Association between circulating micronutrient pattern, glycemic control, and insulin resistance in type 2 diabetes mellitus.

The circulating micronutrient pattern in type 2 diabetes mellitus (T2DM) may impact glycemic control and insulin resistance; however, there is a scarcity of studies that have evaluated the circulating micronutrient pattern in the T2DM population. Therefore, our objective was to identify circulating micronutrient pattern and their association with markers of glycemic control and insulin resistance in individuals with T2DM. We developed a cross-sectional observational study involving adults with T2DM in Sergipe, Brazil. We assessed plasma levels of magnesium, zinc, calcium, potassium, and serum 25-hydroxyvitamin D. Additionally, also measured fasting glucose levels, the percentage of glycated hemoglobin (%HbA1c), and calculated the homeostatic model assessment for insulin resistance (HOMA-IR). Patterns of body reserve were established using principal component analysis and categorized into quartiles. Binary logistic regression models were employed. We evaluated 114 individuals (63.7% women), with a median age and body mass index of 49 years and 29.6 kg/m², respectively. Two circulating micronutrient patterns were identified, explaining 62.5% of the variance: Pattern 1 (positive contributions from magnesium, zinc, calcium, and potassium) and Pattern 2 (positive contributions from 25-hydroxyvitamin D and zinc, with a negative contribution from potassium). Lowest quartile for Pattern 1 and Pattern 2 exhibiting a 4.32-fold (p = 0.019) and 3.97-fold (p = 0.038) higher likelihood of increasing HOMA-IR and %HbA1c values, respectively, compared to the larger quartiles. However, no associations were found between these patterns and fasting glucose values. Lowest quartile for both patterns of micronutrients was associated with inadequate metabolic control in individuals with T2DM.

Association among 25-hydroxyvitamin D levels, hypertriglyceridemic-waist phenotype, and cardiometabolic markers in individuals with type 2 diabetes mellitus from regions with high solar incidence.

OBJECTIVE: To evaluate the relationship between vitamin D status and hypertriglyceridemic-waist (HTW) phenotype and cardiometabolic markers in individuals with type 2 diabetes mellitus (T2DM) living in regions with high solar incidence (10° south). METHODS: An observational, cross-sectional study, with 122 individuals with T2DM, of both sexes, aged between 19 and 59 years, residing in Sergipe/Brazil. Measurements included serum 25-hydroxyvitamin D (25[OH]D), glucose, insulin, total cholesterol, LDL-c, HDL-c, triacylglycerols, blood pressure, body mass index, %body fat, and waist circumference. Participants were classified by the presence or absence of the HTW phenotype, according to increased waist circumference and triacylglycerols concentrations. Logistic and linear regression models were applied to verify the association among the concentration of 25(OH)D, HTW phenotype, and lipid profile variables. RESULTS: Triacylglycerols concentrations (p = .013) and %body fat (p = .011) were higher in women with serum 25(OH)D insufficient/deficient than in those with adequate 25(OH)D levels. Individuals with serum 25(OH)D insufficiency/deficiency were 2.595 times more likely to present the HTW phenotype than those with adequate 25(OH)D levels (p = .021). Additionally, a negative association was observed between the concentration of 25(OH)D and total cholesterol (Beta = -0.204, p = .049). CONCLUSION: Insufficiency/deficiency of serum 25(OH)D in individuals with T2DM increases the chances of developing the HTW phenotype.

Copper Deficiency Associated with Glycemic Control in Individuals with Type 2 Diabetes Mellitus.

Adequate copper (Cu) status has been associated with improved glycemic control, partly because of its role in reducing oxidative stress through superoxide dismutase (SOD) activity. Thus, the aim was to investigate the relationship between plasma Cu concentration and markers associated with glycemic control in individuals with type 2 diabetes mellitus (T2DM). This observational and cross-sectional study was conducted in individuals with T2DM of both sexes, aged between 19 and 59 years. Plasma Cu levels were analyzed using inductively coupled plasma optical emission spectrometry (ICP-OES). Fasting glucose and insulin concentrations, C-peptide levels, SOD activity, and glycated hemoglobin (%HbA1c) were measured. Homeostatic model assessments (HOMA%B, HOMA%S, and HOMA-IR) were also performed. Additionally, %body fat and waist circumference were measured, and body mass index was calculated. Participants were categorized based on their plasma Cu concentrations (< 70 µg/dL and ≥ 70 µg/dL). The associations between variables were analyzed using chi-squared or Fisher's test and binary logistic regression models. Statistical significance was set at P < 0.05. Of the 97 participants (74.2% women), 85.5% had Cu deficiency. Cu-deficient individuals showed elevated C-peptide concentrations and HOMA%B values compared to those with adequate Cu levels (2.8 ng/mL vs. 1.8 ng/mL, P = 0.011; and 71.4 vs. 31.0, P = 0.003), respectively. Cu deficiency was associated with insulin resistance (P = 0.044) and decreased likelihood of exceeding the target serum glucose level (OR = 0.147, P = 0.013). However, no significant association was found between SOD activity and plasma Cu concentration. Consequently, Cu deficiency was linked to improved glycemic control, although it was not associated with the other markers.

Magnesium Status and Dietary Patterns Associated with Glycemic Control in Individuals with Type 2 Diabetes Mellitus.

Hypomagnesemia and unhealthy eating patterns are associated with poor glycemic control in individuals with type 2 diabetes mellitus (T2DM). This study aimed to associate magnesium status and dietary patterns with glycemic control in T2DM individuals. This cross-sectional study included 147 individuals with T2DM, aged between 19 and 59 years, of both sexes, residents in Sergipe/Brazil. The BMI, waist circumference, %body fat, plasma magnesium, serum glucose, insulin, %HbA1c, triacylglycerol, total cholesterol, LDL-c, and HDL-c were analyzed. Eating patterns were identified using a 24-h recall method. Logistic regression models were used to verify the association of magnesium status and dietary patterns with markers of glycemic control by adjusting for sex, age, time of T2DM diagnosis, and BMI. A P value < 0.05 was considered significant. Magnesium deficiency increased the chance of elevated %HbA1c by 5.893-fold (P = 0.041). Three main dietary patterns were identified: mixed (MDP), unhealthy (UDP), and healthy (HDP). UDP also increased the chance of elevated %HbA1c levels (P = 0.034). T2DM individuals' who presented magnesium deficiency had a higher chance of elevated %HbA1c levels (8.312-fold) and those in the lowest quartile (Q) of the UDP (Q1: P = 0.007; Q2: P = 0.043) had a lower chance of elevated %HbA1c levels. However, the lower quartiles of the HDP were associated with a greater chance of alterations in the %HbA1c level (Q1: P = 0.050; Q2: P = 0.044). No association was observed between MDP and the variables studied. Magnesium deficiency and UDP were associated with a higher chance of inadequate glycemic control in T2DM individuals.

Intakes of Zinc, Potassium, Calcium, and Magnesium of Individuals with Type 2 Diabetes Mellitus and the Relationship with Glycemic Control.

The role of the concomitant intake of zinc, potassium, calcium, and magnesium in the glycemic control of individuals with type 2 diabetes mellitus (T2DM) has not been extensively discussed. We evaluated the relationship between the dietary intake of these micronutrients and glycemic markers in 95 individuals with T2DM (mean age 48.6 ± 8.4 years). Hierarchical grouping analysis was used to divide the individuals into two clusters according to their micronutrient intake, and differences between clusters were statistically assessed. Effects of individual and combination intake of micronutrients on glycated hemoglobin percentage (%HbA1c) were assessed using multiple linear regression and binary logistic regression analysis. We observed a high likelihood of inadequate intake of the four micronutrients. The group with lower micronutrient intake (cluster 1) displayed higher %HbA1c (p = 0.006) and triglyceride (p = 0.010) levels. High %HbA1c showed an association with cluster 1 (odds ratio (OR) = 3.041, 95% confidence interval (CI) = 1.131; 8.175) and time of T2DM diagnosis (OR = 1.155, 95% CI = 1.043; 1.278). Potassium (ß = -0.001, p = 0.017) and magnesium (ß = -0.007, p = 0.015) intakes were inversely associated with %HbA1c. Reduced concomitant intake of the four micronutrients studied proved to be associated with risk of increased %HbA1c in individuals with T2DM, which was particularly predicted by magnesium and potassium intakes.

Circunferência do pescoço e sua associação com parâmetros antropométricos de adiposidade corporal em adultos / Circumference of the neck and its association with anthropometric parameters of body adiposity in adults

Introdução: A circunferência da cintura (CC), índice de conicidade (IC) e índice de massa corpórea (IMC) são medidas cotidianamente usadas para avaliação corporal e risco cardiovascular. Recentemente, a circunferência do pescoço (CP) tem sido estudada como parâmetro para detecção da adiposidade corporal. Objetivo: Verificar se a CP é um parâmetro antropométrico sensível e fidedigno para avaliação da adiposidade corporal, em comparação às outras variáveis antropométricas. Método: Participaram, desse estudo transversal, 126 adultos entre 18 e 59 anos, de ambos os sexos, os quais foram submetidos a avaliação socioeconômica e antropométrica. Resultados: A maioria dos participantes era do sexo feminino, com média de idade de 36 anos, 58,73% estavam com excesso de peso. A CP mostrou correlação positiva com as variáveis antropométricas de peso, CC, IC e IMC (p=0,000). A curva ROC mostrou o ponto de corte para CP de 31 cm (sensibilidade de 97,3% e especificidade de 63,5%). Conclusão: A CP mostrou associação com indicadores antropométricos classicamente adotados para avaliar o risco cardiovascular. Portanto, essa medida, além de rápida e não invasiva, pode ser útil na detecção precoce da adiposidade corporal.(AU)

Introduction: Waist circumference (WC), conicity index (CI), and body mass index (BMI) are routinely used to assess body condition and cardiovascular risk. Recently, neck circumference (NC) was studied as a parameter for the detection of body adiposity. Objective: To verify if NC is a sensitive and reliable anthropometric parameter for the evaluation of body obesity, in comparison with other anthropometric variables. Methods: A cross-sectional study was carried out on 126 adults, aged 18-59 years, of both sexes, who were submitted to socioeconomic and anthropometric evaluation. Results: The majority of the individuals were females, with mean age of 36 years, 58.73% were overweight. NC showed a positive correlation with the anthropometric variables weight, CC, CI and BMI (p=0.000). The ROC curve presented cut-off values for CP of 31 cm (sensitivity 97,3% and specificity 63,5%). Conclusion: NC showed association with anthropometric indicators classically adopted for cardiovascular risk assessment. Therefore, these indicators, besides fast and non-invasive, can be used in the early detection of adiposity body.(AU)

Magnésio urinário, plasmático e eritrocitário: validação do método de análise por espectrofotometria de absorção atômica com chama / Magnesium contents in urine, plasma and erythrocyte samples: validation of analytical methodology using flame atomic absorption spectrophotometry

Neste estudo foi validada a metodologia de análise de magnésio urinário, plasmático e eritrocitário por espectrofotometria de absorção atômica com chama. As análises foram realizadas em pools de amostras de urina, de plasma e de eritrócitos de humanos. Para a validação, foram considerados os parâmetros de linearidade da curva-padrão, faixa de trabalho, limite de detecção (LD), limite de quantificação (LQ), precisão e exatidão da medição. Os LD e LQ da curva foram, respectivamente, de 0,006 e 0,021 μg/mLde Mg para urina e plasma, e de 0,003 e 0,010 μg/mL de Mg para eritrócitos. A faixa linear de trabalho para determinação de Mg foi entre 0,05 e 0,5 μg/mL de Mg, e as curvas-padrão apresentaram coeficientes de correlação maiores do que 0,99, que demonstram a linearidade da metodologia. As precisões intra e interensaio superiores a 90 por cento foram consideradas adequadas. As recuperações obtidas, usando-se materiais de referência certificados, foram de 101 por cento e de 97 por cento, respectivamente, em urina e plasma. As médias de recuperação por adição de padrão foram de 87 por cento para urina e eritrócitos e de 91 por cento para plasma. A metodologia avaliada foi linear, sensível, seletiva, precisa e exata; portanto, são confiáveis os resultados obtidos.

Avaliação do status de magnésio e da sua associação com o estresse oxidativo e as citocinas inflamatórias na pré-eclâmpsia / Assessment of the magnesium status and its association with oxidative stress and inflammatory cytokines in preeclampsia

O objetivo deste trabalho foi avaliar o status de magnésio (Mg) e a sua relação com o estresse oxidativo e as citocinas inflamatórias na pré-eclâmpsia (PE). Participaram do estudo, 18 gestantes saudáveis (controle - CT) e 18 gestantes com PE, diagnosticadas com pressão arterial >= 140/90 mmHg, proteinúria >= 0,3 g/24 h e sem doenças associadas. Sangue e urina de 24 horas foram coletados para análise de status de Mg, estresse oxidativo [malondialdeído (MDA), 8-isoprostano urinário e a atividade antioxidante das enzimas catalase (CAT) e glutationa peroxidase (GSH-Px)], a concentração de óxido nítrico (NO), e das citocinas inflamatórias [proteína C reativa, interleucina 6 (IL-6) e fator de necrose tumoral (TNF-α)]; Foi aplicado um questionário quantitativo de frequência alimentar para gestantes. As comparações entre os grupos foram feitas pelos testes Qui-quadrado, t-Student ou Mann Whitney. O coeficiente de correlação de Spearman foi usado para verificar associação entre as variáveis. A análise do Receiver Operating Characteristic (ROC) foi realizada para identificar as variáveis que melhor discriminassem os grupos (α=5%). As concentrações de Mg plasmático e eritrocitário, bem como a concentração de NO, a atividade da CAT e as concentrações de TNF-α e IL-6 foram maiores na PE do que no CT. Associações positivas entre o Mg plasmático e a proteinúria (p=0,04), o TNFα (p=0,03) e a IL-6 (p=0,02) foram verificadas; associações negativas foram encontradas entre a atividade da CAT e a concentração de 8-isoprostano urinário (p=0,02) e entre a atividade da GSH-Px e os níveis de pressão arterial diastólica (p=0,01). A análise ROC mostrou que o Mg plasmático e o TNF-α foram as variáveis que mellhor discriminaram as gestantes com PE das CT. Os resultados mostraram que o estresse oxidativo não foi evidente na fisiopatologia da PE, possivelmente devido aos mecanismos antioxidantes compensatórios do organismo. A inflamação e os eventos inerentes à PE, como vasoconstrição, podem ter promovido as alterações no status de Mg

The aim of this study was to assess the magnesium (Mg) status and its relationship with oxidative stress and inflammatory cytokines in preeclampsia (PE). Were included 18 healthy pregnant women (CT- control) and 18 PE, diagnosed with blood pressure >= 140/90 mmHg, proteinuria >= 0,3 g/24 h, and without other diseases. Blood and 24h urine were collected for analyses of the Mg status, oxidative stress [malondialdehyde (MDA), 8-isoprostane urinary and activities of the antioxidant enzymes: catalase (CAT) and glutathione peroxidase (GSH-Px)], nitric oxide (NO) and inflammatory cytokines concentrations [protein C reactive, interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α); Furthermore, a quantitative food frequency questionnaire was applied to pregnant women. The comparisons between groups were done by Chi-square, t-Student or Mann Whitney tests. Spearman correlation coefficient was used to verify association among variables and the Receiver Operating Characteristic (ROC) analysis was performed to identify variables that better discriminated the groups (α = 5 %). The Mg concentration, in plasma and in erythrocyte, as well as NO concentration, CAT activity and TNF-α and IL-6 concentrations were higher in PE than CT group. Positive associations between plasma Mg and proteinuria (p=0,04), TNF-α (p=0,03) and IL-6 (p=0,02) were verified; Negative associations were found between CAT activity and 8-isoprostane urinary concentration (p=0,02) and between GSH-Px activity and diastolic blood pressure levels (p=0,01). ROC analyses showed that plasma Mg and TNF-α were the variables which better discriminate pregnant women with PE from CT. The results showed that oxidative stress was not evident in physiopathology of PE, possibly due to compensatory antioxidant mechanisms present in the body. The inflammatory and the events inherent to PE, such as vasoconstriction, possibly have promoted changes in Mg status

Estado nutricional de pacientes renais crônicos em hemodiálise / Nutritional status of patients on hemodialysis / Estado nutricional de los pacientes en hemodiálisis

A insuficiência renal crônica apresenta alterações metabólicas e nutricionais, estando a desnutrição associada ao aumento da morbimortalidade. O objetivo do estudo foi avaliar o estado nutricional de pacientes renais crônicos em hemodiálise. Foram selecionados 83 de ambos os sexos, numa faixa etária entre 18 e 90 anos, com um tempo médio de diálise de 120 meses, assistidos na Clínica Nefrológica do Hospital Casa Mater, Teresina - PI. Para avaliação da composição corporal, foram utilizados IMC, prega cutânea triciptal, circunferência do braço e circunferência muscular do braço. A avaliação das dietas foi feita utilizando um recordatório de 24h e a análise por meio de um software. Para determinação do estado nutricional dos pacientes, foram utilizados parâmetros antropométricos e bioquímicos (albumina sérica, hematócrito, hemoglobina, uréia e creatinina urinária). Os valores médios encontrados para o IMC foram de 22,52 +- 3,62 kg/m². O consumo médio de energia e proteína foi de 30,0 +- 12,3 Kcal/Kg/dia e 1,3 g/Kg/dia, respectivamente. O valor médio da albumina foi de 4,5 +-0,9g/dL. A concentração de creatinina na urina dos pacientes do sexo masculino e feminino foi de 8,6 +- 2,6mg/dL e 8,9 +-1,8mg/dL, respectivamente. Os valores médios do hematócrito e hemoglobina foram de 29,9% +- 5,9 e 10,1 +- 2,0g/dL para os homens e 30,8% +- 4,8 e 10,4 +- 1,5g/dL para as mulheres, respectivamente. Concluindo, os pacientes apresentaram alteração do estado nutricional, indicando a necessidade de verificar a terapia nutricional na sua qualidade de vida.

Chronic renal failure presents nutritional and metabolic disorders, malnutrition and is associated with increased mortality. The aim of this study was to evaluate the nutritional status of patients on hemodialysis. We selected 83 of both sexes, an age range between 18 and 90 years with a mean time of dialysis was 120 months, assisted at the Hospital Clinic Nephrological House Mater, Teresina - PI. To assess body composition, we used BMI, triceps skinfold, arm circumference and arm muscle circumference. The evaluation of the diets was made using a 24-hour recall and analysis by means of a software. To determine the nutritional status of patients, we used anthropometric and biochemical parameters (serum albumin, hematocrit, hemoglobin, urea and urinary creatinine). The average values for BMI were 22.52 +- 3.62 kg/m². The average consumption of energy and protein was 30.0 +- 12.3 kcal/kg/day and 1.3 g/kg/day, respectively. The mean albumin was 4.5 +- 0.9 g/dL. The concentration of creatinine in the urine of males and females was 8.6 +- 2.6 mg/dL and 8.9 +-1.8 mg/dL, respectively. Mean values of hematocrit and hemoglobin were 29.9% +- 5.9 and 10.1 +- 2.0 g/dL for men and 30.8% +- 4.8 and 10.4 +- 1,5 g/dl for women, respectively. In conclusion, the patients showed alterations of nutritional status, indicating the need to check the nutritional quality of their lives.

La insuficiencia renal crónica presenta desnutrición de nutrición y trastornos metabólicos, y se asocia con una mayor mortalidad. El objetivo de este estudio fue evaluar el estado nutricional de los pacientes en hemodiálisis. Se seleccionaron 83 de ambos sexos, un rango de edad entre 18 y 90 años con un tiempo medio de diálisis fue de 120 meses, atendidos en el Hospital Clínico nefrológica Casa Mater, Teresina - PI. Para evaluar la composición corporal, se utilizó el IMC, el pliegue del tríceps, circunferencia del brazo y circunferencia muscular del brazo. La evaluación de las dietas se realizó mediante un recordatorio de 24 horas y el análisis por medio de un software. Para determinar el estado nutricional de los pacientes, utilizando parámetros antropométricos y bioquímicos (albúmina sérica, hematocrito, hemoglobina, urea y creatinina en orina). Los valores promedio de IMC 22,52 +- 3,62 kg/m². El consumo promedio de energía y proteína fue 30,0 +- 12,3 kcal/kg/día y 1,3 g/kg/día, respectivamente. La albúmina media fue de 4,5 +- 0,9 g/dl. La concentración de creatinina en la orina de los machos y las hembras fue de 8,6 +- 2,6 mg/dl y 8,9 +-1,8 mg/dL, respectivamente. Los valores medios de hematócrito y hemoglobina fueron 29,9% +- 5,9 y 10,1 +- 2,0 g/dl para los hombres y el 30,8% +- 4.8 y 10.4 +- 1,5 g/dl en mujeres, respectivamente. En conclusión, los pacientes presentaron alteraciones del estado nutricional, lo que indica la necesidad de comprobar la calidad nutricional de sus vidas.