491, Trondheim, Norway.,St. Olavs University Hospital, Trondheim, Norway.,Norwegian National Advisory Unit for Aging and Health, Vestfold Health Trust, Tønsberg, 3103, Norway
| |
Collapse
|
10
|
Thomas JJ, Moring JC, Harvey T, Hobbs T, Lindt A. Risk of type 2 diabetes: health care provider perceptions of prevention adherence. Appl Nurs Res 2016; 32:1-6. [PMID: 27969010 DOI: 10.1016/j.apnr.2016.03.002] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 03/11/2016] [Accepted: 03/18/2016] [Indexed: 01/15/2023]
Abstract
The aim of the current study was to describe health care providers' perceptions as to why individuals may or may not follow recommendations for reducing risk of developing type 2 diabetes. A grounded theory research design guided data collection and analysis. Data were collected from 16 health care providers through semi-structured interviews. Results demonstrated that health care providers perceived prevention adherence as related to individual characteristics of the patient and activities of the provider. Specifically, providers described assessment of patient-based characteristics associated with behavior, context, and traits. In addition, providers discussed giving attention to the patient-provider relationship and helping the patient incorporate small lifestyle changes. Providers might utilize social cognitive theory to understand personal and socio-structural aspects of adherence. In addition, providers should focus assessment and relationship building efforts on factors that support self-efficacy.
Collapse
Affiliation(s)
- Jenifer J Thomas
- Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY 82071-2000, USA.
| | - John C Moring
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-2994, USA.
| | - Terra Harvey
- Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY 82071-2000, USA
| | - Talisha Hobbs
- Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY 82071-2000, USA
| | - Adara Lindt
- Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY 82071-2000, USA
| |
Collapse
|