Multiple metals exposure, elevated blood glucose and dysglycemia among Chinese occupational workers.

AIMS: Exposure to metals may adversely affect cardiometabolic health. The aim of this study is to directly evaluate the roles of multiple metals exposure in glucose homeostasis, the dysfunction of which has been linked to diabetes and cardiovascular diseases (CVDs). METHODS: We performed a cross-sectional analysis of baseline data from 464 metal-exposed workers who participated in a large prospective occupational study in China (Jinchang Cohort). The logistic regression model was used to evaluate the association between urinary metal levels and high fasting plasma glucose (high-FPG) (≥ 75th percentile) and dysglycemia. RESULTS: Increasing levels of urinary nickel were prospectively associated with high-FPG: multivariable odds ratios (ORs) were 1.00 for the 1st quartile (lowest), 1.20 (95% confidence interval [CI]: 0.60-2.43) for the 2nd quartile, 1.64 (0.78-3.49) for the 3rd quartile and 3.17 (1.38-7.30) for the 4th quartile (highest) (P-trend=0.004). The positive associations were also observed between urinary zinc and high-FPG (4th vs. 1st quartile=2.71, 95%CI: 1.26-5.84, P-trend=0.01). Inverse associations between urinary cobalt and risk of high-FPG and dysglycemia were observed (P-trend <0.05). For dysglycemia, the positive trends of increasing levels of urinary nickel and zinc still remained, although urinary nickel was no longer statistically significant. A significant association between urinary arsenic and dysglycemia was also found. However, no associations were observed between urinary copper, cadmium, and risk of high-FPG or dysglycemia. CONCLUSION: Multiple urinary metals, particularly arsenic, nickel, zinc, and cobalt, were associated with elevated blood glucose among Chinese occupational workers, supporting the notion that metal exposure plays a critical role in the development of diabetes.

Historical perspectives in clinical pathology: a history of glucose measurement.

This is the second in the series of historical articles dealing with developments in clinical pathology. As one of the most commonly measured analytes in pathology, the assessment of glucose dates back to the time of the ancient Egyptians. It was only in the 19th century that advances in chemistry led to the identification of the sugar in urine being glucose. The following century witnessed the development of more chemical and enzymatic methods which became incorporated into the modern analysers and point-of-care instruments which are as ubiquitous as the modern day cellphones. Tracking the milestones in these developments shows the striking paradigms and the many parallels in the development of other clinical chemistry methods.

[The chronic pancreatitis caused glucose metabolism disturbances before and after distal pancreatic resections].

Glucose metabolism is evaluated before and after the operation in 51 patients (41--men, 10--women), operated on account of the complicated chronic pancreatitis. The distal pancreatic resection (50% of the gland) was performed in all cases. The middle age of the patients is 41.2+/-7.9. Body mass index (BMI) was 23.7+/-3.4 kg/m2. After distal pancreatic resection 33.33% of patients with chronic pancreatitis didn't have glucose metabolism disturbances. In 27.45% of patients diabetes mellitus was diagnosed for the first time after the operation. At the same time, in 5.8% of cases the worsening from the light to the moderate form of diabetes mellitus was observed. As far as blood glucose level (glycemic control) doesn't have any prognostic value in predicting diabetes mellitus in early postoperative period, it is necessary to recommend regular supervision by the endocrinologist to the patient after discharge. All patients with chronic pancreatitis should be carefully investigated so as to detect glycaemic disorders. It is recommended to determine fasting blood glucose level, glycemia throughout the day, glycated hemoglobin, 24 hours' glucosuria. It is also essential to perform an oral glucose tolerance test (OGTT).

[Prevalence and predictors of microalbuminuria in persons with various glucose tolerance levels].

OBJECTIVE: To investigate the prevalence of microalbuminuria in persons with various glucose tolerance levels and the risk factors for the development of microalbuminuria. METHODS: Early morning urine samples were collected from 1,779 subjects with all the data necessary for this survey from a population screened in Baoshan Community, Shanghai by cluster sampling, including 752 with normal glucose tolerance (NGT), 505 impaired glucose tolerance (IGR), and 522 type 2 diabetes mellitus (T2DM) diagnosed according to a 75 g oral glucose tolerance test (OGTT). Urinary albumin-to-creatinine ratio (ACR) was measured by rate-nephelometry method. RESULTS: (1) The incidence rate of MAU of the T2DM group was 11.3%, significantly higher than those of the NGT and IGR groups (4.7% and 6.1% respectively, both P < 0.01). (2) Logistic regression showed that MAU was significantly correlated with 2 h PG, systolic blood pressure, and triglyceride. CONCLUSION: The prevalence of MAU is significantly higher in the diabetic patients. 2 h PG, systolic blood pressure, and triglyceride and independent risk factors of MAU.