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Fiorentino TV, Vito FD, Natale RM, Sergi S, Rubino M, Cassano V, Succurro E, Sciacqua A, Andreozzi F, Sesti G. Reduced glomerular filtration rate in individuals with intermediate hyperglycemia and type 2 diabetes as defined by 1-hour post-load glucose levels according to the newly released IDF criteria. Diabetes Res Clin Pract 2025; 222:112075. [PMID: 40054530 DOI: 10.1016/j.diabres.2025.112075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2025] [Revised: 02/11/2025] [Accepted: 02/25/2025] [Indexed: 03/14/2025]
Abstract
AIMS Recently, the International Diabetes Federation (IDF) has recommended determination of 1 h-post-load glucose (PG) to diagnose intermediate hyperglycemia (IH) and type 2 diabetes (T2DM). Herein, we investigate the implication of IDF recommendation in identifying subjects with chronic kidney disease (CKD). METHODS Estimated glomerular filtration rate (eGFR) was assessed on 2161 subjects classified on the basis of their fasting, 1 h and 2 h-PG, according to the IDF criteria, as having normal glucose tolerance (NGT), isolated impaired fasting glucose (iIFG), IH and T2DM. RESULTS Prevalence of CKD (eGFR < 60 ml/min/1.73 m2) and mildly reduced kidney function (eGFR 90-60 ml/min/1.73 m2) progressively increased at worsening of glucose tolerance. In a logistic regression analysis adjusted for several cardio-metabolic confounders, individuals with iIFG and IH exhibited a 3.48- (95 %CI = 1.01-11.00, P = 0.05) and 3.69- (95 %CI = 1.42-9.60, P = 0.007) fold increased risk of having CKD compared to the NGT group. The risk for CKD was further increased in subjects with T2DM (OR = 3.93, 95 %CI = 1.36-10.66, P = 0.007). Additionally, participants with IH and T2DM had a 1.89-fold (95 %CI = 1.38-2.60, P < 0.0001) and 2.78-fold (95 %CI = 1.97-3.98, P < 0.0001) higher risk of mildly reduced GFR compared to the NGT group. CONCLUSIONS The 1 h-PG thresholds proposed by IDF as diagnostic for IH and T2DM are capable of identifying individuals at risk of kidney dysfunction.
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Affiliation(s)
- Teresa Vanessa Fiorentino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy.
| | - Francesca De Vito
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Resilde Maria Natale
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Silvia Sergi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Mariangela Rubino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Velia Cassano
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Elena Succurro
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, University of Rome-Sapienza, Rome 00189, Italy
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Moffa S, Sorice GP, Di Giuseppe G, Cinti F, Ciccarelli G, Soldovieri L, Brunetti M, Sonnino R, Nista EC, Gasbarrini A, Pontecorvi A, Mezza T, Giaccari A. A single bout of physical exercise improves 1-hour post-load plasma glucose in healthy young adults. J Endocrinol Invest 2025; 48:455-464. [PMID: 39347907 PMCID: PMC11785650 DOI: 10.1007/s40618-024-02438-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 07/29/2024] [Indexed: 10/01/2024]
Abstract
PURPOSE Physical exercise is a key component in the treatment of type 2 diabetes and plays an important role in maintaining a healthy glucose metabolism even in healthy subjects. To date, no studies have investigated the effect of a single bout of aerobic physical exercise on glucose metabolism in young, moderately active, healthy adults. METHODS We performed an OGTT 7 days before and 24 h after a single bout of physical exercise, to evaluate 1-hour post-load plasma glucose and surrogate indexes of insulin sensitivity and insulin secretion. RESULTS Glucose levels were significantly reduced after exercise at baseline and one hour after glucose load; similarly, insulin was significantly lower 1 h after glucose load. We found a significant increase in the Matsuda index, confirmed by OGIS index, QUICKI index, and by significant reduction in HOMA-IR. Conversely, we observed a trend to increase in HOMA-B. CONCLUSION This is the first study to evaluate the effect of a single bout of exercise on 1-hour glucose levels following OGTT. We found a significant reduction in 1-hour glucose levels following OGTT together with an increased insulin sensitivity. A single 30-minute bout of aerobic exercise also seemed to improve the insulin secretion pattern. Modifications in beta cell secretory capacity during exercise are likely secondary to an improvement in insulin action in insulin dependent tissues.
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Affiliation(s)
- Simona Moffa
- Centro per le Malattie Endocrine e Metaboliche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Gian Pio Sorice
- Sezione di Medicina Interna, Endocrinologia, Andrologia e Malattie Metaboliche, Dipartimento di Medicina di Precisione e Rigenerativa e Area Jonica - (DiMePre-J), Università Degli Studi di Bari "Aldo Moro", Bari, Italy
| | - Gianfranco Di Giuseppe
- Centro per le Malattie Endocrine e Metaboliche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Francesca Cinti
- Centro per le Malattie Endocrine e Metaboliche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Gea Ciccarelli
- Centro per le Malattie Endocrine e Metaboliche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Laura Soldovieri
- Centro per le Malattie Endocrine e Metaboliche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Michela Brunetti
- Centro per le Malattie Endocrine e Metaboliche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Rebecca Sonnino
- Centro per le Malattie Endocrine e Metaboliche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Enrico C Nista
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
- Pancreas Unit, Medicina Interna e Gastroenterologia, CEMAD Centro Malattie dell'Apparato Digerente, Fondazione Policlinico Universitario Gemelli IRCCS, Roma, Italy
| | - Antonio Gasbarrini
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
- Pancreas Unit, Medicina Interna e Gastroenterologia, CEMAD Centro Malattie dell'Apparato Digerente, Fondazione Policlinico Universitario Gemelli IRCCS, Roma, Italy
| | - Alfredo Pontecorvi
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Teresa Mezza
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy.
- Pancreas Unit, Medicina Interna e Gastroenterologia, CEMAD Centro Malattie dell'Apparato Digerente, Fondazione Policlinico Universitario Gemelli IRCCS, Roma, Italy.
| | - Andrea Giaccari
- Centro per le Malattie Endocrine e Metaboliche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
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Yuan F, Fang D, Xu H, Nie Y, Cai W, Gu T. One-hour post-load glucose is associated with biopsy-proven metabolic dysfunction-associated steatotic liver disease in obese individuals. DIABETES & METABOLISM 2025; 51:101588. [PMID: 39645036 DOI: 10.1016/j.diabet.2024.101588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2024] [Revised: 10/17/2024] [Accepted: 11/03/2024] [Indexed: 12/09/2024]
Abstract
AIM To investigate the association between one-hour post-load plasma glucose (1h-PG) levels and metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic-associated steatohepatitis (MASH). METHODS Clinical data were collected from 538 obese participants who underwent oral glucose tolerance tests (OGTT) and liver biopsy in the Drum Tower Hospital affiliated with the Nanjing University Medical School. Participants were categorized into normal glucose tolerance (NGT), prediabetes (pre-DM), and type 2 diabetes (T2DM) groups, with further stratification of the NGT group into 1h-PG Low and 1h-PG High. The diagnosis of MASLD and MASH was performed using the NASH Clinical Research Network scoring system. Logistic regression analyses were performed to determine the association between each category and MASLD/ MASH. RESULTS The prevalence of MASLD and MASH progressively increased across NGT 1h-PG Low, NGT 1h-PG High, pre-DM and T2DM groups. Compared to the NGT 1h-PG Low group, the NGT 1h-PG High group had a significantly higher risk of MASLD (OR 3.27 [95 % CI 1.32;8.09]) and MASH (OR 3.08 [1.55;6.11]), which is similar to the pre-DM group. Additionally, elevated 1h-PG levels were associated with hepatic steatosis, lobular inflammation, and fibrosis. Mediation analysis indicated that Matsuda insulin sensitivity index and disposition index played a sequential mediating role between 1h-PG and hepatic steatosis, accounting for 14.23 % of total effect (β 0.014 [95 % CI 0.002;0.035]). CONCLUSION Elevated 1h-PG levels increase the risk of MASLD and MASH in obese individuals. Early screening and management of MASLD are necessary, even in NGT individuals when 1h-PG levels are ≥8.6 mmol/l.
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Affiliation(s)
- Fangqin Yuan
- Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine; Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China
| | - Da Fang
- Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University; Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China
| | - Hao Xu
- Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine; Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China
| | - Yuanyuan Nie
- Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine; Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China
| | - Wen Cai
- Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University; Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China
| | - Tianwei Gu
- Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine; Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University; Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China.
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Dimova R, Chakarova N, Serdarova M, Tankova T. Lipid profile is similar in both subjects with high 1-hour postload glucose and 2-hour postload glucose and is related to cardio-metabolic profile in prediabetes. J Diabetes Complications 2024; 38:108869. [PMID: 39306875 DOI: 10.1016/j.jdiacomp.2024.108869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 08/16/2024] [Accepted: 09/15/2024] [Indexed: 10/26/2024]
Abstract
AIM The study aimed to investigate a lipid profile in people with normal glucose tolerance (NGT), NGT and 1hrOGTT > 8.6 mmol/l, and impaired glucose tolerance (IGT); and to assess its association with some cardio-metabolic parameters. MATERIAL AND METHODS A total of 90 subjects, of mean age 46.7 ± 10.5 years and mean BMI of 32.0 ± 6.3 kg/m2 were enrolled. They were divided into 3 groups: 19 with NGT, 22 with NGT and 1hrOGTT > 8.6 mmol/l, and 49 with IGT; and subdivided into 2 subgroups according to HOMA-IR: 40 with HOMA-IR < 2.5 and 50 with HOMA-IR ≥ 2.5. Body composition (Inbody 720) and advanced glycation end products (AGE Reader) were assessed. Two functional tests (OGTT; MMTT) were performed and AUC for glucose, insulin and triglycerides were calculated. RESULTS There was no difference across the glucose tolerance groups for all evaluated lipids. The results showed higher AUCinsulin during OGTT (p = 0.037 and 0.020), AUCtriglycerides during MMTT (p = 0.048) and triglycerides/HDL ratio (p = 0.064 and 0.016) in the 1hrOGTT and IGT subgroups with HOMA-IR ≥ 2.5 in comparison to those with HOMA-IR < 2.5. AUCtriglycerides during OGTT is independently related to body composition, b-cell function and insulin sensitivity; and AUCtriglycerides during MMTT is independently related to blood pressure and hsCRP in prediabetes. Triglycerides/HDL-C ratio emerged as an independent contributor to glycaemia and insulinemia. CONCLUSION Our results demonstrate a similar lipid profile in subjects with 1hrOGTT > 8.6 mmol/l and IGT, whereas increased AUCtriglycerides during OGTT, AUCtriglycerides during MMTT and triglycerides/HDL-C ratio have been found in the subgroups with insulin resistance. The triglycerides/HDL-C ratio outlined as an independent predictor of insulin secretion and action, and postload triglycerides appear to be independently related to most of the metabolic parameters.
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Affiliation(s)
- Rumyana Dimova
- Department of Endocrinology, Medical University Sofia, 2, Zdrave str., Sofia 1431, Bulgaria.
| | - Nevena Chakarova
- Department of Endocrinology, Medical University Sofia, 2, Zdrave str., Sofia 1431, Bulgaria
| | - Mina Serdarova
- Department of Endocrinology, Medical University Sofia, 2, Zdrave str., Sofia 1431, Bulgaria
| | - Tsvetalina Tankova
- Department of Endocrinology, Medical University Sofia, 2, Zdrave str., Sofia 1431, Bulgaria
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Bergman M, Manco M, Satman I, Chan J, Schmidt MI, Sesti G, Vanessa Fiorentino T, Abdul-Ghani M, Jagannathan R, Kumar Thyparambil Aravindakshan P, Gabriel R, Mohan V, Buysschaert M, Bennakhi A, Pascal Kengne A, Dorcely B, Nilsson PM, Tuomi T, Battelino T, Hussain A, Ceriello A, Tuomilehto J. International Diabetes Federation Position Statement on the 1-hour post-load plasma glucose for the diagnosis of intermediate hyperglycaemia and type 2 diabetes. Diabetes Res Clin Pract 2024; 209:111589. [PMID: 38458916 DOI: 10.1016/j.diabres.2024.111589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
Many individuals with intermediate hyperglycaemia (IH), including impaired fasting glycaemia (IFG) and impaired glucose tolerance (IGT), as presently defined, will progress to type 2 diabetes (T2D). There is confirmatory evidence that T2D can be prevented by lifestyle modification and/or medications, in people with IGT diagnosed by 2-h plasma glucose (PG) during a 75-gram oral glucose tolerance test (OGTT). Over the last 40 years, a wealth of epidemiological data has confirmed the superior value of 1-h plasma glucose (PG) over fasting PG (FPG), glycated haemoglobin (HbA1c) and 2-h PG in populations of different ethnicity, sex and age in predicting diabetes and associated complications including death. Given the relentlessly rising prevalence of diabetes, a more sensitive, practical method is needed to detect people with IH and T2D for early prevention or treatment in the often lengthy trajectory to T2D and its complications. The International Diabetes Federation (IDF) Position Statement reviews findings that the 1-h post-load PG ≥ 155 mg/dL (8.6 mmol/L) in people with normal glucose tolerance (NGT) during an OGTT is highly predictive for detecting progression to T2D, micro- and macrovascular complications, obstructive sleep apnoea, cystic fibrosis-related diabetes mellitus, metabolic dysfunction-associated steatotic liver disease, and mortality in individuals with risk factors. The 1-h PG of 209 mg/dL (11.6 mmol/L) is also diagnostic of T2D. Importantly, the 1-h PG cut points for diagnosing IH and T2D can be detected earlier than the recommended 2-h PG thresholds. Taken together, the 1-h PG provides an opportunity to avoid misclassification of glycaemic status if FPG or HbA1c alone are used. The 1-h PG also allows early detection of high-risk people for intervention to prevent progression to T2D which will benefit the sizeable and growing population of individuals at increased risk of T2D. Using a 1-h OGTT, subsequent to screening with a non-laboratory diabetes risk tool, and intervening early will favourably impact the global diabetes epidemic. Health services should consider developing a policy for screening for IH based on local human and technical resources. People with a 1-h PG ≥ 155 mg/dL (8.6 mmol/L) are considered to have IH and should be prescribed lifestyle intervention and referred to a diabetes prevention program. People with a 1-h PG ≥ 209 mg/dL (11.6 mmol/L) are considered to have T2D and should have a repeat test to confirm the diagnosis of T2D and then referred for further evaluation and treatment. The substantive data presented in the Position Statement provides strong evidence for redefining current diagnostic criteria for IH and T2D by adding the 1-h PG.
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Affiliation(s)
- Michael Bergman
- NYU Grossman School of Medicine, Departments of Medicine and of Population Health, Division of Endocrinology, Diabetes and Metabolism, VA New York Harbor Healthcare System, New York, NY, USA.
| | - Melania Manco
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Ilhan Satman
- Istanbul University Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey
| | - Juliana Chan
- The Chinese University of Hong Kong, Faculty of Medicine, Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity, Hong Kong, China
| | - Maria Inês Schmidt
- Postgraduate Program in Epidemiology, School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, University of Rome-Sapienza, 00189 Rome, Italy
| | - Teresa Vanessa Fiorentino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Muhammad Abdul-Ghani
- Division of Diabetes, University of Texas Health Science Center at San Antonio, San Antonio Texas, USA
| | - Ram Jagannathan
- Hubert Department of Global Health Rollins, School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Rafael Gabriel
- Department of International Health, National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Viswanathan Mohan
- Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, India
| | - Martin Buysschaert
- Department of Endocrinology and Diabetology, Université Catholique de Louvain, University, Clinic Saint-Luc, Brussels, Belgium
| | - Abdullah Bennakhi
- Dasman Diabetes Institute Office of Regulatory Affairs, Ethics Review Committee, Kuwait
| | - Andre Pascal Kengne
- South African Medical Research Council, Francie Van Zijl Dr, Parow Valley, Cape Town, 7501, South Africa
| | - Brenda Dorcely
- NYU Grossman School of Medicine, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, New York, NY, USA
| | - Peter M Nilsson
- Department of Clinical Sciences and Lund University Diabetes Centre, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Tiinamaija Tuomi
- Folkhälsan Research Center, Helsinki, Finland; Abdominal Center, Endocrinology, Helsinki University Central Hospital, Research Program for Diabetes and Obesity, Center of Helsinki, Helsinki, Finland
| | | | - Akhtar Hussain
- Faculty of Health Sciences, Nord University, Bodø, Norway; Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Brazil; International Diabetes Federation (IDF), Brussels, Belgium; Diabetes in Asia Study Group, Post Box: 752, Doha-Qatar; Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | | | - Jaakko Tuomilehto
- Department of International Health, National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain; Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland; Saudi Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
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Condoleo V, Maio R, Cassano V, Bonfrate L, Pelaia C, Armentaro G, Miceli S, Fiorentino TV, Perticone M, Succurro E, Andreozzi F, Sesti G, Sciacqua A. Association between non-dipping blood pressure pattern and different glucometabolic profile during oral glucose tolerance test. Intern Emerg Med 2024; 19:81-89. [PMID: 37801209 PMCID: PMC10827950 DOI: 10.1007/s11739-023-03442-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/20/2023] [Indexed: 10/07/2023]
Abstract
It is known that, a not physiological blood pressure (BP) circadian pattern has been associated with increased risk of organ damage and cardiovascular (CV) event. The aim of this study was to assess the association between circadian BP pattern and glucometabolic phenotypes occurring after oral glucose tolerance test (OGTT). We recruited 810 hypertensive Caucasian patients. All participants underwent to OGTT, laboratory test and 24-h ambulatory BP monitoring (ABPM). The analysis of collected data allowed classifying patients based on nocturnal BP profiles into four categories: dippers, non-dippers, extreme dippers, and reverse dippers. Considering the dipping pattern, the proportion of non-dippers in normal glucose tolerance patients with 1-h glucose ≥ 155 mg/dL (NGT ≥ 155) (36.4%) was higher than NGT < 155 (29.6%) and impaired glucose tolerance (IGT) (34.8%), but lower than type 2 diabetes group (T2DM) (52.6%) (p = 0.001). The proportion of dippers was lower in NGT ≥ 155 (47%) and T2DM (34.6%), when compared with NGT < 155 (53.8%) and IGT (51.2%) (p = 0.017). From logistic regression analysis, 1-h glucose ≥ 155 increased the risk of a pathological nocturnal drop in BP by 74%, (OR = 1.740, 95% CI 1.254-2.415, p < 0.0001). In addition, the improvement in 1 unit of Matsuda was responsible for a 3.5% risk decrease (OR = 0.965, 95% CI 0.958-0.971, p < 0.0001), while e-GFR determined a 0.9% risk reduction of nocturnal BP drop (OR = 0.991, 95% CI 0.984-0.999, p = 0.020). Our data demonstrated the existence, in newly diagnosed hypertensive patients, of an association between circadian BP profile and altered glycemic response during OGTT, in particular NGT ≥ 155 subjects are associated with a non-dipper BP pattern, this is clinically relevant because may explain, at least in part, the increased CV risk in this setting of patients.
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Affiliation(s)
- Valentino Condoleo
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa-Località Germaneto, 88100, Catanzaro, Italy
| | - Raffaele Maio
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa-Località Germaneto, 88100, Catanzaro, Italy
| | - Velia Cassano
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa-Località Germaneto, 88100, Catanzaro, Italy.
| | - Leonilde Bonfrate
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Corrado Pelaia
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa-Località Germaneto, 88100, Catanzaro, Italy
| | - Giuseppe Armentaro
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa-Località Germaneto, 88100, Catanzaro, Italy
| | - Sofia Miceli
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa-Località Germaneto, 88100, Catanzaro, Italy
| | - Teresa Vanessa Fiorentino
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa-Località Germaneto, 88100, Catanzaro, Italy
| | - Maria Perticone
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa-Località Germaneto, 88100, Catanzaro, Italy
| | - Elena Succurro
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa-Località Germaneto, 88100, Catanzaro, Italy
- Research Center for the Prevention and Treatment of Metabolic Diseases (CR METDIS), University Magna Græcia, 88100, Catanzaro, Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa-Località Germaneto, 88100, Catanzaro, Italy
- Research Center for the Prevention and Treatment of Metabolic Diseases (CR METDIS), University Magna Græcia, 88100, Catanzaro, Italy
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa-Località Germaneto, 88100, Catanzaro, Italy
- Research Center for the Prevention and Treatment of Metabolic Diseases (CR METDIS), University Magna Græcia, 88100, Catanzaro, Italy
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7
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Cassano V, Pelaia C, Armentaro G, Miceli S, Tallarico V, Perini DD, Fiorentino VT, Imbalzano E, Maio R, Succurro E, Hribal ML, Andreozzi F, Sesti G, Sciacqua A. New potential biomarkers for early chronic kidney disease diagnosis in patients with different glucose tolerance status. Front Endocrinol (Lausanne) 2023; 14:1206336. [PMID: 37484969 PMCID: PMC10361654 DOI: 10.3389/fendo.2023.1206336] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 06/20/2023] [Indexed: 07/25/2023] Open
Abstract
Background The purpose of the present study was to investigate the role of oxidative stress, platelet activation, and endocan levels in renal dysfunction in normal glucose tolerance (NGT) patients with 1-h plasma glucose values ≥155 mg/dl (NGT ≥ 155), compared to NGT < 155, impaired glucose tolerance (IGT), and type 2 diabetes mellitus (T2DM) newly diagnosed subjects. We enlisted 233 patients subjected to an oral glucose tolerance test (OGTT). Materials and methods The serum levels of platelet activation (glycoprotein VI and sP-selectin), oxidative stress biomarkers (8-isoprostane and Nox-2), and endocan were evaluated using an ELISA test. Results Among NGT < 155 patients and the T2DM group, there was a statistically significant increase in 8-isoprostane (p < 0.0001), Nox-2 (p < 0.0001), glycoprotein VI (p < 0.0001), and sP-selectin (p < 0.0001) serum levels. Higher serum endocan levels were found with the worsening of metabolic profile (p < 0.0001); specifically, NGT ≥ 155 patients presented higher serum endocan values when compared to NGT < 155 patients (p < 0.0001). From the multivariate linear regression analysis, 1-h glucose resulted in the major predictor of estimated glomerular filtration rate (e-GFR) justifying 23.6% of its variation (p < 0.0001); 8-isoprostane and Nox-2 added respectively another 6.0% (p < 0.0001) and 3.2% (p = 0.001). Conclusion Our study confirmed the link between 1-h post-load glucose ≥155 mg/dl during OGTT and the possible increased risk for chronic kidney disease (CKD) in newly diagnosed patients. The novelty is that we demonstrated a progressive increase in oxidative stress, platelet activation, and serum endocan levels with the worsening of metabolic profile, which becomes evident early during the progression of CKD.
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Affiliation(s)
- Velia Cassano
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Corrado Pelaia
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Giuseppe Armentaro
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Sofia Miceli
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Valeria Tallarico
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Daniele Dallimonti Perini
- Department of Experimental and Clinical Medicine, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Vanessa T. Fiorentino
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Egidio Imbalzano
- Department of Clinical and Experimental Medicine, Polyclinic University of Messina, Messina, Italy
| | - Raffaele Maio
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Elena Succurro
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Marta L. Hribal
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
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Magkos F, Reeds DN, Mittendorfer B. Evolution of the diagnostic value of "the sugar of the blood": hitting the sweet spot to identify alterations in glucose dynamics. Physiol Rev 2023; 103:7-30. [PMID: 35635320 PMCID: PMC9576168 DOI: 10.1152/physrev.00015.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/22/2022] Open
Abstract
In this paper, we provide an overview of the evolution of the definition of hyperglycemia during the past century and the alterations in glucose dynamics that cause fasting and postprandial hyperglycemia. We discuss how extensive mechanistic, physiological research into the factors and pathways that regulate the appearance of glucose in the circulation and its uptake and metabolism by tissues and organs has contributed knowledge that has advanced our understanding of different types of hyperglycemia, namely prediabetes and diabetes and their subtypes (impaired fasting plasma glucose, impaired glucose tolerance, combined impaired fasting plasma glucose, impaired glucose tolerance, type 1 diabetes, type 2 diabetes, gestational diabetes mellitus), their relationships with medical complications, and how to prevent and treat hyperglycemia.
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Affiliation(s)
- Faidon Magkos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Dominic N Reeds
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri
| | - Bettina Mittendorfer
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri
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Adegoke TE, Sabinari IW, Usman TO, Abdulkareem TO, Michael OS, Adeyanju OA, Dibia C, Omotoye OO, Oyabambi AO, Olatunji LA. Allopurinol and valproic acid improve cardiac triglyceride and Na +-K +-ATPase activity independent of circulating aldosterone in female rats with glucose intolerance. Arch Physiol Biochem 2022; 128:1283-1289. [PMID: 32447998 DOI: 10.1080/13813455.2020.1767148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Context: Studies have shown that cardiac triglyceride accumulation and impaired Na+-K+-ATPase activity are linked to diabetes- related cardiovascular disease, particularly in women.Objectives: We hypothesised that allopurinol (ALL) and valproic acid (VPA) treatment would improve cardiac triglyceride and Na+-K+-ATPase activity independent of circulating aldosterone in Combined Oral Contraceptive (COC)-induced dysglycemiaMaterials and methods: Rats received COC (1.0 μg ethinylestradiol and 5.0 μg levonorgestrel; po) with or without ALL (1 mg; po) and VPA (20 mg; po) for 6 weeks.Results: COC-treatment led to impaired glucose tolerance, accumulated abdominal fat, dyslipidemia, elevated plasma MDA, PAI-1 and aldosterone levels and also reduced plasma nitric oxide bioavailability and cardiac Na+-K+-ATPase activity. However, either ALL or VPA treatment ameliorated these alterations comparably independent of elevated aldosterone levelDiscussion and conclusion: Our results suggest that either ALL or VPA would improve cardiac TG and Na+-K+-ATPase activity comparably in COC-treated rats, regardless of circulating aldosterone level.
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Affiliation(s)
- Tolulope E Adegoke
- Department of Physiology, HOPE Cardiometabolic Research Team, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Isiah W Sabinari
- Department of Physiology, HOPE Cardiometabolic Research Team, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Taofeek O Usman
- Department of Physiology, HOPE Cardiometabolic Research Team, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
- Department of Physiology, Cardiometabolic Research Unit, College of Health Sciences, Osun State University, Osogbo, Nigeria
| | - Toyyib O Abdulkareem
- Department of Physiology, HOPE Cardiometabolic Research Team, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Olugbenga S Michael
- Department of Physiology, HOPE Cardiometabolic Research Team, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
- Department of Physiology, Cardiometabolic Research Unit, College of Health and Medical Sciences, Bowen University, Iwo, Nigeria
| | - Oluwaseun A Adeyanju
- Department of Physiology, HOPE Cardiometabolic Research Team, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
- Department of Physiology, Cardiometabolic Research Unit, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Chinaza Dibia
- Department of Physiology, HOPE Cardiometabolic Research Team, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Omotola O Omotoye
- Department of Physiology, HOPE Cardiometabolic Research Team, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Adewumi O Oyabambi
- Department of Physiology, HOPE Cardiometabolic Research Team, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Lawrence A Olatunji
- Department of Physiology, HOPE Cardiometabolic Research Team, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
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Immuno-Mediated Inflammation in Hypertensive Patients with 1-h Post-Load Hyperglycemia. Int J Mol Sci 2022; 23:ijms231810891. [PMID: 36142799 PMCID: PMC9502333 DOI: 10.3390/ijms231810891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022] Open
Abstract
Inflammation plays a key role in the pathogenesis/progression of atherosclerosis, and inflammatory molecules contribute to the progression of cardiovascular disease. Subjects with normal post-load glucose tolerance and 1-h post-load plasma glucose >155 mg/dL have an increased risk of subclinical target organ damage and incident diabetes. We aimed to test possible differences in immune-mediated inflammatory parameters in newly-diagnosed hypertensives with or without 1-h post-load hyperglycemia. We enrolled 25 normotensives (NGT) and 50 hypertensives normotolerant on oral glucose tolerance test, further divided into two groups based on 1-h post-load plasma glucose: NGT 1-h ≥ 155 (n = 25) and NGT 1-h < 155 (n = 25). We measured toll-like receptor (TLR) 2, TLR4, nuclear factor kβ (NF-kβ), interleukin (IL)-1β, IL-6, IL-8, IL-10, and tumor necrosis factor (TNF)-α. Hypertensives showed significantly worse metabolic and lipid profiles, and higher values of body mass ass index (BMI), creatinine, and inflammatory parameters, compared to controls. NGT 1-h ≥ 155 had a worse glycometabolic profile and higher values of TLR2 (9.4 ± 4.2 vs. 5.9 ± 2.6 MFI), TLR4 (13.1 ± 3.9 vs. 7.8 ± 2.3 MFI), NF-kβ (0.21 ± 0.07 vs. 0.14 ± 0.04), IL-1β (6.9 ± 3.4 vs. 3.2 ± 2.1 pg/mL), IL-6 (10.8 ± 2.6 vs. 4.1 ± 1.6 pg/mL), IL-8 (27.6 ± 9.3 vs. 13.3 ± 5.6 pg/mL), TNF-α (6.4 ± 2.9 vs. 3.3 ± 1.4 pg/mL), and high-sensitivity C-reactive protein (hs-CRP) (4.8 ± 1.5 vs. 2.7 ± 1.0 mg/dL) in comparison with NGT 1-h < 155. Matsuda-index and 1-h post-load glycemia were retained as major predictors of TLRs and NF-kβ. These results contribute to better characterizing cardiovascular risk in hypertensives.
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Saunajoki A, Auvinen J, Bloigu A, Saramies J, Tuomilehto J, Uusitalo H, Hussi E, Cederberg-Tamminen H, Suija K, Keinänen-Kiukaanniemi S, Timonen M. Elevated One-Hour Post-Load Glucose Is Independently Associated with Albuminuria: A Cross-Sectional Population Study. J Clin Med 2022; 11:jcm11144124. [PMID: 35887888 PMCID: PMC9317539 DOI: 10.3390/jcm11144124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/08/2022] [Accepted: 07/14/2022] [Indexed: 02/01/2023] Open
Abstract
The purpose of this study was to examine and compare the associations between albuminuria and fasting (FPG), 1 h post-load (1 h PG) and 2 h post-load plasma glucose (2 h PG) in an oral glucose tolerance test (OGTT). A total of 496 people free of known diabetes (mean age 72 years) participated in the examinations including the OGTT with plasma glucose measurements at 0, 1, and 2 h and levels of HbA1c. Albuminuria was determined by the urinary albumin-to-creatinine ratio and was defined as ≥3.0 mg/mmol. Compared with those without albuminuria, participants with albuminuria had significantly higher 1 h PG and 2 h PG levels, but not FPG or HbA1c levels. An elevated 1 h PG increased the estimated odds ratio of albuminuria more than three times in people with prediabetic 1 h PG (8.6–11.5 mmol/L: OR 3.60; 95% CI 1.70–7.64) and diabetic 1 h PG (≥11.6 mmol/L: OR 3.05; 95% CI 1.29–7.23). After adjusting for blood pressure and age, the association of elevated 1 h PG with albuminuria remained significant. Prediabetic or diabetic FPG, 2 h PG, or HbA1c did not have a statistically significant association with albuminuria. These findings suggest that 1 h PG seems to be the best glycemic parameter and is useful in recognizing persons with an elevated risk of early kidney disease due to hyperglycemia.
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Affiliation(s)
- Anni Saunajoki
- Center for Life Course Health Research, University of Oulu, 90220 Oulu, Finland; (J.A.); (A.B.); (J.S.); (K.S.); (S.K.-K.); (M.T.)
- Correspondence:
| | - Juha Auvinen
- Center for Life Course Health Research, University of Oulu, 90220 Oulu, Finland; (J.A.); (A.B.); (J.S.); (K.S.); (S.K.-K.); (M.T.)
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, 90220 Oulu, Finland
| | - Aini Bloigu
- Center for Life Course Health Research, University of Oulu, 90220 Oulu, Finland; (J.A.); (A.B.); (J.S.); (K.S.); (S.K.-K.); (M.T.)
| | - Jouko Saramies
- Center for Life Course Health Research, University of Oulu, 90220 Oulu, Finland; (J.A.); (A.B.); (J.S.); (K.S.); (S.K.-K.); (M.T.)
- South Karelia Social and Health Care District, 53130 Lappeenranta, Finland;
| | - Jaakko Tuomilehto
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland;
- Diabetes Research Group, King Abdulaziz University, Jeddah 22254, Saudi Arabia
| | - Hannu Uusitalo
- Department of Ophthalmology, Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland;
- Tays Eye Centre, Tampere University Hospital, 33014 Tampere, Finland
| | - Esko Hussi
- South Karelia Social and Health Care District, 53130 Lappeenranta, Finland;
| | - Henna Cederberg-Tamminen
- Department of Endocrinology, Abdominal Center, Helsinki University Hospital, 00290 Helsinki, Finland;
| | - Kadri Suija
- Center for Life Course Health Research, University of Oulu, 90220 Oulu, Finland; (J.A.); (A.B.); (J.S.); (K.S.); (S.K.-K.); (M.T.)
- Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, 50411 Tartu, Estonia
| | - Sirkka Keinänen-Kiukaanniemi
- Center for Life Course Health Research, University of Oulu, 90220 Oulu, Finland; (J.A.); (A.B.); (J.S.); (K.S.); (S.K.-K.); (M.T.)
- Healthcare and Social Services of Selänne, 98530 Pyhäjärvi, Finland
| | - Markku Timonen
- Center for Life Course Health Research, University of Oulu, 90220 Oulu, Finland; (J.A.); (A.B.); (J.S.); (K.S.); (S.K.-K.); (M.T.)
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, 90220 Oulu, Finland
- Unit of General Practice, Oulu University Hospital, 90220 Oulu, Finland
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Chen Z, Li D, Lin M, Jiang H, Xu T, Shan Y, Fu G, Wang M, Zhang W. Association of Hemoglobin Glycation Index With Contrast-Induced Acute Kidney Injury in Patients Undergoing Coronary Angiography: A Retrospective Study. Front Physiol 2022; 13:870694. [PMID: 35669583 PMCID: PMC9163394 DOI: 10.3389/fphys.2022.870694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background: The hemoglobin glycation index (HGI) quantifies interindividual variation in glycation and is positively associated with cardiovascular diseases. However, the association between HGI and contrast-induced acute kidney injury (CI-AKI) remains unclear. Therefore, this study aimed to assess the association of HGI with CI-AKI. Methods: In this observational study, a total of 3,142 patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI) were included. The HGI was calculated as the difference between the measured glycated hemoglobin (HbA1c) and predicted HbA1c. CI-AKI was defined as an increase of either 25% or 0.5 mg/dl (44.2 μmol/L) in the serum creatinine (SCr) level within 72 h following the exposure to contrast medium. Piecewise linear regression analysis was conducted to testify the association of HGI with the proportion of SCr elevation. Modified Poisson’s regression analysis was performed to determine the association between HGI and CI-AKI. Exploratory analysis was also performed according to the stratification of HbA1c levels. Results: Among 3,142 patients, the average age was 66.9 years and 483 of them (15.4%) suffered CI-AKI. Piecewise linear regression analysis demonstrated the linear association of HGI with the proportion of SCr elevation on both positive and negative sides of HGI [HGI <0: β = −9.537, 95% CI (−12.057 to −7.017), p < 0.001; HGI ≥0: β = 1.655, 95% CI (0.125 to 3.186), p = 0.034]. Modified Poisson’s regression analysis showed that the higher absolute value of HGI was strongly associated with higher incidence of CI-AKI [(<−1.0 vs. −0.2 to 0.2): aRR = 1.897, 95% CI [1.467 to 2.452], p < 0.001 (≥1.0 vs. −0.2 to 0.2): aRR = 1.545, 95% CI (1.171 to 2.037), p = 0.002]. Furthermore, the results in exploratory analysis showed that such association still remained irrespective of HbA1c levels. Conclusion: The higher absolute value of HGI was strongly associated with higher incidence of CI-AKI in patients undergoing CAG and PCI.
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Affiliation(s)
- Zhezhe Chen
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Duanbin Li
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Maoning Lin
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Hangpan Jiang
- Department of Cardiology, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Yiwu, China
| | - Tian Xu
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Yu Shan
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Guosheng Fu
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Min Wang
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
- *Correspondence: Min Wang, ; Wenbin Zhang,
| | - Wenbin Zhang
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
- *Correspondence: Min Wang, ; Wenbin Zhang,
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Cassano V, Miceli S, Armentaro G, Mannino GC, Fiorentino VT, Perticone M, Succurro E, Hribal ML, Andreozzi F, Perticone F, Sesti G, Sciacqua A. Oxidative Stress and Left Ventricular Performance in Patients with Different Glycometabolic Phenotypes. Nutrients 2022; 14:nu14061299. [PMID: 35334956 PMCID: PMC8950717 DOI: 10.3390/nu14061299] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 12/14/2022] Open
Abstract
The aim of the present study was to evaluate the possible correlation between oxidative stress and subclinical myocardial damage, assessed with speckle tracking echocardiography (STE), in normal glucose tolerance (NGT) patients with one-hour plasma glucose values ≥ 155 mg/dL (NGT ≥ 155), comparing them to NGT < 155 subjects, impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) newly diagnosed patients. We enrolled 100 Caucasian patients. All subjects underwent OGTT. The serum values of oxidative stress markers (8-isoprostane and Nox-2) were assessed with an ELISA test. Echocardiographic recordings were performed using an E-95 Pro ultrasound system. We observed significant differences, among the four groups, for fasting plasma glucose (p < 0.0001), one-hour postload (p < 0.0001), and two-hour postload plasma glucose (p < 0.0001). As compared with NGT < 155, NGT ≥ 155 exhibited significantly worse insulin sensitivity and higher values of hs-CRP. No significant differences were observed between NGT ≥ 155 and IGT patients. There was a significant increase in 8-isoprostane (p < 0.0001) and Nox-2 (p < 0.0001), from the first to fourth group, indicating an increase in oxidative stress with the worsening of the metabolic status. Serum levels of 8-isoprostane and Nox-2 were significantly increased in NGT ≥ 155 compared to the NGT < 155 group, but similar to IGT. The global longitudinal strain (GLS) appeared progressively lower proceeding from the NGT < 155 to T2DM group (p < 0.0001). For similar values of left ventricular ejection fraction (LVEF), NGT ≥ 155 exhibited reduced GLS compared to NGT < 155 (p = 0.001), but similar to IGT patients. Our study demonstrated that NGT ≥ 155 subjects exhibit early functional impairment of myocardial contractile fibres, these alterations are correlated with increased oxidative stress.
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Affiliation(s)
- Velia Cassano
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (S.M.); (G.A.); (G.C.M.); (V.T.F.); (M.P.); (E.S.); (M.L.H.); (F.A.); (F.P.)
| | - Sofia Miceli
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (S.M.); (G.A.); (G.C.M.); (V.T.F.); (M.P.); (E.S.); (M.L.H.); (F.A.); (F.P.)
| | - Giuseppe Armentaro
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (S.M.); (G.A.); (G.C.M.); (V.T.F.); (M.P.); (E.S.); (M.L.H.); (F.A.); (F.P.)
| | - Gaia Chiara Mannino
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (S.M.); (G.A.); (G.C.M.); (V.T.F.); (M.P.); (E.S.); (M.L.H.); (F.A.); (F.P.)
| | - Vanessa Teresa Fiorentino
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (S.M.); (G.A.); (G.C.M.); (V.T.F.); (M.P.); (E.S.); (M.L.H.); (F.A.); (F.P.)
| | - Maria Perticone
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (S.M.); (G.A.); (G.C.M.); (V.T.F.); (M.P.); (E.S.); (M.L.H.); (F.A.); (F.P.)
| | - Elena Succurro
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (S.M.); (G.A.); (G.C.M.); (V.T.F.); (M.P.); (E.S.); (M.L.H.); (F.A.); (F.P.)
- Research Center for the Prevention and Treatment of Metabolic Diseases, University of Catanzaro, 88100 Catanzaro, Italy
| | - Marta Letizia Hribal
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (S.M.); (G.A.); (G.C.M.); (V.T.F.); (M.P.); (E.S.); (M.L.H.); (F.A.); (F.P.)
- Research Center for the Prevention and Treatment of Metabolic Diseases, University of Catanzaro, 88100 Catanzaro, Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (S.M.); (G.A.); (G.C.M.); (V.T.F.); (M.P.); (E.S.); (M.L.H.); (F.A.); (F.P.)
- Research Center for the Prevention and Treatment of Metabolic Diseases, University of Catanzaro, 88100 Catanzaro, Italy
| | - Francesco Perticone
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (S.M.); (G.A.); (G.C.M.); (V.T.F.); (M.P.); (E.S.); (M.L.H.); (F.A.); (F.P.)
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, University Rome-Sapienza, 00185 Roma, Italy;
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (S.M.); (G.A.); (G.C.M.); (V.T.F.); (M.P.); (E.S.); (M.L.H.); (F.A.); (F.P.)
- Research Center for the Prevention and Treatment of Metabolic Diseases, University of Catanzaro, 88100 Catanzaro, Italy
- Correspondence: ; Tel.: +39-0961-3694103; Fax: +39-0961-3647192
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Perticone M, Di Lorenzo C, Arabia G, Arturi F, Caroleo B, Tassone B, Pujia R, Fiorentino TV, Chiriaco C, Sesti G, Quattrone A, Perticone F. One Hour-Post-load Plasma Glucose ≥155 mg/dl in Healthy Glucose Normotolerant Subjects Is Associated With Subcortical Brain MRI Alterations and Impaired Cognition: A Pilot Study. Front Aging Neurosci 2021; 13:608736. [PMID: 33613266 PMCID: PMC7891177 DOI: 10.3389/fnagi.2021.608736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Glucose alterations are associated with impaired cognition. The 1-h-post-load plasma glucose ≥155 mg/dl in non-diabetic subjects confers an increased risk of cardiovascular events and diabetes. This pilot study aimed to investigate whether the 1-h-post-load plasma glucose ≥155 mg/dl negatively affects the subcortical regions of the brain and the cognitive functions. Methods: We enrolled 32 non-diabetic subjects. Patients were divided into two groups based on 1-h- post-load plasma glucose value > or < 155 mg/dl: normal glucose tolerance (NGT) 1-h-high and NGT 1-h-low subjects. All subjects underwent 3 Tesla MRI and standard neuropsychological tests. Results: NGT 1-h-high subjects showed significantly lower values of both right (4.9 ± 0.9 vs. 5.1 ± 0.9 ml) and left (4.8 ± 1.1 vs. 5.1 ± 1.1 ml) hippocampal hemisphere volume, while right hemisphere hippocampal diffusivity was lower in the NGT 1-h-high group (10.0 ± 0.6 vs. 10.6 ± 0.5 10-4 mm2s-1). NGT 1-h-high subjects also showed a poorer memory performance. In particular, for both Rey Auditory Verbal Learning Task (RAVLT)-immediate-recall and Free and Cued Selective Reminding Test (FCSRT)-delayed total recall, we found lower cognitive test scores in the NGT-1 h-high group (26.5 ± 6.3 and 10.4 ± 0.3, respectively). Conclusions: One-hour-post-load hyperglycemia is associated with morpho-functional subcortical brain alterations and poor memory performance tests.
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Affiliation(s)
- Maria Perticone
- Geriatrics Division, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Cherubino Di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies, La Sapienza University Polo Pontino, Latina, Italy
| | - Gennarina Arabia
- Neurology Division, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Franco Arturi
- Internal Medicine Division, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Benedetto Caroleo
- Geriatric Division, Azienda Ospedaliero-Universitaria Mater Domini, Catanzaro, Italy
| | - Bruno Tassone
- Internal Medicine Division, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Roberta Pujia
- Internal Medicine Division, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Teresa Vanessa Fiorentino
- Internal Medicine Division, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Carmelina Chiriaco
- Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, La Sapienza University, Rome, Italy
| | - Aldo Quattrone
- Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Francesco Perticone
- Geriatrics Division, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
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Jagannathan R, Neves JS, Dorcely B, Chung ST, Tamura K, Rhee M, Bergman M. The Oral Glucose Tolerance Test: 100 Years Later. Diabetes Metab Syndr Obes 2020; 13:3787-3805. [PMID: 33116727 PMCID: PMC7585270 DOI: 10.2147/dmso.s246062] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 09/24/2020] [Indexed: 12/15/2022] Open
Abstract
For over 100 years, the oral glucose tolerance test (OGTT) has been the cornerstone for detecting prediabetes and type 2 diabetes (T2DM). In recent decades, controversies have arisen identifying internationally acceptable cut points using fasting plasma glucose (FPG), 2-h post-load glucose (2-h PG), and/or HbA1c for defining intermediate hyperglycemia (prediabetes). Despite this, there has been a steadfast global consensus of the 2-h PG for defining dysglycemic states during the OGTT. This article reviews the history of the OGTT and recent advances in its application, including the glucose challenge test and mathematical modeling for determining the shape of the glucose curve. Pitfalls of the FPG, 2-h PG during the OGTT, and HbA1c are considered as well. Finally, the associations between the 30-minute and 1-hour plasma glucose (1-h PG) levels derived from the OGTT and incidence of diabetes and its complications will be reviewed. The considerable evidence base supports modifying current screening and diagnostic recommendations with the use of the 1-h PG. Measurement of the 1-h PG level could increase the likelihood of identifying high-risk individuals when the pancreatic ß-cell function is substantially more intact with the added practical advantage of potentially replacing the conventional 2-h OGTT making it more acceptable in the clinical setting.
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Affiliation(s)
- Ram Jagannathan
- Division of Hospital Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - João Sérgio Neves
- Department of Surgery and Physiology, Cardiovascular Research and Development Center, Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Endocrinology, Diabetes and Metabolism, Sa˜o Joa˜ o University Hospital Center, Porto, Portugal
| | - Brenda Dorcely
- NYU Grossman School of Medicine, Division of Endocrinology, Diabetes, Metabolism, New York, NY10016, USA
| | - Stephanie T Chung
- Diabetes, Obesity, and Endocrinology Branch, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Kosuke Tamura
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD20892, USA
| | - Mary Rhee
- Emory University School of Medicine, Department of Medicine, Division of Endocrinology, Metabolism, and Lipids, Atlanta VA Health Care System, Atlanta, GA30322, USA
| | - Michael Bergman
- NYU Grossman School of Medicine, NYU Diabetes Prevention Program, Endocrinology, Diabetes, Metabolism, VA New York Harbor Healthcare System, Manhattan Campus, New York, NY10010, USA
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16
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Adeyanju OA, Michael OS, Soladoye AO, Olatunji LA. Blockade of mineralocorticoid receptor ameliorates oral contraceptive-induced insulin resistance by suppressing elevated uric acid and glycogen synthase kinase-3 instead of circulating mineralocorticoid. Arch Physiol Biochem 2020; 126:225-234. [PMID: 30318954 DOI: 10.1080/13813455.2018.1509220] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Context: Estrogen-progestin combined oral contraceptive (COC) has been connected to mineralocorticoid receptor (MR) activation and adverse cardiometabolic events. We consequently hypothesised that insulin resistance (IR), hyperuricemia, and elevated circulating GSK-3 induced by COC is through activation of MR via mineralocorticoid and glucocorticoid pathways.Methods: Female Wistar rats aged 12 weeks received (po) vehicle and COC (1.0 μg ethinylestradiol plus 5.0 μg levonorgestrel) with or without MR blocker (0.25 mg/kg spironolactone; Spl), daily for eight weeks.Results: Data showed that COC treatment led to increased IR, 1-hour postload glucose level, insulinemia, triglyceride/HDL-cholesterol ratio, total cholesterol/HDL-cholesterol ratio, uric acid, GSK-3, aldosterone, corticosterone values, impaired glucose tolerance and pancreatic β-cell function. However, MR blockade by Spl ameliorated all these alterations except that of aldosterone.Conclusion: The results demonstrate that COC induces IR, hyperuricemia and high GSK-3 levels through activation of MR via glucocorticoid dependent pathway.
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Affiliation(s)
- O A Adeyanju
- HOPE Cardiometabolic Research Team, Department of Physiology, University of Ilorin, Ilorin, Nigeria
- Cardiometabolic Research Unit, Department of Physiology, College of Medicine and Health sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - O S Michael
- HOPE Cardiometabolic Research Team, Department of Physiology, University of Ilorin, Ilorin, Nigeria
- Cardiometabolic Research Unit, Department of Physiology, College of Health sciences, Bowen University, Iwo, Nigeria
| | - A O Soladoye
- HOPE Cardiometabolic Research Team, Department of Physiology, University of Ilorin, Ilorin, Nigeria
- Cardiometabolic Research Unit, Department of Physiology, College of Health sciences, Bowen University, Iwo, Nigeria
| | - L A Olatunji
- HOPE Cardiometabolic Research Team, Department of Physiology, University of Ilorin, Ilorin, Nigeria
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17
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Mengen E, Uçaktürk SA. Evaluation of the relationship between the one-hour plasma glucose concentration and beta-cell functions and cardiometabolic parameters during oral glucose tolerance test in obese children and adolescents. J Pediatr Endocrinol Metab 2020; 33:767-775. [PMID: 32447335 DOI: 10.1515/jpem-2020-0016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/19/2020] [Indexed: 11/15/2022]
Abstract
Background In this study, we aimed to evaluate the relationship between the 1-h plasma glucose (PG) level in the oral glucose tolerance test (OGTT) and conventional glycemic parameters, indices evaluating beta-cell functions, and cardiometabolic risk factors. Methods The records of 532 obese patients who were followed up in the Pediatric Endocrinology Polyclinic and who underwent standard OGTT were evaluated retrospectively. All patients were divided into two groups according to OGTT data as the 1-h plasma glucose concentration <155 mg/dL (n=329) and ≥155 mg/dL (n=203). Patients with normal glucose tolerance (NGT) were divided into two groups according to the 1-h PG level, as 218 patients with NGT 1 h-low (<155 mg/dL) and 53 patients with high NGT 1 h-high (≥155 mg/dL). Results There was a statistically significant difference between the lipid profiles of individuals with NGT 1 h-low (<155 mg/dL) and individuals with NGT 1 h-high (≥155 mg/dL) (p<0.001). Total cholesterol, LDL cholesterol, and triglyceride levels were higher, while HDL cholesterol levels were lower in individuals with NGT 1 h-high (≥155 mg/dL). The indices evaluating beta-cell functions were significantly higher in individuals with NGT 1 h-low (<155 mg/dL). Conclusion As a result, a plasma glucose concentration above or equal to 155 mg/dL at 1 h during an OGTT is associated with a worse clinical phenotype characterized by changes in insulin sensitivity and β-cell function. Therefore, this threshold value can predict the progression of prediabetes in obese young people with NGT.
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Affiliation(s)
- Eda Mengen
- Department of Pediatric Endocrinology, Ankara City Hospital, Children's Hospital, Ankara, Turkey
| | - Seyit Ahmet Uçaktürk
- Department of Pediatric Endocrinology, Ankara City Hospital, Children's Hospital, Ankara, Turkey
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18
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Saunajoki AE, Auvinen JP, Bloigu AH, Timonen MJ, Keinänen-Kiukaanniemi SM. Evaluating the 1-h post-load glucose level to predict future type 2 diabetes. Diabetes Res Clin Pract 2020; 160:108009. [PMID: 31926844 DOI: 10.1016/j.diabres.2020.108009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 12/06/2019] [Accepted: 01/07/2020] [Indexed: 12/25/2022]
Abstract
AIMS To evaluate the predictive ability of 2-h post-load glucose level in addition to fasting and 1-h glucose levels in predicting the risk of type 2 diabetes. METHODS We examined a prospective population-based cohort study of 654 subjects without type 2 diabetes at baseline. All subjects underwent an oral glucose tolerance test (OGTT), with measurement of glucose at 0, 60, and 120 min at baseline, and after 12 years in a follow-up survey. We evaluated the predictive properties of fasting, 1- and 2-h post-load glucose levels by comparing the areas under the receiver-operating characteristic (ROC) curve. RESULTS We found that 2-h glucose concentration in the prediction model with fasting and 1-h glucose levels did not significantly increase the predictability of type 2 diabetes compared to a model only including fasting and 1-h glucose levels (AUC 0.83 vs. AUC 0.82, respectively; p = 0.23). The area under the ROC curve was the largest for 1-h glucose level (AUC 0.81), compared to fasting (AUC 0.71; p < 0.01) and 2-h glucose levels (AUC 0.72; p = 0.01). CONCLUSIONS Adding 2-h glucose to the model with fasting and 1-h glucose levels did not improve the predictability of new onset type 2 diabetes.
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Affiliation(s)
- Anni E Saunajoki
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.
| | - Juha P Auvinen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Healthcare and Social Services of Oulunkaari, Ii, Finland.
| | - Aini H Bloigu
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.
| | - Markku J Timonen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Healthcare and Social Services of Oulunkaari, Ii, Finland.
| | - Sirkka M Keinänen-Kiukaanniemi
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; Healthcare and Social Services of Selänne, Pyhäjärvi, Finland.
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19
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Adeyanju OA, Olatunji LA. Drospirenone-containing oral contraceptives do not affect glucose regulation and circulating corticosterone. J Basic Clin Physiol Pharmacol 2019; 30:jbcpp-2018-0184. [PMID: 31469652 DOI: 10.1515/jbcpp-2018-0184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 06/17/2019] [Indexed: 12/19/2022]
Abstract
Background Combined oral contraceptive (COC) use has been associated with an increased risk of insulin resistance (IR) and other adverse cardiovascular events, despite efforts to reduce the dosage and/or progestin type. COC containing drospirenone (DRSP) is an analog of spironolactone, hence its antimineralocorticoid and antiandrogenic characteristics have been deemed beneficial, although the benefits and/or negative outcome of its usage have not been fully elucidated. We therefore hypothesized that COC with DRSP component will not affect glucose regulation and circulating corticosterone. Method Ten-week-old female Wistar rats were divided into three groups: control (CON), ethinylestradiol/drospirenone COC (EE/DRSP)-treated, and ethinylestradiol/levonorgestrel COC (EE/LN)-treated rats. The treatment lasted for 8 weeks. Results Results showed that with the exception of lipid profiles, EE/LN but not EE/DRSP COC treatment affected body weight, glucose tolerance, plasma insulin, corticosterone, (IR), and pancreatic β-cell dysfunction. Conclusion Taken together, the findings showed that the beneficial effect of EE/DRSP could possibly be through the DRSP component. The result also implies that COCs containing DRSP may be a better and safer means of contraception than those with LN with less cardiovascular risks.
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Affiliation(s)
- Oluwaseun A Adeyanju
- Department of Physiology, College of Health Sciences, University of Ilorin, Ilorin 240003, Nigeria.,Cardiometabolic Research Unit, Department of Physiology, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Lawrence A Olatunji
- Department of Physiology, College of Health Sciences, University of Ilorin, PMB 1515, Ilorin 240003, Nigeria, Phone: +2348035755360
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20
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Adeyanju OA, Falodun TO, Fabunmi OA, Olatunji LA, Soladoye AO. Very low dose spironolactone protects experimentally-induced polycystic ovarian syndrome from insulin-resistant metabolic disturbances by suppressing elevated circulating testosterone. Chem Biol Interact 2019; 310:108742. [PMID: 31295448 DOI: 10.1016/j.cbi.2019.108742] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 07/01/2019] [Accepted: 07/08/2019] [Indexed: 11/30/2022]
Abstract
Polycystic ovarian syndrome (PCOS) is the most common endocrinological disorder in women of reproductive age and hyperandrogenism is a prominent feature of PCOS resulting in infertility and increased risk of developing metabolic disorders including insulin resistance (IR), abdominal adiposity, glucose intolerance and cardiovascular diseases. Spironolactone (SPL), a non-selective mineralocorticoid receptor (MR) antagonist, has been in wide clinical use for several decades. In this study, we investigated the effects of SPL on IR and metabolic disturbances in letrozole-induced PCOS rats. Eighteen adults female Wistar rats were randomly divided into 3 groups and treated with vehicle, letrozole (LET; 1 mg/kg) and LET + SPL (SPL; 0.25 mg/kg), p.o. once daily for 21 consecutive days. Results showed that LET treatment induced PCOS characterised by elevated plasma testosterone and luteinizing hormone (LH) accompanied with increased body weight and visceral adiposity, IR, glucose intolerance, dyslipidemia and altered histomorphological ovaries. Treatment with SPL however attenuated the elevated testosterone in LET-induced PCOS model accompanied with a reversal in all the observed alterations. Taken together, analysis of the physical, biochemical and histological evidences shows that the protective effect of this very low dose spironolactone may be through its anti-androgenic mechanism.
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Affiliation(s)
- Oluwaseun A Adeyanju
- Cardiometabolic Research Unit, Department of Physiology, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria; HOPE Cardiometabolic Research Team & Department of Physiology, University of Ilorin, Ilorin, Nigeria.
| | - Timothy O Falodun
- Cardiometabolic Research Unit, Department of Physiology, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | | | - Lawrence A Olatunji
- HOPE Cardiometabolic Research Team & Department of Physiology, University of Ilorin, Ilorin, Nigeria
| | - Ayodele O Soladoye
- Cardiometabolic Research Unit, Department of Physiology, College of Health and Medical Sciences, Bowen University, Iwo, Nigeria
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21
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Sciacqua A, Perticone M, Miceli S, Pinto A, Cassano V, Succurro E, Andreozzi F, Hribal ML, Sesti G, Perticone F. Elevated 1-h post-load plasma glucose is associated with right ventricular morphofunctional parameters in hypertensive patients. Endocrine 2019; 64:525-535. [PMID: 30790176 DOI: 10.1007/s12020-019-01873-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 02/13/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE Emerging data demonstrate that type 2 diabetes mellitus (T2DM) is associated with right ventricular (RV) dysfunction. A cutoff point of 155 mg/dL for the 1-hour (h) post-load plasma glucose, during oral glucose tolerance test (OGTT), identifies patients with normal glucose tolerance (NGT) at high risk to develop T2DM and cardiovascular (CV) disease. We investigated if 1-h post-load glucose may affect RV geometry and function in a group of never-treated hypertensive individuals. METHODS We enrolled 446 Caucasian newly diagnosed hypertensive outpatients. All patients underwent an OGTT and a standard echocardiography. The tricuspid annular plane systolic excursion (TAPSE) and the RV fractional area change (RVFAC) were measured together with systolic pulmonary arterial pressure (s-PAP) and pulmonary vascular resistances (PVR). Insulin sensitivity was evaluated using the Matsuda index. RESULTS Among all partecipants, 296 had NGT, 100 impaired glucose tolerance (IGT), and 50 T2DM. Considering the cutoff point of 155 mg/dl for 1-h glucose, NGT subjects were stratified into two groups: NGT < 155 (n = 207), NGT ≥ 155 (n = 89). Subjects NGT ≥ 155 presented a worse metabolic and inflammatory profile than NGT < 155. RV functional parameters (TAPSE, RVFAC, TAPSE/s-PAP, and TAPSE/PVR) were significantly reduced in NGT ≥ 155 subjects compared with NGT < 155 patients. On the contrary, s-PAP and PVR were significantly higher. At multiple regression analysis, 1-h glucose was the strongest predictor of TAPSE in NGT ≥ 155, IGT, and T2DM. CONCLUSIONS The presence of RV impairment in hypertensive NGT ≥ 155 subjects further complicates their CV burden and it may, at least in part, justify the worse clinical outcome in this setting of patients.
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Affiliation(s)
- Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy.
| | - Maria Perticone
- Department of Experimental and Clinical Medicine, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Sofia Miceli
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Angelina Pinto
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Velia Cassano
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Elena Succurro
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Marta Letizia Hribal
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Giorgio Sesti
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Francesco Perticone
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
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22
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Haverals L, Van Dessel K, Verrijken A, Dirinck E, Peiffer F, Verhaegen A, De Block C, Van Gaal L. Cardiometabolic importance of 1-h plasma glucose in obese subjects. Nutr Diabetes 2019; 9:16. [PMID: 31127083 PMCID: PMC6534543 DOI: 10.1038/s41387-019-0084-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 01/31/2019] [Accepted: 04/11/2019] [Indexed: 01/04/2023] Open
Abstract
Background/objectives To study the importance and clinical usefulness of the 1-h plasma glucose (1hPG) in a Caucasian obese population with regard to the presence of prediabetes, diabetes, and metabolic syndrome (MetS). Subjects/methods We conducted a cross-sectional study of 2439 overweight or obese subjects. All received an oral glucose tolerance test (OGTT) using the American Diabetes Association criteria. ROC-curves were used to compare the sensitivity and (1-specificity) of 1hPG versus FPG and 2hPG to diagnose prediabetes and diabetes. Results Of 2439 patients (72.1% female) (age 43 ± 13 years, BMI 37.9 (34.6–41.6) kg/m2), 1262 (51.7%) had a 1hPG ≥ 155 mg/dL. The prevalence of prediabetes was 33.8% and of diabetes 9.8%. In these 240 diabetic patients, only 1.6% (four patients) did not show a 1hPG ≥ 155 mg/dL. Subjects with 1hPG ≥ 155 mg/dL were more insulin resistant (p < 0.001), had a higher waist (p < 0.001), visceral adipose tissue (VAT) (p < 0.001), systolic blood pressure (p < 0.001), microalbuminuria (p < 0.001), PAI-1 (p < 0.001), and worse lipid profile (p < 0.001) than subjects with 1hPG < 155 mg/dL. MetS was present in 64.1% of subjects with 1hPG ≥ 155 mg/dL versus 42.5% of subjects with 1hPG < 155 mg/dL (p < 0.001). In the group with 1hPG ≥ 155 mg/dL 32.6% had a normal glucose tolerance (NGT), 48.9% had prediabetes, and 18.5% was diagnosed with T2DM compared to 81.7% NGT, 17.7% prediabetes, and 0.6% T2DM in subjects with 1hPG < 155 mg/dL (p < 0.001). Among NGT subjects, 30.0% had a 1hPG ≥ 155 mg/dL and showed higher HOMA-IR (p = 0.008), VAT (p < 0.001), blood pressure (p < 0.001), and worse lipid profile (p = 0.001). Compared to 1hPG < 155 mg/dL, the sensitivity and specificity of 1hPG ≥ 155 mg/dL of prediabetes were 74.8% and 60.0% and for diabetes 97.1% and 53.2%, respectively. Conclusions This study supports the role of 1hPG value as a valuable tool in the detection of obese subjects at high risk for T2DM and MetS.
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Affiliation(s)
- Lien Haverals
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - Kristof Van Dessel
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium.
| | - An Verrijken
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - Eveline Dirinck
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - Frida Peiffer
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - Ann Verhaegen
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - Christophe De Block
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - Luc Van Gaal
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
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Peddinti G, Bergman M, Tuomi T, Groop L. 1-Hour Post-OGTT Glucose Improves the Early Prediction of Type 2 Diabetes by Clinical and Metabolic Markers. J Clin Endocrinol Metab 2019; 104:1131-1140. [PMID: 30445509 PMCID: PMC6382453 DOI: 10.1210/jc.2018-01828] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 11/12/2018] [Indexed: 12/19/2022]
Abstract
CONTEXT Early prediction of dysglycemia is crucial to prevent progression to type 2 diabetes. The 1-hour postload plasma glucose (PG) is reported to be a better predictor of dysglycemia than fasting plasma glucose (FPG), 2-hour PG, or glycated hemoglobin (HbA1c). OBJECTIVE To evaluate the predictive performance of clinical markers, metabolites, HbA1c, and PG and serum insulin (INS) levels during a 75-g oral glucose tolerance test (OGTT). DESIGN AND SETTING We measured PG and INS levels at 0, 30, 60, and 120 minutes during an OGTT in 543 participants in the Botnia Prospective Study, 146 of whom progressed to type 2 diabetes within a 10-year follow-up period. Using combinations of variables, we evaluated 1527 predictive models for progression to type 2 diabetes. RESULTS The 1-hour PG outperformed every individual marker except 30-minute PG or mannose, whose predictive performances were lower but not significantly worse. HbA1c was inferior to 1-hour PG according to DeLong test P value but not false discovery rate. Combining the metabolic markers with PG measurements and HbA1c significantly improved the predictive models, and mannose was found to be a robust metabolic marker. CONCLUSIONS The 1-hour PG, alone or in combination with metabolic markers, is a robust predictor for determining the future risk of type 2 diabetes, outperforms the 2-hour PG, and is cheaper to measure than metabolites. Metabolites add to the predictive value of PG and HbA1c measurements. Shortening the standard 75-g OGTT to 1 hour improves its predictive value and clinical usability.
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Affiliation(s)
- Gopal Peddinti
- VTT Technical Research Center of Finland Ltd, Espoo, Finland
- Correspondence and Reprint Requests: Gopal Peddinti, PhD, VTT Technical Research Center of Finland Ltd, PO Box 1000, 02044VTT, Tietotie 2, Espoo, Finland. E-mail:
| | - Michael Bergman
- NYU School of Medicine, Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, NYU Langone Diabetes Prevention Program, New York, New York
| | - Tiinamaija Tuomi
- Folkhälsan Research Center, Helsinki, Finland
- Abdominal Center, Endocrinology, Helsinki University Central Hospital; Research Program for Diabetes and Obesity, University of Helsinki, Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Leif Groop
- Folkhälsan Research Center, Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Lund University Diabetes Centre, Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
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Fiorentino TV, Succurro E, Andreozzi F, Sciacqua A, Perticone F, Sesti G. One-hour post-load hyperglycemia combined with HbA1c identifies individuals with higher risk of cardiovascular diseases: Cross-sectional data from the CATAMERI study. Diabetes Metab Res Rev 2019; 35:e3096. [PMID: 30378248 DOI: 10.1002/dmrr.3096] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 10/09/2018] [Accepted: 10/25/2018] [Indexed: 12/30/2022]
Abstract
AIMS A value of 1-hour post-load plasma glucose (PG) ≥155 mg/dL combined with the recently established HbA1c diagnostic thresholds for prediabetes increases the ability to predict diabetes and to detect subclinical cardiovascular organ damage. Herein, we evaluated whether a value of 1-hour PG ≥155 mg/dL may recognize non-diabetic individuals with an increased risk of cardiovascular diseases (CVD) within HbA1c-defined glycemic categories. MATERIALS AND METHODS The prevalence of composite and individual CVD, including coronary artery disease (CAD) and cerebrovascular disease, was assessed in 1010 non-diabetic individuals. RESULTS Within the group with HbA1c <5.7%, a higher proportion of subjects with 1-hour PG ≥ 155 mg/dL had composite CVD and individual CAD in comparison to those having 1-hour PG˂155 mg/dL. Similarly, within the group with HbA1c-defined prediabetes (5.7%-6.4%), the prevalence of composite CVD and individual CAD in subjects with 1-hour PG ≥155 mg/dL was higher than in the group with individuals having 1-hour PG < 155 mg/dL. In a logistic regression analysis adjusted for several CVD risk factors individuals with HbA1c <5.7% and 1-hour PG ≥ 155 mg/dL and those with HbA1c 5.7% to 6.4% and 1-hour PG ≥ 155 mg/dL had a 4.5- (95%CI: 1.02-20.44) and 6.2- (95%CI: 1.29-29.74) fold increased risk of composite CVD and 6.2- (95%CI: 1.05-36.32) and 8.0- (95%CI: 1.25-51.70) fold increased risk of having CAD, respectively, in comparison to individuals with HbA1c <5.7% and 1-hour PG < 155 mg/dL. CONCLUSIONS 1-hour post-load hyperglycemia may identify a subset of individuals within HbA1c-defined glycemic categories at higher risk of having CVD.
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Affiliation(s)
- Teresa Vanessa Fiorentino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Elena Succurro
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Francesco Perticone
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Giorgio Sesti
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
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25
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Colaci M, Giuggioli D, Spinella A, Vacchi C, Lumetti F, Mattioli AV, Coppi F, Aiello V, Perticone M, Malatino L, Ferri C. Established coronary artery disease in systemic sclerosis compared to type 2 diabetic female patients: a cross-sectional study. Clin Rheumatol 2019; 38:1637-1642. [DOI: 10.1007/s10067-019-04427-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/24/2018] [Accepted: 01/01/2019] [Indexed: 12/13/2022]
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Bergman M, Manco M, Sesti G, Dankner R, Pareek M, Jagannathan R, Chetrit A, Abdul-Ghani M, Buysschaert M, Olsen MH, Nilsson PM, Medina JL, Roth J, Groop L, Del Prato S, Raz I, Ceriello A. Petition to replace current OGTT criteria for diagnosing prediabetes with the 1-hour post-load plasma glucose ≥ 155 mg/dl (8.6 mmol/L). Diabetes Res Clin Pract 2018; 146:18-33. [PMID: 30273707 DOI: 10.1016/j.diabres.2018.09.017] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 09/25/2018] [Indexed: 02/08/2023]
Abstract
Many individuals with prediabetes, as presently defined, will progress to diabetes (T2D) despite the considerable benefit of lifestyle modification. Therefore, it is paramount to screen individuals at increased risk with a more sensitive method capable of identifying prediabetes at an even earlier time point in the lengthy trajectory to T2D. This petition reviews findings demonstrating that the 1-hour (1-h) postload plasma glucose (PG) ≥ 155 mg/dl (8.6 mmol/L) in those with normal glucose tolerance (NGT) during an oral glucose tolerance test (OGTT) is highly predictive for detecting progression to T2D, micro- and macrovascular complications and mortality in individuals at increased risk. Furthermore, the STOP DIABETES Study documented effective interventions that reduce the future risk of T2D in those with NGT and a 1-h PG ≥ 155 mg/dl (8·6 mmol/L). The 1-h OGTT represents a valuable opportunity to extend the proven benefit of diabetes prevention to the sizeable and growing population of individuals at increased risk of progression to T2D. The substantial evidence provided in this petition strongly supports redefining current diagnostic criteria for prediabetes with the elevated 1-h PG level. The authors therefore advocate a 1-h OGTT to detect prediabetes and hence, thwart the global diabetes epidemic.
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Affiliation(s)
- Michael Bergman
- NYU School of Medicine, Department of Medicine and of Population Health, Division of Endocrinology and Metabolism, NYU Langone Diabetes Prevention Program, New York, NY, USA.
| | - Melania Manco
- Research Unit for Multifactorial Diseases and Complex Phenotypes, Bambino Gesù Children Hospital, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Rome, Italy
| | - Giorgio Sesti
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Rachel Dankner
- The Feinstein Institute for Medical Research, Manhasset, North Shore, NY, USA; Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, School of Public Health, Department of Epidemiology and Preventive Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Manan Pareek
- Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, University of Southern Denmark, Denmark; Cardiology Section, Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
| | - Ram Jagannathan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 18, Atlanta, GA, USA
| | - Angela Chetrit
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Muhammad Abdul-Ghani
- Division of Diabetes, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Martin Buysschaert
- Department of Endocrinology and Diabetology, Université Catholique de Louvain, University, Clinic Saint-Luc, Brussels, Belgium
| | - Michael H Olsen
- Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, University of Southern Denmark, Denmark; Cardiology Section, Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
| | - Peter M Nilsson
- Department of Clinical Sciences and Lund University Diabetes Centre, Lund University, Skåne University Hospital, Malmö, Sweden
| | | | - Jesse Roth
- The Feinstein Institute for Medical Research, Manhasset, North Shore, NY, USA
| | - Leif Groop
- Lund University, Lund University Diabetes Centre, Malmö, Sweden
| | - Stefano Del Prato
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Itamar Raz
- Diabetes Unit at Hadassah University Hospital, Hadassah Center for the Prevention of Diabetes, Diabetes Clinical Research Center, Jerusalem, Israel
| | - Antonio Ceriello
- Institut d'Investigacions Biomèdiques August Pi I Sunyer and Centro de Investigación Biomedica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Barcelona, Spain; Department of Cardiovascular and Metabolic Diseases, Istituto Ricerca Cura Carattere Scientifico Multimedica, Sesto, San Giovanni, MI, Italy
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27
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Fiorentino TV, Marini MA, Succurro E, Andreozzi F, Perticone M, Hribal ML, Sciacqua A, Perticone F, Sesti G. One-Hour Postload Hyperglycemia: Implications for Prediction and Prevention of Type 2 Diabetes. J Clin Endocrinol Metab 2018; 103:3131-3143. [PMID: 30020454 DOI: 10.1210/jc.2018-00468] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 07/12/2018] [Indexed: 12/18/2022]
Abstract
CONTEXT Recently, a value of 1-hour postload glucose concentration (1-h-PG) ≥155 mg/dL (8.6 mmol/L) in individuals with normal glucose tolerance (NGT) has been found to be associated with an increased risk for future type 2 diabetes mellitus (T2DM). In this review, we analyze the implication of 1-h-PG determination in prediction of T2DM and cardiovascular disease. DESIGN A literature search was performed using MEDLINE. We included all English studies published up to February 2018 in peer-reviewed journals that examined the relationship between 1-h-PG and diabetes, cardiometabolic alterations, organ damage, and cardiovascular disease. RESULTS Several longitudinal studies have consistently shown that 1-h-PG ≥155 mg/dL can recognize individuals at increased risk for future T2DM among subjects with NGT. Additionally, we describe the pathophysiological abnormalities associated with 1-h-PG ≥155 mg/dL including impaired insulin sensitivity, β-cell dysfunction, and increased glucose intestinal absorption, which are known to be involved in T2DM pathogenesis. Importantly, numerous studies have demonstrated that a value of 1-h-PG ≥155 mg/dL in individuals with NGT is not only linked to an increased risk for future T2DM, but also able to identify those having a worse cardiovascular phenotype and an increased risk of adverse cardiovascular outcomes. CONCLUSIONS Although 1-h-PG determination is not currently recommended by the American Diabetes Association for identifying high-risk individuals, the available evidence indicates that a value of 1-h-PG ≥155 mg/dL may be a useful tool to recognize, among subjects with NGT, those at increased risk of T2DM and cardiovascular disease.
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Affiliation(s)
- Teresa Vanessa Fiorentino
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Viale Europa, Catanzaro, Italy
| | | | - Elena Succurro
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Viale Europa, Catanzaro, Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Viale Europa, Catanzaro, Italy
| | - Maria Perticone
- Department of Experimental and Clinical Medicine, University Magna Græcia of Catanzaro, Viale Europa, Catanzaro, Italy
| | - Marta Letizia Hribal
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Viale Europa, Catanzaro, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Viale Europa, Catanzaro, Italy
| | - Francesco Perticone
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Viale Europa, Catanzaro, Italy
| | - Giorgio Sesti
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Viale Europa, Catanzaro, Italy
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Bergman M, Jagannathan R, Buysschaert M, Pareek M, Olsen MH, Nilsson PM, Medina JL, Roth J, Chetrit A, Groop L, Dankner R. Lessons learned from the 1-hour post-load glucose level during OGTT: Current screening recommendations for dysglycaemia should be revised. Diabetes Metab Res Rev 2018; 34:e2992. [PMID: 29460410 DOI: 10.1002/dmrr.2992] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/14/2018] [Accepted: 02/02/2018] [Indexed: 02/06/2023]
Abstract
This perspective covers a novel area of research describing the inadequacies of current approaches for diagnosing dysglycaemia and proposes that the 1-hour post-load glucose level during the 75-g oral glucose tolerance test may serve as a novel biomarker to detect dysglycaemia earlier than currently recommended screening criteria for glucose disorders. Considerable evidence suggests that a 1-hour post-load plasma glucose value ≥155 mg/dl (8.6 mmol/L) may identify individuals with reduced β-cell function prior to progressing to prediabetes and diabetes and is highly predictive of those likely to progress to diabetes more than the HbA1c or 2-hour post-load glucose values. An elevated 1-hour post-load glucose level was a better predictor of type 2 diabetes than isolated 2-hour post-load levels in Indian, Japanese, and Israeli and Nordic populations. Furthermore, epidemiological studies have shown that a 1-hour PG ≥155 mg/dl (8.6 mmol/L) predicted progression to diabetes as well as increased risk for microvascular disease and mortality when the 2-hour level was <140 mg/dl (7.8 mmol/L). The risk of myocardial infarction or fatal ischemic heart disease was also greater among subjects with elevated 1-hour glucose levels as were risks of retinopathy and peripheral vascular complications in a Swedish cohort. The authors believe that the considerable evidence base supports redefining current screening and diagnostic recommendations with the 1-hour post-load level. Measurement of the 1-hour PG level would increase the likelihood of identifying a larger, high-risk group with the additional practical advantage of potentially replacing the conventional 2-hour oral glucose tolerance test making it more acceptable in a clinical setting.
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Affiliation(s)
- Michael Bergman
- Division of Endocrinology and Metabolism, Department of Medicine and of Population Health, School of Medicine, NYU Langone Diabetes Prevention Program, New York, NY, USA
| | - Ram Jagannathan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Martin Buysschaert
- Department of Endocrinology and Diabetology, Université Catholique de Louvain, University Clinic Saint-Luc, Brussels, Belgium
| | - Manan Pareek
- Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, University of Southern Denmark, Odense, Denmark
- Cardiology Section, Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
| | - Michael H Olsen
- Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, University of Southern Denmark, Odense, Denmark
- Cardiology Section, Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
| | - Peter M Nilsson
- Department of Clinical Sciences and Lund University Diabetes Centre, Lund University, Skåne University Hospital, Malmö, Sweden
| | | | - Jesse Roth
- The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Angela Chetrit
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Leif Groop
- Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Rachel Dankner
- The Feinstein Institute for Medical Research, Manhasset, NY, USA
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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29
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Jagannathan R, Buysschaert M, Medina JL, Katz K, Musleh S, Dorcely B, Bergman M. The 1-h post-load plasma glucose as a novel biomarker for diagnosing dysglycemia. Acta Diabetol 2018; 55:519-529. [PMID: 29383586 PMCID: PMC7977481 DOI: 10.1007/s00592-018-1105-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 01/11/2018] [Indexed: 02/06/2023]
Abstract
Identifying the earliest moment for intervention to avert progression to prediabetes and diabetes in high-risk individuals is a substantial challenge. As β-cell function is already compromised in prediabetes, attention should therefore be focused on identifying high-risk individuals earlier in the so-called pre-prediabetes stage. Biomarkers to monitor progression and identify the time point at which β-cell dysfunction occurs are therefore critically needed. Large-scale population studies have consistently shown that the 1-h plasma glucose (1-h PG) ≥ 155 mg/dl (8.6 mmol/l) during the oral glucose tolerance test detected incident type 2 diabetes and associated complications earlier than fasting plasma glucose or 2-h plasma glucose levels. An elevated 1-h PG level appears to be a better alternative to HbA1c [5.7-6.4% (37-47 mmol/mol)] or traditional glucose criteria for identifying high-risk individuals at a stage when ß-cell function is substantially more intact than in prediabetes. Diagnosing high-risk individuals earlier proffers the opportunity for potentially reducing progression to diabetes, development of microvascular complications and mortality, thereby advancing benefit beyond that which has been demonstrated in global diabetes prevention programs.
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Affiliation(s)
- Ram Jagannathan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 18, Atlanta, GA, USA
| | - Martin Buysschaert
- Department of Endocrinology and Diabetology, Université Catholique de Louvain, University Clinic Saint-Luc, Brussels, Belgium
| | | | - Karin Katz
- NYU Langone Diabetes Prevention Program, Division of Endocrinology and Metabolism, Department of Medicine, NYU School of Medicine, 530 First Avenue, Schwartz East, Suite 5E, New York, NY, 10016, USA
| | - Sarah Musleh
- NYU Langone Diabetes Prevention Program, Division of Endocrinology and Metabolism, Department of Medicine, NYU School of Medicine, 530 First Avenue, Schwartz East, Suite 5E, New York, NY, 10016, USA
| | - Brenda Dorcely
- NYU Langone Diabetes Prevention Program, Division of Endocrinology and Metabolism, Department of Medicine, NYU School of Medicine, 530 First Avenue, Schwartz East, Suite 5E, New York, NY, 10016, USA
| | - Michael Bergman
- NYU Langone Diabetes Prevention Program, Division of Endocrinology and Metabolism, Department of Medicine, NYU School of Medicine, 530 First Avenue, Schwartz East, Suite 5E, New York, NY, 10016, USA.
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30
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Adeyanju OA, Soetan OA, Soladoye AO, Olatunji LA. Oral hormonal therapy with ethinylestradiol–levonorgestrel improves insulin resistance, obesity, and glycogen synthase kinase-3 independent of circulating mineralocorticoid in estrogen-deficient rats. Can J Physiol Pharmacol 2018; 96:577-586. [DOI: 10.1139/cjpp-2017-0630] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Estrogen deficiency has been associated with increased incidence of cardiovascular diseases , and recent clinical trials of standard formulations of hormonal therapies have not demonstrated consistent beneficial effects. Estrogen–progestin therapy has been used as exogenous estrogen to normalize depressed estrogen level during menopause. Ovariectomized rodents mimic an estrogen-deficient state in that they develop cardiometabolic dysfunction, including insulin resistance (IR). We therefore hypothesized that hormonal therapy with combined oral contraceptive steroids, ethinylestradiol–levonorgestrel (EEL), improves IR, obesity, and glycogen synthase kinase-3 (GSK-3) through reduction of circulating mineralocorticoid in ovariectomized rats. Twelve-week-old female Wistar rats were divided into 4 groups: sham-operated (SHM) and ovariectomized (OVX) rats were treated with or without EEL (1.0 μg ethinylestradiol and 5.0 μg levonorgestrel) daily for 8 weeks. Results showed that OVX or SHM + EEL treated rats had increased HOMA-IR (homeostatic model assessment of IR), 1 h postload glucose, HOMA-β, triglycerides (TG), total cholesterol (TC), TC/HDL cholesterol, TG/HDL cholesterol, plasma insulin, GSK-3, corticosterone, and aldosterone. On the other hand, OVX + EEL treatment ameliorated all these effects except that of aldosterone. Taken together, the results demonstrate that oral hormonal replacement with EEL improves IR and pancreatic β-cell function and suppresses GSK-3 and glucocorticoid independent of circulating aldosterone, suggesting a positive cardiometabolic effect of oral EEL therapy in estrogen-deficient rats.
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Affiliation(s)
- Oluwaseun A. Adeyanju
- Cardiovascular Research Laboratory, Department of Physiology, University of Ilorin, Ilorin, Nigeria
- Cardiometabolic Research Unit, Department of Physiology, Afe Babalola University, Ado-Ekiti, Ekiti State, Nigeria
| | - Olaniyi A. Soetan
- Cardiovascular Research Laboratory, Department of Physiology, University of Ilorin, Ilorin, Nigeria
| | - Ayodele O. Soladoye
- Cardiovascular Research Laboratory, Department of Physiology, University of Ilorin, Ilorin, Nigeria
| | - Lawrence A. Olatunji
- Cardiovascular Research Laboratory, Department of Physiology, University of Ilorin, Ilorin, Nigeria
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31
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Michael OS, Olatunji LA. Ameliorative effect of nicotine exposure on insulin resistance is accompanied by decreased cardiac glycogen synthase kinase-3 and plasminogen activator inhibitor-1 during oral oestrogen-progestin therapy. Arch Physiol Biochem 2018; 124:139-148. [PMID: 28868937 DOI: 10.1080/13813455.2017.1369549] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
CONTEXT Cigarette smoking is considered to be a major risk factor for the development of diabetes and cardiovascular disease. Oestrogen-progestin combined oral contraceptive (COC) use has been associated with adverse cardiometabolic events. OBJECTIVE We hypothesized that nicotine would ameliorate insulin resistance (IR) that is accompanied by decreased cardiac glycogen synthase kinase-3 (GSK-3) and plasminogen activator inhibitor-1 (PAI-1). METHODS Female Wistar rats received (po) low-(0.1 mg/kg) or high-nicotine (1.0 mg/kg) with or without COC containing 5.0 µg levonorgestrel plus 1.0 µg ethinylestradiol daily for 8 weeks. RESULTS Data showed that COC treatment or nicotine exposure led to IR, glucose deregulation, atherogenic dyslipidemia, increased corticosterone, aldosterone, cardiac and circulating GSK-3 values and PAI-1. However, these effects with the exception of corticosterone and aldosterone were ameliorated in COC + nicotine-exposed rats. CONCLUSION Amelioration of IR induced by COC treatment is accompanied by decreased circulating PAI-1, cardiac PAI-1 and GSK-3 instead of circulating aldosterone and corticosterone.
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Affiliation(s)
- Olugbenga S Michael
- a Cardiovascular Research Laboratory, Department of Physiology , University of Ilorin, Ilorin, Nigeria
- b Hope Cardiometabolic Research Centre , Ilorin , Nigeria
- c Cardiometabolic Research Unit, Department of Physiology , College of Health sciences, Bowen University , Iwo , Nigeria
| | - Lawrence A Olatunji
- a Cardiovascular Research Laboratory, Department of Physiology , University of Ilorin, Ilorin, Nigeria
- b Hope Cardiometabolic Research Centre , Ilorin , Nigeria
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32
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Paddock E, Hohenadel MG, Piaggi P, Vijayakumar P, Hanson RL, Knowler WC, Krakoff J, Chang DC. One-hour and two-hour postload plasma glucose concentrations are comparable predictors of type 2 diabetes mellitus in Southwestern Native Americans. Diabetologia 2017; 60:1704-1711. [PMID: 28664298 PMCID: PMC6476564 DOI: 10.1007/s00125-017-4332-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 05/16/2017] [Indexed: 02/06/2023]
Abstract
AIMS/HYPOTHESIS Elevated 2-h plasma glucose concentration (2 h-PG) during a 75 g OGTT predict the development of type 2 diabetes mellitus. However, 1-h plasma glucose concentration (1 h-PG) is associated with insulin secretion and may be a better predictor of type 2 diabetes. We aimed to investigate the association between 1 h-PG and 2 h-PG using gold standard methods for measuring insulin secretion and action. We also compared 1 h-PG and 2 h-PG as predictors of type 2 diabetes mellitus. METHODS This analysis included adult volunteers without diabetes, predominantly Native Americans of Southwestern heritage, who were involved in a longitudinal epidemiological study from 1965 to 2007, with a baseline OGTT that included measurement of 1 h-PG. Group 1 (n = 716) underwent an IVGTT and hyperinsulinaemic-euglycaemic clamp for measurement of acute insulin response (AIR) and insulin-stimulated glucose disposal (M), respectively. Some members of Group 1 (n = 490 of 716) and members of a second, larger, group (Group 2; n = 1946) were followed-up to assess the development of type 2 diabetes (median 9.0 and 12.8 years follow-up, respectively). RESULTS Compared with 2 h-PG (r = -0.281), 1 h-PG (r = -0.384) was more closely associated with AIR, whereas, compared with 1 h-PG (r = -0.340), 2 h-PG (r = -0.408) was more closely associated with M. Measures of 1 h-PG and 2 h-PG had similar abilities to predict type 2 diabetes, which did not change when both were included in the model. A 1 h-PG cut-off of 9.3 mmol/l provided similar levels of sensitivity and specificity as a 2 h-PG cut-off of 7.8 mmol/l; the latter is used to define impaired glucose tolerance, a recognised predictor of type 2 diabetes mellitus. CONCLUSIONS/INTERPRETATION The 1 h-PG was associated with important physiological predictors of type 2 diabetes and was as effective as 2 h-PG for predicting type 2 diabetes mellitus. The 1 h-PG is, therefore, an alternative method of identifying individuals with an elevated risk of type 2 diabetes mellitus.
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Affiliation(s)
- Ethan Paddock
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 N. 16th Street, Phoenix, AZ, 85016, USA.
| | - Maximilian G Hohenadel
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 N. 16th Street, Phoenix, AZ, 85016, USA
| | - Paolo Piaggi
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 N. 16th Street, Phoenix, AZ, 85016, USA
| | - Pavithra Vijayakumar
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 N. 16th Street, Phoenix, AZ, 85016, USA
| | - Robert L Hanson
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 N. 16th Street, Phoenix, AZ, 85016, USA
| | - William C Knowler
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 N. 16th Street, Phoenix, AZ, 85016, USA
| | - Jonathan Krakoff
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 N. 16th Street, Phoenix, AZ, 85016, USA
| | - Douglas C Chang
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 N. 16th Street, Phoenix, AZ, 85016, USA.
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33
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Jagannathan R, Bergman M. Use of 1-h post-load plasma glucose concentration to identify individuals at high risk of developing Type 2 diabetes. Diabet Med 2017; 34:877-878. [PMID: 28453866 DOI: 10.1111/dme.13370] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2017] [Indexed: 12/01/2022]
Affiliation(s)
- R Jagannathan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - M Bergman
- NYU School of Medicine, Department of Medicine, Division of Endocrinology and Metabolism, NYU Langone Diabetes Prevention Program, New York, NY, USA
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Fiorentino TV, Marini MA, Succurro E, Sciacqua A, Andreozzi F, Perticone F, Sesti G. Elevated hemoglobin glycation index identify non-diabetic individuals at increased risk of kidney dysfunction. Oncotarget 2017; 8:79576-79586. [PMID: 29108337 PMCID: PMC5668070 DOI: 10.18632/oncotarget.18572] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 06/11/2017] [Indexed: 01/29/2023] Open
Abstract
Hemoglobin glycation index (HGI), calculated as the difference between the observed value of HbA1 and the predicted HbA1c based on plasma glucose concentration, is a measure of the individual tendency toward non-enzymatic hemoglobin glycation which has been found to be positively associated with nephropathy in subjects with diabetes. In this cross-sectional study we aimed to evaluate whether higher HGI levels are associated with impaired kidney function also among nondiabetic individuals. The study group comprised 1505 White nondiabetic individuals stratified in quartiles according to HGI levels. Estimated glomerular filtration rate (eGFR) was calculated by using the MDRD equation. Individuals in the intermediate and high HGI groups exhibited a worse metabolic phenotype with increased levels of visceral obesity, total cholesterol, triglycerides, inflammatory biomarkers such as hsCRP and white blood cells count and lower values of HDL and insulin sensitivity assessed by Matsuda index in comparison to the lowest quartile of HGI. Subjects in the intermediate and high HGI groups displayed a graded decrease of eGFR levels in comparison with the lowest quartile of HGI. In a logistic regression analysis individuals in the highest quartile of HGI exhibited a significantly 3.6-fold increased risk of having chronic kidney disease (95% CI: 1.13–11.24, P = 0.03) and a significantly 1.6-fold increased risk of having a mildly reduced kidney function (95% CI: 1.19–2.28, P = 0.003) in comparison to individuals in the lowest HGI group. In conclusion HGI may be a useful tool to identify nondiabetic individuals with an increased risk of having kidney dysfunction.
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Affiliation(s)
- Teresa Vanessa Fiorentino
- Department of Medical and Surgical Sciences, Viale Europa, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy
| | | | - Elena Succurro
- Department of Medical and Surgical Sciences, Viale Europa, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, Viale Europa, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, Viale Europa, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy
| | - Francesco Perticone
- Department of Medical and Surgical Sciences, Viale Europa, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy
| | - Giorgio Sesti
- Department of Medical and Surgical Sciences, Viale Europa, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy
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Bergman M, Jagannathan R, Buysschaert M, Medina JL, Sevick MA, Katz K, Dorcely B, Roth J, Chetrit A, Dankner R. Reducing the prevalence of dysglycemia: is the time ripe to test the effectiveness of intervention in high-risk individuals with elevated 1 h post-load glucose levels? Endocrine 2017; 55:697-701. [PMID: 28124259 DOI: 10.1007/s12020-017-1236-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 01/17/2017] [Indexed: 02/07/2023]
Abstract
Identifying the earliest time point on the prediabetic continuum is critical to avoid progressive deterioration in β-cell function. Progressively rising glucose levels even within the "normal range" occur considerably late in the evolution to diabetes thus presenting an important opportunity for earlier diagnosis, treatment, and possible reversal. An elevated 1 h postprandial glucose level, not detected by current diagnostic standards, may provide an opportunity for the early identification of those at risk. When the 1 h post-load glucose level is elevated, lifestyle intervention may have the greatest benefit for preserving β-cell function and prevent further progression to prediabetes and diabetes. In view of the considerable consistent epidemiologic data in large disparate populations supporting the predictive capacity of the1 h post-load value for predicting progression to diabetes and mortality, the time is therefore ripe to evaluate this hypothesis in a large, prospective multicenter randomized trial with lifestyle intervention.
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Affiliation(s)
- Michael Bergman
- NYU School of Medicine, Department of Medicine, Division of Endocrinology and Metabolism, NYU Langone Diabetes Prevention Program, New York, NY, 10016, USA.
| | - Ram Jagannathan
- NYU School of Medicine, Department of Population Health, Division of Health Behavior Change, New York, NY, 10016, USA
| | - Martin Buysschaert
- Department of Endocrinology and Diabetology, Université Catholique de Louvain, University Clinic Saint-Luc, Brussels, Belgium
| | | | - Mary Ann Sevick
- NYU School of Medicine, Department of Population Health, Division of Health Behavior Change, New York, NY, 10016, USA
| | - Karin Katz
- NYU School of Medicine, Department of Medicine, Division of Endocrinology and Metabolism, NYU Langone Diabetes Prevention Program, New York, NY, 10016, USA
| | - Brenda Dorcely
- NYU School of Medicine, Department of Medicine, Division of Endocrinology and Metabolism, NYU Langone Diabetes Prevention Program, New York, NY, 10016, USA
| | - Jesse Roth
- The Feinstein Institute for Medical Research, Manhasset, North Shore, New York, 11030, USA
| | - Angela Chetrit
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621, Israel
| | - Rachel Dankner
- The Feinstein Institute for Medical Research, Manhasset, North Shore, New York, 11030, USA
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621, Israel
- Sackler Faculty of Medicine, School of Public Health, Department of Epidemiology and Preventive Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, 69978, Israel
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High salt intake does not aggravate glucose dysregulation and dyslipidemia induced by estrogen-progestin oral contraceptive. ACTA ACUST UNITED AC 2017; 24:91-98. [PMID: 28238536 DOI: 10.1016/j.pathophys.2017.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 01/13/2017] [Accepted: 02/05/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Estrogen-progestogen combined oral contraceptive (OC) use has been associated with increased cardiometabolic risk factors, including glucose dysregulation, dyslipidemia, hypertension, and pro-inflammatory state. However, the effect of a high-salt diet on these risk factors during OC use is not yet investigated. We therefore hypothesized that a high-salt diet would increase cardiometabolic risk factors in female rats treated with a combination of OC steroids, levonorgestrel (L) and ethinylestradiol (EE), and that elevated plasma levels of pro-inflammatory markers are associated with the cardiometabolic effects. METHODS Female Wistar rats were given (p.o.) vehicle, high-dose (1.0μg EE plus 5.0μgL) or low-dose (0.1μg EE plus 0.5μgL) OC with or without a high-salt diet (8%) daily for 8 weeks. Insulin resistance (IR) was estimated using the homeostatic model of assessment (HOMA). RESULTS Results showed that OC treatment or high salt diet led to significant increases in insulin resistance, plasma insulin, total cholesterol (TC), triglyceride (TG), TC/HDL-cholesterol, uric acid levels, and decreased glucose tolerance. OC treatment but not a high-salt diet resulted in increased plasma C-reactive protein and TG/HDL-cholesterol. However, a high-salt diet did not aggravate the effects of OC treatment. CONCLUSION The results from the present study indicate that glucose dysfunction and dyslipidemia induced by OC use, but not those induced by increased dietary salt are associated with elevated plasma C-reactive protein. Besides, increased dietary salt does not worsen abnormal cardiometabolic impact of OC use.
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Di Pino A, Urbano F, Piro S, Purrello F, Rabuazzo AM. Update on pre-diabetes: Focus on diagnostic criteria and cardiovascular risk. World J Diabetes 2016; 7:423-432. [PMID: 27795816 PMCID: PMC5065662 DOI: 10.4239/wjd.v7.i18.423] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 06/24/2016] [Accepted: 08/15/2016] [Indexed: 02/05/2023] Open
Abstract
Pre-diabetes, which is typically defined as blood glucose concentrations higher than normal but lower than the diabetes threshold, is a high-risk state for diabetes and cardiovascular disease development. As such, it represents three groups of individuals: Those with impaired fasting glucose (IFG), those with impaired glucose tolerance (IGT) and those with a glycated haemoglobin (HbA1c) between 39-46 mmol/mol. Several clinical trials have shown the important role of IFG, IGT and HbA1c-pre-diabetes as predictive tools for the risk of developing type 2 diabetes. Moreover, with regard to cardiovascular disease, pre-diabetes is associated with more advanced vascular damage compared with normoglycaemia, independently of confounding factors. In view of these observations, diagnosis of pre-diabetes is mandatory to prevent or delay the development of the disease and its complications; however, a number of previous studies reported that the concordance between pre-diabetes diagnoses made by IFG, IGT or HbA1c is scarce and there are conflicting data as to which of these methods best predicts cardiovascular disease. This review highlights recent studies and current controversies in the field. In consideration of the expected increased use of HbA1c as a screening tool to identify individuals with alteration of glycaemic homeostasis, we focused on the evidence regarding the ability of HbA1c as a diagnostic tool for pre-diabetes and as a useful marker in identifying patients who have an increased risk for cardiovascular disease. Finally, we reviewed the current evidence regarding non-traditional glycaemic biomarkers and their use as alternatives to or additions to traditional ones.
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Chamukuttan S, Ram J, Nanditha A, Shetty AS, Sevick MA, Bergman M, Johnston DG, Ramachandran A. Baseline level of 30-min plasma glucose is an independent predictor of incident diabetes among Asian Indians: analysis of two diabetes prevention programmes. Diabetes Metab Res Rev 2016; 32:762-767. [PMID: 26991329 DOI: 10.1002/dmrr.2799] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 03/02/2016] [Accepted: 03/06/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND The objective was to study the ability of the 30-min plasma glucose (30-min PG) during an oral glucose tolerance test to predict the future risk of type 2 diabetes among Asian Indians with impaired glucose tolerance. METHODS For the present analyses, we utilized data from 753 participants from two diabetes primary prevention studies, having complete data at the end of the study periods, including 236 from Indian Diabetes Prevention Programme-1 and 517 from the 2013 study. Baseline 30-min PG values were divided into tertiles: T1 < 9.1 mmol/L (<163.0 mg/dL); T2 9.2-10.4 mmol/L (164.0-187.0 mg/dL) and T3 ≥ 10.4 mmol/L (≥188 mg/dL). The predictive values of tertiles of 30-min PG for incident diabetes were assessed using Cox regression analyses RESULTS: At the end of the studies, 230 (30.5%) participants developed diabetes. Participants with higher levels of 30-min PG were more likely to have increased fasting, 2-h PG and HbA1c levels, increased prevalence of impaired fasting glucose and decreased beta cell function. The progression rate of diabetes increased with increasing tertiles of 30-min PG. Cox's regression analysis showed that 30-min PG was an independent predictor of incident diabetes after adjustment for an array of covariates [Hazard Ratio (HR):1.44 (1.01-2.06)] CONCLUSIONS: This prospective analysis demonstrates, for the first time, an independent association between an elevated 30-min PG level and incident diabetes among Asian Indians with impaired glucose tolerance. Predictive utility of glycemic thresholds at various time points other than the traditional fasting and 2-h PG values should therefore merit further consideration. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Snehalatha Chamukuttan
- India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, 600008, India
| | - Jagannathan Ram
- Department of Population Health, Center for Healthful Behavior Change, NYU School of Medicine, NYU Langone Medical Centre, New York, USA
| | - Arun Nanditha
- India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, 600008, India
| | - Ananth Samith Shetty
- India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, 600008, India
| | - Mary Ann Sevick
- Department of Population Health, Center for Healthful Behavior Change, NYU School of Medicine, NYU Langone Medical Centre, New York, USA
| | - Michael Bergman
- Department of Medicine, Division of Endocrinology and Metabolism, NYU Diabetes Prevention Program, NYU Langone Medical Centre, New York, USA
| | | | - Ambady Ramachandran
- India Diabetes Research Foundation and Dr. A. Ramachandran's Diabetes Hospitals, Chennai, 600008, India.
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Bergman M, Chetrit A, Roth J, Jagannathan R, Sevick M, Dankner R. One-hour post-load plasma glucose level during the OGTT predicts dysglycemia: Observations from the 24year follow-up of the Israel Study of Glucose Intolerance, Obesity and Hypertension. Diabetes Res Clin Pract 2016; 120:221-8. [PMID: 27596059 DOI: 10.1016/j.diabres.2016.08.013] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/09/2016] [Accepted: 08/19/2016] [Indexed: 01/04/2023]
Abstract
AIMS The present study assessed the longitudinal association of an elevated 1-h plasma glucose [1-h-PG >8.6mmol/l (155mg/dl)] with and without impaired glucose tolerance [IGT; 2-h-PG 7.8-11.0mmol/l (140-199mg/dl)] with cumulative incident of diabetes and prediabetes over 24years in a non-diabetic cohort. METHODS From 1979 to 1984, 1970 non-diabetic men and women completed an oral glucose tolerance test (OGTT), physical and biochemical measurements as well as a questionnaire related to lifestyle and medical background. During the years 2000-2004, 853 survivors of the original cohort were interviewed and re-examined for glycemic progression. RESULTS Individuals with 1-h-PG >8.6mmol/l (155mg/dl) but with 2-h-PG <7.8mmol/l (140mg/dl) had a significantly elevated risk, compared to those with both 1-h-PG ⩽8.6mmol/l (155mg/dl) and 2-h-PG <7.8mmol/l (140mg/dl), for both diabetes [OR:4.35 (95%CI: 2.50-7.73)] and prediabetes outcomes [OR:1.87 (95%CI 1.09-3.26)], adjusted for sex and age, smoking, body mass index, blood pressure, fasting blood glucose and insulin. CONCLUSIONS The risk for diabetes associated with a 1-h level >8.6mmol/l (155mg/dl) is increased and further worsened in the presence of IGT. Identifying individuals at risk with a 1-h-PG glucose level during an OGTT is recommended.
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Affiliation(s)
- Michael Bergman
- NYU School of Medicine, Department of Medicine, Division of Endocrinology and Metabolism, NYU Langone Diabetes Prevention Program, 530 First Avenue, Schwartz East, Suite 5E, New York, NY 10016, USA.
| | - Angela Chetrit
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer 52621, Israel
| | - Jesse Roth
- The Feinstein Institute for Medical Research, Manhasset, North Shore, New York 11030, USA
| | - Ram Jagannathan
- NYU School of Medicine, Department of Population Health, Division of Health Behavior Change, New York, NY 10016, USA
| | - Mary Sevick
- NYU School of Medicine, Department of Population Health, Division of Health Behavior Change, New York, NY 10016, USA
| | - Rachel Dankner
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer 52621, Israel; The Feinstein Institute for Medical Research, Manhasset, North Shore, New York 11030, USA; Sackler Faculty of Medicine, School of Public Health, Department of Epidemiology and Preventive Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 69978, Israel
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Mahajan A, Rodan AR, Le TH, Gaulton KJ, Haessler J, Stilp AM, Kamatani Y, Zhu G, Sofer T, Puri S, Schellinger JN, Chu PL, Cechova S, van Zuydam N, Arnlov J, Flessner MF, Giedraitis V, Heath AC, Kubo M, Larsson A, Lindgren CM, Madden PAF, Montgomery GW, Papanicolaou GJ, Reiner AP, Sundström J, Thornton TA, Lind L, Ingelsson E, Cai J, Martin NG, Kooperberg C, Matsuda K, Whitfield JB, Okada Y, Laurie CC, Morris AP, Franceschini N. Trans-ethnic Fine Mapping Highlights Kidney-Function Genes Linked to Salt Sensitivity. Am J Hum Genet 2016; 99:636-646. [PMID: 27588450 PMCID: PMC5011075 DOI: 10.1016/j.ajhg.2016.07.012] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 07/08/2016] [Indexed: 01/09/2023] Open
Abstract
We analyzed genome-wide association studies (GWASs), including data from 71,638 individuals from four ancestries, for estimated glomerular filtration rate (eGFR), a measure of kidney function used to define chronic kidney disease (CKD). We identified 20 loci attaining genome-wide-significant evidence of association (p < 5 × 10(-8)) with kidney function and highlighted that allelic effects on eGFR at lead SNPs are homogeneous across ancestries. We leveraged differences in the pattern of linkage disequilibrium between diverse populations to fine-map the 20 loci through construction of "credible sets" of variants driving eGFR association signals. Credible variants at the 20 eGFR loci were enriched for DNase I hypersensitivity sites (DHSs) in human kidney cells. DHS credible variants were expression quantitative trait loci for NFATC1 and RGS14 (at the SLC34A1 locus) in multiple tissues. Loss-of-function mutations in ancestral orthologs of both genes in Drosophila melanogaster were associated with altered sensitivity to salt stress. Renal mRNA expression of Nfatc1 and Rgs14 in a salt-sensitive mouse model was also reduced after exposure to a high-salt diet or induced CKD. Our study (1) demonstrates the utility of trans-ethnic fine mapping through integration of GWASs involving diverse populations with genomic annotation from relevant tissues to define molecular mechanisms by which association signals exert their effect and (2) suggests that salt sensitivity might be an important marker for biological processes that affect kidney function and CKD in humans.
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Affiliation(s)
- Anubha Mahajan
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - Aylin R Rodan
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75229, USA
| | - Thu H Le
- Department of Medicine, University of Virginia, Charlottesville, VA 22908, USA
| | - Kyle J Gaulton
- Department of Pediatrics, University of California San Diego, La Jolla, CA 92093, USA
| | - Jeffrey Haessler
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Adrienne M Stilp
- Department of Biostatistics, University of Washington, Seattle, WA 98195, USA
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama 230-0045, Japan
| | - Gu Zhu
- Genetic Epidemiology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia
| | - Tamar Sofer
- Department of Biostatistics, University of Washington, Seattle, WA 98195, USA
| | - Sanjana Puri
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75229, USA
| | - Jeffrey N Schellinger
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75229, USA
| | - Pei-Lun Chu
- Department of Medicine, University of Virginia, Charlottesville, VA 22908, USA
| | - Sylvia Cechova
- Department of Medicine, University of Virginia, Charlottesville, VA 22908, USA
| | - Natalie van Zuydam
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK
| | - Johan Arnlov
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala 751 85, Sweden; School of Health and Social Studies, Dalarna University, Falun 791 88, Sweden
| | - Michael F Flessner
- National Institute of Diabetes, Digestive, and Kidney Disease, NIH, Bethesda, MD 20892, USA
| | - Vilmantas Giedraitis
- Department of Public Health and Caring Sciences, Molecular Geriatrics, Uppsala University, Uppsala 752 37, Sweden
| | - Andrew C Heath
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Michiaki Kubo
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Yokohama 230-0045, Japan
| | - Anders Larsson
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala 751 85, Sweden
| | - Cecilia M Lindgren
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK; Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 7BN, UK
| | - Pamela A F Madden
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Grant W Montgomery
- Molecular Epidemiology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia
| | - George J Papanicolaou
- Epidemiology Branch, Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, Bethesda, MD 20892, USA
| | - Alex P Reiner
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Johan Sundström
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala 751 85, Sweden
| | - Timothy A Thornton
- Department of Biostatistics, University of Washington, Seattle, WA 98195, USA
| | - Lars Lind
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala 751 85, Sweden
| | - Erik Ingelsson
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala 752 37, Sweden; Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jianwen Cai
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Nicholas G Martin
- Genetic Epidemiology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Koichi Matsuda
- Laboratory of Molecular Medicine, Human Genome Center, Institute of Medical Science, University of Tokyo, Tokyo 108-8639, Japan
| | - John B Whitfield
- Genetic Epidemiology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia
| | - Yukinori Okada
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama 230-0045, Japan; Department of Statistical Genetics, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
| | - Cathy C Laurie
- Department of Biostatistics, University of Washington, Seattle, WA 98195, USA
| | - Andrew P Morris
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK; Department of Biostatistics, University of Liverpool, Liverpool L69 3GL, UK.
| | - Nora Franceschini
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC 27514, USA.
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Fiorentino TV, Sesti F, Andreozzi F, Pedace E, Sciacqua A, Hribal ML, Perticone F, Sesti G. One-hour post-load hyperglycemia combined with HbA1c identifies pre-diabetic individuals with a higher cardio-metabolic risk burden. Atherosclerosis 2016; 253:61-69. [PMID: 27588935 DOI: 10.1016/j.atherosclerosis.2016.08.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 08/03/2016] [Accepted: 08/19/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND AND AIMS Evidence suggests that combining 1-hour plasma glucose ≥155 mg/dl during an oral glucose tolerance test (OGTT) with glycosylated hemoglobin (HbA1c) significantly increases their predictive power for incident diabetes, while their individual and joint associations with cardio-metabolic risk factors remain undefined. Herein, we evaluated whether 1-hour post-load plasma glucose ≥155 mg/dl combined with HbA1c may identify pre-diabetic individuals with a higher cardio-metabolic risk. METHODS Anthropometric and metabolic characteristics, insulin sensitivity and insulin secretion assessed by OGTT-derived indexes, carotid intima-media thickness (IMT), pulse pressure, and rate pressure product were evaluated in 1495 individuals. RESULTS As compared with subjects with 1-hour post-load glucose <155 mg/dl, individuals with 1-hour post-load glucose ≥155 mg/dl exhibited a significantly worse cardio metabolic profile, both in the group with HbA1c <5.7%, and in the group with prediabetes (HbA1c 5.7-6.4%). Specifically, in both groups, subjects with 1-hour post-load glucose ≥155 mg/dl had higher fasting and 2-h post-load glucose (p < 0.0001 for all in both groups), higher HOMA-IR (p < 0.0001 in both groups), and carotid IMT (p = 0.05 in the group with HbA1c <5.7% and p = 0.03 in the group HbA1c 5.7-6.4%), as well as lower Matsuda index, insulinogenic index and disposition index (p < 0.0001 in both groups), and lower insulin-stimulated glucose disposal (p < 0.0001 in the group with HbA1c <5.7% and p = 0.03 in the group HbA1c 5.7-6.4%). CONCLUSIONS Hyperglycemia at 1-hour during an OGTT may be a useful tool to identify a subset of individuals within HbA1c-defined glycemic categories at higher risk of developing type 2 diabetes and cardiovascular disease.
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Affiliation(s)
- Teresa Vanessa Fiorentino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | | | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Elisabetta Pedace
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Marta Letizia Hribal
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy; Catholic University, Rome, Italy
| | - Francesco Perticone
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Giorgio Sesti
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
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Jagannathan R, Sevick MA, Fink D, Dankner R, Chetrit A, Roth J, Buysschaert M, Bergman M. The 1-hour post-load glucose level is more effective than HbA1c for screening dysglycemia. Acta Diabetol 2016; 53:543-50. [PMID: 26794497 DOI: 10.1007/s00592-015-0829-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 12/11/2015] [Indexed: 12/12/2022]
Abstract
AIM To assess the performance of HbA1c and the 1-h plasma glucose (PG ≥ 155 mg/dl; 8.6 mmol/l) in identifying dysglycemia based on the oral glucose tolerance test (OGTT) from a real-world clinical care setting. METHODS This was a diagnostic test accuracy study. For this analysis, we tested the HbA1c diagnostic criteria advocated by the American Diabetes Association (ADA 5.7-6.4 %) and International Expert Committee (IEC 6.0-6.4 %) against conventional OGTT criteria. We also tested the utility of 1-h PG ≥ mg/dl; 8.6 mmol/l. Prediabetes was defined according to ADA-OGTT guidelines. Spearman correlation tests were used to determine the relationships between HbA1c, 1-h PG with fasting, 2-h PG and indices of insulin sensitivity and β-cell function. The levels of agreement between diagnostic methods were ascertained using Cohen's kappa coefficient (Κ). Receiver operating characteristic (ROC) curve was used to analyze the performance of the HbA1c and 1-h PG test in identifying prediabetes considering OGTT as reference diagnostic criteria. The diagnostic properties of different HbA1c thresholds were contrasted by determining sensitivity, specificity and likelihood ratios (LR). RESULTS Of the 212 high-risk individuals, 70 (33 %) were identified with prediabetes, and 1-h PG showed a stronger association with 2-h PG, insulin sensitivity index, and β-cell function than HbA1c (P < 0.05). Furthermore, the level of agreement between 1-h PG ≥ 155 mg/dl (8.6 mmol/l) and the OGTT (Κ[95 % CI]: 0.40[0.28-0.53]) diagnostic test was stronger than that of ADA-HbA1c criteria 0.1[0.03-0.16] and IEC criteria (0.17[0.04-0.30]). The ROC (AUC[95 % CI]) for HbA1c and 1-h PG were 0.65[0.57-0.73] and 0.79[0.72-0.85], respectively. Importantly, 1-h PG ≥ 155 mg/dl (8.6 mmol/l) showed good sensitivity (74.3 % [62.4-84.0]) and specificity 69.7 % [61.5-77.1]) with a LR of 2.45. The ability of 1-h PG to discriminate prediabetes was better than that of HbA1c (∆AUC: -0.14; Z value: 2.5683; P = 0.01022). CONCLUSION In a real-world clinical practice setting, the 1-h PG ≥ 155 mg/dl (8.6 mmol/l) is superior for detecting high-risk individuals compared with HbA1c. Furthermore, HbA1c is a less precise correlate of insulin sensitivity and β-cell function than the 1-h PG and correlates poorly with the 2-h PG during the OGTT.
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Affiliation(s)
- Ram Jagannathan
- NYU School of Medicine, Department of Population Health, Center for Healthful Behavior Change, New York, NY, USA
| | - Mary Ann Sevick
- NYU School of Medicine, Department of Population Health, Center for Healthful Behavior Change, New York, NY, USA
| | - Dorothy Fink
- NYU School of Medicine, Department of Medicine, Division of Endocrinology and Metabolism, NYU Langone Diabetes Prevention Program, 530 First Avenue, Schwartz East, Suite 5E, New York, NY, 10016, USA
| | - Rachel Dankner
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621, Israel
- The Feinstein Institute for Medical Research, Manhasset, North Shore, NY, 11030, USA
- Sackler Faculty of Medicine, School of Public Health, Department of Epidemiology and Preventive Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel
| | - Angela Chetrit
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621, Israel
| | - Jesse Roth
- The Feinstein Institute for Medical Research, Manhasset, North Shore, NY, 11030, USA
| | - Martin Buysschaert
- Service d'Endocrinologie et Nutrition Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Michael Bergman
- NYU School of Medicine, Department of Medicine, Division of Endocrinology and Metabolism, NYU Langone Diabetes Prevention Program, 530 First Avenue, Schwartz East, Suite 5E, New York, NY, 10016, USA.
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Sciacqua A, Perticone M, Tassone EJ, Cimellaro A, Caroleo B, Miceli S, Andreucci M, Licata A, Sesti G, Perticone F. Renal function is impaired in normotensive chronic HCV patients: role of insulin resistance. Intern Emerg Med 2016; 11:553-9. [PMID: 26597876 DOI: 10.1007/s11739-015-1349-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 10/28/2015] [Indexed: 12/27/2022]
Abstract
Renal dysfunction is an independent predictor for cardiovascular morbidity and mortality. We investigated whether chronic hepatitis C virus (HCV) infection and the related insulin resistance/hyperinsulinemia influence renal function in comparison with a group of healthy subjects and with another group with metabolic syndrome. We enrolled 130 newly diagnosed HCV outpatients matched for age and gender with 130 patients with metabolic syndrome and 130 healthy subjects. Renal function was evaluated by calculation of glomerular filtration rate (e-GFR, mL/min/1.73 m(2)) using the CKD-EPI equation. The following laboratory parameters were measured: fasting plasma glucose and insulin, total, LDL- and HDL-cholesterol, triglyceride, creatinine, and HOMA to evaluate insulin sensitivity. HCV patients with respect to both healthy subjects and metabolic syndrome patients have a decreased e-GFR: 86.6 ± 16.1 vs 120.2 ± 23.1 mL/min/1.73 m(2) (P < 0.0001) and 94.9 ± 22.6 mL/min/1.73 m(2) (P = 0.003), respectively. Regarding biochemical variables, HCV patients, in comparison with healthy subjects, have a higher triglyceride level, creatinine, fasting insulin and HOMA (3.4 ± 1.4 vs 2.6 ± 1.3; P < 0.0001). At linear regression analysis, the correlation between e-GFR and HOMA is similar in the metabolic syndrome (r = -0.555, P < 0.0001) and HCV (r = -0.527, P < 0.0001) groups. At multiple regression analysis, HOMA is the major determinant of e-GFR in both groups, accounting for, respectively, 30.8 and 27.8 % of its variation in the metabolic syndrome and HCV. In conclusion, we demonstrate that HCV patients have a significant reduction of e-GFR and that insulin resistance is the major predictor of renal dysfunction.
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Affiliation(s)
- Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, V.le Europa, 88100, Catanzaro, Italy
| | - Maria Perticone
- Department of Experimental and Clinical Medicine, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Eliezer J Tassone
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, V.le Europa, 88100, Catanzaro, Italy
| | - Antonio Cimellaro
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, V.le Europa, 88100, Catanzaro, Italy
| | - Benedetto Caroleo
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, V.le Europa, 88100, Catanzaro, Italy
| | - Sofia Miceli
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, V.le Europa, 88100, Catanzaro, Italy
| | - Michele Andreucci
- Department of Health Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Anna Licata
- Biomedical Department of Internal and Specialistic Medicine, University of Palermo, Palermo, Italy
| | - Giorgio Sesti
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, V.le Europa, 88100, Catanzaro, Italy
| | - Francesco Perticone
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, V.le Europa, 88100, Catanzaro, Italy.
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Jagannathan R, Sevick MA, Li H, Fink D, Dankner R, Chetrit A, Roth J, Bergman M. Elevated 1-hour plasma glucose levels are associated with dysglycemia, impaired beta-cell function, and insulin sensitivity: a pilot study from a real world health care setting. Endocrine 2016; 52:172-5. [PMID: 26419850 PMCID: PMC5319479 DOI: 10.1007/s12020-015-0746-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 09/16/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Ram Jagannathan
- Department of Population Health, Division of Health Behavior Change, NYU School of Medicine, New York, NY, USA
| | - Mary Ann Sevick
- Department of Population Health, Division of Health Behavior Change, NYU School of Medicine, New York, NY, USA
| | - Huilin Li
- Department of Population Health, Division of Biostatistics, NYU School of Medicine, New York, NY, USA
| | - Dorothy Fink
- Department of Medicine, NYU Diabetes Prevention Program, Division of Endocrinology and Metabolism, NYU School of Medicine, 530 First Avenue, Schwartz East, Suite 5E, New York, NY, 10016, USA
| | - Rachel Dankner
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel
- The Feinstein Institute for Medical Research, Manhasset, North Shore, NY, 11030, USA
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621, Israel
| | - Angela Chetrit
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621, Israel
| | - Jesse Roth
- The Feinstein Institute for Medical Research, Manhasset, North Shore, NY, 11030, USA
| | - Michael Bergman
- Department of Medicine, NYU Diabetes Prevention Program, Division of Endocrinology and Metabolism, NYU School of Medicine, 530 First Avenue, Schwartz East, Suite 5E, New York, NY, 10016, USA.
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Heianza Y, Hara S, Saito K, Tsuji H, Tanaka S, Kodama S, Kobayashi T, Arase Y, Sone H. Assessment of kidney dysfunction with cystatin C- and creatinine-based estimated glomerular filtration rate and predicting type 2 diabetes: Toranomon Hospital Health Management Center Study 21. Diabetes Res Clin Pract 2016; 113:60-8. [PMID: 26972964 DOI: 10.1016/j.diabres.2016.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 01/17/2016] [Accepted: 01/22/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Whether early stages of kidney dysfunction assessed by the estimated glomerular filtration rate from cystatin C measurements (eGFRCysC) rather than from creatinine measurements (eGFRCr) would more precisely reflect the risk of developing type 2 diabetes (T2D) has not been clarified. We compared the risk of developing T2D associated with renal dysfunction indicated by eGFRCysC or eGFRCr measurements. METHODS Studied were 2131 Japanese individuals without diabetes. Hazard ratios (HRs) for the development of T2D over 3-5 y were calculated across categories of eGFRCysC and eGFRCr, respectively. RESULTS Reduced levels of eGFRCysC were associated with a step-wise increase in the cumulative incidence rate of T2D (p=0.007). In comparison with the eGFRCysC >85th percentile group (≥ 117.4 ml/min/1.73 m(2)), the lowest group, which was the eGFRCysC <15th percentile group (<86.2 ml/min/1.73 m(2)), had an adjusted HR of 2.30 (95% CI 1.13, 4.68) for T2D. Compared with the eGFRCr >85th percentile group, the lowest eGFRCr group (<15th percentile) had an HR of 1.19 (0.63, 2.24) for T2D. However, individuals with eGFRCr <60 ml/min/1.73 m(2) had a significantly increased risk of T2D. Clustering of both low eGFRCysC and low eGFRCr further elevated the HR for T2D compared with the presence of either. CONCLUSIONS Although eGFRCr in ranges indicating chronic kidney disease reflected an elevated risk of developing diabetes, earlier stages of kidney dysfunction indicated by reduced eGFRCysC, which could not be captured by reduced eGFRCr, would be a marker for an elevated risk of developing T2D.
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Affiliation(s)
- Yoriko Heianza
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan; Health Management Center, Toranomon Hospital, Tokyo, Japan
| | - Shigeko Hara
- Health Management Center, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan
| | - Kazumi Saito
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan; Health Management Center, Toranomon Hospital, Tokyo, Japan
| | - Hiroshi Tsuji
- Health Management Center, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan
| | - Shiro Tanaka
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Satoru Kodama
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan; Health Management Center, Toranomon Hospital, Tokyo, Japan
| | - Tetsuro Kobayashi
- Health Management Center, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan
| | - Yasuji Arase
- Health Management Center, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan
| | - Hirohito Sone
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan; Health Management Center, Toranomon Hospital, Tokyo, Japan.
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Perticone M, Tassone EJ, Scarpino PE, Naccarato P, Addesi D, di Cello S, Sciacqua A, Maio R, Andreucci M, Carrao S, Licata A, Sesti G, Perticone F. Sympathovagal balance and 1-h postload plasma glucose in normoglucose tolerant hypertensive patients. Acta Diabetol 2016; 53:41-7. [PMID: 25813368 DOI: 10.1007/s00592-015-0740-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 03/11/2015] [Indexed: 01/19/2023]
Abstract
AIMS Normoglucose tolerant (NGT) subjects with a 1-h postload plasma glucose (PLPG) value ≥155 mg/dL have an increased risk of type-2 diabetes and subclinical organ damage. Heart rate variability (HRV) reflects cardiac autonomic balance, frequently impaired in course of diabetes. At this time, no data support the association between 1-h PLPG and HRV; thus, we investigated the possible association between 1-h PLPG and HRV. METHODS We enrolled 92 never-treated hypertensive subjects (56 women, 36 men), aged 55 ± 9.8 years. During OGTT, the patients underwent electrocardiographic recordings to evaluate HRV in the time domain (SDNN). Insulin sensitivity was assessed by Matsuda index. RESULTS Among participants, 56 were NGT, 20 had impaired glucose tolerance (IGT), and 16 had type-2 diabetes. According to the 1-h PLPG cutoff point of 155 mg/dL, we divided NGT subjects into: NGT < 155 (n = 38) and NGT ≥ 155 (n = 18). Glucose tolerance status was associated with a significant (P < 0.0001) increase in PLPG and insulin and the reduction in Matsuda index. In all groups, the SDNN values significantly (P < 0.0001) decreased during the first hour of OGTT. A complete recovery in NGT groups was observed at the end of the second hour; in IGT and type-2 diabetes, SDNN remained significantly lower with respect to baseline values. At multiple regression analysis, Matsuda index resulted in the only determinant of SDNN modification, explaining the 12.3 % of its variability. CONCLUSIONS Our data demonstrate that during OGTT, sympathovagal balance is acutely affected by both glucose and insulin modifications. Particularly, NGT ≥ 155 subjects behave in the same way of IGT and type-2 diabetes patients.
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Affiliation(s)
- Maria Perticone
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Eliezer J Tassone
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Paola E Scarpino
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Paola Naccarato
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Desirée Addesi
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Serena di Cello
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Raffaele Maio
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Michele Andreucci
- Department of Health Science, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Salvatore Carrao
- Biomedical Department of Internal Medicine and Speciality, University of Palermo, Palermo, Italy
| | - Anna Licata
- Biomedical Department of Internal Medicine and Speciality, University of Palermo, Palermo, Italy
| | - Giorgio Sesti
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Francesco Perticone
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy.
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Priya MM, Amutha A, Pramodkumar TA, Ranjani H, Jebarani S, Gokulakrishnan K, Pradeepa R, Unnikrishnan R, Anjana RM, Mohan V. β-Cell Function and Insulin Sensitivity in Normal Glucose-Tolerant Subjects Stratified by 1-Hour Plasma Glucose Values. Diabetes Technol Ther 2016; 18:29-33. [PMID: 26492404 DOI: 10.1089/dia.2015.0065] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
AIM This study was designed to assess β-cell function and insulin sensitivity indices among normal glucose tolerance (NGT) subjects stratified by 1-h plasma glucose (1hPG) values during an oral glucose tolerance test (OGTT). MATERIALS AND METHODS One hundred sixty-six NGT subjects underwent a five-point OGTT, and glucose and insulin levels were estimated. We calculated the following indices: (a) β-cell function (homeostasis assessment model-β-cell function [HOMA-β] and Insulinogenic Index [IGI]) and (b) insulin sensitivity (homeostasis assessment model-insulin resistance [HOMA-IR], Matsuda Index, and Insulin Sensitivity Index [ISI]). RESULTS NGT subgroups with elevated 1hPG values (i.e., 1hPG ≥143 to <155 mg/dL and 1hPG ≥155 mg/dL) did not differ from those with 1hPG <143 mg/dL by HOMA-β (P = 0.236) but had significantly lower IGIs (367 ± 239 vs. 257 ± 243 vs. 246 ± 239; P = 0.019). With respect to ISIs, HOMA-IR was not significantly different among the groups (P = 0.103). However, the Matsuda Index (11.2 ± 5.0 vs. 7.4 ± 4.8 vs. 5.5 ± 4.9; P < 0.001) and ISI (0.015 ± 0.010 vs. 0.012 ± 0.006 vs. 0.011 ± 0.011; P = 0.028) were significantly lower in subjects with elevated 1hPG values. CONCLUSIONS NGT subjects with elevated 1hPG levels have alterations in β-cell function and insulin sensitivity compared with those with normal 1hPG levels.
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Affiliation(s)
- Miranda M Priya
- Dr. Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation, WHO Collaborating Centre for Noncommunicable Diseases-Prevention and Control ; and International Diabetes Federation Centre of Education, Chennai, India
| | - Anandakumar Amutha
- Dr. Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation, WHO Collaborating Centre for Noncommunicable Diseases-Prevention and Control ; and International Diabetes Federation Centre of Education, Chennai, India
| | - T A Pramodkumar
- Dr. Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation, WHO Collaborating Centre for Noncommunicable Diseases-Prevention and Control ; and International Diabetes Federation Centre of Education, Chennai, India
| | - Harish Ranjani
- Dr. Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation, WHO Collaborating Centre for Noncommunicable Diseases-Prevention and Control ; and International Diabetes Federation Centre of Education, Chennai, India
| | - Saravanan Jebarani
- Dr. Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation, WHO Collaborating Centre for Noncommunicable Diseases-Prevention and Control ; and International Diabetes Federation Centre of Education, Chennai, India
| | - Kuppan Gokulakrishnan
- Dr. Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation, WHO Collaborating Centre for Noncommunicable Diseases-Prevention and Control ; and International Diabetes Federation Centre of Education, Chennai, India
| | - Rajendra Pradeepa
- Dr. Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation, WHO Collaborating Centre for Noncommunicable Diseases-Prevention and Control ; and International Diabetes Federation Centre of Education, Chennai, India
| | - Ranjit Unnikrishnan
- Dr. Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation, WHO Collaborating Centre for Noncommunicable Diseases-Prevention and Control ; and International Diabetes Federation Centre of Education, Chennai, India
| | - Ranjit Mohan Anjana
- Dr. Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation, WHO Collaborating Centre for Noncommunicable Diseases-Prevention and Control ; and International Diabetes Federation Centre of Education, Chennai, India
| | - Viswanathan Mohan
- Dr. Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation, WHO Collaborating Centre for Noncommunicable Diseases-Prevention and Control ; and International Diabetes Federation Centre of Education, Chennai, India
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Fiorentino TV, Marini MA, Andreozzi F, Arturi F, Succurro E, Perticone M, Sciacqua A, Hribal ML, Perticone F, Sesti G. One-Hour Postload Hyperglycemia Is a Stronger Predictor of Type 2 Diabetes Than Impaired Fasting Glucose. J Clin Endocrinol Metab 2015; 100:3744-51. [PMID: 26274345 DOI: 10.1210/jc.2015-2573] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
CONTEXT Subjects with normal glucose tolerance (NGT) but 1-h postload glucose ≥ 155 mg/dL (NGT-1h-high) exhibit an intermediate cardiometabolic risk profile between individuals with NGT and impaired glucose tolerance (IGT). OBJECTIVE This study aimed to evaluate whether NGT-1h-high subjects have different cardiometabolic characteristics and an increased risk of type 2 diabetes compared with individuals with isolated impaired fasting glucose (IFG). SETTING, DESIGN, AND PATIENTS A cross-sectional analysis was performed on 595 nondiabetic subjects who underwent an oral glucose tolerance test and an euglycemic hyperinsulinemic clamp in an ambulatory care setting. In addition, a longitudinal analysis was performed on 392 individuals, who were reexamined after a followup of 5.2 ± 0.9 y. MAIN OUTCOME MEASURES Insulin sensitivity, beta-cell function, and risk of developing diabetes were measured. RESULTS Subjects with NGT-1h-high have a significant reduction of peripheral insulin sensitivity and beta-cell function, assessed by the disposition index, compared with either 1-h postload glucose < 155 mg/dL (NGT-1h-low) or IFG individuals, but not compared with IGT. Among the 392 subjects studied in the longitudinal analysis the incidence rate of type 2 diabetes over the follow-up period was 2.9, 16.7, 12.5, and 31.4% for subjects with NGT-1h-low, NGT-1h-high, IFG, and IGT, respectively. In a Cox proportional hazard regression analysis the risk of developing diabetes for NGT-1h-high subjects was 4.02 (95% confidence interval [CI] 1.06-15.26); an even higher risk (6.67; 95% CI, 2.09-21.24) was observed in subjects with IGT, but not in the isolated IFG group (1.91; 95% CI, 0.44-8.29). CONCLUSIONS NGT-1h-high subjects exhibit a higher risk of developing diabetes than those with IFG or NGT-1h-low, likely due to decreased insulin sensitivity and beta-cell function.
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Affiliation(s)
- Teresa Vanessa Fiorentino
- Department of Medical and Surgical Sciences (T.V.F., F.An., F.Ar., E.S., M.P., A.S., M.L.H., F.P., G.S.), University Magna Graecia of Catanzaro, Catanzaro, 88100 Italy; and Department of Systems Medicine (M.A.M.), University of Rome-Tor Vergata, Rome, 00133 Italy
| | - Maria Adelaide Marini
- Department of Medical and Surgical Sciences (T.V.F., F.An., F.Ar., E.S., M.P., A.S., M.L.H., F.P., G.S.), University Magna Graecia of Catanzaro, Catanzaro, 88100 Italy; and Department of Systems Medicine (M.A.M.), University of Rome-Tor Vergata, Rome, 00133 Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences (T.V.F., F.An., F.Ar., E.S., M.P., A.S., M.L.H., F.P., G.S.), University Magna Graecia of Catanzaro, Catanzaro, 88100 Italy; and Department of Systems Medicine (M.A.M.), University of Rome-Tor Vergata, Rome, 00133 Italy
| | - Franco Arturi
- Department of Medical and Surgical Sciences (T.V.F., F.An., F.Ar., E.S., M.P., A.S., M.L.H., F.P., G.S.), University Magna Graecia of Catanzaro, Catanzaro, 88100 Italy; and Department of Systems Medicine (M.A.M.), University of Rome-Tor Vergata, Rome, 00133 Italy
| | - Elena Succurro
- Department of Medical and Surgical Sciences (T.V.F., F.An., F.Ar., E.S., M.P., A.S., M.L.H., F.P., G.S.), University Magna Graecia of Catanzaro, Catanzaro, 88100 Italy; and Department of Systems Medicine (M.A.M.), University of Rome-Tor Vergata, Rome, 00133 Italy
| | - Maria Perticone
- Department of Medical and Surgical Sciences (T.V.F., F.An., F.Ar., E.S., M.P., A.S., M.L.H., F.P., G.S.), University Magna Graecia of Catanzaro, Catanzaro, 88100 Italy; and Department of Systems Medicine (M.A.M.), University of Rome-Tor Vergata, Rome, 00133 Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences (T.V.F., F.An., F.Ar., E.S., M.P., A.S., M.L.H., F.P., G.S.), University Magna Graecia of Catanzaro, Catanzaro, 88100 Italy; and Department of Systems Medicine (M.A.M.), University of Rome-Tor Vergata, Rome, 00133 Italy
| | - Marta Letizia Hribal
- Department of Medical and Surgical Sciences (T.V.F., F.An., F.Ar., E.S., M.P., A.S., M.L.H., F.P., G.S.), University Magna Graecia of Catanzaro, Catanzaro, 88100 Italy; and Department of Systems Medicine (M.A.M.), University of Rome-Tor Vergata, Rome, 00133 Italy
| | - Francesco Perticone
- Department of Medical and Surgical Sciences (T.V.F., F.An., F.Ar., E.S., M.P., A.S., M.L.H., F.P., G.S.), University Magna Graecia of Catanzaro, Catanzaro, 88100 Italy; and Department of Systems Medicine (M.A.M.), University of Rome-Tor Vergata, Rome, 00133 Italy
| | - Giorgio Sesti
- Department of Medical and Surgical Sciences (T.V.F., F.An., F.Ar., E.S., M.P., A.S., M.L.H., F.P., G.S.), University Magna Graecia of Catanzaro, Catanzaro, 88100 Italy; and Department of Systems Medicine (M.A.M.), University of Rome-Tor Vergata, Rome, 00133 Italy
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Fiorentino TV, Hribal ML, Andreozzi F, Perticone M, Sciacqua A, Perticone F, Sesti G. Plasma complement C3 levels are associated with insulin secretion independently of adiposity measures in non-diabetic individuals. Nutr Metab Cardiovasc Dis 2015; 25:510-517. [PMID: 25813686 DOI: 10.1016/j.numecd.2015.02.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Revised: 01/28/2015] [Accepted: 02/13/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS To evaluate if complement C3 is associated with insulin secretion, as suggested by recent in vitro studies, independently of confounders including adiposity measures. METHODS AND RESULTS 1010 nondiabetic subjects were stratified into quartiles according to complement C3 values. Insulin secretion was assessed using indexes derived from oral glucose tolerance test (OGTT) in the whole study group and from intravenous glucose tolerance test (IVGTT) in a subgroup (n = 110). Significant differences between quartiles of C3 were observed in body mass index (BMI), waist, fat mass, blood pressure, total cholesterol, high density lipoprotein (HDL), triglycerides, fasting and 2-h post-load glucose, fasting insulin, C reactive protein (hsCRP), fibrinogen, aspartate aminotransferase (AST), alanine aminotransferase (ALT), complement C4, and insulin sensitivity with C3 quartiles exhibiting graded increases in cardio-metabolic risk factors. Differences in insulin secretion indexes between C3 quartiles remained significant after adjustment for age, gender, BMI, insulin sensitivity, blood pressure, total cholesterol, HDL, triglycerides, hsCRP, fibrinogen, and complement C4 levels (P < 0.0001). A multivariable regression analysis revealed that complement C3 is a contributor of insulin secretion, explaining 2.4% and 1.9% of variation of the Stumvoll index for first-phase and second-phase insulin secretion, respectively, and 2.1% of variation of the InsAUC30/GluAUC30 index, independently of gender, age, BMI, waist, fat mass, blood pressure, total cholesterol, HDL, triglycerides, hsCRP, fibrinogen, AST, ALT. CONCLUSIONS Complement C3 concentrations are associated with insulin secretion independently of important determinants of glucose homeostasis such as gender, age, adiposity, subclinical inflammation, and insulin sensitivity.
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Affiliation(s)
- T V Fiorentino
- Department of Medical and Surgical Sciences, Viale Europa, University Magna-Græcia of Catanzaro, 88100 Catanzaro, Italy
| | - M L Hribal
- Department of Medical and Surgical Sciences, Viale Europa, University Magna-Græcia of Catanzaro, 88100 Catanzaro, Italy
| | - F Andreozzi
- Department of Medical and Surgical Sciences, Viale Europa, University Magna-Græcia of Catanzaro, 88100 Catanzaro, Italy
| | - M Perticone
- Department of Medical and Surgical Sciences, Viale Europa, University Magna-Græcia of Catanzaro, 88100 Catanzaro, Italy
| | - A Sciacqua
- Department of Medical and Surgical Sciences, Viale Europa, University Magna-Græcia of Catanzaro, 88100 Catanzaro, Italy
| | - F Perticone
- Department of Medical and Surgical Sciences, Viale Europa, University Magna-Græcia of Catanzaro, 88100 Catanzaro, Italy
| | - G Sesti
- Department of Medical and Surgical Sciences, Viale Europa, University Magna-Græcia of Catanzaro, 88100 Catanzaro, Italy.
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50
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Kuang L, Huang Z, Hong Z, Chen A, Li Y. Predictability of 1-h postload plasma glucose concentration: A 10-year retrospective cohort study. J Diabetes Investig 2015; 6:647-54. [PMID: 26543538 PMCID: PMC4627541 DOI: 10.1111/jdi.12353] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 02/23/2015] [Accepted: 03/12/2015] [Indexed: 11/30/2022] Open
Abstract
Aims/Introduction Elevated 1-h postload plasma glucose concentration (1hPG) during oral glucose tolerance test has been linked to an increased risk of type 2 diabetes and a poorer cardiometabolic risk profile. The present study analyzed the predictability and cut-off point of 1hPG in predicting type 2 diabetes in normal glucose regulation (NGR) subjects, and evaluated the long-term prognosis of NGR subjects with elevated 1hPG in glucose metabolism, kidney function, metabolic states and atherosclerosis. Materials and Methods A total of 116 Han Chinese classified as NGR in 2002 at the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China, were investigated. Follow-up was carried out in 2012 to evaluate the progression of glucose metabolism, kidney function, metabolic syndrome and carotid atherosclerosis. Results The areas under receiver operating characteristic curves were higher for 1hPG than FPG or 2hPG (0.858 vs 0.806 vs 0.746). The cut-off value of 1hPG with the maximal sum of sensitivity and specificity in predicting type 2 diabetes in NGR subjects was 8.85 mmol/L. The accumulative incidence of type 2 diabetes in subjects with 1hPG ≥8.85 mmol/L was higher than those <8.85 mmol/L (46.2% vs 3.3%, P = 0.000; relative risk 13.846, 95% confidence interval 4.223–45.400). On follow up, the prevalence of metabolic syndrome and abnormal carotid intima-media thickness in the subjects with 1hPG ≥8.85 mmol/L tended to be higher compared with those <8.85 mmol/L. Conclusions 1hPG is a good predictor of type 2 diabetes in NGR subjects, and the best cut-off point is 8.85 mmol/L. Some tendency indicates that NGR subjects with 1hPG ≥8.85 mmol/L are more prone to metabolic syndrome and carotid atherosclerosis.
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Affiliation(s)
- Lifen Kuang
- Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong, China
| | - Zhimin Huang
- Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong, China
| | - Zhenzhen Hong
- Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong, China
| | - Ailing Chen
- Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong, China
| | - Yanbing Li
- Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong, China
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