Frequency of abnormal carbohydrate metabolism and diabetes in a population-based screening of adolescents

OBJECTIVE: To document the frequency of glucose intolerance in adolescents in a population-based study of primarily African-American/Non-Hispanic whites in an urban-suburban school district. STUDY DESIGN: Measurement of fasting and 2-hour post-glucose load plasma glucose concentrations. RESULTS: Carbohydrate intolerance (either impaired fasting glucose, impaired glucose tolerance, or both) was identified in 8.0%, near-diabetes (1 fasting glucose > or = 126 mg/dL [7.0 mmol/L] and/or 2-hour glucose > or = 200 mg/dL [11.1 mmol/L]) in 0.3%, and diabetes in 0.36% (type 1A = 0.24%; type 2 = 0.08%; undiagnosed type 2 = 0.04%). A model for abnormal carbohydrate metabolism was constructed with regression analysis in the Carbohydrate Intolerance (CI)/near-diabetes group and with logistic regression in the entire study population. Risk factors for the development of CI/near-diabetes included having a 1 unit increase in body mass index (BMI) z-score and either being non-Hispanic white or in the pubertal group. Increased fasting glucose correlated with having puberty and decreased BMI z-score, whereas 2-hour glucose correlated with increased BMI z-score. By using National Health and Nutrition Survey (NHANES) III (1988-1994) definitions, impaired fasting glucose was present in 2.0% in this study versus 1.7% (NHANES III). CONCLUSION: The prevalence of CI/near-diabetes was 8.3%. Undiagnosed diabetes mellitus was rare. One third of adolescents with diabetes mellitus could be classified as having type 2 diabetes mellitus. The adult model of the progression of insulin resistance to type 2 diabetes mellitus in adolescents may be valid. Despite the increase in the overweight population since NHANES III, abnormalities in glucose metabolism have not changed significantly.     

“Silent” Diabetes and Clinical Outcome After Treatment With Contemporary Drug-Eluting Stents: The BIO-RESORT Silent Diabetes Study

Objectives

This study sought to assess the prevalence and clinical impact of silent diabetes and pre-diabetes in “nondiabetic” percutaneous coronary intervention (PCI) all-comers.

Extra Virgin Olive Oil Reduces Gut Permeability and Metabolic Endotoxemia in Diabetic Patients

Background: Extra virgin olive oil (EVOO) improves post-prandial glycemia, but the underlying mechanism has not been fully elucidated. We tested the hypothesis that EVOO improves post-prandial glycemia by reducing gut permeability-derived low-grade endotoxemia. Methods: Serum levels of lipopolysaccharides (LPS), zonulin, a marker of gut permeability, glucose, insulin and glucagon-like peptide 1 (GLP1) were measured in 20 patients with impaired fasting glucose (IFG) and 20 healthy subjects (HS) matched for sex and age. The same variables were measured in IFG patients (n = 20) and HS (n = 20) before and after a Mediterranean diet with 10 g EVOO added or not (n = 20) or in IFG patients (n = 20) before and after intake of 40 g chocolate with EVOO added or not. Results: Compared to HS, IFG had higher levels of LPS and zonulin. In HS, meal intake was associated with a significant increase of blood glucose, insulin, and GLP1 with no changes of blood LPS and zonulin. Two hours after a meal intake containing EVOO, IFG patients showed a less significant increase of blood glucose, a more marked increase of blood insulin and GLP1 and a significant reduction of LPS and zonulin compared to IFG patients not given EVOO. Correlation analysis showed that LPS directly correlated with blood glucose and zonulin and inversely with blood insulin. Similar findings were detected in IFG patients given a chocolate added or without EVOO. Conclusion: Addition of EVOO to a Mediterranean diet or chocolate improves gut permeability and low-grade endotoxemia.     

空腹血糖受损人群复合式营养干预效果评价

目的观察复合式营养干预对空腹血糖受损（IFG）人群作用的综合效果，评价复合式营养干预对糖尿病（DM）的预防作用。方法在南京市6个主城区4142名中老年基线调查对象中，抽取空腹血糖受损者，随机分为复合式营养干预组196人，给予粗杂粮干预加健康教育讲座；空白对照组72人，不采取任何干预措施。试验周期为半年。试验前后对所有受试人员进行体检。结果试验后，复合式营养干预组人群空腹血糖（FBG）、血总胆固醇（TC）、甘油三酯（TG）、体重、体质指数（BMI）、腰臀比（WHR）明显下降（P〈0．05）；且FBG降至正常（〈5．6mmol／L）的人群所占比率明显高于空白对照组（P〈0．05），而发展为糖尿病（FBG≥7．0mmol／L）的人群所占比率明显低于空白对照组（P〈0．05）。结论空腹血糖受损人群为糖尿病的危险人群，复合式营养干预可以降低空腹血糖受损人群的血糖水平，是预防糖尿病行之有效的措施。     

Association between fasting serum glucose levels and incidence of colorectal cancer in Korean men: The Korean Cancer Prevention Study-II

Introduction

The incidence of colorectal cancer (CRC) is steadily increasing worldwide. Numerous studies have demonstrated that diabetes mellitus is related to an increased risk of CRC; however, the association between impaired fasting glucose and CRC is unclear. Therefore, we evaluated the correlation between fasting serum glucose (FSG) levels and the incidence of CRC, which can be used to develop novel methods for preventing CRC.

Methods

A total of 175,677 individuals from the Korean Metabolic Syndrome Research Initiative study were enrolled between 2004 and 2011. The incidence of CRC was assessed during a mean follow-up of 4.7 years. Hazard ratios (HR) for CRC according to FSG levels were calculated with the Cox proportional hazard model adjusted for age, sex, body mass index, smoking status, alcohol consumption, and regular exercise.

Results

The risk of developing CRC in subjects with high FSG was significant (HR, 1.45; 95% confidence interval [CI], 1.10–1.90), and the risk was higher in men (HR, 1.51; 95% CI, 1.12–2.05). The HR of rectal cancer, but not colon cancer, was significantly higher both in the total population and in men in the high FSG group.

Conclusions

The incidence of CRC positively correlated with FSG levels in men. Rectal cancer incidence was especially correlated with high FSG in the site-specific analysis. Therefore, serum glucose levels maybe a potential marker of colorectal cancer. Early detection and intervention for controlling elevated glucose levels may be indicated as a way to prevent carcinogenesis.     

耳穴贴压加中药治疗糖调节受损的临床研究

目的观察并评价耳穴贴压加中药治疗糖调节受损（IGR）患者的疗效。方法通过对社区45岁以上糖尿病高危人群筛查,将88例糖调节受损患者随机分为两组,观察组45例采用耳穴（胰胆、屏间、阿是穴等）贴压王不留行籽,配合服用中药十味玉泉胶囊：对照组43例进行健康教育干预治疗。结果观察组干预前后血糖、血脂显著降低（P〈0．01）：两组比较差异有统计学意义（P〈0．01）。结论耳穴贴压加中药对糖调节受损的干预治疗,降糖效果显著,为中医药在参与社区糖尿病的防治中探索一条新途径和新思路。     

Hand or spoon? Exploring the neural basis of affective touch in 5-month-old infants

In adults, affective touch leads to widespread activation of cortical areas including posterior Superior Temporal Sulcus (pSTS) and Inferior Frontal Gyrus (IFG). Using functional Near Infrared Spectroscopy (fNIRS), we asked whether similar areas are activated in 5-month-old infants, by comparing affective to non-affective touch. We contrasted a human touch stroke to strokes performed with a cold metallic spoon. The hypothesis that adult-like activation of cortical areas would be seen only in response to the human touch stroke was not confirmed. Similar patterns of activation were seen in both conditions. We conclude that either the posterior STS and IFG have not yet developed selective responses to affective touch, or that additional social cues are needed to be able to identify this type of touch.     

The lactase persistence genotype is associated with body mass index and dairy consumption in the D.E.S.I.R. study

Objective

The T allele of a functional polymorphism (rs4988235: LCT-13910 C > T), close to the lactase gene, correlates with lactase persistence (LP) in adults. The LP genotype (TT + TC) has been associated with a higher BMI in European populations in cross-sectional studies. In the French D.E.S.I.R. cohort, a high consumption of dairy products was associated with a lower body weight gain over 9-years, and with a lower incidence of high plasma glucose levels and/or the metabolic syndrome. Our aim was to test in this study, the association of rs4988235 with BMI and related metabolic diseases, in interaction with dairy product consumption.

Methods

Among 5212 subjects from D.E.S.I.R., 3575 Caucasians born in mainland France were genotyped and followed over 9 years.

Results

Those with the LP genotype (frequency: 78.5%) had a higher dairy product consumption, at inclusion and at year-9 (P < 0.001). They also had a higher BMI at both time points (difference = 0.3 kg/m², P = 0.05), but this effect was restricted to medium/high dairy product consumers (difference = 0.5 kg/m², P = 0.006). This genotype was also associated with the metabolic syndrome (IDF definition), but this association disappeared after adjustment for BMI. In the whole population, the C allele was associated with a higher prevalence of impaired fasting glycemia and/or type 2 diabetes.

Conclusions

The lactase persistence genotype was shown to be associated with a higher BMI in a longitudinal study, mainly in those consuming high amounts of dairy products. The association of the C allele, responsible for lactase non-persistence, with the risk of hyperglycemia needs to be replicated.