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Zhang T, Jiang W, Huang Y, Wang C, Cao J, Qiu W, Huang R, Zhang J, Ye W, Zhang Q. The influence of socioeconomic status on the association between residential greenness and gestational diabetes mellitus in an urban setting: a multicenter study. BMC Public Health 2025; 25:1708. [PMID: 40340950 PMCID: PMC12060297 DOI: 10.1186/s12889-025-22913-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2025] [Accepted: 04/24/2025] [Indexed: 05/10/2025] Open
Abstract
BACKGROUND Inconsistencies were found between residential greenness and the risk of gestational diabetes mellitus (GDM), possibly due to variations in susceptibility among populations with different characteristics. However, little is known about whether this association could be modified by population characteristics like socioeconomic status (SES). This multicenter study conducted in a dense megacity aims to clarify these associations and explore the modification effects of demographic and socioeconomic factors. METHODS The study included 19,618 pregnant women in 20 hospitals throughout Shanghai, China, between 2015 and 2017. Multivariable logistic regression models were utilized to assess the associations of satellite-based greenness indicators [normalized difference vegetation index (NDVI) within 500 m- and 1000 m buffers] with GDM and whether demographic and socioeconomic factors modified the associations. Potential mediation effects of fine particulate matter (PM2.5) on the associations between greenness and GDM were also explored. RESULTS During the first two trimesters of pregnancy, an increase in NDVI-500 m or NDVI-1000 m interquartile range was consistently associated with lower GDM risks, with adjusted odds ratios (aORs) and 95% confidence interval (CI) ranging from 0.82 (0.76, 0.88) to 0.90 (0.85, 0.96). Stratified analyses revealed that the health benefits of residential greenness are more pronounced during the first two trimesters among unemployed women (aOR = 0.70; 95%CI: 0.60, 0.82), those with lower education levels (aOR = 0.72; 95%CI: 0.63, 0.82), and those without medical insurance (aOR = 0.76; 95%CI: 0.69, 0.84). Mediation analysis shows that PM2.5 reduction by greenness may explain 16.4% of the inverse association between the NDVI-500 m during early pregnancy and the risk of GDM. CONCLUSIONS Our research indicates that elevated residential greenness was associated with reduced GDM risks, partly attributed to decreased PM2.5 levels. Women with lower SES experience amplified benefits from greenness. These findings highlight the significance of bolstering urban green infrastructure, particularly in communities confronting socioeconomic challenges and areas with high levels of air pollution.
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Affiliation(s)
- Tian Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Wen Jiang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Huang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Cuiping Wang
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Jun Cao
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Qiu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rong Huang
- Department of Obstetrics and Gynecology, Lunenfeld-Tanenbaum Research Institute, Prosserman Center for Population Health Research, Mount Sinai Hospital, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiping Ye
- Department of Obstetrics and Gynecology, Shanghai Putuo Maternity and Infant Hospital, Shanghai, 200061, China.
| | - Qingli Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Lu Y, Liu D, Liang Z, Liu R, Chen P, Liu Y, Li J, Feng Z, Li LM, Sheng B, Jia W, Chen L, Li H, Wang Y. A pretrained transformer model for decoding individual glucose dynamics from continuous glucose monitoring data. Natl Sci Rev 2025; 12:nwaf039. [PMID: 40191259 PMCID: PMC11970253 DOI: 10.1093/nsr/nwaf039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2025] [Revised: 01/22/2025] [Accepted: 02/05/2025] [Indexed: 04/09/2025] Open
Abstract
Continuous glucose monitoring (CGM) technology has grown rapidly to track real-time blood glucose levels and trends with improved sensor accuracy. The ease of use and wide availability of CGM will facilitate safe and effective decision making for diabetes management. Here, we developed an attention-based deep learning model, CGMformer, pretrained on a well-controlled and diverse corpus of CGM data to represent individual's intrinsic metabolic state and enable clinical applications. During pretraining, CGMformer encodes glucose dynamics including glucose level, fluctuation, hyperglycemia, and hypoglycemia into latent space with self-supervised learning. It shows generalizability in imputing glucose value across five external datasets with different populations and metabolic states (MAE = 3.7 mg/dL). We then fine-tuned CGMformer towards a diverse panel of downstream tasks in the screening of diabetes and its complications using task-specific data, which demonstrated a consistently boosted predictive accuracy over direct fine-tuning on a single task (AUROC = 0.914 for type 2 diabetes (T2D) screening and 0.741 for complication screening). By learning an intrinsic representation of an individual's glucose dynamics, CGMformer classifies non-diabetic individuals into six clusters with elevated T2D risks, and identifies a specific cluster with lean body-shape but high risk of glucose metabolism disorders, which is overlooked by traditional glucose measurements. Furthermore, CGMformer achieves high accuracy in predicting an individual's postprandial glucose response with dietary modelling (Pearson correlation coefficient = 0.763) and helps personalized dietary recommendations. Overall, CGMformer pretrains a transformer neural network architecture to learn an intrinsic representation by borrowing information from a large amount of daily glucose profiles, and demonstrates predictive capabilities fine-tuned towards a broad range of downstream applications, holding promise for the early warning of T2D and recommendations for lifestyle modification in diabetes management.
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Affiliation(s)
- Yurun Lu
- Center for Excellence in Mathematical Sciences, National Center for Mathematics and Interdisciplinary Sciences, Hua Loo-Keng Center for Mathematical Sciences, Key Laboratory of Management, Decision and Information System, Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing 100190, China
- School of Mathematics, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Beijing 100049, China
| | - Dan Liu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Zhongming Liang
- Key Laboratory of Systems Health Science of Zhejiang Province, School of Life Science, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310024, China
- BGI-Research, Hangzhou 310030, China
| | - Rui Liu
- School of Mathematics, South China University of Technology, Guangzhou 510640, China
| | - Pei Chen
- School of Mathematics, South China University of Technology, Guangzhou 510640, China
| | - Yitong Liu
- Center for Excellence in Mathematical Sciences, National Center for Mathematics and Interdisciplinary Sciences, Hua Loo-Keng Center for Mathematical Sciences, Key Laboratory of Management, Decision and Information System, Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing 100190, China
- School of Mathematics, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Beijing 100049, China
| | - Jiachen Li
- Center for Excellence in Mathematical Sciences, National Center for Mathematics and Interdisciplinary Sciences, Hua Loo-Keng Center for Mathematical Sciences, Key Laboratory of Management, Decision and Information System, Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing 100190, China
- School of Mathematics, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Beijing 100049, China
| | - Zhanying Feng
- Center for Excellence in Mathematical Sciences, National Center for Mathematics and Interdisciplinary Sciences, Hua Loo-Keng Center for Mathematical Sciences, Key Laboratory of Management, Decision and Information System, Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing 100190, China
- Department of Statistics, Department of Biomedical Data Science, Bio-X Program, Stanford University, Stanford CA 94305, USA
| | - Lei M Li
- Center for Excellence in Mathematical Sciences, National Center for Mathematics and Interdisciplinary Sciences, Hua Loo-Keng Center for Mathematical Sciences, Key Laboratory of Management, Decision and Information System, Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing 100190, China
| | - Bin Sheng
- Department of Computer Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Luonan Chen
- State Key Laboratory of Cell Biology, Center for Excellence in Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, Shanghai 200031, China
- Key Laboratory of Systems Health Science of Zhejiang Province, School of Life Science, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310024, China
- Guangdong Institute of Intelligence Science and Technology, Zhuhai 519031, China
- Pazhou Laboratory (Huangpu), Guangzhou 510555, China
| | - Huating Li
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yong Wang
- Center for Excellence in Mathematical Sciences, National Center for Mathematics and Interdisciplinary Sciences, Hua Loo-Keng Center for Mathematical Sciences, Key Laboratory of Management, Decision and Information System, Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing 100190, China
- School of Mathematics, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Beijing 100049, China
- Key Laboratory of Systems Health Science of Zhejiang Province, School of Life Science, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310024, China
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Sehmbi T, Cao R, Sapkota R, Pardhan S. Knowledge and awareness of healthcare systems and the uptake of diabetic services among Chinese people diagnosed with type 2 diabetes in the UK. ETHNICITY & HEALTH 2025:1-18. [PMID: 40266023 DOI: 10.1080/13557858.2025.2496188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2024] [Accepted: 04/16/2025] [Indexed: 04/24/2025]
Abstract
OBJECTIVES Diabetes poses a significant public health challenge. The Chinese community has unique cultural characteristics that can influence their understanding of the diabetes healthcare system and engagement with services. This study aims to explore the knowledge and awareness of the diabetes healthcare system and the uptake of healthcare services in the UK Chinese population. DESIGN This study adopted a qualitative design. Three focus group discussions (FGDs) were conducted on Zoom with 22 Chinese participants with self-reported type 2 diabetes living in the UK. Participants ranged from 24 to 85 years (mean age = 66 years, SD = 17.1). A purposive sample was recruited through study adverts in Chinese community centres and snowball sampling. Data were analysed using Braun and Clarke's thematic analysis (TA). RESULTS This paper discusses 4 themes: Awareness and understanding of diabetes, healthcare access and utilisation, attitudes towards diabetes prevention programmes and Chinese medicine vs. Western medicine. Limited knowledge and awareness of diabetes was highlighted, with cultural factors impacting this. Factors which impacted healthcare access and utilisation were linguistic/ communication challenges, and trust and perception of the NHS. Participants were unaware of diabetes prevention programmes and highlighted that these were culturally inappropriate. Generational preferences were noted in the way participants wished to receive diabetes education. The western medical system was viewed as medication focused, therefore the older Chinese community trusted familiar natural methods of illness management. CONCLUSION These findings highlight the importance of ensuring diabetes education is culturally appropriate. Generational differences in education preference should be recognised by healthcare professionals to increase healthcare engagement. These findings demonstrate the important need to educate UK healthcare professionals with the unique sociocultural contexts for this ethnic group. This study uncovers gaps in awareness and service uptake, highlighting the need for co-development of interventions that promote health equity and improve diabetes management within this population.
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Affiliation(s)
- Tarnjit Sehmbi
- Vision and Eye Research Institute (VERI), Anglia Ruskin University, Cambridge, UK
| | - Ran Cao
- Vision and Eye Research Institute (VERI), Anglia Ruskin University, Cambridge, UK
| | - Raju Sapkota
- Vision and Eye Research Institute (VERI), Anglia Ruskin University, Cambridge, UK
| | - Shahina Pardhan
- Vision and Eye Research Institute (VERI), Anglia Ruskin University, Cambridge, UK
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Sun L, Goh HJ, Govindharajulu P, Leow MKS, Henry CJ. Comparative efficacy of preloading plant-based versus animal-based proteins in evoking insulin and incretin responses to attenuate postprandial glucose. Eur J Nutr 2025; 64:155. [PMID: 40237897 DOI: 10.1007/s00394-025-03675-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/02/2025] [Indexed: 04/18/2025]
Abstract
BACKGROUND Previous studies have reported that the type of protein consumed as preloads significantly affects postprandial glucose and insulin excursions in healthy and type 2 diabetes. But little is known how protein synergistic preloading affects human health. OBJECTIVE Using two typical Asian protein type (soya tofu and chicken) with carbohydrate (white rice), the aim of this study was to compare the effects of two different protein types presented synergistically as preloads on postprandial glycemia, insulinemia and incretin secretions in healthy adults. DESIGN Sixteen healthy Chinese male adults participated in a randomized, controlled, crossover meal trial. Subjects consumed, in random order, 4 experimental meals that differed in protein type and proportion. Glucose, insulin, incretins and triglyceride concentrations were measured over 3 h. RESULTS There were significant protein type preload treatment x time interaction effects on plasma glucose, insulin, glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and triglycerides concentrations (P < 0.001). In comparison with rice alone treatment, preloading with Soya, Chicken and Soya/Chicken (50% soya tofu combined with 50% chicken breast) prior to rice consumption all significantly attenuated postprandial glucose response. Soya + Rice treatment induced a significantly lower incremental peak and incremental area under curve (iAUC) (0-60 min) glucose level compared with Chicken + Rice. The postprandial insulin response (incremental peak, iAUC 0-180 min) was significantly lower after Soya + Rice than Chicken + Rice group. Soya/Chicken + Rice treatment did not induce any significant difference in glucose and insulin levels between Soya + Rice or Chicken + Rice group. Notably, Soya/Chicken + Rice as well as Soya + Rice induced a significantly higher GLP1 and GIP responses compared with Rice or Chicken + Rice groups. Soya + Rice and Soya/Chicken + Rice groups stimulated higher triglyceride concentration than the other two groups. CONCLUSIONS Different protein preload with rice can considerably influence its glycemic, insulinemic and incretin responses. Soya or Soya/Chicken protein synergistic preloading induced higher incretins responses to modulate glycemic response in healthy adults.
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Affiliation(s)
- Lijuan Sun
- Institute for Human Development and Potential (IHDP), Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Brenner Centre for Molecular Medicine, Singapore, 117609, Singapore.
| | - Hui Jen Goh
- Institute for Human Development and Potential (IHDP), Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Brenner Centre for Molecular Medicine, Singapore, 117609, Singapore
| | - Priya Govindharajulu
- Singapore Institute of Food and Biotechnology Innovation, A*STAR, Singapore, Singapore
| | - Melvin Khee-Shing Leow
- Institute for Human Development and Potential (IHDP), Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Brenner Centre for Molecular Medicine, Singapore, 117609, Singapore
- Singapore Institute of Food and Biotechnology Innovation, A*STAR, Singapore, Singapore
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore, Singapore
- Cardiovascular and Metabolic Diseases Program, Duke-NUS Medical School, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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5
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Zhou Z, Liu J. Association between body roundness index and incidence of type 2 diabetes in a population-based cohort study. Sci Rep 2025; 15:13186. [PMID: 40240415 PMCID: PMC12003785 DOI: 10.1038/s41598-025-92652-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2025] [Accepted: 03/03/2025] [Indexed: 04/18/2025] Open
Abstract
There is limited national data on the association between body roundness index (BRI) and type 2 diabetes (T2D). A total of 10,785 participants from the China Health and Retirement Longitudinal Study (CHARLS) with repeated BRI measurements from 2011 to 2020 were included. We used Cox proportional hazards model and restricted cubic splines (RCS) to examine the association between BRI and T2D. During a mean follow-up of 7.72 years, 1,653 incident T2D cases were documented. Multivariable Cox proportional hazards regression model demonstrated a significant correlation between the BRI and the risk of T2D. Specifically, every 1-SD increase in BRI corresponded to a 27% heightened risk of T2D (HR: 1.27, 95% CI 1.20-1.35). The analysis also uncovered a non-linear pattern in this relationship, pinpointed by an inflection point at a BRI value of 3.96. Before the inflection point, the HR was 0.85 (95% CI 0.74-0.96), while after the inflection point, the HR increased to 1.29 (95% CI 1.18-1.41). In the middle-aged and elderly Chinese population, elevated BRI was significantly and positively associated with T2D risk. BRI could be a valuable addition to current clinical and public health strategies aimed at reducing the burden of T2D.
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Affiliation(s)
- Zigui Zhou
- School of Exercise and Health, Shanghai University of Sport, 200 Hengren Road, Yangpu, Shanghai, 200438, China
| | - Jingjing Liu
- School of Exercise and Health, Shanghai University of Sport, 200 Hengren Road, Yangpu, Shanghai, 200438, China.
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Sun Z, Zheng Y. Metabolic diseases in the East Asian populations. Nat Rev Gastroenterol Hepatol 2025:10.1038/s41575-025-01058-8. [PMID: 40200111 DOI: 10.1038/s41575-025-01058-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/05/2025] [Indexed: 04/10/2025]
Abstract
East Asian populations, which account for approximately 20% of the global population, have become central to the worldwide rise of metabolic diseases over the past few decades. The prevalence of metabolic disorders, including type 2 diabetes mellitus, hypertension and metabolic dysfunction-associated steatotic liver disease, has escalated sharply, contributing to a substantial burden of complications such as cardiovascular disease, chronic kidney disease, cancer and increased mortality. This concerning trend is primarily driven by a combination of genetic predisposition, unique fat distribution patterns and rapidly changing lifestyle factors, including urbanization and the adoption of Westernized dietary habits. Current advances in genomics, proteomics, metabolomics and microbiome research have provided new insights into the biological mechanisms that might contribute to the heightened susceptibility of East Asian populations to metabolic diseases. This Review synthesizes epidemiological data, risk factors and biomarkers to provide an overview of how metabolic diseases are reshaping public health in East Asia and offers insights into biological and societal drivers to guide effective, region-specific strategies.
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Affiliation(s)
- Zhonghan Sun
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yan Zheng
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China.
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Lau ESH, Luk AOY, Lim LL, Wu H, Yang A, Kong APS, Ma RCW, Ozaki R, Chow EYK, Tsang CC, O CK, Fu A, Gregg EW, Clarke P, So WY, Lui JNM, Chan JCN. Development and Validation of the Patient-Level Chinese Diabetes Outcome Model on Long-term Complications in Type 2 Diabetes: An Application of the Hong Kong Diabetes Register. Diabetes Care 2025; 48:579-587. [PMID: 39998909 DOI: 10.2337/dca24-0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Accepted: 01/10/2025] [Indexed: 02/27/2025]
Abstract
OBJECTIVE Patient-level simulation models, mainly developed in Western populations, capture complex interactions between risk factors and complications to predict the long-term effectiveness and cost-effectiveness of novel treatments and identify high-risk subgroups for personalized care. However, incidence of outcomes varies significantly by ethnicity and region. We used high-quality, patient-level register data to develop the Chinese Diabetes Outcomes Model (CDOM) for predicting incident and recurrent events in type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS The CDOM was developed using the prospective Hong Kong Diabetes Register (HKDR) cohort (n = 21,453; median follow-up duration, 7.9 years; 166,433 patient-years). It was externally validated with a retrospective territory-wide cohort of Chinese patients with T2D attending Hong Kong publicly funded diabetes centers and community clinics (n = 176,120; follow-up duration, 7.2 years; 953,523 patient-years). RESULTS The CDOM predicted first and recurrent events with satisfactory performance during internal (C-statistic = 0.740-0.941) and external (C-statistic = 0.758-0.932) validation after calibration. The respective C-statistic values for cancer were 0.664 and 0.661. Subgroup analysis showed consistent performance during internal (C-statistic = 0.632-0.953) and external (C-statistic = 0.598-0.953) validation after calibration. CONCLUSIONS The CDOM, developed using comprehensive register data with long-term follow-up, is a robust tool for predicting long-term outcomes in Chinese patients with T2D. The model enables the identification of patient subgroups to augment study design and develop tailored novel treatment strategies, inform policy, and guide practice to improve cost-effectiveness of diabetes care.
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Affiliation(s)
- Eric S H Lau
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Asia Diabetes Foundation, Hong Kong Special Administrative Region, People's Republic of China
| | - Andrea O Y Luk
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Lee-Ling Lim
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hongjiang Wu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Aimin Yang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Alice P S Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Ronald C W Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Risa Ozaki
- Prince of Wales Hospital, Hong Kong Hospital Authority, Hong Kong Special Administrative Region, People's Republic of China
| | - Elaine Y K Chow
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Chiu-Chi Tsang
- Alice Ho Miu Ling Nethersole Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Chun-Kwun O
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Amy Fu
- Asia Diabetes Foundation, Hong Kong Special Administrative Region, People's Republic of China
| | - Edward W Gregg
- Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Imperial College of London, London, U.K
| | - Philip Clarke
- Health Economics Research Centre, University of Oxford, Oxford, U.K
| | - Wing-Yee So
- Prince of Wales Hospital, Hong Kong Hospital Authority, Hong Kong Special Administrative Region, People's Republic of China
| | - Juliana N M Lui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Asia Diabetes Foundation, Hong Kong Special Administrative Region, People's Republic of China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Juliana C N Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Asia Diabetes Foundation, Hong Kong Special Administrative Region, People's Republic of China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
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8
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Zhang F, Zhou R, Bai Y, Huang L, Li J, Zhong Y. Hemoglobin glycation index and rapid kidney function decline in diabetes patients: Insights from CHARLS. Diabetes Res Clin Pract 2025; 222:112054. [PMID: 39986657 DOI: 10.1016/j.diabres.2025.112054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2025] [Revised: 02/05/2025] [Accepted: 02/17/2025] [Indexed: 02/24/2025]
Abstract
AIMS This study aimed to assess the relationship between hemoglobin glycation index (HGI) and risk of rapid kidney function decline (RKFD) in diabetic patients. METHODS HGI was calculated as actual measured HbA1c minus predicted HbA1c. RKFD was defined as a 30 % decline in estimated glomerular filtration rate during follow-up. Participants were categorized into three groups based on HGI levels: lower (HGI ≤ -0.55), medium (-0.55 < HGI ≤ 0.22) and higher (HGI > 0.23). To understand the association between HGI and risk of RKFD in diabetic patients, directed acyclic graph were drawn and multivariate Cox proportional hazards models were used to adjust for covariates. RESULTS During a median follow-up of 4.0 years, RKFD occurred in 43 patients (6.3 %) with diabetes. After adjusting for potential confounders, Compared to the lower-HGI group, the hazard ratios for RKFD were 1.75 (95 % confidence interval [95 % CI]: 0.72, 4.25) and 2.64 (95 % CI: 1.12, 6.21) in the medium- and higher-HGI groups, respectively. HGI showed a linearly associated with RKFD (Pfor nonlinear = 0.383). The magnitude of associations was not materially altered in all sensitivity analyses, but with none significantly. CONCLUSION Higher HGI may be associated with an increased risk of RKFD in diabetic patients.
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Affiliation(s)
- Fan Zhang
- Department of Nephrology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Rui Zhou
- Department of Nephrology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Bai
- Department of Endocrinology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Liuyan Huang
- Department of Nephrology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jiao Li
- Department of Nephrology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - Yifei Zhong
- Department of Nephrology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Li Y, Kar S, Li C, Liu M, Luan Z, Yuan G, Zhong X, Mu Y. Once-Weekly Insulin Icodec Versus Once-Daily Insulin Degludec in Insulin-Naive Chinese Participants with Type 2 Diabetes: A Post Hoc Analysis of ONWARDS 3. Diabetes Ther 2025; 16:685-699. [PMID: 40016570 PMCID: PMC11926311 DOI: 10.1007/s13300-025-01701-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2024] [Accepted: 01/27/2025] [Indexed: 03/01/2025] Open
Abstract
INTRODUCTION This post hoc analysis evaluated subgroup data from China (Chinese mainland, n = 100; Taiwan, n = 45) in ONWARDS 3, a 26-week, randomized, double-blind, double-dummy, treat-to-target, phase 3a trial comparing the efficacy and safety of once-weekly insulin icodec (icodec) versus once-daily insulin degludec (degludec) in insulin-naive participants with type 2 diabetes (T2D). METHODS Adults were randomized 1:1 to icodec and once-daily placebo (icodec; n = 72) or degludec and once-weekly placebo (degludec; n = 73). The primary endpoint was change in glycated hemoglobin (HbA1c) (baseline to week 26). Secondary assessments included change in fasting plasma glucose (FPG; baseline to week 26); total weekly insulin dose (weeks 24-26); body weight change (baseline to week 26); and clinically significant or severe hypoglycemia rates (baseline to week 31 [5-week follow-up included]). RESULTS At week 26, from baseline values of 8.22% (icodec) and 8.39% (degludec), estimated mean changes in HbA1c were - 1.38% points and - 1.10% points, respectively (estimated treatment difference [95% confidence interval], - 0.28%-points [- 0.50%-points, - 0.05%-points]; p = 0.0152). For icodec and degludec, estimated mean FPG change (- 2.3 mmol/L vs. - 2.3 mmol/L), estimated mean insulin doses (158 U/week vs. 142 U/week), and estimated body weight change (2.5 kg vs. 2.4 kg) were similar. Combined clinically significant or severe hypoglycemia rates were low (0.10 [icodec] vs. 0.07 [degludec] events per patient-year of exposure), with no statistically significant difference between groups. CONCLUSION In insulin-naive Chinese individuals with T2D, once-weekly icodec treatment showed significantly greater HbA1c reductions after 26 weeks than once-daily degludec, with low combined clinically significant or severe hypoglycemia rates across groups. CLINICALTRIALS GOV IDENTIFIER NCT04795531.
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Affiliation(s)
- Yijun Li
- Department of Endocrinology, The First Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, 100853, China
| | - Soumitra Kar
- Novo Nordisk Service Centre India Private Ltd, Bangalore, India
| | - Congcong Li
- Department of General Practice, Central Hospital Affiliated to Shandong First Medical University, No. 105, Jiefang District, Jinan, China
| | - Ming Liu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Zijian Luan
- Novo Nordisk Pharmaceutical Co. Ltd, Beijing, China
| | - Guoyue Yuan
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Jiangsu, China
| | - Xing Zhong
- Novo Nordisk Pharmaceutical Co. Ltd, Beijing, China
| | - Yiming Mu
- Department of Endocrinology, The First Medical Centre of Chinese People's Liberation Army General Hospital, Beijing, 100853, China.
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Pan Q, Zhang W, Chen X, Li Y, Tu C. A study of trends in body morphology, overweight, and obesity in Chinese adults aged 40-59 years. BMC Public Health 2025; 25:833. [PMID: 40025505 PMCID: PMC11874844 DOI: 10.1186/s12889-025-21890-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Accepted: 02/10/2025] [Indexed: 03/04/2025] Open
Abstract
OBJECTIVE To reveal the changing pattern of anthropometry of middle-aged adults aged 40-59 in China from 2000-2020, and to predict the development trend in the next decade, to provide a reference basis for curbing the prevalence of overweight and obesity in them. METHODS A grey GM(1,1) prediction model was established for the cross-sectional data on anthropometric measures of 422,851 adults obtained from five series of national physical fitness surveillance in China. RESULTS 1) From 2000 to 2020, all anthropometric indicators of middle-aged people aged 40-59 years in China maintained growth, with waist circumference increasing at the highest rate, weight at the second highest rate, and height at the slowest rate; 2) Overweight and obesity rates are increasing rapidly, with an average annual increase of 0.37 percentage points and 0.30 percentage points, with a greater increase for men than for women. CONCLUSION Without stronger interventions, overweight and obesity rates among middle-aged adults are likely to continue to increase in the future, and coordinated efforts are needed to slow down the obesity epidemic and improve the physical health of middle-aged adults.
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Affiliation(s)
- Qi Pan
- School of Teacher (Physical) Education, Taizhou University, Taizhou, 318000, China
- College of Physical Education, Hangzhou Normal University, Hangzhou, 311121, China
| | - Weifeng Zhang
- Department of Physical Education, Hangzhou Youth Activity Center, Hangzhou, 310016, China
| | - Xiaolong Chen
- School of Teacher (Physical) Education, Taizhou University, Taizhou, 318000, China
- College of Physical Education, Hangzhou Normal University, Hangzhou, 311121, China
| | - Yuyu Li
- School of Teacher (Physical) Education, Taizhou University, Taizhou, 318000, China
- College of Physical Education, Hangzhou Normal University, Hangzhou, 311121, China
| | - Chunjing Tu
- School of Teacher (Physical) Education, Taizhou University, Taizhou, 318000, China.
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11
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Chee HK, Abbas F, van Winkelhoff AJ, Tjakkes GH, Htoon HM, Li H, de Waal Y, Vissink A, Seneviratne CJ. Identifying Undiagnosed Diabetes and Prediabetes in the Dental Setting in an Asian Population-A Clinical Risk Model. J Clin Periodontol 2025; 52:324-338. [PMID: 39532695 DOI: 10.1111/jcpe.14090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 10/25/2024] [Accepted: 10/29/2024] [Indexed: 11/16/2024]
Abstract
AIM To assess the glycaemic status of Asian patients in a tertiary care dental setting and develop a risk model for undiagnosed diabetes mellitus (DM). MATERIAL AND METHODS A total of 1074 participants completed a diabetes risk test questionnaire, full-mouth periodontal examination and a point-of-care HbA1c finger-prick blood test. Univariable logistic regression was performed to assess the effect of potential factors to predict DM, with confirmed diabetes as the outcome. Subsequently, multivariable logistic regression analysis with stepwise variable selection was employed to develop the final models for predicting DM. RESULTS Sixty-five (6.1%) and 83 (7.7%) of the 1074 participants were medically confirmed with T2DM and prediabetes, respectively. The 'best' predictive risk model for DM included body mass index (BMI), family history of diabetes, smoking and a diagnosis of Stage III/IV or severe periodontitis with an area under the curve (AUC) of 0.717 (95% confidence interval, CI [0.689-0.744]) and 0.721 (95% CI [0.693-0.748]), respectively. Including the oral health measure marginally increased the AUC. CONCLUSIONS Dental patients clinically diagnosed with advanced periodontitis in combination with high BMI, positive family history of DM and smoking are potentially at high risk for DM and should be screened for DM and referred for medical confirmation and management.
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Affiliation(s)
- Hoe Kit Chee
- National Dental Centre of Singapore, Singapore
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Frank Abbas
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Arie Jan van Winkelhoff
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Geerten Has Tjakkes
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Huihua Li
- National Dental Centre of Singapore, Singapore
- National Dental Research Institute Singapore, Singapore
| | - Yvonne de Waal
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Chaminda Jayampath Seneviratne
- National Dental Centre of Singapore, Singapore
- National Dental Research Institute Singapore, Singapore
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
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Tsuda A, Mori K, Uedono H, Nakatani S, Nagata Y, Kurajoh M, Yamada S, Morioka T, Ishimura E, Uchida J, Emoto M. Definition of hyperfiltration taking into account age-related decline in renal function in kidney donor candidates with obesity and glucose tolerance disorder. Hypertens Res 2025; 48:1115-1124. [PMID: 39663390 DOI: 10.1038/s41440-024-02020-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 10/11/2024] [Accepted: 11/04/2024] [Indexed: 12/13/2024]
Abstract
The definition of hyperfiltration, the main pathogenesis in renal impairment in obesity and diabetes mellitus, is uncertain. Glomerular filtration rate (GFR) declines physiologically with aging, and there is inaccuracy in GFR in obesity due to body surface area (BSA) correction. Here, we defined hyperfiltration using GFR without BSA correction, but with inclusion of aging, and investigated hyperfiltration using this definition and absolute GFR > 125 mL/min. The subjects were 180 kidney donor candidates (56.4 ± 11.3 years old, 79 males). GFR was evaluated using inulin clearance. A two-hour 75-g oral glucose tolerance test was also performed. The subjects were divided into four groups with and without a combination of glucose tolerance disorder and BMI. Normal glucose tolerance (NGT) and BMI < 25 kg/m2 were defined as normal, and hyperfiltration was defined as the upper 95% confidence interval of the relationship of aging and GFR in normal cases, and compared with GFR > 125 mL/min. RESULTS: GFR without BSA correction and UAE in non-NGT subjects with obesity were higher than in other groups, but GFR with BSA correction did not show this relationship. In multiple regression analysis, BMI was independently associated with GFR without BSA correction, but not with BSA correction. Aging was consistently associated with GFR. The prevalence of hyperfiltration by our definition (GFR = -0.883 × Age + 167.398) was significantly higher than that using GFR > 125 mL/min (P < 0.0001). Hyperfiltration in obesity and/or glucose tolerance disorder should be evaluated using GFR without BSA correction and including the decline of GFR due to aging.
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Affiliation(s)
- Akihiro Tsuda
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
| | - Katsuhito Mori
- Department of Nephrology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Hideki Uedono
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Shinya Nakatani
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Yuki Nagata
- Department of Vascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Masafumi Kurajoh
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Shinsuke Yamada
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Tomoaki Morioka
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Eiji Ishimura
- Department of Nephrology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
- Department of Nephrology, Meijibashi Hospital, Matsubara, Osaka, Japan
| | - Junji Uchida
- Department of Urology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Masanori Emoto
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
- Department of Nephrology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
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Anver Pasha SF, Sadathulla Syed S, Mohamed Saber Mohamed Mohamed Sharafeldin A, Nazari Fard EH, Srinivasamurthy SK, Goud M. Interrelation Among Anthropometric Indices, Body Composition, Physical Fitness, and Glycated Hemoglobin in a Cohort of Young Female University Students: A Cross-Sectional Study. Cureus 2025; 17:e80324. [PMID: 40206940 PMCID: PMC11979732 DOI: 10.7759/cureus.80324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2025] [Indexed: 04/11/2025] Open
Abstract
INTRODUCTION Glycated hemoglobin (HbA1c) reflects average blood glucose levels over the preceding three months, independent of fasting state. It is widely used for diagnosing type 2 diabetes and prediabetes and monitoring glucose control in patients with diabetes. This study highlights how anthropometry, body composition, and physical fitness affect glycated hemoglobin (HbA1c) levels in a cohort of female university students. MATERIALS AND METHODS This cross-sectional study, conducted between October 2023 and January 2024 among university female students (n=86; ages 17-22 years) in the United Arab Emirates (UAE), aimed to determine the relationship between HbA1c, anthropometric indices, physical fitness, and body composition. Participants were recruited in person, provided written informed consent, and completed demographic and physical activity questionnaires. Weight, body mass index (BMI), visceral fat, and muscle and fat percentage were measured using a body composition monitor scale (Omron HBF-514C, OMRON Healthcare, Inc., Kyoto, Japan). A stadiometer was used to measure height and an electronic sphygmomanometer to measure blood pressure. The waist and hip circumferences were measured using a measuring tape, and the waist-to-hip ratio was further calculated. Glycated hemoglobin (HbA1c) was measured using an immunofluorescence assay analyzer (Getein 1160 Immunofluorescence Quantitative Analyzer, Getein Biotech, Inc., Nanjing, China). RESULTS AND DISCUSSION The main objective of our study was to establish a relationship between anthropometric measurements and body composition with physical fitness levels, including sedentary time, and how it influences HbA1c levels in young female students. Of the 90 participants, data from 86 were analyzed. Significant correlations were found between HbA1c and diastolic blood pressure (BP) (r=0.227) and sedentary hours (r=0.206). Linear regression analysis revealed sedentary behavior (p=0.021) and diastolic BP (p=0.034) as significant predictors of HbA1c levels. In conclusion, our research study provides valuable insights into how lifestyle factors such as sedentary lifestyle and diastolic BP influence glycemic (HbA1c) control in a specific cohort of young female university students of ages 17-22 years. Although BMI was not a significant predictor in our study, sedentary hours and diastolic blood pressure were independently linked to HbA1c levels.
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Affiliation(s)
| | - Salwa Sadathulla Syed
- Internal Medicine, RAK Medical and Health Sciences University (RAKMHSU), Ras Al Khaimah, ARE
| | | | | | | | - Manjunatha Goud
- Biochemistry, RAK Medical and Health Sciences University (RAKMHSU), Ras Al Khaimah, ARE
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14
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Chan JC, Cheung M, Luk AO, Chung H, Loo KM, Leung MKW, Chow KM, Lui JN, Wong MC, Chung KL, Lee M, Szeto CC, Tsang MW, Wong S, Ng JKC, Tang SC, Kung K, Lui SL, Chao DV, Cyzewski C, Green T, Hung VHF, Pang FC, Li PKT. A 30-year case study of local implementation of global guidelines for data-driven diabetes management starting with the Hong Kong Diabetes Register. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2025; 56:101505. [PMID: 40171472 PMCID: PMC11960639 DOI: 10.1016/j.lanwpc.2025.101505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2024] [Revised: 01/07/2025] [Accepted: 02/13/2025] [Indexed: 04/03/2025]
Affiliation(s)
- Juliana C.N. Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region of China
- Asia Diabetes Foundation, Shatin, Hong Kong Special Administrative Region of China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region of China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region of China
| | | | - Andrea O.Y. Luk
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region of China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region of China
| | - Harriet Chung
- Shumshuipo District Health Centre, Hong Kong Special Administrative Region of China
| | - Kit Man Loo
- Diabetes & Endocrine Centre, Day Treatment Block and Children Wards, Prince of Wales Hospital, Hong Kong Special Administrative Region of China
| | - Maria Kwan Wa Leung
- Department of Family Medicine & Primary Health Care, New Territories East Cluster, Hospital Authority, Hong Kong Special Administrative Region of China
| | - Kai-Ming Chow
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region of China
- Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Juliana N.M. Lui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region of China
| | - Martin C.S. Wong
- Centre for Health Education and Health Promotion, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
- School of Public Health, Peking University, Beijing, China
- The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- School of Public Health, Fudan University, Shanghai, China
| | - Kin Lai Chung
- Prince of Wales Hospital, New Territories East Cluster, Hong Kong Special Administrative Region of China
| | - Maggie Lee
- Department of Medicine & Geriatrics, New Territories West Cluster, Hospital Authority, Hong Kong Special Administrative Region of China
| | - Cheuk Chun Szeto
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region of China
- Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Man Wo Tsang
- Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong Special Administrative Region of China
| | - Sunny Wong
- Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong Special Administrative Region of China
| | - Jack Kit Chung Ng
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region of China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region of China
- Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Sydney C.W. Tang
- Division of Nephrology, Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Kenny Kung
- The GBA Healthcare Group, Hong Kong Special Administrative Region of China
| | - Sing Leung Lui
- Department of Medicine, Tung Wah Hospital, Hong Kong Special Administrative Region of China
| | - David V.K. Chao
- Department of Family Medicine and Primary Health Care, United Christian Hospital, Hong Kong Special Administrative Region of China
| | | | | | - Victor Hin-Fai Hung
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong Special Administrative Region of China
| | - Fei Chau Pang
- Primary Healthcare Office, Health Bureau, Hong Kong Special Administrative Region of China
| | - Philip Kam-Tao Li
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region of China
- Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
- International Association of Chinese Nephrologists, Shatin, Hong Kong Special Administrative Region of China
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15
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Faramarzi E, Mehrtabar S, Molani-Gol R, Dastgiri S. The relationship between hepatic enzymes, prediabetes, and diabetes in the Azar cohort population. BMC Endocr Disord 2025; 25:41. [PMID: 39953488 PMCID: PMC11827479 DOI: 10.1186/s12902-025-01871-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Accepted: 02/06/2025] [Indexed: 02/17/2025] Open
Abstract
BACKGROUND Early prediabetes screening holds immense significance in decreasing the incidence of diabetes. Therefore, we aimed to evaluate the association of hepatic enzymes with prediabetes and diabetes in the Azar cohort population in Iran. METHODS This cross-sectional study utilized data from the Azar cohort study, initiated in 2014, with 14,865 participants aged 35-70 years. This study defines prediabetes, according to the American Diabetes Association (ADA), as fasting blood sugar (FBS) of 100-125 mg/dl. An FBS ≥ 126 mg/dL or a history of diabetes indicates diabetes. Serum liver enzymes including alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP) were measured, and associations with prediabetes and diabetes were analyzed using binary logistic regression. RESULTS In a study of 14,865 participants, 16% had prediabetes and 14.1% had diabetes. The serum levels of ALT, AST, GGT, and ALP were significantly higher (P < 0.05) in the prediabetic and diabetic patients. The adjusted logistic regression model showed a dose-response increase for all hepatic enzymes, with the highest ORs in the fourth quartile for both prediabetes and diabetes. The highest OR for prediabetes and diabetes was in the fourth GGT quartile. CONCLUSION Our findings suggest that serum ALT, GGT, and ALP levels are strongly associated with prediabetes and diabetes. These hepatic enzymes may be considered easy and valuable early indicators of diabetes risk, prompting timely interventions to slow disease progression.
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Affiliation(s)
- Elnaz Faramarzi
- Liver and Gastrointestinal Diseases Research Center Tabriz, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saba Mehrtabar
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roghayeh Molani-Gol
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Saeed Dastgiri
- Tabriz Health Services Management Research Center School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
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Takao T, Suka M, Nishikawa M, Yanagisawa H, Ishii T. Patterns of trajectories of glycated hemoglobin, fasting plasma glucose, and body mass index until the first clinic visit: the real-world history of type 2 diabetes using repeated health checkup data of Japanese workers. Fam Pract 2025; 42:cmae054. [PMID: 39446604 PMCID: PMC11809247 DOI: 10.1093/fampra/cmae054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2024] Open
Abstract
BACKGROUND There is a lack of evidence regarding the trajectories of type 2 diabetes until the first clinic visit, including the untreated period after diagnosis. OBJECTIVE We aimed to determine the real-world history of type 2 diabetes until the first clinic visit, including the untreated duration, and to assess the effective timing of the therapeutic intervention. METHODS A total of 23,622 nondiabetic Japanese workers with a mean (SD) age of 38.8 (11.5) years were retrospectively followed from 2008 to 2022 for annual health checkups. The trajectories of glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and body mass index (BMI) until the first clinic visit in diabetes individuals were determined. ROC analysis was performed to assess the contribution of each measure to the first visit. RESULTS During a median follow-up of 12.0 years, 1,725 individuals developed type 2 diabetes, of whom 532 individuals visited clinics. HbA1c and FPG trajectories steeply rose in the year before the first clinic visit after their progressive upward trends. ROC analysis showed cutoff values for each measure. As the untreated duration increased, glycemia increased and BMI decreased among individuals who visited clinics. CONCLUSIONS To prevent the initial worsening of diabetes, early therapeutic intervention is necessary during the increasing trends before the steep rise in glycemia, regardless of the degree of obesity. HbA1c ≥6.5% (47.5 mmol/mol) and an HbA1c ≥0.2% (2.2 mmol/mol)/year increase may be an effective timing for therapeutic intervention.
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Affiliation(s)
- Toshiko Takao
- JR East Health Promotion Center, East Japan Railway Company, 2-1-19 Hiromachi, Shinagawa-ku, Tokyo, 140-0005, Japan
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Machi Suka
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Masako Nishikawa
- Clinical Research Support Center, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroyuki Yanagisawa
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Toru Ishii
- JR East Health Promotion Center, East Japan Railway Company, 2-1-19 Hiromachi, Shinagawa-ku, Tokyo, 140-0005, Japan
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Li M, Ding L, Cao L, Zhang Z, Li X, Li Z, Xia Q, Yin K, Song S, Wang Z, Du H, Zhao D, Li X, Wang Z. Natural products targeting AMPK signaling pathway therapy, diabetes mellitus and its complications. Front Pharmacol 2025; 16:1534634. [PMID: 39963239 PMCID: PMC11830733 DOI: 10.3389/fphar.2025.1534634] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Accepted: 01/15/2025] [Indexed: 02/20/2025] Open
Abstract
Diabetes mellitus (DM) ranks among the most prevalent chronic metabolic diseases, characterized primarily by a persistent elevation in blood glucose levels. This condition typically stems from either insufficient insulin secretion or a functional defect in the insulin itself. Clinically, diabetes is primarily classified into type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), with T2DM comprising nearly 90% of all diagnosed cases. Notably, the global incidence of T2DM has surged dramatically over recent decades. The adenylate-activated protein kinase (AMPK) signaling pathway is crucial in regulating cellular energy metabolism, marking it as a significant therapeutic target for diabetes and related complications. Natural products, characterized by their diverse origins, multifaceted bioactivities, and relative safety, hold considerable promise in modulating the AMPK pathway. This review article explores the advances in research on natural products that target the AMPK signaling pathway, aiming to inform the development of innovative antidiabetic therapies.
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Affiliation(s)
- Min Li
- Northeast Asia Research Institute of Traditional Chinese Medicine, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efcacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Changchun University of Chinese Medicine, Jilin, China
| | - Lu Ding
- Northeast Asia Research Institute of Traditional Chinese Medicine, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efcacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Changchun University of Chinese Medicine, Jilin, China
- Research Center of Traditional Chinese Medicine, The Affiliated Hospital to Changchun University of Chinese Medicine, Jilin, China
| | - Liyuan Cao
- Northeast Asia Research Institute of Traditional Chinese Medicine, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efcacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Changchun University of Chinese Medicine, Jilin, China
| | - Zepeng Zhang
- Research Center of Traditional Chinese Medicine, The Affiliated Hospital to Changchun University of Chinese Medicine, Jilin, China
| | - Xueyan Li
- Northeast Asia Research Institute of Traditional Chinese Medicine, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efcacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Changchun University of Chinese Medicine, Jilin, China
| | - Zirui Li
- Northeast Asia Research Institute of Traditional Chinese Medicine, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efcacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Changchun University of Chinese Medicine, Jilin, China
| | - Qinjing Xia
- Northeast Asia Research Institute of Traditional Chinese Medicine, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efcacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Changchun University of Chinese Medicine, Jilin, China
| | - Kai Yin
- Northeast Asia Research Institute of Traditional Chinese Medicine, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efcacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Changchun University of Chinese Medicine, Jilin, China
| | - Siyu Song
- Northeast Asia Research Institute of Traditional Chinese Medicine, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efcacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Changchun University of Chinese Medicine, Jilin, China
| | - Zihan Wang
- Northeast Asia Research Institute of Traditional Chinese Medicine, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efcacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Changchun University of Chinese Medicine, Jilin, China
| | - Haijian Du
- Northeast Asia Research Institute of Traditional Chinese Medicine, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efcacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Changchun University of Chinese Medicine, Jilin, China
| | - Daqing Zhao
- Northeast Asia Research Institute of Traditional Chinese Medicine, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efcacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Changchun University of Chinese Medicine, Jilin, China
| | - Xiangyan Li
- Northeast Asia Research Institute of Traditional Chinese Medicine, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efcacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Changchun University of Chinese Medicine, Jilin, China
| | - Zeyu Wang
- Northeast Asia Research Institute of Traditional Chinese Medicine, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efcacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Changchun University of Chinese Medicine, Jilin, China
- Research Center of Traditional Chinese Medicine, The Affiliated Hospital to Changchun University of Chinese Medicine, Jilin, China
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18
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Lim EB, Cho YS. Identification of genetic loci enriched in obese or lean T2D cases in the Korean population. Genes Genomics 2025; 47:235-243. [PMID: 39693004 DOI: 10.1007/s13258-024-01602-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2024] [Accepted: 11/26/2024] [Indexed: 12/19/2024]
Abstract
BACKGROUND Obesity causes many complex diseases including type 2 diabetes (T2D). Obesity increases the risk of T2D in Europeans, but there are many non-obese (lean) T2D patients in East Asia. OBJECTIVE To discover genetic factors enriched in obese or lean T2D patients, we conducted a genome-wide association (GWA) analysis for T2D stratified by BMI in the Korean population. METHODS In the discovery stage, 654 and 247 individuals classified as obese (BMI > 25) and lean (BMI < 23) T2D patients, respectively, were compared with 3,842 control subjects for GWA analysis. Several BMI-stratified T2D variants detected in the discovery stage were further tested in the replication stage, which included 402 obese and 220 lean T2D cases, and 3,615 controls. RESULTS Meta-analysis combining the discovery and replication stages detected two variants with genome-wide significance: rs2356138 [P = 2.8 × 10-8, OR = 2.06 (1.59-2.65)] in obese T2D subjects and rs9295478 [P = 2.5 × 10-9, OR = 1.61 (1.38-1.88)] in lean ones. The SNP rs9295478 is located in CDKAL1, a well-known T2D gene previously identified in several GWA studies. Meanwhile, the SNP rs2356138 is a previously unknown variant located in PKP4. CONCLUSION We discovered genetic loci enriched in obese or lean T2D patients in the Korean population. Our findings should facilitate more effective control of T2D in Koreans.
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Affiliation(s)
- Eun Bi Lim
- Department of Biomedical Science, Hallym University, Chuncheon, Gangwon State, 24252, Republic of Korea
| | - Yoon Shin Cho
- Department of Biomedical Science, Hallym University, Chuncheon, Gangwon State, 24252, Republic of Korea.
- Department of Neuroscience, Hallym University College of Medicine, Chuncheon, Gangwon State, 24252, Republic of Korea.
- GenoMax Co., Ltd, Humanities Building 2, 4314-4, Hallymdaehakgil 1, Chuncheon, Gangwon State, Republic of Korea.
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Suzuki K, Tsujiguchi H, Hara A, Takeshita Y, Goto H, Nakano Y, Yamamoto R, Takayama H, Tajima A, Yamashita T, Honda M, Nakamura H, Takamura T. Hepatokine leukocyte cell-derived chemotaxin 2 as a biomarker of insulin resistance, liver enzymes, and metabolic dysfunction-associated steatotic liver disease in the general population. J Diabetes Investig 2025; 16:298-308. [PMID: 39570764 PMCID: PMC11786172 DOI: 10.1111/jdi.14351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 10/20/2024] [Accepted: 10/27/2024] [Indexed: 02/02/2025] Open
Abstract
AIMS/INTRODUCTION Leukocyte cell-derived chemotaxin 2 (LECT2) is an obesity-associated hepatokine that causes skeletal muscle insulin resistance. Since LECT2 is up-regulated by the inactivation of the energy sensor AMPK in the liver, we hypothesized that LECT2 has potential as a biomarker for metabolic dysfunction-associated steatotic liver disease (MASLD). Therefore, we investigated whether circulating LECT2 levels are associated with insulin sensitivity, liver enzymes, and MASLD. MATERIALS AND METHODS This cross-sectional study included 138 Japanese individuals. Plasma LECT2 levels were measured using fasting blood samples. B-mode ultrasonography was used to assess hepatic steatosis. RESULTS The mean age and body mass index (BMI) of participants were 63.5 ± 10.2 years and 23.0 ± 3.1 kg/m2, respectively. Higher LECT2 levels positively correlated with homeostatic model assessment for insulin resistance (HOMA-IR) values and negatively correlated with the quantitative insulin sensitivity check index (QUICKI) among all participants (HOMA-IR; non-standardized β (B) = 6.38, P < 0.01: QUICKI; B = -161, P < 0.01). These correlations were stronger in the low BMI group (HOMA-IR; B = 13.85, P < 0.01: QUICKI; B = -180, P < 0.01). LECT2 levels also positively correlated with gamma-glutamyl transferase levels (B = 0.01, P = 0.01) and alanine aminotransferase levels (B = 0.33, P = 0.02). Higher LECT2 levels correlated with the prevalence of MASLD (odds ratio = 1.14, P = 0.02). CONCLUSIONS The present results suggest the potential of plasma LECT2 levels as a biomarker for insulin resistance in individuals who are not overweight and the prevalence of MASLD in the general population.
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Affiliation(s)
- Keita Suzuki
- Kanazawa University Advanced Preventive Medical Sciences Research CenterKanazawaIshikawaJapan
| | - Hiromasa Tsujiguchi
- Kanazawa University Advanced Preventive Medical Sciences Research CenterKanazawaIshikawaJapan
- Department of Public Health, Graduate School of Advanced Preventive Medical SciencesKanazawa UniversityKanazawaIshikawaJapan
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health SciencesKanazawa UniversityKanazawaIshikawaJapan
| | - Akinori Hara
- Kanazawa University Advanced Preventive Medical Sciences Research CenterKanazawaIshikawaJapan
- Department of Public Health, Graduate School of Advanced Preventive Medical SciencesKanazawa UniversityKanazawaIshikawaJapan
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health SciencesKanazawa UniversityKanazawaIshikawaJapan
| | - Yumie Takeshita
- Department of Endocrinology and MetabolismKanazawa University Graduate School of Medical SciencesKanazawaIshikawaJapan
| | - Hisanori Goto
- Department of Endocrinology and MetabolismKanazawa University Graduate School of Medical SciencesKanazawaIshikawaJapan
| | - Yujiro Nakano
- Department of Endocrinology and MetabolismKanazawa University Graduate School of Medical SciencesKanazawaIshikawaJapan
| | - Reina Yamamoto
- Department of Endocrinology and MetabolismKanazawa University Graduate School of Medical SciencesKanazawaIshikawaJapan
| | - Hiroaki Takayama
- Department of Endocrinology and MetabolismKanazawa University Graduate School of Medical SciencesKanazawaIshikawaJapan
| | - Atsushi Tajima
- Kanazawa University Advanced Preventive Medical Sciences Research CenterKanazawaIshikawaJapan
- Faculty of Medicine, Department of Bioinformatics and Genomics, Institute of Medical, Pharmaceutical and Health SciencesKanazawa UniversityKanazawaIshikawaJapan
| | - Tatsuya Yamashita
- Department of GastroenterologyKanazawa University Graduate School of Medical SciencesKanazawaIshikawaJapan
| | - Masao Honda
- Department of GastroenterologyKanazawa University Graduate School of Medical SciencesKanazawaIshikawaJapan
| | - Hiroyuki Nakamura
- Kanazawa University Advanced Preventive Medical Sciences Research CenterKanazawaIshikawaJapan
- Department of Public Health, Graduate School of Advanced Preventive Medical SciencesKanazawa UniversityKanazawaIshikawaJapan
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health SciencesKanazawa UniversityKanazawaIshikawaJapan
| | - Toshinari Takamura
- Department of Endocrinology and MetabolismKanazawa University Graduate School of Medical SciencesKanazawaIshikawaJapan
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20
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Lee J, Yoon KH. Evolving Characteristics of Type 2 Diabetes Mellitus in East Asia. Endocrinol Metab (Seoul) 2025; 40:57-63. [PMID: 39814030 PMCID: PMC11898318 DOI: 10.3803/enm.2024.2193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2024] [Revised: 10/15/2024] [Accepted: 10/29/2024] [Indexed: 01/18/2025] Open
Abstract
In East Asians, type 2 diabetes mellitus (T2DM) is primarily characterized by significant defects in insulin secretion and comparatively low insulin resistance. Recently, the prevalence of T2DM has rapidly increased in East Asian countries, including Korea, occurring concurrently with rising obesity rates. This trend has led to an increase in the average body mass index among East Asian T2DM patients, highlighting the influence of insulin resistance in the development of T2DM within this group. Currently, the incidence of T2DM in Korea is declining, which may indicate potential adaptive changes in insulin secretory capacity. This review focuses on the changing epidemiology of T2DM in East Asia, with a particular emphasis on the characteristics of peak functional β-cell mass.
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Affiliation(s)
- Joonyub Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kun-Ho Yoon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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21
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Chen Y, Jiang Q, Xing X, Yuan T, Li P. Clinical research progress on β-cell dysfunction in T2DM development in the Chinese population. Rev Endocr Metab Disord 2025; 26:31-53. [PMID: 39382753 DOI: 10.1007/s11154-024-09914-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2024] [Indexed: 10/10/2024]
Abstract
The prevalence of type-2 diabetes mellitus (T2DM) has increased over 10-fold in the past 40 years in China, which now has the largest T2DM population in the world. Insulin resistance and β-cell dysfunction are the typical features of T2DM. Although both factors play a role, decreased β-cell function and β-cell mass are the predominant factors for progression to T2DM. Considering the differences between Chinese T2DM patients and those of other ethnicities, it is important to characterize β-cell dysfunction in Chinese patients during T2DM progression. Herein, we reviewed the studies on the relationships between β-cell function and T2DM progression in the Chinese population and discussed the differences among individuals of varying ethnicities. Meanwhile, we summarized the risk factors and current treatments of T2DM in Chinese individuals and discussed their impacts on β-cell function with the hope of identifying a better T2DM therapy.
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Affiliation(s)
- Yibing Chen
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, China
- Diabetes Research Center of Chinese Academy of Medical Sciences, Beijing, 100050, China
- CAMS Key Laboratory of Molecular Mechanism and Target Discovery of Metabolic Disorder and Tumorigenesis, Beijing, 100050, China
| | - Qian Jiang
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, China
- Diabetes Research Center of Chinese Academy of Medical Sciences, Beijing, 100050, China
- CAMS Key Laboratory of Molecular Mechanism and Target Discovery of Metabolic Disorder and Tumorigenesis, Beijing, 100050, China
| | - Xiaowei Xing
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, China
- Diabetes Research Center of Chinese Academy of Medical Sciences, Beijing, 100050, China
- CAMS Key Laboratory of Molecular Mechanism and Target Discovery of Metabolic Disorder and Tumorigenesis, Beijing, 100050, China
| | - Tao Yuan
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
| | - Pingping Li
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, China.
- Diabetes Research Center of Chinese Academy of Medical Sciences, Beijing, 100050, China.
- CAMS Key Laboratory of Molecular Mechanism and Target Discovery of Metabolic Disorder and Tumorigenesis, Beijing, 100050, China.
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22
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Alcaide-Leyva JM, Romero-Saldaña M, García-Rodríguez M, Molina-Luque R, Jiménez-Mérida MDR, Molina-Recio G. Metabolic Syndrome in the Amazon: Customizing Diagnostic Methods for Urban Communities. Nutrients 2025; 17:538. [PMID: 39940395 PMCID: PMC11820743 DOI: 10.3390/nu17030538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2025] [Revised: 01/27/2025] [Accepted: 01/29/2025] [Indexed: 02/16/2025] Open
Abstract
Background/Objectives: Metabolic syndrome is a significant public health issue, particularly in urbanizing regions like the Peruvian Amazon, where lifestyle changes have increased the prevalence of metabolic disorders. This study aimed to develop and validate a simple, cost-effective diagnostic model for early detection of metabolic syndrome in the urban population of San Juan Bautista, Iquitos. Methods: A cross-sectional study was conducted with 251 adults aged over 18 years. Data collection included anthropometric measurements, body composition analysis, and biochemical assessments. Logistic regression analyses identified key predictors of metabolic syndrome, and clinical decision trees were developed to enhance diagnostic accuracy. Results: The prevalence of metabolic syndrome was 47.9%. Systolic blood pressure, triglycerides, and very-low-density lipoprotein cholesterol were the strongest predictors. The most effective diagnostic model, combining very-low-density lipoprotein cholesterol and systolic blood pressure, achieved a sensitivity of 91.6% and a specificity of 78.5%, demonstrating high diagnostic accuracy. Conclusions: The proposed model offers a practical, low-cost tool for early detection of metabolic syndrome in resource-limited urban settings. However, its findings are limited by the small sample size and the lack of external validation, requiring further studies to confirm its generalizability and applicability to other populations. Its implementation in primary healthcare could facilitate timely interventions, reducing the risk of chronic diseases in vulnerable populations.
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Affiliation(s)
- José M. Alcaide-Leyva
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14014 Cordoba, Spain; (J.M.A.-L.); (R.M.-L.); (G.M.-R.)
- Associated Research Group GA16 Lifestyles, Technology and Health, Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), 14014 Cordoba, Spain
| | - Manuel Romero-Saldaña
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14014 Cordoba, Spain; (J.M.A.-L.); (R.M.-L.); (G.M.-R.)
- Associated Research Group GA16 Lifestyles, Technology and Health, Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), 14014 Cordoba, Spain
| | - María García-Rodríguez
- Department of Nursing and Nutrition, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Calle Tajo S/N, 28670 Madrid, Spain
| | - Rafael Molina-Luque
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14014 Cordoba, Spain; (J.M.A.-L.); (R.M.-L.); (G.M.-R.)
- Associated Research Group GA16 Lifestyles, Technology and Health, Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), 14014 Cordoba, Spain
| | - María del Rocío Jiménez-Mérida
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14014 Cordoba, Spain; (J.M.A.-L.); (R.M.-L.); (G.M.-R.)
- Associated Research Group GA16 Lifestyles, Technology and Health, Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), 14014 Cordoba, Spain
| | - Guillermo Molina-Recio
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14014 Cordoba, Spain; (J.M.A.-L.); (R.M.-L.); (G.M.-R.)
- Associated Research Group GA16 Lifestyles, Technology and Health, Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), 14014 Cordoba, Spain
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23
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Wang J, Chen J, Liu Y, Xu J. Use of the FHTHWA Index as a Novel Approach for Predicting the Incidence of Diabetes in a Japanese Population Without Diabetes: Data Analysis Study. JMIR Med Inform 2025; 13:e64992. [PMID: 39881429 PMCID: PMC11793195 DOI: 10.2196/64992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 11/14/2024] [Accepted: 11/17/2024] [Indexed: 01/31/2025] Open
Abstract
Background Many tools have been developed to predict the risk of diabetes in a population without diabetes; however, these tools have shortcomings that include the omission of race, inclusion of variables that are not readily available to patients, and low sensitivity or specificity. Objective We aimed to develop and validate an easy, systematic index for predicting diabetes risk in the Asian population. Methods We collected the data from the NAGALA (NAfld [nonalcoholic fatty liver disease] in the Gifu Area, Longitudinal Analysis) database. The least absolute shrinkage and selection operator model was used to select potentially relevant features. Multiple Cox proportional hazard analysis was used to develop a model based on the training set. Results The final study population of 15464 participants had a mean age of 42 (range 18-79) years; 54.5% (8430) were men. The mean follow-up duration was 6.05 (SD 3.78) years. A total of 373 (2.41%) participants showed progression to diabetes during the follow-up period. Then, we established a novel parameter (the FHTHWA index), to evaluate the incidence of diabetes in a population without diabetes, comprising 6 parameters based on the training set. After multivariable adjustment, individuals in tertile 3 had a significantly higher rate of diabetes compared with those in tertile 1 (hazard ratio 32.141, 95% CI 11.545-89.476). Time receiver operating characteristic curve analyses showed that the FHTHWA index had high accuracy, with the area under the curve value being around 0.9 during the more than 12 years of follow-up. Conclusions This research successfully developed a diabetes risk assessment index tailored for the Japanese population by utilizing an extensive dataset and a wide range of indices. By categorizing the diabetes risk levels among Japanese individuals, this study offers a novel predictive tool for identifying potential patients, while also delivering valuable insights into diabetes prevention strategies for the healthy Japanese populace.
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Affiliation(s)
- Jiao Wang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
- Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang, China
- Jiangxi Branch of National Clinical Research Center for Metabolic Disease, Nanchang, China
| | - Jianrong Chen
- Department of Endocrinology and Metabolism, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
- Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang, China
- Jiangxi Branch of National Clinical Research Center for Metabolic Disease, Nanchang, China
| | - Ying Liu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
- Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang, China
- Jiangxi Branch of National Clinical Research Center for Metabolic Disease, Nanchang, China
| | - Jixiong Xu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
- Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang, China
- Jiangxi Branch of National Clinical Research Center for Metabolic Disease, Nanchang, China
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Choudhry SS, Mehmood H, Akhtar T, Haroon M, Musa M, Sajid Z. Design, Synthesis, and In Silico Molecular Docking Studies of Adamantanyl Hydrazinylthiazoles as Potential Antidiabetic Agents. Chem Biodivers 2025:e202402409. [PMID: 39856497 DOI: 10.1002/cbdv.202402409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2024] [Revised: 01/21/2025] [Accepted: 01/24/2025] [Indexed: 01/27/2025]
Abstract
Diabetes mellitus (DM) is a widespread disease that poses a major threat to millions of people. To address this issue, we have synthesized seventeen new 4-(adamantan-1-yl)-(2-(arylidene)hydrazinyl)thiazoles (3a-q) via Hantzsch synthetic approach. The molecular structures of all the compounds were confirmed using FT-IR, 1H- and 13C-NMR spectroscopy, and HR-mass spectrometry. Protein kinase, α-amylase, glycation, and oxidation inhibition potential of all compounds were also investigated, and it was found that compounds 3b, 3c, 3e-3g, and 3i-3q have shown excellent α-amylase inhibition (IC50 = 7.91 ± 0.07 to 28.57 ± 0.1 µM), compounds 3c, 3e, 3i, 3k, and 3p (IC50 = 30.6 ± 0.06 to 37.8 ± 0.005 ppm) were found to be highly potent anti-glycating agents, and compounds 3c, 3g, 3h, 3k, and 3m were found to be more potent protein kinase inhibitors as compared to standards. The compounds 3b, 3c, 3d, 3e, 3f, 3g, 3i, 3k, 3l, 3m, 3n, 3p, and 3q have shown good antioxidant potential (IC50 = 27.5 ± 0.09 to 48.8 ± 0.09 µM) as compared to standard ascorbic acid (IC50 = 51.3 ± 0.1 µM). The biocompatibility of all samples was also tested by employing brine shrimp lethality and in vitro hemolytic assays and was found to be safe to human erythrocytes at tested concentrations. Furthermore, the molecular docking simulation study also revealed that almost all synthesized compounds have potential interactions with target proteins at the molecular level.
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Affiliation(s)
- Sabah Siddique Choudhry
- Department of Chemistry, Mirpur University of Science and Technology (MUST), Mirpur, Azad Kashmir, Pakistan
| | - Hasnain Mehmood
- Department of Chemistry, Mirpur University of Science and Technology (MUST), Mirpur, Azad Kashmir, Pakistan
| | - Tashfeen Akhtar
- Department of Chemistry, Mirpur University of Science and Technology (MUST), Mirpur, Azad Kashmir, Pakistan
| | - Muhammad Haroon
- Department of Chemistry and Biochemistry, Miami University, 651 E High St, Oxford, Ohio, United States
| | - Mustapha Musa
- GSK Carbon Neutral Laboratories for Sustainable Chemistry, University of Nottingham, Nottingham, UK
| | - Zaroon Sajid
- Department of Chemistry, Mirpur University of Science and Technology (MUST), Mirpur, Azad Kashmir, Pakistan
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Yang H, Liu Y, Huang Z, Deng G. Achieving prediabetes reversal in China: a nationwide longitudinal study on the role of blood glucose and lipid management in middle-aged and elderly adults. Front Endocrinol (Lausanne) 2025; 15:1463650. [PMID: 39911240 PMCID: PMC11794071 DOI: 10.3389/fendo.2024.1463650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Accepted: 12/30/2024] [Indexed: 02/07/2025] Open
Abstract
Background Prediabetes, impacting a third of the adult Chinese population, is linked to a variety of detrimental health outcomes. However, scant research has delved into the factors that affect a regression from prediabetes to normal glucose regulation (NGR) in middle-aged and elderly Chinese adults. Methods We conducted a longitudinal analysis of 2,655 adults, aged 45 years and above, drawing data from wave 1 and wave 3 of the China Health and Retirement Longitudinal Study (CHARLS). We employed a stepwise logistic regression model to identify factors associated with the regression to NGR. Restricted Cubic Spline (RCS) analysis was used to evaluate the dose-response relationships between baseline fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) levels and the likelihood of regression to NGR. Attribution fraction (AF) analysis was conducted to measure the impact of modifiable factors on the regression of prediabetes. We further examined how changes in these factors were associated with regression to NGR. Results During the 4-year follow-up, 570 of 2,655 prediabetes participants regressed to NGR. The stepwise logistic regression model identified older age, female sex, abdominal obesity (OR 0.70, 95% CI 0.57-0.86), elevated LDL-C (OR 0.69, 95% CI 0.48-0.97), higher FPG (OR 0.68, 95% CI 0.52-0.90), and higher HbA1c (OR 0.23, 95% CI 0.18-0.30) as factors associated with regression to NGR. AF analysis showed that a lower initial HbA1c was the most influential factor for regression to NGR. Additionally, evaluated blood lipid profiles reduced the odds of regression to NGR. Conclusion This study underscores the influence of age, gender, abdominal obesity, LDL-C levels, FPG, HbA1c, and blood lipid profiles on the likelihood of regressing from prediabetes to NGR. It suggests that adopting a healthy lifestyle and preemptively mitigating these risks may be more beneficial than addressing them after they have been identified in clinical settings.
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Affiliation(s)
- Hongguang Yang
- Department of Clinical Nutrition, Shenzhen Nanshan People’s Hospital, Shenzhen, Guangdong, China
| | - Yao Liu
- Department of Clinical Nutrition, Shenzhen Nanshan People’s Hospital, Shenzhen, Guangdong, China
| | - Zhenhe Huang
- Geriatric Medicine Department, Shenzhen Nanshan People’s Hospital, Shenzhen, Guangdong, China
| | - Guifang Deng
- Department of Clinical Nutrition, Shenzhen Nanshan People’s Hospital, Shenzhen, Guangdong, China
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26
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Jia W, Chan JC, Wong TY, Fisher EB. Diabetes in China: epidemiology, pathophysiology and multi-omics. Nat Metab 2025; 7:16-34. [PMID: 39809974 DOI: 10.1038/s42255-024-01190-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 11/25/2024] [Indexed: 01/16/2025]
Abstract
Although diabetes is now a global epidemic, China has the highest number of affected people, presenting profound public health and socioeconomic challenges. In China, rapid ecological and lifestyle shifts have dramatically altered diabetes epidemiology and risk factors. In this Review, we summarize the epidemiological trends and the impact of traditional and emerging risk factors on Chinese diabetes prevalence. We also explore recent genetic, metagenomic and metabolomic studies of diabetes in Chinese, highlighting their role in pathogenesis and clinical management. Although heterogeneity across these multidimensional areas poses major analytic challenges in classifying patterns or features, they have also provided an opportunity to increase the accuracy and specificity of diagnosis for personalized treatment and prevention. National strategies and ongoing research are essential for improving diabetes detection, prevention and control, and for personalizing care to alleviate societal impacts and maintain quality of life.
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Affiliation(s)
- Weiping Jia
- Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Institute for Proactive Healthcare, Shanghai Jiao Tong University, Shanghai, China.
| | - Juliana Cn Chan
- Department of Medicine and Therapeutics, Li Ka Shing Institute of Health Sciences and Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Tien Y Wong
- Tsinghua Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
- Singapore National Eye Center, SingHealth, Singapore, Singapore
| | - Edwin B Fisher
- Peers for Progress, Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Wu Y, Zhang Y, Zhao Y, Zhang X, Gu M, Huo W, Fu X, Li X, Guo B, Li J, Lu X, Hu F, Hu D, Zhang M. Elevated lipid accumulation product trajectory patterns are associated with increasing incident risk of type 2 diabetes mellitus in China. Prev Med 2025; 190:108186. [PMID: 39612991 DOI: 10.1016/j.ypmed.2024.108186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 11/21/2024] [Accepted: 11/23/2024] [Indexed: 12/01/2024]
Abstract
PURPOSE Our study aimed to identify the trajectory patterns of lipid accumulation product (LAP) and investigate their association with the incident risk of type 2 diabetes mellitus (T2DM) in China. METHODS This study included 37,316 eligible participants, with data collected between1998 and 2021. The LAP trajectory patterns were identified through latent mixture modeling. Logistic regression models were used to examine the association between different LAP trajectory patterns and the incident risk of T2DM. RESULTS Over an average period of 12.7 years, 3195 participants developed T2DM. Four LAP trajectory patterns were identified: low stable, moderate slow-increasing, high decreasing, and moderate fast-increasing. After adjusting for demographic and clinical confounders, the odds ratios (ORs) and 95 % confidence intervals (CIs) for T2DM were 1.67 (1.50, 1.86) for the moderate slow-increasing group, 1.63 (1.38, 1.94) for the high decreasing group, and 2.43 (2.07, 2.85) for the moderate fast-increasing group compared with the low stable group. Similar trajectory patterns were found in sex-specific populations as in the general population, while the elevated LAP trajectory pattern was more strongly associated with an increase in the incident risk of T2DM in females. CONCLUSION Individuals with moderate fast-increasing LAP trajectory patterns had a 2.4 times higher risk of developing T2DM compared to those with low stable LAP patterns. More attention should be paid to preventing T2DM in people with high levels of LAP, especially females, the elderly, drinkers, and people with a history of diabetes.
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Affiliation(s)
- Yuying Wu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, PR China
| | - Yanyan Zhang
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Yang Zhao
- Department of General Practice, Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, PR China
| | - Xing Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, PR China
| | - Minqi Gu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, PR China
| | - Weifeng Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xueru Fu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xi Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Botang Guo
- Department of General Practice, Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, PR China
| | - Jianxin Li
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Xiangfeng Lu
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Fulan Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, PR China
| | - Dongsheng Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, PR China; Department of General Practice, Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, PR China
| | - Ming Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, PR China.
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Lee MH, Febriana E, Lim M, Baig S, Shen L, Dalakoti M, Chew N, Loh TP, Chan M, Chia KS, Kong APS, Cook AR, Halter JB, Magkos F, Toh SA. Performance of the 1 h oral glucose tolerance test in predicting type 2 diabetes and association with impaired β-cell function in Asians: a national prospective cohort study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2025; 54:101278. [PMID: 39840148 PMCID: PMC11750441 DOI: 10.1016/j.lanwpc.2024.101278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Revised: 12/19/2024] [Accepted: 12/20/2024] [Indexed: 01/23/2025]
Abstract
Background Postprandial glucose concentration 1-h (1 h-PG) after an oral glucose tolerance test (OGTT) has similar or superior performance to 2 h-PG in predicting type-2 diabetes mellitus (T2DM) in several populations, and is simpler to obtain in clinical practice. However, studies in Asians are scarce. We investigated the utility of elevated baseline 1 h-PG in predicting T2DM incidence within three years, and its relationship with β-cell function in 1250 non-diabetic Asian participants. Methods Participants underwent an OGTT, an intravenous glucose challenge and a hyperinsulinemic-euglycemic clamp to determine glucose tolerance, acute insulin response (AIR) and insulin sensitivity at baseline. OGTTs were repeated every six months until study completion to monitor T2DM conversion. Findings The area under the receiver operating characteristic curve of 1 h-PG was not significantly different from 2 h-PG (AUC1h-PG = 0.883 vs. AUC2h-PG = 0.907; ΔAUC = -0.024, P = 0.124) and the optimal 1 h-PG cut-off was ≥10.7 mmol/L. When groups of high/low 1 h-PG and 2 h-PG at baseline were compared, AIR and disposition index were significantly lower in groups with high 1 h-PG, and both had a stronger correlation with 1 h-PG, indicating that impaired β-cell function was more strongly associated with elevated 1 h-PG than 2 h-PG. Interpretation The ability of 1 h-PG to detect Asians at risk of developing T2DM within three years is on par with 2 h-PG and the optimal cut-off is 10.7 mmol/L. Elevated 1 h-PG is associated with β-cell dysfunction. We conclude that 1 h-PG can be considered as a primary OGTT time point to identify Asians at risk for T2DM, allowing for screening at a reduced time and cost, and with lower patient burden. Funding National Medical Research Council (NMRC), Ministry of Health (MOH; Singapore) Industry Alignment Fund [NMRC/MOHIAFCat1/0048/2016] and Janssen Pharmaceuticals Inc. (USA).
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Affiliation(s)
- Michelle H. Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- NOVI Health, Singapore
| | - Eveline Febriana
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Maybritte Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Medicine, National University Hospital, Singapore
| | - Sonia Baig
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Liang Shen
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mayank Dalakoti
- Department of Medicine, Ng Teng Fong General Hospital, Singapore
- Department of Cardiology, National University Heart Centre, Singapore
| | - Nicholas Chew
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Cardiology, National University Heart Centre, Singapore
| | - Tze Ping Loh
- Department of Laboratory Medicine, National University Hospital, Singapore
| | - Mark Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Cardiology, National University Heart Centre, Singapore
| | - Kee Seng Chia
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Alice Pik-Shan Kong
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong SAR, China
| | - Alex R. Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Jeffrey B. Halter
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Geriatric and Palliative Medicine, University of Michigan, USA
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | - Sue-Anne Toh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- NOVI Health, Singapore
- Department of Medicine, National University Hospital, Singapore
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Lui JNM, Lau ESH, Li AQY, Zhang Y, Lim LL, Chun-KwunO, Wong KTC, Yang A, Wu H, Ma RCW, Kong APS, Ozaki R, Luk AOY, Chow EYK, Chan JCN. Temporal incremental healthcare costs associated with complications in Hong Kong Chinese patients with type 2 diabetes: A prospective study in Joint Asia diabetes evaluation (JADE) Register (2007-2019). Diabetes Res Clin Pract 2025; 219:111961. [PMID: 39701541 DOI: 10.1016/j.diabres.2024.111961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2024] [Revised: 12/01/2024] [Accepted: 12/10/2024] [Indexed: 12/21/2024]
Abstract
OBJECTIVE We examined incremental healthcare costs (inpatient and outpatient) related to complications in Chinese patients with type 2 diabetes (T2D) during the year of occurrence and post-event years, utilizing the Joint Asia Diabetes Evaluation (JADE) Register cohort of Hong Kong Chinese patients with T2D between 2007 and 2019. RESEARCH DESIGN AND METHODS 19,440 patients with T2D underwent structured evaluation utilizing the JADE platform with clinical outcomes data retrieved from territory-wide electronic medical records including inpatient, outpatient and emergency care. Two-part model was adopted to account for skewed healthcare costs distribution. Incremental healthcare costs associated with nine non-fatal diabetes complications and all-cause death were estimated, adjusted for demographic, clinical, lifestyle factors and comorbidities. RESULTS In this prospective cohort [mean ± SD age:59.9 ± 11.9 years, 56.6 % men, duration of diabetes:7.3 ± 7.5 years, HbA1C:7.5 ± 1.6 %] observed for 7 (interquartile range:4-9) years (142,132 patient-years), the mean annual healthcare costs, mainly due to inpatient cost, were USD$2,990 ± 9,960. Lower extremity amputation (LEA) (USD$31,302; 95 %CI: 25,706-37,004), hemorrhagic stroke (USD$21,164; 17,680-24,626), ischemic stroke (USD$17,976; $15,937-20,352) and end-stage disease (ESRD) (USD$14,774; 13,405-16,250) in the year of event incurred the highest cost. Residual healthcare costs in the post-event years were highest for ESRD, LEA, haemorrhagic stroke and incident cancer. CONCLUSION These comprehensive temporal healthcare cost estimates for diabetes-related complications allows the performance of long-term, patient-level, cost-effectiveness analyses on T2D prevention and treatment strategies relevant to an Asian and possibly global contexts. These may inform decision-makers on resource allocation aimed at reducing the burden of T2D and chronic diseases.
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Affiliation(s)
- Juliana N M Lui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong Prince of Wales Hospital, Shatin, Hong Kong; Asia Diabetes Foundation, Shatin, Hong Kong. %
| | - Eric S H Lau
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong Prince of Wales Hospital, Shatin, Hong Kong; Asia Diabetes Foundation, Shatin, Hong Kong
| | - Abby Q Y Li
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong Prince of Wales Hospital, Shatin, Hong Kong
| | - Yuzheng Zhang
- China National Health Development Research Centre, Beijing, China
| | - Lee-Ling Lim
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; University of Malaya, Malaysia
| | - Chun-KwunO
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Kelly T C Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Aimin Yang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong Prince of Wales Hospital, Shatin, Hong Kong
| | - Hongjiang Wu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong Prince of Wales Hospital, Shatin, Hong Kong
| | - Ronald C W Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong Prince of Wales Hospital, Shatin, Hong Kong
| | - Alice P S Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong Prince of Wales Hospital, Shatin, Hong Kong
| | - Risa Ozaki
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Andrea O Y Luk
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong Prince of Wales Hospital, Shatin, Hong Kong; Asia Diabetes Foundation, Shatin, Hong Kong
| | - Elaine Y K Chow
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong Prince of Wales Hospital, Shatin, Hong Kong.
| | - Juliana C N Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong Prince of Wales Hospital, Shatin, Hong Kong; Asia Diabetes Foundation, Shatin, Hong Kong.
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30
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Pham KH, Hubáček JA. Selected Genetic Characteristics of the Vietnamese Minority Living in the Czech Republic. Folia Biol (Praha) 2025; 71:1-7. [PMID: 40308198 DOI: 10.14712/fb2025071010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2025]
Abstract
The aim of this study was to analyse the allelic distribution of selected genes in the Czech and Vietnamese populations. We analysed samples from 94 Vietnamese volunteers and 2,859 Czech population-based subjects (2,559 from the Czechs post-MONICA and 300 volunteers from the South region of the Czech Republic). There were significant differences between the two populations for most, but not all, of the SNPs analysed. In particular, the prevalence of risk alleles in the analysed polymorphisms tended to be lower in the Vietnamese community compared to the Czech population, especially within the FTO (rs17817449; associated with obesity risk, P < 0.0001), TCF7L2 (rs7903146; linked to type 2 dia-betes, P < 0.0001) and ADH1B (rs1229984; related to alcohol consumption, P < 0.0001) genes. The genotype within the MCM6/LCT cluster (rs4988235) associated with lactase persistence was not present in the Vietnamese population. Slight genotype differences were detected for one HFE polymorphism (rs1799945 with P = 0.005; but not for rs1800562). Only the genotype frequencies within the MC4R and APOE genes were almost identical in both populations. We conclude that the Vietnamese population may have a lower genetic predisposition to the non-communicable diseases such as obesity or diabetes mellitus.
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Affiliation(s)
- Khanh Ha Pham
- 3rd Department of Medicine - Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
- Thomayer University Hospital, Prague, Czech Republic
| | - Jaroslav A Hubáček
- Experimental Medicine Centre, Institute of Clinical and Experimental Medicine, Prague, Czech Republic.
- 3rd Department of Medicine - Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
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Kim B, Kim GM, Huh U, Lee J, Kim E. Association of HOMA-IR Versus TyG Index with Diabetes in Individuals Without Underweight or Obesity. Healthcare (Basel) 2024; 12:2458. [PMID: 39685081 DOI: 10.3390/healthcare12232458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Revised: 12/01/2024] [Accepted: 12/02/2024] [Indexed: 12/18/2024] Open
Abstract
Background: There are higher numbers of Asian individuals with metabolically obese, normal weight (MONW) who are susceptible to diabetes than other ethnic groups. The homeostatic model assessment for insulin resistance (HOMA-IR) has been used for years to evaluate IR; however, the triglyceride-glucose (TyG) index has been highlighted as a reliable and cost-effective insulin resistance indicator. Thus, this study explored the association of the HOMA-IR versus the TyG index with diabetes in individuals without underweight or obesity. Methods: This cross-sectional study included 10,471 Korean individuals whose body mass index was ≥18.5 and <25.0 kg/m2. Depending on metabolic syndrome criteria, subjects with no conditions, one or two conditions, and three or more conditions were assigned to the metabolically healthy and normal weight (MHNW), pre-MONW, and MONW groups, respectively. Diabetes was diagnosed based on HbA1C and medication information. Results: The HOMA-IR and TyG index discriminated between each group, showing an increasing trend from the MHNW group to the MONW group. However, this trend was more robust for the TyG index. The cut-off values in the TyG index and HOMA-IR were >8.9 and >1.6 in males and >8.7 and >1.6 in females, respectively. The TyG index's area under the curve was higher than that of the HOMA-IR in both sexes. MONWs distinguished by the cut-off values of the TyG index and HOMA-IR were 2.370 and 1.726 for males and 2.249 and 1.710 for females times more likely to develop diabetes. Conclusions: The TyG index showed a stronger association with diabetes in Korean individuals without underweight or obesity than the HOMA-IR.
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Affiliation(s)
- Bokun Kim
- Future Convergence Research Institute, Changwon National University, Changwon 51140, Republic of Korea
- Human Community Renovation Research Center, R Professional University of Rehabilitation, Tsuchiura 300-0032, Ibaraki, Japan
| | - Gwon-Min Kim
- Human Community Renovation Research Center, R Professional University of Rehabilitation, Tsuchiura 300-0032, Ibaraki, Japan
- Medical Research Institute, Pusan National University, Busan 49241, Republic of Korea
| | - Up Huh
- Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea
| | - Juhyun Lee
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Eunji Kim
- Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea
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Watada H, Ásbjörnsdóttir B, Nishida T, Nishimura R, Yamamoto Y, Yamauchi T, Kadowaki T. Efficacy and safety of once-weekly insulin icodec versus once-daily basal insulin in Japanese individuals with type 2 diabetes: A subgroup analysis of the ONWARDS 1, 2 and 4 trials. Diabetes Obes Metab 2024; 26:5882-5895. [PMID: 39344833 DOI: 10.1111/dom.15960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 09/02/2024] [Accepted: 09/02/2024] [Indexed: 10/01/2024]
Abstract
AIM To explore the efficacy and safety of once-weekly insulin icodec (icodec) in Japanese adults (≥20 years old) with type 2 diabetes from the global ONWARDS 1, 2 and 4 trials. MATERIALS AND METHODS Insulin-naive (ONWARDS 1) and insulin-experienced (ONWARDS 2 and 4) individuals were randomized to icodec or a once-daily insulin comparator: insulin glargine U100 [ONWARDS 1 (basal insulin only) and 4 (basal-bolus regimen)] or insulin degludec [ONWARDS 2 (basal insulin only)]. The primary outcome was change in glycated haemoglobin from baseline to end of treatment (EOT) (ONWARDS 1: Week 52; ONWARDS 2 and 4: Week 26). Here, we present the Japanese subgroup results. RESULTS Similar reductions in glycated haemoglobin from baseline to EOT were observed in each trial for icodec and comparators. The proportion of time in range (blood glucose 3.9-10.0 mmol/L) at EOT was also comparable across treatment groups (time in range: 58%-68%), as was time spent with blood glucose below 3.0 mmol/L (<1.0%). Combined clinically significant (blood glucose <3.0 mmol/L) or severe (requiring external assistance for recovery) hypoglycaemia rates were low, with no severe events (ONWARDS 1 and 2) or a single severe event (ONWARDS 4; icodec group) reported. These results generally aligned with findings from the respective global populations. No new safety issues were identified. CONCLUSIONS Icodec improved glycaemic control to a similar degree as once-daily basal insulin comparators while maintaining low levels of clinically significant or severe hypoglycaemia. The findings support icodec use in Japanese individuals with different levels of type 2 diabetes progression.
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Affiliation(s)
- Hirotaka Watada
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | | | | | - Rimei Nishimura
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | | | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Sakai K, Okamura T, Toyokuni E, Okada H, Obora A, Kojima T, Hamaguchi M, Fukui M. Metabolic dysfunction-associated steatotic liver disease: A superior predictor for incident type 2 diabetes over traditional criteria - NAGALA study. J Diabetes Investig 2024; 15:1788-1796. [PMID: 39283748 PMCID: PMC11615691 DOI: 10.1111/jdi.14315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 08/28/2024] [Accepted: 09/02/2024] [Indexed: 12/06/2024] Open
Abstract
AIMS/INTRODUCTION The 2023 Delphi consensus recommended the use of new term, metabolic dysfunction-associated steatotic liver disease (MASLD), aiming conceptual shift from the conventional non-alcoholic fatty liver disease (NAFLD). The association between NAFLD and type 2 diabetes mellitus (T2DM) development is well known. This study aimed to examine the correlation between MASLD and T2DM development, comparing their utility as predictors. MATERIALS AND METHODS This retrospective cohort study obtained data from a medical health checkup program conducted at Asahi University Hospital, Japan, between 2004 and 2021. Logistic regression analysis was used to assess the association between MASLD and incident T2DM over 5 years. To compare the predictive utility of NAFLD and MASLD, receiver operating characteristic curves were drawn, followed by area under the curve (AUC) comparisons. RESULTS In total, 15,039 participants (59.6% males; median [interquartile range {IQR}] age, 44 [38, 50] years) were included. Out of 2,682 participants meeting the criteria for MASLD, 234 individuals (8.7%) developed T2DM. Multivariate analysis revealed a significantly elevated risk of T2DM in MASLD compared with the reference healthy group (without steatotic liver disease or cardiometabolic risk), presenting an OR of 127.00 (95% CI 40.40-399.00, P < 0.001). The concordance rate of diagnosis between NAFLD and MASLD was 98.7%. The AUC values were 0.799 for NAFLD and 0.807 for MASLD, respectively. Comparative analysis of the AUC showed a statistical difference between NAFLD and MASLD (P < 0.001). CONCLUSIONS MASLD was shown to be a significant risk factor for incident T2DM, exhibiting a potentially higher predictive capacity than conventional NAFLD.
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Affiliation(s)
- Kimiko Sakai
- Department of Endocrinology and Metabolism, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Ema Toyokuni
- Department of Endocrinology and Metabolism, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Hiroshi Okada
- Department of Endocrinology and Metabolism, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Akihiro Obora
- Department of GastroenterologyAsahi University HospitalGifuJapan
| | - Takao Kojima
- Department of GastroenterologyAsahi University HospitalGifuJapan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
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Zhang H, Chen R, Ma A, Li W, Zhao X, Pang T, Wen H, Qu H, Xu X. The association between abdominal obesity and depressive symptoms among Chinese adults: Evidence from national and regional communities. J Affect Disord 2024; 365:49-55. [PMID: 39147156 DOI: 10.1016/j.jad.2024.08.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 06/18/2024] [Accepted: 08/12/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND The association between body shape and depressive symptoms has been reported in adults. The present study aimed to investigate the association between body shape-specific abdominal obesity and depressive symptoms among multi-regional Asian adults. METHODS The 2011-2012 China Health and Retirement Longitudinal Study and 2022-2023 Hangzhou study were used as the discovery and validation datasets, respectively. Body shape was assessed by body mass index categories. Abdominal obesity was defined as a body shape index (ABSI) ≥ 75th centile. Depression was measured using 10-item Centre for Epidemiological Studies Depression Scale and Geriatric Depression Scale short 15-item version, respectively. General linear and multinomial logistic models were used to explore the association of ABSI, abdominal obesity with depressive scores and presence, respectively. RESULTS A total of 12,229 and 1210 participants were included in the discovery and validation datasets, respectively. A non-linear reverse L-shaped association was found between ABSI and depressive scores. Participants with abdominal obesity had higher depressive scores (β = 0.05, 95%CI = 0.01-0.09; and β = 0.13, 95%CI = 0.01-0.24; respectively). Stratified analyses showed that abdominal obesity was associated with higher depressive scores (β = 0.09, 95%CI = 0.00-0.17; and β = 0.25, 95%CI = 0.05-0.46; respectively) and presence (OR = 1.46, 95%CI = 1.02-2.10; and OR = 3.95, 95%CI = 1.58-9.84; respectively) in overweight adults. Furthermore, abdominal obesity was associated with depressive symptoms among overweight females, but not among males. LIMITATION Causal links weren't addressed because of the observational study design. CONCLUSION Abdominal obesity exhibited a positive association with depressive symptoms among Asian overweight adults, particularly in females. Prevention and early diagnosis of depressive symptoms should focus on overweight females.
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Affiliation(s)
- Haoran Zhang
- School of Public Health and the Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China; The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang 310058, PR China
| | - Renwei Chen
- School of Public Health and the Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China; The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang 310058, PR China
| | - Aiju Ma
- School of Public Health and the Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China; The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang 310058, PR China
| | - Wanxin Li
- School of Public Health and the Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China; The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang 310058, PR China
| | - Xuhao Zhao
- School of Public Health and the Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China; The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang 310058, PR China
| | - Ting Pang
- School of Public Health and the Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China; The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang 310058, PR China
| | - Haoxuan Wen
- School of Public Health and the Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China; The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang 310058, PR China
| | - Hangbo Qu
- Department of Orthopaedics, Affiliated Zhejiang Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China.
| | - Xin Xu
- School of Public Health and the Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China; The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang 310058, PR China; Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Wang Y, Chin WY, Lam CLK, Wan EYF. Trajectory of haemoglobin A1c and incidence of cardiovascular disease in patients with type 2 diabetes mellitus. Diabetes Obes Metab 2024; 26:5138-5146. [PMID: 39161066 DOI: 10.1111/dom.15856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/17/2024] [Accepted: 07/21/2024] [Indexed: 08/21/2024]
Abstract
AIM To evaluate the association between changes in haemoglobin A1c (HbA1c) and the concurrent incidence of cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM) patients. METHOD We conducted a retrospective cohort study among T2DM patients with HbA1c measurement after T2DM diagnosis between August 2009 and September 2010. The patients were classified into six subgroups based on baseline HbA1c (<7%; 7%-7.9%; ≥8%) and age (<65; ≥65 years), and then clustered into classes by HbA1c trajectory and CVD incidence over the 12-year follow-up period using joint latent class mixture models. We explored the HbA1c trajectories and CVD incidences in each latent class. Multinomial logistic regression was used to compare the baseline characteristics among different latent classes. RESULTS A total of 128 843 T2DM patients were included with a median follow-up period of 11.7 years. Ten latent classes were identified in patients with baseline HbA1c ≥ 8% and age <65 years, while seven classes were identified in the other five groups. Among all the identified latent classes, patients with fluctuating HbA1c trajectories, characterized by alternating periods of increase and decrease, had higher CVD incidences. Male patients, and patients with higher baseline HbA1c and use of antidiabetic drugs were more likely to have a fluctuating HbA1c trajectory. More specifically, patients aged < 65 years with younger age or a smoking habit, and patients aged ≥ 65 years with a longer duration of T2DM were more likely to have a fluctuating HbA1c trajectory. CONCLUSION We found that T2DM patients with fluctuating HbA1c trajectories could have a higher CVD risk. Different trajectory-associated characteristics in age subgroups highlight the need for individualized management of T2DM patients.
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Affiliation(s)
- Yuan Wang
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Weng Yee Chin
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Cindy Lo Kuen Lam
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Department of Family Medicine, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong SAR, China
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Wang J, Wei HJ, Mao RF, Chang X. Gut microbiota modulating therapy for diabetes mellitus should be individualized. World J Diabetes 2024; 15:2152-2156. [PMID: 39493555 PMCID: PMC11525721 DOI: 10.4239/wjd.v15.i10.2152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 09/14/2024] [Accepted: 09/18/2024] [Indexed: 09/26/2024] Open
Abstract
In this editorial, we commented on two articles published online in August and September 2024 in the World Journal of Diabetes, which focused on modifying the gut microbiota (GM) to prevent or delay the progression of diabetes mellitus (DM) and DM-related complications. Numerous studies, many of which are animal studies, have indicated the potential role of GM in the pathogenesis of DM. However, the detailed causality and mechanisms between GM and DM have not been fully clarified. Although there have been some reports of a potential role of modifying the GM in treating DM, most lack long-term observations and are not mechanistic. Additionally, the GM and its role in DM might vary among individuals; therefore, GM-targeted interventions should be individualized to realize their therapeutic potential.
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Affiliation(s)
- Jin Wang
- Department of Ultrasound Medicine, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 211200, Jiangsu Province, China
| | - Hong-Juan Wei
- Neonatal Intensive Care Unit, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 211200, Jiangsu Province, China
| | - Rui-Feng Mao
- School of Life Science, Huaiyin Normal University, Huai'an 223300, Jiangsu Province, China
| | - Xin Chang
- Department of Ultrasound Medicine, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 211200, Jiangsu Province, China
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Liu J, An Y, Yang N, Xu Y, Wang G. Longitudinal associations of dietary fiber and its source with 48-week weight loss maintenance, cardiometabolic risk factors and glycemic status under metformin or acarbose treatment: a secondary analysis of the March randomized trial. Nutr Diabetes 2024; 14:81. [PMID: 39358341 PMCID: PMC11447090 DOI: 10.1038/s41387-024-00340-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 09/16/2024] [Accepted: 09/19/2024] [Indexed: 10/04/2024] Open
Abstract
AIMS To examine longitudinal and dose-d ependent associations between dietary fiber intake and various clinical outcomes over 48 weeks of pharmacological treatment in T2DM patients. METHODS In this secondary analysis, we used data from the MARCH trial, which was designed to compare the efficacy of acarbose or metformin monotherapy as the initial therapy in Chinese patients newly diagnosed with T2DM. Dietary data were obtained using a 24-h dietary recall method to evaluate the intakes of dietary fiber from different sources as well as the carbohydrate-to-fiber ratio. RESULTS A total of 551 newly-diagnosed patients with T2DM complete dietary records (286 in the acarbose group and 265 in the metformin group) were included. Higher intake of total fiber and whole grain fiber was positively associated with better β-cell function, insulin sensitivity and postprandial glycemic control under acarbose treatment. Higher intake of legume fiber was associated with better glycemic control under both acarbose and metformin treatment but with better weight loss only under metformin treatment. A high-carbohydrate-low-fiber diet was associated with worse glycemic control and lower HDL-C under acarbose treatment but with higher insulin sensitivity and better weight loss under metformin treatment. CONCLUSIONS The notable effects of various dietary fibers when combined with different oral glucose-lowering medications should be considered to maximize therapeutic benefit.
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Affiliation(s)
- Jia Liu
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yu An
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Ning Yang
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yuan Xu
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Guang Wang
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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Imamura M, Maeda S. Genetic studies of type 2 diabetes, and microvascular complications of diabetes. Diabetol Int 2024; 15:699-706. [PMID: 39469559 PMCID: PMC11512959 DOI: 10.1007/s13340-024-00727-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/24/2024] [Indexed: 10/30/2024]
Abstract
Genome-wide association studies (GWAS) have significantly advanced the identification of genetic susceptibility variants associated with complex diseases. As of 2023, approximately 800 variants predisposing individuals to the risk of type 2 diabetes (T2D) were identified through GWAS, and the majority of studies were predominantly conducted in European populations. Despite the shared nature of the majority of genetic susceptibility loci across diverse ethnic populations, GWAS in non-European populations, including Japanese and East Asian populations, have revealed population-specific T2D loci. Currently, polygenic risk scores (PRSs), encompassing millions of associated variants, can identify individuals with a higher T2D risk than the general population. However, GWAS focusing on microvascular complications of diabetes have identified a limited number of disease-susceptibility loci. Ongoing efforts are crucial to enhance the applicability of PRS for all ethnic groups and unravel the genetic architecture of microvascular complications of diabetes.
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Affiliation(s)
- Minako Imamura
- Department of Advanced Genomic and Laboratory Medicine, Graduate School of Medicine, University of the Ryukyus, Nishihara-Cho, Okinawa 903-0215 Japan
- Division of Clinical Laboratory and Blood Transfusion, University of the Ryukyus Hospital, Nishihara-Cho, Okinawa 930-0215 Japan
| | - Shiro Maeda
- Department of Advanced Genomic and Laboratory Medicine, Graduate School of Medicine, University of the Ryukyus, Nishihara-Cho, Okinawa 903-0215 Japan
- Division of Clinical Laboratory and Blood Transfusion, University of the Ryukyus Hospital, Nishihara-Cho, Okinawa 930-0215 Japan
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Mahmood T, Rahman H, Jahan S, Sultana N, Hasan M, Hasan MI, Shehab MA, Fariduddin M, Salimullah M, Hasanat MA. Higher Serum Dipeptidyl Peptidase-4 Activity in Newly Diagnosed Young-Onset Type 2 Diabetes Mellitus. Cureus 2024; 16:e70968. [PMID: 39507187 PMCID: PMC11538487 DOI: 10.7759/cureus.70968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2024] [Indexed: 11/08/2024] Open
Abstract
Background Dipeptidyl peptidase-4 (DPP4) enzyme inhibition is a therapeutic modality for type 2 diabetes mellitus (T2DM). However, its activity is insufficiently explored yet in youth-onset T2DM. Objective The objective of this study is to measure serum DPP4 enzyme activities in youth-onset T2DM and compare them with those in patients with normal glucose tolerance (NGT). Methods This cross-sectional study comprised 29 young participants with newly diagnosed untreated T2DM (age 24.5±4.5 years, range 13-30 years, 51.7% female) and an equal number of young participants with NGT (age 26.5±2.9 years, 48.3% female) screened by a two-sample 75gm oral glucose tolerance test. The relevant history of each participant was obtained, and the waist circumference, waist-hip ratio, blood pressure, and body mass index (BMI) were measured according to the standard procedure and recorded in the data collection sheet. Plasma glucose was measured using the glucose oxidase method, and serum DPP4 activity was measured using the colorimetry method. Results Participants with DM exhibited significantly higher serum DPP4 activity than NGT (DM vs. NGT: 481.4±70.4 pmol/min. vs. 420.3±49.2 pmol/min, mean±SD; p<0.001). A multivariate linear regression model adjusted for age, sex, BMI, and hypertension, found DM as an independent predictor for DPP4 activity (β=0.63.5, 95% CI 28.7-98.4, p=0.022). Conclusion DPP4 activity was significantly elevated in young participants with newly diagnosed T2DM. There might be a pathophysiological implication of DPP4 activity in young-onset T2DM.
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Affiliation(s)
- Tahseen Mahmood
- Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Hadisur Rahman
- Molecular Biotechnology, National Institute of Biotechnology, Dhaka, BGD
| | - Sharmin Jahan
- Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Nusrat Sultana
- Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Mashfiqul Hasan
- Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Md Imrul Hasan
- Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Md Abu Shehab
- Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Md Fariduddin
- Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Md Salimullah
- Molecular Biotechnology, National Institute of Biotechnology, Dhaka, BGD
| | - M A Hasanat
- Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
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Yue JC, Wang HC, Chang TC. Application of type II diabetes incidence and mortality rates for insurance. PLoS One 2024; 19:e0307508. [PMID: 39321149 PMCID: PMC11423961 DOI: 10.1371/journal.pone.0307508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 07/05/2024] [Indexed: 09/27/2024] Open
Abstract
Prolonging life is a global trend, and more medical expenditure is being spent on chronic diseases owing to population aging. Diseases commonly seen in middle-aged and elderly people, such as heart disease and diabetes, have slowed mortality improvement in recent years. Diabetes is a common chronic disease and comorbidity of many serious health conditions. The total estimated cost of diabetes in the United States was $327 billion in 2017. However, many people are unaware that diabetes is common, and at least 21.4% of adults do not know that they have diabetes. The number of diabetes-related deaths has been increasing, and diabetes was the 5th cause of death in Taiwan in 2019. In this study, we explore the trend and influence of diabetes in Taiwan and apply mortality models, such as the Lee-Carter and Age-Period-Cohort models, using data from Taiwan's National Insurance to model the incidence and mortality rates of diabetes. We found that the Lee-Carter model provides fairly satisfactory estimates and that people with diabetes regularly taking diabetes medication have lower mortality rates. Moreover, we demonstrate how these results can be used to design diabetes related insurance products and prepare the insured to face the impact of incurring diabetes. In addition, we consider different criteria for judging whether people have diabetes (as there is no consensus on these criteria) and investigate the issue of moral hazard in designing diabetes insurance products.
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Affiliation(s)
- Jack C Yue
- Department of Statistics, National Chengchi University, Taipei, Taiwan, Republic of China
| | - Hsin-Chung Wang
- Department of Statistical Information and Actuarial Science, Aletheia University, New Taipei City, Taiwan, Republic of China
| | - Ting-Chung Chang
- Department of Accounting Information, Chihlee University of Technology, New Taipei City, Taiwan, Republic of China
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Silveira ASDA, Alves ACDA, Gimenes GM, Quessada PDS, Lobato TB, Dias BB, Pereira ACG, Iser-Bem PN, Pereira JNB, Hatanaka E, Masi LN, Pithon-Curi TC, Mattaraia VGDM, Hirabara SM, Crisma AR, Gorjão R, Curi R. Evidence for a Pro-Inflammatory State of Macrophages from Non-Obese Type-2 Diabetic Goto-Kakizaki Rats. Int J Mol Sci 2024; 25:10240. [PMID: 39408569 PMCID: PMC11477416 DOI: 10.3390/ijms251910240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Revised: 09/07/2024] [Accepted: 09/13/2024] [Indexed: 10/20/2024] Open
Abstract
Obesity causes insulin resistance (IR) through systemic low-grade inflammation and can lead to type 2 diabetes mellitus (T2DM). However, the mechanisms that cause IR and T2DM in non-obese individuals are unclear. The Goto-Kakizaki (GK) rat develops IR spontaneously and is a model of non-obese T2DM. These rats exhibit hyperglycemia beginning at weaning and exhibit lower body mass than control Wistar rats. Herein, we tested the hypothesis that macrophages of GK rats are permanently in a pro-inflammatory state, which may be associated with a systemic inflammation condition that mimics the pathogenesis of obesity-induced T2DM. Using eighteen-week-old GK and control Wistar rats, we investigated the proportions of M1 (pro-inflammatory) and M2 (anti-inflammatory) macrophages isolated from the peritoneal cavity. Additionally, the production of inflammatory cytokines and reactive oxygen species (ROS) in cultured macrophages under basal and stimulated conditions was assessed. It was found that phorbol myristate acetate (PMA) stimulation increased GK rat macrophage ROS production 90-fold compared to basal levels. This response was also three times more pronounced than in control cells (36-fold). The production of pro-inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α), tended to be upregulated in cultured macrophages from GK rats under basal conditions. Macrophages from GK rats produced 1.6 times more granulocyte-macrophage colony-stimulating factor (GM-CSF), 1.5 times more monocyte chemoattractant protein-1 (MCP-1) and 3.3 times more TNF-α than control cells when stimulated with lipopolysaccharide (LPS) (p = 0.0033; p = 0.049; p = 0.002, respectively). Moreover, compared to control cells, GK rats had 60% more M1 (p = 0.0008) and 23% less M2 (p = 0.038) macrophages. This study is the first to report macrophage inflammatory reprogramming towards a pro-inflammatory state in GK rats.
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Affiliation(s)
- Amanda Santos de Almeida Silveira
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo 01506-000, SP, Brazil (T.B.L.); (S.M.H.)
| | - Amara Cassandra dos Anjos Alves
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo 01506-000, SP, Brazil (T.B.L.); (S.M.H.)
| | - Gabriela Mandú Gimenes
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo 01506-000, SP, Brazil (T.B.L.); (S.M.H.)
| | - Patrícia da Silva Quessada
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo 01506-000, SP, Brazil (T.B.L.); (S.M.H.)
| | - Tiago Bertola Lobato
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo 01506-000, SP, Brazil (T.B.L.); (S.M.H.)
| | - Beatriz Belmiro Dias
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo 01506-000, SP, Brazil (T.B.L.); (S.M.H.)
| | - Ana Carolina Gomes Pereira
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo 01506-000, SP, Brazil (T.B.L.); (S.M.H.)
| | - Patrícia Nancy Iser-Bem
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo 01506-000, SP, Brazil (T.B.L.); (S.M.H.)
| | - Joice Naiara Bertaglia Pereira
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo 01506-000, SP, Brazil (T.B.L.); (S.M.H.)
- Butantan Institute, São Paulo 05585-000, SP, Brazil
| | - Elaine Hatanaka
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo 01506-000, SP, Brazil (T.B.L.); (S.M.H.)
| | - Laureane Nunes Masi
- Multicenter Graduate Program in Physiological Sciences, Department of Physiological Sciences, Center of Biological Sciences, Federal University of Santa Catarina, Florianopolis, SC 88037-000, Brazil
| | - Tânia Cristina Pithon-Curi
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo 01506-000, SP, Brazil (T.B.L.); (S.M.H.)
| | | | - Sandro Massao Hirabara
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo 01506-000, SP, Brazil (T.B.L.); (S.M.H.)
| | - Amanda Rabello Crisma
- Department of Clinical Analysis, Federal University of Paraná, Curitiba 80210-170, PR, Brazil
| | - Renata Gorjão
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo 01506-000, SP, Brazil (T.B.L.); (S.M.H.)
| | - Rui Curi
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo 01506-000, SP, Brazil (T.B.L.); (S.M.H.)
- Butantan Institute, São Paulo 05585-000, SP, Brazil
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Hong S, Hao Y, Sun L, Li P, Yang J, Zhang F, He L, Zhang J, Wei H. Prevalence and risk factors of significant fibrosis in chronic hepatitis B patients with concurrent metabolic dysfunction-associated steatotic liver disease. Ann Hepatol 2024; 30:101589. [PMID: 39303822 DOI: 10.1016/j.aohep.2024.101589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 08/13/2024] [Accepted: 09/01/2024] [Indexed: 09/22/2024]
Abstract
INTRODUCTION AND OBJECTIVES Significant fibrosis is an indicator of clinical intervention for both chronic hepatitis B (CHB) and metabolic dysfunction-associated steatotic liver disease (MASLD). There remains a paucity of data regarding the clinical impact of biopsy-defined MASLD on significant fibrosis in CHB patients. The current study aims to elucidate whether patients with concomitant MASLD are at higher risk of significant fibrosis in patients with CHB. PATIENTS AND METHODS This retrospective research of two tertiary hospitals comprised 1818 patients between 2009 and 2021 with CHB and hepatic steatosis who had not received antiviral therapy. Pathologic findings by liver biopsy were contrasted between CHB group (n = 844) and CHB + MASLD (n = 974) group. METAVIR values of F≥2 were used to categorize significant fibrosis. RESULTS Patients with CHB + MASLD had more significant fibrosis (35.5 % vs. 23.5 %, p < 0.001) than CHB group. The presence of MASLD [adjusted odds ratio (aOR) 2.055, 95 % confidence interval (CI) 1.635-2.584; p < 0.001] was strongly associated with significant fibrosis in all CHB patients. There was a trend for patients with more cardiometabolic risk factors (CMRFs) to have a higher prevalence of significant fibrosis: (25.7 % in CMRF1 subgroup v.s. 34.9 % in CMRF2 subgroup v.s. 53.7 % in CMRF≥ 3 subgroup, p < 0.001). Patients with CMRF≥3 had a three-fold higher significant fibrosis than those with just one CMRF. CONCLUSIONS MASLD was associated with higher fibrosis stage in patients with CHB. Early detection and intervention are crucial to patients with three or more cardiometabolic risk factors.
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Affiliation(s)
- Shan Hong
- Department of Gastroenterology, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, PR China
| | - Yiwei Hao
- Department of Medical Records and Statistics, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, PR China
| | - Lei Sun
- Department of Pathology, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, PR China
| | - Ping Li
- Department of Gastroenterology, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, PR China
| | - Junru Yang
- Department of Gastroenterology, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, PR China
| | - Fuyang Zhang
- Department of Gastroenterology, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, PR China
| | - Lingling He
- Department of Gastroenterology, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, PR China
| | - Jing Zhang
- Department of Hepatology, Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, PR China.
| | - Hongshan Wei
- Department of Gastroenterology, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, PR China.
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Lin D, Jin Y, Shao X, Xu Y, Ma G, Jiang Y, Xu Y, Jiang Y, Hu D. Global, regional, and national burden of inflammatory bowel disease, 1990-2021: Insights from the global burden of disease 2021. Int J Colorectal Dis 2024; 39:139. [PMID: 39243331 PMCID: PMC11380638 DOI: 10.1007/s00384-024-04711-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2024] [Indexed: 09/09/2024]
Abstract
PURPOSE The prevalence of inflammatory bowel disease (IBD) is on the rise worldwide. We utilizes data from the Global Burden of Diseases (GBD) 2021 to analyze the national-level burden of IBD, trends in disease incidence, and epidemiological characteristics. METHODS Detailed information on IBD was gathered from 204 countries and territories spanning 1990 to 2021, sourced from the GBD 2021. Calculations were performed for incidence rates, mortality rates, disease-adjusted life years (DALYs), and estimated annual percentage changes (EAPCs). These trends were analyzed based on region, nationality, age, gender, and World Bank income level stratifications. RESULTS The global age-standardised incident rate (ASIR) of IBD increased from 4.22 per 100000 in 1990 to 4.45 per 100000 in 2021. However, the age-standardised mortality rate (ASMR) decreased from 0.60 per 100000 in 1990 to 0.52 per 100000 in 2021. Similarly, the age-standardised DALYs rate decreased from 21.55 per 100000 in 1990 to 18.07 per 100000 in 2021. Gender comparisons showed negligible differences in disease burden. The greatest increase in IBD-associated ASIR and ASMR occurred in World Bank upper-middle income region (EAPCs, 1.25) and World Bank high-income region (EAPCs, 1.00), respectively. Regionally, East Asia experienced the largest increase in ASIR (EAPCs, 2.89). Among 204 countries, China had the greatest increases in ASIR (EAPCs, 2.93), Netherlands had the highest ASMR in 2021 (2.21 per 100000). CONCLUSIONS Global incidence rate of IBD have been increasing from 1990 to 2021, while the DALYs and mortality have been decreasing. The escalating incident rates in select Asian regions deserves further attention.
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Affiliation(s)
- Daopo Lin
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Yang Jin
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Xiaoxiao Shao
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Yuan Xu
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Guolong Ma
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Yi Jiang
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Yinghe Xu
- Department of Critical Care Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang Province, China.
| | - Yongpo Jiang
- Department of Critical Care Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang Province, China.
| | - Dingyuan Hu
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
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Lee J, Yoon K. Islet transplantation in Korea. J Diabetes Investig 2024; 15:1165-1170. [PMID: 39105663 PMCID: PMC11363101 DOI: 10.1111/jdi.14264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 06/22/2024] [Accepted: 06/27/2024] [Indexed: 08/07/2024] Open
Abstract
Type 1 diabetes mellitus is characterized by absolute insulin deficiency, which requires life-long insulin replacement. Exogenous multiple-daily insulin injections are most commonly prescribed for patients with type 1 diabetes mellitus. However, exogenous insulin supply often fails to cope with real-time changing life-log variables, such as activity, diet and stress, which results in recurrent hypo- and hyperglycemia in patients with type 1 diabetes mellitus. Islet transplantation is an ideal method to treat patients with type 1 diabetes mellitus, as it can restore the endogenous capacity of glucose-stimulated insulin secretion. However, due to donor scarcity and technical barriers, only a limited number of islet transplantations have been carried out in Asia, including South Korea. Since 2013, our center has carried out two allogenic islet transplantations, with one case leading to near total insulin independence after one-to-one islet transplantation. Although the other patient failed to restore endogenous insulin production, there was a remarkable improvement in hypoglycemia. We speculate that islet transplantation remains an important and ideal treatment option for patients with type 1 diabetes mellitus who suffer from recurrent severe hypoglycemia.
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Affiliation(s)
- Joonyub Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Seoul St Mary's HospitalThe Catholic University of KoreaSeoulKorea
| | - Kun‐Ho Yoon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Seoul St Mary's HospitalThe Catholic University of KoreaSeoulKorea
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Yamashita S, Hirano T, Shimano H, Tsukamoto K, Yoshida M, Yoshida H. Managing hypertriglyceridemia for cardiovascular disease prevention: Lessons from the PROMINENT trial. Eur J Clin Invest 2024; 54:e14227. [PMID: 38662591 DOI: 10.1111/eci.14227] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/14/2024] [Accepted: 04/06/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Numerous epidemiological studies have shown that hypertriglyceridemia is a significant risk factor for cardiovascular diseases (CVD). However, large clinical studies on triglyceride-lowering therapy have yielded inconsistent results. In the current review, we reassess the importance of triglyceride-lowering therapy in preventing CVD based on previous literature and the recently published findings of the PROMINENT trial. METHODS This narrative review is based on literature and public documents published up to November 2023. RESULTS Meta-analyses of trials on peroxisome proliferator-activated receptor α agonists and triglyceride-lowering therapy, including the PROMINENT trial, have indicated that triglyceride-lowering therapy can reduce CVD events. Mendelian randomization studies have also indicated that triglyceride is indeed a true risk factor for coronary artery disease, leaving no doubt about its relationship to CVD. Meanwhile, the negative results from the PROMINENT trial were likely due to the insufficient triglyceride-lowering effect, slight increases in low-density lipoprotein cholesterol and apolipoprotein B, and the inclusion of mostly high-intensity statin users as target patients. It is unlikely that adverse events counteracted the effectiveness of pemafibrate on outcomes. Additionally, pemafibrate has shown positive effects on non-alcoholic fatty liver disease and peripheral artery disease. CONCLUSION Although the PROMINENT trial did not demonstrate the significance of pemafibrate as a triglyceride-lowering therapy in a specific population, it does not necessarily negate the potential benefits of treating hypertriglyceridemia in reducing CVD events. It is necessary to explore appropriate populations that could benefit from this therapy, utilize data from the PROMINENT trial and other databases, and validate findings in real-world settings.
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Affiliation(s)
| | - Tsutomu Hirano
- Diabetes Center, Ebina General Hospital, Ebina, Kanagawa, Japan
| | - Hitoshi Shimano
- Department of Endocrinology and Metabolism, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kazuhisa Tsukamoto
- Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Masayuki Yoshida
- Department of Medical Genetics, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Life Science and Bioethics, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroshi Yoshida
- Section of Internal Medicine of Metabolism and Nutrition, The Jikei University Graduate School of Medicine, Tokyo, Japan
- Department of General Medicine, The Jikei University Kashiwa Hospital, Chiba, Japan
- Department of Laboratory Medicine, The Jikei University Kashiwa Hospital, Chiba, Japan
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Park JY, Lee J, Choi YH, Min KW, Han KA, Ahn KJ, Lim S, Kim YH, Ahn CW, Choi KM, Yoon KH, the Practical Evidence of Antidiabetic Combination Therapy in Korea (PEAK) study investigators. Efficacy and Safety of Alogliptin-Pioglitazone Combination for Type 2 Diabetes Mellitus Poorly Controlled with Metformin: A Multicenter, Double-Blind Randomized Trial. Diabetes Metab J 2024; 48:915-928. [PMID: 38650099 PMCID: PMC11449827 DOI: 10.4093/dmj.2023.0259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/30/2023] [Indexed: 04/25/2024] Open
Abstract
BACKGRUOUND Guidelines for switching to triple combination therapy directly after monotherapy failure are limited. This study investigated the efficacy, long-term sustainability, and safety of either mono or dual add-on therapy using alogliptin and pioglitazone for patients with type 2 diabetes mellitus (T2DM) who did not achieve their target glycemic range with metformin monotherapy. METHODS The Practical Evidence of Antidiabetic Combination Therapy in Korea (PEAK) was a multicenter, placebo-controlled, double-blind, randomized trial. A total of 214 participants were randomized to receive alogliptin+pioglitazone (Alo+Pio group, n=70), alogliptin (Alo group, n=75), or pioglitazone (Pio group, n=69). The primary outcome was the difference in glycosylated hemoglobin (HbA1c) levels between the three groups at baseline to 24 weeks. For durability, the achievement of HbA1c levels <7% and <6.5% was compared in each group. The number of adverse events was investigated for safety. RESULTS After 24 weeks of treatment, the change of HbA1c in the Alo+Pio, Alo, and Pio groups were -1.38%±0.08%, -1.03%±0.08%, and -0.84%±0.08%, respectively. The Alo+Pio group had significantly lower HbA1c levels than the other groups (P=0.0063, P<0.0001) and had a higher proportion of patients with target HbA1c achievement. In addition, insulin sensitivity and β-cell function, lipid profiles, and other metabolic indicators were also improved. There were no significant safety issues in patients treated with triple combination therapy. CONCLUSION Early combination triple therapy showed better efficacy and durability than the single add-on (dual) therapy. Therefore, combination therapy with metformin, alogliptin, and pioglitazone is a valuable early treatment option for T2DM poorly controlled with metformin monotherapy.
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Affiliation(s)
- Ji-Yeon Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joonyub Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoon-Hee Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- MedicalExcellence Inc., Seoul, Korea
| | - Kyung Wan Min
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Kyung Ah Han
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Kyu Jeung Ahn
- Division of Endocrinology and Metabolism, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Soo Lim
- Division of Endocrinology and Metabolism, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Young-Hyun Kim
- Division of Endocrinology and Metabolism, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Chul Woo Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Mook Choi
- Department of Endocrinology, Korea University Guro Hospital, Seoul, Korea
| | - Kun-Ho Yoon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - the Practical Evidence of Antidiabetic Combination Therapy in Korea (PEAK) study investigators
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- MedicalExcellence Inc., Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
- Division of Endocrinology and Metabolism, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
- Division of Endocrinology and Metabolism, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Division of Endocrinology and Metabolism, Bundang Jesaeng Hospital, Seongnam, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Department of Endocrinology, Korea University Guro Hospital, Seoul, Korea
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Chakraborty R, Mukherjee AK, Bala A. Breakthroughs in road mapping IL-35 mediated immunotherapy for type-1 and autoimmune diabetes mellitus. Cytokine 2024; 181:156692. [PMID: 38986251 DOI: 10.1016/j.cyto.2024.156692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/22/2024] [Accepted: 07/05/2024] [Indexed: 07/12/2024]
Abstract
IL-35 is a recently discovered protein made up of IL-12α and IL-27β chains. It is encoded by IL12A and EBI3 genes. Interest in researching IL-35 has significantly increased in recent years, as evidenced by numerous scientific publications. Diabetes is on the rise globally, causing more illness and death in developing countries. The International Diabetes Federation (IDF) reports that diabetes is increasingly affecting children and teenagers, with varying rates across different regions. Therefore, scientists seek new diabetes treatments despite the growth of drug research. Recent research aims to emphasize IL-35 as a critical regulator of diabetes, especially type 1 and autoimmune diabetes. This review provides an overview of recent research on IL-35 and its link to diabetes and its associated complications. Studies suggest that IL-35 can offer protection against type-1 diabetes and autoimmune diabetes by regulating macrophage polarization, T-cell-related cytokines, and regulatory B cells (Bregs). This review will hopefully assist biomedical scientists in exploring the potential role of IL-35-mediated immunotherapy in treating diabetes. However, further research is necessary to determine the exact mechanism and plan clinical trials.
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Affiliation(s)
- Ratul Chakraborty
- Pharmacology and Drug Discovery Research Laboratory, Division of Life Sciences, Institute of Advanced Study in Science and Technology (IASST), Vigyan Path, Guwahati 781035, Assam, India; Academy of Scientific and Innovative Research (AcSIR), AcSIR (an Indian Institute of National Importance), Sector 19, Kamla Nehru Nagar, Ghaziabad, Uttar Pradesh 201002, India
| | - Ashis K Mukherjee
- Microbial Biotechnology and Protein Research Laboratory, Division of Life Sciences, Institute of Advanced Study in Science and Technology (IASST), Vigyan Path, Guwahati 781035, Assam, India
| | - Asis Bala
- Pharmacology and Drug Discovery Research Laboratory, Division of Life Sciences, Institute of Advanced Study in Science and Technology (IASST), Vigyan Path, Guwahati 781035, Assam, India; Academy of Scientific and Innovative Research (AcSIR), AcSIR (an Indian Institute of National Importance), Sector 19, Kamla Nehru Nagar, Ghaziabad, Uttar Pradesh 201002, India.
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Minato-Inokawa S, Tsuboi-Kaji A, Honda M, Takeuchi M, Kitaoka K, Kurata M, Wu B, Kazumi T, Fukuo K. Low muscle mass is associated with low insulin sensitivity, impaired pancreatic β cell function, and high glucose excursion in nondiabetic nonobese Japanese women. Metabol Open 2024; 23:100306. [PMID: 39188637 PMCID: PMC11347059 DOI: 10.1016/j.metop.2024.100306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 07/29/2024] [Accepted: 07/29/2024] [Indexed: 08/28/2024] Open
Abstract
Aim We tested whether skeletal muscle mass is associated with insulin sensitivity, pancreatic β-cell function, and postglucose glycemia. Methods Appendicular skeletal muscle mass (ASM) (relative to body size, %ASM) by DXA, surrogate measures of insulin sensitivity, insulin secretion and the disposition index (insulin sensitivity adjusted insulin secretion: a product of the insulinogenic index and Matsuda insulin sensitivity index) inferred from serum insulin kinetics during a 75 g oral glucose tolerance test (OGTT) were evaluated in 168 young and 65 middle-aged women, whose BMI averaged <23.0 kg/m2 and HbA1c ≦ 5.5 %. Results In two groups of women, %ASM was associated negatively with homeostasis model assessment insulin resistance (HOMA-IR) and 2-h insulin (both p < 0.01 or less). In middle-aged women not in young women, %ASM was associated inversely with the Matsuda index (p < 0.001). In middle-aged women only, it also showed a positive association with the disposition index (p = 0.02) and inverse associations with 1-h and 2-h glucose (both p < 0.01) and area under the glucose concentration curve during OGTT (p = 0.006). On multivariate linear regression analyses, 2-h insulin emerged as a determinant of %ASM independently of HOMA-IR in young women (standardized β: 0.287, p < 0.001, R2 = 0.077). In middle-aged women, the Matsuda index emerged as a determinant of %ASM (standardized β: 0.476, p < 0.001) independently of HOMA-IR, log ODI and AUCg and explained 21.3 % of %ASM variability. Post-glucose glycemia and AUCg were higher and log ODI was lower in middle-aged women with low compared with high %ASM. Conclusion Low skeletal muscle mass (relative to body size) was associated with low insulin sensitivity in young and middle-aged Japanese women who were neither obese nor diabetic. Middle-aged women with low muscle mass had low disposition index, an early marker of inadequate pancreatic β-cell compensation, and hence high glucose excursion. Low skeletal muscle mass may be associated with the development of type 2 diabetes at a much lower BMI in Japanese people.
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Affiliation(s)
- Satomi Minato-Inokawa
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Laboratory of Community Health and Nutrition, Department of Bioscience, Graduate School of Agriculture, Ehime University, Matsuyama, Ehime, Japan
| | - Ayaka Tsuboi-Kaji
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Nutrition, Osaka City Juso Hospital, Osaka, Japan
| | - Mari Honda
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Health, Sports, and Nutrition, Faculty of Health and Welfare, Kobe Women's University, Kobe, Hyogo, Japan
| | - Mika Takeuchi
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
| | - Kaori Kitaoka
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Advanced Epidemiology, Noncommunicable Disease (NCD) Epidemiology Research Center, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Miki Kurata
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Food Sciences and Nutrition, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
| | - Bin Wu
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Tsutomu Kazumi
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Medicine, Hakuhoukai Kakogawa Hospital, Kakogawa, Hyogo, Japan
| | - Keisuke Fukuo
- Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Department of Food Sciences and Nutrition, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
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Jia W, Xiao J, Chan JCN. Tirzepatide-New Evidence for the Treatment of Obesity From China. JAMA 2024; 332:536-538. [PMID: 38819984 DOI: 10.1001/jama.2024.9104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Affiliation(s)
- Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute for Proactive Healthcare, Shanghai Jiao Tong University, Shanghai, China
| | - Jianzhong Xiao
- Department of Endocrinology and Metabolism, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
| | - Juliana C N Chan
- Department of Medicine and Therapeutics, Li Ka Shing Institute of Health Sciences and Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
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Neikirk K, Kabugi K, Mungai M, Kula B, Smith N, Hinton AO. Ethnicity-related differences in mitochondrial regulation by insulin stimulation in diabetes. J Cell Physiol 2024; 239:e31317. [PMID: 38775168 PMCID: PMC11324399 DOI: 10.1002/jcp.31317] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 04/26/2024] [Accepted: 05/07/2024] [Indexed: 08/15/2024]
Abstract
Mitochondrial dysfunction has long been implicated in the development of insulin resistance, which is a hallmark of type 2 diabetes. However, recent studies reveal ethnicity-related differences in mitochondrial processes, underscoring the need for nuance in studying mitochondrial dysfunction and insulin sensitivity. Furthermore, the higher prevalence of type 2 diabetes among African Americans and individuals of African descent has brought attention to the role of ethnicity in disease susceptibility. In this review, which covers existing literature, genetic studies, and clinical data, we aim to elucidate the complex relationship between mitochondrial alterations and insulin stimulation by considering how mitochondrial dynamics, contact sites, pathways, and metabolomics may be differentially regulated across ethnicities, through mechanisms such as single nucleotide polymorphisms (SNPs). In addition to achieving a better understanding of insulin stimulation, future studies identifying novel regulators of mitochondrial structure and function could provide valuable insights into ethnicity-dependent insulin signaling and personalized care.
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Affiliation(s)
- Kit Neikirk
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, 37232, USA
| | - Kinuthia Kabugi
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, 37232, USA
| | - Margaret Mungai
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, 37232, USA
| | - Bartosz Kula
- Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester, School of Medicine and Dentistry, Rochester, USA 14642
| | - Nathan Smith
- Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester, School of Medicine and Dentistry, Rochester, USA 14642
| | - Antentor O. Hinton
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, 37232, USA
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