Childhood maltreatment and the risk of impaired glucose metabolism or type 2 diabetes in young adults: Findings from the Lifelines Cohort Study.

We examined the associations between childhood maltreatment and the risk of impaired glucose metabolism (IGM) or type 2 diabetes (T2D) in young adults aged 18-35. Participants (N = 8506) from the Lifelines Cohort Study without IGM or diabetes at baseline (2007-2013) were included. Childhood maltreatment was assessed by the Childhood Trauma Questionnaire (CTQ) and incident IGM/T2D was assessed by haemoglobin A1c levels (≥5.7%) in 2014-2017. There were 223 (2.6%) cases of IGM/T2D during the follow-up period. After adjusting for sociodemographic and health/lifestyle covariates and follow-up time, only the CTQ Sexual Abuse subscale was significantly associated with IGM/T2D (RR = 1.05 [95% CI = 1.01, 1.10]). The association remained when additionally accounting for depressive and anxiety symptoms (RR = 1.05 [95% CI = 1.00, 1.09]). Childhood sexual abuse was associated with an increased risk of IGM/T2D in young adults, highlighting the long-term metabolic consequences of childhood maltreatment.

Should carbohydrate-modified diets be the first option for weight loss in people with impaired glucose metabolism? A scoping review.

While the "precision nutrition" movement is at an early stage of development, several investigations have compared low-fat versus carbohydrate (CHO)-modified diets (i.e., low-or-reduced-CHO, low glycemic index/load diets, and high-fiber) in people with normal versus impaired glucose metabolism. The purpose of this scoping review was to summarize evidence in support of the hypothesis that CHO-modified diets are more effective for weight loss among people with impaired glucose metabolism. Fifteen articles were included in this review: seven retrospective analyses of randomized clinical trials and eight prospective randomized clinical trials with prespecified hypotheses related to a diet (low-fat vs. CHO-modified) × phenotype (normal vs. impaired) interaction. Evidence in support of the hypothesis was identified in six of seven retrospective and three of eight prospective studies, which led to a recommendation of CHO-modified diets as a first-line option for people with impaired glucose metabolism. However, the evidence in support of this recommendation is relatively weak, and dietary prescriptions should consider additional contextual information that may influence overall dietary adherence. Additional and rigorous research using innovative randomized experimental approaches is needed for stronger dietary weight loss recommendations based on pretreatment glycemic status.

High prevalence of impaired glucose metabolism among children and adolescents living with HIV in Ghana.

BACKGROUND: Antiretroviral therapy (ART)-associated metabolic abnormalities, including impairment of glucose metabolism, are prevalent in adults living with HIV. However, the prevalence and pathogenesis of impaired glucose metabolism in children and adolescents living with HIV, particularly in sub-Saharan Africa, are not well characterized. We investigated the prevalence of impaired glucose metabolism among children and adolescents living with perinatally infected HIV in Ghana. METHODS: In this multicentre, cross-sectional study, we recruited participants from 10 paediatric antiretroviral treatment clinics from January to June 2022 in 10 facilities in Greater Accra and Eastern regions of Ghana. We determined impaired glucose metabolism in the study sample by assessing fasting blood sugar (FBS), insulin resistance as defined by the homeostatic model assessment for insulin resistance (HOMA-IR) index and glycated haemoglobin (HbA1c) levels. The prevalence of impaired glucose metabolism using each criterion was stratified by age and sex. The phenotypic correlates of glucose metabolism markers were also assessed among age, sex, body mass index (BMI) and waist-to-hip ratio (WHR). RESULTS: We analysed data from 393 children and adolescents living with HIV aged 6-18 years. A little over half (205/393 or 52.25%) of the children were female. The mean age of the participants was 11.60 years (SD = 3.50), with 122/393 (31.00%) aged 6-9 years, 207/393 (52.67%) aged 10-15 years, and 62/393 (15.78%) aged 16-18 years. The prevalence rates of glucose impairment in the study population were 15.52% [95% confidence interval (CI): 12.26-19.45], 22.39% (95% CI: 18.54-26.78), and 26.21% (95% CI: 22.10-30.78) using HbA1c, HOMA-IR, and FBS criteria, respectively. Impaired glucose metabolism detected by FBS and HOMA-IR was higher in the older age group, whereas the prevalence of abnormal HbA1c levels was highest among the youngest age group. Age and BMI were positively associated with FBS and HOMA-IR (p < 0.001). However, there was negative correlation of WHR with HOMA-IR (p < 0.01) and HbA1c (p = 0.01). CONCLUSION: The high prevalence of impaired glucose metabolism observed among the children and adolescents living with HIV in sub-Saharan Africa is of concern as this could contribute to the development of metabolic syndrome in adulthood.

Glucose Metabolism and Cognitive Decline in Progressive Supranuclear Palsy and Corticobasal Syndrome: A Preliminary Study.

Multiple studies have analyzed the possible correlations between diabetes and Alzheimer's disease. Less is known about the context of cognitive deterioration among patients with atypical Parkinsonian syndromes and glucose metabolism impairment. The aim of this study was to evaluate the association between the impaired glucose metabolism and cognitive decline among patients with progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS). The study included 22 patients with PSP and CBS with disease durations varying from 3 to 6 years. The levels of glycated hemoglobin (HbA1C), fasting blood glucose, fasting C-peptide and the presence of microalbuminuria were evaluated, and oral glucose tolerance tests (OGTT) were performed. Based on the OGTT results, the glycemic variability, mean glycemia, glycemia standard deviation (SD) and coefficient of variation (%CV) were calculated. All patients underwent a three-Tesla brain magnetic resonance (MRI) examination and neuropsychological cognitive assessment with the use of standardized scales: Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB). A statistical analysis revealed that poor control of glycemia with high glycemic variability and increased atrophy of the medial temporal lobe among patients with PSP and CBS correlated with worse cognitive performance independent of age or sex, even among patients who did not fulfill the criteria for diabetes. The study results indicate the importance of glucose metabolism control and optimal treatment in the context of cognition maintenance among patients with PSP and CBS. Due to the relatively small number of analyzed patients, the issue requires further assessment. To the best of our knowledge, this is the first study discussing the role of glycemic variability in atypical Parkinsonian syndromes.

The prolactin receptor gene (PRLR) is linked and associated with the risk of polycystic ovarian syndrome.

The prolactin receptor gene (PRLR) may contribute to polycystic ovarian syndrome (PCOS) since it plays important roles in physiological ovarian functions. PRLR-knockout mice have irregular cycles and subfertility and variants in or around the PRLR gene were associated in humans with female testosterone levels and recurrent miscarriage. We tested 40 variants in the PRLR gene in 212 Italian families phenotyped by type 2 diabetes (T2D) and PCOS and found two intronic PRLR-variants (rs13436213 and rs1604428) significantly linked to and/or associated with the risk of PCOS. This is the first study to report PRLR as a novel risk gene in PCOS. Functional studies are needed to confirm these results.

Association between impaired glucose metabolism and long-term prognosis at the time of diagnosis of depression: Impaired glucose metabolism as a promising biomarker proposed through a machine-learning approach.

BACKGROUND: Predicting the course of depression is necessary for personalized treatment. Impaired glucose metabolism (IGM) was introduced as a promising depression biomarker, but no consensus was made. This study aimed to predict IGM at the time of depression diagnosis and examine the relationship between long-term prognosis and predicted results. METHODS: Clinical data were extracted from four electronic health records in South Korea. The study population included patients with depression, and the outcome was IGM within 1 year. One database was used to develop the model using three algorithms. External validation was performed using the best algorithm across the three databases. The area under the curve (AUC) was calculated to determine the model's performance. Kaplan-Meier and Cox survival analyses of the risk of hospitalization for depression as the long-term outcome were performed. A meta-analysis of the long-term outcome was performed across the four databases. RESULTS: A prediction model was developed using the data of 3,668 people, with an AUC of 0.781 with least absolute shrinkage and selection operator (LASSO) logistic regression. In the external validation, the AUCs were 0.643, 0.610, and 0.515. Through the predicted results, survival analysis and meta-analysis were performed; the hazard ratios of risk of hospitalization for depression in patients predicted to have IGM was 1.20 (95% confidence interval [CI] 1.02-1.41, p = 0.027) at a 3-year follow-up. CONCLUSIONS: We developed prediction models for IGM occurrence within a year. The predicted results were related to the long-term prognosis of depression, presenting as a promising IGM biomarker related to the prognosis of depression.

Targeted proteomics identifies potential biomarkers of dysglycaemia, beta cell function and insulin sensitivity in Black African men and women.

AIMS/HYPOTHESIS: Using a targeted proteomics approach, we aimed to identify and validate circulating proteins associated with impaired glucose metabolism (IGM) and type 2 diabetes in a Black South African cohort. In addition, we assessed sex-specific associations between the validated proteins and pathophysiological pathways of type 2 diabetes. METHODS: This cross-sectional study included Black South African men (n=380) and women (n=375) who were part of the Middle-Aged Soweto Cohort (MASC). Dual-energy x-ray absorptiometry was used to determine fat mass and visceral adipose tissue, and fasting venous blood samples were collected for analysis of glucose, insulin and C-peptide and for targeted proteomics, measuring a total of 184 pre-selected protein biomarkers. An OGTT was performed on participants without diabetes, and peripheral insulin sensitivity (Matsuda index), HOMA-IR, basal insulin clearance, insulin secretion (C-peptide index) and beta cell function (disposition index) were estimated. Participants were classified as having normal glucose tolerance (NGT; n=546), IGM (n=116) or type 2 diabetes (n=93). Proteins associated with dysglycaemia (IGM or type 2 diabetes) in the MASC were validated in the Swedish EpiHealth cohort (NGT, n=1706; impaired fasting glucose, n=550; type 2 diabetes, n=210). RESULTS: We identified 73 proteins associated with dysglycaemia in the MASC, of which 34 were validated in the EpiHealth cohort. Among these validated proteins, 11 were associated with various measures of insulin dynamics, with the largest number of proteins being associated with HOMA-IR. In sex-specific analyses, IGF-binding protein 2 (IGFBP2) was associated with lower HOMA-IR in women (coefficient -0.35; 95% CI -0.44, -0.25) and men (coefficient -0.09; 95% CI -0.15, -0.03). Metalloproteinase inhibitor 4 (TIMP4) was associated with higher insulin secretion (coefficient 0.05; 95% CI 0.001, 0.11; p for interaction=0.025) and beta cell function (coefficient 0.06; 95% CI 0.02, 0.09; p for interaction=0.013) in women only. In contrast, a stronger positive association between IGFBP2 and insulin sensitivity determined using an OGTT (coefficient 0.38; 95% CI 0.27, 0.49) was observed in men (p for interaction=0.004). A posteriori analysis showed that the associations between TIMP4 and insulin dynamics were not mediated by adiposity. In contrast, most of the associations between IGFBP2 and insulin dynamics, except for insulin secretion, were mediated by either fat mass index or visceral adipose tissue in men and women. Fat mass index was the strongest mediator between IGFBP2 and insulin sensitivity (total effect mediated 40.7%; 95% CI 37.0, 43.6) and IGFBP2 and HOMA-IR (total effect mediated 39.1%; 95% CI 31.1, 43.5) in men. CONCLUSIONS/INTERPRETATION: We validated 34 proteins that were associated with type 2 diabetes, of which 11 were associated with measures of type 2 diabetes pathophysiology such as peripheral insulin sensitivity and beta cell function. This study highlights biomarkers that are similar between cohorts of different ancestry, with different lifestyles and sociodemographic profiles. The African-specific biomarkers identified require validation in African cohorts to identify risk markers and increase our understanding of the pathophysiology of type 2 diabetes in African populations.

Dietary patterns and type 2 diabetes: A cohort study / 中华内分泌代谢杂志

Objective:To explore the association between dietary patterns and the incidence of type 2 diabetes mellitus(T2DM), so as to provide insights for the prevention and management of T2DM.Methods:Participants were recruited from the " The Tianjin Chronic Inflammation and Health Cohort Study(TCLSIH)" cohort study from 2013 to 2018, who had completed the modified semiquantitative food frequency questionnaire(FFQ) and blood glucose testing( n=26 425), free of cardiovascular disease, cancer, or diabetes at baseline. The relevant information collected includes food frequency, blood glucose concentration, and other confounding factors. In this study, the correlation between dietary patterns and T2DM was tested using Cox proportional risk regression model, and the gender stratification analysis and body mass index stratification analysis of different gender groups were carried out. All statistical analysis was performed using SAS 9.3 software. Results:The age of all participants was (41.0±11.5)years, and the cumulative incidence was 3.84% for T2DM. The cumulative incidence of T2DM in male population was 5.29%, while that in female population was 2.16%. There were significant differences in the incidence of T2DM among different genders( P <0.001). The multivariable-adjusted hazard ratios( HR) and corresponding 95% CI of T2DM across the plant-based dietary pattern score were 1.09(95% CI 0.91-1.31), 0.80(95% CI 0.66-0.97), and 0.76(95% CI 0.62-0.94; Ptrend =0.010). Moreover, no statistically significant differences were observed between animal and traditional northern Chinese diets with the incidence of T2DM. Conclusions:The plant-based dietary patterns were associated with substantially lower risk of developing T2DM, and there were no significant association between animal and traditional northern Chinese dietary patterns with T2DM. Plant-based dietary patterns characterized by a variety of fruit, leeks, onions, seaweed may be beneficial to the prevention and control of T2DM.

The association between an oral glucose tolerance test performed at term pregnancy and obstetric outcomes.

Aims: Assessing the value of oral glucose tolerance test performed at term pregnancy in identifying obstetric complications. Methods: Retrospective cohort study of women with a normal 50 g glucose challenge test who also had an oral glucose tolerance test at term (defined as at or after 37 weeks of gestation). Comparison between the pathological and normal oral glucose tolerance test groups was performed. Results: The mean glucose in the glucose challenge test of women in the normal oral glucose tolerance test (n = 256) group was lower than that in the pathological oral glucose tolerance test (N = 16) group (105 ± 17 mg/dl (5.8 ± 0.9 mmol/l) vs 117 ± 13 mg/dl (6.5 ± 0.7 mmol/l), p = 0.007). Relevant obstetrical complications did not differ significantly between the groups. Of note, in the pathological oral glucose tolerance test group only one woman delivered a macrosomic infant. Conclusions: A pathological oral glucose tolerance test performed at term was unable to identify women at risk for impaired glucose metabolism-related obstetric complications and is therefore of limited clinical value and seems to be unjustified.

Exploring Minimally Invasive Approach to Define Stages of Type 1 Diabetes Remotely.

Objective: New methods are pivotal in accurately predicting, monitoring, and diagnosing the clinical manifestation of type 1 diabetes (T1D) in high-risk children. Continuous glucose monitoring (CGM) is a valuable tool for patients with T1D, but there is still a knowledge gap regarding its utility in the prediction of diabetes. The current study explored whether 10-day CGM or CGM during an oral glucose tolerance test (OGTT) performed in the laboratory or at home (home-OGTT) could be accurate in detecting stages of T1D. Research Design and Methods: Forty-six subjects 4-25 years of age carrying genetic risk for T1D were recruited and classified into the following groups: islet autoantibody (IAb) negative, one IAb, and stages 1-3 of T1D, based on the laboratory OGTT and IAb results at baseline. A 10-day CGM was initiated before the OGTT. Results: In this study, we showed that CGM was sensitive in detecting asymptomatic individuals at stage 3, and dysglycemic individuals in stage 2 of T1D both during OGTT and the 10-day period. CGM also showed significant differences in several variables during the 10-day sensoring among individuals at different stages of T1D. Furthermore, CGM showed different OGTT profiles and detected significantly more abnormal OGTT results when compared with plasma glucose. Conclusions: CGM together with home-OGTT could detect stages of T1D and offer an alternative method to confirm normoglycemia in high-risk individuals.

Dairy Product Consumption in Relation to Incident Prediabetes and Longitudinal Insulin Resistance in the Rotterdam Study.

Evidence suggests neutral or moderately beneficial effects of dairy intake on type 2 diabetes mellitus risk. Nevertheless, evidence on associations with early phases of type 2 diabetes remains inconsistent. We aimed to examine associations between dairy-type intake with prediabetes risk and longitudinal insulin resistance. The analytic sample consisted of 6770 participants (aged 62 ± 4 years, 59% female) free of (pre-)diabetes at baseline from the prospective population-based Rotterdam Study. Dairy intake was measured at baseline using food frequency questionnaires. Data on prediabetes (fasting blood glucose 6.1-6.9 mmol/L or non-fasting 7.7-11.1 mmol/L) and the longitudinal homeostatic model assessment of insulin resistance (HOMA-IR) were available from 1993-2015. Associations with these outcomes were analyzed with dairy intake in quartiles (Q4 vs. Q1) and continuous using multivariable Cox proportional hazard models and linear mixed models. During a mean follow-up of 11.3 ± 4.8 years, 1139 incident prediabetes cases were documented (18.8%). In models adjusting for sociodemographic, lifestyle and dietary factors, a higher intake of high-fat yogurt was associated with lower prediabetes risk (HRQ4vsQ1 0.70, 95% CI 0.54-0.91 and HRserving/day 0.67, 0.51-0.89). In addition, a higher intake of high-fat milk was associated with lower prediabetes risk (HRQ4vsQ1 0.81, 0.67-0.97, HRserving/day 0.88, 0.79-0.99). Associations were found for low-fat dairy, low-fat milk and total cheese with a higher prediabetes risk (HRserving/day ranging from 1.05-1.07, not significant in quartiles). Associations with longitudinal HOMA-IR were similar to prediabetes for high-fat yogurt, low-fat dairy and low-fat milk. Fermented dairy, low-fat yogurt, high-fat cheese, cream and ice cream were not associated with the outcomes. In conclusion, a higher intake of high-fat yogurt was associated with a lower prediabetes risk and lower longitudinal insulin resistance. Additionally, high-fat milk was associated with a lower prediabetes risk. Some low-fat dairy types were inconsistently associated with these outcomes. Studies are needed to confirm associations and to examine the influence of confounding by population characteristics.

Association of MRI-based adrenal gland volume and impaired glucose metabolism in a population-based cohort study.

OBJECTIVES: The aim of this study was to assess adrenal gland volume by using magnetic resonance imaging (MRI) and to study its role as an indirect marker of impaired glucose metabolism and hypothalamic-pituitary-adrenal (HPA) axis activation in a population-based cohort. METHODS: Asymptomatic participants were enrolled in a nested case-control study and underwent a 3-T MRI, including T1w-VIBE-Dixon sequences. For the assessment of adrenal gland volume, adrenal glands were manually segmented in a blinded fashion. Impaired glucose metabolism was determined using fasting glucose and oral glucose tolerance test. Cardiometabolic risk factors were also obtained. Inter- and intrareader reliability as well as univariate and multivariate associations were derived. RESULTS: Among 375 subjects included in the analysis (58.5% male, 56.1 ± 9.1 years), 25.3% participants had prediabetes and 13.6% had type 2 diabetes (T2DM). Total adrenal gland volume was 11.2 ± 4.2 ml and differed significantly between impaired glucose metabolism and healthy controls with largest total adrenal gland volume in T2DM (healthy controls: 10.0 ± 3.9 ml, prediabetes: 12.5 ± 3.8 ml, T2DM: 13.9 ± 4.6 ml; p < 0.001). In the multivariate analysis, association of T2DM and increased adrenal gland volume was independent of age, sex, hypertension, triglycerides and body mass index (BMI), but was attenuated in subjects with prediabetes after adjustment for BMI. CONCLUSIONS: T2DM is significantly associated with increased adrenal gland volume by MRI in an asymptomatic cohort, independent of age, sex, dyslipidaemia, hypertension and BMI. Adrenal gland volume may represent an indirect marker of impaired glucose metabolism and HPA axis dysfunction.

Melatonin supplementation in the culture medium rescues impaired glucose metabolism in IVF mice offspring.

Increasing evidence suggests that in vitro fertilization (IVF) may be associated with an increased risk of developing obesity and metabolic diseases later in life in the offspring. Notably, the addition of melatonin to culture medium may improve embryo development and prevent cardiovascular dysfunction in IVF adult mice. This study aimed to determine if melatonin supplementation in the culture medium can reverse impaired glucose metabolism in IVF mice offspring and the underlying mechanisms. Blastocysts used for transfer were generated by natural mating (control group) or IVF with or without melatonin (10-6  M) supplementation (mIVF and IVF group, respectively) in clinical-grade culture media. Here, we first report that IVF decreased hepatic expression of Fbxl7, which was associated with impaired glucose metabolism in mice offspring. Melatonin addition reversed the phenotype by up-regulating the expression of hepatic Fbxl7. In vitro experiments showed that Fbxl7 enhanced the insulin signaling pathway by degrading RhoA through ubiquitination and was up-regulated by transcription factor Foxa2. Specific knockout of Fbxl7 in the liver of adult mice, through tail intravenous injection of recombinant adeno-associated virus, impaired glucose tolerance, while overexpression of hepatic Fbxl7 significantly improved glucose tolerance in adult IVF mice. Thus, the data suggest that Fbxl7 plays an important role in maintaining glucose metabolism of mice, and melatonin supplementation in the culture medium may rescue the long-term risk of metabolic diseases in IVF offspring.

Screening for diabetes and impaired glucose metabolism in Qatar: Models' development and validation.

AIM: To establish two scoring models for identifying individuals at risk of developing Impaired Glucose Metabolism (IGM) or Type two Diabetes Mellitus (T2DM) in Qatari. MATERIALS AND METHODS: A sample of 2000 individuals, from Qatar BioBank, was evaluated to determine features predictive of T2DM and IGM. Another sample of 1000 participants was obtained for external validation of the models. Several scoring models screening for T2DM were evaluated and compared to the model proposed by this study. RESULTS: Age, gender, waist-to-hip-ratio, history of hypertension and hyperlipidemia, and levels of educational were statistically associated with the risk of T2DM and constituted the Qatar diabetes mellitus risk score (QDMRISK). Along with, the 6 aforementioned variables, the IGM model showed that BMI was statistically significant. The QDMRISK performed well with area under the curve (AUC) 0.870 and .815 in the development and external validation cohorts, respectively. The QDMRISK showed overall better accuracy and calibration compared to other evaluated scores. The IGM model showed good accuracy and calibration, with AUCs .796 and .774 in the development and external validation cohorts, respectively. CONCLUSIONS: This study developed Qatari-specific diabetes and IGM risk scores to identify high risk individuals and can guide the development of a nationwide primary prevention program.

Dairy product consumption and incident prediabetes in Dutch middle-aged adults: the Hoorn Studies prospective cohort.

PURPOSE: Our aim was to investigate prospective associations of consumption of total dairy and dairy types with incident prediabetes in a Dutch population-based study. METHODS: Two enrolment waves of the Hoorn Studies were harmonized, resulting in an analytic sample of 2262 participants without (pre-) diabetes at enrolment (mean age 56 ± 7.3 years; 50% male). Baseline dietary intake was assessed by validated food frequency questionnaires. Relative risks (RRs) were calculated between dairy, fermented dairy, milk, yogurt (all total/high/low fat), cream and ice cream and prediabetes. Additionally, substituting one serving/day of dairy types associated with prediabetes with alternative dairy types was analysed. RESULTS: During a mean 6.4 ± 0.7 years of follow-up, 810 participants (35.9%) developed prediabetes. High fat fermented dairy, cheese and high fat cheese were associated with a 17% (RR 0.83, 95% CI 0.69-0.99, ptrend = 0.04), 14% (RR 0.86, 95% CI 0.73-1.02, ptrend = 0.04) and 21% (RR 0.79, 95% CI 0.66-0.94, ptrend = 0.01) lower risk of incident prediabetes, respectively, in top compared to bottom quartiles, after adjustment for confounders. High fat cheese consumption was continuously associated with lower prediabetes risk (RRservings/day 0.94, 95% CI 0.88-1.00, p = 0.04). Total dairy and other dairy types were not associated with prediabetes risk in adjusted models, irrespective of fat content (RR ~ 1). Replacing high fat cheese with alternative dairy types was not associated with prediabetes risk. CONCLUSION: The highest intake of high fat fermented dairy, cheese and high fat cheese were associated with a lower risk of prediabetes, whereas other dairy types were not associated. Cheese seems to be inversely associated with type 2 diabetes risk, despite high levels of saturated fatty acids and sodium.

The Cutoff Value of Low Sex Hormone-Binding Globulin and Its Predictive Role in Impaired Glucose Metabolism Among Chinese Women with Polycystic Ovarian Syndrome.

Background: Low levels of sex hormone-binding globulin (SHBG) is a potential predictor of type 2 diabetes mellitus (T2DM), and when combined with insulin resistance (IR), lead to impaired glucose metabolism. Few studies involve women with polycystic ovarian syndrome (PCOS). Studies on cutoff values of SHBG among Asian women were scanty. Methods: The cutoff level of SHBG was computed using the 25th percentile method. Parameters were compared between the lower and higher SHBG subgroup. Area under the curve (AUC) for sensitivity and specificity of SHBG in predicting IR and impaired glucose metabolism was calculated. Results: This study included 733 patients with PCOS 20-45 years of age and 469 age-matched controls. The 25th percentile of SHBG in the control group was 51.90 nM. There were negative correlations between SHBG and age (r = -0.085, P < 0.05), body mass index (BMI) (r = -0.461, P < 0.01), waist-to-hip ratio (WHR) (r = -0.349, P < 0.01), fasting plasma glucose (r = -0.242, P < 0.01), Glucose-1h (r = -0.303, P < 0.01), Glucose-2h (r = -0.336, P < 0.01), fasting insulin (r = -0.324, P < 0.01), Insulin-1h (r = -0.238, P < 0.01), Insulin-2h (r = -0.307, P < 0.01), and homeostasis model 2 assessment of insulin resistance (HOMA2-IR) (r = -0.329, P < 0.01). Age, BMI, WHR, glucose and insulin levels (both pre- and postload), HOMA2-IR, free testosterone, and dehydroepiandrosterone sulfate were all higher in the lower than the higher SHBG subgroup. The AUC of SHBG for predicting IR was 0.706 [95% confidence interval (CI) 0.665-0.745, P < 0.001], impaired fasting glucose was 0.674 (95% CI 0.513-0.838, P < 0.001), impaired glucose tolerance was 0.637 (95% CI 0.586-0.690, P < 0.001), and T2DM was 0.674 (95% CI 0.556-0.780, P < 0.001). Conclusions: A 51.90 nM should be identified as the cutoff value of SHBG. Women with PCOS with lower SHBG values have a higher risk of developing impaired glucose metabolism. Low SHBG should be a predictive biomarker of impaired glucose metabolism in women with PCOS in southern China.

Carbohydrate score and rice intake for breakfast, lunch, and dinner and impaired glucose metabolism in a working population: A cross-sectional study.

BACKGROUND & AIM: Few studies have examined the association between carbohydrate intake and diabetes with consideration to time of eating. We investigated the association of carbohydrate score and rice intake for breakfast, lunch, and dinner with impaired glucose metabolism in a Japanese working population. METHODS: Participants were 1416 workers (aged 18-69 years) without a history of diabetes or serious disease who participated in a health survey. Intakes of rice, bread, and noodles at each meal were ascertained using a questionnaire, and carbohydrate score was calculated from these intakes. Impaired glucose metabolism was defined by fasting blood glucose ≥110 mg/dl or HbA1c ≥ 6.0% Logistic regression analysis was used to estimate the odds ratios of impaired glucose metabolism for quartile of carbohydrate score or rice intake for each meal with adjustment for covariates. RESULTS: Carbohydrate score and rice intake for each meal were not significantly associated with impaired glucose metabolism. However, among non-obese participants (BMI <25 kg/m2), a higher intake of rice at dinner was associated with an increased odds of having impaired glucose metabolism (P for trend = 0.02), with a multivariable-adjusted odds ratio for the highest versus lowest quartile of rice intake at dinner of 3.43 (95% confidence interval 1.22-9.70). In contrast, no such association was observed among obese participants (BMI ≥25 kg/m2) (P for interaction = 0.097). CONCLUSIONS: Our results suggest that carbohydrate score and rice intake for each meal are not associated with impaired glucose metabolism. The increased odds of having impaired glucose metabolism associated with higher rice intake at dinner among non-obese participants requires further investigation.

Hepatic steatosis and hepatic iron overload modify the association of iron markers with glucose metabolism disorders and metabolic syndrome.

BACKGROUND: Iron status has been linked with impaired glucose metabolism (IGM), type 2 diabetes mellitus (T2DM) and the metabolic syndrome (MetS), but the role of hepatic steatosis or iron overload on these associations remains uncertain. METHODS: We analysed data from 2310 participants without known T2DM of the population-based Study of Health in Pomerania (SHIP-TREND, Germany) through logistic regression models. We tested additive and multiplicative interactions between ferritin and hepatic steatosis or iron overload. RESULTS: Serum ferritin was positively associated with IGM (OR per 100 µg/L: 1.11 [1.01, 1.23]), T2DM (OR per 100 µg/L: 1.20 [1.06, 1.36]) and MetS (OR per 100 µg/L: 1.11 [1.02, 1.20]) in the total population as well as in participants without hepatic iron overload. However, the synergistic effect of higher ferritin concentrations and hepatic iron overload showed stronger associations with IGM and T2DM. Similarly, while ferritin was positively associated with T2DM and MetS even in the absence of hepatic steatosis, the synergistic effect of higher ferritin concentrations and hepatic steatosis showed stronger associations with IGM, T2DM and MetS. Transferrin was associated with isolated impaired glucose tolerance but not with T2DM and MetS. CONCLUSIONS: Our study suggests that ferritin may be associated with glucose metabolism disorders and MetS even in people without hepatic steatosis or iron overload. However, in individuals with higher ferritin concentrations, the presence of hepatic steatosis may indicate stronger risk for glucose metabolism disorders and MetS, while the presence of hepatic iron overload may indicate stronger risk only for glucose metabolism disorders.

Hemoglobin glycation index is associated with incident chronic kidney disease in subjects with impaired glucose metabolism: A 10-year longitudinal cohort study.

AIM: We investigated the associations between hemoglobin glycation index (HGI) and incident chronic kidney disease (CKD) in treatment-naïve subjects with prediabetes or diabetes. METHODS: We conducted a prospective cohort study comprising 2187 subjects with prediabetes or diabetes. HGI was calculated as the difference between the measured and predicted values of HbA1c using the linear relationship between HbA1c level and fasting plasma glucose levels. Incident CKD was considered if eGFR decreased to <60 mL/min/1.73 m2 and by >25% from the baseline value during follow up. The hazard ratios (HRs) for incident CKD were calculated using Cox proportional hazards regression models. RESULTS: The overall prevalence of CKD was 15.3% (n = 335) during the 10-year follow-up period. The prevalence of CKD increased significantly from the low to the high HGI groups. In the multivariate analysis, the highest HGI group showed the highest adjusted HR for incident CKD (HR, 1.57; 95% confidence interval, 1.06-2.34), and this remained significant even after adjusting for the HbA1c level. CONCLUSIONS: High HGI was associated with an increased risk of incident CKD among treatment-naïve subjects with prediabetes or diabetes, suggesting that HGI may be used to predict CKD in these patients regardless of HbA1c levels.

Fish Cooking Methods and Impaired Glucose Metabolism Among Japanese Workers: The Furukawa Nutrition and Health Study.

The aim of this study was to examine the cross-sectional association between fish and shellfish intake and impaired glucose metabolism with consideration for cooking methods in a Japanese working population. Participants were 1774 workers aged 18-69 years. Dietary intake was assessed using a validated self-administered diet history questionnaire. Participants were asked about their most frequently used cooking method for fish, and the method was classified as either "raw and stewing" or "broiling, deep-frying, and stir-frying". Impaired glucose metabolism was defined by a history of diabetes, current use of anti-diabetic drugs, fasting blood glucose ≥110 mg/dl, or HbA1c ≥6.0%. Logistic regression analysis was used to estimate the odds ratios of impaired glucose metabolism for fish intake by cooking method. Fish intake was not associated with impaired glucose metabolism in either group. When the outcome was defined as diabetes, the odds of diabetes increased with fish intake among participants who most frequently used broiling, deep-frying, or stir-frying methods, albeit they were not statistically significant; the multivariable-adjusted odds ratio for the highest versus the lowest tertiles of fish intake was 1.95 (95%CI, 0.71-5.41). Cooking methods for fish may not modify the association between fish intake and impaired glucose metabolism among Japanese populations.