Power to Localize the Major Gene for Disease Liability Is Increased After Accounting for the Effects of Related Quantitative Phenotypes

We used the simulated general population data for Genetic Analysis Workshop 12 to test whether power to localize the major gene for liability to disease is increased after accounting for the effects of correlated quantitative phenotypes. We performed the multipoint variance‐component linkage analyses for the discrete trait twice: first analysis with age, sex, and EF1 as covariates, and the second analysis with age, sex, EF1, and Q1–Q5 as covariates. Major locus heritability (h²_q,) (0.80 ± 0.06) and lod score (6.4) averaged over the number of replicates used are significantly higher in the second analysis compared with the first analysis (h²_q= 0.39 ± 0.12, lod = 2.6). Thus, in the present analysis, power to detect linkage and localize the genes for liability to disease appears to be increased after accounting for the effects of five quantitative traits that are correlated with the liability. © 2001 Wiley‐Liss, Inc.     

First degree family history of diabetes and risk factors for cardiovascular disease in non-diabetic subjects in the National Telephone Company: A metabolic survey

The effect of first degree family history of diabetes on known risk factors for cardiovascular disease was evaluated in 4989 non-diabetic employees of the Italian Telephone Company. Family history of diabetes was present in 759 subjects (476 males and 283 females); in these subjects body mass index, diastolic blood pressure, blood glucose levels (fasting and one and two-hour post-load), triglyceride and cholesterol levels were significantly higher than in age and sex-matched controls. In different age groups (<30, 31–40, 41–50, >50 years) the effect of first degree family history of diabetes was evaluated after stratification by sex. In males with first degree family history of diabetes; this effect was strongest in the under 30 age group: body mass indices, systolic and diastolic blood pressures, fasting and two-hour post-load blood glucose levels, triklyceride and cholesterol levels were all significantly higher than in subjects with negative family history of diabetes. These differences between subjects with negative and positive family histories declined with age and disappeared in subjects over 50.In females the effect of familial diabetes was weaker and delayed for body mass index and one hour blood glucose, appearing only in subjects over 30.Multiple logistic analysis indicated that only body mass index and one-hour blood glucose levels were independently associated with positive family history of diabetes. The differences observed between males and females in the youngest age group were also confirmed by this analysis. These data may indicate a multifactorial genetic link leading to increased cardiovascular morbidity in subjects with diabetes.     

Evaluation of Self-Care Practices and Emotional Distress Among People with Type 2 Diabetes Mellitus in Dar Es Salaam,Tanzania

This study was conducted to determine self-care practices and diabetes related emotional distress among people with Type 2 diabetes mellitus in Dar es Salaam, Tanzania. A cross sectional survey-involving 121 Types 2 diabetics was conducted in 4 diabetic clinics located in Dar es Salaam. Anthropometric and biomedical measurements namely weight, height, waist, hip, mid-upper arm circumference, blood pressure and fasting blood glucose were measured. Self-care practices and diabetic related emotion distress were evaluated by using validated instruments. Results revealed that, the average fasting plasma glucose was 11.2 ± 5.5 mmol/l, blood pressure was 134.7/86.1 mm/Hg and the mean BMI for males and females were 25.0 ± 4.3 and 27.0 ± 5.1 kg/m², respectively. Subject's self-care score for general diet, specific diet, physical exercise, foot-care and medication were 4.6 ± 2.4, 3.7 ± 1.5, 3.4 ± 1.8, 3.6 ± 2.8 and 5.5 ± 2.8 days per week, respectively. Self-monitoring of blood glucose was irregular and only 46.3% of the subjects tested their levels of blood glucose at least once in between the appointments (90 days). Low income was the major limitation for complying with the self-care practices related to diet, blood glucose testing and medication. It is recommended that, the Government of Tanzania should in the short run subsidize the prices of diabetes drugs, remove all taxes on the glucose test kits and establish a national diabetes program that would coordinate and oversee provision of the basic services such as screening, glucose testing, medication, counseling and management of the condition. In the long run, the government should establish a preventive public health program in order to curtail the escalation of diabetes. Further research should be conducted to determine how factors such as socio-cultural and demographic, self-care, and psychosocial distress interact to determine biomedical outcomes such as blood pressure, blood glucose and body mass index.     

哈萨克族代谢综合征与游离脂肪酸及胰岛素抵抗关系

目的 探讨游离脂肪酸(FFA)、胰岛素抵抗(IR)与新疆哈萨克族代谢综合征(MS)关系。方法 在哈萨克族人群现况调查中,随机抽取MS患者195例和健康者120人进行病例对照研究;检测糖代谢相关指标,采用比色法测定FFA浓度,采用放射免疫法测定空腹胰岛素(FINS)浓度,计算胰岛素抵抗指数(HOMA_IR)。结果 MS病例组男性FFA为(0.57±0.22)mmol/L,女性为(0.65±0.24)mmol/L,对照组男性为(0.46±0.22)mmol/L,女性为(0.52±0.17)mmol/L;MS病例组男性HOMA_IR为(5.17±4.89),女性为(3.75±3.37),对照组男性为(1.62±1.29),女性为(2.20±1.53);2组男、女性FFA、HOMA-IR差异均有统计学意义(均P<0.01);随着FFA浓度与HOMA_IR的增加,MS患者比例增加;多因素logistic回归分析显示,FFA浓度为0.55 mmol/L～、0.69 mmol/L～,对MS的影响分别OR=4.374(95%CI=1.271～15.046)和OR=4.208(95%CI=1.068～16.586);HOMA_IR为3.96～时,对MS的影响OR=8.552(95%CI=2.064～35.428);FFA、HOMA_IR与MS各组分的相关均有统计学意义(P<0.05);调整年龄、性别、HOMA_IR等影响后,FFA只与腰围、舒张压相关(P<0.05)。结论 胰岛素抵抗可能是新疆哈萨克族人群中MS重要的独立危险因素,而FFA可能不是一个独立危险因子,它可能通过其他机制影响机体产生胰岛素抵抗,从而导致MS及其各组分的发生和发展。     

Genetics of the apnea hypopnea index in Caucasians and African Americans: I. Segregation analysis

Differences in age of presentation and anatomic risk factors for obstructive sleep apnea (OSA) in Caucasians and African Americans suggest possible racial differences in the genetic underpinnings of the disorder. In this study, we assess transmission patterns in a Caucasian sample consisting of 177 families (N = 1,195) and in an African American sample consisting of 125 families (N = 720) for two variables: 1) apnea hypopnea index (AHI) log transformed and adjusted for age, and 2) AHI log transformed and adjusted for age and body mass index (BMI). We allowed for residual familial correlations and sex-specific means in all models. Analysis of the Caucasian sample showed transmission patterns consistent with that of a major gene that were stronger in the age-adjusted variable than in the age- and BMI-adjusted variable. However, in the African American families, adjusting for BMI in addition to age gave stronger evidence for segregation of a codominant gene with an allele frequency of 0.14, accounting for 35% of the total variance. These results provide support for an underlying genetic basis for OSA that in African Americans is independent of the contribution of BMI.     

Relation of visfatin to cardiovascular risk factors and adipocytokines in patients with impaired fasting glucose

ObjectiveThe discovery of visfatin has great potential to significantly enhance our understanding of impaired fasting glucose and diabetes mellitus. The aim of the present study was to explore the relation of visfatin concentrations to cardiovascular risk factors and serum adipocytokine concentrations in patients with impaired fasting glucose.MethodsA sample of 55 patients with impaired fasting glucose was analyzed in a prospective way. All patients with a 2-wk weight-stabilization period before recruitment were enrolled. Weight, blood pressure, basal glucose, lipoprotein(a), C-reactive protein, insulin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triacylglycerols, blood, and adipocytokines (visfatin, leptin, adiponectin, resistin, tumor necrosis factor-α [TNF-α], and interleukin-6) levels were measured. Tetrapolar impedancometry, indirect calorimetry, and prospective serial assessment of nutritional intake with 3-d written food records were performed.ResultsFourteen men (25.5%) and 41 women (74.5%), with a mean age of 57.3 ± 11.7 y and mean body mass index of 35.8 ± 3.6 kg/m², were included. Patients were divided in two groups by median visfatin value (18.2 ng/mL): group I had low values and group II had high values. Patients in group I had greater weight, body mass index, fat mass, fat-free mass, and adiponectin than patients in group II. Patients in group II had higher total cholesterol, low-density lipoprotein cholesterol, resistin, and TNF-α levels than patients in group I. In the multivariate analysis with age- and sex-adjusted basal visfatin concentration as a dependent variable, only TNF-α remained an independent predictor in the model (F = 8.4, P < 0.05), with an inverse correlation. Visfatin concentration decreased 7.33 ng/mL (95% confidence interval 2.10–12.58) for each nanogram per milligram of TNF-α increase.ConclusionOnly TNF-α is related in an independent way to serum visfatin levels.     

儿童青少年双生子瘦素遗传度估计及影响因素分析

目的 分析影响儿童青少年瘦素的遗传因素和环境因素,探讨性别、年龄和体质量指数(BMI)的作用,为儿童肥胖早期预防提供依据.方法 选择6～18岁同性别双生子337对,平均年龄(12.3±3.5)岁,其中同卵双生子257对,异卵双生子80对.采用DNA微卫星多态性鉴定卵性.应用Mx结构方程模型分别计算年龄和BMI调整前后瘦素的遗传度,并检验性别、年龄和BMI对于模型的作用.结果 不同性别间身高、体重和瘦素水平差异均有统计学意义(P值均＜0.05).相关分析显示,瘦素水平与性别、年龄和BMI相关(P值均＜0.0l).遗传分析发现,调整前年龄方差在女生中影响较大,而男生则受共同环境方差影响较大.调整后男生特异性性别方差降低,最适模型为ACE(scale)模型.男、女生瘦素遗传模型一致,遗传度为20％.结论 儿童青少年人群中瘦素水平与性别、年龄和BMI相关.瘦素受遗传和环境因素共同影响.调整年龄及BMI后,瘦素遗传度不受性别影响.     

Segregation analysis of cardiovascular reactivity to laboratory stressors

To better understand the contribution of major gene influences to individual differences in cardiovascular reactivity, we performed a segregation analysis on blood pressure responses to two laboratory tasks, mental arithmetic and bicycle exercise. The study population consisted of 1,451 adults (age ≥18 years) who were members of 81 Utah pedigrees. Only 864 members performed the bicycle task because persons age 60 years or older or with heart disease were excluded. Blood pressure reactivity to mental arithmetic was defined as change from resting values, and reactivity to the bicycle task was defined as the difference between maximum blood pressure during exercise and resting values adjusted for the individual's workload. Complex segregation analysis and likelihood procedures were used to test for a major gene effect controlling blood pressure reactivity to each task. Two modifiers of the penetrance, age and sex, were considered parameters in these models. We found that diastolic blood pressure (DBP) but not systolic blood pressure reactivities to the mental arithmetic and bicycle exercise tasks were controlled by major gene effects. The best-fitting model, however, differed for the two tasks. For DBP reactivity to mental arithmetic, a major codominant model with gene frequency 0.10 was the best-fitting model; for the bicycle task, the best-fitting model was a mixed recessive model with gene frequency 0.21. Sex differences in DBP reactivity were significant in both tasks; the effect of age was significant only for the mental arithmetic task. These results suggest a significant genetic component for DBP reactivity to laboratory stressors. Genet. Epidemiol. 14:35–49,1997. © 1997 Wiley-Liss, Inc.     

中国东部地区青少年血糖与血脂关系

目的 研究中国东部地区12～17岁青少年血糖与血脂各组分的关系.方法 数据来自2016-2017年"中国儿童与乳母营养健康监测"项 目,采用多阶段分层整群抽样的方法,抽取东部地区的8个省3个直辖市8873名青少年(男生4405名,女生4468名)作为研究对象,测定空腹血糖及血脂生化指标.采用Logistic回归分析青少...     

Statistical genetics of normal variation in family data for oligogenic diseases

A quadrivariate quantitative genetic analysis detected significant heritabilities for four simulated quantitative traits (Q1-Q4) with additive genetic pleiotropy between traits Q1, Q2, and Q3. Using univariate segregation analysis, we tentatively detected five major loci: one each for Q2, Q3, and Q4 and two, at different maxima, for Q1. Bivariate one-locus segregation analysis identified significant major locus pleiotropy for Q1, Q2, and Q3 only; and suggested identity between one of Q1's major genes and that for Q2, and between the second Q1 major gene and that for Q3. Patterns of linkage, supportive of inferences from the bivariate segregation analyses, were detected between three candidate genes and the major genes for Q1, Q2 and Q4. © 1995 Wiley-Liss, Inc.     

The Physiological Response of Animals to β-Nitronaphthalene

The effect of lead exposure on blood pressure in the modern industrial setting is controversial. In this study, we followed 67 workers in a lead-battery plant for 6–10 y, and blood pressure and blood lead levels were measured every 6 mo. Weight, height, alcohol intake, cigarette smoking, and age were recorded. Partial correlation coefficients showed that initial systolic blood pressure, age, and body mass index (i.e., weight/height squared) accounted for 25%, 30.9%, and 20.2%, respectively, of the variance in systolic blood pressure (p < .001 in all cases). Conversely, average blood lead levels (13 ± 3 tests/worker) accounted for only 0.4% of the variance (not significant). Repeated-measures analysis of variance showed a small—but significant—association between blood lead levels and systolic blood pressure. There was a negative correlation between blood lead levels and diastolic blood pressure. There were 18 men with average blood lead levels that were less than 30 μg/dl (average = 25 ± 3 μg/dl), and 32 men had levels of 40 μg/dl or more (average = 47 ± 6 μg/dl). The mean final systolic blood pressure, adjusted for age, and initial systolic blood pressure were 117 ± 13 mm Hg and 114 ± 11 mm Hg, respectively. We concluded that blood lead levels had no clinically significant effect on blood pressure in lead-battery workers. The main predictors of the follow-up systolic blood pressure were age, body mass index, and initial systolic blood-pressure measurements.     

C-反应蛋白、肿瘤坏死因子与妊娠期糖尿病的胰岛素抵抗、血脂相关性研究

目的:探讨妊娠期糖尿病患者血清中C-反应蛋白(CRP)、肿瘤坏死因子(TNF-α)水平变化及其与胰岛素抵抗、血脂的关系。方法:采用双抗体夹心酶联法于妊娠24～28周测定无孕前肥胖的30例妊娠期糖尿病孕妇(GDM组)和30例正常妊娠晚期孕妇(正常妊娠组)的空腹血清TNF-α水平;同时测定两组孕妇血清CRP、空腹血糖(FBS)、胰岛素(FINS)、C肽、总胆固醇(TG)和甘油三酯(TC)水平,并根据公式计算孕前体重指数(BMI),胰岛素抵抗指数(HOMA-IRI)以评价胰岛素抵抗程度。结果:①GDM组孕妇空腹血清CRP、TNF-α、FBS、FINS、C肽、HOMA-IRI、TG水平及孕前BMI分别为(3.9±0.7)mg/L、(38.8±5.6)ng/L、(4.7±0.8)mmol/L、(18.1±3.4)IU/L、(5.8±0.9)mmol/L、(3.9±1.2)、(6.3±0.7)mmol/L、(23.5±3.7)kg/m2,正常妊娠组孕妇分别为(2.5±0.6)mg/L、(25.7±2.4)ng/L、4.2±0.8mmol/L、13.5±2.6IU/L、4.1±0.6mmol/l、2.5±0.7、5.6±0.7mmol/l、21.7±3.3kg/m2;两组比较,差异有显著性(P<0.01或P<0.05)。两组孕妇血清TC水平比较无明显差异性(P>0.05)。②将孕前BMI(协变量)控制后,对上述各项指标进行协方差分析,结果显示GDM组孕妇空腹血清CRP、TNF-α、FBS、FINS、C肽、HOMA-IRI、TG水平与正常妊娠组比较,差异仍有显著性(P<0.01或P<0.05);两组孕妇血清TC水平比较无明显差异(P>0.05)。③GDM组孕妇血清CRP和TNF-α与HOMA-IRI、TG、TC多元线性相关性分析结果显示,CRP和TNF-α的水平分别与HOMA-IRI、TG呈正相关性(r=0.891、0.782,P(0.05和r=0.662、0.714,P<0.05);CRP和TNF-α的水平分别与TC无相关性(P(0.05)。④将孕前BMI作为协变量,CRP和TNF-α与HOMA-IRI、TG、TC相关性分析采用偏相关分析法,结果显示GDM组孕妇血清CRP和TNF-α的水平分别与HOMA-IRI、TG呈正相关(r=0.727、0.539,P(0.05和r=0.385、0.515,P(0.05);与TC无相关性。结论:在无孕前肥胖状况下,妊娠期糖尿病患者血清中CRP、TNF-α水平升高与胰岛素抵抗、血脂指标异常有关。     

Effects of black and green tea consumption on blood glucose levels in non-obese elderly men and women from Mediterranean Islands (MEDIS epidemiological study)

Background Obesity and diabetes are metabolic disorders that affect a large amount of the elderly population and are related to increased cardiovascular risk. Tea intake has been associated with lower risk of mortality and morbidity in some, but not all studies. We evaluated the association between tea intake, blood glucose levels, in a sample of elderly adults. Methods During 2005–2006, 300 men and women from Cyprus, 142 from Mitilini and 100 from Samothraki islands (aged 65–100 years) were enrolled. Dietary habits (including tea consumption) were assessed through a food frequency questionnaire. Among various factors, fasting blood glucose and body mass index (BMI) were measured. Results Fifty-four percent of the participants reported that they consume tea at least once a week (mean intake 1.6 ± 1.1 cup/day). A significant interaction was observed between tea intake, obesity status on glucose levels (P < 0.001). After adjusting for various confounders, tea intake was associated with lower blood glucose levels in non-obese (P for trend <0.001), but not in obese people (P = 0.24). Multiple logistic regression analysis revealed that moderate tea consumption (1–2 cups/day) was associated with 88% (95% CI 76–98%) lower odds of having diabetes among non-obese participants, irrespective of age, sex, smoking, physical activity status, dietary habits and other clinical characteristics. Conclusion Tea consumption is associated with reduced levels of fasting blood glucose only among non-obese elderly people.     

Evidence for genetic factors underlying the insulin resistance syndrome in american indians

Previous analyses of American Indians of the Strong Heart Study have demonstrated that various insulin-resistance variables cluster, although knowledge about the genetic determination of these clusters is unknown. In an effort to explore the influences on the aggregation of insulin-resistance phenotypes, we used principal component factor analysis to examine the clustering of these phenotypes in participants of the Strong Heart Family Study and evaluated the genetic and environmental contributions of such factors. Nine traits were chosen for principal component factor analysis: BMI, diastolic blood pressure, fasting glucose, high-density lipoprotein-cholesterol, natural log-transformed insulin, natural log-transformed triglycerides, percentage of body fat, systolic blood pressure, and waist-to-hip ratio. Analyses revealed three clusters: glucose/insulin/obesity, blood pressure, and dyslipidemia factors. Using a variance component approach and accounting for the effects of age, sex, center, and medication, we detected significant heritabilities (h2) for the three factors: h2 = 0.67, h2 = 0.33, and h2 = 0.61, respectively. In multivariate analysis, no significant genetic correlations among factors were found. These results suggest that heredity explains a substantial proportion of the variability of the factors that underlie the insulin resistance syndrome in American Indians and that these factors are genetically independent.     

Hyperglycemia and coronary risk factors results from western Austria

We investigated mean levels and prevalences of total cholesterol, HDL cholesterol, triglycerides, fasting blood glucose, systolic blood pressure and body mass index in adults aged 25 to 64 years participating in the WHO Country-wide Integrated Noncommunicable. Diseases Intervention (CINDI) Programme in Vorarlberg, western Austria. According to the Austrian expert panel and based upon the above age standardized risk factors 50.9% of the male and 29.3% of the female population were at high risk for developing coronary heart disease. Risk factor levels were further compared between euglycemic and hyperglycemic participants. After adjusting for age hyperglycemia was associated with higher body mass index in men (p=0.026) and women (p<0.001), higher systolic blood pressure in men (p<0.001) and women (p=0.003), and higher levels of triglycerides in women (p=0.008). No significant differences were observed in total and HDL cholesterol in either sex. When controlling for age and body mass index, fasting blood glucose levels had significant associations only with systolic blood pressure in men (p=0.001). But, with respect to all risk factors, hyperglycemic participants had an age-adjusted adverse coronary risk profile both in men (p=0.002) and in women (p<0.001).     

Sex differences in fasting glycemia as a risk factor for ischemic heart disease death

The relation between fasting plasma glucose and mortality from ischemic heart disease was examined in a population of 3,458 nondiabetics (aged 40-79 years) in Rancho Bernardo, California, who were free of heart disease at baseline and were followed for an average of 14 years, from 1972 to 1987. A linear increase of age-adjusted ischemic heart disease mortality rates with fasting glucose was observed in men, and a threshold relation at 110 mg/100 ml plasma glucose was observed in women. On the basis of Cox proportional hazards analysis, the observed sex differential in the association between plasma glucose and ischemic heart disease mortality proved to be statistically significant and independent of the effects of age, systolic blood pressure, body mass index, plasma cholesterol, plasma triglyceride, and, in women, estrogen use. In sex-specific multivariate models, interaction terms representing a threshold effect at glucose levels greater than or equal to 110 mg/100 ml were statistically significant in women (p = 0.007), but not in men, and interaction between sex and the glucose threshold term was observed in multivariate analysis of men and women combined (p = 0.07). The authors conclude that sex differences in the effect of fasting glycemia on ischemic heart disease mortality among nondiabetics exist and are unexplained. Elucidation may hold a key to the sex difference in heart disease and the relatively greater importance of diabetes and impaired glucose tolerance as risk factors for ischemic heart disease in women compared with men.     

Impact of time since last caloric intake on blood glucose levels

Blood glucose (BG) is usually measured after a caloric restriction of at least 8 h; however evidence-based recommendations for the duration of a fasting status are missing. Here we analyze the effect of fasting duration on levels of BG to determine the minimal fasting duration to achieve comparable BG levels to conventional fasting measurements. We used data of a cross-sectional study on primary care patients, performed in October 2005. We included 28,024 individuals (age-range 18–99 years; 63% women) without known diabetes mellitus and without missing data for BG and fasting status. We computed general linear models, adjusting for age, sex, time of blood withdrawal, systolic blood pressure, waist circumference, total- and HDL-cholesterol, physical activity, smoking, intake of beta-blocker and alcohol. We tested the intra-individual variability with respect to fasting status. Overall, the mean BG differed only slightly between individuals fasting ≥8 h and those fasting <8 h (men: 5.1 ± 0.8 mmol/L versus 5.2 ± 1.2 mmol/L; women: 4.9 ± 0.7 mmol/L, 5.0 ± 1.0 mmol/L). After 3 h of fasting differences of BG diminished in men to −0.08 mmol/L (95%-CI: −0.15; −0.01 mmol/L), in women to −0.07 mmol/L (−0.12; −0.03 mmol/L) compared to individuals fasting ≥8 h. Noteworthy, age, time of day of blood withdrawal, physical activity, and intake of hard liquor influenced BG levels considerably. Our data challenge the necessity for a fasting duration of ≥8 h when measuring blood glucose, suggesting a random sampling or a fasting duration of 3 h as sufficient. Rather, our study indicates that essentially more effort on the assessment of additional external/internal factors on BG levels is necessary.     

A high protein low fat meal does not influence glucose and insulin responses in obese individuals with or without type 2 diabetes

Background: When substituted for carbohydrate in a meal, dietary protein enhances glycaemic control in subjects with type 2 diabetes (DM2). It is unknown whether the effect is a result of increased protein or reduced carbohydrate. The present study aimed to compare the effects of two meals differing in protein to fat ratios on post‐prandial glucose and insulin responses. Methods: This was a crossover, blind study in which obese subjects with (n = 23) and without (n = 26) DM2 consumed two meals in random order with equal amounts of energy (3.1 MJ, 741 kcal), fibre and carbohydrates and a 1‐week washout period. Meals were a high protein, low fat (30% protein, 51% carbohydrates, 19% fat) meal and a low protein, high fat (15% protein, 51% carbohydrates, 34% fat) meal. Subjects were matched for age and body mass index. Plasma glucose and insulin were measured at fasting, 30, 60, 90, 120 min post‐prandially. Insulin resistance and insulin sensitivity were assessed. Results: There was no significant meal effect on glucose and insulin responses within groups. Glucose response was higher in diabetic (120 min 11 ± 0.7 mmol L⁻¹) compared to nondiabetic (120 min 5 ± 0.2; P < 0.001) subjects. Diabetic subjects had significantly higher insulin resistance (P < 0.001) and lower insulin sensitivity (P < 0.001) than nondiabetics. Although peak insulin levels, 60 min post‐prandially, did not differ between groups (81 ± 9 pmol L⁻¹ for diabetic versus 79 ± 7 pmol L⁻¹ for nondiabetic subjects), they were achieved much later, 90 min post‐prandially, in diabetic, (99 ± 8 pmol L⁻¹) compared to nondiabetic (63 ± 7 pmol L⁻¹, P = 0.002) subjects. Conclusions: Manipulating protein to fat ratio in meals does not affect post‐prandial plasma blood glucose or insulin responses in obese people with and without DM2.     

High Prevalence of Diabetes and Impaired Fasting Glucose Among Chinese Immigrants in New York City

Asians have an increased susceptibility to type 2 diabetes, despite relatively low prevalence of obesity in this population. Asian American is a diverse population and there are yet limited data on the prevalence of diabetes among different Asian subgroups and existing studies are limited by small sample size. Hence, we conducted a cross-sectional survey to estimate the prevalence of diabetes and impaired fasting glucose (IFG) in this population among Chinese Americans, the largest Asian subgroup in the US. Our study population consisted 2,071 individuals (52.8% women; mean age: 52.7 ± 13.8 years and mean body mass index (BMI): 23.9 ± 3.2 kg/m²) living in New York City. Data on sociodemographic factors, anthropometric measurements and medical history is obtained during a 1 day clinic visit. In addition, a fasting blood sample was collected to perform measurements on plasma glucose and lipids. Diabetes was defined as self-reported treatment or a fasting glucose ≥126 mg/dl) and IFG was defined as fasting glucose of 100–125 mg/dl. The age-adjusted prevalence of diabetes in this population was 8.6% and that of IFG was 34.6%. The prevalence of IFG/diabetes was high (38.3%) even among those with low BMI by Asian standards (<23.0 kg/m²) and showed a linear increasing trend with increasing waist circumference. These data suggest a high prevalence of impaired glucose regulation in Chinese immigrants even among individuals with normal BMI. Future studies should focus on evaluating the mechanisms of increased susceptibility of IFG and diabetes in this population.     

孕中期血清胆红素与妊娠期糖尿病的相关性研究

目的探讨孕期中胆红素与妊娠期糖尿病(GDM)的相关性。方法以来自在华中科技大学附属武汉市中心医院进行产检和分娩的孕妇为研究对象,对其采用回顾性研究获得基本信息,采用钒酸盐氧化法测定血清中总胆红素(TB)、直接胆红素(DB),采用酶法测定空腹血糖(GLU)的水平,采用免疫比浊法测定c-反应蛋白(CRP)和白蛋白(Alb)。结果 GDM的发病率为7.86%(102/1 297)。TB、DB在GDM组的值要低于非GDM组(5.8±2.2和6.4±2.4,P=0.023;2.4±1.3和2.5±0.9,P=0.036)。进一步采用线性回归分析的方法分析TB、DB与空腹血糖、1h血糖、2h血糖间的线性关系,TB、DB与血糖值呈负相关。Logistic回归分析TB、DB与GDM的相关性,其最高层与最低层相比患GDM的风险降低(RR 0.54;95%CI,0.31~0.95)和(RR 0.61;95%CI,0.38~0.99)。结论妊娠中期高胆红素水平患GDM的风险性降低。