Evaluation of interleukin-33 & sST2 levels in type-2 diabetic mellitus patients with or without metabolic syndrome

Background & objectives: Diabetes mellitus (DM) is characterized by increase in blood glucose levels due to defective insulin secretion or insulin sensitivity. Interleukins (ILs) are known to play an important role in the pathogenesis of DM. The aim of this study was to investigate the serum concentration of IL-33 and its receptor soluble ST2 (sST2) in patients with diabetes and draw a correlation between their serum levels and different standard glycaemic indices of patients affected with type-2 diabetes with or without metabolic syndrome. Methods: Thirty type-2 diabetic individuals and 30 healthy controls were recruited for this study. Serum and plasma were separated by centrifugation of blood for quantitative measurement of IL-33, sST2 and other biochemical parameters. Results: It was observed that serum IL-33 levels were significantly less and sST2 levels were significantly high in type-2 diabetic individuals as compared to healthy controls. A significant correlation between the serum IL-33 concentration and fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) levels were also found. Additionally, data also elucidated that serum levels of high-density lipoprotein, low-density lipoprotein or triglyceride in type-2 diabetics did not influence the serum levels of IL-33 and sST2, thereby excluding these factors as the major drivers of changes in serum IL-33 and sST2 concentration. Interpretation & conclusions: This study demonstrated alteration in serum levels of IL-33 and sST2 in type-2 diabetic individuals. Further mechanistic studies, focusing on the progression of type-2 diabetes could elucidate the involvement of IL-33 in the cellular acquisition of insulin resistance as observed in type-2 diabetics

elationship between preoperative fasting plasma glucose and postoperative pulmonary complications after lung resection in type 2 diabetic patients / 中国胸心血管外科临床杂志

@#Objective     To explore the relationship between preoperative fasting plasma glucose (FPG) and postoperative pulmonary complications (PPCs) in type 2 diabetic patients undergoing elective thoracoscopic lung resection, and provide a reference for prediction and prevention of PPCs in the clinic. Methods     A retrospective analysis was performed on the type 2 diabetic patients who underwent elective thoracoscopic lung resection for the first time in our hospital from January 2017 to March 2021. According to the level of FPG one day before the operation, the patients were divided into three groups: a hypoglycemia group (<6.1 mmol/L), a medium level blood glucose group (≥6.1 mmol/L and <8.0 mmol/L) and a high blood glucose group (≥8.0 mmol/L). Besides, the patients were divided into a PPCs group and a non-PPCs group according to whether PPCs occurred. The risk factors for PPCs were analyzed by logistic regression analysis, and the predictive value of preoperative FPG level on PPCs was estimated by the area under the receiver operating characteristic curve (AUC). Results     A total of 130 patients were included, including 75 (57.7%) males and 55 (42.3%) females with an average age of 63.5±9.0 years. Logistic regression analysis showed that compared to non-PPCs patients, the level of preoperative FPG (P=0.023) and smoking history ratio (P=0.036) were higher and the operation time was longer (P=0.004) in the PPCs patients. High FPG level on preoperative day 1 and longer operation time were associated with PPCs risk. Besides, the preoperative FPG of 6.79 mmol/L was the threshold value to predict the occurrence of PPCs [AUC=0.653, 95%CI (0.559, 0.747), P=0.003]. Conclusion     There is a certain correlation between preoperative FPG level and postoperative PPCs, which may be used as an index to predict the occurrence of PPCs.

Disease burden of chronic kidney disease attributable to metabolic factors in Jiangsu Province in 1990 -2019 / 公共卫生与预防医学

Objective To analyze the burden of chronic kidney disease (CKD) attributable to metabolic factors in Jiangsu Province from 1990 to 2019, and to provide evidence for the formation and implementation of intervention policies. Methods Using data from Jiangsu Province from the 2019 Global Burden of Disease Study (GBD 2019), mortality and disability-adjusted life-years (DALYs) were selected as indicators for analysis and standardized with the age structure of the world standard population. The effects of three metabolic factors including high systolic blood pressure (SBP), high fasting glycaemic index (FPG) and high body mass index (BMI) on the disease burden of CKD were analyzed, and the attributable disease burden by gender and age was compared. Results The rank of the three attributable risk factors was high SBP, high FPG, and high BMI. Standardized mortality rates attributable to high SBP, high FPG, and high BMI all showed an overall upward trend from 1990 to 2019, with annual average percent changes (AAPCs) of 0.3%, 0.0%, and 2.8%, respectively. Age-standardized DALYs attributed to high SBP and high BMI showed increasing trends, with the AAPCs of 0.5% and 3.1% (both P＜0.05), respectively. There was no statistical significance of high FPG (P > 0.05). Mortality and disease burden attributed to high SBP both showed upward trends with increasing age. Age-standardized mortality and age-standardized DALYs attributed to high FPG peaked at 45-49 and 50-54 age-group, respectively. Both age-standardized mortality and age-standardized DALYs attributed to high BMI peaked at ages 60-64 age-group. Conclusion The trends of mortality and DALYs attributed to the three risk factors can reflect the changes of population structure and lifestyle in Jiangsu Province in the past 30 years to a certain extent. Early screening of population at high risk of CKD and targeted provision of health policies can reduce the mortality and disease burden of CKD.

Relationship among fasting plasma glacose coefficient of variation and macular morphology and microcirculation in patients with nonproliferative diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the relationship among the fasting plasma glucose coefficient of variation(FPG-CV)and macular morphology and microcirculation in patients with nonproliferative diabetic retinopathy(NPDR).METHODS: A retrospective analysis of 82 cases(82 eyes)with NPDR admitted to our hospital from February 2018 to June 2022 was the research object, and another 82 cases(82 eyes)of non-diabetic retinopathy(NDR)patients during the same period were selected as the control group, and the clinical data of the two groups of patients were analyzed. Multivariate Logistic regression was used to analyze the risk factors affecting the incidence of NPDR, and the back propagation(BP)neural network model was established and evaluated. Pearson correlation was used to analyze the correlation among FPG-CV and macular morphology and microcirculation in patients. RESULTS: The results of multivariate Logistic regression analysis showed that the disease duration ≥7.2a, glycated hemoglobin A1c(HbA1c)≥7.7%, triglyceride(TG)≥1.9 mmol/L, microalbuminuria(MALB)≥24.5 mg/L, FPG-CV ≥9.8%, superficial capillary plexus-vessel density(SCP-VD)&#x0026;#x003C;27.6%, deep capillary plexus-vessel density(DCP-VD)&#x0026;#x003C;47.7%, foveal avascular zone(FAZ)area ≥0.38 mm2, central retinal thickness(CRT)≥197.7 μm and subfoveal choroidal thickness(SFCT)&#x0026;#x003C;227.7 μm were risk factors for NPDR(P&#x0026;#x003C;0.05). The number of hidden layer nodes is 5, and the receiver operating characteristic(ROC)curve, calibration curve and clinical decision curve show that the prediction model has good discrimination, accuracy and validity. The results of Pearson correlation analysis showed that FPG-CV was negatively correlated with SCP-VD, DCP-VD and SFCT(P&#x0026;#x003C;0.05); FPG-CV was positively correlated with FAZ area and CRT(P&#x0026;#x003C;0.05).CONCLUSION: The course of disease, HbA1c, TG, MALB, FPG-CV, SCP-VD, DCP-VD, FAZ area, CRT and SFCT are all related to the pathogenesis of NPDR. With the increase of FPG-CV, the indexes of macular morphology and microcirculation changed. FPG-CV was negatively correlated with SCP-VD, DCP-VD and SFCT and positively correlated with FAZ area and CRT.

Relationship between vitamin D and blood pressure in patients with type 2 diabetes mellitus in semi-urban North Indian population

Background: Besides being associated with cardiovascular diseases, hypertension has emerged as a risk factor for diabetes. A few studies have focused on the role of vitamin D in the control of blood pressure in hypertensive people. There is still debate about whether serum vitamin D levels play a role in causing hypertension or not. Aim and Objectives: The aim of this study was to find out the relationship between vitamin D and blood pressure in type diabetes. Materials and Methods: In this cross-sectional observational study, a total of 180 type 2 diabetes patients participated. Patients were divided into two groups on the bases of Vitamin D levels. Vitamin D levels below 20 ng/ml are considered Vitamin D deficient and more than 20ng/ml are considered as no vitamin D deficient. An independent t-test was used for comparison of glycemic parameters and blood pressure between the two groups. Person correlation was used to find out the relationship between Vitamin D and blood pressure. Results: Glycated hemoglobin and fasting plasma glucose were significantly higher in vitamin D deficient groups (P ? 0.001). Furthermore, a significant difference was found in systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP). Moreover, a significant negative correlation was observed only with vitamin D deficient group and SBP (r = –0.22, P = 0.04); it was also true for DBP and MAP (r = –0.24, P = 0.03, r = –0.24, P = 0.01), respectively. Conclusion: A low vitamin D is negatively associated with blood pressure in type 2 diabetic patients. Vitamin D supplementation can improve blood pressure along with glycemic parameter.

Impaired glucose tolerance in dengue fever: A case-control study

Background: Studies on dengue fever demonstrated that the dengue viral infection of pancreas is often associated with disease morbidity and complication. Aims and Objectives: The pancreas-pathogen interactions in dengue-infected persons were evaluated using endocrine deregulation as an investigation marker of complication. Materials and Methods: A prospective observational study was conducted in a tertiary care medical college and hospital of West Bengal, over 1 year and 4 months. Blood samples from 286 cases and 258 controls were collected on day 2. After plasma glucose determination, 44 cases and 39 controls were excluded as frank cases of diabetes mellitus. On day 6, fasting and 2 h postprandial plasma glucose estimation were done in 73 cases and 61 controls by glucose oxidase-peroxidase method using autoanalyzer. Data were analyzed using the Statistical Package for the Social Sciences version 20.0. Results: The prevalence of impaired glucose tolerance was higher in cases on day 2 than on follow-up on day 6 (12.3% vs. 8%). There existed no statistical difference in terms of fasting plasma glucose between cases and control on day 2 and day 6 and postprandial (PP) plasma glucose on day 2. However, the PP values on day 6 in cases were significantly higher in cases in comparison to controls (P = 0.006). Among cases, day 6 values were higher than day 2 values (0.016). Conclusion: Dengue viral infection correlates with the involvement of the pancreas in terms of impaired tolerance to glucose which has implications for understanding disease pathogenesis in terms of developing chronic complications.

In Hospital Mortality in Patients with Impaired Fasting Glucose and Acute Myocardial Infarction in a Tertiary Care Centre of Rural Bengal

Introduction : The Cardiovascular mortality in Diabetics is 2-4 times higher than in Non-diabetic population. But there is still controversy regarding Pre-diabetes (IFG and IGT) as a Cardiovascular Risk Factor. Aims and Objectives : In this study we aimed to investigate the early in-hospital mortality among Acute Myocardial Infarction (AMI) patients having Impaired Fasting Glucose (IFG) during the first 7 days of hospitalization. Materials and Methods: A total of 150 AMI patients were evaluated and followed up for their glycemic status and early in hospital mortality (first 7 days) at Burdwan Medical College, Burdwan, West Bengal. Result and Analysis: Mortality in patients having IFG (18%) was higher and as much as in DM (20%) compared to euglycemic (4%) patients but the mortality is not correlated with mean Fasting Plasma Glucose (FPG) level. Conclusion : IFG (ie, pre-diabetes) increases Cardiovascular mortality as much as diabetes. So, IFG may be a marker or risk factor for mortality but lowering FPG in AMI patients is unlikely to yield beneficial effect regarding mortality.

A cohort study on the correlation between fasting plasma glucose trajectories and new-onset carotid plaque / 中华健康管理学杂志

Objective:To investigate the correlation between fasting plasma glucose (FPG) and new-onset carotid plaque through latent class trajectory models.Methods:A total of 953 observation objects came from the first affiliated hospital of Zhengzhou University in accordance with the inclusion criteria. According to the FPG values of the observed subjects during the annual physical examination from January 2017 to December 2019, the following four different FPG trajectories groups were determined by latent class trajectory modelling tools: the low-stable group, the medium stable group, the medium-high stable group, and the high stable group. Carotid plaque incidence in each group was followed up in 2020 to compare the differences of the cumulative incidences of the four groups. The Cox proportional risk regression model was used to analyze the correlation between different FPG trajectories and new-onset carotid plaque.Results:The incidence of carotid plaque increased with the increase of FPG trajectories by 11.13%, 19.70%, 23.44%, 23.81%, respectively, with significance ( P<0.001). After adjusting gender, age, BMI and other confounding factors with the cox proportional risk regression model, the risk of carotid plaque in the FPG medium stable group, medium and high stable group, high-stable group was still 1.895 (95% CI: 1.296-2.769), 2.273 (95% CI: 1.241-4.161), 2.527 (95% CI: 1.219-5.241) times of the low stable group (all P<0.05). Conclusion:The long-term high FPG levels are independent risk factors for the incidence of carotid plaque, and controlling FPG at a low level steadily can reduce the risk of carotid plaque.

Evaluation of dyslipidemia in normal and underweight diabetics patient and its association with BMI and gender

Objectives: To assess the frequency of dyslipidemia in type II diabetes mellitus in normal and underweight patients. Material and methods: This cross sectional study was conducted at Basic Health Unit, Manzabta District Okara. Total 218 type II diabetics having age 30-70 years either male or female, having BMI 15 to 24.99 were selected for this study. Five ml fasting blood sample was taken and sent to laboratory for lipid profile. Results: In present study total 218 type 2 diabetics were selected. Mean age of the patients was 48.33 ± 13.85 years, mean weight was 52.66 ± 8.63 Kg, mean height was 61.54 ± 2.46 inches and mean BMI was 22.73 ± 2.45. Out of 218 diabetics, dyslipidemia was noted in 152 (70%) patients.Total 163 (74.77%) patients were normal weight and 55 (25.23%) patients were under weight. Dyslipidemia was noted in 140 (85.9%) normal weight patients and 12 (21.8%) underweight patients. Significantly (P = 0.000) higher rate of dyslipidemia was noted in normal weight patients as compared to underweight patients. Conclusion: In present study, higher rate of dyslipidemia was noted in type II diabetics. There were not association of dyslipidemia with age and gender. But highly significant association of dyslipidemia with normal and underweight was noted.

Analysis of the prevalence and influencing factors of elevated FPG in Liaoning Province / 上海预防医学

Objective To determine the prevalence rate of elevated fasting plasma glucose(FPG)in residents of Liaoning Province and to identify the risk factors, which will help to effectively prevent/alleviate the occurrence and development of diabetes for reduction of socioeconomic burden. Methods A multi-stage stratified random cluster sampling method was used to investigate the residents of 3 towns and 3 rural areas in Liaoning Province. A total of 53 497 adults(aged 35-75 years)were surveyed by questionnaires and the risk or protective factors were analyzed by logistic regression method. Results The prevalence rate of elevated FPG was 24.7% with 23.2% in males and 26.0% in females, respectively. The results of multivariate logistic regression showed that age increase, female, high education, occupation(except farmers), alcohol drinking, obesity, hypertension, and dyslipidemia were risk factors of FPG(P < 0.05 or P < 0.001). Conclusion The prevalence of elevated FPG is high in the study population aged 35-75 years in Liaoning. It is necessary to strengthen the intervention in this part of the population in order to reduce the incidence of diabetes mellitus.

Discordance between Fasting Plasma Glucose (FPG) and HbA1c in Diagnosing Diabetes and Pre-diabetes in The Malaysian Cohort / Journal of the ASEAN Federation of Endocrine Societies

Objective@#In this present study, we aim to evaluate the accuracy of the HbA1c relative to fasting plasma glucose (FPG) in the diagnosis of diabetes and pre-diabetes among The Malaysian Cohort (TMC) participants.@*Methodology@#FPG and HbA1c were taken from 40,667 eligible TMC participants that have no previous history of diabetes, aged between 35-70 years and were recruited from 2006 – 2012. Participants were classified as normal, diabetes and pre-diabetes based on the 2006 World Health Organization (WHO) criteria. Statistical analyses were performed using ANOVA and Chi-square test, while Pearson correlation and Cohen’s kappa were used to examine the concordance rate between FPG and HbA1c.@*Results@#The study samples consisted of 16,224 men and 24,443 women. The prevalence of diabetes among the participants was 5.7% and 7.5% according to the FPG and HbA1c level, respectively. Based on FPG, 10.6% of the participants had pre-diabetes but this increased to 14.2% based on HbA1c (r=0.86; P<0.001). HbA1c had a sensitivity of 58.20 (95% CI: 56.43, 59.96) and a specificity of 98.59 (95% CI: 98.46, 98.70).@*Conclusion@#A higher prevalence of pre-diabetes and diabetes was observed when using HbA1c as a diagnosis tool, suggesting that it could possibly be more useful for early detection. However, given that HbA1c may also have lower sensitivity and higher false positive rate, several diagnostic criteria should be used to diagnose diabetes accurately.

Screening of gestational diabetes mellitus using fasting plasma glucose before the 24th gestational week in women with different pre-pregnancy body mass index

Background: Gestational Diabetes Mellitus (GDM) is usually diagnosed between 24th and 28th gestational week using the 75-g Oral Glucose Tolerance Test (OGTT). It is controversial that if FPG ?92 mg/dL before 24th gestational week should be intervened or not. The aim of this study was to evaluate the value of FPG to screen GDM before 24th gestational week in women with different pre-pregnancy Body Mass Index (BMI).Methods: This was a hospital based retrospective cohort study done at CHC Balipatna, Khurdha, Odisha. Women who had a singleton live birth between June 20, 2016 and June 30, 2019, resided in Balipatna block area and received prenatal care in the Community Health Centre, were included in this study. Pre-pregnancy BMI, FPG before the 24th gestational week, and one-step GDM screening with 75 g-OGTT at the 24th to 28th gestational weeks were extracted from medical records and analyzed. The pregnant women were classified into four groups based on pre-pregnancy BMI: Group A (underweight), Group B (normal), Group C (overweight) and Group D (obesity). Statistical analysis using independent sample t-test, Analysis of Variance (ANOVA) and Pearson Chi-square test was done.Results: The prevalence of GDM was 20.0% (68/341) in the study population. FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. The incidence of GDM in women with FPG ?92 mg/dL in the 19th to 24th gestational weeks and pre-pregnancy overweight or obesity was significantly higher than that in women with FPG ?92 mg/dL and pre-pregnancy BMI <24.0 kg/m2.Conclusions: FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. Pre-pregnancy overweight or obesity was associated with an increased FPG value before the 24th gestational week. FPG ?92 mg/dL between 19 and 24 gestational weeks should be treated as GDM in women with pre-pregnancy overweight and obesity.

Effect of transcutaneous auricular vagus nerve stimulation on hyperglycemia and insulin receptors expression in impaired glucose tolerance rats / 针刺研究

OBJECTIVE: To explore the effect of transcutaneous auricular vagus nerve stimulation (taVNS) on blood glucose regulation and the expression of insulin receptors (INR) of hypothalamus, liver and skeletal muscle tissues in impaired glucose tolerance (IGT) rats, so as to reveal its mechanisms underlying improvement of IGT. METHODS: Thirty-six male Wistar rats were randomly divided into control, model, transcutaneous auricular none-vagus nerve stimulation (tnVNS), and taVNS groups (n=9 in each group). The IGT model was established by feeding the rats with high-fat and high-sugar diet for 5 weeks, and subsequent intraperitoneal injection of a dose of streptozotocin (20 mg/kg). Transcutaneous electrostimulation (2 mA, 2 Hz/15 Hz) was applied to auricular concha (taVNS) or auricular margin (tnVNS), respectively. The treatment was conducted for 30 min once daily for 4 weeks. The body weight, fasting plasma glucose (FPG), 2 h plasma glucose (2 h PG) were recorded every week. The contents of plasma insulin (INS), glucagon (GC), glycosylated hemoglobin (GHbA1c) were detected by using enzyme linked immunosorbent assay (ELISA). The expression levels of INR in hypothalamus, liver and skeletal muscle tissues were detected by Western blot. RESULTS: After modeling, the rats' body weight, the contents of FPG, 2 h PG, GC and GHbA1c were significantly up-regulated (P<0.001, P<0.05, P<0.01), and the content of INS and expression of INR in hypothalamus, liver and skeletal muscle tissues were significantly down-regulated in the model group compared with the control group (P<0.001, P<0.01, P<0.05). Following the treatment, the increased FPG, 2 h PG, GC, and the decreased INS and INR expression of hypothalamus, liver and skeletal muscle tissues were apparently reversed in the taVNS group relevant to the model group (P<0.001, P<0.01, P<0.05). Compared with the tnVNS group, the FPG and 2 h PG contents were considerable decreased, and the content of INS and INR expression of hypothalamus and liver were obviously increased in the taVNS group (P<0.001, P<0.05, P<0.01). CONCLUSION: taVNS can improve the blood glucose and insulin sensitivity in IGT rats, which may contribute to its effectiveness in up-regulating the expression of INR in hypothalamus, liver and skeletal muscle tissues.

Correlation between fasting plasma glucose, HbA1c and DNA methylation in adult twins / 北京大学学报(医学版)

OBJECTIVE@#To explore the cytidine-phosphate-guanosine (CPG) sites associated with fas-ting plasma glucose (FPG) and glycated haemoglobin (HbA1c) in twins.@*METHODS@#In the study, 169 pairs of monozygotic twins were recruited in Qingdao, Zhejiang, Jiangsu, Sichuan and Heilongjiang in June to December of 2013 and June 2017 to October 2018. The methylation was detected by Illumina Infinium HumanMethylation450 BeadChip and Illumina Infinium MethylationEPIC BeadChip. According to the Linear Mixed Effect model (LME model), fasting plasma glucose and HbA1c were taken as the main effects, the methylation level (β value) was taken as the dependent variable, continuous variables, such as age, body mass index (BMI), blood pressure, components of blood cells, surrogate variables generated by SVA, and categorical variables, such as gender, smoking and drinking status, hypoglycemic drugs taking, were included in the fixed effect model as covariates, and the identity numbers (ID) of the twins was included in the random effect model. The intercept was set as a random. Regression analysis was carried out to find out the CpG sites related to fasting blood glucose or HbA1c, respectively.@*RESULTS@#In this study, 338 monozygotic twins (169 pairs) were included, with 412 459 CpG loci. Among them, 114 pairs were male, and 55 pairs were female, with an average age of (48.2±11.9) years. After adjustment of age, gender, BMI, blood pressure, smoking, drinking, blood cell composition, and other covariates, and multiple comparison test, 7 CpG sites (cg19693031, cg01538969, cg08501915, cg04816311, ch.8.1820050F, cg06721411, cg26608667) were found related to fasting blood glucose, 3 of which (cg08501915, ch.8.1820050f, cg26608667) were the newly found sites in this study; whereas 10 CpG sites (cg19693031, cg04816311, cg01538969, cg01339781, cg01676795, cg24667115, cg09029192, cg20697417, ch.4.1528651F, cg16097041) were found related to HbA1c, and 4 of which(cg01339781, cg24667115, cg20697417, and ch.4.1528651f) were new. We found that cg19693031 in TXNIP gene was the lowest P-value site in the association analysis between DNA methylation and fas-ting plasma glucose and HbA1c (PFPG=2.42×10-19, FDRFPG<0.001; PHbA1c=1.72×10-19, FDRHbA1c<0.001).@*CONCLUSION@#In this twin study, we found new CpG sites related to fasting blood glucose and HbA1c, and provided some clues that partly revealed the potential mechanism of blood glucose metabolism in terms of DNA methylation, but it needed further verification in external larger samples.

Effect of Ramadan fasting on glycaemic parameters & body mass index in type II diabetic patients: A meta-analysis

Background & objectives: There has been an ongoing debate about the impact of Ramadan fasting (RF) on the health of these individuals who fast during Ramadan. The aim of this meta-analysis was to evaluate the relationship between RF and glycaemic parameters in type 2 diabetes mellitus (T2DM) patients. Methods: Search terms were decided and databases such as MEDLINE EBSCO, Google Scholar and EMBASE were searched for eligible studies. Standardized mean differences and 95 per cent confidence intervals (CIs) of post-prandial plasma glucose (PPG), fasting plasma glucose (FPG), glycated haemoglobin (HbA1c) (%) and fructosamine levels were calculated for different treatment regimens. Results: Of the 40 studies, 19 were found eligible for inclusion in the meta-analysis. Based on pooled results, significant reductions in FPG were found in single oral antidiabetics (OAD) [standardized weighted mean difference (SMD)=0.47, 95% CI=(0.20-0.74)], multi-OAD [SMD=0.36, 95% CI=(0.11-0.61)] and multitreatment subgroups [SMD=0.65, 95% CI=(0.03-1.27)] and overall [SMD=0.48, 95% CI=(0.27-0.70)]. Furthermore, HbA1c(%) [SMD=0.26, 95% CI=(0.03-0.49)] and body mass index (BMI) [SMD=0.18, 95% CI=(0.04-0.31)] were significantly decreased in the multi-OAD group. Interpretation & conclusions: The meta-analysis showed that RF was not associated with any significant negative effects on PPG and fructosamine levels. However, BMI and FPG and HbA1c(%) were positively affected by RF.

Prediction of gestational diabetes mellitus in the first trimester: comparison of maternal fetuin-A, N-terminal proatrial natriuretic peptide, high-sensitivity C-reactive protein, and fasting glucose levels

ABSTRACT Objective We investigated the utility of maternal fetuin-A, N-terminal proatrial natriuretic peptide (pro-ANP), high-sensitivity C-reactive protein (hs-CRP), and fasting glucose levels at 11-14 gestation weeks for predicting pregnancies complicated by gestational diabetes mellitus (GDM). Subjects and methods This prospective cohort study included 327 low-risk pregnant women who completed antenatal follow-up at a tertiary research hospital between January and April 2014. Maternal blood samples were collected between 11-14 gestational weeks in the first trimester of pregnancy and then stored at -80 °C until further analyses. During follow-up, 29 (8.8%) women developed GDM. The study population was compared 1:2 with age- and body mass index-matched pregnant women who did not develop GDM (n = 59). Fasting plasma glucose (FPG) levels and serum fetuin-A, pro-ANP, and hs-CRP levels were measured using automated immunoassay systems. Results There was a significant negative correlation between fetuin-A and hs-CRP (CC = -0.21, p = 0.047) and a positive correlation between FPG and hs-CRP (CC = 0.251, p = 0.018). The areas under the receiver operating characteristic curve for diagnosing GDM were 0.337 (p = 0.013), 0.702 (p = 0.002), and 0.738 (p < 0.001) for fetuin-A, hs-CRP, and FPG, respectively. The optimal cut-off values were > 4.65, < 166, and > 88.5 mg/dL for maternal hs-CRP, fetuin-A, and FPG, respectively. Conclusion Reduced fetuin-A, elevated hs-CRP, and FPG levels in women in the first trimester can be used for the early detection of GDM. Further research is needed before accepting these biomarkers as valid screening tests for GDM.

Effect of natural polyphenols on diabetes mellitus (type-2) with myocardial infarction: a double-blind placebo controlled trial

Background: Diabetes Mellitus Type-2(T2D); is a leading disease in world wide. T2D is a clinical syndrome characterized by hyperglycaemia. Hyperglycemias are caused by an absolute or relative deficiency of insulin and due to insulin resistance. Diabetic patients are highly prone to Reactive Oxygen Species (ROS) and leads to Cardio vascular complications. Several medicines have been recommended to cure T2D; and still discovery of newer drugs are in process. Now a day, the focus of researches in diabetes includes discovery of newer anti-diabetic agents as well as isolating the active compounds from herbal sources. One such herbal source is pomegranate. Pomegranate is polyphenols and antioxidants rich fruit; which has potency to cure T2D and ROS.Methods: A Pomegranate Extract of Whole Fruit (PEWF) was prepared as tablet of 300mg to investigate its effects in patients with T2D. Total 40 participants of either gender with nested cases of T2D with Myocardial Infarction (MI) were included in study. All participants were assigned in two groups (20 each). One group was under “Add On” therapy of PEWF and matching placebos of same colour, shape and size were used as comparator agent for second group (300mg BD for 1 month).Results: Levels of biochemical markers related to T2D were compared to analysed pre and post drug effects by Z test, chi square test and by coefficient of variations. Results highlighted that those participants who were under “add-on” therapy of PEWF showed highly prognostic significance. Thus, PEWF should be consumed in diet as food supplementation.Conclusions: In conclusion, polyphenols and antioxidants rich fruit supplements should be taken in diet for healthy living.

Efficiency comparison of fasting plasma glucose combined with 1,5-anhydroglucitol and combined with glycated albumin in diabetes mellitus screening / 上海交通大学学报（医学版）

Objective: To analyze and compare the clinical value of serum 1,5-anhydroglucitol (1,5-AG) with glycated albumin (GA) combined with fasting plasma glucose (FPG),respectively,in screening diabetes mellitus in Chinese population at the risk of diabetes mellitus. Methods: A total of 701 subjects with high risk of diabetes were enrolled in this study,including 324 males and 377 females. All subjects underwent 75 g oral glucose tolerance test (OGTT). Diabetes was diagnosed according to the cut-off points of 2010 American Diabetes Association standards. The sensitivity,specificity and area under ROC curve (AUC) of GA combined with FPG and 1,5-AG combined with FPG in screening diabetes mellitus were analyzed. Results: Among 701 subjects,350 (49.93%) cases were diagnosed as having diabetes mellitus. The sensitivity,specificity,and AUC of 1,5-AG combined with FPG were 84.29%,91.45% and 0.939,respectively. The sensitivity of GA combined with FPG was 77.71%,and the specificity and AUC were 90.88% and 0.932,respectively. There was no significant difference in AUC between the two screening methods (P>0.05),but the sensitivity of 1,5-AG combined with FPG was higher than that of GA combined with FPG (P=0.001). The proportion of the subjects in need of further OGTT judged by 1,5-AG combined with FPG was 27.82%,which was 11.27% lower than that judged by FPG alone,and 2.57% lower than that judged by GA combined with FPG. Conclusion: In Chinese population with high risk of diabetes mellitus,serum 1,5-AG or GA combined with FPG can improve the efficiency of diabetes screening. Compared with GA combined with FPG,1,5-AG combined with FPG may have more clinical value.

Update on the current modalities used to screen high risk youth for prediabetes and/or type 2 diabetes mellitus

The modalities currently employed to screen for type 2 diabetes mellitus (T2DM)/prediabetes are HbA1(c), fasting plasma glucose (FPG), and 2-hour plasma glucose (PG) during an oral glucose tolerance test (OGTT). The purpose of this review is to highlight the positive qualities and pitfalls of these diagnostic modalities and reflect on the most reasonable and effective approach to screen high risk youth. Given its inherent preanalytical advantages, glycated hemoglobin (HbA1(c)) continues to be the preferred diagnostic modality used by pediatricians to screen high risk youth. However, when the three aforementioned tests are performed in youths of different races/ethnicities, discrepant results for T2DM/prediabetes are observed. The prevalence rates for T2DM vary from 0.53% in Chinese youth (including youth of all body mass indexes) to 18.3% in high-risk, overweight, obese Korean youth. Moreover, the FPG is abnormal (>100 less than <126 mg/dL) in 15% of Korean youth versus 8.7% of Chinese youth. The prevalence rates for prediabetes are 1.49% in Chinese youth versus 21% in Emirati youth (HbA1(c), 5.7%–6.4%). The coefficient of agreement, k, between these screening tests for T2DM are fair, 0.45–0.5 across all youth. However, using HbA1(c) as a comparator, the agreement is weak with FPG (k=0.18 in German youth versus k=0.396 in Korean youth). The American Diabetes Association (ADA) Standards of Medical Care Guidelines define “high risk youth” who need to be tested for T2DM and/or prediabetes. OGTT and HbA1(c) do not always detect T2DM in similar individuals. HbA1(c) may not be an ideal test for screening Hispanic and African American youth. FPG and OGTT are suitable screening tests for youth of ethnic minorities and those with cystic fibrosis or hemoglobinopathies. Performing all three tests either together or sequentially may be the only way to encompass all youth who have aberrations in different aspects of glucose homeostasis.

Prevalence and risk factors of hyperuricemia in physical examination group of Zhangjiakou / 预防医学

Objective To investigate the prevalence and risk factors of hyperuricemia in physical examination group of Zhangjiakou, and to provide evidence for the prevention of hyperuricemia. Methods The physical examination people in the Number One Hospital of Zhangjiakou were selected as the research objects from May 2016 to May 2017 . Their physique indexes such as height, weight and blood pressure were tested, and their blood sample were collected and biochemical indexes such as fasting plasma glucose (FPG), blood uric acid (UA), triglyceride (TG) and total cholesterol (TC) were detected. Logistic regression model were used to analyze the influencing factors of hyperuricemia. Results A total of 17273 examinees were recruited, with the average age of (47.42±14.28) years. There were 10324 men (59.77％) and 6949 women (40.23％) . The prevalence rate of hyperuricemia was 22.14％. The prevalence rate of hyperuricemia in men was 28.39％, higher than that of women (12.87％) (P<0.001) . Logistic regression analysis showed that obesity/overweight (OR=2.206, 95％ CI: 1.986-2.450), high TG (OR=2.089, 95％CI: 1.903-2.293) and high TC (OR=1.121, 95％CI: 1.006-1.249) were risk factors of the male patients with hyperuricemia, while the elderly (OR=0.982, 95％CI: 0.979-0.985) and high FPG (OR=0.657, 95％ CI: 0.587-0.736) were protective factors. The risk factors of the female patients with hyperuricemia were the elderly (OR=1.008, 95％CI: 1.001-1.014), obesity/overweight (OR=2.193, 95％CI: 1.864-2.579), high FPG (OR=1.379, 95％CI: 1.128-1.687) and high TG (OR=2.209, 95％ CI: 1.879-2.597) . Conclusion The prevalence of hyperuricemia among residents in Zhangjiakou of Hebeiis high. Overweight / obesity and high TG are the risk factors for hyperuricemia.