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In patients undergoing total joint arthroplasty, the use of dexamethasone (DEX) may cause perioperative blood glucose (BG) disorders, leading to complications even in patients who do not have diabetes. We aimed to evaluate the effects of different DEX doses on perioperative BG levels. A total of 135 patients who do not have diabetes were randomized into three groups: preoperative intravenous (IV) injection of normal saline (Group A, the placebo group), preoperative IV injection of 10 mg DEX (Group B), and preoperative IV injection of 20 mg DEX (Group C). Postoperative fasting BG (FBG) levels were designated as the primary outcome, while postoperative postprandial BG (PBG) levels were assigned as the secondary outcome. The incidence of complications was recorded. We also investigated the risk factors for FBG ≥ 140 mg/dL and PBG ≥ 180 mg/dL. The FBG levels were higher in Groups B and C than in Group A on postoperative days (PODs) 0 and 1. The PBG levels were lower for Groups A and B compared to Group C on POD 1. No differences in FBG or PBG were detected beyond POD 1. Elevated preoperative glycosylated hemoglobin A1c levels increased the risk of FBG ≥ 140 mg/dL and PBG ≥ 180 mg/dL, respectively. However, preoperative IV injection of DEX was not associated with FBG ≥ 140 mg/dL or PBG ≥ 180 mg/dL. No differences were found in postoperative complications among the three groups. The preoperative IV administration of 10 or 20 mg DEX in patients who do not have diabetes showed transient effects on postoperative BG after total joint arthroplasty. The preoperative glycosylated hemoglobin A1c level threshold (regardless of the administration or dosage of DEX) that increased the risk for the occurrence of FBG ≥ 140 mg/dL and PBG ≥ 180 mg/dL was 5.75 and 5.85%, respectively. [ABSTRACT FROM AUTHOR]

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Objectives Methods Results Conclusion To investigate the association between gestational diabetes mellitus (GDM) and blood levels of gelsolin (an inflammation‐related protein thought to be reduced in type 2 diabetes mellitus) and to determine its role in potential diagnosis and neonatal outcomes.This prospective case–control study was conducted at Ankara Etlik City Hospital between November 2023 and February 2024 with 40 pregnant women with GDM and 40 normoglycemic women. Pregnant women aged 18–40 years who were in their 24th to 28th week of pregnancy and had no known chronic disease were included in the present study and it was investigated as to whether there was a significant difference between the two groups in terms of gelsolin levels and neonatal outcome.Gelsolin level was statistically significantly lower in the GDM group than in the control group (P = 0.004). In patients with fasting blood glucose <96 mg/dL, maternal serum gelsolin levels were associated with GDM, with a cut‐off of 15.38 or less, showing a sensitivity of 73%, a specificity of 67%, and an area under the curve (AUC) of 0.703 (95% confidence interval [CI] 0.576–0.810, P = 0.002). There was no difference between groups in terms of adverse obstetric outcomes, but gelsolin levels were associated with composite neonatal adverse outcome (macrosomia, Apgar score at 5 min less than 7, preterm birth, need for neonatal intensive care), with a cut‐off value of 16.66 or less showing a sensitivity of 84.6%, specificity of 40.7% and AUC of 0.644 (95% CI 0.529–0.748, P = 0.031).Gelsolin could potentially serve as a promising biomarker for the diagnosis of GDM. [ABSTRACT FROM AUTHOR]

To investigate the effects of methadone maintenance therapy on body mass index (BMI) and some biochemical parameters, including fasting blood glucose, lipid profile, and liver function indices as indicators of the biochemical function of the body for 3 years. This interventional study was performed on 43 opioid use disorder patients who had been selected for methadone maintenance therapy from 2016 to 2020. The morphine test on blood samples was carried out monthly for all patients. Fasting blood glucose, lipid profile including triglyceride, total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, and liver function tests including alkaline phosphatase (ALP), alanine transaminase (ALT), aspartate transaminase (AST), and body mass index (BMI) were measured over 3 years. Data analysis was performed using SPSS software. FBS in second and third year of therapy increased by 15.57 mg/dL (p-value 0.01) and 21.87 mg/dL (p-value 0.009), respectively; none of lipid profile variables was significantly different over time (p-value > 0.05). Only mean ALP levels significantly decreased 21.51 IU/L (p-value 0.04), 21.02 IU/L (p-value 0.04), and 26.07 IU/L (p-value 0.01) in liver function tests. The mean BMI increases each years but not significantly. Methadone treatment affects some biochemical parameters such as blood sugar and liver activity, so changes in biochemical parameters should be considered. [ABSTRACT FROM AUTHOR]

Purpose: We prospectively analyzed the correlation between fasting plasma glucose (FPG) and the risk of breast cancer in women; explored the independent risk factors for breast cancer in women, and compared the effect of FPG level on the risk of young and non-young breast cancer. Our study provides new evidence and ideas for research into breast cancer etiology in China, improves the accuracy of secondary prevention of breast cancer, and provides options for the clinical diagnosis and treatment of breast cancer patients with diabetes. Materials and methods: Three cohorts of women participating in the first health examination of the Kailuan Group in 2006, 2008 and 2010 were assembled to conduct a descriptive analysis of the baseline data on FPG. The cumulative incidence of breast cancer in different groups over 13 years was calculated using the Kaplan-Meier method and groups were compared using the log-rank test. A Cox proportional hazards regression model was used to analyze the association between FPG level and the risk of breast cancer. Results: The cumulative incidence of breast cancer increased in people with FPG higher than 5.29 mmol/L, but there was no significant difference in the effect of different levels of FPG on the risk of young breast cancer in the population. Different degrees of fasting glucose can affect the risk of non-young breast cancer in the population. Conclusion: The results of this study suggest that the risk of breast cancer can be reversed by early intervention to control levels of FPG. Regular monitoring of FPG may reduce the misdiagnosis rate of breast cancer in the population. [ABSTRACT FROM AUTHOR]

Obesity is a risk factor for the development of gestational diabetes mellitus (GDM). However, the most optimal type of nutritional intervention to prevent GDM in high-risk women is not clearly defined. This study investigates if nutritional treatment based on the Mediterranean diet (MedDiet) before the 12th gestational week (GW) in women at high risk due to a body mass index (BMI) ≥ 25 kg/m2 reduces the rate of GDM and metabolic syndrome (MetS) at 3 years postpartum. We performed a post-hoc analysis of the San Carlos Gestational Prevention Study. A total of 735 women with BMI ≥ 25 kg/m2 were evaluated between 2015 and 2018, with 246 in the standard diet control group (CG) and 489 in the MedDiet intervention group (IG). The rate of GDM was significantly lower in IG compared to CG (25.1% vs. 31.7%), relative risk (95% confidence interval), and 0.89 (0.78–0.99); p = 0.037. Postnatal follow-up was completed by 141 women in CG (57%) and 312 women in IG (64%). At 3 years postpartum, we observed a reduction in the rates of impaired fasting glucose (IFG) (0.51 (0.28–0.92); p = 0.019), obesity (0.51 (0.28–0.92); p = 0.041), waist circumference (WC) ≥ 89.5 cm (0.54 (0.31–0.94); p = 0.022), and MetS (0.56 (0.33–0.94); p = 0.003). MedDiet reduces the rate of GDM and postpartum MetS in women with BMI) ≥ 25 kg/m2, suggesting that its implementation should be routinely recommended from the first GWs. [ABSTRACT FROM AUTHOR]

Objective Design Setting Population Methods Main Outcome Measures Results Conclusions To investigate the positive rate of late‐onset gestational diabetes mellitus (GDM) by additional fasting blood glucose (FBG) screening at 32–34 gestational weeks (GW) and analyse the perinatal outcomes of late‐onset GDM after standard treatment.An Prospective cohort study.Single centre in China.1130 singleton pregnancies with negative GDM screening in their first and second trimester.Additional FBG testing was performed at 32–34 GW. Pregnancies with FBG ≥5.1 mmol/L were diagnosed as GDM and received standardized treatment. Perinatal outcomes were collected and compared.Diagnosis of late‐onset GDM, obstetric and neonatal outcomes.6.3% (71/1130) of participants had FBG values ≥5.1 mmol/L and were diagnosed with late‐onset GDM. Sixty‐five (91.5%) were treated by dietary therapy and 6 (8.5%) by insulin therapy. The perinatal outcomes of full‐term delivery were compared. The incidence of macrosomia (22.7% vs. 5.1%, adjusted odds ratio (aOR) 5.51, 95% confidence interval (CI) 1.83–16.61, p = 0.002) and NICU transferring (18.3% vs. 10.1%, aOR 1.94, 95% CI 1.01–3.74, p = 0.046) was significantly higher in late‐onset GDM group than that in FBG <5.1 mmol/L group. Elevated FBG was associated with overweight or obesity during pregnancy (54.9% vs. 34.9%, OR 2.27, 95% CI 1.40–3.68, p = 0.001).6.3% of singleton pregnancies with normal GDM screening results in the first and second trimester were found to have late‐onset GDM by additional FBG screening at 32–34 GW, and their risk of macrosomia during a full‐term pregnancy remains significantly higher after standard treatment. [ABSTRACT FROM AUTHOR]

Three glucose-6-phosphatase catalytic subunits, that hydrolyze glucose-6-phosphate (G6P) to glucose and inorganic phosphate, have been identified, designated G6PC1-3, but only G6PC1 and G6PC2 have been implicated in the regulation of fasting blood glucose (FBG). Elevated FBG has been associated with multiple adverse clinical outcomes, including increased risk for type 2 diabetes and various cancers. Therefore, G6PC1 and G6PC2 inhibitors that lower FBG may be of prophylactic value for the prevention of multiple conditions. The studies described here characterize a G6PC2 inhibitor, designated VU0945627, previously identified as Compound 3. We show that VU0945627 preferentially inhibits human G6PC2 versus human G6PC1 but activates human G6PC3. VU0945627 is a mixed G6PC2 inhibitor, increasing the Km but reducing the Vmax for G6P hydrolysis. PyRx virtual docking to an AlphaFold2-derived G6PC2 structural model suggests VU0945627 binds two sites in human G6PC2. Mutation of residues in these sites reduces the inhibitory effect of VU0945627. VU0945627 does not inhibit mouse G6PC2 despite its 84% sequence identity with human G6PC2. Mutagenesis studies suggest this lack of inhibition of mouse G6PC2 is due, in part, to a change in residue 318 from histidine in human G6PC2 to proline in mouse G6PC2. Surprisingly, VU0945627 still inhibited glucose cycling in the mouse islet-derived βTC-3 cell line. Studies using intact mouse liver microsomes and PyRx docking suggest that this observation can be explained by an ability of VU0945627 to also inhibit the G6P transporter SLC37A4. These data will inform future computational modeling studies designed to identify G6PC isoform-specific inhibitors. • GWAS, mouse and molecular data show that G6PC2 regulates fasting blood glucose (FBG) levels. • Elevated FBG levels are associated with increased risk for type 2 diabetes and various cancers. • We characterized the specificity of a previously described G6PC2 inhibitor, called Compound 3. • Compound 3 was shown to inhibit both G6PC1 and G6PC2 but also block G6P transport. • The data will help direct the future development of G6PC2-specific inhibitors. [ABSTRACT FROM AUTHOR]

Background: In patients undergoing total joint arthroplasty (TJA), the administration of dexamethasone may contribute to perioperative blood glucose (BG) disturbances, potentially resulting in complications, even in patients without diabetes. This study aimed to demonstrate the impact of different administration regimens of dexamethasone in postoperative BG levels. Methods: In this randomized, controlled, double-blind trial, 136 patients without diabetes scheduled for TJA were randomly assigned to three groups: two perioperative saline injections (Group A, placebo); a single preoperative injection of 20 mg dexamethasone and a postoperative saline injection (Group B), and two perioperative injections of 10 mg dexamethasone (Group C). Primary outcomes were the postoperative fasting blood glucose (FBG) levels. Secondary outcome parameters were the postoperative postprandial blood glucose (PBG) levels. Postoperative complications within 90 days were also recorded. Risk factors for FBG ≥ 140 mg/dl and PBG ≥ 180 mg/dl were investigated. Results: Compared to Group A, there were transient increases in FBG and PBG on postoperative days (PODs) 0 and 1 in Groups B and C. Statistical differences in FBG and PBG among the three groups were nearly absent from POD 1 onward. Both dexamethasone regimens did not increase the risk for postoperative FBG ≥ 140 mg/dl or PBG ≥ 180 mg/dl. Elevated preoperative HbA1c levels may increase the risk of postoperative FBG ≥ 140 mg/dl or PBG ≥ 180 mg/dl, respectively. Conclusion: Perioperative intravenous high-dose dexamethasone to patients without diabetes has transient effects on increasing BG levels after TJA. However, no differences were found between the split-dose and single high-dose regimens. The elevated preoperative HbA1c, but not the dexamethasone regimens were the risk factor for FBG ≥ 140 mg/dl and PBG ≥ 180 mg/dl. Trial registration: Chinese Clinical Trail Registry, ChiCTR2300069473. Registered 17 March 2023, https://www.chictr.org.cn/showproj.html?proj=186760. [ABSTRACT FROM AUTHOR]

Background/Aim: Vildagliptin is one of the dipeptidyl peptidase-4 (DPP-4) inhibitors that have been shown to improve hyperglycemia in clinical trials among patients with type 2 diabetes. However, few studies have examined the efficacy of vildagliptin in patients with diabetic kidney disease (DKD). Patients and Methods: Eight patients with DKD received oral vildagliptin 50-100 mg/day. The duration of diabetes was 6.7±5.9 years and observation period was 23.6±9.8 months. Changes in fasting blood glucose, and hemoglobin A1c (HbA1c), estimated glomerular filtration rate (eGFR), and urine protein-to-creatinine ratio (UPCR) were studied before and after the administration of vildagliptin. Results: Vildagliptin treatment significantly decreased fasting blood glucose and HbA1c, compared to baseline (132±56 mg/dl, p=0.036, 6.0±0.3, p=0.041, respectively). UPCR tended to be decreased, albeit without statistical significance. However, eGFR was decreased after the administration of vildagliptin. No significant adverse effects were observed in all patients during the study. Conclusion: Although the sample size was limited and the observation period was brief, vildagliptin was found to be an effective and reasonably well-tolerated treatment for patients with DKD. [ABSTRACT FROM AUTHOR]

Background: The influence of genetic variants on the glucose-lowering effects of dapagliflozin remains unclear. This study aims to investigate the impact of polymorphisms in solute carrier family 5 member 2 (SLC5A2), uridine diphosphate glucuronosyltransferase 1A9 (UGT1A9), solute carrier family 2 member 2 (SLC2A2) and member 4 (SLC2A4) on the anti-hyperglycemic effect of dapagliflozin in patients with type-2 diabetes mellitus (T2DM). Methods: A total of 141 patients with T2DM were included in this prospective cohort study. Twenty-nine single nucleotide polymorphisms (SNPs) were selected and genotyped using the Sequenom MassArray platform or Sanger sequencing. Glycated hemoglobin (HbA1c) and fasting blood glucose (FBG) levels were compared before and after the treatment with dapagliflozin. Results: Among the 29 SNPs selected, 27 were successfully analyzed. After three months of dapagliflozin treatment, FBG levels were significantly reduced (8.00 mmol/L (5.45– 10.71) mmol/L vs 6.40 mmol/L (5.45– 9.20) mmol/L, p = 0.003) in patients with T2DM. However, there was no significant change in HbA1c levels (8.10% (6.88– 10.00)% vs 8.10% (6.83– 10.00)%, p = 0.452). Analysis of covariance showed that patients with the minor allele homozygote or heterozygote of rs12471030 (CT/TT), rs12988520 (AC/CC) or rs2602381 (TC/CC) had higher FBG levels compared to those with the major allele homozygote (p = 0.014, p = 0.024, and p = 0.044, respectively). After adjusting for baseline FBG level, age, gender, body mass index, use of insulin and use of metformin, three SNPs—rs12471030, rs12988520 and rs2602381—were associated with the anti-hyperglycemic effect of dapagliflozin. However, using a stringent significance threshold (p < 0.002 with Bonferroni correction), none of these selected SNPs were significantly associated with FBG and HbA1c levels after dapagliflozin treatment. Conclusion: After adjusting for confounding variables, polymorphisms in SLC5A2, UGT1A9, SLC2A2 and SLC2A4 genes were not associated with the anti-hyperglycemic effect of dapagliflozin in the Chinese population. Clinical Trial Registration Number: ChiCTR2200059645. [ABSTRACT FROM AUTHOR]

Background and Aim: Evidence suggests a beneficial effect of sun exposure on type 2 diabetes mellitus (DM). However, little is known about the characteristics of sun exposure among DM patients or individuals at risk of developing DM. The aim of this study was to analyze the sun exposure behaviors of individuals diagnosed with DM and those susceptible to developing DM within a semi-urban community in North India. Materials and Methods: A population-based cross-sectional study was conducted in northern India with 494 participants aged 25-60, with or without DM. The participants' sun exposure characteristics were assessed through a sunlight exposure questionnaire, and total sun exposure in a day was computed using the veritable sun exposure (VSE) index. Fasting blood sugar, anthropometric measurements, and demographic details were also collected. Results: The study had 56.5% female participants, and 9.1% of the participants had DM. The VSE of the study participants ranged from 0.01 to 0.81, with a mean of 0.15 (±0.14) and a median of 0.10, indicating that more than half of the study samples had less than 10% h/day of sunlight exposure. The use of sunscreen, gender, and disease status all influenced VSE. Our data suggest that the characteristics of sun exposure among Indians significantly deviate from standard recommendations. Conclusion: Our results propose a need for evidence-based guidelines and policies that promote awareness about sun exposure among DM patients as well as those at risk of developing DM. Nevertheless, these findings need to be validated through large-scale observational studies. [ABSTRACT FROM AUTHOR]

Ning Rong,1 Zhi-Wei Li,1 Jian Yuan,2 Ze-Min Shao,2 Yun Deng,2 De-Sheng Zhu,2,3 Zhong-Wu Sun1 1Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China; 2Department of Neurology, Baoshan Branch, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200444, People’s Republic of China; 3Department of Neurology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, People’s Republic of ChinaCorrespondence: Zhong-Wu Sun, Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China, Tel +86-13805515857, Email sunzhwu@126.com De-Sheng Zhu, Department of Neurology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160, Pujian Road, Shanghai, 200127, People’s Republic of China, Tel +86-13564719779, Email deshengzhu2008@sina.comObjective: Fasting blood glucose (FBG) is a recognized risk factor for Ischemic Stroke, but little research has examined the interaction among FBG, Platelet Distribution Width (PDW) and the severity of neuronal damage. Thus, the present study constructs a moderated mediation model aimed to elucidate the relationships among FBG, PDW, and NIHSS scores in patients with acute ischemic stroke (AIS).Methods: We conducted a cross-sectional study on 431 AIS patients. Upon hospital admission, we assessed the patients’ NIHSS scores and collected blood samples to measure FBG and PDW levels. The relationship between FBG and NIHSS scores moderated by PDW was analyzed by linear curve fitting analysis, multiple linear regression analysis, and moderated mediation analysis respectively.Results: In the tertile grouping based on FBG, both PDW and NIHSS scores of AIS patients demonstrated an increase corresponding with rising levels of FBG (p< 0.001 for both). Multiple linear regression analysis revealed that, the β coefficients (95% CI) for the relationship between FBG and NIHSS scores were 1.49 (1.27– 1.71, p< 0.01) post-adjustment for potential confounders. The β coefficients (95% CI) for the relationship between FBG and PDW were 0.02 (0.01– 0.04, p< 0.01) post-adjustment. Likewise, for the relationship between PDW and NIHSS scores, the β coefficients (95% CI) were 4.33 (3.07– 5.59, p< 0.01) after adjustment. These positive association remained consistent in sensitivity analysis and hierarchical analysis. Smoothed plots suggested that there are linear relationships between FBG and PDW and NIHSS scores respectively. Further mediation analysis indicated that increased PDW significantly (p< 0.01) mediated 5.91% of FBG-associated increased NIHSS scores.Conclusion: This study suggested that FBG levels were associated with NIHSS scores, and the FBG-associated neurological impairment may be partially mediated by PDW. These findings underscore the importance of monitoring FBG and PDW levels in AIS patients, potentially guiding risk intervention strategies.Keywords: acute ischemic stroke, fasting blood glucose, platelet distribution width, multivariate analysis, mediation analysis

Abstract Background In patients undergoing total joint arthroplasty (TJA), the administration of dexamethasone may contribute to perioperative blood glucose (BG) disturbances, potentially resulting in complications, even in patients without diabetes. This study aimed to demonstrate the impact of different administration regimens of dexamethasone in postoperative BG levels. Methods In this randomized, controlled, double-blind trial, 136 patients without diabetes scheduled for TJA were randomly assigned to three groups: two perioperative saline injections (Group A, placebo); a single preoperative injection of 20 mg dexamethasone and a postoperative saline injection (Group B), and two perioperative injections of 10 mg dexamethasone (Group C). Primary outcomes were the postoperative fasting blood glucose (FBG) levels. Secondary outcome parameters were the postoperative postprandial blood glucose (PBG) levels. Postoperative complications within 90 days were also recorded. Risk factors for FBG ≥ 140 mg/dl and PBG ≥ 180 mg/dl were investigated. Results Compared to Group A, there were transient increases in FBG and PBG on postoperative days (PODs) 0 and 1 in Groups B and C. Statistical differences in FBG and PBG among the three groups were nearly absent from POD 1 onward. Both dexamethasone regimens did not increase the risk for postoperative FBG ≥ 140 mg/dl or PBG ≥ 180 mg/dl. Elevated preoperative HbA1c levels may increase the risk of postoperative FBG ≥ 140 mg/dl or PBG ≥ 180 mg/dl, respectively. Conclusion Perioperative intravenous high-dose dexamethasone to patients without diabetes has transient effects on increasing BG levels after TJA. However, no differences were found between the split-dose and single high-dose regimens. The elevated preoperative HbA1c, but not the dexamethasone regimens were the risk factor for FBG ≥ 140 mg/dl and PBG ≥ 180 mg/dl. Trial registration Chinese Clinical Trail Registry, ChiCTR2300069473. Registered 17 March 2023, https://www.chictr.org.cn/showproj.html?proj=186760 .

Abstract Background This cross-sectional study aims to explore whether there exists an interaction between selenium and menopause concerning type 2 diabetes (T2D) prevalence and its related indicators such as fasting blood glucose (FBG) and homeostasis model assessment of insulin resistance (HOMA-IR). Methods 150 women aged 35–60 years old were finally analyzed in this study. Multivariate linear or logistic regression modeling was conducted to explore the association of selenium and the prevalence of T2D besides its related indicators. Subgroup analyses were conducted based on menopause status to assess the potential impact on the relationship. Results In the fully adjusted model, serum selenium was positively associated with FBG (β: 0.03, CI: 0.01–0.05) and the prevalence of T2D (OR: 1.04, CI: 1.00–1.08). After stratifying the data by menopause status, compared with the postmenopausal women group, as the serum selenium concentrations increased, the FBG concentrations were significantly higher in the premenopausal women group (p for interaction = 0.0020). Conclusions The present study found serum selenium was positively associated with FBG and the prevalence of T2D. Furthermore, the relationship between serum selenium and FBG was different in the premenopausal and postmenopausal women. More studies are still needed in the future to verify the relationship as well as to explore the specific mechanisms.

Abstract Background Several studies showed the hypoglycemic and hypolipidemic effects of Satureja Khuzestanica (SK) in animal models. This study aimed to determine the effect of SK supplementation on glycemic and lipid outcomes of patients with type 2 diabetes mellitus (T2DM). Methods The study was designed as a double-blind, placebo-controlled, randomized clinical trial using block randomization. Seventy-eight T2DM patients were randomly assigned to intervention (n = 39) or placebo (n = 39) groups. They received SK or placebo in 500 mg capsules daily for 12 weeks. Anthropometric, blood pressure, liver enzymes, glycemic, and lipid outcomes were measured before and after the intervention. Results At baseline, there were no significant differences in age, sex, or glycated hemoglobin (HbA1c) levels between the groups. SK supplementation led to a significant decrease in FBS (-12.6 ± 20.7 mg/dl in the intervention group versus 3.5 ± 31.9 mg/dl; p = 0.007), HbA1c (-0.28 ± 0.45 in the intervention group versus 0.11 ± 0.54% in the placebo group; p =

Abstract Background Evidence regarding the relationship between fasting blood glucose (FBG) and suicide attempts (SA) in patients with major depressive disorder (MDD) was limited. Therefore, the objective of this research was to investigate whether FBG was independently related to SA in Chinese patients with first-episode drug-naïve (FEDN) MDD after adjusting for other covariates. Methods The present study was a cross-sectional study. A total of 1718 participants (average age: 34.9 ± 12.4 years, 65.8% females) with FEDN MDD were involved in a hospital in China from September 2016 to December 2018. Multiple logistic regression analysis and smooth curve fitting were used to estimate the association between FBG and the risk of SA. The threshold effect was examined by the two-piecewise linear regression model. Interaction and stratified analyses were conducted according to sex, education, marital status, comorbid anxiety, and psychotic symptoms. Results The prevalence of SA in patients with FEDN MDD was 20.1%. The result of fully adjusted binary logistic regression showed FBG was positively associated with the risk of SA (odds ratio (OR) = 1.62, 95% CI: 1.13–2.32). Smoothing plots also revealed a nonlinear relationship between FBG and SA, with the inflection point of FBG being 5.34 mmol/l. The effect sizes and the confidence intervals on the left and right sides of the inflection point were 0.53 (0.32–0.88, P = 0.014) and 1.48 (1.04–2.10, P = 0.030), respectively. Conclusions A U-shaped relationship between FBG and SA in FEDN MDD patients was found, with the lowest risk of SA at a FBG of 5.34 mmol/l, indicating that both the lower and higher FBG levels may lead to an increased risk of SA.

Background: This cross-sectional study aims to explore whether there exists an interaction between selenium and menopause concerning type 2 diabetes (T2D) prevalence and its related indicators such as fasting blood glucose (FBG) and homeostasis model assessment of insulin resistance (HOMA-IR). Methods: 150 women aged 35–60 years old were finally analyzed in this study. Multivariate linear or logistic regression modeling was conducted to explore the association of selenium and the prevalence of T2D besides its related indicators. Subgroup analyses were conducted based on menopause status to assess the potential impact on the relationship. Results: In the fully adjusted model, serum selenium was positively associated with FBG (β: 0.03, CI: 0.01–0.05) and the prevalence of T2D (OR: 1.04, CI: 1.00–1.08). After stratifying the data by menopause status, compared with the postmenopausal women group, as the serum selenium concentrations increased, the FBG concentrations were significantly higher in the premenopausal women group (p for interaction = 0.0020). Conclusions: The present study found serum selenium was positively associated with FBG and the prevalence of T2D. Furthermore, the relationship between serum selenium and FBG was different in the premenopausal and postmenopausal women. More studies are still needed in the future to verify the relationship as well as to explore the specific mechanisms. [ABSTRACT FROM AUTHOR]

ObjectiveMethodResultsConclusionsTo examine the possible effects of chronotype on nutritional status and fasting blood glucose(FBG) among female university students.The study was conducted in two stages.In the first stage,the chronotype of the participants were determined by applying the Morningness Eveningness Questionnaire(MEQ) questionnaire to 384 students.Also physical activity records and sociodemographic characteristics were questioned. Women who didn’t meet the criteria were eliminated.In the second stage, study groups were formed with 92 students(46 evening and 46 morning type). Afterwards,3-day food consumption records were taken from 92 participants and FBG measurements were taken only from the volunteers.Significant differences were found between the food consumption and FBG values of students of different chronotypes.Evening type students' protein(g),protein percentage,fiber intake were found to be significantly low,while carbohydrate percentage intakes were higher(p < 0.05).Also BMI(β = -0.240; p < 0.05) and FBG(β = -0.314; p < 0.05) were found significant predictors of MEQ scores whereas age was not(β = -0.136; p > 0.05).Dieticians/nutritionists should give nutritional advice to the students and organize their diet by considering their chronotype to prevent health problems that may arise. [ABSTRACT FROM AUTHOR]

Introduction: Individuals with Turner syndrome (TS) are at increased risk of developing diabetes mellitus (DM). Currently, annual DM screening with hemoglobin A1c (HbA1c) with or without fasting blood glucose (FBG) is recommended starting at age 10. However, the optimal DM screening for individuals with TS is not known. The purpose of this study was to evaluate the correlation between HbA1c, FBG, and the 2-h oral glucose tolerance test (OGTT). A second goal was to query whether optimal HbA1c and FBG cut points for TS-associated DM and impaired glucose tolerance (IGT), as defined by the OGTT 2-h blood glucose (BG), might differ from those for the general population. Methods: Individuals with TS ≥ age 10 from the TS: Genotype Phenotype study in the National Institute of Child Health and Human Development's Data and Specimen Hub (DASH) who had 2-h OGTT BG, HbA1c, and FBG were included. Correlations between HbA1c, FBG, and 2-h OGTT BG were evaluated. Areas under the receiver operative characteristic (ROC-AUC) curves were generated. Optimal cut points for predicting TS-associated IGT (2-h BG ≥7.77 mmol/L) and DM (2-h BG ≥11.10 mmol/L) were determined. Results: 348 individuals had complete data (2-h OGTT BG <7.77 mmol/L, n = 239; TS-associated IGT, n = 79; DM, n = 30). ROC-AUC was poor for HbA1c to predict IGT (0.57, 0.49–0.65) but better for DM (0.81, 0.71–0.90). ROC-AUC was also poor for FBG to predict IGT (0.63, 0.56–0.70) but better for DM (0.85, 0.77–0.93). At a cut point of 38 mmol/mol (5.6%), HbA1c had 67% sensitivity (95% CI: 47–83%) and 86% specificity (95% CI: 82–90%) for identifying TS-associated DM defined by 2-h OGTT BG. Conclusions: The correlation of HbA1c and 2-h OGTT BG is lower in TS than in other published studies regarding type 2 DM. HbA1c is fairly specific for DM in TS but lacks sensitivity, especially at currently utilized levels. Future research should focus on characterizing individuals with TS whose glycemic status is discordant, as this may provide additional insights into the pathophysiology of glucose metabolism in TS. Longitudinal assessment of glycemia as it relates to micro- and macrovascular complications in individuals with TS will further inform DM screening in this population. [ABSTRACT FROM AUTHOR]

Background: Several studies showed the hypoglycemic and hypolipidemic effects of Satureja Khuzestanica (SK) in animal models. This study aimed to determine the effect of SK supplementation on glycemic and lipid outcomes of patients with type 2 diabetes mellitus (T2DM). Methods: The study was designed as a double-blind, placebo-controlled, randomized clinical trial using block randomization. Seventy-eight T2DM patients were randomly assigned to intervention (n = 39) or placebo (n = 39) groups. They received SK or placebo in 500 mg capsules daily for 12 weeks. Anthropometric, blood pressure, liver enzymes, glycemic, and lipid outcomes were measured before and after the intervention. Results: At baseline, there were no significant differences in age, sex, or glycated hemoglobin (HbA1c) levels between the groups. SK supplementation led to a significant decrease in FBS (-12.6 ± 20.7 mg/dl in the intervention group versus 3.5 ± 31.9 mg/dl; p = 0.007), HbA1c (-0.28 ± 0.45 in the intervention group versus 0.11 ± 0.54% in the placebo group; p = < 0.001), insulin (-1.65 ± 6.18 in the intervention group versus 2.09 ± 5.90 mIU/L in the placebo group; p = 0.03), total cholesterol (-14.6 ± 21.1 mg/dl in the intervention group versus 8.2 ± 30.9 mg/dl in the placebo group; p < 0.001), LDL-cholesterol (-4.6 ± 15.2 mg/dl in the intervention group versus 5.8 ± 14.6 mg/dl in placebo group; p < 0.001) levels, and significant increase in HDL-cholesterol (3.9 ± 4.9 mg/dl in the intervention group versus 0.9 ± 5.2 mg/dl in placebo group; p = 0.005). Conclusion: Based on the study results, SK supplementation may improve glycemic indices and lipid profile of patients with T2DM. Our findings may provide novel complementary treatments without adverse effects for diabetes complications. These results need to be further confirmed in clinical trials. Registration: : This trial has been registered in the Iranian Registry of Clinical Trials (IRCT ID: IRCT20190715044214N1, registration date: 21/02/2021). [ABSTRACT FROM AUTHOR]

Background: Evidence regarding the relationship between fasting blood glucose (FBG) and suicide attempts (SA) in patients with major depressive disorder (MDD) was limited. Therefore, the objective of this research was to investigate whether FBG was independently related to SA in Chinese patients with first-episode drug-naïve (FEDN) MDD after adjusting for other covariates. Methods: The present study was a cross-sectional study. A total of 1718 participants (average age: 34.9 ± 12.4 years, 65.8% females) with FEDN MDD were involved in a hospital in China from September 2016 to December 2018. Multiple logistic regression analysis and smooth curve fitting were used to estimate the association between FBG and the risk of SA. The threshold effect was examined by the two-piecewise linear regression model. Interaction and stratified analyses were conducted according to sex, education, marital status, comorbid anxiety, and psychotic symptoms. Results: The prevalence of SA in patients with FEDN MDD was 20.1%. The result of fully adjusted binary logistic regression showed FBG was positively associated with the risk of SA (odds ratio (OR) = 1.62, 95% CI: 1.13–2.32). Smoothing plots also revealed a nonlinear relationship between FBG and SA, with the inflection point of FBG being 5.34 mmol/l. The effect sizes and the confidence intervals on the left and right sides of the inflection point were 0.53 (0.32–0.88, P = 0.014) and 1.48 (1.04–2.10, P = 0.030), respectively. Conclusions: A U-shaped relationship between FBG and SA in FEDN MDD patients was found, with the lowest risk of SA at a FBG of 5.34 mmol/l, indicating that both the lower and higher FBG levels may lead to an increased risk of SA. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To systematically evaluate the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on body composition and glucose metabolism-related indexes in overweight or obese patients with type 2 diabetes and to compare the improvement effect of the two exercise modalities, thereby providing a reference basis for the development of exercise prescription for overweight or obese patients with type 2 diabetes. METHODS: The Cochrane Library, PubMed, EMbase, Web of Science, CNKI, CBM, WanFang, and ClinicalTrials.gov were searched for randomized controlled trials comparing the effects of HIIT and MICT interventions on body composition and glucose metabolism-related indicators in overweight or obese patients with type 2 diabetes. The search was conducted from database inception to June 2022. Meta-analysis of outcome indicators was performed using RevMan 5.4. RESULTS: (1) A total of 13 randomized controlled trials with 371 subjects were included, and the overall quality of the included studies was relatively high. (2) There was no significant difference in the improvement of body composition between HIIT and MICT [body mass: weighted mean difference (WMD)=2.44, 95% confidence interval (CI): -3.01-7.89, P > 0.05; body mass index: WMD=0.28, 95%CI: -1.21-1.77, P > 0.05; waist circumference: WMD=2.16, 95% CI: -2.04-6.35, P > 0.05; body fat percentage: WMD=0.47, 95%CI: -2.11-3.05, P > 0.05). (3) The results of subgroup analysis showed that there was a significant difference in body mass and body mass index between the “training cycle ≥ 12 weeks” subgroup and the “training frequency ≤ 3 times/week” subgroup (training cycle ≥ 12 weeks subgroup: WMD=4.25, 95% CI: 0.90-7.59, P=0.01; WMD=2.71, 95%CI: 1.92-3.51, P < 0.000 01; training frequency ≤ 3 times/week subgroup: WMD=5.14, 95%CI: 1.7-8.57, P=0.003; WMD=1.67, 95% CI: 0.66-2.67, P=0.001). (4) The results of sensitivity analysis showed that there was a significant difference in body fat percentage between the HIIT and MICT groups (WMD=2.17, 95% CI: 1.20-3.14, P < 0.000 1), while there was no significant difference in the improvement of glucose metabolism between the HIIT and MICT groups (fasting blood glucose: WMD=0.31, 95% CI: -0.17-0.79, P > 0.05; glycosylated hemoglobin: WMD=0.01, 95% CI: -0.19-0.20, P > 0.05; insulin resistance index: WMD=-0.14, 95%CI: -0.71-0.42, P > 0.05). (5) The results of subgroup analysis showed that fasting blood glucose was significantly different in the subgroup of “training frequency ≤ 3 times/week” (WMD=0.92, 95% CI: 0.25-1.60, P=0.007) and glycosylated hemoglobin was significantly different in the “training frequency > 3 times/week” subgroup (WMD=-0.2, 95% CI: -0.3 to -0.1, P < 0.000 1). CONCLUSION: Overall, there is no significant difference between HIIT and MICT in improving body composition such as body mass, body mass index, waist circumference, body fat percentage as well as improving glucose metabolic indexes such as fasting blood glucose, glycated hemoglobin and insulin resistance index in overweight or obese patients with type 2 diabetes. When the training period is ≥ 12 weeks and the training frequency is ≤ 3 times/week, MICT has a better effect on the improvement of body mass as well as body mass index. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus, a chronic metabolic disorder, is known to impact serum trace element levels. Objectives: to investigates the association between serum trace elements (Co, Cr, and Cu) and glycemic control in individuals with type 2 diabetes. Material and Methods: A 209 type 2 diabetes patients from Dr. H. Abdul Moeloek Hospital in Bandar Lampung and Hasan Sadikin Hospital in Bandung participated in the study. Patients underwent assessments for serum trace element levels (Co, Cr, and Cu) and glycemic control indicators (FBG and HbA1c). Results: Results indicated significantly lower Co levels in uncontrolled diabetes versus controlled cases (P<0.05). Co, Cr, and Cu levels displayed a significant negative correlation with HbA1c (P<0.05), while Cr and Cu showed a significant negative correlation with FBG (P<0.05). Age did not show significant correlations with serum trace element levels. Conclusion: serum trace element levels (Co, Cr, Cu) are inversely linked to glycemic control in type 2 diabetes individuals. [ABSTRACT FROM AUTHOR]

Majhool date (Phoenix dactylifera), renowned for its premium taste and texture, is extensively consumed in the Islamic world, particularly during Ramadan. Despite its popularity, concerns persist regarding its potential to induce diabetes in non-patients. This study aims to explore the diabetogenic effects of prolonged Majhool date (Phoenix dactylifera) consumption, the widely used fruit in the Islamic world, through animal experiments and human clinical data. Medjool dates were processed into an ethanolic extract for the animal experiment. Then, 21 Balb/c mice received varying doses of the extract for one month. The fasting blood glucose levels were analyzed at the beginning and after one month of consumption of the Majhool date extract. For the clinical study, 387 healthy participants were recruited, with fasting blood glucose levels assessed before and after Ramadan, a period of heightened Majhool date consumption. all groups of the experimental animals exhibited a significant (p<0.05) weight increase after Majhool date consumption, while no significant (p>0.05) alteration in fasting blood glucose levels among groups. In addition, it was found that fasting blood glucose levels remained statistically unchanged (p>0.05) after heightened Majhool date consumption among humans. The study challenges the belief that Majhool date induces diabetes, supported by both animal and human data. Findings suggest that Majhool date consumption, even at higher doses, does not induce diabetes. Further investigations could explore the impact of other date varieties on the fasting blood glucose levels. [ABSTRACT FROM AUTHOR]

Introduction: Tirzepatide is a novel hypoglycemic agent for type 2 diabetes mellitus (T2DM). However, the pathophysiology of T2DM in Asians is different from that in non-Asians, and there is no evidence to explain the differences in the efficacy and safety of tirzepatide between different races. Methods: A literature search was conducted in China National Knowledge Infrastructure (CNKI), PubMed, Cochrane Library, Clinical Trials.gov, and Embase databases for clinical studies of tirzepatide for T2DM. The data extraction process was done independently by two authors. All analyses were performed using STATA 14.0 software and Review Manager 5.3 software. Results: A total of 2118 patients with T2DM from 6 studies were involved, with doses of tirzepatide ranging from 5 to 15 mg administered subcutaneously once weekly. The results showed that compared with control/placebo, tirzepatide was more effective in decreasing fasting blood glucose (FBG) in non-Asians than in Asians, and 10 mg rather than 15 mg was the optimal dose to decrease FBG. Similarly, non-Asians were more effective than Asians in improving glycated hemoglobin (HbA1c). Asians were significantly more effective than non-Asians in reducing body weight and ≥ 5% weight loss. In terms of adverse events, the incidence of gastrointestinal adverse events was higher in Asians than in non-Asians at the same dose, while the incidence of metabolic and nutrition disorders was higher in non-Asians than in Asians. Conclusion: Tirzepatide is a novel agent for the treatment of diabetes and has different efficacy in Asians and non-Asians. Asians were more likely to experience weight loss and gastrointestinal adverse events, whereas non-Asians were more likely to have better glycemic control and more metabolic and nutritional disorders. Trial Registration: PROSPERO registration no. CRD42023489588. [ABSTRACT FROM AUTHOR]

Introduction: Gluconeogenesis and glycogenolysis are highly regulated metabolic processes that are critical in maintaining blood glucose levels within the physiological range. Any aberration in the regulation of these processes can lead to an inadequate repository or accumulation of excess glycogen in hepatocytes. Glycogen Storage Disease type I (GSD type I), also known as Von Gierke's disease, is categorized under inborn errors of metabolism caused due to either inactivity or complete absence of the Glucose-6-phosphatase enzyme (G6Pase). Objectives: This study's focus is to suppress G6Pase, hepatic glucose synthesis, and induce the symptoms of GSD type I in experimental rats. Materials and Methods: The in silico approach using Chlorogenic Acid (CGA) and G6Pase exhibited a good docking score (-8.9), and promising binding patterns, molecular dynamic simulation studies (at 100 nanoseconds) also confirmed the stability of the docked complex. Based on this in silico speculation, the in vivo study was designed, where, in the pilot study varying doses (50, 100, 200, 400 mg/kg) and CGA-liposome formulation were scrutinized, Results: It was corroborated that the CGA can cause hypoglycemia, hence CGA (200 mg/kg) was chosen for the study, to further augment the other major GSD type I manifestations, metformin (500 mg/kg) was included in the study for 49 days, manifestations like hypoglycemia, suppressed G6Pase activity, elevated hepatic glycogen and lactate dehydrogenase were evident. Conclusion: The observations suggest that chlorogenic acid has the potential to induce GSD type I manifestations along with metformin, which can be an alternative animal model to match the genetically modified disease models. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels, affecting millions of people worldwide. This study aimed to evaluate the potential anti-diabetic activity of Schefflera stellata leaves ethanolic extract in a streptozotocin (STZ)-induced diabetic Wistar rat model. Wistar rats were induced with diabetes using STZ and subsequently treated with Schefflera stellata leaves ethanolic extract. Various biochemical parameters such as fasting blood glucose levels, serum insulin levels, lipid profile, and antioxidant enzyme activities were assessed. Additionally, histopathological examination of pancreatic tissues was performed to evaluate the impact of the extract on structural alterations. The results revealed a significant reduction in fasting blood glucose levels in rats treated with Schefflera stellata extract compared to the untreated diabetic group. Moreover, the extract exhibited a positive influence on serum insulin levels, lipid profile, and antioxidant enzyme activities, suggesting its potential in ameliorating diabetes-induced metabolic dysregulation. Histopathological analysis of pancreatic tissues indicated a preservation of islet architecture in the extracttreated group, highlighting the protective effects of Schefflera stellata against STZ-induced pancreatic damage. [ABSTRACT FROM AUTHOR]

BackgroundBased on previous research, elevated fasting blood glucose (FBG) and decreased high-density lipoprotein cholesterol (HDL-C) levels are associated with non-alcoholic fatty liver disease (NAFLD). It is hypothesized that the prevalence of NAFLD may be proportional to the FBG-to-HDL-C ratio (GHR).MethodsIn this study, 3,842 participants from the National Health and Nutrition Examination Survey (NHANES) (2013–2020) were investigated. Liver steatosis was assessed using vibration-controlled transient elastography (VCTE). NAFLD was defined as controlled attenuation parameter (CAP) ≥288 dB/m.ResultsAfter adjusting for race, gender, age, diabetes, BMI, moderate activities, uric acid, albumin, ALT, GGT, ALP, total bilirubin and creatinine, multiple logistic regression analysis indicated a positive correlation between GHR and the prevalence of NAFLD (OR = 1.22, 95% CI = 1.17–1.28). Additionally, multiple linear regression analysis showed a positive correlation between GHR and the severity of liver steatosis according to CA p-values (β = 4.97, 95% CI: 4.28, 5.66). According to the subgroup analysis, the correlation was stronger in other race, participants at the age

IntroductionIntegrated transcriptome and microRNA differential gene expression (DEG) analyses may help to explain type 2 diabetes (T2D) pathogenesis in at-risk populations. The purpose of this study was to characterize DEG in banked biospecimens from underactive adult participants who responded to a randomized clinical trial measuring the effects of lifestyle interventions on T2D risk factors. DEGs were further examined within the context of annotated biological pathways.MethodsParticipants (n = 52) in a previously completed clinical trial that assessed a 12-week behavioural intervention for T2D risk reduction were included. Participants who showed >6mg/dL decrease in fasting blood glucose were identified as responders. Gene expression was measured by RNASeq, and overrepresentation analysis within KEGG pathways and weighted gene correlation network analysis (WGCNA) were performed.ResultsNo genes remained significantly differentially expressed after correction for multiple comparisons. One module derived by WGCNA related to body mass index was identified, which contained genes located in KEGG pathways related to known mechanisms underlying risk for T2D as well as pathways related to neurodegeneration and protein misfolding. A network analysis showed indirect connections between genes in this module and islet amyloid polypeptide (IAPP), which has previously been hypothesized as a mechanism for T2D.DiscussionWe validated prior studies that showed pathways related to metabolism, inflammation/immunity, and endocrine/hormone function are related to risk for T2D. We identified evidence for new potential mechanisms that include protein misfolding. Additional studies are needed to determine whether these are potential therapeutic targets to decrease risk for T2D.

BackgroundLong-term exposure to ambient fine particulate matter (PM2.5) may increase the risk of diabetes, and a healthy diet can effectively control fasting blood glucose levels. However, it is unclear whether dietary factors have a moderating effect on the risk of diabetes associated with atmospheric PM2.5 exposure. ObjectiveTo investigate the association between long-term exposure to PM2.5 and diabetes in rural areas of Ningxia, and potential interaction of long-term exposure to atmospheric PM2.5 and diet on diabetes.MethodsThe study subjects were selected from the baseline survey data of the China Northwest Cohort-Ningxia (CNC-NX) , a natural population cohort. A total of 13917 subjects were included, excluding participants with missing covariate information. We utilized the annual average ambient PM2.5 concentration from 2014 to 2018 as the long-term exposure level. Logistic regression and multiple linear regression were employed to analyze the associations of long-term atmospheric PM2.5 exposure with diabetes and fasting blood glucose levels. Stratification by frequency of vegetable consumption, frequency of fruit consumption, and salty taste was used to examine moderating effects on the diabetes risk associated with atmospheric PM2.5 exposure.ResultsThe mean age of the 13917 subjects was (56.8±10.0) years, and the prevalence of diabetes was 9.8%. Between 2014 and 2018, the average annual concentration of PM2.5 was (38.10±4.67) μg·m−3. The risk (OR) of diabetes was 1.018 (95%CI: 1.005, 1.032) and the fasting blood glucose was increased by 0.011 (95%CI: 0.004, 0.017) mmol·L−1 for each 1 μg·m−3 increase in PM2.5 concentration. Compared to those who consumed vegetables < 1 time per week, individuals who consume vegetables 1-3 times per week and ≥4 times per week had a reduced risk of developing diabetes by 27.1% (OR=0.729, 95%CI: 0.594, 0.893) and 16.8% (OR=0.832, 95%CI: 0.715, 0.971) respectively. Similarly, when compared to those who consumed fruits

目的 探讨空腹血糖与接受静脉溶栓的缺血性卒中患者功能结局的关系。 方法 回顾性收集2018年10月—2020年11月首都医科大学附属北京天坛医院静脉溶栓患者的病历资料。纳入发病4.5 h内接受阿替普酶静脉溶栓的缺血性卒中患者为研究对象，采集相关研究数据（包括空腹血糖等）。研究结局设定为出院时功能结局良好，即mRS评分0～1分。采用多因素logistic回归分析探讨空腹血糖与功能结局的关联性。 结果 共入组205例患者，平均年龄为（63.21±11.67）岁，其中153例（74.63%）患者为男性，入院NIHSS评分为5（3～9）分。其中117例（57.07%）患者出院时功能结局不良，88例（42.93%）患者出院时功能结局良好。功能结局良好的患者空腹血糖水平低于功能结局不良的患者[5.10（4.46～7.06）mmol/L vs. 6.33（5.09～7.79）mmol/L，P=0.001]。多因素logistic回归分析结果显示，校正年龄、性别、NIHSS评分后，空腹血糖水平与接受静脉溶栓功能结局相关（OR 0.876，95%CI 0.774～0.991，P=0.035）；校正年龄、性别、NIHSS评分、桥接取栓后，关联性没有达到统计学意义（OR 0.891，95%CI 0.791～1.004，P=0.058）。 结论 对于接受静脉溶栓的缺血性卒中患者，高水平空腹血糖可能会增加静脉溶栓后出院功能结局不良风险。 Abstract: Objective To investigate the association between fasting blood glucose and functional outcomes in ischemic stroke patients treated with intravenous thrombolysis. Methods The study data of patients treated with intravenous thrombolysis in Beijing Tiantan Hospital, Capital Medical University from October 2018 to November 2020 were collected retrospectively. Ischemic stroke patients who received alteplase intravenous thrombolysis within 4.5 h of onset were included, and study data including fasting blood glucose were collected. The study outcome was set as a good functional outcome at discharge (mRS score 0-1). Multivariate logistic regression analysis was used to investigate the association between the fasting blood glucose and functional outcomes. Results A total of 205 patients were enrolled. The mean age was (63.21±11.67) years. The percentage of male was 153 (74.63%). The admission NIHSS score was 5 (3-9). There were 117 patients (57.07%) who did not have a good functional outcome at discharge and 88 patients (42.93%) who did. Fasting blood glucose levels in patients with good functional outcomes were lower than those in patients with poor functional outcomes [5.10 (4.46-7.06) mmol/L vs. 6.33 (5.09-7.79) mmol/L, P=0.001]. Multivariate logistic regression analysis showed that after adjusting for age, gender, and NIHSS score, there was a correlation between fasting blood glucose level and the outcome of receiving intravenous thrombolysis (OR 0.876, 95%CI 0.774-0.991, P=0.035). After adjusting for age, sex, NIHSS score and mechanical thrombectomy, the association was not statistically significant (OR 0.891, 95%CI 0.791-1.004, P=0.058). Conclusions In ischemic stroke patients undergoing intravenous thrombolysis, high level of fasting blood glucose may increase the risk of adverse discharge outcomes after intravenous thrombolysis.

Abstract Purpose There is controversy concerning the relationship between Helicobacter pylori (H. pylori) infection and osteoporosis. This study is to examine the causal relationship between H. pylori infection and osteoporosis and to analyze the potential mechanism underlying the relationship. Methods The clinical data of H. pylori infection and bone mineral density from patients or physical examiner with good general condition in our hospital between September 2019 and September 2020 were retrospectively collected. The relationship between H. pylori infection and osteoporosis was compared and analyzed, using logistic regression to examine the potential mechanism underlying the association. To investigate the causal effects of H. pylori infection and osteoporosis, we conducted a two-sample bidirectional Mendelian randomization (MR) analysis. Results A total of 470 patients were positive for H. pylori, with a detection rate of 52.22%. It was found that age, SBP, FPG, DBP, ALB, LDL-C, hs-CRP, and OC were positively correlated with osteoporosis, while negative correlations were observed with BMI, LYM, ALB, TP, TG, HDL-C, SCr, UA, and VitD. After stratified analysis of sex and age, it was found that there was a significant correlation between H. pylori infection and osteoporosis. The levels of SBP, ALP, FPG, LDL-C, hs-CRP, and OC in both H. pylori-positive group and osteoporosis group were higher than those in the H. pylori-negative group while the levels of BMI, ALB, TP, HDL-C, SCr, UA, and VitD in the positive group were significantly lower than those in the negative group. Logistic regression analyses with gender and age showed that ALB, FPG, HDL-C, and VitD were common risk factors for osteoporosis and H. pylori infection. In the MR analysis, the IVW results found a positive effect of H. pylori infection on osteoporosis (OR = 1.0017, 95% CI: 1.0002–1.0033, P = 0.0217). Regarding the reverse direction analysis, there was insufficient evidence to prove the causal effects of osteoporosis on H. pylori infection. Conclusion Our study provides evidence for causal effects of H. pylori infection on osteoporosis. H. pylori may affect osteoporosis through serum albumin, high-density lipoprotein, fasting blood glucose and vitamin D.

Background: There is currently a scarcity of population-based records related to the prevalence of gestational diabetes mellitus (GDM) in India. There were various recommendations for screening and diagnostic tests for GDM, and no uniform standard has yet been established. Hence, a comparative study was conducted to assess the usefulness of the glucose challenge test (GCT) and fasting blood glucose (FBG)/post-prandial blood glucose (PPBG) test for the screening of GDM in pregnant women attending the prenatal clinic outpatient department. Methods: This is a comparative observational study involving 300 apparently normal pregnant who were randomly allocated to GCT and FBG/PPBG cohorts of 150 each. The tests were performed at 4 intervals: 8 to 10 weeks, 16 to 20 weeks, 24 to 28 weeks, and 32 to 36 weeks. All diagnosed GDM cases were appropriately handled. Results: Gestational diabetes mellitus was seen in 2.67% of the FBG/PPBG cohort and 5.34% of the GCT cohort. The GCT test identified 25% of GDM subjects before 24 weeks of gestation, 50% in 24 and 28 weeks, and 25% in > 32 weeks of gestation. The highest prevalence of GDM was noted in the 26–30-year age group. The highest prevalence of GDM was noted in pregnant women with ≥ 26 kg/m2 of body mass index (BMI), with 75% in the FBG/PPBG group and 62.5% in the GCT group. The incidence of GDM was higher in primigravida, 75% in the FBG/PPBG group, and 50% in the GCT group. A higher prevalence was observed in pregnant women of class 4 of socioeconomic status, and it was 75% in the FBG/PPBG group and 75% in the GCT group. A higher prevalence was noted in those with higher secondary education. The majority of GDM cases gave birth at term by labor, and there were no assisted vaginal births in this group. Moreover, 75% of GDM cases in the FBG/PPBG cohort and 62.5% of GDM cases in the GCT cohort had Caesarean section. Besides, 50% of infants from GDM mothers in the FBG/PPBG cohort were hospitalized, while 12.75% were admitted in the GCT cohort. The birth weight of neonates from GDM mothers was 3.09 ± 0.5 kg, 3.11 ± 0.6 kg in normal mothers, 2.98 ± 0.6 kg in the FBG/PPBG cohort, and 2.9 ± 0.5 kg in the GCT cohort. Conclusion: Irrespective of the last meal, the GCT in all pregnant women is an effective and easy screening approach for 1-step screening for the early diagnosis of GDM for subsequent management at the early gestational pregnancy, which can minimize the adverse obstetric and perinatal outcomes.

Introduction: In 2019, type 2 diabetes mellitus (DM) at Perumnas I Public Health Center was sixth-placed among the top ten diseases with 1,118 cases. This study aimed to determine the dietary habits of type 2 DM patients based on body mass index (BMI) and fasting blood glucose at Perumnas I Public Health Center, West Pontianak. Methods: This was an observational analysis study with a cross-sectional design. A total of 78 type 2 DM patients who were treated from January to July 2021 at Perumnas I Public Health Center were involved in this study. This study used a three-day food record questionnaire to get patients’ food dishes and the Wilcoxon test for correlation between variables. Results: Most of the respondents had a calorie deficit for three days straight (70.5% on the first day, 76.9% on the second day, and 71.8% on the third day), a normal BMI (51.3%), and above-normal fasting blood glucose (88.5%). The p-value of the Wilcoxon test that showed dietary habits on the first day, the second day, and the third day with BMI was 0.000. The p-value of the Wilcoxon test that showed dietary habits on the first day, the second day, and the third day with fasting blood glucose was 0.000. This showed a significant distinction between patients’ three-day dietary habits and their BMI and fasting blood glucose. Conclusion: There was a significant difference between nutritional status and fasting blood glucose in three-day dietary habits in type 2 DM patients at Perumnas I Public Health Center, West Pontianak.

AbstractBackground Hypertension, hyperlipidemia, and hyperglycemia have emerged as global health concerns of paramount significance. With the burgeoning popularity of mind-body therapy, cardiovascular patients have increasingly exhibited a vested interest in the practice of Tai Chi. The objective of this study seeks to quantitatively assess the impact of Tai Chi interventions on blood pressure, lipid levels, and glucose concentrations among the elderly population, thereby explaining the optimal intervention protocol.Methods An extensive search was conducted across multiple databases, including Web of Science, PubMed, CNKI, WANFANG DATA, RISS, KISS, and DBPIA, comprising English, Korean, and Chinese literature. The search strategy employed a retrieval method of subject term 1 + subject term 2, which included both full names and abbreviations of the terms. Specifically, “taijiquan” or “Tai Chi” were set as the Term 1, while Term 2 was set as “blood pressure,” “BP,” “Fasting blood glucose,” “FBG,” “Triglyceride,” and “TG.” Thereafter, the retrieved articles were filtered in accordance with the PICOS method. Risk of bias assessment was performed using RoB 2.0, while data analysis was conducted using Comprehensive Meta-Analysis 3.7.Results A total of 57 studies, including 3,856 research subjects, were eligible for inclusion. The findings of the primary effect quantitative synthesis demonstrated that Tai Chi exerted an improvement on systolic blood pressure (SBP) (ES = −0.764, p

Due to the complexity of environmental exposure factors and the low levels of exposure in the general population, identifying the key environmental factors associated with diabetes and understanding their potential mechanisms present significant challenges. This study aimed to identify key polycyclic aromatic hydrocarbons (PAHs) contributing to increased fasting blood glucose (FBG) concentrations and to explore their potential metabolic mechanisms. We recruited a highly PAH-exposed diesel engine exhaust testing population and healthy controls. Our findings found a positive association between FBG concentrations and PAH metabolites, identifying 1-OHNa, 2-OHPh, and 9-OHPh as major contributors to the rise in FBG concentrations induced by PAH mixtures. Specifically, each 10 % increase in 1-OHNa, 2-OHPh, and 9-OHPh concentrations led to increases in FBG concentrations of 0.201 %, 0.261 %, and 0.268 %, respectively. Targeted metabolomics analysis revealed significant alterations in metabolic pathways among those exposed to high levels of PAHs, including sirtuin signaling, asparagine metabolism, and proline metabolism pathway. Toxic function analysis highlighted differential metabolites involved in various dysglycemia-related conditions, such as cardiac arrhythmia and renal damage. Mediation analysis revealed that 2-aminooctanoic acid mediated the FBG elevation induced by 2-OHPh, while 2-hydroxyphenylacetic acid and hypoxanthine acted as partial suppressors. Notably, 2-aminooctanoic acid was identified as a crucial intermediary metabolic biomarker, mediating significant portions of the associations between the multiple different structures of OH-PAHs and elevated FBG concentrations, accounting for 16.73 %, 10.84 %, 10.00 %, and 11.90 % of these effects for 1-OHPyr, 2-OHFlu, the sum concentrations of 2- and 9-OHPh, and the sum concentrations of total OH-PAHs, respectively. Overall, our study explored the potential metabolic mechanisms underlying the elevated FBG induced by PAHs and identified 2-aminooctanoic acid as a pivotal metabolic biomarker, presenting a potential target for intervention.

Several observational studies have suggested that proton‐pump inhibitor (PPI) use might increase diabetes risk, but the mechanism remains unclear. This study aimed to investigate the effects of PPI use on gut microbiota and bile acids (BAs) profiles, and to explore whether these changes could mediate the association of PPIs use with fasting blood glucose (FBG) levels and insulin resistance (IR) in Chinese population. A cross‐sectional study was conducted in Shenzhen, China, from April to August 2021, enrolled 200 eligible patients from the local hospital. Participants completed a questionnaire and provided blood and stool samples. Gut microbiome was measured by16S rRNA gene sequencing, and bile acids were quantified by UPLC‐MS/MS. Insulin resistance (IR) was assessed using the Homeostasis Model Assessment 2 (HOMA2‐IR). PPI use was positively associated with higher levels of FBG and HOMA2‐IR after controlling for possible confounders. PPI users exhibited a decreased Firmicutes and an increase in Bacteroidetes phylum, alongside higher levels of glycoursodeoxycholic acid (GUDCA) and taurochenodeoxycholic acid (TCDCA). Higher abundances of Bacteroidetes and Fusobacterium as well as higher levels of TCDCA in PPI users were positively associated with elevated FBG or HOMA2‐IR. Mediation analyses indicated that the elevated levels of FBG and HOMA2‐IR with PPI use were partially mediated by the alterations in gut microbiota and specific BAs (i.e., Fusobacterium genera and TCDCA). Long‐term PPI use may increase FBG and HOMA2‐IR levels, and alterations in gut microbiota and BAs profiles may partially explain this association. [ABSTRACT FROM AUTHOR]

Objective: The current controversy surrounding the association between fasting blood glucose (FBG) and albuminuria necessitates further investigation. Hence, the primary objective of this study was to examine the relationship between FBG and urinary albumin-to-creatinine ratio (UACR). Methods: A cohort of complete data from National Health and Nutrition Examination Survey (NHANES) participants (1999-2020) was analyzed. Linear regression analyses and a generalized additive model explored the association between FBG and UACR. Furthermore, the stability of this relationship across different populations was assessed. Results: The study involved a total of 20,264 participants who were identified as U.S. citizens. By employing linear regression analysis, a statistically significant relationship was observed between elevated FBG levels and an increase in UACR (P<0.0001). Additionally, using a generalized additive model analysis, a U-shaped correlation between FBG and UACR was identified. Further examination using threshold effect analysis indicated a turning point for FBG at 5.44 mmol/L. A noteworthy finding in multiple populations is the consistent U-shaped association between FBG and UACR, except for individuals with serum uric acid levels ≥420 mmol/L and those who refrain from alcohol consumption. Conclusion: The general U.S. population has a U-shaped nonlinear relationship between FBG and UACR. [ABSTRACT FROM AUTHOR]

Purpose: There is controversy concerning the relationship between Helicobacter pylori (H. pylori) infection and osteoporosis. This study is to examine the causal relationship between H. pylori infection and osteoporosis and to analyze the potential mechanism underlying the relationship. Methods: The clinical data of H. pylori infection and bone mineral density from patients or physical examiner with good general condition in our hospital between September 2019 and September 2020 were retrospectively collected. The relationship between H. pylori infection and osteoporosis was compared and analyzed, using logistic regression to examine the potential mechanism underlying the association. To investigate the causal effects of H. pylori infection and osteoporosis, we conducted a two-sample bidirectional Mendelian randomization (MR) analysis. Results: A total of 470 patients were positive for H. pylori, with a detection rate of 52.22%. It was found that age, SBP, FPG, DBP, ALB, LDL-C, hs-CRP, and OC were positively correlated with osteoporosis, while negative correlations were observed with BMI, LYM, ALB, TP, TG, HDL-C, SCr, UA, and VitD. After stratified analysis of sex and age, it was found that there was a significant correlation between H. pylori infection and osteoporosis. The levels of SBP, ALP, FPG, LDL-C, hs-CRP, and OC in both H. pylori-positive group and osteoporosis group were higher than those in the H. pylori-negative group while the levels of BMI, ALB, TP, HDL-C, SCr, UA, and VitD in the positive group were significantly lower than those in the negative group. Logistic regression analyses with gender and age showed that ALB, FPG, HDL-C, and VitD were common risk factors for osteoporosis and H. pylori infection. In the MR analysis, the IVW results found a positive effect of H. pylori infection on osteoporosis (OR = 1.0017, 95% CI: 1.0002–1.0033, P = 0.0217). Regarding the reverse direction analysis, there was insufficient evidence to prove the causal effects of osteoporosis on H. pylori infection. Conclusion: Our study provides evidence for causal effects of H. pylori infection on osteoporosis. H. pylori may affect osteoporosis through serum albumin, high-density lipoprotein, fasting blood glucose and vitamin D. [ABSTRACT FROM AUTHOR]

Background: The association between the sensorineural hearing loss (SNHL) and triglyceride-glucose (TyG) index remains inadequately understood. This investigation seeks to elucidate the connection between the TyG index and SNHL. Methods: In this cross-sectional study, we utilized datasets sourced from the National Health and Nutrition Examination Survey (NHANES). A comprehensive analysis was conducted on 1,851 participants aged 20 to 69, utilizing complete audiometry data from the NHANES database spanning from 2007 to 2018. All enrolled participants had accessible hearing data, and the average thresholds were measured and calculated as both low-frequency pure-tone average and high-frequency pure-tone average. Sensorineural hearing loss (SNHL) was defined as an average pure tone of 20 dB or higher in at least one better ear. Our analysis involved the application of multivariate linear regression models to examine the linear relationship between the TyG index and SNHL. To delineate any non-linear associations, we utilized fitted smoothing curves and conducted threshold effect analysis. Furthermore, we conducted a two-sample Mendelian randomization (MR) study, leveraging genetic data from genome-wide association studies (GWAS) on circulating lipids, blood glucose, and SNHL. The primary analytical method for the MR study was the application of the inversevariance-weighted (IVW) approach. Results: In our multivariate linear regression analysis, a substantial positive correlation emerged between the TyG index and SNHL [2.10 (1.80-2.44), p < 0.0001]. Furthermore, using a two-segment linear regression model, we found an L-shaped relationship between TyG index, fasting blood glucose and SNHL with an inflection point of 9.07 and 94 mg/dL, respectively. Specifically, TyG index [3.60, (1.42-9.14)] and blood glucose [1.01, (1.00-1.01)] concentration higher than the threshold values was positively associated with SNHL risk. Genetically determined triglyceride levels demonstrated a causal impact on SNHL (OR = 1.092, p = 8.006 × 10-4). In addition, blood glucose was found to have a protective effect on SNHL (OR = 0.886, p = 1.012 × 10-2). Conclusions: An L-shaped association was identified among the TyG index, fasting blood glucose, and SNHL in the American population. TyG index of more than 9.07 and blood glucose of more than 94 mg/dL were significantly and positively associated with SNHL risk, respectively. [ABSTRACT FROM AUTHOR]

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Background and objectives: Low-grade inflammation is associated with metabolic disturbances like diabetes. The systemic immune-inflammation index (SII) has been proposed as a predictive tool to identify individuals at a greater risk of diabetes. This study aims to examine the association between SII and diabetes markers. Method and materials: We used retrospective data from a large cohort of adults (n = 3895) aged ≥18 in Saudi Arabia. The SII was calculated, and the markers of diabetes such as fasting blood glucose (FBG), insulin, and hemoglobin A1c (HbA1c) were included. Results: Across the quartiles of SII, FBG, insulin, and HbA1c were significantly higher in adults with higher compared to lower SII (p < 0.0001, p = 0.04, p < 0.0001, respectively). A two SD higher FBG was significantly associated with an SII difference of 47.7 (95% CI: (15.5, 91.9)). In subgroup analysis, this relationship prevailed in normal-weight participants and among those with normoglycemia and prediabetes but was attenuated in participants with diabetes. The association also prevailed in separate analyses for males and females but was stronger among females. Linear regression models showed no significant association between insulin, HbA1c, and SII. Conclusions: SII was associated with the markers of diabetes. The utility of SII for predicting diabetes can be confirmed with prospective cohort studies. [ABSTRACT FROM AUTHOR]

Introduction: The ratio of Triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) is a crucial indicator for diabetes diagnosis. Methods: This study utilizes the Copula function to model and fit the non-linear correlation among fasting blood glucose (Glu), glycosylated hemoglobin (HbA1C), and TG/HDL-C in patients with diabetes. The Copula function chosen for this study includes the two-dimensional Archimedes and Elliptical distribution family, as well as the multidimensional Vine Copula function, for fitting the data. The evaluation of the fitting effect is performed using the mean absolute error (MAE) and mean square error (MSE). Results: The results indicate that the Clayton Copula exhibits the highest effectiveness in fitting the pairwise relationship between Glu and TG/HDL-C, as well as HbA1C and TG/HDL-C, displaying the smallest fitting error. Additionally, the Vine Copula function produces a satisfactory fit for the relationship among all three indicators. Compared to linear analysis methods, the Copula function more accurately depicts the correlation among these three types of indicators. Discussion: Moreover, our findings indicate a stronger correlation in the lower tail between Glu and HbA1C, as well as TG/HDL-C, suggesting that the Copula function provides greater accuracy and applicability in depicting the relationship among these indicators. As a result, it can offer a more precise auxiliary diagnosis and serve as a valuable reference in clinical judgment. [ABSTRACT FROM AUTHOR]

Introduction: Low estimated glomerular filtration rate (eGFR) is associated with an increased risk of arterial stiffness in participants with kidney damage. It is uncertain whether this association is due to eGFR itself or is mediated by the eGFR-associated increases in fasting blood glucose (FBG). Method: The cross-sectional study included 865 Japanese participants with decreased kidney function, whose eGFR was less than 90 mL/min/1.73 m2, and recruited individuals who received medical healthcare. The mediating variable was FBG, with eGFR as the independent variable and brachial-ankle pulse wave velocity (baPWV) as the dependent variable. A mediation analysis was used to evaluate the mediating effect of FBG on the association between eGFR and arterial stiffness. Results: The mean age of the participants was 51.69 ± 9.25 years old, with 65.90% individuals being male. The mean values for FBG, eGFR, and baPWV were 5.46 ± 0.79 mmol/L, 68.83 ± 10.05 mL/min/1.73 m2, and 1,423.50 ± 247.78 cm/s, respectively. The mediation analysis revealed that eGFR had a significant direct effect on baPWV (β = −25.68 95% CI: −46.42, −7.45), and that FBG played a partial mediating role in the indirect effect of eGFR on baPWV (β = −3.54 95% CI: −11.88, −0.079). Mediation analysis showed that 12.10% of the effect of eGFR on risk of arterial stiffness was mediated through FBG. Conclusion: The study indicated that there is a mediating relationship between eGFR and FBG in people with decreased kidney function, which is associated with the risk of arterial stiffness. Therefore, the importance of FBG as a mediator should be acknowledged and taken into consideration. [ABSTRACT FROM AUTHOR]