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Aim: Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease and also closely related to cardiometabolic disease. Its prevalence was estimated at over one-fourth in the general population in China. We aimed to develop effective score tools for detecting NAFLD.Methods: A total of 17,212 participants aged 45-70 years old were surveyed in Shanghai between 2013 and 2014, and 13,293 participants were included in this analysis. All participants were randomly classified into the exploratory group or the validation group. Candidate categorical variables were selected using a logistic regression model. The score points were generated according to the β-coefficients.Results: We developed the Shanghai Nicheng NAFLD Score I (SHNC NAFLD Score I), which included body mass index and waist circumference with an area under the receiver-operating characteristic curve (AUC) of 0.802 (95% CI 0.792-0.811) in the exploratory group and 0.802 (95% CI 0.793-0.812) in the validation group. We further developed the SHNC NAFLD Score II by adding fasting plasma glucose, triglyceride, and alanine aminotransferase/aspartate aminotransferase ratio to the SHNC NAFLD Score I, achieving an AUC of 0.852 (95% CI 0.843-0.861) in the exploratory group and 0.843 (95% CI 0.834-0.852) in the validation group. The two score tools also performed well in subjects with normal alanine aminotransferase (ALT) levels.Conclusions: Based on anthropometric and clinical categorical variables, our two scores are effective tools for detecting NAFLD in both this southern Chinese population and their subpopulation with normal ALT levels. [ABSTRACT FROM AUTHOR]

Aims: To investigate the frequency of dawn phenomenon (DP) and its relationship with time in range (TIR) and glycemic variability (GV) using continuous glucose monitoring (CGM).Methods: 781 subjects of a multicenter CGM study in China were included: those with normal glucose tolerance (NGT n = 360); impaired glucose regulation (IGR n = 173); newly diagnosed type 2 diabetes mellitus (T2D n = 248). Analysis of the magnitude of DP (ΔG) was conducted with the primary definition of 1.11 mmol/L and a secondary definition of 0.56 mmol/L.Results: The frequency of DP was 8.9%, 30.1% and 52.4% in NGT, IGR and T2D group, respectively, using the primary definition. In all three groups, TIR was lower (all P < 0.05), coefficient of variation (CV) was higher in DP subgroup (all P < 0.05). In DP subgroup of T2D, TIR was 7.0% (1.68 h) lower and CV was 3.0% higher, and HbA1c was 0.6% (7 mmol/mol) higher using the primary definition (all P < 0.05).Conclusions: DP was present in a high percent of subjects with NGT and IGR. In newly diagnosed T2D group, the presence of DP was associated with poorer overall glycemic control. [ABSTRACT FROM AUTHOR]

Aims: Continuous glucose monitoring (CGM)-derived time-in-range (TIR) of 3.9-10 mmol/L is associated with diabetic retinopathy in type 2 diabetes (T2DM), but its relationship to peripheral nerve function has not been previously investigated. To explore the association between the TIR and nerve conduction study parameters in patients with T2DM, we performed a cross-sectional analysis.Methods: A total of 740 patients with T2DM were enrolled in this study. All of the participants were divided into tertiles according to the TIR (TIR low: ≤53%; TIR medium: 54-76%; TIR high: ≥77%). Composite Z-scores of nerve conduction velocity (CV), latency, and amplitude were calculated. The linear correlation between the TIR and composite nerve function Z-score was evaluated and risk assessment was analysed using binary logistic regression.Results: The composite Z-score of the CV and amplitude increased with higher TIR and the composite Z-score of latency significantly decreased as the TIR tertiles increased (all P trend < 0.05). After adjusting for age, diabetes duration, height, weight and other confounding factors, higher TIR was associated with a higher composite Z-score of CV (β = 0.230, P < 0.001), amplitude (β = 0.099, P = 0.010), and lower composite Z-score of latency (β = -0.172, P < 0.001). The risk of TIR tertiles and low composite Z-score of CV remained significant even after adjustment of HbA1c (TIR medium: OR = 0.48, P = 0.001; TIR high: OR = 0.41, P < 0.001).Conclusions: Higher TIR tertiles were independently associated with better peripheral nerve function. CGM-derived TIR may be a promising approach to screen patients for further assessment of possible diabetic peripheral neuropathy. [ABSTRACT FROM AUTHOR]

Background: Alterations in gut microbiota have been associated with improvements in blood glucose due to bariatric surgery.Objectives: Our aim is to identify specific gut microbiota that contribute to the remission of T2D after RYGB and SG.Methods: Rats fed a high-fat diet (HFD) were administered a low dose of streptozotocin as T2D models; next, their caecum content was collected 8 weeks after RYGB and SG. We also used case-control of gut microbial profiles of T2D patients and healthy people by collecting the mucosal-luminal interface from the ascending colon. Samples were profiled by 16S rRNA gene sequencing.Results: RYGB and SG reduced weight and improved glucose and insulin tolerance. Principal coordinate analysis showed that SG and, especially, RYGB cause changes in the composition of gut microbiota. We found that family Alcaligenaceae (genus Sutterella) was significantly decreased in the ascending colon of patients with T2D and increased after RYGB surgery in the caecum of T2D rats as shown by a linear discriminant analysis effect size (LEfSe) analysis, with no significant changes after SG. This result might benefit the improvement of glycometabolism.Conclusions: RYGB can significantly reduce weight, improve glycometabolism and change the composition of the gut microbiota. Sutterella may have beneficial effects on glycometabolism in T2D patients after RYGB. [ABSTRACT FROM AUTHOR]