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1.
Nutrients ; 13(7)2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34371867

RESUMO

BACKGROUND: There is a growing interest in the considerable benefits of dietary supplementations, such as folic acid, on the glycemic profile. We aimed to investigate the effects of folic acid supplementation on glycemic control markers in adults. METHODS: Randomized controlled trials examining the effects of folic acid supplementation on glycemic control markers published up to March 2021 were detected by searching online databases, including Scopus, PubMed, Embase, and ISI web of science, using a combination of related keywords. Mean change and standard deviation (SD) of the outcome measures were used to estimate the mean difference between the intervention and control groups at follow-up. Meta-regression and non-linear dose-response analysis were conducted to evaluate the association between pooled effect size and folic acid dosage (mg/day) and duration of the intervention (week). From 1814 detected studies, twenty-four studies reported fasting blood glucose (FBG), fasting insulin, hemoglobin A1C (HbA1C), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) as an outcome measure. RESULTS: Results revealed significant reductions in FBG (weighted mean difference (WMD): -2.17 mg/dL, 95% CI: -3.69, -0.65, p = 0.005), fasting insulin (WMD: -1.63 pmol/L, 95% CI: -2.53, -0.73, p < 0.001), and HOMA-IR (WMD: -0.40, 95% CI: -0.70, -0.09, p = 0.011) following folic acid supplementation. No significant effect was detected for HbA1C (WMD: -0.27%, 95% CI: -0.73, 0.18, p = 0.246). The dose-response analysis showed that folic acid supplementation significantly changed HOMA-IR (r = -1.30, p-nonlinearity = 0.045) in non-linear fashion. However, meta-regression analysis did not indicate a linear relationship between dose, duration, and absolute changes in FBG, HOMA-IR, and fasting insulin concentrations. CONCLUSIONS: Folic acid supplementation significantly reduces some markers of glycemic control in adults. These reductions were small, which may limit clinical applications for adults with type II diabetes. Further research is necessary to confirm our findings.


Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Diabetes Mellitus Tipo 2/terapia , Suplementos Nutricionais , Ácido Fólico/administração & dosagem , Controle Glicêmico/métodos , Adulto , Glicemia/efeitos dos fármacos , Diabetes Mellitus Tipo 2/sangue , Jejum/sangue , Feminino , Hemoglobina A Glicada/efeitos dos fármacos , Humanos , Insulina/sangue , Resistência à Insulina , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Análise de Regressão , Resultado do Tratamento , Adulto Jovem
2.
Medicine (Baltimore) ; 100(31): e26521, 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34397795

RESUMO

ABSTRACT: The influencing factors of gestational diabetes mellitus (GDM) in the polycystic ovary syndrome (PCOS) patients remain unclear, we aimed to investigate the risk factors of GDM in patients with PCOS, to provide reliable evidence for the prevention and treatment of GDM in PCOS patients.PCOS patients treated in our hospital from January 1, 2019 to October 31, 2020 were included. The personal and clinical treatment details of GDM and no GDM patients were analyzed. Logistic regressions were performed to analyze the factors influencing the occurrence of GDM.A total of 196 PCOS patients were included, the incidence of GDM in patients with PCOS was 23.98%. There were significant differences in the age, body mass index, insulin resistance index, fasting insulin, testosterone, androstenedione, and sex hormone-binding protein between GDM and no GDM patients with PCOS (all P < .05), and no significant differences in the family history of GDM, the history of adverse pregnancy, and multiple pregnancies were found (all P > .05). Age ≥30 years (odds ratio (OR) 2.418, 95% confidence interval (CI) 1.181-3.784), body mass index ≥24 kg/m2 (OR 1.973, 95%CI 1.266-3.121), insulin resistance index ≥22.69 (OR 2.491, 95%CI 1.193-4.043), fasting insulin ≥22.71 mIU/L (OR 2.508, 95%CI 1.166-5.057), testosterone ≥2.85 nmol/L (OR 1.821, 95%CI 1.104-2.762), androstenedione ≥6.63 nmol/L (OR 1.954, 95%CI 1.262-2.844), sex hormone-binding protein <64.22 nmol/L (OR 1.497, 95%CI 1.028-2.016) were the independent risk factors of GDM in patients with PCOS (all P < .05). The incidence of preeclampsia, premature delivery, premature rupture of membranes, polyhydramnios, and postpartum hemorrhage in the GDM group was significantly higher than that of the no-GDM group (all P < .05). There was no significant difference in the incidence of oligohydramnios between the 2 groups (P = .057).The incidence of GDM in PCOS patients is high, and the measures targeted at the risk factors are needed to reduce the occurrence of GDM in patients with PCOS.


Assuntos
Diabetes Gestacional/epidemiologia , Diabetes Gestacional/fisiopatologia , Síndrome do Ovário Policístico/fisiopatologia , Adulto , Fatores Etários , Androstenodiona/sangue , Índice de Massa Corporal , China/epidemiologia , Diabetes Gestacional/etiologia , Jejum/sangue , Feminino , Ruptura Prematura de Membranas Fetais/epidemiologia , Humanos , Incidência , Insulina/sangue , Resistência à Insulina , Síndrome do Ovário Policístico/complicações , Poli-Hidrâmnios/epidemiologia , Hemorragia Pós-Parto/epidemiologia , Pré-Eclâmpsia/epidemiologia , Gravidez , Nascimento Prematuro/epidemiologia , Fatores de Risco , Globulina de Ligação a Hormônio Sexual/metabolismo , Testosterona/sangue , Adulto Jovem
3.
Medicine (Baltimore) ; 100(34): e26974, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34449465

RESUMO

ABSTRACT: Fasting plasma glucose level was linearly associated with colorectal cancer (CRC) risk. However, the dose-response relationship between fasting blood glucose (FBG) and CRC risk was still uncertain.A total of 11,632 patients without self-reported diabetes mellitus and colorectal polyps' history were identified in the Korean Multicenter Cancer Cohort (1993-2005). The nonlinear relationship was estimated through a restricted cubic spline regression, and a two-piece-wise Cox proportional hazards model was further performed to calculate the threshold effect. Multiple imputation was used to control the bias from missing data.Overall, 1.1% (n = 132) of participants were diagnosed with CRC in the follow-up duration. With a median follow-up duration of 12.0 years, participants with FBG ≥126 mg/dL were associated with higher CRC risk (adjusted hazard ratio [HR], 1.67; 95% confidence interval [CI]: 1.01, 2.76). Landmark analyses limited to long-term survivors demonstrated increased CRC risk with FBG ≥ 126 mg/dL in all subsets (≥3years: HR,1.93 (95% CI: 1.13-3.29); ≥5years: HR, 2.04 (95% CI: 1.-3.63); ≥10years: HR, 2.50 (95% CI: 1.19-5.25)). With FBG smoothly increasing before, the latter increased dramatically after the turning point (P for nonlinearity = 0.283). When FBG was increasing per mmol/L, HR was 1.07(95% CI: 0.90, 1.29) for FBG < 126 mg/dL and 1.27 (95% CI: 1.06, 1.53) for FBG ≥ 126 mg/dL. Besides, HR was 1.09 (95% CI: 1.02, 1.16) for the CRC risk.In the population without self-reported diabetes mellitus and colorectal polyps' history. FBG was linearly associated with CRC risk, especially for FBG over 126 mg/dL.


Assuntos
Glicemia/análise , Neoplasias Colorretais/sangue , Neoplasias Colorretais/epidemiologia , Jejum/sangue , Fatores Etários , Idoso , Comorbidade , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Autorrelato , Fatores Sexuais , Sudão do Sul
4.
Nutrients ; 13(8)2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34444846

RESUMO

BACKGROUND: Research indicates potential cardiometabolic benefits of energy consumption earlier in the day. This study examined the association between fasting duration, timing of first and last meals, and cardiometabolic endpoints using data from the National Health and Nutrition Examination Survey (NHANES). METHODS: Cross-sectional data from NHANES (2005-2016) were utilized. Diet was obtained from one to two 24-h dietary recalls to characterize nighttime fasting duration and timing of first and last meal. Blood samples were obtained for characterization of C-reactive protein (CRP); glycosylated hemoglobin (HbA1c %); insulin; glucose; and high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol. Survey design procedures for adjusted linear and logistic regression were performed. RESULTS: Every one-hour increase in nighttime fasting duration was associated with a significantly higher insulin and CRP, and lower HDL. Every one-hour increase in timing of the last meal of the day was statistically significantly associated with higher HbA1c and lower LDL. Every one-hour increase in first mealtime was associated with higher CRP (ß = 0.044, p = 0.0106), insulin (ß = 0.429, p < 0.01), and glucose (ß = 0.662, p < 0.01), and lower HDL (ß = -0.377, p < 0.01). CONCLUSION: In this large public health dataset, evidence for the beneficial effect of starting energy consumption earlier in the day on cardiometabolic endpoints was observed.


Assuntos
Ingestão de Energia/fisiologia , Jejum/sangue , Refeições/fisiologia , Fenômenos Fisiológicos da Nutrição/fisiologia , Fatores de Tempo , Adulto , Glicemia/análise , Proteína C-Reativa/análise , Fatores de Risco Cardiometabólico , Colesterol/sangue , Estudos Transversais , Inquéritos sobre Dietas , Feminino , Hemoglobina A Glicada/análise , Humanos , Insulina/sangue , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais
5.
Nutrients ; 13(8)2021 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-34444888

RESUMO

To investigate the relationship between breastfeeding duration and lipid profile among children and adolescents, a cross-sectional survey using random cluster sampling was performed, and a national sample of 12,110 Chinese children and adolescents aged 5-19 years were collected. Breastfeeding duration and sociodemographic factors were collected by questionnaires. Fasting blood samples were obtained to test the lipid profile. Linear regression and logistic regression models were employed to evaluate the association between breastfeeding duration and lipid profile. We found that prolonged breastfeeding was related with a low level of total cholesterol (TC), LDL-C, HDL-C, and TC/HDL-C in children and adolescents. With an increased duration of breastfeeding, the magnitude of the association between breastfeeding and lipid profile enlarged. The levels of TC, LDL-C, HDL-C, and TC/HDL-C in participants who were breastfed for more than 12 months decreased by 6.225 (95% CI: -8.390, -4.059), 1.956 (95% CI: -3.709, -0.204), 1.273 (95% CI: -2.106, -0.440) mg/dL, and 0.072 (95%CI: -0.129, -0.015), respectively, compared with those who were not breastfed. The corresponding risk of high TC declined by 43% (aOR: 0.570, 95% CI: 0.403, 0.808). The association was similar in both boys and girls, but only statistically significant in children and young adolescents aged 5-14 years. This suggested that prolonged breastfeeding duration was related with low lipid levels and decreased abnormal lipid risk, especially in children and young adolescents. These findings support the intervention of prompting a prolonged duration of breastfeeding to improve the childhood lipid profile.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Lipídeos/sangue , Fatores de Tempo , Adolescente , Criança , China/epidemiologia , Análise por Conglomerados , Estudos Transversais , Jejum/sangue , Feminino , Humanos , Modelos Logísticos , Masculino , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/etiologia , Adulto Jovem
6.
Molecules ; 26(11)2021 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-34199645

RESUMO

Interest has arisen on the anti-inflammatory action of dietary components, including long-chain n-3 fatty acids (LCn3) and polyphenols (PP). The aim of this study was to evaluate the effects of diets rich in PP and oily fish (high-LCn3 diets) on markers of subclinical inflammation and growth factors in people at high cardiometabolic risk. Individuals with high waist circumference and one more component of metabolic syndrome were randomized to one of the following isoenergetic diets: low LCn3&PP, high LCn3, high PP, high LCn3&PP. Before and after 8 weeks, fasting and postprandial plasma concentrations of hs-CRP and fasting serum concentrations of IL-1, IL-4, IL-6, IL-10, IL-17, INF-, TNF-, FGF, VEGF, PDGF-, G-CSF, and GM-CSF were determined. An oily fish diet reduced fasting plasma hs-CRP (1.28 ± 12.0, -12.5 ± 6.9, 22.5 ± 33.6, -12.2 ± 11.9; 8-week percent change, Mean ± SEM; low LCn3&PP, high LCn3, high PP, high LCn3&PP group, respectively), postprandial 6h-AUC hs-CRP (4.6 ± 16.3, -18.2 ± 7.2, 26.9 ± 35.1, -11.5 ± 11.8, 8-week percent change) and fasting IL-6 (20.8 ± 18.7, -2.44 ± 12.4, 28.1 ± 17.4, -9.6 ± 10.2), IL-17 (2.40 ± 4.9, -13.3 ± 4.9, 3.8 ± 4.43, -11.5 ± 4.7), and VEGF (-5.7 ± 5.8, -5.6 ± 7.5, 3.5 ± 5.8, -11.1 ± 5.5) (8-week percent change; p < 0.05 for LCn3 effect for all; no significant effect for PP; 2-factor ANOVA). An oily fish diet improved subclinical inflammation, while no significant effect was observed for dietary polyphenols.


Assuntos
Proteína C-Reativa/metabolismo , Doenças Cardiovasculares/prevenção & controle , Citocinas/sangue , Óleos de Peixe/administração & dosagem , Sobrepeso/imunologia , Adulto , Idoso , Doenças Cardiovasculares/sangue , Jejum/sangue , Ácidos Graxos Ômega-3/administração & dosagem , Ácidos Graxos Ômega-3/farmacologia , Feminino , Óleos de Peixe/farmacologia , Humanos , Masculino , Pessoa de Meia-Idade , Sobrepeso/sangue , Polifenóis/administração & dosagem , Polifenóis/farmacologia , Período Pós-Prandial
7.
Nutrients ; 13(6)2021 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-34201027

RESUMO

BACKGROUND: Vitamin D plays pleiotropic roles in the body and hence, changes in its metabolism and distribution during starvation could play an important role in the adaptive response to famine. We aimed to identify the responses of some vitamin D metabolites to 8 d of fasting and exercise. METHODS: A repeated-measures design was implemented, in which 14 male volunteers fasted for 8 d and performed an exercise test before and after fasting. Serum samples were collected on day 1 after night fasting and after 8 d of complete food restriction, before and 1 h and 3 h after exercise. RESULTS: After 8 d of fasting, compared with baseline values, serum 24,25(OH)2D3 and 3-epi-25(OH)D3 levels significantly increased; those of 25(OH)D3 and 1,25(OH)2D3 were unaffected; and those of 25(OH)D2 decreased. Exercise on the first day of fasting induced an increase in serum 3-epi-25(OH)D3 levels, while exercise performed after 8 d of fasting induced an increase in 25(OH)D3, 24,25(OH)2D3, 25(OH)D2, and 3-epi-25(OH)D3 levels. CONCLUSION: Increases in 24,25(OH)2D3 and 3-epi-25(OH)D3 levels imply that fasting stimulates vitamin D metabolism. The effects of exercise on serum vitamin D metabolites, which are most pronounced after fasting and in subjects with serum 25(OH)D3 above 25 ng/mL, support the notion that fasting and exercise augment vitamin D metabolism.


Assuntos
Exercício Físico/fisiologia , Jejum/sangue , Saúde , Metaboloma , Vitamina D/sangue , Composição Corporal , Humanos , Masculino , Pessoa de Meia-Idade , Inanição
8.
Nutrients ; 13(7)2021 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-34206641

RESUMO

Previous studies have reported the therapeutic effects of oleuropein (OP) consumption on the early stage of type 2 diabetes. However, the efficacy of OP on the advanced stage of type 2 diabetes has not been investigated, and the relationship between OP and intestinal flora has not been studied. Therefore, in this study, to explore the relieving effects of OP intake on the advanced stage of type 2 diabetes and the regulatory effects of OP on intestinal microbes, diabetic db/db mice (17-week-old) were treated with OP at the dose of 200 mg/kg for 15 weeks. We found that OP has a significant effect in decreasing fasting blood glucose levels, improving glucose tolerance, lowering the homeostasis model assessment-insulin resistance index, restoring histopathological features of tissues, and promoting hepatic protein kinase B activation in db/db mice. Notably, OP modulates gut microbiota at phylum level, increases the relative abundance of Verrucomicrobia and Deferribacteres, and decreases the relative abundance of Bacteroidetes. OP treatment increases the relative abundance of Akkermansia, as well as decreases the relative abundance of Prevotella, Odoribacter, Ruminococcus, and Parabacteroides at genus level. In conclusion, OP may ameliorate the advanced stage of type 2 diabetes through modulating the composition and function of gut microbiota. Our findings provide a promising therapeutic approach for the treatment of advanced stage type 2 diabetes.


Assuntos
Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Microbioma Gastrointestinal/efeitos dos fármacos , Hipoglicemiantes/farmacologia , Glucosídeos Iridoides/farmacologia , Animais , Glicemia/efeitos dos fármacos , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Tipo 2/sangue , Jejum/sangue , Resistência à Insulina , Masculino , Camundongos , Camundongos Endogâmicos
9.
Nutrients ; 13(7)2021 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-34202194

RESUMO

Although lifestyle interventions can lead to diabetes remission, it is unclear to what extent type 2 diabetes (T2D) remission alters or improves the underlying pathophysiology of the disease. Here, we assess the effects of a lifestyle intervention on T2D reversal or remission and the effects on the underlying pathology. In a Dutch primary care setting, 15 adults with an average T2D duration of 13.4 years who were (pharmacologically) treated for T2D received a diabetes subtyping ("diabetyping") lifestyle intervention (DLI) for six months, aiming for T2D remission. T2D subtype was determined based on an OGTT. Insulin and sulphonylurea (SU) derivative treatment could be terminated for all participants. Body weight, waist/hip ratio, triglyceride levels, HbA1c, fasting, and 2h glucose were significantly improved after three and six months of intervention. Remission and reversal were achieved in two and three participants, respectively. Indices of insulin resistance and beta cell capacity improved, but never reached healthy values, resulting in unchanged T2D subtypes. Our study implies that achieving diabetes remission in individuals with a longer T2D duration is possible, but underlying pathology is only minimally affected, possibly due to an impaired beta cell function. Thus, even when T2D remission is achieved, patients need to continue adhering to lifestyle therapy.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Dieta Saudável/métodos , Estilo de Vida Saudável , Adulto , Idoso , Idoso de 80 Anos ou mais , Glicemia/análise , Diabetes Mellitus Tipo 2/sangue , Jejum/sangue , Estudos de Viabilidade , Feminino , Teste de Tolerância a Glucose , Hemoglobina A Glicada/análise , Humanos , Insulina/sangue , Resistência à Insulina , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Indução de Remissão , Fatores de Tempo , Resultado do Tratamento
10.
PLoS One ; 16(7): e0254847, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34293038

RESUMO

IMPORTANCE: Patients with diabetes are known to be at increased risk for infections including severe coronavirus disease 2019 (COVID-19) but the relationship between COVID-19 severity and specific pre-infection glucose levels is not known. OBJECTIVE: To assess the differential effects of pre-infection glucose levels on the risk for severe COVID-19 amongst patients with and without diabetes. DESIGN: Population based historical cohort study. SETTING: National state-mandated HMO. PATIENTS: All adult patients with a positive SARS-COV2 test between March-October 2020. EXPOSURE: Recent fasting blood glucose (FBG) and glycated hemoglobin (HBA1C), age, gender, body mass index (BMI) and diagnoses of diabetes, hypertension, ischemic heart disease. OUTCOME: Risk for severe COVID-19, defined as resulting in ≥10 hospitalization days, ICU admission or death. RESULTS: 37,121 patients with a positive SARS-COV2 test were identified; 707 defined as severe (1.9%). Unadjusted risk factors for severe disease were age (OR = 1.1 for every year increase; 95% CI 1.09-1.11, p < 0.001), male gender (OR = 1.34, 95% CI 1.06-1.68, p = 0.012); BMI (OR = 1.02 for 1 kg/m2 increase, 95% CI 1.00-1.04, p = 0.025). Controlling for these factors, we found an association between pre-infection FBG and the risk of severe COVID-19, with a differential effect in patients with and without a diagnosis of diabetes. For patients without diabetes, elevated FBG in the pre-diabetes range (106-125 mg/dl) was associated with severe COVID-19 (OR 1.55 95% CI 1.04-2.26 p = 0.027). For patients with a diagnosis of diabetes, we found a J-shaped association between pre-infection glucose control and the risk for severe COVID-19 where the lowest risk for was for patients with FBG 106-125 mg/dl; the risk increased with higher pre-infection glucose levels but strikingly also for patients with a low pre-infection FBG (<100mg/dl) or HbA1C (<5.7%). CONCLUSIONS AND RELEVANCE: Elevated pre-infection blood glucose is a risk factor for severe COVID-19 even in non-diabetics. For patients with a diagnosis of diabetes both high as well as low pre-infection glucose levels are risk factors for severe COVID-19. Further research is required to assess whether these associations are causal, but we believe these findings can already have clinical implications for COVID-19 risk assessment and stratification.


Assuntos
Glicemia/metabolismo , COVID-19/sangue , COVID-19/epidemiologia , Adulto , Idoso , Estudos de Coortes , Jejum/sangue , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
11.
Nutrients ; 13(7)2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34209561

RESUMO

Obesity is one of the major health problems worldwide. Following healthy dietary patterns can be difficult in some countries due to the lack of availability of certain foods; thus, alternative foods are needed. Our aim was to evaluate the effect of a dietary pattern consisting of fruit, avocado, whole grains, and trout (FAWGT) on postprandial insulinemia and lipemia in obese Colombian subjects. A randomized controlled crossover study was conducted, in which 44 subjects with BMI ≥ 30 kg/m2 followed either a FAWGT diet or a diet high in saturated fat and rich in processed carbohydrates. Levels of lipids and carbohydrates were measured during the postprandial state. The FAWGT diet reduced fasting insulin, VLDL, and HOMA-IR after 8 weeks (p < 0.05), while there was a lower postprandial increase in TG, VLDL, and insulin levels after both acute and chronic intake of FAWGT diet (p < 0.05). The intake of FAWGT-diet was characterized by high consumption of foods rich in fiber, MUFAs, and vitamins C and E (p < 0.05). The consumption of a diet composed of fruit, avocado, whole grains, and trout has emerged as a valid alternative to the foods included in other heart-healthy diets since it improves postprandial lipemia and insulinemia in obese people and has similar beneficial effects to these healthy models.


Assuntos
Dieta Saudável/métodos , Ingestão de Alimentos/fisiologia , Hiperinsulinismo/dietoterapia , Hiperlipidemias/dietoterapia , Obesidade/dietoterapia , Animais , Glicemia/análise , Índice de Massa Corporal , VLDL-Colesterol/sangue , Estudos Cross-Over , Carboidratos da Dieta/administração & dosagem , Gorduras na Dieta/administração & dosagem , Jejum/sangue , Feminino , Frutas , Humanos , Hiperinsulinismo/sangue , Hiperinsulinismo/etiologia , Hiperlipidemias/sangue , Hiperlipidemias/etiologia , Insulina/sangue , Resistência à Insulina , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Obesidade/sangue , Obesidade/complicações , Persea , Período Pós-Prandial/fisiologia , Alimentos Marinhos , Triglicerídeos/sangue , Truta , Grãos Integrais
12.
Medicine (Baltimore) ; 100(24): e26289, 2021 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-34128863

RESUMO

BACKGROUND: Atorvastatin treatment has been suggested as a therapeutic method for women with polycystic ovary syndrome (PCOS) in many clinical studies. Nonetheless, the effects of atorvastatin on insulin resistance in PCOS patients still remain controversial. OBJECTIVE: The aim of this report was to evaluate the effects of atorvastatin therapy on the insulin resistance in the treatment of PCOS compared to that of placebo, in order to confer a reference for clinical practice. METHODS: Randomized controlled trials (RCTs) of atorvastatin for PCOS published up to August, 2020 were searched. Standardized mean difference (SMD) and 95% confidence interval (CI) were calculated, and heterogeneity was measured by the I2 test. Sensitivity analysis was also carried out. The outcomes of interest were as follows: fasting glucose concentration, fasting insulin level, homeostasis model assessment of insulin resistance (HOMA-IR) or body mass index (BMI) value. RESULTS: Nine RCTs with 406 participants were included. The difference of fasting glucose concentration in PCOS patients between atorvastatin group and placebo group was not statistically significant (8 trials; SMD -0.06, 95% CI -0.31 to 0.20, P = .66). PCOS patients in atorvastatin group had lower fasting insulin level than those in placebo group (7 trials; SMD -1.84, 95% CI -3.06 to -0.62, P < .003). The homeostasis model assessment of insulin resistance (HOMA-IR) value showed significant decrease in the atorvastatin therapy compared to placebo (6 trials; SMD -4.12, 95% CI -6.00 to -2.23, P < .0001). In contrast to placebo, atorvastatin therapy did not decrease the BMI value significantly in PCOS patients (7 trials; SMD 0.12, 95% CI -0.07 to 0.31, P = .22). CONCLUSIONS: Atorvastatin therapy can reduce insulin resistance in the treatment of patients with PCOS. In addition, further large-sample, multi-center RCTs are needed to identify these findings.


Assuntos
Atorvastatina/uso terapêutico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Resistência à Insulina , Síndrome do Ovário Policístico/tratamento farmacológico , Adolescente , Adulto , Glicemia/efeitos dos fármacos , Índice de Massa Corporal , Jejum/sangue , Feminino , Humanos , Insulina/sangue , Síndrome do Ovário Policístico/sangue , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Adulto Jovem
13.
Nutrients ; 13(5)2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-34062937

RESUMO

The gastrointestinal (GI) side-effects of dietary fibers are recognized, but less is known about their effects on non-GI symptoms. We assessed non-GI symptoms in a trial of the LDL-cholesterol lowering effect of oat ß-glucan (OBG). Participants (n = 207) with borderline high LDL-cholesterol were randomized to an OBG (1 g OBG, n = 104, n = 96 analyzed) or Control (n = 103, n = 95 analyzed) beverage 3-times daily for 4 weeks. At screening, baseline, 2 weeks and 4 weeks participants rated the severity of 16 non-GI symptoms as none, mild, moderate or severe. The occurrence and severity (more or less severe than pre-treatment) were compared using chi-squared and Fisher's exact test, respectively. During OBG treatment, the occurrence of exhaustion and fatigue decreased versus baseline (p < 0.05). The severity of headache (2 weeks, p = 0.032), anxiety (2 weeks p = 0.059) and feeling cold (4 weeks, p = 0.040) were less on OBG than Control. The severity of fatigue and hot flashes at 4 weeks, limb/joint pain at 2 weeks and difficulty concentrating at both times decreased on OBG versus baseline. High serum c-reactive-protein and changes in c-reactive-protein, oxidized-LDL, and GI-symptom severity were associated with the occurrence and severity of several non-GI symptoms. These data provide preliminary, hypothesis-generating evidence that OBG may reduce several non-GI symptoms in healthy adults.


Assuntos
Afeto/efeitos dos fármacos , Fibras na Dieta/farmacologia , Ingestão de Alimentos/psicologia , beta-Glucanas/farmacologia , Adolescente , Adulto , Idoso , Ansiedade/terapia , Proteína C-Reativa/análise , Distribuição de Qui-Quadrado , LDL-Colesterol/sangue , Método Duplo-Cego , Jejum/sangue , Fadiga/terapia , Feminino , Trato Gastrointestinal/efeitos dos fármacos , Cefaleia/terapia , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Dor Musculoesquelética/terapia , Fenômenos Fisiológicos da Nutrição , Índice de Gravidade de Doença , Adulto Jovem
14.
Nutrients ; 13(5)2021 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-34067585

RESUMO

We previously observed beneficial effects of a carbohydrate-reduced, high-protein (CRHP) diet on cardiovascular risk markers in patients with type 2 diabetes mellitus (T2DM) in a crossover 2 × 6-week trial, when all food was provided to subjects as ready-to-eat meals. Here, we report the results from a 6-month open label extension: 28 patients with T2DM were instructed to self-prepare the CRHP diet with dietetic guidance. At weeks 0, 6, 12, and 36, fasting and postprandial (4-h meal test) blood samples were collected for measurements of total, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triacylglycerol (TG), apolipoproteins A1 and B, non-esterified fatty acids (NEFA), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6. Diurnal blood pressure and heart rate were also assessed. At the end of the study (week 36), concentrations of fasting total and LDL-cholesterol, fasting and postprandial NEFA and TG, and fasting apolipoprotein-B, CRP and TNF-α concentrations were significantly lower compared with week 0 (p < 0.05). A significant decrease in diurnal heart rate was also observed. From week 12 to 36, an increase in HDL-cholesterol and apolipoprotein-A1 concentrations and a further reduction in fasting and postprandial NEFA (p < 0.05) were found. These changes were independent of minor fluctuations in body weight. We conclude that the substitution of dietary carbohydrate for protein and fat has beneficial effects on several cardiovascular risk markers in patients with T2DM, which are maintained or augmented over the next 6 months when patients select and prepare the CRHP diet on their own in a dietitian-supported setting.


Assuntos
Diabetes Mellitus Tipo 2/dietoterapia , Dieta Rica em Proteínas e Pobre em Carboidratos/métodos , Preferências Alimentares/psicologia , Idoso , Apolipoproteínas/sangue , Biomarcadores/sangue , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Colesterol/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Culinária , Estudos Cross-Over , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/complicações , Dieta Rica em Proteínas e Pobre em Carboidratos/psicologia , Jejum/sangue , Ácidos Graxos não Esterificados/sangue , Feminino , Seguimentos , Fatores de Risco de Doenças Cardíacas , Humanos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Período Pós-Prandial , Estudos Prospectivos , Triglicerídeos/sangue
15.
Nutrients ; 13(5)2021 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-34065380

RESUMO

Fasting and postprandial hypertriglyceridemia are causal risk factors for atherosclerosis. The prevalence of hypertriglyceridemia is approximately 25-30% and most hypertriglyceridemic patients suffer from mild to moderate hypertriglyceridemia. Data regarding dietary interventions on postprandial triglyceride metabolism of mildly to moderately hypertriglyceridemic patients is, however, sparse. In a randomized controlled trial, eight mildly hypertriglyceridemic patients and five healthy, normolipidemic controls received three separate standardized fat-meals containing either saturated fatty acids (SFA), mono-unsaturated fatty acids (MUFA), or medium-chain fatty acids (MCFA) in a randomized order. Fasting and postprandial lipid parameters were determined over a 10 h period and the (incremental) area under the curve (AUC/iAUC) for plasma triglycerides and other parameters were determined. MCFA do not lead to a significant elevation of postprandial total plasma triglycerides and other triglyceride parameters, while both SFA (patients: p = 0.003, controls: p = 0.03 compared to MCFA) and MUFA (patients: p = 0.001; controls: p = 0.14 compared to MCFA) do lead to such an increase. Patients experienced a significantly more pronounced increase of plasma triglycerides than controls (SFA: patients iAUC = 1006 mg*h/dL, controls iAUC = 247 mg*h/dL, p = 0.02; MUFA: patients iAUC = 962 mg*h/dL, controls iAUC = 248 mg*h/dL, p = 0.05). Replacing SFA with MCFA may be a treatment option for mildly to moderately hypertriglyceridemic patients as it prevents postprandial hypertriglyceridemia.


Assuntos
Gorduras na Dieta/administração & dosagem , Hipertrigliceridemia/metabolismo , Metabolismo dos Lipídeos/efeitos dos fármacos , Refeições/fisiologia , Período Pós-Prandial/efeitos dos fármacos , Adulto , Jejum/sangue , Ácidos Graxos/administração & dosagem , Ácidos Graxos Monoinsaturados/administração & dosagem , Feminino , Humanos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Triglicerídeos/sangue
16.
Diabetes Res Clin Pract ; 176: 108846, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33951481

RESUMO

AIMS: The objective of this study was to compare the islet cell function, insulin sensitivity, and incretin axis between Asian-Indian subjects with either impaired fasting glucose (IFG), or impaired glucose tolerance (IGT), and normal glucose tolerance (NGT). MATERIALS AND METHODS: Prediabetes subjects underwent a mixed meal tolerance test(MMTT) after overnight fasting. Samples for glucose, insulin, glucagon, and glucagon-like peptide-1 (GLP-1) were collected at 0, 30, 60, and 120 min. Insulin secretion sensitivity index -2 (ISSI-2) for beta-cell function and Matsuda index for insulin sensitivity were assessed. Alpha cell function was assessed by measuring the area under the curve (AUC) 0-120 glucagon/AUC0-120 glucose. RESULTS: A total of sixty subjects were recruited with 20 in each group. The beta-cell function represented by ISSI-2 was impaired in prediabetes subjects as compared to NGT group (IFG: 2.09 ± 0.44 vs. NGT: 3.04 ± 0.80, P < 0.0001, and IGT: 2.33 ± 0.59 vs. NGT: 3.04 ± 0.80, P = 0.002). Similarly, AUC0-120 glucagon/AUC0-120 glucose was also lower in prediabetes group as compared to healthy controls (IFG: 0.41(0.54) vs. NGT: 1.07(0.39), P = 0.003 and IGT: 0.57(0.38) vs. NGT: 1.07(0.39), P = 0.001). CONCLUSION: Asian-Indian prediabetes subjects have reduced beta-cell function with lesser glucagon secretion during MMTT as compared to normal healthy controls.


Assuntos
Intolerância à Glucose/metabolismo , Intolerância à Glucose/fisiopatologia , Incretinas/metabolismo , Resistência à Insulina/fisiologia , Células Secretoras de Insulina/fisiologia , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Glicemia/metabolismo , Estudos de Casos e Controles , Jejum/sangue , Feminino , Glucagon/metabolismo , Intolerância à Glucose/etnologia , Teste de Tolerância a Glucose , Humanos , Índia/etnologia , Insulina/metabolismo , Resistência à Insulina/etnologia , Secreção de Insulina/fisiologia , Células Secretoras de Insulina/metabolismo , Masculino , Pessoa de Meia-Idade , Estado Pré-Diabético/etnologia , Estado Pré-Diabético/metabolismo , Estado Pré-Diabético/fisiopatologia , Transdução de Sinais/fisiologia
17.
Environ Health ; 20(1): 39, 2021 04 08.
Artigo em Inglês | MEDLINE | ID: mdl-33832509

RESUMO

BACKGROUND: Hypothalamic-pituitary-adrenal (HPA)-axis dysfunction has been associated with a variety of mental health and cardio-metabolic disorders. While causal models of HPA-axis dysregulation have been largely focused on either pre-existing health conditions or psychosocial stress factors, recent evidence suggests a possible role for central nervous system activation via air pollutants, such as nitrogen dioxide (NO2), ozone (O3) and particulate matter (PM). Therefore, in an observational study of Latino youth, we investigated if monthly ambient NO2, O3, and PM with aerodynamic diameter ≤ 2.5 (PM2.5) exposure were associated with morning serum cortisol levels. METHODS: In this cross-sectional study, morning serum cortisol level was assessed after a supervised overnight fast in 203 overweight and obese Latino children and adolescents (female/male: 88/115; mean age: 11.1 ± 1.7 years; pre-pubertal/pubertal/post-pubertal: 85/101/17; BMI z-score: 2.1 ± 0.4). Cumulative concentrations of NO2, O3 and PM2.5 were spatially interpolated at the residential addresses based on measurements from community monitors up to 12 months prior to testing. Single and multi-pollutant linear effects models were used to test the cumulative monthly lag effects of NO2, O3, and PM2.5 on morning serum cortisol levels after adjusting for age, sex, seasonality, social position, pubertal status, and body fat percent by DEXA. RESULTS: Single and multi-pollutant models showed that higher O3 exposure (derived from maximum 8-h exposure windows) in the prior 1-7 months was associated with higher serum morning cortisol (p < 0.05) and longer term PM2.5 exposure (4-10 months) was associated with lower serum morning cortisol levels (p < 0.05). Stratification by pubertal status showed associations in pre-pubertal children compared to pubertal and post-pubertal children. Single, but not multi-pollutant, models showed that higher NO2 over the 4-10 month exposure period associated with lower morning serum cortisol (p < 0.05). CONCLUSIONS: Chronic ambient NO2, O3 and PM2.5 differentially associate with HPA-axis dysfunction, a mechanism that may serve as an explanatory pathway in the relationship between ambient air pollution and metabolic health of youth living in polluted urban environments. Further research that uncovers how ambient air pollutants may differentially contribute to HPA-axis dysfunction are warranted.


Assuntos
Poluentes Atmosféricos/análise , Hidrocortisona/sangue , Sobrepeso/sangue , Adolescente , Criança , Estudos Transversais , Exposição Ambiental/análise , Jejum/sangue , Feminino , Hispano-Americanos , Humanos , Los Angeles , Masculino , Dióxido de Nitrogênio/análise , Ozônio/análise , Material Particulado/análise , Fatores de Tempo
18.
BMC Cancer ; 21(1): 459, 2021 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-33894746

RESUMO

BACKGROUND: Female breast cancer (FBC) is a malignancy involving multiple risk factors and has imposed heavy disease burden on women. We aim to analyze the secular trends of mortality rate of FBC according to its major risk factors. METHODS: Death data of FBC at the global, regional, and national levels were retrieved from the online database of Global Burden of Disease study 2017. Deaths of FBC attributable to alcohol use, high body-mass index (BMI), high fasting plasma glucose (FPG), low physical activity, and tobacco were collected. Estimated average percentage change (EAPC) was used to quantify the temporal trends of age-standardized mortality rate (ASMR) of FBC in 1990-2017. RESULTS: Worldwide, the number of deaths from FBC increased from 344.9 thousand in 1990 to 600.7 thousand in 2017. The ASMR of FBC decreased by 0.59% (95% CI, 0.52, 0.66%) per year during the study period. This decrease was largely driven by the reduction in alcohol use- and tobacco-related FBC, of which the ASMR was decreased by 1.73 and 1.77% per year, respectively. In contrast, the ASMR of FBC attributable to high BMI and high FPG was increased by 1.26% (95% CI, 1.22, 1.30%) and 0.26% (95% CI, 0.23, 0.30%) per year between 1990 and 2017, respectively. CONCLUSIONS: The mortality rate of FBC experienced a reduction over the last three decades, which was partly owing to the effective control for alcohol and tobacco use. However, more potent and tailored prevention strategies for obesity and diabetes are urgently warranted.


Assuntos
Neoplasias da Mama/mortalidade , Saúde Global/estatística & dados numéricos , Consumo de Bebidas Alcoólicas/mortalidade , Glicemia/análise , Índice de Massa Corporal , Causas de Morte , Intervalos de Confiança , Jejum/sangue , Feminino , Saúde Global/tendências , Humanos , Mortalidade/tendências , Obesidade/mortalidade , Fatores de Risco , Comportamento Sedentário , Fumar/mortalidade
19.
Diabetes Res Clin Pract ; 175: 108832, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33895195

RESUMO

AIMS: To examine third trimester fasting venous plasma glucose (FVPG) according to the distribution of a Danish population of pregnant women and identify potential local FVPG thresholds for GDM diagnosis related to risks of adverse pregnancy outcomes. METHODS: In the observational Odense Child Cohort (OCC) study, 1516 women had FVPG measured at 27-28 weeks' gestation and were considered normal by Danish criteria and remained untreated. Maternal FVPG from OCC were standardized according to the local FVPG mean and standard deviation calibrated to data from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study. Associations between maternal FVPG and clinical and anthropometric outcomes were analysed. Potential FVPG cut points were identified. RESULTS: Unadjusted areas under the ROC curve for FVPG to discriminate for large for gestational age (LGA) and hypertensive disorders of pregnancy were 0.61 (95% CI 0.56, 0.67) and 0.57 (95% CI 0.52, 0.63), respectively. The Youden FVPG cut point for LGA was 5.5 mmol/L and 5.0 mmol/L for hypertensive disorders of pregnancy. CONCLUSIONS: This study identified a potential locally appropriate third trimester FVPG cut point between 5.5 and 5.7 mmol/L based on LGA risk in pregnancy. This cut point should be validated prospectively in other Danish cohorts.


Assuntos
Glicemia/metabolismo , Diabetes Gestacional/diagnóstico , Jejum/sangue , Teste de Tolerância a Glucose/métodos , Adulto , Dinamarca , Feminino , Humanos , Recém-Nascido , Gravidez , Complicações na Gravidez , Resultado da Gravidez
20.
Diabetes Res Clin Pract ; 175: 108799, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33845053

RESUMO

AIMS: The status of metabolic abnormalities including impaired fasting glucose (IFG) can change over time, yet little is known about how exposure duration to IFG is related to diabetes risk. METHODS: Using nationally representative data from the Korean National Health Insurance system, 2,513,127 people who were free of diabetes and who received four consecutive annual health examinations commencing in 2006 or 2007 were followed up at the end of 2016. IFG was defined as fasting blood glucose levels of 100-125 mg/dL. Participants were classified numerically according to the cumulative number of IFG diagnoses. RESULTS: Over 4 years, 53% of the population participants remained normoglycemic, while 3% had persistent IFG and 44% had intermittent IFG. The risk of type 2 diabetes mellitus (DM) increased gradually with increasing IFG exposure score. Subjects with an IFG exposure score of 2, 3, or 4 had a 3.75- to 9.77-fold increased hazard ratio (HR) for incident diabetes (IFG exposure score 0 reference; score 2, HR 3.75, 95% confidence interval [CI] 3.67-3.83; score 3, HR 6.21, 95% CI 6.08-6.36; score 4, HR 9.77, 95% CI 9.53-10.02). CONCLUSIONS: Cumulative IFG exposure was associated with a higher risk of type 2 DM in a dose-response fashion.


Assuntos
Glicemia/metabolismo , Diabetes Mellitus Tipo 2/diagnóstico , Jejum/sangue , Estado Pré-Diabético/sangue , Diabetes Mellitus Tipo 2/patologia , Feminino , Humanos , Masculino , Fatores de Risco
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