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1.
Chinese Medical Journal ; (24): 665-671, 2022.
Article in English | WPRIM | ID: wpr-927560

ABSTRACT

BACKGROUND@#Gestational diabetes mellitus (GDM) brings health issues for both mothers and offspring, and GDM prevention is as important as GDM management. It was shown that a history of GDM was significantly associated with a higher maternal risk for GDM recurrence. The incidence of GDM recurrence was unclear because of the incidence of second-child was low before 2016 in China. We aim to investigate the prevalence of GDM recurrence and its associated high-risk factors which may be useful for the prediction of GDM recurrence in China.@*METHODS@#A retrospective study was conducted which enrolled participants who underwent regular prenatal examination and delivered twice in the same hospital of 18 research centers. All participants were enrolled from January 2018 to October 2018, where they delivered the second baby during this period. A total of 6204 women were enrolled in this study, and 1002 women with a history of GDM were analyzed further. All participants enrolled in the study had an oral glucose tolerance test (OGTT) result at 24 to 28 weeks and were diagnosed as GDM in the first pregnancy according to the OGTT value (when any one of the following values is met or exceeded to the 75-g OGTT: 0 h [fasting], ≥5.10 mmol/L; 1 h, ≥10.00 mmol/L; and 2 h, ≥8.50 mmol/L). The prevalence of GDM recurrence and development of type 2 diabetes mellitus were calculated, and its related risk factors were analyzed.@*RESULTS@#In 6204 participants, there are 1002 women (1002/6204,16.15%) with a history of GDM and 5202 women (5202/6204, 83.85%) without a history of GDM. There are significant differences in age (32.43 ± 4.03 years vs. 33.00 ± 3.34 years vs. 32.19 ± 3.37 years, P  < 0.001), pregnancy interval (4.06 ± 1.44 years vs. 3.52 ± 1.43 years vs. 3.38 ± 1.35 years, P  = 0.004), prepregnancy body mass index (BMI) (27.40 ± 4.62 kg/m2vs. 23.50 ± 3.52 kg/m2vs. 22.55 ± 3.47 kg/m2, P < 0.001), history of delivered macrosomia (22.7% vs. 11.0% vs. 6.2%, P < 0.001) among the development of diabetes mellitus (DM), recurrence of GDM, and normal women. Moreover, it seems so important in the degree of abnormal glucose metabolism in the first pregnancy to the recurrence of GDM and the development of DM. There are significant differences in OGTT levels of the first pregnancy such as area under the curve of OGTT value (18.31 ± 1.90 mmol/L vs. 16.27 ± 1.93 mmol/L vs. 15.55 ± 1.92 mmol/L, P < 0.001), OGTT fasting value (5.43 ± 0.48 mmol/L vs. 5.16 ± 0.49 mmol/L vs. 5.02 ± 0.47 mmol/L, P < 0.001), OGTT 1-hour value (10.93 ± 1.34 mmol/L vs. 9.69 ± 1.53 mmol/L vs. 9.15 ± 1.58 mmol/L, P < 0.001), OGTT 2-hour value (9.30 ± 1.66 mmol/L vs. 8.01 ± 1.32 mmol/L vs. 7.79 ± 1.38 mmol/L, P < 0.001), incidence of impaired fasting glucose (IFG) (fasting plasma glucose ≥5.6 mmol/L) (31.3% vs. 14.6% vs. 8.8%, P < 0.001), and incidence of two or more abnormal OGTT values (68.8% vs. 39.7% vs. 23.9%, P < 0.001) among the three groups. Using multivariate analysis, the factors, such as age (1.07 [1.02-1.12], P = 0.006), prepregnancy BMI (1.07 [1.02, 1.12], P  = 0.003), and area under the curve of OGTT in the first pregnancy (1.14 [1.02, 1.26], P  = 0.02), have an effect on maternal GDM recurrence; the factors, such as age (1.28 [1.01-1.61], P  = 0.04), pre-pregnancy BMI (1.26 [1.04, 1.53], P = 0.02), and area under the curve of OGTT in the first pregnancy (1.65 [1.04, 2.62], P = 0.03), have an effect on maternal DM developed further.@*CONCLUSIONS@#The history of GDM was significantly associated with a higher maternal risk for GDM recurrence during follow-up after the first pregnancy. The associated risk factors for GDM recurrence or development of DM include age, high pre-pregnancy BMI, history of delivered macrosomia, the OGTT level in the first pregnancy, such as the high area under the curve of OGTT, IFG, and two or more abnormal OGTT values. To prevent GDM recurrence, women with a history of GDM should do the preconception counseling before preparing next pregnancy.


Subject(s)
Adult , Blood Glucose/metabolism , China/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Diabetes, Gestational , Female , Fetal Macrosomia , Glucose Intolerance , Humans , Male , Pregnancy , Retrospective Studies
2.
Femina ; 49(9): 520-524, 20211030.
Article in Portuguese | LILACS | ID: biblio-1342318

ABSTRACT

A síndrome dos ovários policísticos (SOP) é frequentemente acompanhada de distúrbio metabólico, principalmente dos carboidratos e dos lipídeos, aumentando o risco de síndrome metabólica. Por essa razão, alguns investigadores ainda denominam a SOP de síndrome metabólica-reprodutiva. O objetivo deste capítulo é descrever as principais repercussões metabólicas, bem como como investigá-las e saber como suas consequências podem ser deletérias para a saúde da mulher. Esta é uma revisão narrativa mostrando a implicação do metabolismo dos carboidratos e dos lipídeos nas dislipidemias, bem como da síndrome metabólica sobre o sistema reprodutor, e o risco cardiovascular da mulher com SOP. Conclui-se que o manejo adequado dos distúrbios metabólicos na SOP é benéfico a curto e a longo prazo tanto para o sistema reprodutor quanto para o cardiovascular.(AU)


Subject(s)
Humans , Female , Polycystic Ovary Syndrome/metabolism , Metabolic Syndrome/diagnosis , Metabolic Syndrome/physiopathology , Insulin Resistance , Risk Factors , Glucose Intolerance/diagnosis , Glucose Metabolism Disorders/physiopathology , Diabetes Mellitus, Type 2/diagnosis , Dyslipidemias/physiopathology , Lipid Metabolism Disorders/physiopathology
3.
Article in Chinese | WPRIM | ID: wpr-888149

ABSTRACT

This study investigated the mechanism of improving impaired glucose tolerance(IGT) of rats by Huanglian Wendan Decoction from the perspective of the skeletal muscle Nod-like receptor protein 3(NLRP3)/cysteinyl aspartate specific proteinase-1(caspase-1)/interleukin-1β(IL-1β), interleukin-18(IL-18) pathway. Healthy male SD rats were fed with the diet containing 45% fat for 20 weeks, accompanied by a high-temperature and high-humidity environment and an inactive lifestyle, for the establishment of the IGT rat model. The rats were divided into the blank control group, model control group, metformin hydrochloride group(positive drug group, 0.05 g·kg~(-1)·d~(-1)) and Huanglian Wendan Decoction group(7.8 g·kg~(-1)·d~(-1)). After continuous intragastric administration for 4 weeks, the obesity and glycemic indexes of all the rats were measured. The fasting serum insulin(FINS) level was determined by ELISA, with the insulin sensitivity index(ISI) and insulin resistance index(IRI) calculated. The mRNA and protein expression le-vels of nuclear factor kappaB(NF-κB), NLRP3, caspase-1, IL-1β and IL-18 in skeletal muscle tissue were detected by real-time polymerase chain reaction(PCR), Western blot and immunofluorescence. Compared with the blank control group, the model control group witnessed significantly increased mRNA and protein expression of NF-κB, NLRP3, caspase-1, IL-1β and IL-18. As revealed by the comparison with the model control group, Huanglian Wendan Decoction could effectively regulate the obesity status, reduce body weight, correct the abnormal levels of 2-hour plasma glucose(2 hPG), insulin resistance index(IRI), insulin sensitivity index(ISI), and lower the mRNA and protein expression of NF-κB, NLRP3, caspase-1, IL-1β and IL-18 in the skeletal muscle tissue of IGT rats. Combined with previous studies, the above results showed that the occurrence and development of IGT was closely related to inflammatory response and the classic pyroptosis pathway in skeletal muscle, such as NLRP3/caspase-1/IL-1β, IL-18. It is inferred that the mechanism of Huanglian Wendan Decoction was to alleviate insulin resistance(IR) and then reverse the course of IGT lies in the regulation of the abnormal insulin receptor signaling pathway based on the NLRP3 inflammasome pathway.


Subject(s)
Animals , Caspase 1/genetics , Drugs, Chinese Herbal , Glucose Intolerance , Interleukin-18/genetics , Interleukin-1beta , Male , Muscle, Skeletal , NF-kappa B/genetics , NLR Family, Pyrin Domain-Containing 3 Protein/genetics , Rats , Rats, Sprague-Dawley
4.
Chinese Medical Journal ; (24): 1191-1198, 2021.
Article in English | WPRIM | ID: wpr-878170

ABSTRACT

BACKGROUND@#The prevalence of skin diseases and diabetes mellitus (DM) are prominent around the world. The current scope of knowledge regarding the prevalence of skin diseases and comorbidities with type 2 DM (T2DM) is limited, leading to limited recognition of the correlations between skin diseases and T2DM.@*METHODS@#We collected 383 subjects from the Da Qing Diabetes Study during the period from July 9th to September 1st, 2016. The subjects were categorized into three groups: Normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and T2DM. The prevalence and clinical characteristics of skin diseases were recorded and investigated.@*RESULTS@#In this cross-sectional study, 383 individuals with ages ranging from 53 to 89-year-old were recruited. The overall prevalence of skin diseases was 93.5%, and 75.7% of individuals had two or more kinds of skin diseases. Additionally, there were 47 kinds of comorbid skin diseases in patients with T2DM, of which eight kinds of skin diseases had a prevalence >10%. The prevalence of skin diseases in NGT, IGT, and T2DM groups were 93.3%, 91.5%, and 96.6%, respectively; stratified analysis by categories showed a statistically significant difference in "disturbances of pigmentation" and "neurological and psychogenic dermatoses". The duration of T2DM also significantly associated with the prevalence of "disturbances of pigmentation" and "neurological and psychogenic dermatoses". Subsequently, the prevalence of "disturbances of pigmentation" was higher in males than females in NGT (P < 0.01) and T2DM (P < 0.01) groups. In addition, the difference in the prevalence of "disturbances of pigmentation" was also significant in NGT and T2DM groups (P < 0.01).@*CONCLUSIONS@#There was a high prevalence of skin diseases in the Da Qing Diabetes Study. To address the skin diseases in the Da Qing Diabetes Study, increased awareness and intervention measures should be implemented.


Subject(s)
Aged , Aged, 80 and over , Blood Glucose , Cross-Sectional Studies , Diabetes Mellitus, Type 2/epidemiology , Female , Glucose Intolerance/epidemiology , Glucose Tolerance Test , Humans , Male , Middle Aged , Skin Diseases/epidemiology
5.
Article in Chinese | WPRIM | ID: wpr-877563

ABSTRACT

OBJECTIVE@#To observe the effect of acupuncture on vascular endothelial function in patients of polycystic ovary syndrome (PCOS) with impaired glucose tolerance (IGT) and normal glucose tolerance (NGT).@*METHODS@#A total of 140 patients with PCOS were divided into an IGT group (70 cases, 11 dropped off) and a NGT group (70 cases, 9 cases dropped off). The patients in the two groups were treated with full-cycle acupuncture at Zhongwan (CV 12), Guanyuan (CV 4), Qihai (CV 6), Tianshu (ST 25), etc. once every other day, 3 times a week, for 3 months. Before and after treatment, TCM symptom score, insulin resistance index [including fasting plasma glucose (FPG), 2-hour blood glucose (2hPG), fasting serum insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR)] and vascular endothelial related factors [including asymmetric dimethylarginine (ADMD), endothelin-1 (ET-1), malondialdehyde (MDA), nitric oxide (NO)] were compared between the two groups; in addition, the obese subgroup and non-obese subgroup of the two groups were further compared.@*RESULTS@#Compared before treatment, the TCM symptom scores, ADMD, ET-1 and MDA after treatment were decreased (@*CONCLUSION@#Acupuncture could improve vascular endothelial function in PCOS patients, IGT patients have better efficacy than NGT patients, and obese patients have better efficacy than non-obese patients.


Subject(s)
Acupuncture Therapy , Blood Glucose , Female , Glucose , Glucose Intolerance/therapy , Humans , Insulin , Insulin Resistance , Polycystic Ovary Syndrome/therapy
6.
Cad. Saúde Pública (Online) ; 37(9): e00255920, 2021. tab, graf
Article in English | LILACS | ID: biblio-1345630

ABSTRACT

Abstract: There is a conflict in the literature regarding the association between serum uric acid (SUA) levels and glycemic status. Therefore, we evaluated the association between SUA level and glycemic status - impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetes mellitus - and insulin resistance, in a large Brazilian study. This is a cross-sectional, observational study with 13,207 participants aged 35-74 years, at baseline (2008-2010) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). A multinomial regression analysis was performed to test the association between SUA and glycemic status (IFG, IGT, and newly diagnosed type 2 diabetes at the cohort baseline) after adjustments by age, sex, skin color, body mass index, physical activity, smoking, alcohol consumption, comorbidities, and medicines use. Logistic regression model was used to evaluate the association between SUA and insulin resistance by HOMA-IR. Stratified analyses by sex were performed. The mean age (standard deviation) was 51.4 (8.9) years, 55.2% of participants were women. There were 1,439 newly diagnosed diabetes. After all adjustments, higher SUA was associated with IFG, IGT, and diabetes, with odds ratio (OR) = 1.15 (95%CI: 1.06; 1.25), 1.23 (95%CI: 1.14; 1.33), and 1.37 (95%CI: 1.24; 1.51), respectively. There was association between SUA levels and insulin resistance with OR = 1.24 (95%CI: 1.13; 1.36). In analysis stratified by sex, higher SUA persisted independently associated with impaired glycemic status. Our results suggest that a higher SUA levels were significantly associated with glycemic status in a large Latin American population, mainly among women.


Resumo: Há uma controvérsia na literatura a respeito da associação entre níveis de ácido úrico sérico (AUS) e glicemia. Portanto, avaliamos a associação entre AUS e glicemia (glicemia em jejum alterada, intolerância glicêmica e diabetes mellitus), além da resistência insulínica, em uma amostra grande no Brasil. O estudo transversal observacional incluiu 13.207 participantes com idade entre 35 e 74 anos na linha de base (2008-2010) do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Foi realizada análise de regressão multivariada para testar a associação entre AUS e glicemia (glicemia em jejum alterada, intolerância glicêmica e diagnóstico novo de diabetes tipo 2 na linha de base da coorte) depois de ajustar para idade, sexo, cor, índice de massa corporal, atividade física, tabagismo, consumo de álcool, comorbidades e uso de medicação. O modelo de regressão logística foi usado para avaliar a associação entre AUS e resistência insulínica por HOMA-IR. Foram realizadas análises estratificadas por sexo. A média de idade (DP) foi 51,4 (8,9) anos, e 55,2% dos participantes eram mulheres. Houve 1.439 novos diagnósticos de diabetes. Depois de todos os ajustes, o AUS esteve associado à glicemia em jejum alterada, intolerância glicêmica e diabetes, com odds ratio (OR) = 1,15 (IC95%: 1,06; 1,25), 1,23 (IC95%: 1,14; 1,33) e 1,37 (IC95%: 1,24; 1,51), respectivamente. Houve uma associação entre níveis de AUS e resistência insulínica, com OR = 1,24 (IC95%: 1,13; 1,36). Na análise estratificada por sexo, persistiu a associação independente entre AUS elevado e glicemia. Os resultados sugerem que níveis elevados de AUS estão associados de maneira significativa com a glicemia em uma população latino-americana grande, sobretudo entre mulheres.


Resumen: Hay un conflicto en la literatura respecto a la asociación entre los niveles de ácido úrico sérico (AUS) y el estado glucémico. Por eso, evaluamos la asociación entre el nivel AUS y el estatus glucémico: glucosa alterada en ayunas (GAA), tolerancia a la glucosa alterada (TGA) y diabetes mellitus (diabetes), comparados con la resistencia a la insulina en un amplio estudio en Brasil. Se realizó un estudio transversal, observacional con 13.207 participantes, con edades comprendidas entre los 35-74 años, en la base de referencia del Estudio Longitudinal de Salud entre Adultos brasileños (2008-2010) (ELSA-Brasil). Se realizó un análisis de regresión multinomial para probar la asociación entre AUS y el estado glucémico (GAA, TGA y de nuevo la diabetes tipo 2, diagnosticada en la cohorte como base de referencia) tras los ajustes por edad, sexo, color de piel, índice de masa corporal, actividad física, fumar, consumo de alcohol, comorbilidades, uso de medicinas. Se usó el modelo de regresión logística para evaluar la asociación entre AUS y la resistencia a la insulina por el HOMA-IR. Se realizó también un análisis estratificado por sexo. La media de edad (desviación estándar) fue 51,4 (8,9) años, un 55,2% de los participantes eran mujeres. Hubo 1.439 nuevos casos de diabetes diagnosticados. Tras todos los ajustes, una AUS más alta estuvo asociada con GAA, TGA y diabetes, con odds ratio (OR) = 1,15 (IC95%: 1,06; 1,25), 1,23 (IC95%: 1,14; 1,33), y 1,37 (IC95%: 1,24; 1,51), respectivamente. Hubo asociación entre los niveles AUS y la resistencia a la insulina con OR = 1,24 (IC95%: 1,13; 1,36). En el análisis estratificado por sexo, una AUS más alta persistía independientemente asociada con un estado glucémico alterado. Nuestros resultados sugieren que unos niveles más altos de AUS estuvieron significativamente asociados con el estado glucémico en una amplia población latinoamericana, principalmente entre mujeres.


Subject(s)
Humans , Female , Adult , Glucose Intolerance/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Uric Acid , Blood Glucose , Brazil/epidemiology , Cross-Sectional Studies , Longitudinal Studies , Fasting , Middle Aged
7.
Rev. cuba. pediatr ; 92(3): e677, jul.-set. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1126771

ABSTRACT

Introducción: La malabsorción de glucosa y de galactosa es una enfermedad genética autosómica recesiva debida a una mutación que afecta al cotransportador de sodio-glucosa. Objetivo: Describir una asociación infrecuente entre el síndrome de Down y la mala absorción de glucosa y de galactosa. Presentación del caso: Niño desnutrido de 3 ½ meses de edad con síndrome de Down, de padres consanguíneos. Presentó precozmente diarrea explosiva, vómitos con deshidratación. Se mejoró tras la eliminación de la alimentación oral y la perfusión hidroelectrolítica y empeoró con la utilización de las sales de rehidratación oral y las fórmulas lácteas, sin proteínas de leche de vaca. El estudio de las heces mostró un pH fecal /5, presencia de glucosa, ionograma de las 24 horas fue: sodio 0,5 mEq (1-10), potasio 2,6 mEq (8-22) y el cálculo realizado para distinguir entre diferentes causas de diarrea dio aumentado: 168 mOsm/kg (50-125). Ante este cuadro clínico se consideró el diagnóstico de malabsorción de glucosa y de galactosa sobre todo tras la mejora de la sintomatología bajo dieta exclusivamente azucarada con fructosa. Conclusiones: Es importante tener en cuenta la malabsorción de glucosa y de galactosa dentro de los diagnósticos diferenciales de las diarreas acuosas congénitas. El diagnóstico precoz y la dieta adecuada con fructosa evitan deshidratación y malnutrición. La particularidad de nuestro caso es la asociación de la malabsorción de glucosa y de galactosa con el síndrome de Down, que, según nuestro conocimiento, es la primera vez que se describe y podría aumentar la morbilidad(AU)


Introduction: Malabsorption of glucose and galactose is a genetic autosomic recesive disease caused by a mutation that affects the co-transportator of sodium-glucose. Objective: To describe an unfrequent relation between the Down syndrome and the malabsortion of glucose and galactose. Case presentation: Undernourished child, 3 and half months old with Down syndrome from parents by blood. He early presented explosive diarrhea and vomiting with dehydration. He improved his state after elimination of oral feeding and a hydroelectrolitic perfusion, and his state worsened with the use of oral rehydration salts and dairy formula, even without cow´s milk proteins. The study of feces showed a fecal pH /5, presence of glucose, and the ionogram after 24 hours showed: sodium 0,5mEg (1-10), potasium 2,6 mEg (8-22) and the calculation made to identify the different causes of diarrhea was increased: 168 mOsm/kg (50-125). Having this clinical records, it was considered a diagnostic of glucose and galactose malabsorption, mainly after the improvement of the symptoms under a diet exclusively sugared with fructose. Conclusions: It is important to take into account glucose and galactose malabsortion in the differential diagnosis of congenital watery diahrrea. The early diagnosis and an adequate diet with fructose avoid dehytration and malnutrition. The particularity of this case is the relation of glucose and galactose malabsorption with Down syndrome, that according to our knowledge is the first time it is described and it can increase the morbility(AU)


Subject(s)
Humans , Male , Infant , Down Syndrome/complications , Glucose Intolerance/complications , Malabsorption Syndromes/complications , Galactose/analysis
8.
Rev. méd. Chile ; 148(4): 436-443, abr. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1127083

ABSTRACT

Background An instrument to help clinicians to evaluate the oral glucose tolerance test (OGTT) at-a-glance is lacking. Aim To generate a program written in HTML squeezing relevant information from the OGTT with glucose and insulin measurements. Material and Methods We reanalyzed a database comprising 90 subjects. All of them had both an OGTT and a pancreatic suppression test (PST) measuring insulin resistance directly. Thirty-seven of the 90 studied participants were insulin resistant (IR). Receiver operating characteristic (ROC) curves and Bayesian analyses delineated the diagnostic performances of four predictors of insulin resistance: HOMA, QUICKI, ISI-OL (Matsuda-DeFronzo) and I0*G60. We validated a new biochemical predictor, the Percentual Relative Insulin Sensitivity (%RIS), and calculated the Percentual Relative Beta Cell Function (%RBCF). Results The best diagnostic performance of the five predictors were those of the I0*G60 and the %RIS. The poorest diagnostic performances were those of the HOMA and QUICKI. The ISI-OL's performance was in between. The %RIS of participants with and without IR was 44.4 ± 7.3 and 101.1 ± 8.8, respectively (p < 0.05). The figures for % RBCF were 55.8 ± 11.8 and 90.8 ± 11.6, respectively (p < 0.05). Mathematical modeling of the relationship between these predictors and the Steady State Plasma Glucose Value from the PST was performed. We developed a program with 10 inputs (glucose and insulin values) and several outputs: I0*G60, HOMA, QUICKI, ISI-OL, Insulinogenic Index, Disposition Index, %RBCF, %RIS, and metabolic categorization of the OGTT (ADA 2003). Conclusions The OGTT data permitted us to write successfully an HTML program allowing the user to fully evaluate at-a-glance its metabolic information.


Subject(s)
Humans , Insulin Resistance , Blood Glucose , Glucose Intolerance , Glucose Tolerance Test , Insulin
9.
Rev. chil. nutr ; 47(1): 125-134, feb. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1092752

ABSTRACT

Actualmente los edulcorantes no nutritivos (ENN) son ampliamente usados para endulzar los alimentos en reemplazo de los azúcares simples, con la ventaja de no aportar energía. A pesar de que en general no presentan efectos tóxicos, los estudios epidemiológicos no han podido evidenciar que su uso contribuya a mejorar la pérdida de peso, sino por el contrario, han revelado que los ENN pueden inducir alteraciones metabólicas como intolerancia a la glucosa. Estudios in vivo e in vitro han mostrado que muchos ENN activan a receptores del sabor dulce no sólo en los botones gustativos, sino que también en los receptores presentes en tejidos como el adiposo y pancreático, interfiriendo con su función normal. Además, el consumo ENN se ha asociado a alteraciones de la composición de la microbiota intestinal que conducen a una respuesta inflamatoria de bajo grado. La nueva evidencia disponible sobre los ENN hace necesario evaluar el uso cada vez más intenso de los ENN en Chile. Debido a que el gusto exacerbado por el sabor dulce que cultivamos desde la infancia es un potente catalizador del uso de ENN, proponemos que una oportuna educación del sentido del gusto puede contribuir a mejorar las elecciones alimentarias.


Currently, non-nutritive sweeteners (NNS) are widely used to sweeten foods instead of simple sugars, as they possess the advantage of not contributing to energy intake. Although they do not present toxic effects in general, epidemiological studies have not been able to show benefits when they are used in weight loss programs. However, they could induce metabolic alterations such as glucose intolerance. In vivo and in vitro studies have shown that many NNSs activate sweet taste receptors not only in the taste buds, but also in receptors present in adipose and pancreatic tissues, interfering with their normal function. In addition, NNS consumption has been associated with an alteration in the composition of the gut microbiota that leads to a low-grade inflammatory response. Due to the wide use of NNS in Chile, it is necessary to evaluate the potential health effects of using NNS in the Chilean population. We propose that a timely education of the sense of taste can contribute to moderating the preference for higher levels of sweet taste that humans develop in childhood, which could help to improve food choices.


Subject(s)
Humans , Glucose Intolerance/chemically induced , Non-Nutritive Sweeteners/adverse effects , Chile , Global Health , Diabetes Mellitus/chemically induced , Obesity
10.
Article in English | WPRIM | ID: wpr-816624

ABSTRACT

BACKGROUND: To evaluate the association between serum 25-hydroxyvitamin D (25(OH)D) at mid-pregnancy and postpartum glucose intolerance in women with gestational diabetes mellitus (GDM).METHODS: We enrolled 348 pregnant women diagnosed with GDM from August 2012 to October 2016. We measured serum 25(OH)D levels at mid-pregnancy and carried out a 75-g oral glucose tolerance test at 6 to 12 weeks after delivery. Vitamin D deficiency was defined as serum 25(OH)D <20 ng/mL.RESULTS: The prevalence of vitamin D deficiency was 76.7% (n=267). Women with vitamin D deficiency had a higher prevalence of postpartum glucose intolerance than did those without vitamin D deficiency (48.7% vs. 32.1%, P=0.011). Serum 25(OH)D level was negatively correlated with hemoglobin A1c at antepartum and postpartum period (antepartum: r=−0.186, P=0.001; postpartum: r=−0.129, P=0.047). Homeostasis model assessment of β-cell function was positively correlated with serum 25(OH)D level only postpartum (r=0.138, P=0.035). The risk of postpartum glucose intolerance was 2.00 times (95% confidence interval, 1.13 to 3.55) higher in women with vitamin D deficiency than in those without vitamin D deficiency (P=0.018).CONCLUSION: In women with GDM, vitamin D deficiency at mid-pregnancy is associated with an elevated risk of postpartum glucose intolerance.


Subject(s)
Diabetes, Gestational , Female , Glucose Intolerance , Glucose Tolerance Test , Glucose , Homeostasis , Humans , Postpartum Period , Pregnancy , Pregnant Women , Prevalence , Vitamin D Deficiency , Vitamin D , Vitamins
11.
Biol. Res ; 53: 39, 2020. graf
Article in English | LILACS | ID: biblio-1131884

ABSTRACT

BACKGROUND: The impaired glucose tolerance (IGT) is a representative prediabetes characterized by defective glucose homeostasis, and palmatine (PAL) is a natural isoquinoline alkaloid with multiple pharmacological effects. Our study aims to investigate the therapeutic effect of PAL on the impaired glucose tolerance. METHODS: Male Sprague-Dawley rats were used to establish an IGT model with high fat diet (HFD). Oral glucose tolerance test (OGTT) and further biochemical analysis were conducted to determine the effect of PAL on glucose intolerance in vivo. Molecular details were clarified in a cellular model of IGT induced by Palmitate (PA) on INS-1 cells. RESULTS: Our study demonstrated a relief of IGT with improved insulin resistance in HFD induced rats after PAL treatment. Besides, promoted pancreas islets function was validated with significantly increased ß cell mass after the treatment of PAL. We further found out that PAL could alleviate the ß cell apoptosis that accounts for ß cell mass loss in IGT model. Moreover, MAPK signaling was investigated in vivo and vitro with the discovery that PAL regulated the MAPK signaling by restricting the ERK and JNK cascades. The insulin secretion assay indicated that PAL significantly promoted the defective insulin secretion in PA-induced INS-1 cells via JNK rather than ERK signaling. Furthermore, PAL treatment was determined to significantly suppress ß cell apoptosis in PA-induced cells. We thus thought that PAL promoted the PA-induced impaired insulin release by inhibiting the ß; cell apoptosis and JNK signaling in vitro. CONCLUSION: In summary, PAL ameliorates HFD-induced IGT with novel mechanisms.


Subject(s)
Animals , Male , Rats , Berberine Alkaloids/pharmacology , Insulin Resistance , Glucose Intolerance/drug therapy , Diet, High-Fat/adverse effects , Blood Glucose , Rats, Sprague-Dawley , Insulin
13.
Gac. méd. Méx ; 155(5): 500-503, Sep.-Oct. 2019. graf
Article in English | LILACS | ID: biblio-1286550

ABSTRACT

The metabolic syndrome describes a group of signs that increase the likelihood for developing type 2 diabetes mellitus, cardiovascular diseases and some types of cancer. The action of insulin depends on its binding to membrane receptors on its target cells. We wonder if blood insulin could travel bound to proteins and if, in the presence of hyperinsulinemia, a soluble insulin receptor might be generated. We used young adult Wistar rats (which have no predisposition to obesity or diabetes), whose drinking water was added 20 % of sugar and that were fed a standard diet ad libitum for two and six months. They were compared with control rats under the same conditions, but that had running water for consumption. At two months, the rats developed central obesity, moderate hypertension, high triglyceride levels, hyperinsulinemia, glucose intolerance and insulin resistance, i.e., metabolic syndrome. Electrophoresis of the rats’ plasma proteins was performed, followed by Western Blot (WB) for insulin and for the outer portion of the insulin receptor. The bands corresponding to insulin and to the receptor external part were at the same molecular weight level, 25-fold higher than that of free insulin. We demonstrated that insulin, both in control animals and in those with hyperinsulinemia, travels bound to the receptor outer portion (ectodomain), which we called soluble insulin receptor, and that is released al higher amounts in response to plasma insulin increase; in rats with metabolic syndrome and hyperinsulinemia, plasma levels are much higher than in controls. Soluble insulin receptor increase in blood might be an early sign of metabolic syndrome.


Subject(s)
Humans , Animals , Rats , Insulin Resistance/physiology , Receptor, Insulin/metabolism , Metabolic Syndrome/etiology , Hyperinsulinism/metabolism , Insulin/metabolism , Hypertriglyceridemia/etiology , Rats, Wistar , Glucose Intolerance/etiology , Metabolic Syndrome/metabolism , Diabetes Mellitus, Type 2/etiology , Disease Models, Animal , Obesity, Abdominal/etiology , Hypertension/etiology , Insulin/blood
14.
Arch. endocrinol. metab. (Online) ; 63(2): 157-166, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1001215

ABSTRACT

ABSTRACT Objectives: Our study aimed to investigate the associations of glucose tolerance status with insulin-like growth factor-I (IGF-I) and other clinical laboratory parameters of acromegalic patients before and after the patients underwent transsphenoidal adenomectomy (TSA) by conducting a single-center, retrospective study. Subjects and methods: A total of 218 patients with acromegaly who had undergone TSA as the first treatment were retrospectively analyzed. Serum IGF-I, growth hormone (GH) and glucose levels were measured before and after surgery. Results: The follow-up levels for random GH, GH nadir, and the percentage of the upper limit of normal IGF-I (%ULN IGF-I) were decreased significantly. The percentages of normal (39.0%), early carbohydrate metabolism disorders (33.0%) and diabetes mellitus (28.0%) changed to 70.2%, 16.5% and 13.3%, respectively, after TSA. %ULN IGF-I at baseline was higher in the diabetes mellitus (DM) group than in the normal glucose tolerance group and impaired glucose tolerance (IGT) /impaired fasting glucose (IFG) groups before TSA, and the DM group exhibited a greater reduction in %ULN IGF-I value after surgery. The follow-up %ULN IGF-I value after surgery was significantly lower in the improved group, and Pearson's correlation analysis revealed that the reductions in %ULN IGF-I corresponded with the reductions in glucose level. Conclusion: This study examined the largest reported sample with complete preoperative and follow-up data. The results suggest that the age- and sex-adjusted IGF-I level, which reflects altered glucose metabolism, and the change of it are associated with improved glucose tolerance in acromegalic patients both before and after TSA.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Acromegaly/blood , Insulin-Like Growth Factor I/analysis , Adenoma/surgery , Glucose Intolerance/blood , Growth Hormone-Secreting Pituitary Adenoma/surgery , Postoperative Period , Blood Glucose/analysis , Adenoma/blood , Retrospective Studies , Follow-Up Studies , Treatment Outcome , Human Growth Hormone/blood , Diabetes Mellitus/blood , Growth Hormone-Secreting Pituitary Adenoma/blood , Preoperative Period
15.
Article in English | WPRIM | ID: wpr-742366

ABSTRACT

Metabolic syndrome (MetS) represents a cluster of conditions that have a negative impact on human health overall. Its prevalence has been rapidly increasing worldwide and has coincided with a global decrease in birth rates and fertility potential. This review aims to address this observation through studying the relationship between MetS and male reproductive health. The effects of obesity, dyslipidemia, hypertension, and insulin resistance on male fertility were examined and supporting evidence explaining the pathophysiology of sperm dysfunction with each MetS component were described. Adopting a healthy lifestyle appears to be the single most important intervention to prevent the unwanted effects of MetS on men's health and fertility. Further studies addressing the components of MetS and their impact on male reproduction are required to enhance our understanding of the underlying pathophysiology and to propose new methods for therapeutic intervention.


Subject(s)
Birth Rate , Dyslipidemias , Fertility , Glucose Intolerance , Humans , Hypertension , Infertility, Male , Insulin Resistance , Life Style , Male , Men's Health , Obesity , Prevalence , Reproduction , Reproductive Health , Spermatozoa
16.
Article in English | AIM | ID: biblio-1258817

ABSTRACT

Background: Emerging patterns in epidemiological transitions have led to increased risk for Non-Communicable Diseases and infectious conditions globally. Diabetes mellitus (DM) in a population is one such risk factor that could lead to the development of Tuberculosis (TB) due to weakened immune functions in affected persons, with implications for mortality. If not diagnosed early, DM also leads to poor treatment outcomes in TB. Objective: To assess the prevalence of DM and impaired glucose tolerance (pre-diabetes) among newly diagnosed tuberculosis cases in Ijebu-Ode Local Government Area of Ogun State, Nigeria. Methods: This cross-sectional study was conducted among 100 newly diagnosed Pulmonary TB patients in ljebu-Ode LGA. The patients were selected from four health facilities and were screened for elevated Fasting Blood Glucose levels using a laboratory spectrophotometer (glucose oxidase method). Results: The mean age of the 100 study participants was 33 years (± 9.82), with ages within 19 -62 years. Eleven (11.0%) had elevated blood glucose levels suggestive of DM, while 20 (20.0%) had impaired fasting blood glucose levels. Among these 31 patients, 18 (58.0%) were males while 13 (42.0%) were females. The modal ages were within 20-39 years. Conclusion: Screening for DM by healthcare providers should be routinely conducted before commencing TB patients on treatment. This will aid early detection, improve treatment outcomes of TB and prevent mortality among patients with these co-morbidities


Subject(s)
Adult , Diabetes Mellitus/diagnosis , Glucose Intolerance , Nigeria , Risk Factors , Tuberculosis
17.
Journal of Korean Diabetes ; : 215-219, 2019.
Article in Korean | WPRIM | ID: wpr-786606

ABSTRACT

The increasing risk of glucose intolerance and diabetes associated with aging is well established. However, it is difficult to determine whether changes in glucose metabolism result from biological aging itself or due to various environmental factors that occur during the aging process. Many epidemiologic studies have shown that plasma glucose levels after oral glucose tolerance test rise consecutively for every decade of age, but many of these studies also demonstrated the effects of environmental factors including obesity and exercise. In some studies, the development of insulin resistance and insulin secretion defects due to biological aging itself have also been identified as major etiologic factors of glucose intolerance. However, the rate of diabetes development due to these factors is expected to be very slow and largely preventable by addressing environmental risk factors.


Subject(s)
Aging , Blood Glucose , Carbohydrate Metabolism , Epidemiologic Studies , Glucose Intolerance , Glucose Tolerance Test , Glucose , Incretins , Insulin , Insulin Resistance , Metabolism , Obesity , Risk Factors
18.
Article in Korean | WPRIM | ID: wpr-761482

ABSTRACT

Dementia, a clinical syndrome affecting memory, thinking, and social abilities primarily caused by neurodegeneration, is becoming one of the greatest health and socioeconomic burdens in the aging society. The age-standardized prevalence of dementia for people aged 60 or older was 5% to 7% in most world regions, affecting 47 million people in 2015. This number is expected to almost double every 20 years. Although aging is the greatest but non-modifiable risk factor, approximately 35% of the risk has been attributed to the combination of potentially modifiable risk factors including education, diet and lifestyle factors, psychiatric factors, and metabolic factors. There is ample evidence that people with glucose intolerance, insulin resistance, and metabolic syndrome are at higher risk for cognitive impairment and dementia compared to age- and sex-matched controls. Meta-analyses and large-scaled pooled analyses demonstrate that diabetes is associated with an approximately 60% to 70% increased risk of all types of dementia. In this article, the associations of hyperglycemia, hypoglycemia, and glucose variability with cognitive dysfunction and dementia are demonstrated. Also, the underlying mechanism of this connection and possible effects of anti-diabetic medications are discussed.


Subject(s)
Aging , Cognition Disorders , Dementia , Diabetes Mellitus , Diet , Education , Glucose , Glucose Intolerance , Hyperglycemia , Hypoglycemia , Insulin Resistance , Life Style , Memory , Prevalence , Risk Factors , Social Skills , Thinking
19.
Rev. Assoc. Med. Bras. (1992) ; 64(5): 433-437, May 2018. tab, graf
Article in English | LILACS | ID: biblio-956471

ABSTRACT

SUMMARY OBJECTIVE With the adoption of optical coherence tomography (OCT), this study targets the impacts on plaque characteristics brought about by impaired glucose tolerance (IGT) in patients with coronary artery disease. METHODS For this study, 150 patients with coronary artery disease were recruited. Regarding glycosylated hemoglobin (HbAlc), the patients were sectioned into normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetes mellitus (DM) groups. Coronary angiography (CAG) and OCT were conducted for 150 patients. RESULTS There were 186 plaques discovered in 150 patients (37, 40, 44, and 65 in the NGT, IFG, IGT, and DM groups, respectively). Compared to the NGT group, the lipid core size, which is presented as the average angle of the lipid arc, was markedly larger in the IFG,IGT and DM groups ( 135.7 ± 32.7 Ê, 161.2 ± 55.7 Ê, 162.5 ± 55.8 Ê, and 170.2 ± 59.7 Ê, respectively, all P values< 0.05). Meanwhile, the fibrous cap over the lipid core in the NGT group was remarkably thicker than that in the IFG, IGT, and DM groups (115.7 ± 47.7 μm vs. 77.7 ± 23.5 μm, 75.1 ± 23.2 µm, 71.2 ± 22.1 µm, all P values<0.05). CONCLUSION Coronary plaques in coronary artery patients with NDT are more stable than in those with IGT and DM.


RESUMO OBJETIVO Com a adoção da tomografia de coerência óptica (OCT), o presente estudo visa as características dos impactos na placa trazidos pela tolerância diminuída à glicose (IGT) em pacientes com doença na artéria coronária. MÉTODOS Cento e cinquenta doentes com doença arterial coronária foram recrutados para este estudo. De acordo com a hemoglobina glicosilada (HbAlc), os pacientes foram divididos em grupos: tolerância normal à glicose (NGT), diminuição da glicemia de jejum (IFG), diminuição da tolerância à glicose (IGT) e diabetes mellitus (DM). Angiografia coronária (CAG) e OCT foram conduzidas para 150 doentes. RESULTADOS Existem 186 placas descobertas em 150 doentes (37, 40, 44 e 65 nos grupos NGT, IFG, IGT e DM, respectivamente). Em relação ao grupo NGT, o tamanho do núcleo lipídico, que é apresentado como o ângulo médio do arco lipídico, foi significativamente maior nos grupos IFG, IGT e DM (135,7 ± 32,7 Ê, 161,2 ± 55,7 Ê, 162,5 ± 55,8 Ê, e 170,2 ± 59,7 Ê, separadamente, os valores de P<0,05). Entretanto, a tampa sobre o núcleo de lipídios fibrosos no grupo NGT estava bem mais grossa do que nos grupos IFG, IGT e DM (115,7 ± 47,7μm vs. 77,7 ± 23,5 μm, 75,1 ± 23,2 µm, 71,2 ± 22,1 µm, todos os valores de P<0,05). CONCLUSÃO Placas coronárias na artéria coronária de pacientes com NDT são mais estáveis do que em doentes com IGT e DM.


Subject(s)
Humans , Male , Female , Aged , Coronary Artery Disease/blood , Glycated Hemoglobin A/analysis , Glucose Intolerance/diagnostic imaging , Tomography, Optical Coherence , Diabetes Mellitus, Type 2/blood , Coronary Artery Disease/diagnostic imaging , Coronary Angiography , Glucose Intolerance/blood , Plaque, Atherosclerotic/complications , Middle Aged
20.
Article in English | WPRIM | ID: wpr-741687

ABSTRACT

BACKGROUND/OBJECTIVES: Perilla frutescens (L.) Britton var. (PF) sprout is a plant of the labiate family. We have previously reported the protective effects of PF sprout extract on cytokine-induced β-cell damage. However, the mechanism of action of the PF sprout extract in type 2 diabetes (T2DM) has not been investigated. The present study was designed to study the effects of PF sprout extract and signaling mechanisms in the T2DM mice model using C57BL/KsJ-db/db (db/db) mice. MATERIALS/METHODS: Male db/db mice were orally administered PF sprout extract (100, 300, and 1,000 mg/kg of body weight) or rosiglitazone (RGZ, positive drug, 1 mg/kg of body weight) for 4 weeks. Signaling mechanisms were analyzed using liver tissues and HepG2 cells. RESULTS: The PF sprout extract (300 and 1,000 mg/kg) significantly reduced the fasting blood glucose, serum insulin, triglyceride and total cholesterol levels in db/db mice. PF sprout extract also significantly improved glucose intolerance and insulin sensitivity, decreased hepatic gluconeogenic protein expression, and ameliorated histological alterations of the pancreas and liver. Levels of phosphorylated AMP-activated protein kinase (AMPK) protein expression also increased in the liver after treatment with the extract. In addition, an increase in the phosphorylation of AMPK and decrease in the phosphoenolpyruvate carboxykinase and glucose 6-phosphatase proteins in HepG2 cells were also observed. CONCLUSIONS: Our results sugges that PF sprout displays beneficial effects in the prevention and treatment of type 2 diabetes via modulation of the AMPK pathway and inhibition of gluconeogenesis in the liver.


Subject(s)
AMP-Activated Protein Kinases , Animals , Blood Glucose , Cholesterol , Diabetes Mellitus , Fasting , Gluconeogenesis , Glucose Intolerance , Glucose-6-Phosphatase , Hep G2 Cells , Humans , Insulin , Insulin Resistance , Liver , Male , Mice , Pancreas , Perilla frutescens , Perilla , Phosphoenolpyruvate , Phosphorylation , Plants , Triglycerides
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