Energy balance and macronutrient distribution in relation to C-reactive protein and HbA1c levels among patients with type 2 diabetes

Dietary patterns, oxidative Stress, inflammation and biological variation in hemoglobin A1c: Association and Mediation analysis in a rural community in north China

OBJECTIVE

The aim is to assess the relationship between the hemoglobin glycation index(HGI) and dietary patterns, and investigates whether inflammation and oxidative stress mediate the relationship.

METHODS

Cross-sectional data were collected from 453 dwellers in a Chinese rural community. Diet was assessed using 24 h food recalls. Based on the energy intake ratio from three macronutrients, dietary patterns were identified by cluster analysis. The HGI was defined as the observed HbA1c minus predicted HbA1c. Indicators of inflammation and oxidative stress were assessed.

RESULT

3 dietary patterns were clustered, namely "fat(n = 100)", "balance(n = 186)" and "carbohydrate(n = 167)". The fat dietary patterns had lower HGI than the other two dietary patterns. TNFα was higher in the carbohydrate dietary pattern. Linear regression analysis suggested that the carbohydrate dietary pattern was correlated with higher HGI levels(β = 0.204,95 %CI(0.071,0.338)), compared with the fat dietary pattern. The relationship disappeared after accounting for biomarkers of inflammation and oxidative stress. Mediation analyses indicated that TNFα might explain for 19.15 % effects of the carbohydrate dietary pattern on HGI, compared with the fat dietary pattern.

CONCLUSION

The carbohydrate dietary pattern had positive associations with HGI and TNFα. TNFα partly mediated the relationship between dietary patterns and HGI.

Relationship between Energy Balance and Circulating Levels of Hepcidin and Ferritin in the Fasted and Postprandial States

Markers of iron metabolism are altered in new-onset diabetes, but their relationship with metabolic signals involved in the maintenance of energy balance is poorly understood. The primary aim was to explore the associations between markers of iron metabolism (hepcidin and ferritin) and markers of energy balance (leptin, ghrelin, and the leptin/ghrelin ratio) in both the fasted and postprandial states. These associations were also studied in the sub-groups stratified by diabetes status. This was a cross-sectional study of individuals without disorders of iron metabolism who were investigated after an overnight fast and, in addition, some of these individuals underwent a mixed meal test to determine postprandial responses of metabolic signals. The associations between hepcidin, ferritin, and leptin, ghrelin, leptin/ghrelin ratio were studied using several multiple linear regression models. A total of 76 individuals in the fasted state and 34 individuals in the postprandial state were included. In the overall cohort, hepcidin was significantly inversely associated with leptin (in the most adjusted model, the β coefficient ± SE was −883.45 ± 400.94; p = 0.031) and the leptin/ghrelin ratio (in the most adjusted model, the β coefficient ± SE was −148.26 ± 61.20; p = 0.018) in the fasted state. The same associations were not statistically significant in the postprandial state. In individuals with new-onset prediabetes or diabetes (but not in those with normoglycaemia or longstanding prediabetes or diabetes), hepcidin was significantly inversely associated with leptin (in the most adjusted model, the β coefficient ± SE was −806.09 ± 395.44; p = 0.050) and the leptin/ghrelin ratio (in the most adjusted model, the β coefficient ± SE was −129.40 ± 59.14; p = 0.037). Leptin appears to be a mediator in the link between iron metabolism and new-onset diabetes mellitus. These findings add to the growing understanding of mechanisms underlying the derangements of glucose metabolism.

The mediatory role of inflammatory markers on the relationship between dietary energy density and body composition among obese and overweight adult women: A cross-sectional study

AIMS

Energy density (ED) is known to influence body composition (BC). Indeed, consumption of high ED foods can increase body fat mass (BFM) and inflammatory markers. We sought to assess the mediatory role of high-sensitive-C-reactive protein (hs-CRP), transforming growth factor-β (TGF-beta), and plasminogen activator inhibitor-1 (PAI-1) on the relationship between ED and BC in women with overweight/obesity.

METHODS

This was a cross-sectional study consisting of 391 women. Body composition (Bioelectrical Impedance Analysis) and a food frequency questionnaire (FFQ) was used to assess the BC and food intake of individuals. Blood samples and serum level of hs-CRP, PAI-1, and TGF-β were collected. ED per one gram of foods was calculated and divided to quartiles. Linear logistic regression was used to investigate the association between BC across quartiles of ED intake.

RESULTS

Total body water (TBW), fat free mass (FFM), visceral fat area (VFA), and fat free mass index (FFMI) appeared to be mediated by hs-CRP across ED quartiles. TBW, FFM with PAI-1, bone mineral content (BMC) with PAI-1 and TGF-beta, and skeletal lean mass (SLM) were inversely associated with hs-CRP, respectively. Fat trunk, TBW, BFM, FFM, SLM, waist circumference (WC), FFMI, and FMI were positively mediated by TGF-beta with increasing ED food intakes. Fat trunk, BFM, SLM, WC, FFMI and FMI were positively mediated by PAI-1.

CONCLUSIONS

Most BC subcategories were positively associated with higher ED intake, mediated by increasing serum levels of PAI-1 and TGF-beta. Moreover, higher serum hs-CRP levels may be related to body fat and water alteration concomitant to a higher ED intake.

Recommendations of the Polish Society of Diabetology and the Lifestyle of Patients with Type 2 Diabetes Mellitus: An Own Research

Background and Objectives:Currently, diabetes is becoming a very serious challenge in medicine;type 2 diabetes mellitus (T2DM) is referred to as a noncontagious epidemic of the 21st century. The aim of the study is to assess the lifestyle of patients with type 2 diabetes, in particular eating habits, physical activity, and tobacco smoking, and to compare the obtained values with the latest recommendations of the Polish Society of Diabetology. Materials and Methods: The study group was comprised of 460 patients with type 2 diabetes, treated in the Diabetes Outpatient Clinic (n = 299) and the Clinical Department of Internal Medicine (n = 166). The study was conducted using a questionnaire, which included the Food Intake Frequency Questionnaire, 24 h dietary recall, and the International Physical Activity Questionnaire. Results: Abnormal excessive consumption of saturated fatty acids and salt and insufficient intake of dietary fiber was observed in the study group. Physical activity was insufficient in over 50% of the study group. In the study group, 17% of patients were smokers and the mean number of pack-years was 23. Conclusions:In the study group, excessive fat consumption (i.e.,saturated fatty acids) and dietary fiber deficiency were found in the daily diet.

The Effect of Habitual Fat Intake, IL6 Polymorphism, and Different Diet Strategies on Inflammation in Postmenopausal Women with Central Obesity

The hypothesis that habitual fat intake, the IL6 genotype, the Mediterranean diet or the central European diet for 16 weeks affect biomarkers of inflammation in centrally obese postmenopausal women, was tested in a randomized controlled trial. Dietary intake was assessed using a three-day food diary. Lipid parameters were measured using a Beckman Coulter AU analyzer. Transcription of TNF and IL6 genes was analyzed in peripheral blood mononuclear cells using real-time PCR. Concentrations of tumor necrosis factor alpha (TNFα) and interleukin 6 (IL6) were measured with ELISA. rs1800795 polymorphism of IL6 was analyzed using hydrolyzing probes. Higher energy intake from fat was associated with higher IL6 levels (p < 0.05). Significantly (p < 0.01) lower total cholesterol (T-C) and low-density lipoprotein cholesterol (LDL-C) concentrations were observed in the GG IL6 rs1800795 genotype group. Both diets significantly (p < 0.001) decreased TNFα concentrations. Neither IL6 gene transcription levels nor blood IL6 concentrations were affected by them. Our findings confirm that habitual fat intake may affect inflammation. The rs1800795 IL6 polymorphism alone did not significantly affect body weight or body composition in aimed group, but C-allele carriers had higher levels of T-C and LDL-C. This polymorphism did not affect inflammation. Both diets may lead to a decrease in TNFα concentration.

Oxidative stress and inflammation, two features associated with a high percentage body fat, and that may lead to diabetes mellitus and metabolic syndrome

Obesity is an important feature of the metabolic syndrome and is associated with an increased risk of type 2 diabetes mellitus, cardiovascular disease, and some cancers. The aim of this study was to determine the relationship between body fat percentage and an imbalance of the prooxidant/antioxidant balance (PAB), serum superoxide dismutase (SOD1) and inflammation (serum hs-CRP) and increase risk of metabolic syndrome and diabetes mellitus. In this study, 9154 individuals were recruited as part of the Mashhad Stroke and Heart Association Disorder (MASHAD) study. Subjects were categorized into two groups according to body fat percentage as defined >25% in male and > 30% in female, according to gender. Biochemical factors, including serum PAB, SOD1, and hs-CRP were measured in all subjects. SPSS version 18 was used for statistical analyses for all. GraphPad Prism 6 for figures was used. Of total number of subjects (9154), 6748 (73.7%) were found to have a high body fat (BF) percentage. Serum hs-CRP and PAB were significantly higher in individuals with a high BF percentage (P < 0.05) but SOD1 was not significantly different between the two groups (P > 0.05). BF percentage, serum PAB and serum hs-CRP were significantly higher in individuals with metabolic syndrome and diabetes versus those without metabolic syndrome and diabetes mellitus (P < 0.05), however serum SOD1 was significantly lower in individuals with metabolic syndrome (P < 0.005). Oxidative stress and inflammation are two factors that may link the presence of high BF percentage with the development of metabolic syndrome, diabetes, and cardiovascular disease. © 2018 BioFactors, 45(1):35-42, 2019.