Nutrient patterns and cardiometabolic risk factors among Iranian adults: Tehran lipid and glucose study.

BACKGROUND: The present study aimed to assess the relation between nutrient patterns and changes in adult anthropometric and cardiometabolic factors. METHODS: This study was conducted on 1637 adults participating in the Tehran Lipid and Glucose Study (2005-2008), who were free of cardiovascular diseases and cancer and had completed dietary data. They were followed to the next survey (2008-2011). Dietary intakes were collected and nutrient patterns were obtained. Three year changes in anthropometric and cardiometabolic factors were measured. RESULTS: Five nutrient patterns were extracted. The first pattern was characterized by "plant protein, thiamine, niacin, and minerals including phosphorus, zinc, copper, magnesium, manganese, and selenium". Animal protein, lactose, vitamin D, riboflavine, pantothenic acid, vitamin B12, calcium, phosphorus, and zinc" were loaded in the second pattern. The third and fourth patterns were characterized by "vitamin K, fiber, calcium, iron, manganese, and potassium", and "high correlation with starch, thiamine and folate, and negative correlation with mono and poly unsaturated fatty acids and vitamin E", respectively. The fifth pattern was high in Fructose, vitamins A, C, pyridoxine, and potassium. There was no association between nutrient patterns and 3-year changes in blood pressure and fasting blood glucose; whereas, per each quartile increment of the fifth pattern adjusted for potential confounders, triglyceride change was decreased [ß = - 3.66, 95% CI (- 6.57, - 0.57); P for trend = 0.014]. CONCLUSION: Present study indicates that nutrient patterns may have an association with cardiometabolic factors, particularly a pattern rich in fructose, vitamins A, C, pyridoxine, and potassium which decreases triglyceride level.

Incident Type 2 Diabetes Among Individuals With CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study.

RATIONALE & OBJECTIVE: Few studies have examined incident type 2 diabetes mellitus (T2DM) in chronic kidney disease (CKD). Our objective was to examine rates of and risk factors for T2DM in CKD, using several alternative measures of glycemic control. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: 1,713 participants with reduced glomerular filtration rates and without diabetes at baseline, enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study. PREDICTORS: Measures of kidney function and damage, fasting blood glucose, hemoglobin A1c (HbA1c), HOMA-IR (homeostatic model assessment of insulin resistance), demographics, family history of diabetes mellitus (DM), smoking status, medication use, systolic blood pressure, triglyceride level, high-density lipoprotein cholesterol level, body mass index, and physical activity. OUTCOME: Incident T2DM (defined as fasting blood glucose ≥ 126mg/dL or prescription of insulin or oral hypoglycemic agents). ANALYTICAL APPROACH: Concordance between fasting blood glucose and HbA1c levels was assessed using κ. Cause-specific hazards modeling, treating death and end-stage kidney disease as competing events, was used to predict incident T2DM. RESULTS: Overall T2DM incidence rate was 17.81 cases/1,000 person-years. Concordance between fasting blood glucose and HbA1c levels was low (κ for categorical versions of fasting blood glucose and HbA1c = 13%). Unadjusted associations of measures of kidney function and damage with incident T2DM were nonsignificant (P ≥ 0.4). In multivariable models, T2DM was significantly associated with fasting blood glucose level (P = 0.002) and family history of DM (P = 0.03). The adjusted association of HOMA-IR with T2DM was comparable to that of fasting blood glucose level; the association of HbA1c level was nonsignificant (P ≥ 0.1). Harrell's C for the models ranged from 0.62 to 0.68. LIMITATIONS: Limited number of outcome events; predictors limited to measures taken at baseline. CONCLUSIONS: The T2DM incidence rate among individuals with CKD is markedly higher than in the general population, supporting the need for greater vigilance in this population. Measures of glycemic control and family history of DM were independently associated with incident T2DM.

The Impact of Low-Volume High-Intensity Interval Training (LV-HIIT) on Fatty Liver Index (FLI) and Estimated Glomerular Filtration Rate (eGFR) in Patients with Type 2 Diabetes Mellitus (T2DM).

BACKGROUND: Prevention and reduction of liver fat accumulation and maintenance of Glomerular Filtration Rate (GFR) have been proposed as important therapeutic goals in patients with Type 2 Diabetes Mellitus (T2DM). AIM: This study aimed to determine the effect of Low-Volume High-Intensity Interval Training (LV-HIIT) on fatty liver index (FLI) and GFR estimation in patients with T2DM. METHODS: This randomized controlled trial included 80 patients with T2DM and a sedentary lifestyle, randomly divided into HIIT (n=40) and a control group (n=40). Patients with a history of T2DM for at least one year and HbA1C levels between 6.4% and 10% were selected. The intervention group underwent a 4-week LV-HIIT course, comprising 3 sessions per week, while the control group did not receive any intervention. FLI, eGFR, anthropometric measurements, and laboratory variables were assessed in all participants before and after the intervention. RESULTS: FLI (62.0 at baseline, 53.0 at follow-up) significantly decreased in the LV-HIIT group after the intervention, while eGFR (71.0 at baseline, 73.6 at follow-up) significantly increased (P<0.001). However, the control group showed a significant reduction only in Fasting Blood Sugar (FBS) (P<0.05). After the intervention, the LV-HIIT group had significantly lower FBS (129.0 at baseline, 121.0 at follow-up), Alanine Aminotransferase (ALT) (24.0 at baseline, 18.0 at follow-up), and Gamma-Glutamyl Transferase (GGT) (22.0 at baseline, 19.0 at follow-up), as well as higher eGFR, compared to the control group (P<0.05). CONCLUSIONS: LV-HIIT exercise appears to be a promising and effective training method for improving FLI and eGFR in patients diagnosed with T2DM.

The effects of canola and olive oils on insulin resistance, inflammation and oxidative stress in women with type 2 diabetes: a randomized and controlled trial.

BACKGROUND: A number of studies have shown that consumption of vegetable oils may improve diabetes complications including inflammatory response and oxidative stress, but no study has been done on the effects of canola oil (CO) and olive oil (OO) consumption in patients with type 2 diabetes. This clinical trial was done to compare the effects of CO and OO on insulin resistance, inflammation and oxidative stress in women with type 2 diabetes. METHODS: This randomized controlled clinical trial was done on 77 type 2 diabetic women. 4 weeks before the intervention, lipid-lowering drugs intakes were cut under the supervision of an endocrinologist. The participants were randomly divided into 2 intervention groups (Balanced diet +30 g/day CO or OO) and one control group (Balanced diet +30 g/day of sunflower oil (SFO)). Dietary intakes were assessed using three 24-h food records at baseline and at weeks 4 and 8 of the interventions. At baseline and after 8 weeks, height, weight, waist circumference, fasting blood sugar (FBS), serum insulin, C-reactive protein (CRP) and malondialdehyde (MDA) were measured. RESULTS: After the intervention in the inter-group analysis, CRP level was reduced significantly in CO and OO groups but no significant changes were observed in other factors. CRP reductions were also significant between all of the groups but not for other factors. CONCLUSIONS: Replacing CO and OO with SFO as part of daily dietary fat in the diet of people with type 2 diabetes is recommended for reducing Inflammation and Oxidative Stress. Trial registration. This study is approved by the Ethics Committee of Shiraz University of Medical Sciences (IR.SUMS.REC.1394.27) and is recorded in the Iranian Registry of Clinical Trials (IRCT2015062722818N1).

Correlation of the serum insulin and the serum uric Acid levels with the glycated haemoglobin levels in the patients of type 2 diabetes mellitus.

BACKGROUND: Type 2 Diabetes mellitus (DM) is a heterogeneous disease which is characterized by variable degrees of insulin resistance and impaired insulin secretion. Insulin is a hormone that regulates the body's use of glucose. The present study was undertaken to find the correlation of the serum uric acid levels in the patients of Type 2 Diabetes mellitus. MATERIAL AND METHOD: This was a case control study. The subjects who were included in the study were divided into two groups. Group A included 50 normal healthy individuals who were in the age group of 40-65 years, who were of either sex and with no family history of Diabetes mellitus. Group B included 50 newly diagnosed patients of Type 2 Diabetes Mellitus, who were in the age group of 40-65 years, who were of either sex, from the same population. Fasting blood samples were drawn and they were investigated for the serum insulin, serum uric acid, fasting blood sugar and the HbA1C levels. The values were compared with those of normal healthy subjects. RESULTS: All the three parameters, HbA1C, serum insulin and serum uric acid were found to be increased in the patients of Type 2 Diabetes Mellitus as compared to their levels in the controls (p<0.001). CONCLUSION: In the present study, it was concluded that the serum uric acid levels linearly increased with increasing serum insulin levels, in newly diagnosed diabetic patients. Therefore, uric acid serves as a potential biomarker of the glucose metabolism.