Future risk of diabetes among Indians with metabolic and phenotypic obesity: Results from the 10-year follow-up of the Chennai Urban Rural Epidemiology Study (CURES-158)

Relationships between atherogenic index of plasma and body mass index with the risk of type 2 diabetes mellitus: insights from CHARLS

BACKGROUND

The complex relationship between obesity and dyslipidemia in type 2 diabetes mellitus (T2DM) remains an area of interest but is not fully understood. This study aimed to evaluate the intricate links between atherogenic index of plasma (AIP), body mass index (BMI), and T2DM risk.

METHODS

Based on data from the China Health and Retirement Longitudinal Study, this analysis comprised 6754 individuals aged 45 and over, free of T2DM in 2011. BMI and AIP were the exposures, with T2DM incidence as the primary focus. Logistic regression models generated odds ratios (ORs), and a thorough decomposition of BMI's impact on T2DM revealed natural indirect and direct effects. The study also examined the complex interactions and combined effects of these two exposures.

RESULTS

By the end of 2018, 972 individuals were diagnosed with T2DM. The AIP played a significant association in the relationship between BMI and T2DM, explaining 21.7% and 18.9% of the association in different BMI ranges. A significant additive effect was observed between BMI and AIP, with a relative excess risk due to interaction of 0.62. BMI ≥ 24.0 kg/m2 and AIP above the median together conferred the highest risk of T2DM, with an OR of 2.31 and a 95% confidence interval (CI) of 1.92-2.79.

CONCLUSION

Exposure to overweight/obesity or high AIP raises T2DM risk among Chinese ≥ 45 years, AIP partly mediates BMI-T2DM link.

Understanding the predictive accuracy of the InsuTAG index over other surrogate indices in normoglycaemic, non-obese males from Southern India

We aimed to evaluate the predictive accuracy of InsuTAG index against M value of the hyperinsulinaemic-Euglycaemic clamp (HEC) procedure and fasting surrogate indices of insulin sensitivity/resistance in young, normoglycaemic, Asian Indian males. HEC studies were done in young (mean age 19.7 ± 1 years), non-obese (mean BMI 19.2 ± 2.6 kg/m2), normoglycemic Asian Indian males (n = 110) and the M value was calculated. Surrogate indices namely InsuTAG index, HOMA-IR, FG-IR, QUICKI and McAuley index were calculated. Pearson's correlation and ROC-AUC at 95% CI were applied. Significant negative correlation was observed for InsuTAG index with the M value (r - 0.23, p = 0.01), McAuley index (r - 0.65, p < 0.01), QUICKI (r - 0.34, p < 0.01) and FGIR (r - 0.35, p < 0.01). Significant positive correlations of InsuTAG index were observed for BMI and waist circumference. The ROC-AUC was higher for InsuTAG index (0.75) than FGIR (0.30), QUICKI (0.31), and McAuley index (0.20). The InsuTAG cut-off value ≥ 19.13 showed 66.7% sensitivity and 69.2% specificity in this study group.

Serum oxidized low density lipoprotein serves as a mediator for the inverse relationship between serum d-ribose and cognitive performance in type 2 diabetic patients

Chronic hyperglycemia, proinflammatory state, and oxidative stress are implicated in the etiology of mild cognitive impairment (MCI) in type 2 diabetes mellitus (T2DM) patients. However, roles and mechanisms of the diabetes-related dys-regulation of serum d-ribose in the pathogenesis remain unclear. This study was to assess: 1) changes of serum d-ribose in T2DM patients with or without MCI compared with healthy controls; and 2) associations of serum d-ribose with key biomarkers of ribosylation [advanced glycation end products (AGEs) and receptor for advanced glycation end products (RAGE)], inflammation (IL-6 and NF-κB) and oxidative stress [oxidized low density lipoproteins (ox-LDL), advanced oxidation protein products (AOPP), total thiol, and non-protein thiol)]. A cross-sectional study was conducted with 1564 initial participants including 362 T2DM patients. Based on their fasting blood glucose concentrations and Montreal cognitive assessment (MoCA) scores, we selected 89 participants and divided them into three groups: 27 healthy controls, 26 T2DM patients with normal cognition, 36 T2DM patients with MCI. All participants were gone through standard anthropometric tests and biochemical examinations of serum clinical profiles and concentrations of d-ribose, AGE, RAGE, IL-6, NF-κB, ox-LDL, AOPP, total thiol, and non-protein thiol. Serum concentrations of d-ribose, ox-LDL, and AOPP were greater (P < 0.05) in the T2DM-MCI patients than that in the T2DM or controls. Serum d-ribose exhibited a positive correlation (P < 0.05) with serum AGEs, RAGE, ox-LDL, and fasting blood glucose, but a negative correlation (P < 0.05) with MoCA score. This negative relationship remained (P < 0.05) after adjusting various covariates, and was found to be mediated (P < 0.05) by serum ox-LDL. In conclusion, our results reveal serum ox-LDL as a potential mediator for the inverse relationship between the elevation of serum d-ribose concentration and the decline of cognitive performance in the T2DM-MCI patients.