The association between blood glucose levels and lipids in the general adult population: results from NHANES (2005-2016).

OBJECTIVE: Although abnormal lipid metabolism is one of the major risk factors for diabetes, the correlation between lipids and glucose is rarely discussed in the general population. The differences in lipid-glucose correlations across gender and ethnicity have been even more rarely studied. We examined the association between fasting blood glucose (FBG) and lipids, including triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and apolipoprotein B (ApoB), using 6,093 participants aged 20 years or older from the National Health and Nutrition Examination Survey (NHANES). METHODS: Analyses were performed using multiple logistic regression and generalised additive models. RESULTS: When other confounders were considered, we found that fasting glucose was positively correlated with triglycerides and negatively correlated with HDL-C, whereas total cholesterol, LDL-C cholesterol, and fasting glucose were related to each other in a U-curve fashion, with inflection points of 5.17 mmol/L and 2.3 mmol/L, respectively.This relationship persisted in subgroups of different sexes and races. A positive correlation was found between fasting glucose and ApoB, but subgroup analyses revealed that this relationship was not correlated across gender and race. CONCLUSION: In the general population, fasting blood glucose levels were positively correlated with TG, negatively correlated with HDL-C, and U-shaped with total cholesterol and LDL-C. The likelihood of developing diabetes was 40% higher when LDL-C was greater than 2.3 mmol/L than in patients with LDL-C less than 2.3 mmol/L.

Prevalence and clinical correlates of impaired fasting blood glucose in children and adolescents with depressive disorder and relationship with triglyceride and high-density lipoprotein ratio.

Depressive disorder is a significant public health problem worldwide, which adversely affects children and adolescents' health. Impaired fasting blood glucose (IFG) is more common in depressive disorder, which becomes a clinical problem that needs to be focused on. The study purposed to determine the prevalence and related factors of IFG in Chinese children and adolescents with depressive disorder and the relationship between triglyceride and high-density lipoprotein cholesterol (TG/HDL-C) ratio and IFG. This research encompassed 756 individuals aged 8 to 18 with major depressive disorders, all diagnosed under DSM-5 criteria at the Third People's Hospital of Fuyang from January 2020 to December 2021. We detected fasting blood glucose (FBG) and lipid levels and assessed the suicidal behaviors and depressive symptoms severity of each participant. The sociodemographic and included study variables were collected and analyzed. Our study employed multiple logistic regression to discern independent factors affecting IFG in conjunction with depressive disorders among children and adolescents. The prevalence of IFG was 6.5% (49/756). IFG was positively correlated with FBG, BMI, TG, TG/HDL-C, and was negatively correlated with gender and the type of antidepressant drug taken. Binary logistic analysis showed that male (OR = 2.57, 95% CI: 1.43-4.63, P = 0.002) and higher levels of TG (OR = 1.63, 95% CI: 1.11-2.38, P = 0.013) were independently associated with IFG in children and adolescents with depressive disorder. The incidence of IFG in children and adolescents with depressive disorder was high and was positively related to the TG/HDL-C ratio. The evaluation and management of IFG in pediatric depression should extend beyond pharmacological interventions. Comprehensive strategies in both assessment and management of IFG are essential to address this condition effectively in young patients facing depressive disorders.

Effectiveness of Prebiotics and Mediterranean and Plant-Based Diet on Gut Microbiota and Glycemic Control in Patients with Prediabetes or Type 2 Diabetes: A Systematic Review and Meta-Analysis.

BACKGROUND: A high-calorie diet results in the development of prediabetes (PD) or type 2 diabetes mellitus (T2DM). This diet has been reported to cause changes in microbial composition, concentration levels of glycemic parameters, and immune cells or inflammatory cytokines. This systematic review and meta-analysis aimed to evaluate the effects of prebiotics, as well as Mediterranean and plant-based dietary interventions, on gut microbiota composition and glucose homeostasis in individuals with PD or T2D. METHODS: This systematic review and meta-analysis was developed according to the 2020 PRISMA guidelines and checklist. PubMed, EBSCOhost and Google Scholar were the three databases that were used to search for electronically published studies. Data extraction was conducted and examined by the reviewers and all the eligible studies were selected. To test for the quality and biases of the included studies, the Downs and Black checklist was used, followed by the use of Review Manager 5.4. A forest plot was used for meta-analysis and sensitivity analysis. The strength of the evidence was assessed using the Grading of Recommendation Assessment, Development and Evaluation approach. RESULTS: Overall, eight studies met the inclusion criteria: seven focused on patients with T2D, and one focused on patients with PD. The prebiotic dietary intervention did not have a statistically significant effect on glycemic control, including fasting blood glucose (FBG) and glycated hemoglobin (HbA1c). However, one study investigating the Mediterranean diet reported a significant effect on glycemic control. Both prebiotic and Mediterranean dietary interventions were found to beneficially influence gut microbial composition in the intervention groups compared to the placebo groups. No studies assessed the impact of a plant-based diet on microbial composition and glucose parameters. CONCLUSIONS: This review indicated that dietary intervention with a prebiotic or Mediterranean diet shows to beneficially improve the gut microbiota composition of Firmicutes, Bacteroidetes and Bifidobacteria in patients with PD or T2D. However, their beneficial effects on FBG and HbA1c were less clear and uncertain due to limited reports, particularly regarding the Mediterranean dietary intervention.

Exploring the Association of VEGF-A and ANGPTL2 with the Prognosis of Non-proliferative and Proliferative Diabetic Retinopathy.

Introduction Diabetic retinopathy (DR) is a microvascular ailment that can arise from the long-term effects of diabetes mellitus. It can potentially cause retinal damage that could endanger vision and cause blindness. The worsening of DR is mainly linked to poor glycemic control, uncontrolled hypertension, and dyslipidemia. There is a need for alternative and clinically significant novel molecules involved in the pathogenesis of DR because the diagnostic and prognostic markers have reached a limit. Materials and method This study included sex and age-matched diabetic patients with proliferative stage (N = 70), non-proliferative stage (N = 80), and control (N = 80, without the sign of DR). These patients were recruited from outpatients in the Department of Ophthalmology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India. A random blood sample was collected from each study participant, and the serum was separated after centrifugation and stored at -80 °C for batch analysis. The biomarkers vascular endothelial growth factor (VEGF-A) and angiopoietin-like protein-2 (ANGPTL2) were measured using a sandwich enzyme-linked immunosorbent assay (ELISA) technique, and the laboratory parameters such as fasting blood sugar (FBS), lipid profile, blood urea nitrogen (BUN), creatine, and glycated hemoglobin (HbA1C) were also assessed. Results We observed statistically significant differences in the duration of diabetes, FBS, total cholesterol (TC), triglyceride level (TGL), BUN, and creatine (p<0.05), and the mean age of study participants was 52.95±8.20 years in the control group, 53.85±10.20 years in the proliferative diabetic retinopathy (PDR) group, and 55.02±7.65 in the non-proliferative diabetic retinopathy (NPDR) group. Furthermore, ANGPTL2 levels were statistically significant according to the severity of the disease (p<0.001*), and they were also linked (p<0.05) with established markers such as VEGF-A. Conclusion Thus, our research implies that the up-regulated markers might be linked to the disease's advancement and could serve as a prognostic indicator or therapeutic target for DR.

Whole body vibration therapy and diabetes type 2: a systematic review and meta-analysis.

Background: Vibration platforms have demonstrated systemic effects generated by the use of mechanical vibrations, which are similar to those of any physical activity. The effect that whole body vibration (WBV) generates on the organism could be recommended in Diabetes Mellitus 2 (DM 2) patients. Objective: To systematically review and meta-analyze the available evidence on the effects of WBV on glycemic control in patients with DM 2. Material and methods: Exhaustive bibliographic searches were carried out until October 2023 in different biomedical portals and databases: Public Medline (PubMed), Scientific Electronic Library Online (SciELO), VHL Regional Portal, Cochrane Central and Latin American and Caribbean Literature in Health Sciences (LILACS). Randomized clinical trials based on the effects of Whole Body Vibration on glycosylated hemoglobin levels, with control group and participants were non-insulin dependent were the inclusion criteria. Two reviewers extracted data independently. A third reviewer was available for discrepancies. Results: Six articles with 223 participants met the criteria and were included in the systematic review; only four of them met the criteria to be part of the meta-analysis. This meta-analysis reveals a positive and significant effect size (µ ê=0.5731), indicating a substantial difference between the groups studied. Although there is some variability between studies (heterogeneity of 30.05%), the overall direction of the effects is consistent. These findings conclusively suggest the presence of a significant influence of the variable evaluated, underscoring the robustness and consistency of the relationship observed in the literature reviewed. Conclusion: There are no conclusive results due to the lack of data for some variables, which prevents comparison; but WBV may be an effective therapy to improve glycemic control in DM 2 patients. More studies with more patients and longer follow-up are needed.

Effect of shared decision-making model on the management of diabetes high-risk groups.

OBJECTIVE: A shared decision-making (SDM) model-based intervention programme was implemented for a population at high risk for diabetes to explore its effectiveness in intervening with blood glucose levels in this population. METHODS: One hundred residents were selected according to the principle of voluntary participation and divided into the intervention group (n = 50) and the control group (n = 50) by using multistage cluster sampling. The control group received only brief diabetes knowledge education through a disease brochure issued by the hospital; the intervention group implemented a SDM model based on large classroom and individualised education for 4 months. Univariate analysis and generalised estimating equation fitting model were used to analyse the effect of intervention on blood glucose parameters in the study subjects. RESULTS: Univariate analysis showed that after 4 months of intervention, fasting blood glucose was lower in the intervention group than in the control group (5.57 ± 0.56 vs. 6.07 ± 0.77, F = 45.721, p < 0.001); glycosylated hemoglobin was lower in the intervention group than in the control group (5.91 ± 0.28 vs. 6.02 ± 0.24, F = 25.998, p < 0.001), decreased by 0.26% in the intervention group and increased by 0.01% in the control group. One-way analysis of variance (ANOVA) showed that fasting blood glucose and glycosylated hemoglobin in the intervention group decreased to different extents from baseline. The generalised estimation equation was fitted with the intervention programme, gender, hypertension, smoking, alcohol consumption, physical activity, age, waist circumference, body mass index, baseline fasting blood glucose, and baseline glycosylated hemoglobin as independent variables, and fasting blood glucose and baseline glycosylated hemoglobin as dependent variables. Results showed that compared with the control group, fasting blood glucose and glycosylated hemoglobin levels were significantly different between the two groups (p < 0.001). CONCLUSION: Applying an intervention programme based on SDM model to people at high risk of diabetes can improve patients' adherence to self-management and establish a good lifestyle, thus contributing to their good glycemic control.

Relationship between triglyceride-glucose index and carotid artery plaques in ischemic stroke patients: Based on blood pressure status, sex, and age.

BACKGROUND: Numerous studies have shown that the triglyceride-glucose (TyG) index is a reliable substitute marker for insulin resistance. Nevertheless, its correlation with carotid artery plaques (CAPs) among patients with ischemic stroke (IS) remains to be elucidated. METHODS: 9248 IS patients hospitalized at the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine were grouped according to the quartiles of TyG index. Patients were further stratified by blood pressure status, sex, age and hypertension control status. Employing logistic regression to examine the connection between the TyG index and CAPs.Additionally, analyzing the receiver operating characteristic (ROC) curve to evaluate the predictive value of the TyG index for CAPs. RESULTS: Participants with an elevated TyG index had an increased prevalence of CAPs. The TyG index was positively correlated with CAPs (OR: 1.26, CI: 1.14-1.40, P<0.001). Compared with normal blood pressure and prehypertensive patients, the TyG index was markedly correlated with CAPs among hypertensive patients (OR: 1.29, 95% CI: 1.15-1.44, P<0.001). Females had a higher OR value than males(OR: 1.31, 95% CI: 1.11-1.54, P=0.001 versus OR: 1.24, 95% CI: 1.09-1.41, P=0.001). Older patients (>60 years) had a higher OR value than their middle-aged counterparts (≤60 years) (OR: 1.35; 95% CI: 1.16-1.58, P<0.001 versus OR: 1.20; 95% CI: 1.05-1.37, P=0.007). Patients with poorly-controlled hypertension had a higher OR value than patients with well-controlled hypertension(OR: 1.36; 95% CI: 1.14-1.63, P=0.001 versus OR: 1.24; 95% CI: 1.07-1.44, P=0.003). After adjusting for potential confounding factors, the area under the ROC curve (AUC) value in the overall population, sex-stratified group, hypertensive patients and hypertension control status-stratified group were all above 0.7 (P<0.01), demonstrating good forecasting capability. CONCLUSIONS: In IS patients, the TyG index was significantly associated with CAPs. Additionally, this correlation was more pronounced in hypertensive patients, females, older individuals and patients with poorly-controlled hypertension.

The key metabolic signatures and biomarkers of polycyclic aromatic hydrocarbon-induced blood glucose elevation in chinese individuals exposed to diesel engine exhaust.

Due to the complexity of environmental exposure factors and the low levels of exposure in the general population, identifying the key environmental factors associated with diabetes and understanding their potential mechanisms present significant challenges. This study aimed to identify key polycyclic aromatic hydrocarbons (PAHs) contributing to increased fasting blood glucose (FBG) concentrations and to explore their potential metabolic mechanisms. We recruited a highly PAH-exposed diesel engine exhaust testing population and healthy controls. Our findings found a positive association between FBG concentrations and PAH metabolites, identifying 1-OHNa, 2-OHPh, and 9-OHPh as major contributors to the rise in FBG concentrations induced by PAH mixtures. Specifically, each 10 % increase in 1-OHNa, 2-OHPh, and 9-OHPh concentrations led to increases in FBG concentrations of 0.201 %, 0.261 %, and 0.268 %, respectively. Targeted metabolomics analysis revealed significant alterations in metabolic pathways among those exposed to high levels of PAHs, including sirtuin signaling, asparagine metabolism, and proline metabolism pathway. Toxic function analysis highlighted differential metabolites involved in various dysglycemia-related conditions, such as cardiac arrhythmia and renal damage. Mediation analysis revealed that 2-aminooctanoic acid mediated the FBG elevation induced by 2-OHPh, while 2-hydroxyphenylacetic acid and hypoxanthine acted as partial suppressors. Notably, 2-aminooctanoic acid was identified as a crucial intermediary metabolic biomarker, mediating significant portions of the associations between the multiple different structures of OH-PAHs and elevated FBG concentrations, accounting for 16.73 %, 10.84 %, 10.00 %, and 11.90 % of these effects for 1-OHPyr, 2-OHFlu, the sum concentrations of 2- and 9-OHPh, and the sum concentrations of total OH-PAHs, respectively. Overall, our study explored the potential metabolic mechanisms underlying the elevated FBG induced by PAHs and identified 2-aminooctanoic acid as a pivotal metabolic biomarker, presenting a potential target for intervention.

Folic Acid as a Potential Vitamin in Glycemic Control: A Systematic Review.

PURPOSE: This systematic review aims to examine the relationship between serum folate level and folic acid supplements with glycemic control parameters (fasting blood glucose (FBG), insulin level, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and Hemoglobin A1C (HbA1c)) in adult individuals with current studies. METHODS: In this study, which was designed as a systematic review, the searches were performed on Web of Science, Science Direct, Medline, Wiley, and Cochrane Library databases between April 10, 2023, and May 10, 2023, and the searches were updated between October 16, 2023, and November 14, 2023. Of the 1855 studies obtained from the screening, 17 met the criteria and were included in the systematic review. The PROSPERO system registered the study protocol (ID: CRD42023472434). RECENT FINDINGS: Although no significant correlation was found between serum folate levels and glycemic control parameters in most of the cross-sectional studies included in this systematic review, most of the randomized controlled trials showed that glycemic control parameters (FBG, insulin, HOMA-IR) decreased significantly in the intervention group receiving folic acid supplementation compared to the control group. However, study durations were short, and HbA1c needed to be evaluated in most studies. This makes it difficult to get information about the long-term effects of folic acid supplementation. More comprehensive studies should be conducted to draw more precise conclusions about the relationship between folic acid levels and folic acid supplementation with glycemic control parameters.

Korean Red Ginseng Extract Powder Mitigates Fasting And Postprandial Hyperglycemia in Type 2 Diabetic Mice.

Type 2 diabetes mellitus (T2DM) involves insulin resistance and elevated blood sugar levels, causing complications. Red ginseng extract powder (RGEP) from Panax ginseng Meyer shows promise for diabetes treatment. However, its efficacy in managing T2DM remains unclear. Therefore, this study aims to evaluate the effectiveness of RGEP in a mouse model of T2DM. The efficacy of RGEP in treating T2DM was assessed in db/db mice. Mice were divided into seven groups: control, db/db, metformin, and RGEP at 50, 100, 200, and 400 mg/kg. Administered orally for 9 weeks, RGEP effects on glucose regulation and insulin sensitivity were assessed through various metabolic parameters. In addition, mRNA expression levels of genes associated with hepatic gluconeogenesis and insulin sensitivity were examined. Fasting blood sugar showed a significant decrease in all RGEP concentration groups, but OGTT and insulin tolerance test showed a significant decrease at the RGEP concentration of 400 mg/kg, indicating enhanced glycemic control. Moreover, RGEP dose-dependently decreased serum glucose, HbA1c levels, and homeostatic model assessment of insulin resistance values, suggesting its effectiveness in reducing insulin resistance in db/db mice. Furthermore, RGEP downregulated mRNA expression of key components in the gluconeogenesis pathway (G6Pase, FOXO1, GLUT4, and PEPCK), insulin sensitivity (leptin, insulin1, PTP1B, GLP-1, and DPP-4), and mitochondria energy metabolism (PGC1) in either the liver or pancreas, while simultaneously upregulating GLP-1 expression. In conclusion, these findings highlight the potential of RGEP as a complementary therapy for T2DM, indicating therapeutic efficacy in managing diabetic complications through improved metabolic parameters.

Correlation between ratio of fasting blood glucose to high density lipoprotein cholesterol in serum and non-alcoholic fatty liver disease in American adults: a population based analysis.

Background: Based on previous research, elevated fasting blood glucose (FBG) and decreased high-density lipoprotein cholesterol (HDL-C) levels are associated with non-alcoholic fatty liver disease (NAFLD). It is hypothesized that the prevalence of NAFLD may be proportional to the FBG-to-HDL-C ratio (GHR). Methods: In this study, 3,842 participants from the National Health and Nutrition Examination Survey (NHANES) (2013-2020) were investigated. Liver steatosis was assessed using vibration-controlled transient elastography (VCTE). NAFLD was defined as controlled attenuation parameter (CAP) ≥288 dB/m. Results: After adjusting for race, gender, age, diabetes, BMI, moderate activities, uric acid, albumin, ALT, GGT, ALP, total bilirubin and creatinine, multiple logistic regression analysis indicated a positive correlation between GHR and the prevalence of NAFLD (OR = 1.22, 95% CI = 1.17-1.28). Additionally, multiple linear regression analysis showed a positive correlation between GHR and the severity of liver steatosis according to CA p-values (ß = 4.97, 95% CI: 4.28, 5.66). According to the subgroup analysis, the correlation was stronger in other race, participants at the age <50 years old and those with non-diabetes. In this study, a non-linear relationship and saturation effect between GHR and the prevalence of NAFLD was also revealed, characterized by an inverted L-shaped curve, with an inflection point of 7.443. Finally, the receiver operating characteristic (ROC) analysis suggested that the area under the curve (AUC) of GHR (AUC = 0.731) significantly exceeded that of FBG and HDL-C. Conclusion: Elevated GHR levels are independently associated with the severity of liver steatosis and the increased prevalence of NAFLD in American adults.

The Role of Platelet Distribution Width in the Association Between Blood Glucose and Neurological Impairment Severity in Acute Ischemic Stroke: A Moderated Mediation Model.

Objective: Fasting blood glucose (FBG) is a recognized risk factor for Ischemic Stroke, but little research has examined the interaction among FBG, Platelet Distribution Width (PDW) and the severity of neuronal damage. Thus, the present study constructs a moderated mediation model aimed to elucidate the relationships among FBG, PDW, and NIHSS scores in patients with acute ischemic stroke (AIS). Methods: We conducted a cross-sectional study on 431 AIS patients. Upon hospital admission, we assessed the patients' NIHSS scores and collected blood samples to measure FBG and PDW levels. The relationship between FBG and NIHSS scores moderated by PDW was analyzed by linear curve fitting analysis, multiple linear regression analysis, and moderated mediation analysis respectively. Results: In the tertile grouping based on FBG, both PDW and NIHSS scores of AIS patients demonstrated an increase corresponding with rising levels of FBG (p<0.001 for both). Multiple linear regression analysis revealed that, the ß coefficients (95% CI) for the relationship between FBG and NIHSS scores were 1.49 (1.27-1.71, p<0.01) post-adjustment for potential confounders. The ß coefficients (95% CI) for the relationship between FBG and PDW were 0.02 (0.01-0.04, p<0.01) post-adjustment. Likewise, for the relationship between PDW and NIHSS scores, the ß coefficients (95% CI) were 4.33 (3.07-5.59, p<0.01) after adjustment. These positive association remained consistent in sensitivity analysis and hierarchical analysis. Smoothed plots suggested that there are linear relationships between FBG and PDW and NIHSS scores respectively. Further mediation analysis indicated that increased PDW significantly (p<0.01) mediated 5.91% of FBG-associated increased NIHSS scores. Conclusion: This study suggested that FBG levels were associated with NIHSS scores, and the FBG-associated neurological impairment may be partially mediated by PDW. These findings underscore the importance of monitoring FBG and PDW levels in AIS patients, potentially guiding risk intervention strategies.

Fasting blood glucose level and risk of all-cause and cause-specific mortality in peritoneal dialysis patients.

BACKGROUND: Glycemic control is crucial in peritoneal dialysis (PD) patients with diabetes. Although fasting blood glucose (FBG) is the most commonly used index to measure blood glucose levels, there is currently no evidence supporting the association between FBG level and mortality risk in PD patients. METHODS: A total of 3548 diabetic PD patients between 2002 and 2018 were enrolled from the National Health Insurance Service database of Korea. We investigated the association between FBG levels and the risk of all-cause and cause-specific mortality. RESULTS: Patients with FBG levels 80-99 mg/dL exhibited the highest survival rates, whereas those with FBG levels ≥180 mg/dL had the lowest survival rates. Compared with FBG levels 80-99 mg/dL, the adjusted hazard ratios and 95% confidence interval for all-cause mortality significantly increased as follows: 1.02 (0.87-1.21), 1.41 (1.17-1.70), 1.44 (1.18-2.75), and 2.05 (1.73-2.42) for patients with FBG 100-124 mg/dL, FBG 125-149 mg/dL, FBG 150-179 mg/dL, and FBG ≥180 mg/dL, respectively. The risk for all-cause mortality also showed an increasing pattern in patients with FBG levels <80 mg/L. The risk of cardiovascular death significantly increased as FBG levels exceeded 125 mg/dL. However, the risk of infection-related and malignancy-related deaths did not show a significant increase with increasing FBG levels. CONCLUSION: There was an increase in the risk of all-cause mortality as FBG levels exceeded 125 mg/dL in PD patients with diabetes, and the risk of cardiovascular death showed a strong correlation with FBG levels compared with other causes of death.

Outdoor light at night is a modifiable environmental factor for metabolic syndrome: The 33 Communities Chinese Health Study (33CCHS).

Metabolic syndrome (MetS) is a significant public health problem and presents an escalating clinical challenge globally. To combat this problem effectively, urgent measures including identify some modifiable environmental factors are necessary. Outdoor artificial light at night (LAN) exposure garnered much attention due to its impact on circadian rhythms and metabolic process. However, epidemiological evidence on the association between outdoor LAN exposure and MetS remains limited. To determine the relationship between outdoor LAN exposure and MetS, 15,477 adults participated the 33 Communities Chinese Health Study (33CCHS) in 2009 were evaluated. Annual levels of outdoor LAN exposure at participants' residential addresses were assessed using satellite data from the Defense Meteorological Satellite Program (DMSP) Operational Linescan System (OLS). Generalized linear mixed effect models were utilized to assess the association of LAN exposure with MetS and its components, including elevated waist circumference (WC), triglycerides (TG), blood pressure (BP), fasting blood glucose (FBG), and reduced high-density lipoprotein cholesterol (HDL-C). Effect modification by various social demographic and behavior factors was also examined. Overall, 4701 (30.37 %) participants were defined as MetS. The LAN exposure ranged from 6.03 to 175.00 nW/cm2/sr. The adjusted odds ratio (OR) of MetS each quartile increment of LAN exposure were 1.43 (95 % CI: 1.21-1.69), 1.44 (95 % CI: 1.19-1.74) and 1.52 (95 % CI: 1.11-2.08), respectively from Q2-Q4. Similar adverse associations were also found for the components of MetS, especially for elevated BP, TG and FBG. Interaction analyses indicated that the above associations were stronger in participants without habitual exercise compared with those with habitual exercise (e.g. OR were 1.52 [95 % CI: 1.28-1.82] vs. 1.27 [95 % CI, 1.04-1.55], P-interaction = 0.042 for MetS). These findings suggest that long-term exposure to LAN can have a significant deleterious effect on MetS, potentially making LAN an important modifiable environmental factor to target in future preventive strategies.

A new classification method for gestational diabetes mellitus: a study on the relationship between abnormal blood glucose values at different time points in oral glucose tolerance test and adverse maternal and neonatal outcomes in pregnant women with gestational diabetes mellitus.

Background: Gestational diabetes mellitus (GDM) can lead to various adverse pregnancy outcomes for both mothers and infants, including gestational hypertension, premature rupture of membranes, preterm birth, macrosomia, large for gestational age (LGA) infants, and neonatal hypoglycemia. Previous studies have mainly focused on the overall risk of GDM for adverse maternal and neonatal outcomes, but there has been limited research specifically investigating the relationship between different patterns of abnormal oral glucose tolerance test (OGTT) results and adverse maternal and neonatal outcomes. Objective: The study aimed to analyze the maternal and neonatal outcomes among GDM women with different OGTT patterns and to explore a new classification method capable of stratifying GDM into high-risk (GDM-HR) and low-risk subtypes based on OGTT results. Study Design: We conducted a retrospective cohort study at the Women's Hospital, School of Medicine, Zhejiang University, spanning from November 1, 2015, to April 30, 2018. During the study period, a total of 3268 cases of GDM were enrolled. Based on the results of the OGTT, these GDM cases were classified into 7 subtypes, and the composition ratio of each subtype and their maternal and neonatal outcomes were analyzed. Innovatively, we proposed to categorize GDM-HR (characterized by elevated fasting blood glucose [FBG] levels, including T0, T0+1, T0+2, and T0+1+2) and low-risk GDM (GDM-LR, without elevated FBG, including T1, T2, and T1+2) and compared the maternal and neonatal outcomes between the two subtypes. Results: (1) In this cohort of 3268 GDM cases, the composition ratios of the 7 GDM subtypes were as follows: T0 (7.9%, n=260), T1 (24.2%, n=791), T2 (27.4%, n=897), T0+1 (5.4%, n=175), T0+2 (1.7%, n=56), T1+2 (26.2%, n=855), and T0+1+2 (7.2%, n=234). (2) GDM subtypes with elevated FBG levels (GDM-HR) exhibit more severe adverse prognostic outcomes compared to those without elevated FBG levels (GDM-LR). (3) Multiple logistic regression analysis revealed that compared to the GDM-LR group, the GDM-HR group showed increased fetal birth weight (by approximately 150 grams), and had higher rates of cesarean section (adjusted odds ratio [aOR]: 1.45, 95% confidence interval [CI]: 1.19-1.76), hypertensive disorders of pregnancy (aOR: 1.78, 95% CI: 1.35-2.35), preterm birth (aOR: 1.59, 95% CI: 1.17-2.16), macrosomia (aOR: 2.66, 95% CI: 2.07-3.43), LGA infants (aOR: 2.46, 95% CI: 2.05-2.97), and neonatal hypoglycemia (aOR: 2.00, 95% CI: 1.37-2.91). Partial correlation analysis shows a positive correlation between fetal birth weight and FBG levels, with r=0.222, P<.001. Multiple linear regression indicates that for every 1 mmol/L increase in FBG, the fetal weight is estimated to increase by approximately 188 grams. Conclusion: The composition ratio of GDM subtypes with elevated FBG (GDM-HR) is relatively low within GDM cases, yet it presents with a higher risk of adverse outcomes compared to subtypes without elevated FBG (GDM-LR), warranting increased attention from obstetricians. Applying this new classification method in clinical practice enables better differentiation and individualized management of GDM.

Triglyceride-Glucose Index, Modifiable Lifestyle, and Risk of Colorectal Cancer: A Prospective Analysis of the Korean Genome and Epidemiology Study.

BACKGROUND: Insulin-mediated pathways plausibly explain the pathogenesis of colorectal cancer (CRC). The triglyceride-glucose index (TyG) is a surrogate of insulin resistance (IR), but its association with CRC in the Korean population has not been evaluated. METHODS: From the 2004-2013 Korean Genome and Epidemiology Study, 98,800 participants aged 40-69 years were followed through 2020. Data on CRC incidence were obtained from the Korean National Cancer Center registry. Cox regression models and restricted cubic splines were fitted to examine the association between the TyG; In [(triglycerides) × (fasting glucose)/2] and CRC incidence. Joint effects of modifiable lifestyle factors and TyG on CRC risk were also investigated. RESULTS: Median follow-up time was 10.6 years, and 699 CRC cases were observed. A unit-increment in TyG was associated with increased risk of CRC combined (hazard ratio, HR: 1.28, and 95% confidence interval, CI: 1.12-1.46), colon (1.29, 1.10-1.54), and rectal cancer (1.24, 1.01-1.52). Associations were dose-dependent, with linear associations observed for CRC and colon, but non-linear associations were observed for rectal cancer. A high TyG index (above 8.4) combined with overweight/obesity was linked to an increased risk of CRC (1.31, 1.07-1.61) and colon cancer (1.33, 1.03-1.72). When combined with low fruit and vegetable intake, the risks were higher for CRC (1.40, 1.12-1.74) and colon cancer (1.57, 1.18-2.09). Combined with high red meat consumption, the risks were elevated for CRC (1.32, 1.05-1.65) and colon cancer (1.52, 1.15-2.02). CONCLUSIONS: A high TyG index was associated with a higher risk of colorectal cancer, and the risk was highest among participants with a high BMI, low fruit and vegetable intake, and high intake of red meat, suggesting a role of both insulin resistance and modifiable lifestyle in colorectal cancer development.

Associations between Global Diet Quality Score and Risk of Metabolic Syndrome and Its Components: Tehran Lipid and Glucose Study.

Background: Various food quality indicators have been proposed as tools for predicting metabolic syndrome (MetS). This study investigated the association between global diet quality score (GDQS) and the risks of developing MetS and its components. Methods: In this secondary analysis, we included elective adult participants (n=4,548) from the Tehran Lipid and Glucose Study. Dietary data were collected by a valid and reliable semi-quantitative food frequency questionnaire. MetS was defined according to the Iranian modified National Cholesterol Education Program. Multivariable Cox proportional hazard regression models were used to estimate the incidence of MetS in association with GDQS. Results: This study involved 1,762 men and 2,786 women with a mean±standard deviation age of 38.6±14.3 and 35.9±11.8 years, respectively. A total of 1,279 subjects developed MetS during the mean follow-up of 6.23 years. Incidence of MetS was associated with GDQS (hazard ratio [HR], 1.00; 0.90 [95% confidence interval, CI, 0.82 to 0.98]; 0.84 [95% CI, 0.76 to 0.91]; 0.80 [95% CI, 0.73 to 0.89]; P for trend <0.001) after adjusting for confounding variables. The healthy food group component of GDQS was related to MetS incidence. GDQS in the range of 12%-17% in the fourth quartile was associated with a decrease in incidence of MetS components. Both healthy and unhealthy food group components of the GDQS decreased the incidence of high triglycerides, high blood pressure, and high fasting blood glucose. Conclusion: Higher GDQS was associated with a lower risk of the incidence of MetS or its components among Tehranian adults. Higher intake of healthy food group components and lower consumption of unhealthy food group components of the GDQS predicted lower MetS incidence and risk factors.

Evaluating the diagnostic potential of gelsolin in gestational diabetes mellitus: A case-control study.

OBJECTIVES: To investigate the association between gestational diabetes mellitus (GDM) and blood levels of gelsolin (an inflammation-related protein thought to be reduced in type 2 diabetes mellitus) and to determine its role in potential diagnosis and neonatal outcomes. METHODS: This prospective case-control study was conducted at Ankara Etlik City Hospital between November 2023 and February 2024 with 40 pregnant women with GDM and 40 normoglycemic women. Pregnant women aged 18-40 years who were in their 24th to 28th week of pregnancy and had no known chronic disease were included in the present study and it was investigated as to whether there was a significant difference between the two groups in terms of gelsolin levels and neonatal outcome. RESULTS: Gelsolin level was statistically significantly lower in the GDM group than in the control group (P = 0.004). In patients with fasting blood glucose <96 mg/dL, maternal serum gelsolin levels were associated with GDM, with a cut-off of 15.38 or less, showing a sensitivity of 73%, a specificity of 67%, and an area under the curve (AUC) of 0.703 (95% confidence interval [CI] 0.576-0.810, P = 0.002). There was no difference between groups in terms of adverse obstetric outcomes, but gelsolin levels were associated with composite neonatal adverse outcome (macrosomia, Apgar score at 5 min less than 7, preterm birth, need for neonatal intensive care), with a cut-off value of 16.66 or less showing a sensitivity of 84.6%, specificity of 40.7% and AUC of 0.644 (95% CI 0.529-0.748, P = 0.031). CONCLUSION: Gelsolin could potentially serve as a promising biomarker for the diagnosis of GDM.

Risk factors and diagnostic performance of predictors as a screening technique for gestational diabetes mellitus: a retrospective cross-sectional study.

Background: Gestational diabetes mellitus (GDM) is a condition that can have negative impacts on both mother and baby. Detecting GDM early is crucial, and fasting plasma glucose (FPG) has been suggested as a possible screening method. This retrospective cross-sectional study aims to investigate potential risk factors and complications associated with GDM. Additionally, it aims to establish the diagnostic performance of predictive factors as a screening method for GDM. Methods: Data were collected from the medical records of 247 pregnant women who visited outpatient Obstetrics clinics between 2021 and 2022. The study investigated potential risk factors and complications associated with GDM, including impaired fasting glucose/impaired glucose tolerance (IFG/IGT), family history of diabetes mellitus (DM), and medical conditions. Moreover, the study evaluated the diagnostic performance of potential predictors as screening techniques for GDM. Results: The study found that IFG/IGT (P<0.001), a history of GDM (P<0.001), and a family history of DM (P=0.022) were significant factors associated with GDM. Healthy individuals had a lower risk of developing GDM (P<0.001). No significant correlation was found between GDM and macrosomia, hypertension, polycystic ovarian syndrome, or other obstetric complications. Although a weak association was observed between fasting blood glucose levels during the first trimester and GDM, it was not significant. Conclusion: In conclusion, this study found that IFG/IGT and a past history of GDM were significantly associated with GDM. Additionally, a family history of diabetes increased the likelihood of developing GDM, while no significant association was found between GDM and other obstetric complications. Although a weak association was observed between fasting blood glucose levels during the first trimester and GDM, it was not statistically significant.

Cut-off value of glycated hemoglobin A1c for detecting diabetic retinopathy in the Chinese population.

BACKGROUND: Glycated hemoglobin A1c (HbA1c) is considered the most suitable for diabetes mellitus diagnosis due to its accuracy and convenience. However, the effect of HbA1c on diabetic retinopathy (DR) in the Han and Korean populations in Jilin, China, remains inconclusive. AIM: To determine the best cut-off of HbA1c for diagnosing DR among the Chinese. METHODS: This cross-sectional study included 1933 participants from the Yanbian area of Jilin Province, China. Trained investigators employed a questionnaire-based survey, physical examination, laboratory tests, and fundus photography for the investigation. The best cut-off value for HbA1c was established via the receiver operating characteristic curve. The factors associated with HbA1c-associated risk factors were determined via linear regression. RESULTS: The analysis included 887 eligible Chinese Han and Korean participants, 591 of whom were assigned randomly to the training set and 296 to the validation set. The prevalence of DR was 3.27% in the total population. HbA1c of 6.2% was the best cut-off value in the training set, while it was 5.9% in the validation set. In both Chinese Han and Korean populations, an HbA1c level of 6.2% was the best cut-off value. The optimal cut-off values of fasting blood glucose (FBG) ≥ 7 mmol/L and < 7 mmol/L were 8.1% and 6.2% respectively in Han populations, while those in Korean populations were 6.9% and 5.3%, respectively. Age, body mass index, and FBG were determined as the risk factors impacting HbA1c levels. CONCLUSION: HbA1c may serve as a useful diagnostic indicator for DR. An HbA1c level of 6.2% may be an appropriate cut-off value for DR detection in the Chinese population.