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Khalangot MD, Gurianov VG, Zakharchenko TF, Pysarenko YM, Kravchenko VI. Metabolic and Anthropometric Parameters of Persons at Risk of Developing Type 2 Diabetes Mellitus Before and After 3 Months of Consuming Insoluble Dietary Fiber. Nutr Metab Insights 2022; 15:11786388221125181. [PMID: 36172505 PMCID: PMC9510971 DOI: 10.1177/11786388221125181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Observational studies have shown that insoluble fiber (IF) can be effective
in preventing type 2 diabetes (T2D), but there is a lack of experimental
data on the effect of short-term consumption of IF on metabolic parameters.
We tried to investigate whether there was an improvement in glycemia and
body composition in individuals at risk for T2D after 3 months of IF
consumption. Methods: This “Type 2 Diabetes Mellitus Prevention Ukraine (T2DPUA)” study describes
participants with impaired fasting glucose (IFG) as determined by ADA
criteria. The study involved 30 people, including 21 women (70%). Daily,
15 g of IF derived from wheat was used. T2DPUA did not have a placebo group
and the intervention lasted 3 months. Evaluation of fasting plasma glucose
(FPG) and 2h plasma glucose (2hPG), glycated hemoglobin (HbA1c), total
cholesterol, HDL-cholesterol, triacylglycerols, uric acid, and γ-glutamyl
transferase was performed. The baseline and 3-monthly anthropometric
examinations included measurements of weight, waist and hip circumference.
Fat mass was assessed by bioelectrical impedance analysis. Paired samples
t-test or Wilcoxon test were used. Result: A decrease of FPG (P = .042), HbA1c
(P < .001), 2hPG (P = .005), weight
(P < .001), body mass index
(P < .001), the proportion of body fat
(P = .006), and the absolute amount of fat
(P < .001), increases in systolic
(P < .001) and diastolic (P = .008)
blood pressure was shown. The number of people with hypertension did not
change. The absolute amount of body fat decreased by almost 5% and tolerance
to the standard glucose load improved by 15%. The dynamics of other
metabolic parameters were not revealed. Conclusion and Recommendation: Data about improvement of glycemia and body composition over a short period
of using IF by individuals with IFG are new and deserve larger studies.
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Affiliation(s)
- Mykola D Khalangot
- Endocrinology Department, Shupyk National Healthcare University, Kyiv, Ukraine.,Epidemiology Department, Komisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | - Vitaly G Gurianov
- Medical and Biological Physics and Informatics Department, Bogomolets National Medical University, Kyiv, Ukraine
| | - Tamara F Zakharchenko
- Epidemiology Department, Komisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | | | - Victor I Kravchenko
- Epidemiology Department, Komisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
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Fedotkina O, Jain R, Prasad RB, Luk A, García-Ramírez M, Özgümüs T, Cherviakova L, Khalimon N, Svietleisha T, Buldenko T, Kravchenko V, Jain D, Vaag A, Chan J, Khalangot MD, Hernández C, Nilsson PM, Simo R, Artner I, Lyssenko V. Neuronal Dysfunction Is Linked to the Famine-Associated Risk of Proliferative Retinopathy in Patients With Type 2 Diabetes. Front Neurosci 2022; 16:858049. [PMID: 35600617 PMCID: PMC9119187 DOI: 10.3389/fnins.2022.858049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Persons with type 2 diabetes born in the regions of famine exposures have disproportionally elevated risk of vision-threatening proliferative diabetic retinopathy (PDR) in adulthood. However, the underlying mechanisms are not known. In the present study, we aimed to investigate the plausible molecular factors underlying progression to PDR. To study the association of genetic variants with PDR under the intrauterine famine exposure, we analyzed single nucleotide polymorphisms (SNPs) that were previously reported to be associated with type 2 diabetes, glucose, and pharmacogenetics. Analyses were performed in the population from northern Ukraine with a history of exposure to the Great Ukrainian Holodomor famine [the Diagnostic Optimization and Treatment of Diabetes and its Complications in the Chernihiv Region (DOLCE study), n = 3,583]. A validation of the top genetic findings was performed in the Hong Kong diabetes registry (HKDR, n = 730) with a history of famine as a consequence of the Japanese invasion during WWII. In DOLCE, the genetic risk for PDR was elevated for the variants in ADRA2A, PCSK9, and CYP2C19*2 loci, but reduced at PROX1 locus. The association of ADRA2A loci with the risk of advanced diabetic retinopathy in famine-exposed group was further replicated in HKDR. The exposure of embryonic retinal cells to starvation for glucose, mimicking the perinatal exposure to famine, resulted in sustained increased expression of Adra2a and Pcsk9, but decreased Prox1. The exposure to starvation exhibited a lasting inhibitory effects on neurite outgrowth, as determined by neurite length. In conclusion, a consistent genetic findings on the famine-linked risk of ADRA2A with PDR indicate that the nerves may likely to be responsible for communicating the effects of perinatal exposure to famine on the elevated risk of advanced stages of diabetic retinopathy in adults. These results suggest the possibility of utilizing neuroprotective drugs for the prevention and treatment of PDR.
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Affiliation(s)
- Olena Fedotkina
- Department of Clinical Science, Center for Diabetes Research, University of Bergen, Bergen, Norway
| | - Ruchi Jain
- Department of Clinical Sciences, Lund University Diabetes Center, Skane University Hospital, Malmö, Sweden
| | - Rashmi B. Prasad
- Department of Clinical Sciences, Lund University Diabetes Center, Skane University Hospital, Malmö, Sweden
| | - Andrea Luk
- Prince of Wales Hospital, Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | | | - Türküler Özgümüs
- Department of Clinical Science, Center for Diabetes Research, University of Bergen, Bergen, Norway
| | | | | | | | - Tetiana Buldenko
- Department of Health Care of Chernihiv Regional State Administration, Chernihiv, Ukraine
| | - Victor Kravchenko
- Komisarenko Institute of Endocrinology and Metabolism, Kyiv, Ukraine
| | - Deepak Jain
- Department of Clinical Sciences, Lund University Diabetes Center, Skane University Hospital, Malmö, Sweden
| | - Allan Vaag
- Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Juliana Chan
- Prince of Wales Hospital, Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Mykola D. Khalangot
- Komisarenko Institute of Endocrinology and Metabolism, Kyiv, Ukraine
- Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
| | | | - Peter M. Nilsson
- Department of Clinical Sciences, Lund University Diabetes Center, Skane University Hospital, Malmö, Sweden
| | - Rafael Simo
- Vall d’Hebron Research Institute and CIBERDEM, Barcelona, Spain
| | - Isabella Artner
- Department of Clinical Sciences, Lund University Diabetes Center, Skane University Hospital, Malmö, Sweden
| | - Valeriya Lyssenko
- Department of Clinical Science, Center for Diabetes Research, University of Bergen, Bergen, Norway
- Department of Clinical Sciences, Lund University Diabetes Center, Skane University Hospital, Malmö, Sweden
- *Correspondence: Valeriya Lyssenko,
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Fedotkina O, Luk A, Jain R, Prasad RB, Shungin D, Simó‐Servat O, Özgümüs T, Cherviakova L, Khalimon N, Svietleisha T, Buldenko T, Kravchenko V, Hernández C, Jain D, Simo R, Artner I, Nilsson PM, Khalangot MD, Vaiserman AM, Chan J, Vaag A, Lyssenko V. Perinatal famine is associated with excess risk of proliferative retinopathy in patients with type 2 diabetes. Acta Ophthalmol 2022; 100:e539-e545. [PMID: 34169655 DOI: 10.1111/aos.14948] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 05/31/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE Intrauterine undernutrition is associated with increased risk of type 2 diabetes. Children born premature or small for gestational age were reported to have abnormal retinal vascularization. However, whether intrauterine famine act as a trigger for diabetes complications, including retinopathy, is unknown. The aim of the current study was to evaluate long-term effects of perinatal famine on the risk of proliferative diabetic retinopathy (PDR). METHODS We studied the risk for PDR among type 2 diabetes patients exposed to perinatal famine in two independent cohorts: the Ukrainian National Diabetes Registry (UNDR) and the Hong Kong Diabetes Registry (HKDR). We analysed individuals born during the Great Famine (the Holodomor, 1932-1933) and the WWII (1941-1945) famine in 101 095 (3601 had PDR) UNDR participants. Among 3021 (251 had PDR) HKDR participants, we studied type 2 diabetes patients exposed to perinatal famine during the WWII Japanese invasion in 1942-1945. RESULTS During the Holodomor and WWII, perinatal famine was associated with a 1.76-fold (p = 0.019) and 3.02-fold (p = 0.001) increased risk of severe PDR in the UNDR. The risk for PDR was 1.66-fold elevated among individuals born in 1942 in the HKDR (p < 0.05). The associations between perinatal famine and PDR remained statistically significant after corrections for HbA1c in available 18 507 UNDR (padditive interaction < 0.001) and in 3021 HKDR type 2 diabetes patients (p < 0.05). CONCLUSION In conclusion, type 2 diabetes patients, exposed to perinatal famine, have increased risk of PDR compared to those without perinatal famine exposure. Further studies are needed to understand the underlying mechanisms and to extend this finding to other diabetes complications.
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Affiliation(s)
- Olena Fedotkina
- Department of Clinical Science Center for Diabetes Research University of Bergen Bergen Norway
| | - Andrea Luk
- Hong Kong Institute of Diabetes and Obesity Prince of Wales Hospital The Chinese University of Hong Kong Hong Kong SAR China
| | - Ruchi Jain
- Department of Clinical Sciences Lund University Diabetes Center Skåne University Hospital Malmoe Sweden
| | - Rashmi B. Prasad
- Department of Clinical Sciences Lund University Diabetes Center Skåne University Hospital Malmoe Sweden
| | - Dmitry Shungin
- Broad Institute of Harvard and MIT Cambridge MA USA
- Institute of Odontology Umeå University Umeå Sweden
| | - Olga Simó‐Servat
- Vall d'Hebron Research Institute Universitat Autònoma de Barcelona and CIBERDEM Barcelona Spain
| | - Türküler Özgümüs
- Department of Clinical Science Center for Diabetes Research University of Bergen Bergen Norway
| | | | | | | | - Tetiana Buldenko
- Department of Health Care of Chernihiv Regional State Administration Chernihiv Ukraine
| | | | - Cristina Hernández
- Vall d'Hebron Research Institute Universitat Autònoma de Barcelona and CIBERDEM Barcelona Spain
| | - Deepak Jain
- Department of Clinical Sciences Lund University Diabetes Center Skåne University Hospital Malmoe Sweden
| | - Rafael Simo
- Vall d'Hebron Research Institute Universitat Autònoma de Barcelona and CIBERDEM Barcelona Spain
| | - Isabella Artner
- Department of Clinical Sciences Lund University Diabetes Center Skåne University Hospital Malmoe Sweden
| | - Peter M. Nilsson
- Department of Clinical Sciences Lund University Diabetes Center Skåne University Hospital Malmoe Sweden
| | - Mykola D. Khalangot
- Komisarenko Institute of Endocrinology and Metabolism Kyiv Ukraine
- Shupyk National Medical Academy of Postgraduate Education Kyiv Ukraine
| | | | - Juliana Chan
- Hong Kong Institute of Diabetes and Obesity Prince of Wales Hospital The Chinese University of Hong Kong Hong Kong SAR China
| | - Allan Vaag
- Steno Diabetes Center Copenhagen Copenhagen Denmark
| | - Valeriya Lyssenko
- Department of Clinical Science Center for Diabetes Research University of Bergen Bergen Norway
- Department of Clinical Sciences Lund University Diabetes Center Skåne University Hospital Malmoe Sweden
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Magliano DJ, Chen L, Islam RM, Carstensen B, Gregg EW, Pavkov ME, Andes LJ, Balicer R, Baviera M, Boersma-van Dam E, Booth GL, Chan JCN, Chua YX, Fosse-Edorh S, Fuentes S, Gulseth HL, Gurevicius R, Ha KH, Hird TR, Jermendy G, Khalangot MD, Kim DJ, Kiss Z, Kravchenko VI, Leventer-Roberts M, Lin CY, Luk AOY, Mata-Cases M, Mauricio D, Nichols GA, Nielen MM, Pang D, Paul SK, Pelletier C, Pildava S, Porath A, Read SH, Roncaglioni MC, Lopez-Doriga Ruiz P, Shestakova M, Vikulova O, Wang KL, Wild SH, Yekutiel N, Shaw JE. Trends in the incidence of diagnosed diabetes: a multicountry analysis of aggregate data from 22 million diagnoses in high-income and middle-income settings. Lancet Diabetes Endocrinol 2021; 9:203-211. [PMID: 33636102 PMCID: PMC10984526 DOI: 10.1016/s2213-8587(20)30402-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Diabetes prevalence is increasing in most places in the world, but prevalence is affected by both risk of developing diabetes and survival of those with diabetes. Diabetes incidence is a better metric to understand the trends in population risk of diabetes. Using a multicountry analysis, we aimed to ascertain whether the incidence of clinically diagnosed diabetes has changed over time. METHODS In this multicountry data analysis, we assembled aggregated data describing trends in diagnosed total or type 2 diabetes incidence from 24 population-based data sources in 21 countries or jurisdictions. Data were from administrative sources, health insurance records, registries, and a health survey. We modelled incidence rates with Poisson regression, using age and calendar time (1995-2018) as variables, describing the effects with restricted cubic splines with six knots for age and calendar time. FINDINGS Our data included about 22 million diabetes diagnoses from 5 billion person-years of follow-up. Data were from 19 high-income and two middle-income countries or jurisdictions. 23 data sources had data from 2010 onwards, among which 19 had a downward or stable trend, with an annual estimated change in incidence ranging from -1·1% to -10·8%. Among the four data sources with an increasing trend from 2010 onwards, the annual estimated change ranged from 0·9% to 5·6%. The findings were robust to sensitivity analyses excluding data sources in which the data quality was lower and were consistent in analyses stratified by different diabetes definitions. INTERPRETATION The incidence of diagnosed diabetes is stabilising or declining in many high-income countries. The reasons for the declines in the incidence of diagnosed diabetes warrant further investigation with appropriate data sources. FUNDING US Centers for Disease Control and Prevention, Diabetes Australia Research Program, and Victoria State Government Operational Infrastructure Support Program.
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Affiliation(s)
- Dianna J Magliano
- Department of Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Lei Chen
- Department of Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Rakibul M Islam
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Bendix Carstensen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Edward W Gregg
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Meda E Pavkov
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Linda J Andes
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ran Balicer
- Clalit Research Institute, Clalit Health Services, Tel Aviv, Israel
| | - Marta Baviera
- Laboratory of Cardiovascular Prevention, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy
| | - Elise Boersma-van Dam
- Department of General Practice, Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | - Gillian L Booth
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Juliana C N Chan
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yi Xian Chua
- Epidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore
| | - Sandrine Fosse-Edorh
- Department of Non-Communicable Diseases and Trauma, Santé Publique France, Saint-Maurice, France
| | - Sonsoles Fuentes
- Department of Non-Communicable Diseases and Trauma, Santé Publique France, Saint-Maurice, France
| | - Hanne L Gulseth
- Department for Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Romualdas Gurevicius
- Center of Health Information, Institute of Hygiene, Vilnius, Lithuania; Faculty of Public Governance and Business, Mykolas Romeris University, Vilnius, Lithuania
| | - Kyoung Hwa Ha
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea
| | - Thomas R Hird
- Department of Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - György Jermendy
- 3rd Medical Department, Bajcsy-Zsilinszky Hospital, Budapest, Hungary
| | - Mykola D Khalangot
- Komisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences, Kyiv, Ukraine; Endocrinology Department, Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea
| | - Zoltán Kiss
- 2nd Department of Medicine and Nephrological Center, Medical Faculty, University of Pécs, Pécs, Hungary
| | - Victor I Kravchenko
- Komisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences, Kyiv, Ukraine
| | - Maya Leventer-Roberts
- Clalit Research Institute, Clalit Health Services, Tel Aviv, Israel; Department of Pediatrics and Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Chun-Yi Lin
- General Clinical Research Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Andrea O Y Luk
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Manel Mata-Cases
- CIBER of Diabetes and Associated Metabolic Diseases, Instituto de Salud Carlos III, Barcelona, Spain; DAP-Cat Group, Institut Català de la Salut, Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain
| | - Didac Mauricio
- CIBER of Diabetes and Associated Metabolic Diseases, Instituto de Salud Carlos III, Barcelona, Spain; DAP-Cat Group, Institut Català de la Salut, Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain; Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
| | - Gregory A Nichols
- Science Programs Department, Kaiser Permanente Center for Health Research, Portland, OR, USA
| | - Mark M Nielen
- Department of General Practice, Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | - Deanette Pang
- Epidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore
| | - Sanjoy K Paul
- Melbourne EpiCentre, University of Melbourne, Melbourne, VIC, Australia
| | - Catherine Pelletier
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Santa Pildava
- Research and Health Statistics Department, Centre for Disease Prevention and Control, Riga, Latvia
| | - Avi Porath
- Research Institute, Maccabi Healthcare Services, Tel Aviv, Israel; Faculty of Health, Ben Gurion University, Beer-Sheva, Israel
| | | | - Maria Carla Roncaglioni
- Laboratory of Cardiovascular Prevention, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy
| | - Paz Lopez-Doriga Ruiz
- Department for Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Olga Vikulova
- Diabetes Institute, Endocrinology Research Center, Moscow, Russia
| | - Kang-Ling Wang
- General Clinical Research Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Sarah H Wild
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Naama Yekutiel
- Research Institute, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Jonathan E Shaw
- Department of Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; School of Life Sciences, Latrobe University, Bundoora, VIC, Australia
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Khalangot MD, Kovtun VA, Gurianov VG, Pysarenko YM, Kravchenko VI. Evaluation of type 2 diabetes prevention through diet modification in people with impaired glucose regulation: A population-based study. Prim Care Diabetes 2019; 13:535-541. [PMID: 31023525 DOI: 10.1016/j.pcd.2019.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 03/17/2019] [Accepted: 03/25/2019] [Indexed: 01/04/2023]
Abstract
PURPOSE A few interventional studies to date have specifically assessed the association between dairy products and/or sugar consumption and the risk of type 2 diabetes mellitus (T2D) incidence. The aim of this study was to assess the effectiveness of diet modification in people with impaired glucose regulation (IGR) as defined by a glucose tolerance test (GTT). METHODS A quasi-experimental study design was used for this study. A total of 318 randomly selected 18-year-old or older participants from the rural area of the Kyiv region of Ukraine who had not been registered as T2D patients before underwent GTT between June 2013 and June 2017. For those who had been diagnosed with IGR, World Health Organization (WHO)/International Diabetes Federation criteria were used. Of 318 participants screened for T2D, 123 (74% of them females) were diagnosed with IGR. They were aged 18 to 79 years old with a median (QI - QIII) age of 62 (52-68) years. They were repeatedly tested during the study and completed a questionnaire on average 2.8 (1.1) years (standard deviation [SD]), after they had received their lifestyle-based T2D prevention recommendations. In addition to basic recommendations, they were advised to consume approximately 200 g of low-fat dairy products and less than 25 g of sugar daily. Cases of screen-detected diabetes mellitus (SDDM) were diagnosed and reported as an outcome variable if a fast capillary blood glucose level reached 6.1 mmol/L and above. To define the association between implementation of recommendations and the risk of SDDM, the Cox proportional-hazards regression analysis was used. RESULTS During the study observation period, 56 (45.5%) of 123 IGR-positive participants were recognized as SDDM cases. Those individuals with IGR (n = 111) who confirmed their adherence to preventive recommendations had a significantly lower risk of identifying SDDM, age- and gender-adjusted hazard ratio (HR) 0.26 (95% CІ; 0.09-0.72). This effect appears to be related to the recommendation to reduce the daily intake of sugar to less than 25 g (n = 99), corresponding to age- and gender-adjusted HR 0.44 (95% CІ; 0.2-0.99). We cannot prove that increasing consumption of dairy products, vegetables, and fruit or increased physical activity had similar effectiveness. CONCLUSIONS After 2.8 years of follow-up, the individuals who are IGR-positive and who confirmed their adherence to lifestyle-based preventive recommendations had a significantly lower risk of identifying SDDM. This effect appears to be related to recommendations to reduce the daily intake of sugar to less than 25 g.
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Affiliation(s)
- Mykola D Khalangot
- Endocrinology Department, Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine; Epidemiology Department, Komisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine.
| | - Volodymyr A Kovtun
- Epidemiology Department, Komisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | - Vitaly G Gurianov
- Medical & Biological Physics and Informatics Department, Bogomolets National Medical University, Kyiv, Ukraine
| | | | - Victor I Kravchenko
- Epidemiology Department, Komisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
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6
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Khalangot MD, Krasnienkov DS, Chizhova VP, Korkushko OV, Shatilo VB, Kukharsky VM, Kravchenko VI, Kovtun VA, Guryanov VG, Vaiserman AM. Additional Impact of Glucose Tolerance on Telomere Length in Persons With and Without Metabolic Syndrome in the Elderly Ukraine Population. Front Endocrinol (Lausanne) 2019; 10:128. [PMID: 30873125 PMCID: PMC6404635 DOI: 10.3389/fendo.2019.00128] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 02/11/2019] [Indexed: 12/30/2022] Open
Abstract
Rationale: Association between different components of metabolic syndrome and the rate of age-related telomere shortening was reported repeatedly, although some findings are inconsistent across studies, suggesting the need for further research on the topic. In the present study, we examined relationships between different components of metabolic syndrome (MetS); glucose tolerance reflected in 2-h post-load plasma glucose (2hPG) levels and age on the leukocyte telomere length (LTL) in Ukraine population. Methods: The study was conducted on the 115 adult individuals residing in the Kyiv region (Ukraine). Among them, 79 were diagnosed with MetS according to the International Diabetes Federation definition. LTL were determined by a qPCR-based method. Multivariate logistic regression (MLR) and artificial neural networks (ANN) modeling were used for the analysis of the results. ROC-analysis was also performed to compare the predictively values of this models. Results: MetS was associated with a high (OR = 3.0 CI 1.3-6.7; p = 0.01) risk of having shorter telomeres that remained significant after adjusting for age, gender and 2hPG levels. Fasting plasma glucose (FPG) levels and other MetS components did not affect the magnitude of the relationship and did not reveal the independent influence of these factors. The level of 2hPG in turn, demonstrated a significant relationship (OR = 1.3 CI 1.0-1.6 per 1 mmol/l; p = 0.04) with LTL regardless of the presence of MetS. The non-linearity of the interactions between age, gender and 2hPG level was revealed by neural network modeling (AUC = 0.76 CI 0.68-0.84). Conclusion: Our study found that impaired glucose tolerance, but not FPG levels, affected the association between LTL and MetS, which may be also indicative for pathophysiological differences in these hyperglycemia categories. 2hPG levels can provide an opportunity for a more accurate diagnostics of MetS and for evaluating the rate of aging in patients with MetS. Further research, however, is needed to verify this assumption.
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Affiliation(s)
- Mykola D. Khalangot
- Epidemiology Department, Komisarenko Institute of Endocrinology and Metabolism, Kyiv, Ukraine
- Endocrinology Department, Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
- *Correspondence: Mykola D. Khalangot
| | | | | | - Oleg V. Korkushko
- Laboratory of Epigenetics, Chebotariov Institute of Gerontology, Kyiv, Ukraine
| | - Valery B. Shatilo
- Laboratory of Epigenetics, Chebotariov Institute of Gerontology, Kyiv, Ukraine
| | - Vitaly M. Kukharsky
- Laboratory of Epigenetics, Chebotariov Institute of Gerontology, Kyiv, Ukraine
| | - Victor I. Kravchenko
- Epidemiology Department, Komisarenko Institute of Endocrinology and Metabolism, Kyiv, Ukraine
| | - Volodymyr A. Kovtun
- Epidemiology Department, Komisarenko Institute of Endocrinology and Metabolism, Kyiv, Ukraine
| | - Vitaly G. Guryanov
- Public Health Management Department, Bogomolets National Medical University, Kyiv, Ukraine
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Krasnienkov DS, Khalangot MD, Kravchenko VI, Kovtun VA, Guryanov VG, Chizhova VP, Korkushko OV, Shatilo VB, Kukharsky VM, Vaiserman AM. Hyperglycemia attenuates the association between telomere length and age in Ukrainian population. Exp Gerontol 2018; 110:247-252. [PMID: 29958997 DOI: 10.1016/j.exger.2018.06.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 06/23/2018] [Accepted: 06/25/2018] [Indexed: 12/15/2022]
Abstract
Diabetes-related conditions such as chronic hyperglycemia and related oxidative stress and inflammation were repeatedly associated with accelerated telomere shortening in epidemiological studies, although some findings are inconsistent. In present study, we aimed to assess the impact of disturbances in glucose metabolism on association between age and leukocyte telomere length (LTL) in the Ukrainian population. The study was conducted on the 119 adult subjects aged between 43 and 87 years residing in the Kyiv region, Ukraine. LTL was determined by a quantitative PCR-based method. LTL was negatively correlated with the measure of abdominal obesity such as waist-hip ratio, as well as with both fasting plasma glucose (FPG) and two-hour post-load glucose (2hPG) levels. Consistently with previous studies, a significant negative association between LTL and age was observed in individuals with normal (<5.6 mmol/L) FPG levels. Unexpectedly, however, no association was found in subjects with impaired glucose metabolism assessed by abnormal FPG or/and 2hPG levels. No association between LTL and age was observed in a logistic regression model; the association between LTL and age became significant after adjusting for FPG level. In the FPG-adjusted model, 1.6-time lower odds to have long telomere length were indicated for each 10 years increase in age. We hypothesize that the attenuation of association between LTL and age in hyperglycemic persons can likely be attributed to the interaction of multidirectional processes determining this relationship.
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Affiliation(s)
| | - Mykola D Khalangot
- Komisarenko Institute of Endocrinology and Metabolism NAMS of Ukraine, Kyiv 04114, Ukraine; Department of Endocrinology, Shupyk National Medical Academy of Postgraduate Education, Kyiv 04112, Ukraine
| | - Victor I Kravchenko
- Komisarenko Institute of Endocrinology and Metabolism NAMS of Ukraine, Kyiv 04114, Ukraine
| | - Volodymyr A Kovtun
- Komisarenko Institute of Endocrinology and Metabolism NAMS of Ukraine, Kyiv 04114, Ukraine
| | - Vitaly G Guryanov
- Department of Medical and Biological Physics and Informatics, Bogomolets National Medical University, Kyiv 02000, Ukraine
| | | | - Oleg V Korkushko
- Chebotariov Institute of Gerontology NAMS of Ukraine, Kyiv 04114, Ukraine
| | - Valery B Shatilo
- Chebotariov Institute of Gerontology NAMS of Ukraine, Kyiv 04114, Ukraine
| | - Vitaly M Kukharsky
- Chebotariov Institute of Gerontology NAMS of Ukraine, Kyiv 04114, Ukraine
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Khalangot MD, Kovtun VA, Okhrimenko NV, Gurianov VG, Kravchenko VI. Glucose Tolerance Testing and Anthropometric Comparisons Among Rural Residents of Kyiv Region: Investigating the Possible Effect of Childhood Starvation-A Community-Based Study. Nutr Metab Insights 2017; 10:1178638817741281. [PMID: 29225471 PMCID: PMC5714066 DOI: 10.1177/1178638817741281] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 10/06/2017] [Indexed: 12/13/2022] Open
Abstract
A relationship between childhood starvation and type 2 diabetes mellitus (T2D) in adulthood was previously indicated. Ukraine suffered a series of artificial famines between 1921 and 1947. Famines of 1932 to 1933 and 1946 were most severe among them. Long-term health consequences of these famines remain insufficiently investigated. Type 2 diabetes mellitus screening was conducted between June 2013 and December 2014. A total of 198 rural residents of Kyiv region more than 44 years of age, not registered as patients with T2D, were randomly selected. In all, 159 persons answered the question about starvation of parental family, including 73 born before 1947. Among them, 62 persons answered positive. Anthropometric measurements and glucose tolerance tests were performed. A logistic regression model was used to evaluate results. Type 2 diabetes mellitus was detected in 7 of 62 persons (11.3%), who starved during childhood vs 6 of 11 (54.5%) who did not (P = .002), age-adjusted and sex-adjusted odds ratio (OR) (95% confidence interval): 0.063 (0.007-0.557). Analysis of the anthropometric data revealed a negative connection between adulthood height and neck circumference (cm, continued variables) and childhood starvation: age-adjusted and sex-adjusted ORs 0.86 (0.76-0.97) and 0.73 (0.54-0.97), respectively. Individuals who starved during famines of 1932 to 1933 and 1946 in Ukraine had a decreased T2D prevalence several decades after the famine episodes.
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Affiliation(s)
- Mykola D Khalangot
- Endocrinology Department, Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine.,Epidemiology Department, Komisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | - Volodymir A Kovtun
- Epidemiology Department, Komisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | - Nadia V Okhrimenko
- Epidemiology Department, Komisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | - Vitaly G Gurianov
- Medical & Biological Physics and Informatics Department, Bogomolets National Medical University, Kyiv, Ukraine
| | - Victor I Kravchenko
- Epidemiology Department, Komisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
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Lumey LH, Khalangot MD, Vaiserman AM. Association between type 2 diabetes and prenatal exposure to the Ukraine famine of 1932-33: a retrospective cohort study. Lancet Diabetes Endocrinol 2015; 3:787-94. [PMID: 26342852 DOI: 10.1016/s2213-8587(15)00279-x] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 07/14/2015] [Accepted: 07/15/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND The effect of fetal and early childhood living conditions on adult health has long been debated, but empirical assessment in human beings remains a challenge. We used data from during the man-made Ukrainian famine of 1932-33 to examine the association between restricted nutrition in early gestation and type 2 diabetes in offspring in later life. METHODS We included all patients with type 2 diabetes diagnosed at age 40 years or older in the Ukraine national diabetes register 2000-08, and used all individuals born between 1930 and 1938 from the 2001 Ukraine national census as the reference population. This study population includes individuals born before and after the famine period as controls, and those from regions that experienced extreme, severe, or no famine. We used prevalence odds ratios (ORs) as the measure of association between type 2 diabetes and early famine exposure, with stratification by region, date of birth, and sex for comparisons of diabetes prevalence in specific subgroups. FINDINGS Using these two datasets, we compared the odds of type 2 diabetes by date and region of birth in 43,150 patients with diabetes and 1,421,024 individuals born between 1930 and 1938. With adjustment for season of birth, the OR for developing type 2 diabetes was 1·47 (95% CI 1·37-1·58) in individuals born in the first half of 1934 in regions with extreme famine, 1·26 (1·14-1·39) in individuals born in regions with severe famine, and there was no increase (OR 1·00, 0·91-1·09) in individuals born in regions with no famine, compared with births in other time periods. Multivariable analyses confirmed these results. The associations between type 2 diabetes and famine around the time of birth were similar in men and women. INTERPRETATION These results show a dose-response relation between famine severity during prenatal development and odds of type 2 diabetes in later life. Our findings suggest that early gestation is a critical time window of development; therefore, further studies of biological mechanisms should include this period. FUNDING Ukraine State Diabetes Mellitus Program, US National Institutes of Health.
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Affiliation(s)
- L H Lumey
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Molecular Epidemiology, Leiden University Medical Center, Leiden, Netherlands.
| | - Mykola D Khalangot
- Komisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences, Kiev, Ukraine; Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine
| | - Alexander M Vaiserman
- Chebotarev Institute of Gerontology, National Academy of Medical Sciences, Kiev, Ukraine
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Khalangot MD. Comment on: Pantalone et al. The risk of overall mortality in patients with type 2 diabetes receiving glipizide, glyburide, or glimepiride monotherapy: a retrospective analysis. Diabetes Care 2010;33:1224-1229. Diabetes Care 2011; 34:e138; author reply 139. [PMID: 21788641 PMCID: PMC3142028 DOI: 10.2337/dc11-0756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Mykola D. Khalangot
- From the Komisarenko Institute of Endocrinology and Metabolism, Academy of Medical Sciences, Kiev, Ukraine
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Vaiserman AM, Khalangot MD, Carstensen B, Tronko MD, Kravchenko VI, Voitenko VP, Mechova LV, Koshel NM, Grigoriev PE. Seasonality of birth in adult type 2 diabetic patients in three Ukrainian regions. Diabetologia 2009; 52:2665-7. [PMID: 19756485 DOI: 10.1007/s00125-009-1519-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2009] [Accepted: 08/11/2009] [Indexed: 11/27/2022]
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Vaiserman AM, Carstensen B, Voitenko VP, Tronko MD, Kravchenko VI, Khalangot MD, Mechova LV. Seasonality of birth in children and young adults (0-29 years) with type 1 diabetes in Ukraine. Diabetologia 2007; 50:32-5. [PMID: 17093948 DOI: 10.1007/s00125-006-0456-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2006] [Accepted: 07/31/2006] [Indexed: 02/07/2023]
Abstract
AIMS/HYPOTHESIS Numerous epidemiological studies have shown differences in seasonality of birth patterns between the general population and the group who develop type 1 diabetes mellitus. This finding indicates that environmental factors operating during pre- and/or postnatal development could be aetiologically important. We examined whether the pattern of month of birth for type 1 diabetes patients in Ukraine differs from that for total live births. METHODS Data consist of prevalent cases of type 1 diabetes in Ukraine by the end of 2003. Cases are restricted to persons born after 1 January 1960, diagnosed with type 1 diabetes before the age of 30 years (n = 20,117). People born during the same time in the general population (n = 29,105,560) were the reference standard. Seasonal patterns were estimated using logistic regression with harmonic terms. RESULTS We found a strongly significant seasonal pattern of type 1 diabetes incidence rates (p < 0.001), with the lowest rates in December and the highest in April. The rate ratio between the extremes was 1.32 (95% CI 1.27-1.39). Tests for seasonal patterns in subgroups defined by sex and age or by sex and date of birth were all significant with p values less than 0.02. We found no interactions with sex (p = 0.142) or age at diagnosis (p = 0.207), but found a strong interaction with period of birth (p < 0.0001). CONCLUSIONS/INTERPRETATION The results obtained indicate that early-life factors linked to seasons may influence type 1 diabetes risk later in life.
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Affiliation(s)
- A M Vaiserman
- Laboratory of Mathematical Modelling of Ageing Processes, Institute of Gerontology, Vyshgorodskaya st. 67, Kiev 04114, Ukraine.
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