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1.
JAMA Cardiol ; 2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31365039

RESUMO

Importance: Whether optimal cardiovascular health metrics may counteract the risk of cardiovascular events among patients with prediabetes or diabetes is unclear. Objective: To investigate the associations of ideal cardiovascular health metrics (ICVHMs) with subsequent development of cardiovascular disease (CVD) among participants with prediabetes or diabetes as compared with participants with normal glucose regulation. Design, Setting, and Participants: The China Cardiometabolic Disease and Cancer Cohort Study was a nationwide, population-based, prospective cohort study of 20 communities from various geographic regions in China. The study included 111 765 participants who were free from CVD or cancer at baseline. Data were analyzed between 2011 and 2016. Exposures: Prediabetes and diabetes were defined according to the American Diabetes Association 2010 criteria. Seven ICVHMs were adapted from the American Heart Association recommendations. Main Outcomes and Measures: The composite of incident fatal or nonfatal CVD, including cardiovascular death, myocardial infarction, stroke, and hospitalized or treated heart failure. Results: Of the 111 765 participants, 24 881 (22.3%) had normal glucose regulation, 61 024 (54.6%) had prediabetes, and 25 860 (23.1%) had diabetes. Mean (SD) age ranged from 52.9 (8.6) years to 59.4 (8.7) years. Compared with participants with normal glucose regulation, among participants with prediabetes, the multivariable-adjusted hazard ratio for CVD was 1.34 (95% CI, 1.16-1.55) for participants who had 1 ICVHM or less and 0.57 (95% CI, 0.43-0.75) for participants who had at least 5 ICVHMs; among participants with diabetes, the hazard ratios for CVD were 2.05 (95% CI, 1.76-2.38) and 0.80 (95% CI, 0.56-1.15) for participants who had 1 ICVHM or less and at least 5 ICVHMs, respectively. Such pattern of association between ICVHM and CVD was more prominent for participants younger than 55 years (prediabetes and at least 5 ICVHMs: hazard ratio [HR], 0.32; 95% CI, 0.16-0.63; 1 ICVHM or less: HR, 1.58, 95% CI, 1.13-2.21; diabetes and at least 5 ICVHMs: HR, 0.99; 95% CI, 0.44-2.26; 1 ICVHM or less: HR, 2.46; 95% CI, 1.71-3.54; compared with normal glucose regulation) than for participants 65 years or older (prediabetes and at least 5 ICVHMs: HR, 0.80; 95% CI, 0.50-1.26; 1 ICVHM or less: HR, 1.01; 95% CI, 0.79-1.31; diabetes and at least 5 ICVHMs: HR, 0.79; 95% CI, 0.46-1.35; 1 ICVHM or less: HR, 1.73; 95% CI, 1.36-2.22, compared with normal glucose regulation; P values for interaction ≤.02). Additionally, the hazard ratio for CVD per additional ICVHM was 0.82 (95% CI, 0.79-0.86) among participants with prediabetes and was 0.85 (95% CI, 0.80-0.89) among participants with diabetes. Conclusions and Relevance: Participants with prediabetes or diabetes who had 5 or more ICVHMs exhibited lower or no significant excess CVD risks compared with the participants with normal glucose regulation.

2.
J Diabetes ; 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170331

RESUMO

BACKGROUND: This study investigated the association between birth weight and diabetes in a Chinese population, and the effects of body mass index (BMI) and lifestyle factors in later life on this association. METHODS: Data from 49 118 participants aged ≥40 years with recalled birth weight from the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study, a nationwide population-based cohort, were used. Diabetes diagnosis was based on oral glucose tolerance tests and HbA1c measurements. Logistic regression models were used to evaluate the association of birth weight and risk of diabetes in later life. RESULTS: Increased risk of diabetes was associated with lower or higher birth weight. Compared with individuals with a birth weight of 2500 to 3499 g, the odds ratios (ORs) and 95% confidence intervals (CIs) of diabetes for individuals with a birth weight of <2500, between 3500 and 3999, and ≥4000 g were 1.28 (1.11-1.47), 1.11 (1.04-1.19), and 1.20 (1.07-1.34), respectively. Significant associations were prominent in participants with a current BMI ≥24 kg/m2 , but not detected in those with a normal BMI (OR 1.20 [95% CI 0.96-1.49], 1.11 [95% CI 0.98-1.25], and 1.10 [95% CI 0.89-1.37], respectively). Moreover, there was no increased risk of diabetes in individuals with a low birth weight but with healthy dietary habits (OR 0.94; 95% CI 0.68-1.29) or ideal physical activity (OR 1.41; 95% CI 0.97-2.04). CONCLUSIONS: A U-shaped association was observed between birth weight and the risk of diabetes. Healthy lifestyles (healthy dietary habits or ideal physical activity) may eliminate the negative effects of low birth weight in the development of diabetes, but not the effect of high birth weight.

3.
Diabetes Care ; 42(8): 1539-1548, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31152120

RESUMO

OBJECTIVE: Uncertainty remains regarding the predictive value of various glycemic measures as they relate to the risk of diabetes and its complications. Using the cutoffs recommended by the American Diabetes Association's 2010 criteria, we determined the associations of fasting plasma glucose (FPG), 2-h postload glucose (2h-PG), and HbA1c with the outcomes. RESEARCH DESIGN AND METHODS: Baseline medical history, FPG, 2h-PG, and HbA1c were obtained from a population-based cohort of 193,846 adults aged ≥40 years in China during 2011-2012. A follow-up visit was conducted during 2014-2016 in order to assess incident diabetes, cardiovascular disease (CVD), cancer, and mortality. RESULTS: We documented 8,063 cases of diabetes, 3,014 CVD-related events, 1,624 cases of cancer, and 2,409 deaths during up to 5 years of follow-up. Multivariable-adjusted risk ratios (95% CIs) of diabetes associated with prediabetes based on FPG of 100-125 mg/dL, 2h-PG of 140-199 mg/dL, or HbA1c of 5.7-6.4% (39-47 mmol/mol) were 1.60 (1.43-1.79), 2.72 (2.43-3.04), and 1.49 (1.36-1.62), respectively. Restricted cubic spline analyses suggested J-shaped associations of FPG, 2h-PG, and HbA1c levels with CVD, cancer, and mortality. Multivariable-adjusted hazard ratios (95% CIs) associated with untreated diabetes based on FPG ≥126 mg/dL, 2h-PG ≥200 mg/dL, or HbA1c ≥6.5% (48 mmol/mol) were 1.18 (1.05-1.33), 1.31 (1.18-1.45), and 1.20 (1.07-1.34) for CVD; 1.10 (0.92-1.32), 1.44 (1.25-1.67), and 1.08 (0.92-1.28) for cancer; and 1.37 (1.20-1.57), 1.57 (1.41-1.76), and 1.33 (1.17-1.52) for mortality, respectively. 2h-PG remained significantly associated with outcomes in models including FPG and HbA1c as spline terms. Furthermore, 2h-PG significantly improved the ability of the C statistic to predict diabetes, CVD, and mortality. CONCLUSIONS: 2h-PG remains independently predictive of outcomes in models including FPG and HbA1c. Therefore, in addition to FPG and HbA1c, routine testing of 2h-PG should be considered in order to better assess the risks of outcomes.

4.
J Diabetes Investig ; 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31197979

RESUMO

AIMS/INTRODUCTION: The purpose of the present study was to observe the relationship between serum α-klotho (KL) protein level and diabetic retinopathy (DR), and to further examine the effects of KL protein on apoptosis induced by palmitic acid (PA) in human retinal endothelial cells. MATERIALS AND METHODS: A total of 17 healthy people and 60 type 2 diabetes patients were included. According to the results from fundus fluorescein angiography, the diabetes patients were divided into three subgroups: without DR, non-proliferative DR and proliferative DR. Serum KL level was measured by enzyme-linked immunosorbent assay. In vitro, human retinal endothelial cells were exposed to PA with or without KL protein. Apoptosis rates were analyzed by flow cytometry analysis. Apoptotic-related protein expressions were detected by western blotting analysis. RESULTS: Serum KL level was lower in diabetes patients than that in healthy participants (P = 0.007), and was gradually decreased among the without DR, non-proliferative DR and proliferative DR subgroups (P = 0.045). A logistic regression analysis showed that after adjusting for the other confounding factors, serum KL level was independently and negatively related with DR (P = 0.049). Furthermore, the increased apoptosis rates induced by PA were inhibited with the addition of KL protein. Consistently, KL protein reversed the expression levels of the increased pro-apoptotic protein Bax and the decreased anti-apoptotic protein Bcl-2 induced by PA. However, the anti-apoptotic effect of KL protein was attenuated by LY294002 through the phosphatidylinositol 3 kinase-serine∕threonine kinase pathway. CONCLUSIONS: The data suggested that KL protein was probably a potential protective factor against retinopathy in type 2 diabetes patients.

5.
J Diabetes Investig ; 9(5): 1128-1134, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29432659

RESUMO

AIMS/INTRODUCTION: To detect serum adipsin levels in individuals with different glucose tolerance, and investigate the relationship between adipsisn and the first phase of insulin secretion. MATERIALS AND METHODS: A total of 56 patients with newly diagnosed type 2 diabetes mellitus, 36 patients with impaired glucose tolerance (IGT) and 45 individuals with normal glucose tolerance were enrolled. Intravenous glucose tolerance tests were carried out to evaluate pancreatic ß-cell function. The serum levels of adipsin, interleukin-1ß and high-sensitivity C-reactive protein were assayed. RESULTS: Serum adipsin levels were significantly lower in the type 2 diabetes mellitus and the IGT patients than those in the normal glucose tolerance group (P < 0.05). The acute insulin response and area under the curve showed a progressive decrease in the normal glucose tolerance and IGT groups, and decreased to the lowest levels in the type 2 diabetes mellitus group (P < 0.05). Adipsin was found to be negatively correlated with waist-to-hip ratio, free fatty acid, fasting plasma glucose, 2-h postprandial plasma glucose, glycated hemoglobin, homeostasis model assessment of insulin resistance, interleukin-1ß and high-sensitivity C-reactive protein (P < 0.05 or P < 0.001), and positively correlated with homeostasis model assessment of ß-cell function, high-density lipoprotein cholesterol, the area under the curve of the first phase insulin secretion and acute insulin response (P < 0.05 or P < 0.001). Stepwise multiple regression analysis showed that homeostasis model assessment for ß-cell function and acute insulin response were independently related to adipsin (P < 0.05). CONCLUSIONS: Serum adipsin levels were lower in type 2 diabetes mellitus and IGT patients, and correlated with the first phase of insulin secretion. Adipsin might be involved in the pathology of type 2 diabetes mellitus.

6.
J Diabetes ; 10(5): 408-418, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29144059

RESUMO

BACKGROUND: A number of primary studies suggested that active smoking could be independently associated with incident diabetes. However less is known about the effect of active smoking and smoking cessation on glycemic control in patients with diabetes. The aim of this study was to evaluate the associations of active smoking and smoking cessation with glycemic control in diabetic patients. METHODS: The present was a cross-sectional study of 10 551 men and 15 297 women with diabetes from the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study. Risk factors for glycemic control and the association of active smoking with glycemic control were evaluated using logistic regression models. Poor glycemic control was defined as HbA1c ≥7.0%. RESULTS: Current smokers have an increased risk of poor glycemic control, and the multivariable-adjusted odds ratio (OR) and 95% confidence intervals (CI) of HbA1c ≥7.0% with current smoking were 1.49 (1.35-1.66) in men and 1.56 (1.13-2.15) in women. Further analysis demonstrated a dose-dependent relationship between active smoking and the risk of poor glycemic control in men. Former smokers who quit smoking for <10 years remained at increased risk of poor glycemic control, with the risk leveling off after 10 years of smoking cessation compared with non-smokers, but risk in former smokers was significantly lower than that in current smokers. CONCLUSIONS: Active smoking is a modifiable risk factor for poor glycemic control in Chinese diabetic patients.


Assuntos
Glicemia/efeitos dos fármacos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Abandono do Hábito de Fumar , Fumar/efeitos adversos , Adulto , Idoso , Biomarcadores/sangue , Glicemia/metabolismo , Distribuição de Qui-Quadrado , China/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Hemoglobina A Glicada/metabolismo , Humanos , Incidência , Modelos Logísticos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Prevalência , Fatores de Risco , Fumar/sangue , Fumar/epidemiologia , Fatores de Tempo
7.
Obes Res Clin Pract ; 12(1S1): 9-15, 2018 Jan - Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27554132

RESUMO

AIMS: To examine circulating betatrophin concentrations in subjects with different glucose tolerance status and to investigate the relationship between serum betatrophin levels and first-phase of glucose-stimulated insulin secretion. METHODS: Serum betatrophin concentrations were measured in 110 age- and sex-matched subjects: 47 newly diagnosed type 2 diabetes mellitus (T2DM), 29 impaired glucose tolerance (IGT) and 34 normal glucose tolerance (NGT). Oral glucose tolerance test and intravenous glucose tolerance test were performed to assess glucose tolerance and first-phase of glucose-stimulated insulin secretion. RESULTS: Serum betatrophin levels were significantly higher in the T2DM and IGT group than in the NGT group (2.10±1.16ng/mL vs 0.77±0.44ng/mL, 1.73±1.28ng/mL vs 0.77±0.44ng/mL; P<0.01). The AIR and AUC among the three groups showed a progressive decrease from the NGT to IGT group with the lowest value in the T2DM group (P<0.01). Betatrophin were found to be positively correlated with BMI, waist circumference (WC), homeostatic model assessment of insulin resistance (HOMA-IR) and triglyceride (TG), and inversely associated with HDL-c (all P<0.01), but not significantly correlated with 0-10min insulin the area under the curve (AUC) and acute insulin response (AIR) (P>0.05). Stepwise multiple regression analysis showed that HOMA-IR and TG were independently related to betatrophin (P<0.05). CONCLUSION: Serum betatrophin concentrations were higher in T2DM and IGT, and were closely related to glucolipid disorder, insulin resistance, but not related to the first-phase of glucose-stimulated insulin secretion.

9.
Exp Clin Endocrinol Diabetes ; 125(8): 547-553, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28704853

RESUMO

Aim To investigate the RBP4/Lp-PLA2/Netrin-1 signal regulation of cognitive function impairment in diabetic nephropathy patients with silent cerebral infarction (SCI). Methods One-hundred patients newly diagnosed with diabetic nephropathy patients were included. The patients were divided into SCI group and NSCI group according to the radiological data. The degrees of cognitive dysfunction were evaluated. Serum RBP4 concentrations were determined by ELISA and protein expressions of Lp-PLA2 and Netrin-1 were determined by Western Blot. Results Compared with NSCI group, the cognitive function of patients in SCI group was impaired, the concentrations of RBP4 and the expressions of Lp-PLA2 and Netrin-1 increased (P<0.05). RBP4 concentrations were positively correlated with the cognitive dysfunction of SCI patients. Moreover, there existed a regression correlation between them. Conclusion RBP4 may be used as a predictive factor of diabetic nephropathy patients complicated with SCI and is positively correlated with cognitive dysfunction. RBP4/Lp-PLA2/Netrin-1 pathway activation may be one of the occurrence mechanisms in diabetic nephropathy complicated with SCI.


Assuntos
1-Alquil-2-acetilglicerofosfocolina Esterase/sangue , Infarto Cerebral/sangue , Disfunção Cognitiva/sangue , Nefropatias Diabéticas/sangue , Netrina-1/sangue , Proteínas Plasmáticas de Ligação ao Retinol/metabolismo , Transdução de Sinais , Idoso , Infarto Cerebral/etiologia , Disfunção Cognitiva/etiologia , Nefropatias Diabéticas/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
10.
Angiology ; 68(8): 716-721, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28743220

RESUMO

We assessed the correlation between the visceral adiposity index (VAI; a useful indicator of adipose distribution and function) and homeostatic model assessment of insulin resistance (HOMA-IR) in participants with normal waist circumference. A cross-sectional study was conducted, which included 1834 Chinese adults. The blood pressure, anthropometric measurements, fasting and postprandial blood glucose, fasting insulin, and lipid profiles were measured. The VAI and HOMA-IR were calculated. Participants were divided into 4 groups according to the HOMA-IR level, and the correlation between the VAI and HOMA-IR was analyzed. The VAI gradually increased across the HOMA-IR quartiles ( P < .05), and a Pearson correlation analysis showed that VAI was positively related to the HOMA-IR ( P < .001) in males and females. After adjusting for the other covariates, VAI was independently correlated with the HOMA-IR. A logistic regression analysis indicated that VAI elevation was the main risk factor for the increased HOMA-IR in both genders. Overall, the VAI was closely correlated with the HOMA-IR in a population without central obesity.

11.
J Steroid Biochem Mol Biol ; 168: 71-90, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28216152

RESUMO

Diabetic cardiomyopathy (DCM) can increase the risk of heart failure and death in diabetic patients. However, no effective approaches are available to prevent its progression and development. Studies have shown that vitamin D is greatly implicated in cardiac hypertrophy and fibrosis, and there is a high prevalence of vitamin D deficiency in diabetic patients. In this study, we investigated whether 1,25-Dihydroxyvitamin-D3 (1,25D3) can improve DCM through a vitamin D receptor (VDR)-dependent mechanism associated with autophagy and the ß-catenin/T-cell factor/lymphoid enhancer factor (TCF4)/glycogen synthase kinase-3ß (GSK-3ß)/mammalian target of rapamycin (mTOR) pathway. In this study, streptozotocin (STZ)-induced type 1 diabetic rats were established and were treated with 1,25D3 and/or chloroquine and/or VDR gene silencing for 8 weeks before being sacrificed. Compared with untreated diabetic rats, 1,25D3 partly attenuated the myocardial hypertrophy and interstitial fibrosis, improved cardiac function and restored the impaired cardiac autophagy in diabetic rats, all of which were reversed by silencing the VDR gene in diabetic rats. In high-glucose cultured H9C2 cells, 1,25D3 increased autophagy in a dose-dependent manner. Besides, the ß-catenin/TCF4/GSK-3ß and mTOR signaling were activated both in diabetic rats and in high-glucose cultured H9C2 cells. Treatment with 1,25D3 inhibited the ß-catenin/TCF4/GSK-3ß and mTOR signaling in H9C2 cells, whereas co-treatment with lithium chloride (LiCl) reversed this situation and abolished the beneficial effect of 1,25D3 on autophagy. These data suggest that 1,25D3 may improve DCM in type 1 diabetic rats by modulating autophagy through the ß-catenin/TCF4/GSK-3ß and mTOR pathway. Vitamin D may exist as a new therapeutic target for the treatment of DCM.


Assuntos
Autofagia/efeitos dos fármacos , Calcitriol/farmacologia , Cardiomiopatias Diabéticas/prevenção & controle , Transdução de Sinais , Animais , Pressão Sanguínea , Linhagem Celular , Linhagem Celular Tumoral , Proteínas de Ligação a DNA/metabolismo , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Tipo 1/metabolismo , Relação Dose-Resposta a Droga , Ecocardiografia , Inativação Gênica , Glucose/metabolismo , Glicogênio Sintase Quinase 3 beta/metabolismo , Masculino , Ratos , Ratos Sprague-Dawley , Serina-Treonina Quinases TOR/metabolismo , Distribuição Tecidual , Fator de Transcrição 4 , Fatores de Transcrição/metabolismo , beta Catenina/metabolismo
12.
Mol Nutr Food Res ; 61(5)2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-27561793

RESUMO

SCOPE: Diabetic cardiomyopathy is one of the most important cardiac complications associated with diabetes. However, the mechanisms underlying diabetic cardiomyopathy remain unclear. The PARP1, SIRT1, and mTOR pathways have been implicated in cardiac diseases, and they are also associated with diabetes. 1,25(OH)2 D3 was recently recognized as a potential PARP1inhibitor in a macrophage cell line. The aim of our study was to investigate whether 1,25(OH)2 D3 can improve diabetic cardiomyopathy through a vitamin D receptor (VDR)-dependent mechanism associated with the PARP1/SIRT1/mTOR pathway. METHODS AND RESULTS: 1,25(OH)2 D3 -treated diabetic rats displayed improved left ventricular wall thickness and end-diastolic/systolic diameter, end-diastolic/systolic volume, left ventricular ejection fraction, fractional shortening, atrial natriuretic peptide, and brain natriuretic peptide gene expression, and interstitial fibrosis compared with untreated diabetic rats, while silencing the VDR gene in DM rats blocked the above results. 1,25(OH)2 D3 treatment also decreased PARP1 and increased SIRT1 expression levels and repressed the phosphorylation of mTOR. Treating neonatal cardiomyocytes with 1,25(OH)2 D3 and a PARP1 inhibitor decreased PARP1 and increased SIRT1 protein expression. CONCLUSION: The present study demonstrates that 1,25(OH)2 D3 treatment has the potential to improve diabetic cardiomyopathy in rats and suggests that VD-VDR signaling induces this protective effect against diabetic cardiomyopathy might partly through the PARP1/SIRT1/mTOR pathway.


Assuntos
Calcitriol/farmacologia , Diabetes Mellitus Tipo 1/complicações , Cardiomiopatias Diabéticas/tratamento farmacológico , Coração/fisiopatologia , Animais , Glicemia/metabolismo , Células Cultivadas , Diabetes Mellitus Experimental/tratamento farmacológico , Fibrose , Ventrículos do Coração/efeitos dos fármacos , Ventrículos do Coração/metabolismo , Hipertrofia , Masculino , Miócitos Cardíacos/efeitos dos fármacos , Miócitos Cardíacos/metabolismo , Poli(ADP-Ribose) Polimerase-1/genética , Poli(ADP-Ribose) Polimerase-1/metabolismo , Ratos , Ratos Sprague-Dawley , Receptores de Calcitriol/genética , Receptores de Calcitriol/metabolismo , Sirtuína 1/genética , Sirtuína 1/metabolismo , Serina-Treonina Quinases TOR/genética , Serina-Treonina Quinases TOR/metabolismo
13.
J Diabetes ; 9(2): 180-189, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27038292

RESUMO

BACKGROUND: The aims of the present study were to detect serum brain-derived neurotrophic factor (BDNF) protein concentrations in healthy and diabetic subjects with sleep disorders and to explore correlations among serum BDNF concentrations, metabolic parameters and inflammation. METHODS: In all, 377 eligible subjects were recruited to the study and underwent a 75-g oral glucose tolerance test. Various clinical parameters of metabolic disorders and cytokines were measured. Sleep disorders were assessed using the Pittsburgh Sleep Quality Index (PSQI). Subjects were grouped into those with normal glucose tolerance (NGT), those with NGT and sleep disorders (NGT-SDi), those with newly diagnosed type 2 diabetes mellitus (T2DM), and those with newly diagnosed T2DM and sleep disorders (T2DM-SDi). RESULTS: Serum BDNF levels were higher in the NGT-SDi and T2DM-SDi subgroups than in the NGT and T2DM groups, respectively. Multiple linear regression analysis revealed that serum BDNF concentrations were independently correlated with PSQI scores, homeostasis model assessment of insulin resistance, and HbA1c, interleukin 6 and tumor necrosis factor-α concentrations (P < 0.05 for all). Binary logistic regression analysis revealed that significant associations remained between serum BDNF concentrations and sleep disorders after adjustment for glucose- and metabolic-related factors in both the NGT-SDi and T2DM-SDi subgroups. CONCLUSIONS: Serum BDNF concentrations were higher in patients with sleep disorders and were associated with various metabolic parameters and inflammatory cytokines.


Assuntos
Fator Neurotrófico Derivado do Encéfalo/sangue , Diabetes Mellitus Tipo 2/sangue , Resistência à Insulina , Transtornos do Sono-Vigília/sangue , Grupo com Ancestrais do Continente Asiático , China , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/etnologia , Feminino , Teste de Tolerância a Glucose , Hemoglobina A Glicada/metabolismo , Humanos , Interleucina-6/sangue , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/etnologia , Inquéritos e Questionários , Fator de Necrose Tumoral alfa/sangue
14.
J Diabetes ; 9(9): 837-845, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27734593

RESUMO

BACKGROUND: Diagnosed diabetes has been associated with chronic kidney disease (CKD). However, the association between non-diabetic hyperglycemia and CKD remained uncertain. The aim of the present study was to investigate the association between different glycemic status and CKD in Chinese adults and to assess the prevalence and control of diabetes among individuals with CKD. METHODS: In all, 250 752 adults aged ≥40 years were selected from the baseline cohort of the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study. Plasma glucose concentrations and biochemical and other clinical data were collected; CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min per 1.73 m2 . RESULTS: The prevalence of CKD increased gradually with deterioration of glucose metabolic status in both men and women ( P trend < 0.001 for both). Compared with individuals with normal glucose regulation, men with prediabetes and diabetes had higher risks of prevalent CKD (prediabetes odds ratio [OR] 1.15, 95% confidence interval [CI] 1.02-1.32; newly diagnosed diabetes OR 1.27, 95% CI 1.08-1.49; previously diagnosed diabetes OR 2.05, 95% CI 1.78-2.35). Similar results were observed in women, but not among those with prediabetes. In male CKD patients with diabetes, 52.1% received antidiabetic treatment and 41.8% of those treated had effective glycemic control, higher than values for females. CONCLUSIONS: Prediabetes and diabetes were associated with an increased risk of CKD in Chinese men. Control of diabetes among Chinese CKD patients is far from optimal.


Assuntos
Glicemia/metabolismo , Hiperglicemia/epidemiologia , Falência Renal Crônica/epidemiologia , Estado Pré-Diabético/epidemiologia , Idoso , China/epidemiologia , Estudos de Coortes , Feminino , Taxa de Filtração Glomerular , Humanos , Falência Renal Crônica/sangue , Falência Renal Crônica/fisiopatologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Inquéritos e Questionários
15.
Am J Cancer Res ; 6(10): 2334-2344, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27822422

RESUMO

Hyperinsulinemia and insulin resistance were reported to play a crucial role in diabetes-cancer relationship. This study aimed to explore the associations between insulin resistance and several female cancers in a non-diabetic population. This cross-sectional study was conducted in 121,230 middle-aged and elderly non-diabetic women. Cancer diagnosis was self-reported and further validated by medical records. Insulin resistance was defined as homeostasis model assessment of insulin resistance (HOMA-IR) ≥ 2.50. The prevalence of both premenopausal and postmenopausal breast cancer, postmenopausal ovarian cancer and premenopausal endometrial cancer were higher in insulin-resistant participants than in insulin-sensitive participants (premenopausal breast cancer, 0.45 vs 0.28%; postmenopausal breast cancer, 0.86 vs 0.63%; postmenopausal ovarian cancer, 0.17 vs 0.09%; premenopausal endometrial cancer, 0.43 vs 0.25%, respectively, all P < 0.05). Individuals with insulin resistance had higher odds ratio (OR) of breast cancer, both premenopausal and postmenopausal (OR 1.98, 95% confidence interval (CI) 1.19-3.32; OR 1.29, 95% CI 1.01-1.63), postmenopausal ovarian cancer (OR 2.17, 95% CI 1.10-3.40) as well as total endometrial cancer (OR 1.47, 95% CI 1.02-2.12). Subgroup analysis revealed that the possitive association between insulin resistance and risk of prevalent breast cancer was observed in popualtion with younger age, overweight or obesity, higher education and impaired glucose tolerance (IGR). No relationships were observed for the risk of prevalent cervical cancers with insulin resistance. Non-diabetic women with insulin resistance had higher risk of prevalent breast, ovarian and endomatrial cancer, which suggests special attentions to these female cancer screening and prevention.

16.
J Diabetes Res ; 2016: 9438760, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27738641

RESUMO

Aims. To detect the association of C1q/TNF-related protein-3 (CTRP-3) and high-mobility group box-1 (HMGB-1) in subjects with prediabetes (pre-DM) and newly diagnosed type 2 diabetes (nT2DM). Methods. 224 eligible participants were included. The 75 g oral glucose tolerance test (OGTT) and several clinical parameters of metabolic disorders and cytokines were measured. All participants were divided into three groups: normal glucose tolerance (NGT, n = 62), pre-DM (n = 111), and nT2DM group (n = 56). Results. Plasma CTRP-3 concentrations were significantly lower in subjects with pre-DM and nT2DM than that of the NGT group, while plasma HMGB-1 levels were higher in pre-DM and nT2DM group compared with the NGT group (P < 0.05). A multiple linear regression analysis showed both plasma CTRP-3 and HMGB-1 concentrations were independently associated with homeostasis model assessment for insulin resistance (HOMA-IR) and interleukin-6 (IL-6) (P < 0.05 for all). Further multiple logistical regression analyses revealed that both plasma CTRP-3 and HMGB-1 levels were significantly associated with pre-DM and nT2DM after adjusting for several confounders (P < 0.001 for all). Conclusions. Circulating CTRP-3 and HMGB-1 concentrations might be promising biomarkers to predict prediabetes and type 2 diabetes.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Proteína HMGB1/sangue , Estado Pré-Diabético/sangue , Fatores de Necrose Tumoral/sangue , Adulto , Idoso , Feminino , Teste de Tolerância a Glucose , Humanos , Interleucina-6/sangue , Masculino , Pessoa de Meia-Idade
17.
BMJ Open ; 6(9): e011939, 2016 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-27609847

RESUMO

OBJECTIVES: Various studies have revealed a close association between sedentary behaviour and metabolic diseases, yet the association between sedentary time and non-alcoholic fatty liver disease (NAFLD) remains unclear. In this study, we investigated the association between sitting time and NAFLD in a Chinese male population and explored its underlying mechanism. STUDY DESIGN: A cross-sectional study. SETTING: Chongqing, China. PARTICIPANTS: Our study included 2054 male participants; all of the participants were of Han nationality. PRIMARY OUTCOME MEASURES: Sitting time was assessed using a self-reported questionnaire concerning the time devoted to sitting behaviour. Various clinical and demographic biomarkers were measured. Logistic regression analyses were used to investigate the ORs and the 95% CIs between sitting time and NAFLD. RESULTS: We found a higher proportion of NAFLD across the tertiles of sitting time (p trend=0.003). Multivariate linear regression analyses showed sitting time independently correlated with homoeostasis model assessment for insulin resistance (HOMA-IR), alanine aminotransferase, γ-glutamyl transpeptidase, body mass index, triglyceride and the high-sensitive C reactive protein (hsCRP) (all p<0.05). Further logistic regression analyses showed that longer sitting time (>7.1 hours/day) was associated with a higher prevalence of NAFLD (OR 1.09; 95% CI (1.04 to 1.67)) after adjusting for confounders. However, this association was insignificant after further adjusting for hsCRP (OR 1.03; 95% CI (0.92 to 1.84)). CONCLUSIONS: Sitting time was positively associated with the prevalence of NAFLD, and this association might be affected by inflammation.


Assuntos
Emprego , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Postura , Comportamento Sedentário , Adulto , Idoso , China/epidemiologia , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários , Fatores de Tempo
18.
Am J Epidemiol ; 184(5): 400-9, 2016 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-27530336

RESUMO

Pairs of spouses share common lifestyle factors. In a cross-sectional analysis, we investigated whether spouses of diabetic individuals had a higher prevalence of diabetes and cardiometabolic disorders in a community-based population of Chinese adults aged 40 years or older between 2011 and 2012. A total of 34,805 pairs of spouses were identified. All participants underwent a standard oral glucose tolerance test and provided detailed clinical, sociodemographic, and lifestyle information. Diabetes and multiple cardiometabolic disorders were defined according to standard criteria. Compared with participants whose spouses did not have diabetes, participants whose spouses had diabetes had higher odds of having diabetes (for men, odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.22, 1.45; for women, OR = 1.35, 95% CI: 1.24, 1.47), obesity (for men, OR = 1.34, 95% CI: 1.13, 1.59; for women, OR = 1.19, 95% CI: 1.05, 1.35), metabolic syndrome (for men, OR = 1.31, 95% CI: 1.21, 1.42; for women, OR = 1.12, 95% CI: 1.04, 1.20), and cardiovascular disease (for men, OR = 1.18, 95% CI: 1.03, 1.34; for women, OR = 1.18, 95% CI: 1.03, 1.35). The associations were independent of age, body mass index, education, family history of diabetes, cigarette smoking, alcohol drinking, physical activity, and diet. Spousal diabetes was simple and valuable information for identifying individuals at risk for diabetes and cardiometabolic disorders.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Saúde da Família/estatística & dados numéricos , Estilo de Vida , Síndrome Metabólica/epidemiologia , Cônjuges/estatística & dados numéricos , Índice de Massa Corporal , China/epidemiologia , Estudos Transversais , Feminino , Teste de Tolerância a Glucose , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Fatores de Risco
19.
J Am Heart Assoc ; 5(7)2016 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-27451464

RESUMO

BACKGROUND: Chronic kidney disease (CKD) increases cardiovascular disease (CVD) risk. However, the association of mildly reduced kidney function with CVD risk is unclear. METHODS AND RESULTS: This study investigated the association of estimated glomerular filtration rate (eGFR) with prevalent CVDs, 10-year Framingham risk for coronary heart disease (CHD), and 10-year risk of atherosclerotic cardiovascular diseases (ASCVD) in 239 832 participants from the baseline of the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal study. With an interviewer-assisted questionnaire, we collected information on CVD, including reported CHD, stroke, or myocardial infarction. Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation was used to calculate eGFR. Compared with individuals with normal eGFR (≥90 mL/min per 1.73 m(2)), those with decreased eGFR (75-89, 60-74, and <60 mL/min per 1.73 m(2)) had higher risk of prevalent obesity, diabetes mellitus, hypertension, and dyslipidemia in both men and women (P for trend all <0.001). Moreover, a significantly higher 10-year Framingham risk for CHD and 10-year risk for ASCVD was observed in both men and women with mildly decreased eGFR (60-89 mL/min per 1.73 m(2)). CONCLUSIONS: Even mildly reduced eGFR (under 90 mL/min per 1.73 m(2)) is associated with elevated 10-year Framingham risk for CHD and 10-year ASCVD risk among Chinese adults.


Assuntos
Grupo com Ancestrais do Continente Asiático , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Dislipidemias/epidemiologia , Obesidade/epidemiologia , Insuficiência Renal Crônica/epidemiologia , Adulto , Idoso , China/epidemiologia , Doença das Coronárias/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Prevalência , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia
20.
Acta Diabetol ; 53(5): 817-23, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27393006

RESUMO

AIMS: Nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of metabolic syndrome and is closely associated with insulin resistance (IR). The ZJU index is based on body mass index (BMI), fasting plasma glucose (FPG), triglycerides (TG) and the serum alanine aminotransferase-to-aspartate transaminase ratio, and is proven to be a novel and effective parameter for screening NAFLD in the Chinese population. We aimed to analyze the relationship between the ZJU index and IR. METHODS: A cross-sectional study of 3329 Chinese adults was performed. Blood pressure (BP), anthropometric measurements and biochemical parameters were tested. The BMI, ZJU index and homeostasis model assessment of IR (HOMA-IR) were calculated. RESULTS: In both genders, BP, waist circumference, BMI, total cholesterol, TG, low-density lipoprotein cholesterol levels, FPG, postprandial glucose levels, fasting insulin and the HOMA-IR gradually increased, while the HDL-C decreased across the quartiles of the ZJU index (P < 0.001). The logistic regression analysis showed that the risk of IR was significantly elevated in the highest quartile of the ZJU index. Additionally, the area under the receiver operating characteristic curve of the ZJU index was 0.833 (95 % CI 0.809-0.858) in males and 0.788 (95 % CI 0.758-0.818) in females and was relatively higher than other common variables. CONCLUSIONS: The ZJU index is a useful indicator for recognizing IR in the Chinese general population.


Assuntos
Resistência à Insulina , Síndrome Metabólica/sangue , Hepatopatia Gordurosa não Alcoólica/sangue , Adulto , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Pressão Sanguínea , China , Colesterol/sangue , Feminino , Humanos , Insulina/sangue , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Triglicerídeos/sangue , Circunferência da Cintura
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