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Byeon H. Exploring the risk factors of impaired fasting glucose in middle-aged population living in South Korean communities by using categorical boosting machine. Front Endocrinol (Lausanne) 2022; 13:1013162. [PMID: 36246911 PMCID: PMC9556903 DOI: 10.3389/fendo.2022.1013162] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
Objective This epidemiological study (1) identified factors associated with impaired fasting glucose using 3,019 subjects (≥30 years old and <60 years old) without diabetes mellitus from national survey data and (2) developed a nomogram that could predict groups vulnerable to impaired fasting glucose by using machine learning. Methods This study analyzed 3,019 adults between 30 and 65 years old who completed blood tests, physical measurements, blood pressure measurements, and health surveys. Impaired fasting glucose, a dependent variable, was classified into normal blood glucose (glycated hemoglobin<5.7% and fasting blood glucose ≤ 100mg/dl) and impaired fasting glucose (glycated hemoglobin is 5.7-6.4% and fasting blood glucose is 100-125mg/dl). Explanatory variables included socio-demographic factors, health habit factors, anthropometric factors, dietary habit factors, and cardiovascular disease risk factors. This study developed a model for predicting impaired fasting glucose by using logistic nomogram and categorical boosting (CatBoost). Results In this study, the top eight variables with a high impact on CatBoost model output were age, high cholesterol, WHtR, BMI, drinking more than one shot per month for the past year, marital status, hypertension, and smoking. Conclusion It is necessary to improve lifestyle and continuously monitor subjects at the primary medical care level so that we can detect non-diabetics vulnerable to impaired fasting glucose living in the community at an early stage and manage their blood glucose.
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Affiliation(s)
- Haewon Byeon
- Department of Digital Anti-aging Healthcare (BK21), Graduate School of Inje University, Gimhae, South Korea
- Department of Medical Big Data, College of AI Convergence, Inje University, Gimhae, South Korea
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Roh E, Noh E, Hwang SY, Kim JA, Song E, Park M, Choi KM, Baik SH, Cho GJ, Yoo HJ. Increased Risk of Type 2 Diabetes in Patients With Thyroid Cancer After Thyroidectomy: A Nationwide Cohort Study. J Clin Endocrinol Metab 2022; 107:e1047-e1056. [PMID: 34718625 DOI: 10.1210/clinem/dgab776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Abnormal thyroid function after thyroidectomy and subsequent thyroid-stimulating hormone suppression can have detrimental effects on glucose homeostasis in patients with thyroid cancer. OBJECTIVE To investigate whether thyroidectomy increases the risk of type 2 diabetes in patients with thyroid cancer and to explore the association between levothyroxine dosage and type 2 diabetes risk. METHODS A retrospective population-based cohort study using the Korean National Health Insurance database. We included 36 377 thyroid cancer patients without known diabetes who underwent thyroidectomy between 2004 and 2013. Matched subjects with nonthyroid cancer were selected using 1:1 propensity score matching. The main outcome measure was newly developed type 2 diabetes mellitus. RESULTS Patients with thyroid cancer who underwent thyroidectomy had a higher risk of developing type 2 diabetes mellitus than the matched controls (hazard ratio [HR] 1.43, 95% CI 1.39-1.47). Among patients with thyroid cancer, when the second quartile group (in terms of the mean levothyroxine dosage; 101-127 μg/day) was considered the reference group, the risk of type 2 diabetes mellitus increased in the first quartile (<101 μg/day; HR 1.45, 95% CI 1.36-1.54) and fourth quartile groups (≥150 μg/day; HR 1.37, 95% CI 1.29-1.45); meanwhile, the risk decreased in the third quartile group (128-149 μg/day; HR 0.91, 95% CI 0.85-0.97). CONCLUSION Patients with thyroid cancer who underwent thyroidectomy were more likely to develop type 2 diabetes mellitus than the matched controls. There was a U-shaped dose-dependent relationship between the levothyroxine dosage and type 2 diabetes mellitus risk.
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Affiliation(s)
- Eun Roh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul 03803, Korea
| | - Eunjin Noh
- Smart Healthcare Center, Korea University Guro Hospital, Seoul 03803, Korea
| | - Soon Young Hwang
- Department of Biostatistics, Korea University College of Medicine, Seoul 03803, Korea
| | - Jung A Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul 03803, Korea
| | - Eyun Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul 03803, Korea
| | - Minjeong Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul 03803, Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul 03803, Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul 03803, Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 03803, Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul 03803, Korea
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Li D, Li Y, Wang C, Jiang H, Zhao L, Hong X, Lin M, Luan Y, Shen X, Chen Z, Zhang W. Elevation of Hemoglobin A1c Increases the Atherosclerotic Plaque Vulnerability and the Visit-to-Visit Variability of Lipid Profiles in Patients Who Underwent Elective Percutaneous Coronary Intervention. Front Cardiovasc Med 2022; 9:803036. [PMID: 35187124 PMCID: PMC8852677 DOI: 10.3389/fcvm.2022.803036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/11/2022] [Indexed: 02/05/2023] Open
Abstract
Background Increased plaque vulnerability and higher lipid variability are causes of adverse cardiovascular events. Despite a close association between glucose and lipid metabolisms, the influence of elevated glycated hemoglobin A1c (HbA1c) on plaque vulnerability and lipid variability remains unclear. Methods Among subjects undergoing percutaneous coronary intervention (PCI) from 2009 through 2019, 366 patients received intravascular optical coherence tomography (OCT) assessment and 4,445 patients underwent the scheduled follow-ups within 1 year after PCI. Vulnerability features of culprit vessels were analyzed by OCT examination, including the assessment of lipid, macrophage, calcium, and minimal fibrous cap thickness (FCT). Visit-to-visit lipid variability was determined by different definitions including standard deviation (SD), coefficient of variation (CV), and variability independent of the mean (VIM). Multivariable linear regression analysis was used to verify the influence of HbA1c on plaque vulnerability features and lipid variability. Exploratory analyses were also performed in non-diabetic patients. Results Among enrolled subjects, the pre-procedure HbA1c was 5.90 ± 1.31%, and the average follow-up HbA1c was 5.98 ± 1.16%. By OCT assessment, multivariable linear regression analyses demonstrated that patients with elevated HbA1c had a thinner minimal FCT (β = −6.985, P = 0.048), greater lipid index (LI) (β = 226.299, P = 0.005), and higher macrophage index (β = 54.526, P = 0.045). Even in non-diabetic patients, elevated HbA1c also linearly decreased minimal FCT (β = −14.011, P = 0.036), increased LI (β = 290.048, P = 0.041) and macrophage index (β = 120.029, P = 0.048). Subsequently, scheduled follow-ups were performed during 1-year following PCI. Multivariable linear regression analyses proved that elevated average follow-up HbA1c levels increased the VIM of lipid profiles, including low-density lipoprotein cholesterol (β = 2.594, P < 0.001), high-density lipoprotein cholesterol (β = 0.461, P = 0.044), non-high-density lipoprotein cholesterol (β = 1.473, P < 0.001), total cholesterol (β = 0.947, P < 0.001), and triglyceride (β = 4.217, P < 0.001). The result was consistent in non-diabetic patients and was verified when SD and CV were used to estimate variability. Conclusion In patients undergoing elective PCI, elevated HbA1c increases the atherosclerotic plaque vulnerability and the visit-to-visit variability of lipid profiles, which is consistent in non-diabetic patients.
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Affiliation(s)
- Duanbin Li
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Ya Li
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Cao Wang
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
- Department of Cardiology, Haiyan People's Hospital, Jiaxing, China
| | - Hangpan Jiang
- Department of Cardiology, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Yiwu, China
| | - Liding Zhao
- Department of Cardiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xulin Hong
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Maoning Lin
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Yi Luan
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Xiaohua Shen
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
- *Correspondence: Wenbin Zhang
| | - Zhaoyang Chen
- Department of Cardiology, Union Hospital, Fujian Medical University, Fuzhou, China
- Zhaoyang Chen
| | - Wenbin Zhang
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
- Xiaohua Shen
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Laryushina Y, Parakhina V, Turgunova L, Sheryazdanova D, Dosmagambetova R, Turmukhambetova A, Ponamareva O, Orbetzova M. Association of Plasminogen Activator Inhibitor-1 and Cardiovascular Events Development in Patients with Prediabetes. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background. Plasminogen activator inhibitor-1(PAI-1) is a marker of endothelial dysfunction(ED) and a predictor of both the development of type 2 diabetes mellitus, and a cardiovascular event(CVE). Its role in the CVE development was sufficiently studied in patients without carbohydrate metabolism disorders, and understudied in patients with prediabetes.
Aim: the research interest is the study of PAI-1 in patients with prediabetes and its effect on the CVE development.
Materials and methods. The case-control study of 168 patients aged from 18 to 65 was carried out among the local population from January to December 2019.After clinical examination, patients were divided into 3 groups: group 1 (n=55)– patients with prediabetes and with CVE; group 2 (n=93) - patients with prediabetes and without CVE; the control group n=20.
Results. Differences in PAI-1 level were found in groups 1 (Me=30718.6 pg/ml) and 2 (Me=24692.0 pg/ml; p≤0.001), even greater differences were found in both groups compared to the control one (p≤0.001).
The correlation analysis has found in both group influence such IR indicators as fasting glucose, IR-HOMA index, glucagon, C-peptide to elevation of PAI-1. These findings indicate that with an elevation of the PAI-1 level, the concentration of fasting glucose, glucagon, C-peptide and scores of IR-HOMA index increase in both group.
The Binary regression analysis has demonstrated, that an elevation of the PAI-1 biomarker increases the likelihood of CVE by 3.3 fold in patients with prediabetes (p≤0.01). In addition to, a model has been derived for assessing the risk of cardiovascular events in patients with prediabetes.
Conclusions. Elevation of PAI-1 concentration is associated with insulin resistance which leads to ED, and further development risk of CVE in patients with prediabetes.
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Increasing glycaemia is associated with a significant decline in HDL cholesterol in women with prediabetes in two national populations. Sci Rep 2021; 11:12194. [PMID: 34108497 PMCID: PMC8190299 DOI: 10.1038/s41598-021-91075-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/20/2021] [Indexed: 12/17/2022] Open
Abstract
Internationally, studies have shown associations between lipids and glycemia; however, whether the link varies by gender and population has been rarely examined. We investigated relationships between glycemia and HDL- and Non-HDL-cholesterol and their modification by gender. We undertook a cross-sectional analysis from the National Health Examination Survey for Thailand (NHES-Thailand) and the Health Survey for England (HS-England) in adults aged 18–75 year. Glycaemia was assessed by FPG in Thailand and by HbA1c in the UK. In population- and gender-stratified analyses, the relationships between glycemia and lipids were explored. A total of 15,145 Thai and 3484 UK adults with blood measurement were included. The prevalences of prediabetes were: in NHES-Thailand, 16% (SE = 0.004), based on FPG (5.6 to < 7.0 mmol/L) and in HS-England, 19% (0.007) based on HbA1c (39 to < 48 mmol/mol). Increasingly abnormal glucose homeostasis was associated with increasing age, adiposity, SBP, proportion of antihypertensive and lipid-lowering agent use and with decreasing HDL-cholesterol. Independent of age, adiposity, smoking, alcohol, physical activity, and lipid and BP lowering drug use, increasing glycemia was associated with decreasing HDL-cholesterol specifically in women with prediabetes (NHES-Thailand, beta-coefficient − 0.07 (95% CI − 0.15, − 0.001) p = 0.04 and HS-England, − 0.03 (− 0.04, − 0.006) p = 0.01). In both populations, among those with prediabetes, increasing glycaemia is associated with an adverse, significant decline in HDL cholesterol, specifically in women. These adverse effects are apparent in widely-differing international populations.
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Stuber JM, Vissers LET, Verschuren WMM, Boer JMA, van der Schouw YT, Sluijs I. Substitution among milk and yogurt products and the risk of incident type 2 diabetes in the EPIC-NL cohort. J Hum Nutr Diet 2020; 34:54-63. [PMID: 32438495 PMCID: PMC7891431 DOI: 10.1111/jhn.12767] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background Higher dairy consumption has been associated with lower type 2 diabetes (T2D) risk, whereas dairy product subtypes appear to differ in their T2D risk association. We investigated whether replacing one type of milk or yogurt product with another is associated with T2D incidence. Methods Participants of the European Prospective Investigation into Cancer and Nutrition‐Netherlands (EPIC‐NL) cohort (n = 35 982) were included in the present study. Information on milk and yogurt consumption at baseline was obtained by a validated food frequency questionnaire. T2D cases were identified by self‐report or linkage to the hospital discharge registry, and validated by consulting the general practitioner. Multivariable Cox proportional hazard models were used to estimate associations. Results During a mean of 15 years of follow‐up, 1467 indecent T2D cases were validated. Median total milk and yogurt intake was 1.5 servings (25th percentile to 75th percentile: 0.8–2.4). After adjustment for demographic and cardiovascular risk factors, replacement of one serving (200 g) of whole‐fat milk [hazard ratio (HR) = 0.93, 95% confidence interval (CI) = 0.60–1.44], buttermilk (HR = 0.88, 95% CI = 0.58‐1.34), skimmed milk (HR = 0.87, 95% CI = 0.57–1.32) or skimmed fermented milk (HR = 0.99, 95% CI = 0.63–1.54) with whole‐fat yogurt was not associated with T2D risk. Substitutions among other milk and yogurt products were also not associated with T2D risk. Sensitivity analysis investigating T2D risk halfway follow‐up suggested a lower risk for substitutions with whole‐fat yogurt. Conclusions No evidence was found for the association between substitutions among milk and yogurt products and the risk of incident T2D, although we cannot exclude possible attenuation of results as a result of dietary changes over time. This analysis should be repeated in a population with a wider consumption range of whole‐fat yogurt.
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Affiliation(s)
- J M Stuber
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - L E T Vissers
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - W M M Verschuren
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - J M A Boer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Y T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - I Sluijs
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Mengzi S, Min W, Chong S, Pingping Z, Yaogai L, Liyuan P, Shuo L, Yan Y, Lina J. The cut-off value of impaired fasting glucose should be lower: Based on the associations of fasting blood glucose with blood lipids. Prim Care Diabetes 2020; 14:147-153. [PMID: 31405610 DOI: 10.1016/j.pcd.2019.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 07/05/2019] [Accepted: 07/16/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The previous study served impaired fasting glucose (IFG), a pre-diabetic state which was much greater than that of diabetic patients, have reached no consensus on its cut-off value. In this study, we aimed to explore the cut-off value of IFG via the associations of blood lipids with fasting plasma glucose (FPG). DESIGN A cross-sectional study in Jilin province, China, 2012. SAMPLE 13,093 participants aged 18-79 years in Jilin province were involved in the study. The Lamba-Mu-Sigma (LMS) method and generalized additive model (GAM) were used to explore the associations of different levels of FPG and blood lipids. RESULTS The distributions of FPG, triglyceride (TG) and high-density lipoprotein cholesterol (HDL-c) were significantly different by gender (p<0.01). In general, both LMS and GAM results showed that the TG and HDL-c curves had a steeper tendency when the FPG was greater than 6.0mmol/L. CONCLUSION FPG was positively associated with TG while negatively associated with HDL-c, and the associations were stronger in females. The cut-off value of IFG was suggested to be 6.0mmol/L.
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Affiliation(s)
- Sun Mengzi
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Wang Min
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Sun Chong
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Zheng Pingping
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Lv Yaogai
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Pu Liyuan
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Li Shuo
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Yao Yan
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China.
| | - Jin Lina
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China.
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Zhou T, Liu X, Liu Y, Li X. Meta-analytic evaluation for the spatio-temporal patterns of the associations between common risk factors and type 2 diabetes in mainland China. Medicine (Baltimore) 2019; 98:e15581. [PMID: 31096461 PMCID: PMC6531165 DOI: 10.1097/md.0000000000015581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 04/12/2019] [Accepted: 04/15/2019] [Indexed: 01/19/2023] Open
Abstract
There is a dearth of accurate information about the associations between risk factors and type 2 diabetes in mainland China. We conducted a systematic review and meta-analysis to explore the spatio-temporal patterns of the associations between common risk factors and type 2 diabetes in adults at least 18 years old in mainland China.We searched English and Chinese databases from January 1st, 1997 to December 31st, 2017 for relevant observational studies. Overall and stratification analyses including secular trends and temporal distributions were conducted, odds ratio (OR) and 95% confidence interval (CI) were calculated by applying random-effects model.Thirty-five studies were included. Type 2 diabetes was positively associated with a family history of type 2 diabetes (OR 2.89, 95%CI 2.38-3.49), hypertension (OR 2.73, 95%CI 2.25-3.36), central obesity (OR 2.28, 95%CI 1.94-2.68), dyslipidemia (OR 2.23, 95%CI 1.70-2.91), hypertriglyceridemia (OR 2.18, 95%CI 1.64-2.92), general obesity (OR 1.90, 95%CI 1.66-2.18), hypercholesterolemia (OR 1.65, 95%CI 1.32-2.06), smoking (OR 1.26, 95%CI 1.13-1.40), and drinking (OR 1.20, 95%CI 1.05-1.36), whereas a negative association with female gender (OR 0.87, 95%CI 0.78-0.97) existed. Except for female gender and drinking, the pooled effects of temporal and spatial stratification for the other five risk factors were consistent with the above results. For temporal stratification, the ORs of general obesity increased gradually during the periods of 1992 to 2005, 2006 to 2010, and 2011 to 2017, while the ORs of a family history declined. For regional stratification, the magnitudes of ORs for hypertension, dyslipidemia, and hypercholesterolemia in northern areas were larger than that in southern areas, while opposite situation occurred for a family history. Except for the factor a family history, provincial results for the other nine risk factors differed from the overall results and among provinces.Effect differences existed for modifiable and non-modifiable risk factors in secular trends and regional distribution, which is of potential public health importance for type 2 diabetes prevention.
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Affiliation(s)
- Ting Zhou
- Department of Epidemiology and Biostatistics
| | - Xiang Liu
- Department of Health and Social Behavior, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | | | - Xiaosong Li
- Department of Epidemiology and Biostatistics
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Mahat RK, Singh N, Rathore V. Association of myeloperoxidase with cardiovascular disease risk factors in prediabetic subjects. Diabetes Metab Syndr 2019; 13:396-400. [PMID: 30641731 DOI: 10.1016/j.dsx.2018.10.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 10/10/2018] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Prediabetes is a chronic low-grade inflammatory disease and considered as a risk factor for the development of diabetes mellitus and cardiovascular disease. Myeloperoxidase (MPO) is a leukocyte-derived enzyme, linked to both oxidative stress and inflammation and has been proposed as a possible mediator of atherosclerosis, the major cause of cardiovascular disease. The objective of the present study was to evaluate the level of MPO in prediabetic subjects and correlate it with other cardiovascular disease risk factors. MATERIALS AND METHODS In this cross-sectional study, a total of 400 subjects were recruited. Of them, 200 were prediabetic subjects and 200 were age and gender-matched controls. For each subject, blood pressure, weight, height, waist circumference, hip circumference and lipid parameters were measured. In addition, MPO was determined. RESULTS MPO was significantly increased in prediabetic subjects as compared to controls. In correlation analysis, MPO was found to be significantly and positively correlated with all the cardiovascular disease risk factors i.e. age, body mass index (BMI), waist-to-hip ratio (WHR), blood pressure [both systolic blood pressure (SBP) and diastolic blood pressure (DBP)], lipid parameters except high density lipoprotein (HDL) to which it was negatively correlated. CONCLUSION In conclusion, MPO is well correlated with cardiovascular disease risk factors in prediabetes. Hence, MPO could be used to detect cardiovascular risk among prediabetic subjects and also can be used as an early biomarker of oxidative stress and inflammation in prediabetes.
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Affiliation(s)
- Roshan Kumar Mahat
- Department of Biochemistry, Gajra Raja Medical College, Jiwaji University, Gwalior, Madhya Pradesh, 474009, India.
| | | | - Vedika Rathore
- Department of Biochemistry, Shyam Shah Medical College, Rewa, Madhya Pradesh, 486001, India
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Nayak VKR, Raghurama Nayak K, Vidyasagar S, Kamath A. Body composition analysis, anthropometric indices and lipid profile markers as predictors for prediabetes. PLoS One 2018; 13:e0200775. [PMID: 30114196 PMCID: PMC6095495 DOI: 10.1371/journal.pone.0200775] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 07/03/2018] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To compare different anthropometric indices, Body composition analysis and lipid profile markers in terms of their ability to predict prediabetes (PD). METHODS We enrolled 83 subjects with PD and 84 normoglycemic subjects who were matched for age and gender. The diagnosis of prediabetes was done according to the American Diabetes Association (ADA) criteria. All subjects were aged between 30-55 years of age and visited the outpatient department of tertiary care hospital. Anthropometric and lipid profile measurements were obtained. Analysis of body composition was done using Bodystat 1500MDD Instrument. Backward logistic regression was performed for detecting the predictors of PD. A receiver operator characteristic curve (ROC) with area under curve (AUC) was utilized for the accuracy of the predictors of PD. RESULTS Comparison of anthropometric measurement and body composition analysis parameters between the two groups showed that Waist circumference (WC), Body mass index, Body Fat% were significantly higher whereas Extracellular water and Dry lean weight in percentage (ECW% and DLW%) were found to be lower in PD (p< 0.05). Higher triglyceride (TG) levels and lower high-density cholesterol (HDL-C) with high TG/HDL-C were seen in subjects with PD. Backward logistic regression analysis found the combination of Body Fat % with WC, TG, ECW% and DLW% as strong predictors of PD. In ROC analysis, ECW% (AUC = 0.703) was the most predictive measure, followed by WC (AUC = 0.702). CONCLUSION This study demonstrated that estimation of Body Fat % combined with waist circumference, Extracellular water and Dry lean weight in percentage are valuable in screening and diagnosis of prediabetes. Plasma levels of TG in lipid profile measurements can also serve as an additional marker for prediction of prediabetes.
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Affiliation(s)
| | - Kirtana Raghurama Nayak
- Department of Physiology, KMC Manipal, Manipal Academy of Higher Education, Karnataka, India
| | - Sudha Vidyasagar
- Department of Medicine, KMC Manipal, Manipal Academy of Higher Education, Karnataka, India
| | - Asha Kamath
- Department of Statistics, PSPH, Manipal Academy of Higher Education, Karnataka, India
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Metabolomics-Based Clinical Efficacy and Effect on the Endogenous Metabolites of Tangzhiqing Tablet, a Chinese Patent Medicine for Type 2 Diabetes Mellitus with Hypertriglyceridemia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:5490491. [PMID: 30140295 PMCID: PMC6081579 DOI: 10.1155/2018/5490491] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 05/29/2018] [Accepted: 06/27/2018] [Indexed: 01/27/2023]
Abstract
Tangzhiqing tablet (TZQ) is derived from Tangzhiqing formula, which has been used to regulate glucose and lipid metabolism in China for hundreds of years. However, as a new Chinese patent medicine, its clinical indication is not clear. To explore the clinical indication and effect on the patients with type 2 diabetes mellitus (T2DM), a pilot clinical trial and metabolomics study were carried out. In the clinical study, T2DM patients were divided into three groups and treated with TZQ, placebo, or acarbose for 12 weeks, respectively. The metabolomic study based on UPLC Q-TOF MS was performed including patients with hypertriglyceridemia in TZQ and placebo groups and healthy volunteers. The clinical results showed that TZQ could reduce glycosylated hemoglobin (HbA1c) and fasting insulin. For patients with hypertriglyceridemia in TZQ group, the levels of HbA1c all decreased and were correlated with the baseline level of triglyceride. Metabonomics data showed a significant difference between patients and healthy volunteers, and 17 biomarkers were identified. After 12-week treatment with TZQ, 11 biomarkers decreased significantly (p<0.05), suggesting that TZQ could improve the metabolomic abnormalities in these participants. In conclusion, the clinical indication of TZQ was T2DM with hypertriglyceridemia, and its target was related to glycerophospholipid metabolism.
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Gholizadeh Shamasbi S, Dehgan P, Mohammad-Alizadeh Charandabi S, Aliasgarzadeh A, Mirghafourvand M. The effect of resistant dextrin as a prebiotic on metabolic parameters and androgen level in women with polycystic ovarian syndrome: a randomized, triple-blind, controlled, clinical trial. Eur J Nutr 2018; 58:629-640. [DOI: 10.1007/s00394-018-1648-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 02/22/2018] [Indexed: 12/15/2022]
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Jeng CJ, Hsieh YT, Yang CM, Yang CH, Lin CL, Wang IJ. Diabetic Retinopathy in Patients with Dyslipidemia: Development and Progression. ACTA ACUST UNITED AC 2018; 2:38-45. [DOI: 10.1016/j.oret.2017.05.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 05/20/2017] [Accepted: 05/23/2017] [Indexed: 12/28/2022]
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Associations of lipid profiles with insulin resistance and β cell function in adults with normal glucose tolerance and different categories of impaired glucose regulation. PLoS One 2017; 12:e0172221. [PMID: 28199386 PMCID: PMC5310856 DOI: 10.1371/journal.pone.0172221] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 02/01/2017] [Indexed: 12/17/2022] Open
Abstract
Aims To investigate the associations of dyslipidemia with insulin resistance and β cell function in individuals with normal glucose tolerance (NGT) and different categories of impaired glucose regulation (IGR). Methods 544 subjects (365 with dyslipidemia and/or IGR and 179 with normal lipid and glucose tolerance) were enrolled in the study. All subjects underwent oral glucose tolerance test (OGTT). HOMA-IR was used to evaluate insulin sensitivity. Disposition index (DI) was used to evaluate β cell function. Multiple linear regression analysis was performed to assess correlations among lipid profiles, insulin resistance and β cell function. Results Among subjects with NGT, those with dyslipidemia had higher level of HOMA-IR but lower level of DI. While among subjects with different categories of IGR, those with dyslipidemia and CGI had significantly decreased DI. No obvious differences of insulin resistance or β cell function were found in IFG or IGT subjects with or without dyslipidemia. TG and HDL-C were correlated with HOMA-IR (β = 0.79, p <0.001; β = -0.38, p = 0.027, respectively, compared with subjects in the low level groups). Moreover, TG and TC were negatively correlated with DI (β = -2.17, p = 0.013; β = -2.01, p = 0.034 respectively, compared with subjects in the low level groups) after adjusting for confounding parameters. Conclusions Dyslipidemia induces insulin resistance and impaired β cell response to insulin resistance in individuals with NGT. Furthermore, dyslipidemia diminishes β cell function in subjects with CGI. TG and HDL-C were correlated with insulin resistance, and TG, TC were negatively correlated with β cell response to insulin resistance in non-diabetic individuals.
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Gholi Z, Heidari-Beni M, Feizi A, Iraj B, Askari G. The characteristics of pre-diabetic patients associated with body composition and cardiovascular disease risk factors in the Iranian population. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2016; 21:20. [PMID: 27904566 PMCID: PMC5122248 DOI: 10.4103/1735-1995.179888] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 11/13/2015] [Accepted: 02/09/2016] [Indexed: 01/04/2023]
Abstract
Background: Different populations have shown various patterns of association between impaired fasting glucose (IFG) and body composition parameters and risk factors of cardiovascular disease (CVD). The current study aimed at investigating the differences between persons with prediabetes and healthy people in terms of CVD risk factors including body composition parameters, blood pressure, and lipid profile in a sample of the Iranian population. Materials and Methods: In a case-control setting, a sample containing 386 (193 prediabetic subjects and 193 normal subjects) of the first-degree relatives of diabetic patients aged 35-55 years were investigated. Samples were assessed using glucose tolerance categories. Prediabetes was defined according to the American Diabetes Association (ADA) criteria. Body composition parameters, blood pressure, glucose parameters, and lipid profile were measured and compared between the two groups. Results: Prediabetic patients had higher body mass index (BMI), waist circumference (WC), and body fat (BF) in comparison to the control group (P < 0.05). In addition, prediabetic subject had a higher intake of energy, carbohydrate, protein, fat, and cholesterol and it seems that these patients had an unhealthy dietary intake (P < 0.05). Fasting blood glucose (FBG) (P < 0.001), total cholesterol (P = 0.007), low-density lipoprotein cholesterol (LDL-C), and triglyceride (P = 0.021) were higher in prediabetic patients (P < 0.05) than in the controls. Conclusion: Both the risk factors of CVD and body composition parameters were different between the prediabetic and normal groups; total cholesterol (TC), triglyceride (TG), and FBS were predictors of the risk of prediabetes.
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Affiliation(s)
- Zahra Gholi
- Department of Community Nutrition, Food Security Research Center, School of Nutrition and Food Sciences, Isfahan, Iran
| | - Motahar Heidari-Beni
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, Isfahan Endocrine and Metabolism Research Center, School of Health, Isfahan, Iran
| | - Bijan Iraj
- Department of Internal Medicine and Endocrinology, Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Askari
- Department of Community Nutrition, Food Security Research Center, School of Nutrition and Food Sciences, Isfahan, Iran
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Mohieldein AH, Hasan M, Al-Harbi KK, Alodailah SS, Azahrani RM, Al-Mushawwah SA. Dyslipidemia and reduced total antioxidant status in young adult Saudis with prediabetes. Diabetes Metab Syndr 2015; 9:287-291. [PMID: 25470641 DOI: 10.1016/j.dsx.2014.04.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIMS Lifestyle related noncommunicable health conditions are having an increasingly negative impact on the health. This study aimed to assess the lipid profile, total antioxidant capacity, and the lifestyle predictors of conversion to prediabetes in young Saudis with prediabetes. MATERIALS AND METHODS One hundred and twenty-one young Saudis with fasting plasma glucose (<125 mg/dl) enrolled in this study who further categorized into normal glucose tolerance "NGT" group (n=86) and prediabetes group (IFG; n=08/IGT; n=27) based on American Association criteria. Venous blood samples were collected at fasting and 2h postprandial from participants. Chemistry parameters and total antioxidant status (TAS) were assayed by standard procedures. Questionnaires were applied to collect information including demographic characteristics, physical activity, and family history to diabetes. Statistical analysis was performed using SPSS version 17. RESULTS Compared to NGT subjects, the prediabetics characterized by marked obesity (p=.027), visceral obesity (p=.002), dyslipidemia, significantly increased HbA1c (p=.003), reduced TAS (p<.001), more sedentary lifestyle (p=.010). Positive correlations were documented between FPG, 2-h plasma glucose and HbA1c, BMI, WC, TC, LDL cholesterol, TG while negative correlations with HDL cholesterol, TAS. CONCLUSION The current study reported that prediabetes condition (in young adult Saudis) was associated with dyslipidemia, reduced total antioxidant status, obesity, central obesity, and physical inactivity compared to those with normoglycemia. Lifestyle modifications (through weight loss, regular physical activity, and healthy diet) should be encouraged especially among young Saudis to prevent the progression to type 2 diabetes and its complications from prediabetes state.
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Affiliation(s)
- Abdelmarouf H Mohieldein
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Al-Qassim, Saudi Arabia.
| | - Marghoob Hasan
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Al-Qassim, Saudi Arabia
| | - Khalid K Al-Harbi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Al-Qassim, Saudi Arabia
| | - Sattam S Alodailah
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Al-Qassim, Saudi Arabia
| | - Rajab M Azahrani
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Al-Qassim, Saudi Arabia
| | - Sami A Al-Mushawwah
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Al-Qassim, Saudi Arabia
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Chen GY, Li L, Dai F, Li XJ, Xu XX, Fan JG. Prevalence of and Risk Factors for Type 2 Diabetes Mellitus in Hyperlipidemia in China. Med Sci Monit 2015; 21:2476-84. [PMID: 26297334 PMCID: PMC4550046 DOI: 10.12659/msm.894246] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background We explored the prevalence of and risk factors for type 2 diabetes in the adult population of Shanghai (China) with and without dyslipidemia. Material/Methods We conducted a cross-sectional survey including 14 385 adults (aged 16 to 88 years) in Shanghai using a stratified, multistage cluster sampling approach. Results Type 2 diabetes and hyperlipidemia were found in 1456 (10.1%) and 4583 (31.9%) subjects, respectively. Type 2 diabetes was more common in males (11.4%) than in females (9.2%, P<0.01), in the elderly (> or =65 years, 22.5%) than in younger (<55 years, <10%, P<0.01) individuals, and in urban (12.8%) than in rural populations (5.2%, P<0.01). Diabetes incidence was higher among patients with hyperlipidemia than in controls (16.9% vs. 7.0%, P<0.01; OR=2.72, 95% CI 2.44–3.03). Compared with controls, the risk for diabetes in subjects with isolated hypertriglyceridemia, isolated hypercholesterolemia, and mixed hyperlipidemia increased 1.75-fold (95% CI 1.53–1.99), 1.53-fold (95% CI 1.17–2.01), and 2.93-fold (95% CI 2.37–3.63), respectively. The fasting plasma glucose (FPG) and 2h-postprandial plasma glucose (2h-PG) increased with age in both sexes. The age- and sex-adjusted FPG and 2h-PG levels in hyperlipidemia were significantly higher than in controls (P<0.01). Conclusions A high prevalence of type 2 diabetes in hyperlipidemia patients exists in Shanghai. Hyperlipidemia is associated with elevated blood glucose levels and therefore requires prompt intervention for prevention and treatment of diabetes in patients with dyslipidemia.
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Affiliation(s)
- Guang-Yu Chen
- Center for Fatty Liver Disease, Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland)
| | - Lui Li
- Department of Chronic Disease, Shanghai Center for Disease Control and Prevention, Shanghai, China (mainland)
| | - Fei Dai
- School of Public Health, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
| | - Xing-Jian Li
- Department of Chronic Disease, Shanghai Center for Disease Control and Prevention, Shanghai, China (mainland)
| | - Xiao-Xin Xu
- Research Center for Clinical Epidemiology, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
| | - Jian-Gao Fan
- Center for Fatty Liver Disease, Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland)
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Wei SH, Lin JD, Hsu CH, Wu CZ, Hsieh CH, Pei D, Chang JB, Liang YJ, Hsia TL, Chen YL. Higher normal range of fasting plasma glucose still has a higher risk for metabolic syndrome: a combined cross-sectional and longitudinal study in elderly. Int J Clin Pract 2015; 69:863-70. [PMID: 25757152 DOI: 10.1111/ijcp.12633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION It is well known that higher fasting plasma glucose (FPG) is associated with metabolic syndrome (MetS). This relationship still exists even the FPG is within the normal range. However, most of these studies did not exclude subjects who were on medications which would affect the results of the studies. At the same time, there is no longitudinal study done to validate this correlation, especially in elderly. In this study, the relationships between normal FPG and MetS were evaluated. METHOD We randomly selected 57,517 subjects who were ≥ 60-years old from health screening centre. In the first part of study, subjects were enrolled in the cross-sectional study to find out the optimal cut-off value of FPG with higher chances to have MetS. In the second part of current study, subjects with MetS at baseline were excluded from the same study group, and performed a median 5.3-year longitudinal study. RESULTS There were 18,287 subjects enrolled in this study. In the first part of study, the cross-sectional study, optimal cut-off values of FPG were determined by the ROC curve and the sensitivity for these cut-off values were 56.6% in men and 60.9% in women, respectively. The result showed that lower FPG is healthier than the higher (log-rank test, p < 0.001). During the follow-up period, 5039 subjects showed hazard ratios of 2.09 for men and 1.884 for women developing future MetS. CONCLUSION Our study is the first longitudinal design in elderly and showed that older subjects with higher FPG proved to have higher risk of Mets even the FPG is still within its normal range.
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Affiliation(s)
- S-H Wei
- Department of Family Medicine, School of Medicine, Cardinal Tien Hospital, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - J-D Lin
- Division of Endocrinology and Metabolism, Department of Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - C-H Hsu
- Department of Family Medicine, School of Medicine, Cardinal Tien Hospital, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - C-Z Wu
- Division of Endocrinology and Metabolism, Department of Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - C-H Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - D Pei
- Department of Internal Medicine, School of Medicine, Cardinal Tien Hospital, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - J-B Chang
- Division of Clinical Pathology, Department of Pathology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Y-J Liang
- Department of Life-Science, Fu-Jen Catholic University, Taipei, Taiwan
| | - T-L Hsia
- Department of Internal Medicine, School of Medicine, Cardinal Tien Hospital, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Y-L Chen
- Department of Pathology, School of Medicine, Cardinal Tien Hospital, Fu-Jen Catholic University, New Taipei City, Taiwan
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The relationship between serum 25-hydroxyvitamin D concentration, cardiorespiratory fitness, and insulin resistance in Japanese men. Nutrients 2014; 7:91-102. [PMID: 25551248 PMCID: PMC4303828 DOI: 10.3390/nu7010091] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 12/15/2014] [Indexed: 11/29/2022] Open
Abstract
Here, we aim to investigate the independent and combined associations of serum 25-hydroxyvitamin D (25(OH)D) and cardiorespiratory fitness (CRF) with glucose metabolism. Fasting blood samples of 107 men aged 40–79 years were analyzed for 25(OH)D, glucose, insulin, glycated hemoglobin, and lipid profile. Homeostasis model assessment of insulin resistance index (HOMA-IR) was calculated from the fasting concentrations of glucose and insulin. Visceral fat area (VFA) was determined by magnetic resonance imaging and CRF by measuring maximal oxygen uptake. Median 25(OH)D concentration was 36.3 nmol/L, while the prevalence of 25(OH)D deficiency was 74.8%. Participants with high CRF had significantly lower HOMA-IR, glycated hemoglobin, and insulin values than participants with low CRF (p < 0.05). Higher 25(OH)D concentration was strongly correlated with lower HOMA-IR and insulin values independent of VFA (p < 0.01) but significantly affected by CRF. In the high CRF group, participants with higher 25(OH)D concentration had lower HOMA-IR values than participants with low 25(OH)D concentration (p < 0.05). Higher 25(OH)D and CRF are crucial for reducing insulin resistance regardless of abdominal fat. In addition, higher 25(OH)D concentration may strengthen the effect of CRF on reducing insulin resistance in middle-aged and elderly Japanese men with high CRF.
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Martinez-Hervas S, Carmena R, Ascaso JF, Real JT, Masana L, Catalá M, Vendrell J, Vázquez JA, Valdés S, Urrutia I, Soriguer F, Serrano-Rios M, Rojo-Martínez G, Pascual-Manich G, Ortega E, Mora-Peces I, Menéndez E, Martínez-Larrad MT, López-Alba A, Gomis R, Goday A, Girbés J, Gaztambide S, Franch J, Delgado E, Castell C, Castaño L, Casamitjana R, Calle-Pascual A, Bordiú E. Prevalence of plasma lipid abnormalities and its association with glucose metabolism in Spain: the di@bet.es study. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2014; 26:107-14. [PMID: 24461346 DOI: 10.1016/j.arteri.2013.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 11/26/2013] [Accepted: 12/03/2013] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Dyslipidemia is a significant contributor to the elevated CVD risk observed in type 2 diabetes mellitus. We assessed the prevalence of dyslipidemia and its association with glucose metabolism status in a representative sample of the adult population in Spain and the percentage of subjects at guideline-recommended LDL-C goals. MATERIAL AND METHODS The di@bet.es study is a national, cross-sectional population-based survey of 5728 adults. RESULTS A total of 4776 subjects were studied. Dyslipidemia was diagnosed in 56.8% of subjects; only 13.2% of subjects were treated with lipid lowering drugs. Lipid abnormalities were found in 56.8% of Spanish adults: 23.3% with high LDL-C, 21.5% high TG, 35.8% high non-HDL-C, and 17.2% low HDL-C. Most normal subjects showed an LDL-C ≤ 3.36 mmol/l. Pre-diabetics presented similar proportion when considering a goal of 3.36 mmol/l, but only 35% of them reached an LDL-C goal ≤ 2.6 mmol/l. Finally, 45.3% of diabetics had an LDL-C ≤ 2.6 mmol/l, and only 11.3% achieved an LDL-C ≤ 1.8 mmol/l. CONCLUSIONS Our study demonstrates a high prevalence of dyslipidemia in the adult Spanish population, and a low use of lipid-lowering drugs. Moreover, the number of subjects achieving their corresponding LDL-C goal is small, particularly in subjects at high cardiovascular risk, such as diabetics.
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Affiliation(s)
- Sergio Martinez-Hervas
- Service of Encodrinology and Nutrition, Hospital Cliníco Universitario de Valencia, Valencia, Spain; Instituto de Investigación Sanitaria HCUV-INCLIVA, Spain; Department of Medicine, University of Valencia, Valencia, Spain; CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Spain.
| | - Rafael Carmena
- Service of Encodrinology and Nutrition, Hospital Cliníco Universitario de Valencia, Valencia, Spain; Instituto de Investigación Sanitaria HCUV-INCLIVA, Spain; Department of Medicine, University of Valencia, Valencia, Spain; CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Spain
| | - Juan F Ascaso
- Service of Encodrinology and Nutrition, Hospital Cliníco Universitario de Valencia, Valencia, Spain; Instituto de Investigación Sanitaria HCUV-INCLIVA, Spain; Department of Medicine, University of Valencia, Valencia, Spain; CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Spain
| | - Jose T Real
- Service of Encodrinology and Nutrition, Hospital Cliníco Universitario de Valencia, Valencia, Spain; Instituto de Investigación Sanitaria HCUV-INCLIVA, Spain; Department of Medicine, University of Valencia, Valencia, Spain; CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Spain
| | - Luis Masana
- CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Spain; Vascular Medicine and Metabolism Unit, Research Unit on Lipids and Atherosclerosis, Sant Joan University Hospital, Universitat Rovira i Virgili, IISPV, Reus, Tarragona, Spain
| | - Miguel Catalá
- Service of Encodrinology and Nutrition, Hospital Cliníco Universitario de Valencia, Valencia, Spain; Instituto de Investigación Sanitaria HCUV-INCLIVA, Spain; Department of Medicine, University of Valencia, Valencia, Spain; CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Spain
| | - Joan Vendrell
- CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Spain; Department of Endocrinology and Nutrition, Hospital Universitario Joan XXIII, Institut d'Investigacions Sanitàries Pere Virgili, Tarragona, Spain
| | | | - Sergio Valdés
- CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Spain; Department of Endocrinology and Nutrition, Hospital Universitario Carlos Haya, Málaga, Spain
| | - Inés Urrutia
- CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Spain; Diabetes Research Group, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain
| | - Federico Soriguer
- CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Spain; Department of Endocrinology and Nutrition, Hospital Universitario Carlos Haya, Málaga, Spain
| | - Manuel Serrano-Rios
- CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Spain; Lipids and Diabetes Laboratory, Hospital Universitario S. Carlos de Madrid, Madrid, Spain
| | - Gemma Rojo-Martínez
- CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Spain; Department of Endocrinology and Nutrition, Hospital Universitario Carlos Haya, Málaga, Spain
| | - Gemma Pascual-Manich
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Emilio Ortega
- CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Canarian Health Service, Tenerife, Spain
| | | | - Edelmiro Menéndez
- Department of Endocrinology and Nutrition, Hospital Central de Asturias, Oviedo, Spain
| | - Maria T Martínez-Larrad
- CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Spain; Lipids and Diabetes Laboratory, Hospital Universitario S. Carlos de Madrid, Madrid, Spain
| | | | - Ramón Gomis
- CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Endocrinology and Diabetes Unit, Hospital Clínic de Barcelona, Universitat de Barcelona (UB), Barcelona, Spain
| | - Albert Goday
- Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain
| | - Juan Girbés
- Diabetes Unit, Hospital Arnau de Vilanova, Valencia, Spain
| | - Sonia Gaztambide
- CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Spain; Diabetes Research Group, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain
| | - Josep Franch
- EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Primary Care, Unitat de Suport a la Recerca (IDIAP-Fundació Jordi Gol), Barcelona, Spain
| | - Elías Delgado
- Department of Endocrinology and Nutrition, Hospital Central de Asturias, Oviedo, Spain
| | - Conxa Castell
- Public Health Division, Department of Health, Autonomous Government of Catalonia, Barcelona, Spain
| | - Luis Castaño
- CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Spain; Diabetes Research Group, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain
| | - Roser Casamitjana
- CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Spain; Biomedic Diagnostic Centre University, Hospital Clínic, Barcelona, Spain
| | - Alfonso Calle-Pascual
- Department of Endocrinology and Nutrition, Hospital Universitario San Carlos, Madrid, Spain
| | - Elena Bordiú
- Laboratorio de Endocrinología, Hospital Universitario S. Carlos de Madrid, Spain
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Lian WC, Lin JD, Hsia TL, Hsu CH, Wu CZ, Hsieh CH, Pei D, Chen YL. Metabolic syndrome in normoglycaemic elderly men. Int J Clin Pract 2013; 67:964-70. [PMID: 24073972 DOI: 10.1111/ijcp.12166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 03/10/2013] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Type-2 diabetes is mainly the metabolic defect involving multiple organs. To conclude their intricate relationships, the term 'ominous octet' had been proposed to denote this phenomenon. In this study, we enrolled older men without any medications for MetS components to further elucidate the relationships between normoglycaemic state and MetS. METHODS We enrolled male subjects with FPG less than 100 mg/dl and aged 65 and older undergoing routine health check-ups in Taiwan. After excluding subjects taking medications that might affect the components of MetS, a total of 6679 men were eligible for the analysis. Study subjects were further grouped into FPG tertiles (< 91 mg/dl, 92-95 mg/dl and > 95 mg/dl for tertil 1, tertil 2 and tertil 3, respectively). RESULTS There was a significant trend between the FPG and percentages of subjects having MetS (p = 0.009). The relationships between the MetS components were higher in FPG 2 and FPG 3 than FPG 1. In simple correlation, all of the MetS and LDL-C were positively correlated with FPG level and multiple regression further confirmed the same result except for HDL-C that became non-significant. Subjects in FPG3 had significantly higher ORs (ORs = 1.19) for having MetS than those in FPG1. CONCLUSIONS In conclusion, higher FPG still had higher risk of having MetS in normoglycaemic range in elderly male. More strict FPG level control may be valuable in CVD prevention and warrants further investigations.
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Affiliation(s)
- W-C Lian
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital and School of Medicine, Tzu Chi University, Hualian, Taiwan
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Onat A, Can G, Çiçek G, Ayhan E, Doğan Y, Kaya H. Fasting, non-fasting glucose and HDL dysfunction in risk of pre-diabetes, diabetes, and coronary disease in non-diabetic adults. Acta Diabetol 2013; 50:519-28. [PMID: 21769500 DOI: 10.1007/s00592-011-0313-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Accepted: 06/28/2011] [Indexed: 12/23/2022]
Abstract
We determined in non-diabetic persons the risk of fasting and non-fasting glucose levels for pre-diabetes, diabetes, and coronary heart disease (CHD), including the roles of serum C-reactive protein (CRP) and HDL cholesterol, and delineated risk profiles of the pre-diabetic states. Over 7¼ years, 2,619 middle-aged Turkish adults free of diabetes and CHD were studied prospectively. Using different serum glucose categories including impaired fasting glucose (IFG, 6.1-6.97 mmol/L) and impaired glucose tolerance (IGT), outcomes were analyzed by Cox regression. IFG was identified at baseline in 112 and IGT in 33 participants. Metabolic syndrome components distinguished individuals with IFG from those with normoglycemia. Participants with IGT tended to differ from adults in normal postprandial glucose categories in regard to high levels of triglycerides, apoA-I, and CRP. Diabetes risk, adjusted for sex, age, waist circumference, CRP, and HDL cholesterol, commenced at a fasting 5.6-6.1 mmol/L threshold, was fourfold at levels 6.1-6.97 mmol/L. Optimal glucose values regarding CHD risk were 5.0-6.1 mmol/L. Fasting and postprandial glucose values were not related to CHD risk in men; IGT alone predicted risk in women (HR 3.74 [1.16;12.0]), independent of age, systolic blood pressure, non-HDL cholesterol, waist circumference, smoking status, and CRP. HDL cholesterol was unrelated to the development of IFG, IGT, and diabetes, while CRP elevation independently predicted the development of diabetes. IGT independently predicts CHD risk, especially in women. HDL dysfunction associated with low-grade inflammation is a co-determinant of pre-diabetic states and their progression to diabetes.
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Affiliation(s)
- Altan Onat
- Department of Cardiology Cerrahpaşa Medical Faculty, Istanbul University, Nisbetiye cad. 59/24, Etiler, 34335, Istanbul, Turkey,
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Hsiao FC, Hsieh CH, Wu CZ, Hsu CH, Lin JD, Lee TI, Pei D, Chen YL. Elevated fasting glucose levels within normal range are associated with an increased risk of metabolic syndrome in older women. Eur J Intern Med 2013; 24:425-9. [PMID: 23647841 DOI: 10.1016/j.ejim.2013.03.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2012] [Revised: 03/19/2013] [Accepted: 03/21/2013] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The prevalence of cardiovascular disease (CVD) and metabolic syndrome (MetS) increases with increasing fasting plasma glucose (FPG) levels in an elderly population with pre-diabetes or diabetes. However, it remains unknown whether the relationship between elevated FPG and increased risks of MetS exists in older women with normoglycemia (FPG<100mg/dL). Therefore, the present study was conducted to fill the lack of information in that area. MATERIALS AND METHODS We included 6505 apparently healthy women, aged 65years and older, with normoglycemia who participated in routine health checkups at health screening centers in Taiwan. Components of MetS (FPG, waist circumference (WC), high-density lipoprotein cholesterol (HDL-C), triglycerides, and systolic/diastolic blood pressure), body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), total cholesterol, and percentage body fat (PBF) were examined in all subjects. RESULTS Subjects were sub-grouped by FPG levels (<90mg/dL, 91-95mg/dL and >95mg/dL for group 1, group 2 and group 3, respectively). Subjects in group 2 and group 3 were 1.22-fold (P=0.017) and 1.25-fold (P=0.007) more likely to have MetS compared with those in group 1. Age, WC, BMI, PBF, systolic and diastolic blood pressure, total cholesterol, triglycerides, and HDL-C were significantly correlated with FPG, whereas HDL-C was negatively correlated with FPG. In a multivariate stepwise regression analysis, PBF, LDL-C, triglycerides, and age were significantly and independently associated with FPG. CONCLUSION Among older women, the risk of MetS was significantly associated with elevated FPG even for subjects with normal FPG. Lifestyle interventions for reducing PBF and controlling dyslipidemia could help reduce the risk of MetS in this population.
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Affiliation(s)
- Fone-Ching Hsiao
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Dehghan P, Pourghassem Gargari B, Asgharijafarabadi M. Effects of high performance inulin supplementation on glycemic status and lipid profile in women with type 2 diabetes: a randomized, placebo-controlled clinical trial. Health Promot Perspect 2013; 3:55-63. [PMID: 24688953 DOI: 10.5681/hpp.2013.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 11/04/2012] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus, as a noncommunicable disease, is the main public health challenge in the 21st century. The prevalence of diabetes mellitus adjusted for the world population in Iran was 8% until the year 2010.Lipid levels are considered as important parameters to be evaluated, as high serum lipid levels are often reported as a complication in patients with diabetes mellitus.It is claimed that functional foods may improve complications of diabetes mellitus, so this study was designed to evaluate the effects of high performance inulin on glycemic status and lipid profile of women with type 2 diabetes. METHODS The study was a randomized controlled clinical trial. Forty-nine type 2 diabetic females (fiber intake <30g/d, 25<BMI<35 kg/m2) were divided into two groups. Patients in the intervention group (n=24) received 10g/d inulin and patients in the control group (n=25) received 10g/d maltodextrin for 8 weeks.Glycemic status and lipid profile indices were measured pre and post intervention. Data were analyzed using SPSS software (verision11.5). Paired, unpaired t-test and ANCOVA were used to compare quantitative variables. RESULTS Supplementation with inulin caused a significant reduction in FBS (8.50%), HbA1c (10.40%), total cholesterol (12.90%), triglyceride (23.60 %), LDL-c (35.30 %), LDL-c/HDL-c ratio (16.25%) and TC/HDL-c ratio (25.20%) and increased HDL-c (19.90%). The changes for the control group parameters were not significant at the end of study. CONCLUSION Inulin may help to control diabetes and its complications via improving glycemic and lipid parameters.
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Affiliation(s)
- Parvin Dehghan
- Student Research Center, Faculty of Health & Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bahram Pourghassem Gargari
- Department of Biochemistry & Diet Therapy, Nutrition Research Center, Faculty of Health & Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asgharijafarabadi
- Tabriz Health Services Management Research Center, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
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Relationship between blood lipid profiles and pancreatic islet β cell function in Chinese men and women with normal glucose tolerance: a cross-sectional study. BMC Public Health 2012; 12:634. [PMID: 22876749 PMCID: PMC3490814 DOI: 10.1186/1471-2458-12-634] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 07/30/2012] [Indexed: 02/05/2023] Open
Abstract
Background Dyslipidemia is present in people with diabetes as well as subjects with normal glucose tolerance (NGT). The purpose of this study was to investigate the relationship between lipid profiles and β cell function in Chinese individuals with NGT but without history of diabetes or prediabetes. Methods A total of 893 men and 1454 women aged 18–76 years living in Sichuan, China, who were not being treated with lipid-lowering drugs were enrolled in this study. Insulin sensitivity (IR) was evaluated using the homeostasis model assessment –IR (HOMA-IR), β-cell function was calculated by the following equation: ΔI30/ΔG30/ HOMA-IR (ΔI30/ΔG30: the ratio of incremental glucose and insulin 30 min after glucose intake). Multivariate linear regression analyses were performed to estimate the relationship between blood lipid and β cell function as standardized coefficients (β). Results β cell function decreased in men and women with increasing age. We found inverse relationships between β cell function and total cholesterol (TC) in men and women (β = −0.157 and −0.113, respectively, both p < 0.001), low-density lipoprotein–cholesterol (LDL-C; β = −0.130 and −0.068, respectively, both p < 0.001), TC/high-density lipoprotein–cholesterol (HDL-C) ratio (β = −0.084, p < 0.01 and −0.096, p < 0.001), and triglycerides (TG) (women only; β = −0.053, p < 0.05). However, β cell function was not associated with HDL-C in men or women (β = −0.034 and 0.000, respectively, both p > 0.05) or the TG/HDL-C ratio (β = −0.035 and −0.013, respectively, both p > 0.05). β cell function was significantly worse in males than in females in all age groups, except in subjects aged > 70 years. Conclusions Dyslipidemia is associated with dysfunction of pancreatic β cells in subjects with NGT and this is particularly evident in people with elevated TC and LDL-C levels, especially males. Trial Registration Number #TR-CCH-Chi CTR-CCH-00000361
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Sone H, Tanaka S, Tanaka S, Iimuro S, Ishibashi S, Oikawa S, Shimano H, Katayama S, Ohashi Y, Akanuma Y, Yamada N. Comparison of various lipid variables as predictors of coronary heart disease in Japanese men and women with type 2 diabetes: subanalysis of the Japan Diabetes Complications Study. Diabetes Care 2012; 35:1150-7. [PMID: 22338107 PMCID: PMC3329821 DOI: 10.2337/dc11-1412] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine the best lipid variable to predict coronary heart disease (CHD) in Japanese patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Eligible Japanese men and women (1,771) aged 40-70 years with type 2 diabetes from 59 institutes nationwide were followed for a planned 8-year period. The performance of eight conventional lipid variables, i.e., total cholesterol (TC), LDL-cholesterol (LDLC), HDL-cholesterol (HDLC), triglycerides (TGs), non-HDLC, TC/HDLC ratio, LDLC/HDLC ratio, and TG/HDLC ratio, as predictors of incident CHD were evaluated by four methods: hazard ratio (HR) per one SD increment by multivariate Cox analysis, χ(2) likelihood ratio test, area under the receiver operating characteristic curve (AUC), and tertile analysis. RESULTS Although all variables significantly predicted CHD events in men, non-HDLC (HR per one SD 1.78 [95% CI 1.43-2.21]; AUC 0.726) and TC/HDLC (HR 1.63 [1.36-1.95]; AUC 0.718) had the better predictive performances among the variables, including LDLC. In women, TGs (log-transformed; HR 1.72 [1.21-2.43]; AUC 0.708) were the best predictor according to results of tertile analysis (HR of the top tertile versus the bottom tertile 4.31 [1.53-12.16]). The associations with incident CHD were linear and continuous. CONCLUSIONS For Japanese diabetic men, non-HDLC and TC/HDLC were the best predictors, whereas TGs were most predictive for women. These findings, which included prominent sex differences, should be considered among clinical approaches to risk reduction among East Asians with diabetes.
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Affiliation(s)
- Hirohito Sone
- Department of Internal Medicine, Institute of Clinical Medicine,University of Tsukuba, Tsukuba, Japan.
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Blood lipids in 75,048 type 2 diabetic patients: a population-based survey from the Swedish National diabetes register. ACTA ACUST UNITED AC 2011; 18:97-105. [PMID: 21354969 DOI: 10.1097/hjr.0b013e32833ba61e] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Type 2 diabetes and diabetic dyslipidemia are high-risk conditions for cardiovascular disease. However, the description of the distribution of blood lipids in diabetic patients has not been based on population-based surveys. The aim of this study was to describe diabetic dyslipidemia in a large unselected sample of patients from the Swedish National Diabetes Register. METHODS Blood lipid profiles and clinical characteristics in 75,048 type 2 diabetic patients (57% men) were studied. RESULTS Pronounced hypertriglyceridemia (triglycerides >4.0mmol/l) was seen in 3.4% of the patients. Total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C) and non-HDL-C were generally higher, and LDL-C/HDL-C and Non-HDL-C/HDL-C ratios were lower in women. Mean TC, LDL-C as well as HDL-C values were lower in patients treated with lipid-lowering agents, whereas triglycerides was higher than in the untreated patients. In patients not treated with lipid-lowering agents all blood lipids increased in women and decreased in men (except HDL-C) at higher ages. Patients with LDL-C/HDL-C ratio ≥ 3 were slightly younger, less frequently used lipid-lowering drugs and had not so often a history of coronary heart disease or stroke. CONCLUSION The distribution of blood lipids in this large sample of unselected type 2 diabetic patients challenges the previous conception of diabetic dyslipidemia, and calls for new studies to explain the roles of LDL-C and HDL-C as strong cardiovascular risk factors in type 2 diabetes.
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ZHAO S, ZHENG H, LU X, LIU Y, SU B, XU G. Metabonomics and phospholipid metabolic profiling of abnormal glucose metabolism based on high performance liquid chromatography-electrospray mass spectrometry. Se Pu 2011; 29:307-13. [DOI: 10.3724/sp.j.1123.2011.00307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Heart-type fatty acid binding protein (H-FABP): relationship with arterial intima-media thickness and role as diagnostic marker for atherosclerosis in patients with ımpaired glucose metabolism. Cardiovasc Diabetol 2011; 10:37. [PMID: 21535886 PMCID: PMC3112391 DOI: 10.1186/1475-2840-10-37] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Accepted: 05/02/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Heart type fatty acid binding protein (H-FABP) has been closely associated with acute coronary syndrome, cardiac abnormalities, stroke, and obstructive sleep disorder in previous studies. The aim of this study was to evaluate and compare the serum H-FABP levels and carotid artery intima-media thickness (CIMT) between patients with prediabetes and control subjects. RESEARCH DESIGN AND METHODS We measured serum H-FABP levels in 58 prediabetic patients, 29 with impaired fasting glucose (IFG) and 29 with impaired glucose tolerance (IGT) and 28 age-, sex- and body mass index-matched control subjects using a sandwich enzyme-linked immunosorbent assay (ELISA), and in order to measure CIMT, all participants underwent high-resolution B-mode ultrasonography. RESULTS Serum H-FABP levels were significantly elevated in pre-diabetic patients when compared with that of control subjects (IFG: 32.5 ± 34.2 ng/dL, IGT: 45.4 ± 45.8 ng/dL, control: 16.8 ± 14.9 ng/dL; p = 0.011). The difference in means of H-FABP levels between patients with IGT or IFG and control subjects was significant (p = 0.010 and p = 0.009, respectively). CIMT was higher in the pre-diabetic groups compared with the control group (IFG: 0.6 ± 0.1, IGT: 0.6 ± 0.1, control: 0.5 ± 0.1; p < 0.001), and H-FABP level was positively correlated with CIMT (p < 0.001, rho = 0.626). CONCLUSION Our results indicate that patients with pre-diabetes are at increased risk for cardiovascular disease. In addition, serum H-FABP levels could represent a useful marker for myocardial performance in patients with IFG and IGT.
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Stančáková A, Paananen J, Soininen P, Kangas AJ, Bonnycastle LL, Morken MA, Collins FS, Jackson AU, Boehnke ML, Kuusisto J, Ala-Korpela M, Laakso M. Effects of 34 risk loci for type 2 diabetes or hyperglycemia on lipoprotein subclasses and their composition in 6,580 nondiabetic Finnish men. Diabetes 2011; 60:1608-16. [PMID: 21421807 PMCID: PMC3292337 DOI: 10.2337/db10-1655] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE We investigated the effects of 34 genetic risk variants for hyperglycemia/type 2 diabetes on lipoprotein subclasses and particle composition in a large population-based cohort. RESEARCH DESIGN AND METHODS The study included 6,580 nondiabetic Finnish men from the population-based Metabolic Syndrome in Men (METSIM) study (aged 57 ± 7 years; BMI 26.8 ± 3.7 kg/m(2)). Genotyping of 34 single nucleotide polymorphism (SNPs) for hyperglycemia/type 2 diabetes was performed. Proton nuclear magnetic resonance spectroscopy was used to measure particle concentrations of 14 lipoprotein subclasses and their composition in native serum samples. RESULTS The glucose-increasing allele of rs780094 in GCKR was significantly associated with low concentrations of VLDL particles (independently of their size) and small LDL and was nominally associated with low concentrations of intermediate-density lipoprotein, all LDL subclasses, and high concentrations of very large and large HDL particles. The glucose-increasing allele of rs174550 in FADS1 was significantly associated with high concentrations of very large and large HDL particles and nominally associated with low concentrations of all VLDL particles. SNPs rs10923931 in NOTCH2 and rs757210 in HNF1B genes showed nominal or significant associations with several lipoprotein traits. The genetic risk score of 34 SNPs was not associated with any of the lipoprotein subclasses. CONCLUSIONS Four of the 34 risk loci for type 2 diabetes or hyperglycemia (GCKR, FADS1, NOTCH2, and HNF1B) were significantly associated with lipoprotein traits. A GCKR variant predominantly affected the concentration of VLDL, and the FADS1 variant affected very large and large HDL particles. Only a limited number of risk loci for hyperglycemia/type 2 diabetes significantly affect lipoprotein metabolism.
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MESH Headings
- Adaptor Proteins, Signal Transducing/genetics
- Cholesterol, VLDL/blood
- Delta-5 Fatty Acid Desaturase
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/genetics
- Fatty Acid Desaturases/blood
- Genotype
- Humans
- Hyperglycemia/blood
- Hyperglycemia/genetics
- Lipoproteins, HDL/blood
- Lipoproteins, IDL/blood
- Lipoproteins, LDL/blood
- Lipoproteins, VLDL/blood
- Magnetic Resonance Spectroscopy
- Male
- Middle Aged
- Polymorphism, Single Nucleotide/genetics
- Receptor, Notch2/blood
- White People
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Affiliation(s)
- Alena Stančáková
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Jussi Paananen
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Pasi Soininen
- Computational Medicine Research Group, Institute of Clinical Medicine, University of Oulu and Biocenter Oulu, Oulu, Finland
- NMR Metabonomics Laboratory, Laboratory of Chemistry, Department of Biosciences, University of Eastern Finland, Kuopio, Finland
| | - Antti J. Kangas
- Computational Medicine Research Group, Institute of Clinical Medicine, University of Oulu and Biocenter Oulu, Oulu, Finland
| | - Lori L. Bonnycastle
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Mario A. Morken
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Francis S. Collins
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Anne U. Jackson
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Michael L. Boehnke
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Johanna Kuusisto
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Mika Ala-Korpela
- Computational Medicine Research Group, Institute of Clinical Medicine, University of Oulu and Biocenter Oulu, Oulu, Finland
- NMR Metabonomics Laboratory, Laboratory of Chemistry, Department of Biosciences, University of Eastern Finland, Kuopio, Finland
- Department of Internal Medicine and Biocenter Oulu, Clinical Research Center, University of Oulu, Oulu, Finland
| | - Markku Laakso
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
- Corresponding author: Markku Laakso,
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Zhang L, Qiao Q, Laatikainen T, Söderberg S, Jousilahti P, Onat A, Nilsson P, Tuomilehto J. The impact of dyslipidaemia on incidence of coronary heart disease in Finns and Swedes with different categories of glucose tolerance. Diabetes Res Clin Pract 2011; 91:406-12. [PMID: 21208674 DOI: 10.1016/j.diabres.2010.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Revised: 11/25/2010] [Accepted: 12/02/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND The association of dyslipidaemia with incidence of coronary heart disease (CHD) has not been well studied in people with different glucose categories. METHODS Data from six population-based prospective studies in Finland and Sweden, with 4818 men and 4269 women aged 25-89 years who were free of CHD and without a prior history of diabetes at baseline, were jointly analysed. Multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for CHD incidence were estimated. RESULTS 457 participants developed CHD during follow-up of 10 years. The multivariate adjusted HRs (95% CIs) for CHD incidence were 1.39 (1.08-1.80), 0.57 (0.39-0.84), 1.21 (1.07-1.37), 1.56 (1.21-2.01) and 1.74 (1.34-2.26), respectively, corresponding to a one unit increase in Z-scores of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), non-HDL-C and TC to HDL ratio, in people with newly diagnosed diabetes. The prediction was also significant in non-diabetic population except for TG in individuals with normoglycaemia and TG and HDL-C in those with isolated IFG. CONCLUSION Adverse lipid profiles were related to increased CHD incidence in normoglycaemic, fasting hyperglycaemic and diabetic individuals, but not in people with IGT. The findings may imply considering different management strategies in people with fasting or post-load hyperglycaemia.
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Affiliation(s)
- Lei Zhang
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland.
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Zhang L, Qiao Q, Tuomilehto J, Janus ED, Lam TH, Ramachandran A, Mohan V, Stehouwer CDA, Dong Y, Nakagami T, Onat A, Söderberg S. Distinct ethnic differences in lipid profiles across glucose categories. J Clin Endocrinol Metab 2010; 95:1793-801. [PMID: 20118302 DOI: 10.1210/jc.2009-2348] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT Dyslipidemia coexists with hyperglycemia. However, little is known about the ethnic differences in lipid profiles at comparable glucose tolerance status. OBJECTIVE The aim was to study ethnic differences in lipid profiles stratified by glucose levels. DESIGN AND SETTING Data from 31 study cohorts of 12 countries, consisting of 24,760 men and 27,595 women aged 25-74 yr, were compared. The odds ratio for having dyslipidemia was estimated for each ethnic group stratified by glucose categories. RESULTS Compared with central and northern Europeans, multivariable adjusted odds ratios (95% confidence intervals) for having lower high-density lipoprotein-cholesterol were 4.74 (4.19-5.37), 5.05 (3.88-6.56), 3.07 (2.15-4.40), and 2.37 (1.67-3.35) in Asian Indian men, but 0.12 (0.09-0.16), 0.07 (0.04-0.13), 0.11 (0.07-0.20), and 0.16 (0.08-0.32) in Chinese men who had normoglycemia, prediabetes, and undiagnosed and diagnosed diabetes, respectively. Similar results were obtained for women. The prevalence of low high-density lipoprotein-cholesterol remained higher in Asian Indians (62.8% of the nondiabetic and 67.4% of the diabetic) than in central and northern Europeans (20.3 and 37.3%), Japanese (25.7 and 34.1%), or Qingdao Chinese (15.7 and 17.0%), even in individuals with low-density lipoprotein-cholesterol of less than 3 mmol/liter. CONCLUSION There are distinct patterns of lipid profiles associated with ethnicity regardless of the glucose levels, suggesting that ethnic-specific strategies and guidelines on risk assessment and prevention of cardiovascular disease are required.
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Affiliation(s)
- Lei Zhang
- Department of Public Health, University of Helsinki, PL41, Mannerheimintie 172, FIN-00014 Helsinki, Finland
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Qian Y, Lin Y, Zhang T, Bai J, Chen F, Zhang Y, Luo S, Shen H. The characteristics of impaired fasting glucose associated with obesity and dyslipidaemia in a Chinese population. BMC Public Health 2010; 10:139. [PMID: 20233452 PMCID: PMC2851684 DOI: 10.1186/1471-2458-10-139] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2009] [Accepted: 03/17/2010] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Different populations have diverse patterns of relationships between Impaired Fasting Glucose (IFG) and obesity and lipid markers, it is important to investigate the characteristics of associations between IFG and other related risk factors including body mass index (BMI), waist circumstance (WC), serum lipids and blood pressure (BP) in a Chinese population. METHODS This was a case-control study of 648 IFG subjects and 1,296 controls derived from a large-scale, community-based, cross-sectional survey of 10,867 participants. Each subject received a face-to-face interview, physical examination, and blood tests, including fasting blood glucose and lipids. Student's t-test, Chi-square test, Spearman correlation and multiple logistic regressions were used for the statistical analyses. RESULTS Fasting plasma glucose (FPG) was positively correlated with BMI, WC, systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), and total cholesterol (TC), and was negatively correlated with high density lipoprotein-cholesterol (HDL-C) (all p < 0.05). BMI was more strongly correlated with IFG than with WC. The correlation coefficient of FPG was remarkably higher with TG (0.244) than with TC (0.134) and HDL-C (-0.192). TG was an important predictor of IFG, with odds ratios of 1.76 (95%CI: 1.31-2.36) for subjects with borderline high TG level (1.70 mmol/l < or = TG < 2.26 mmol/l) and 3.13 (95% CI: 2.50-3.91) for those with higher TG level (TG > or = 2.26 mmol/l), when comparing to subjects with TG < 1.70 mmol/l. There was a significant dose-response relationship between the number of abnormal variables and increased risk of IFG. CONCLUSIONS In this Chinese population, both BMI and WC were important predictors of IFG. Abnormal TG as a lipid marker was more strongly associated with IFG than were TC and HDL-C. These factors should be taken into consideration simultaneously for prevention of IFG.
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Affiliation(s)
- Yun Qian
- Department of Disease Control and Prevention, Wuxi Center for Disease Prevention and Control, Wuxi 214023, Jiangsu, China.
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Chakarova N, Tankova T, Atanassova I, Dakovska L. Serum lipid and hsCRP levels in prediabetes--impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). Diabetes Res Clin Pract 2009; 86:56-60. [PMID: 19674805 DOI: 10.1016/j.diabres.2009.04.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 03/25/2009] [Accepted: 04/03/2009] [Indexed: 10/20/2022]
Abstract
AIM To evaluate cardiovascular risk in prediabetes (IFG and IGT) assessed by serum lipid and hsCRP levels. SUBJECTS AND METHODS 445 subjects with prediabetes (248 with IFG, 197 with IGT), 318 patients with newly-diagnosed diabetes (NDD) and a group of 477 age- and BMI-matched subjects with normal glucose tolerance (NGT) were enrolled. Glucose tolerance was studied during oral glucose tolerance test (OGTT) and 2006 WHO criteria were applied. Serum hsCRP and lipids (total cholesterol, triglycerides, HDL-cholesterol (HDL-c) and free fatty acids (FFAs) were measured. RESULTS Both IFG and IGT showed significantly atherogenic changes in serum lipid and hsCRP levels when compared to NGT. Subjects with IGT presented with significantly higher triglycerides (p=0.01) and FFAs (p<0.0001) and significantly lower HDL-c (p=0.04) as compared to IFG. IFG showed significantly higher levels of HDL-c (p<0.0001) and lower levels of triglycerides (p<0.0001), FFAs (p<0.001) and hsCRP (p=0.04) as compared to NDD, while IGT differed from NDD only in the lower hsCRP (p=0.04). CONCLUSIONS Both IFG and IGT are associated with increased cardiovascular risk as assessed by serum lipid and hsCRP levels. The risk is different in the two categories of prediabetes, IGT being characterized by a more atherogenic risk profile, similar to that in NDD.
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Affiliation(s)
- Nevena Chakarova
- Department of Diabetology, Clinical Center of Endocrinology, University Hospital of Endocrinology, Medical University, Sofia, Bulgaria.
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Zhang L, Qiao Q, Tuomilehto J, Hammar N, Janus ED, Söderberg S, Mohan V, Ramachandran A, Dong YH, Lam TH, Pang ZC. Blood lipid levels in relation to glucose status in seven populations of Asian origin without a prior history of diabetes: the DECODA study. Diabetes Metab Res Rev 2009; 25:549-57. [PMID: 19585489 DOI: 10.1002/dmrr.994] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Dyslipidaemia commonly coexists with diabetes. We investigated the association of lipid profiles with glucose levels in populations of Asian origin without a prior history of diabetes. METHODS Cross-sectional data of 10,374 men and 12,552 women aged 30-74 years from 14 cohorts, representing seven populations of Asian origin were jointly analysed. Multivariable adjusted linear regression analyses with standardized regression coefficients (beta) were performed to estimate relationships between lipids and plasma glucose. RESULTS Within each glucose category, fasting plasma glucose (FPG) levels were correlated with increasing levels of triglycerides (TGs), total cholesterol (TC), TC to high-density lipoprotein (HDL) ratio and non-HDL cholesterol (non-HDL-C) (p < 0.05 in most of the ethnic groups) and inversely associated with HDL-C (p < 0.05 in some, but not all, of the populations). The association of lipids with 2-h plasma glucose (2hPG) followed a similar pattern as that for the FPG, except that an inverse relationship between HDL-C and glucose was more commonly observed for 2hPG than for FPG among different ethnic groups. CONCLUSIONS Hyperglycaemia is associated with adverse lipid profiles in Asians without a prior history of diabetes. The 2hPG appears to be more closely associated with lipid profiles than does FPG. When assessing the risk of cardiovascular disease, the association of the dyslipidaemia with intermediate hyperglycaemia needs to be considered.
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Affiliation(s)
- L Zhang
- Department of Public Health, University of Helsinki, Helsinki, Finland.
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