A non-invasive risk score including skin autofluorescence predicts diabetes risk in the general population

Increased skin autofluorescence (SAF) predicts the development of diabetes-related complications and cardiovascular disease. We assessed the performance of a simple model which includes SAF to identify individuals at high risk for undiagnosed and incident type 2 diabetes, in 58,377 participants in the Lifelines Cohort Study without known diabetes. Newly-diagnosed diabetes was defined as fasting blood glucose ≥ 7.0 mmol/l and/or HbA_1c ≥ 6.5% (≥ 48 mmol/mol) or self-reported diabetes at follow-up. We constructed predictive models based on age, body mass index (BMI), SAF, and parental history of diabetes, and compared to results with the concise FINDRISC model. At 2nd visit to Lifelines, 1113 (1.9%) participants were identified with undiagnosed diabetes and 1033 (1.8%) participants developed diabetes during follow-up. A model comprising age, BMI and SAF yielded an AUC of 0.783 and was non-inferior to the concise FINDRISC model, which had an AUC of 0.797 to predict new diabetes. At a score of 5.8, sensitivity was 78% and specificity of 66%. Model 2 which also incorporated parental diabetes history, had an AUC of 0.792, and a sensitivity of 74% and specificity of 70% at a score of 6.5. Net reclassification index (NRI) did not improve significantly (NRI 1.43% (- 0.50-3.37 p = 0.15). The combination of an easy to perform SAF measurement with age and BMI is a good alternative screening tool suitable for medical and non-medical settings. Parental history of diabetes did not significantly improve model performance in this homogeneous cohort.

Preparation of Isodehydrodigallic Acid Using Ullmann Condensation

Isodehydrodigallic acid, which is an important component of several ellagitannin compounds, was easily synthesized using a classical Ullmann condensation reaction.

Synthesis of an Ellagitannin Component, the Macaranoyl Group with a Tetra-ortho-Substituted Diaryl Ether Structure

Herein, a practical synthesis of the macaranoyl group contained in ellagitannins, i.e., a C-O digallate structure with a tetra-ortho-substituted diaryl ether bond, is described. The methodology involved an oxa-Michael addition/elimination reaction between a brominated ortho-quinone monoketal and a phenol with a hexahydroxydiphenoyl moiety in the presence of 18-crown-6 under dark conditions, followed by reductive aromatization. The existence of rotamers originating from the constructed ether moiety is discussed as well.

Synthesis of diaryl ether components of ellagitannins using ortho-quinone with consonant mesomeric effects

Methods for synthesizing C–O digallate structures, the basic unit of diaryl ether components of natural ellagitannins, are described. In the designed building block, consonantly overlapped mesomeric effects enhanced its electrophilicity.

Fundamental Methods in Ellagitannin Synthesis

This account describes methods for synthesizing natural ellagitannins. The ellagitannins, a class of polyphenols, has a wide variety of chemical structures and biological activities. Here, we focus on three topics, which are the synthesis of the hexahydroxydiphenoyl group, construction of the hexahydroxydiphenoyl bridge, and synthesis of C–O digallates. The hexahydroxydiphenoyl group and the C–O digallates are C–C and C–O coupled galloyl groups, respectively, both group of which are the two major components of ellagitannins. By combining methods described in this account, many ellagitannins might be synthesized.