BACKGROUND Patients with prediabetes are at increased risk of developing cardiovascular disease.The Life's Essential 8(LE8)score,updated by the American Heart Association in 2022,is a tool used to quantify cardiov...BACKGROUND Patients with prediabetes are at increased risk of developing cardiovascular disease.The Life's Essential 8(LE8)score,updated by the American Heart Association in 2022,is a tool used to quantify cardiovascular health(CVH).Quantifying healthy living status on the basis of the uniform standard LE8 will be useful for confirming whether health interventions can reduce the risk of death in prediabetic patients.AIM To investigate the associations between all-cause mortality risk and CVH status(as quantified by the LE8 score)in prediabetic patients.METHODS This study included 5344 participants with prediabetes(age:52.9±15.8 years;51.6%men).The LE8 score includes four health indicators and four health behaviors.Cox proportional hazard ratios were calculated for all-cause mortality in the high CVH(LE8≥80),low CVH(LE8≤50),and moderate CVH(LE850-79)subgroups,and restricted cubic spline analyses were performed.Separate analyses of the associations of all-cause mortality risk with each LE8 component and CVH health behaviors and indicators were also performed.RESULTS In the median follow-up period of 8.33 years,658 deaths occurred.Compared with those among participants with high CVH,the covariate-adjusted HRs(95%confidence intervals)for mortality among participants with moderate and low CVH were 2.55(1.23-5.31)and 3.92(1.70-9.02),respectively.There was a linear relationship between an improvement in CVH status and a reduction in all-cause mortality risk(P-overall<0.0001,P-nonlinear=0.7989).Improved CVH health behaviors had a more significant protective effect on patients with prediabetes than did the improvement in CVH health indicators.CONCLUSION High CVH status(as quantified by the LE8 score)is significantly associated with reduced mortality risk in prediabetic adults in the United States.展开更多
AIM:To investigate normoglycemic,prediabetic and diabetic A1c levels in those with prediabetes;and prediabetic and diabetic A1c levels in those with non-prediabetes.METHODS:The National Health and Nutritional Examinat...AIM:To investigate normoglycemic,prediabetic and diabetic A1c levels in those with prediabetes;and prediabetic and diabetic A1c levels in those with non-prediabetes.METHODS:The National Health and Nutritional Examination Survey(NHANES)2007-2008 and NHANES2009-2010 were utilized to examine and compare trends and differences among five different ethnic groups(Mexican Americans,Other Hispanics,NonHispanic Whites,Non-Hispanic Blacks,Other/Multiracials)with normoglycemic,prediabetic and diabetic A1c levels with self-reported prediabetes and prediabetic and diabetic A1c levels in those with self-reported non-prediabetes.Sample participants of the five ethnic groups were limited to those 20 years of age and older,who had completed the diabetes questionnaire and had A1c measured.Descriptive statistics were computed for all variables.χ2were performed on all five ethnic groups to examine significant differences of normoglycemic,prediabetic and diabetic A1c levels in those with self-reported prediabetes,and prediabetic and diabetic A1c levels in those with self-reported non-prediabetes.RESULTS:This study demonstrates that of the five different ethnic groups from NHANES 2007-2008 to NHANES 2009-2010,Non-Hispanic Whites(6.5%increase)and Non-Hispanic Blacks(0.2%increase)were the only two groups with an increase in the number of self-reported prediabetes.Although the overall percentage of Mexican Americans who self-reported prediabetes had remained the same(5%)from NHANES2007-2008 to NHANES 2009-2010,χ2analysis showed significant differences when examining the different ranges of A1c levels(normoglycemic,prediabetic and diabetic).Among Mexican Americans who self-reported prediabetes,normoglycemic(P=0.0001)and diabetic(P=0.0001)A1c levels from NHANES 2007-2008 to NHANES 2009-2010.For Non-Hispanic Whites who self-reported prediabetes,prediabetic(P=0.0222);and diabetic(P≤0.0001)A1c levels from NHANES2007-2008 to NHANES 2009-2010.For Non-Hispanic Blacks who self-reported prediabetes,there were significant differences(P=0.0001)for all A1c levels(normoglycemic,prediabetic and diabetic A1c levels).For Other/Multi-racials with self-reported prediabetes there was significant differences in those with normoglycemic(P=0.0104)and diabetic(P=0.0067)A1c levels from NHANES 2007-2008 to NHANES 2009-2010.For all combined ethnic groups who self-reported not having prediabetes(non-prediabetes),19.9%of those in NHANES 2007-2008 and 22.4%in the NHANES2009-2010 showed to have prediabetic A1c levels.When separately examining each of the five ethnic groups who self-reported not having prediabetes,all showed an increase in those with prediabetic A1c levels from NHANES 2007-2008 to NHANES 2009-2010.Throughχ2analysis,all five ethnic groups who selfreported not having prediabetes showed significant differences(P<0.0001)in all A1c levels(normoglycemic,prediabetic and diabetic)from NHANES 2007-2008 to NHANES 2009-2010.CONCLUSION:The findings highlight the need of prediabetes awareness and of education in the community as ways to reduce the number of people with prediabetes.展开更多
Sedentary lifestyles promote adipose tissue accumulation that generates systemic inflammation and oxidative damage. Physical activity induces cardiovascular fitness, increases muscle mass, and healthy blood glucose re...Sedentary lifestyles promote adipose tissue accumulation that generates systemic inflammation and oxidative damage. Physical activity induces cardiovascular fitness, increases muscle mass, and healthy blood glucose regulation, while reducing visceral fat, triglycerides and low-density lipoproteins. It is theoretically possible to develop a long-term multi-exercise regimen for health management and enhancement. Pragmatically, time and career restraints, individual choices, genetic factors, or demoralization due to the draconian commitment involved in weight loss, have rendered over a billion of individuals obese, or overweight, burdened by excess lipids, insulin resistance, elevated glucose levels, and inflammation, that foster a number of medical conditions including diabetes. Strenuous overtraining has ensued adverse effects, including an upsurge of proinflammatory cytokines, and hyperglycemia. We implemented an one-month long innovative method with 20 diabetic and prediabetic patients. Results demonstrated a statistically significant reduction of both fasting and PP blood glucose. Fasting and PP insulin reached optimal levels. There was a substantial decline in dyslipidemia, reflecting a reverse relationship of elevated HDL versus triglycerides descending towards the normal range. The notable visceral fat reduction was validated by sonography reports that indicated no evidence of fatty liver in seven patients previously diagnosed with hepatic steatosis. These findings have important implications in improving the health status of obese diabetic and prediabetic individuals, by helping them jumpstart an active lifestyle, or by serving as an exercise alternative to reduce lipids, blood glucose levels and insulin resistance.展开更多
There is shortage of organs,including kidneys,worldwide.Along with deceased kidney transplantation,there is a significant rise in live kidney donation.The prevalence of prediabetes(PD),including impaired fasting gluco...There is shortage of organs,including kidneys,worldwide.Along with deceased kidney transplantation,there is a significant rise in live kidney donation.The prevalence of prediabetes(PD),including impaired fasting glucose and impaired glucose tolerance,is on the rise across the globe.Transplant teams frequently come across prediabetic kidney donors for evaluation.Prediabetics are at risk of diabetes,chronic kidney disease,cardiovascular events,stroke,neuropathy,retinopathy,dementia,depression and nonalcoholic liver disease along with increased risk of all-cause mortality.Unfortunately,most of the studies done in prediabetic kidney donors are retrospective in nature and have a short follow up period.There is lack of prospective long-term studies to know about the real risk of complications after donation.Furthermore,there are variations in recommendations from various guidelines across the globe for donations in prediabetics,leading to more confusion among clinicians.This increases the responsibility of transplant teams to take appropriate decisions in the best interest of both donors and recipients.This review focuses on pathophysiological changes of PD in kidneys,potential complications of PD,other risk factors for development of type 2 diabetes,a review of guidelines for kidney donation,the potential role of diabetes risk score and calculator in kidney donors and the way forward for the evaluation and selection of prediabetic kidney donors.展开更多
BACKGROUND Retinal microcirculation alterations are early indicators of diabetic microvascular complications.Optical coherence tomography angiography(OCTA)is a noninvasive method to assess these changes.This study ana...BACKGROUND Retinal microcirculation alterations are early indicators of diabetic microvascular complications.Optical coherence tomography angiography(OCTA)is a noninvasive method to assess these changes.This study analyzes changes in retinal microcirculation in prediabetic patients during short-term increases in blood glucose using OCTA.AIM To investigate the changes in retinal microcirculation in prediabetic patients experiencing short-term increases in blood glucose levels using OCTA.METHODS Fifty volunteers were divided into three groups:Group 1[impaired fasting glucose(IFG)or impaired glucose tolerance(IGT)],Group 2(both IFG and IGT),and a control group.Retinal microcirculation parameters,including vessel density(VD),perfusion density(PD),and foveal avascular zone(FAZ)metrics,were measured using OCTA.Correlations between these parameters and blood glucose levels were analyzed in both the fasting and postprandial states.RESULTS One hour after glucose intake,the central VD(P=0.023),central PD(P=0.026),and parafoveal PD(P<0.001)were significantly greater in the control group than in the fasting group.In Group 1,parafoveal PD(P<0.001)and FAZ circularity(P=0.023)also increased one hour after glucose intake.However,no significant changes were observed in the retinal microcirculation parameters of Group 2 before or after glucose intake(P>0.05).Compared with the control group,Group 1 had a larger FAZ area(P=0.032)and perimeter(P=0.018),whereas Group 2 had no significant differences in retinal microcirculation parameters compared with the control group(P>0.05).Compared with Group 1,Group 2 had greater central VD(P=0.013)and PD(P=0.008)and a smaller FAZ area(P=0.012)and perimeter(P=0.010).One hour after glucose intake,Group 1 had a larger FAZ area(P=0.044)and perimeter(P=0.038)than did the control group,whereas Group 2 showed no significant differences in retinal microcirculation parameters compared with the control group(P>0.05).Group 2 had greater central VD(P=0.042)and PD(P=0.022)and a smaller FAZ area(P=0.015)and perimeter(P=0.016)than Group 1.At fasting,central PD was significantly positively correlated with blood glucose levels(P=0.044),whereas no significant correlations were found between blood glucose levels and OCTA parameters one hour after glucose intake.CONCLUSION A short-term increase in blood glucose has a more pronounced effect on retinal microcirculation in prediabetic patients with either IFG or IGT.展开更多
It is well known that Diabetes Specific Nutritional Supplements (DSNSs) are linked to improved glycemic control in individuals with diabetes. However, data on efficacy of DSNSs in prediabetics is limited. This was a t...It is well known that Diabetes Specific Nutritional Supplements (DSNSs) are linked to improved glycemic control in individuals with diabetes. However, data on efficacy of DSNSs in prediabetics is limited. This was a two-armed, open-labelled, randomized controlled six-week study on 199 prediabetics [30 - 65 years;Glycosylated Hemoglobin (HbA1c) 5.7% - 6.4% and/or Fasting Blood Glucose (FBG) 100-125 mg/dl]. Two parallel phases were conducted: Acute Blood Glucose Response (ABGR) and Intervention phase. Prediabetic participants were randomized into test (n = 100) and control (n = 99). The primary objective was to assess the ABGR of DSNS versus an isocaloric snack, measured by incremental Area under the Curve (iAUC). Test and control received 60 g of DSNS and 56 g of isocaloric snack (cornflakes) respectively, both in 250 ml double-toned milk on visit days 1, 15, 29 and 43. Postprandial Blood Glucose (PPG) was estimated at 30, 60, 90, 120, 150 and 180 minutes. During the 4 weeks intervention phase, the test group received DSNS with lifestyle counselling (DSNS + LC) and was compared with the control receiving lifestyle counselling alone (LC alone). Impact was studied on FBG, HbA1C, anthropometry, body composition, blood pressure, nutrient intake, and physical activity. The impact of DSNS was also studied using CGM between two 14-day phases: CGM1 baseline (days 1 - 14) and CGM2 endline (days 28 - 42). DSNS showed significantly lower PPG versus isocaloric snack at 30 (p 12, and chromium were reported by DSNS + LC versus LC alone. No other significant changes were reported between groups. It may be concluded that DSNS may be considered as a snack for prediabetic or hyperglycemic individuals requiring nutritional support for improved glycemic control.展开更多
Diabetes Mellitus is one of the most prevalent diseases in the world. In Brazil, 8.7% of the population between 20 and 79 years of age has diabetes, estimating 11.6 million diabetics. It is commonly associated with ot...Diabetes Mellitus is one of the most prevalent diseases in the world. In Brazil, 8.7% of the population between 20 and 79 years of age has diabetes, estimating 11.6 million diabetics. It is commonly associated with other co-morbidities such as hypertension, dyslipidemia and obesity, which put these patients into a high cardiovascular risk profile. This study was performed using the medical records of enrolled population attending a Family Health Unit of Alto do Coqueirinho, Salvador, Northeastern Brazil, consisting of one doctor, one nurse, one dentist, one nursing technician and six community health workers. Medical records and data provided by the system of the Primary Care Information (SIAB), showed total of 2495 patients. Considering the prevalence morbidities in this population, hypertension was present in 9.8% of patients and Type 2 Diabetes in only 3.6%. Since the prevalence of morbidities is the key indicator to the development of public health policies, it seems important a better knowledge on the prevalence rates of diabetes, prediabetes and its co-morbidities of this population. Future plans and projects for health professionals will be based on a consistent medical record.展开更多
Type 2 diabetes(T2D)is an insidious disease associated with neural and vascular complications,acceleration of cardiovascular disease,changes in heart function,and premature death.In the newly released article of the J...Type 2 diabetes(T2D)is an insidious disease associated with neural and vascular complications,acceleration of cardiovascular disease,changes in heart function,and premature death.In the newly released article of the Journal of Sport and Health Science,Liang et al.1 describe results from the UK Biobank data showing the benefits of moderate-to-vigorous intensity physical activity(MVPA)on reducing the risks for vascular events in 11,474 adults with T2D and prediabetes.展开更多
Patients admitted with prediabetes and atrial fibrillation are at high risk for major adverse cardiac or cerebrovascular events independent of confounding variables.The shared pathophysiology between these three serio...Patients admitted with prediabetes and atrial fibrillation are at high risk for major adverse cardiac or cerebrovascular events independent of confounding variables.The shared pathophysiology between these three serious but common diseases and their association with atherosclerotic cardiovascular risk factors establish a vicious circle culminating in high atherogenicity.Because of that,it is of paramount importance to perform risk stratification of patients with prediabetes to define phenotypes that benefit from various interventions.Furthermore,stress hyperglycemia assessment of hospitalized patients and consensus on the definition of prediabetes is vital.The roles lifestyle and metformin play in prediabetes are well established.However,the role of glucagon-like peptide agonists and metabolic surgery is less clear.Prediabetes is considered an intermediate between normoglycemia and diabetes along the blood glucose continuum.One billion people are expected to suffer from prediabetes by the year 2045.Therefore,realworld randomized controlled trials to assess major adverse cardiac or cerebrovascular event risk reduction and reversal/prevention of type 2 diabetes among patients are needed to determine the proper interventions.展开更多
BACKGROUND Prediabetes mellitus(PDM)is receiving increasing attention as a precursor to type 2 diabetes mellitus.Lifestyle and traditional Chinese medicine(TCM)inter-ventions are effective for PDM prevention and treat...BACKGROUND Prediabetes mellitus(PDM)is receiving increasing attention as a precursor to type 2 diabetes mellitus.Lifestyle and traditional Chinese medicine(TCM)inter-ventions are effective for PDM prevention and treatment.Therefore,we con-ducted a preliminary investigation and an exploratory randomised controlled trial to assess the effects of a combined lifestyle and TCM intervention on PDM indicators.AIM To study the effectiveness of Xiaokeqing granules(XQG)and lifestyle inter-ventions in PDM participants while using metabolomics to identify potential markers.METHODS Forty PDM participants with yin deficiency syndrome with excessive heat were recruited and randomly allocated to the control(Con)group or the XQG group(20 per group).The Con group underwent lifestyle interventions,whereas the XQG group underwent lifestyle and XQG interventions.The follow-up duration was 2 months.Fasting blood glucose,2-hour postprandial glucose(2hPG),gly-cated haemoglobin A1c,fasting insulin,homeostasis model assessment-insulin resistance levels,and serum metabolomics characteristics were compared via liquid chromatography-tandem mass spectrometry analysis.RESULTS There were significant differences in 2hPG between the two groups(P<0.05)in the intention-to-treat analysis and per-protocol analysis.The intervention method used in this study was safe(P>0.05).Groenlandicine,kaempferol,isomangiferin,etc.,are the XQG constituents absorbed in the blood.N-Nervonoyl methionine and 5-hydroxy-L-tryptophan are core potential metabolomic biomarkers for the effectiveness of XQG and lifestyle interventions.HTR1A,HTR2C,SLC6A4,etc.,are the core targets of XQG and lifestyle interventions,as well as the reason for their clinical efficacy.Possible mechanistic pathways include tryptophan metabolism,pantothenate and certificate of analysis biosynthesis,lysine degradation and biosynthesis of cofactors.CONCLUSION This pilot study provides evidence that a combined XQG and lifestyle intervention can improve 2hPG in par-ticipants with PDM.The mechanism of action is related to multiple constituents,targets and pathways.展开更多
The current study aims to identify potential metabolic biomarkers that predict the progression to prediabetes in women with a history of gestational diabetes mellitus(GDM).We constructed a prediabetes group(n=42)and a...The current study aims to identify potential metabolic biomarkers that predict the progression to prediabetes in women with a history of gestational diabetes mellitus(GDM).We constructed a prediabetes group(n=42)and a control group(n=40)based on a 2-h 75 g oral glucose tolerance test for women with a history of GDM from six weeks to six months postpartum,and collected their clinical data and biochemical test results.We performed the plasma metabolomics analysis of the subjects at the fasting and 2-h post-load time points using ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UHPLC-Q-TOF-MS/MS).We found that the prediabetes group was older and had higher 2-h post-load glucose levels during pregnancy than the control group.The metabolomic analysis identified 164 differential metabolites between the groups.Compared with the control group,15 metabolites in the prediabetes group exhibited consistent change trends at both time points,including three increased and 12 decreased metabolites.By building a prediction model of the progression from GDM to prediabetes,we found that a combination of three clinical markers yielded an area under the curve(AUC)of 0.71(95%confidence interval[CI],0.60–0.82).We also assessed the discriminative power of the panel of 15 metabolites for distinguishing between postpartum prediabetes and normal glucose tolerance of the subjects at the fasting(AUC,0.98;95%CI,0.94–1.00)and 2-h post-load(AUC,0.99;95%CI,0.97–1.00)time points.The metabolic pathway analysis indicated that energy metabolism and branched-chain amino acids played a role in prediabetes development in women with a history of GDM during the early postpartum period.In conclusion,this study identified potential metabolic biomarkers and pathways associated with the progression from GDM to prediabetes in the early postpartum period.A panel of 15 metabolites showed promising discriminative power for distinguishing between postpartum prediabetes and normal glucose tolerance.These findings provide insights into the underlying pathophysiology of this transition and suggest the feasibility of developing a metabolic profiling test for the early identification of women at high risk of prediabetes following GDM.展开更多
Objective We examined the associations between obesity-related indices and the risk of diabetes progression from prediabetes in older adults,comparing the differences in using the American Diabetes Association(ADA)and...Objective We examined the associations between obesity-related indices and the risk of diabetes progression from prediabetes in older adults,comparing the differences in using the American Diabetes Association(ADA)and World Health Organization(WHO)criteria.Methods Data were obtained from the Healthy Aging Evaluation Longitudinal Study conducted in China.At baseline,prediabetes(in participants without diabetes)was classified based on fasting plasma glucose(FPG)levels using both criteria.Body mass index(BMI)and waist circumference(WC)were categorized according to data distribution and diagnostic cut-off values,respectively.Cox proportional hazards regression models were used to estimate the adjusted hazard ratios(aHRs)with 95%confidence intervals(CIs)for obesity-related indices and diabetes progression from prediabetes.Results Among the 1,127 participants classified as prediabetic according to the ADA criteria,474 met the WHO criteria.Under ADA-defined prediabetes,the highest WC quartile(≥93 cm)was significantly associated with an increased diabetes risk(aHR 1.93[1.06,3.53,P<0.05]),whereas BMI-related and cut-off-based abdominal obesity demonstrated no significant associations(P>0.05).Under WHOdefined prediabetes,both the high tertile of WC(≥90 cm)and general obesity(BMI≥28.0 kg/m^(2))were significantly associated with progression to diabetes(P<0.05),with aHR 2.13(1.06,4.27)and 2.44(1.19,5.01),respectively.However,cut-off-based abdominal obesity and the high BMI tertile(≥25.75 kg/m^(2))were not significantly associated with diabetes progression(P>0.05).Conclusion Elevated WC,rather than BMI-based indices or cut-off-based abdominal obesity,was significantly associated with diabetes progression according to the ADA-defined prediabetes criteria.However,both the evaluated WC and general obesity predicted progression to diabetes according to the WHO criteria.展开更多
BACKGROUND Previous research yielded conflicting results regarding the association between prediabetes and colorectal cancer(CRC).AIM To systematically assess the incidence of CRC in individuals with prediabetes compa...BACKGROUND Previous research yielded conflicting results regarding the association between prediabetes and colorectal cancer(CRC).AIM To systematically assess the incidence of CRC in individuals with prediabetes compared with individuals with normoglycemia via a meta-analysis.METHODS Relevant cohort studies were acquired by searching MEDLINE,Web of Science,and EMBASE.A random-effects model was applied to combine the findings after accounting for heterogeneity.Several subgroup analyses were conducted to assess the impact of study characteristics on the results.RESULTS Eleven cohort studies involving 4996352 participants,including 383917(7.7%)with prediabetes at baseline,were analyzed in this meta-analysis.Over a mean follow-up period of 6.5 years,the combined findings revealed that individuals with prediabetes at baseline had a higher likelihood of developing CRC than those with normoglycemia[risk ratio(RR)=1.18,95%confidence interval=1.11 to 1.25,P<0.001]with low statistical heterogeneity(I2=27%).Subgroup analyses indicated that the association between prediabetes and an increased risk of CRC was mainly observed in studies defining prediabetes using impaired fasting glucose(RR=1.24)and slightly elevated hemoglobin A1c levels(RR=1.18)but not in those that defined prediabetes using impaired glucose tolerance(RR=1.06).Other study characteristics such as design,country,participant age and sex,the duration of follow-up,or adjustment for body mass index did not significantly impact the results(all P>0.05).CONCLUSION People with prediabetes might have a higher likelihood of developing CRC than individuals with normoglycemia.展开更多
Objective:To explore the relationship between obesity,body fat percentage(BF%),blood lipid levels,and prediabetes.Methods:A total of 91 patients with prediabetes who visited the hospital from February 2024 to February...Objective:To explore the relationship between obesity,body fat percentage(BF%),blood lipid levels,and prediabetes.Methods:A total of 91 patients with prediabetes who visited the hospital from February 2024 to February 2025 were included in the observation group,and 90 healthy individuals with normal blood glucose levels during the same period were included in the control group.Physical examination,body fat percentage,and biochemical indicators were checked,and the relationship between these indicators and prediabetes was analyzed.Results:The observation group had higher body weight(BW),waist circumference(WC),body mass index(BMI),fat mass(FM),total cholesterol(TC),low-density lipoprotein(LDL),triglycerides(TG),fasting blood glucose(FBG),and 2-hour postprandial blood glucose(2hPG)compared to the control group,with P<0.05.The detection rates of obesity,abnormal WC,abnormal body fat percentage(BF%),abnormal TC,abnormal TG,and abnormal LDL were higher in the observation group than in the control group,with P<0.05.Multivariate logistic regression analysis showed that WC,TC,TG,BF%,and BMI were independent high-risk factors for prediabetes,with P<0.05.Conclusion:Obesity and dyslipidemia are high-risk factors for prediabetes.Scientific dietary planning and weight management should be implemented to reduce the incidence of diabetes.展开更多
BACKGROUND The dietary index for gut microbiota(DI-GM)demonstrates associations with diabetes prevalence and related mortality outcomes,serving as a nutritional assessment tool for microbial community evaluation.AIM T...BACKGROUND The dietary index for gut microbiota(DI-GM)demonstrates associations with diabetes prevalence and related mortality outcomes,serving as a nutritional assessment tool for microbial community evaluation.AIM To investigate connections between DI-GM values and survival endpoints in populations with impaired glucose metabolism,incorporating both total mortality and cardiovascular-related fatal events.METHODS Cox proportional hazards modeling through survival analysis evaluated the relationship between DI-GM quartile classifications and fatal event probabilities.Restricted cubic spline modeling evaluated non-linear associations between con-tinuous DI-GM values and mortality endpoints.Stratified analyses and robustness checks ensured the validity of the results.RESULTS Higher DI-GM values showed a statistically significant negative correlation with total mortality risk[hazard ratio(HR)=0.96,95%CI:0.93-1.00]and cardiovas-cular-related fatal outcomes(HR=0.93,95%CI:0.87-0.99).When comparing quartiles,analysis indicated that participants in the upper quartile(Q4)had 17%decreased likelihood of all-cause death(HR=0.83,95%CI:0.69-0.99)and 25%lower probability of cardiovascular mortality(HR=0.75,95%CI:0.54-1.00)relative to those in the lowest quartile(Q1).CONCLUSION These findings position DI-GM as a protective determinant against mortality in glucose metabolism disorders.Dietary pattern optimization targeting DI-GM enhancement could constitute a strategic intervention in diabetes care protocols.展开更多
BACKGROUND The impact of varying degrees of pregnancy-induced hypertension(PIH)on the risk of developing diabetes later in life is currently unknown.AIM To assess the long-term risks of type 2 diabetes mellitus(T2DM),...BACKGROUND The impact of varying degrees of pregnancy-induced hypertension(PIH)on the risk of developing diabetes later in life is currently unknown.AIM To assess the long-term risks of type 2 diabetes mellitus(T2DM),prediabetes,and mortality that are associated with hypertensive disorders of pregnancy.METHODS This retrospective cohort study used the TriNetX United States Collaborative Network to examine outcomes,especially T2DM,prediabetes and mortality,related to hypertensive disorders of pregnancy in females aged 21-45.Participants had no history of hypertension or diabetes before pregnancy or before 20 weeks of gestation.Propensity score matching was applied to balance covariates such as gestational diabetes,polycystic ovarian syndrome,chronic kidney disease,hy-perlipidemia,overweight/obesity,nicotine dependence,alcohol abuse,and healthcare utilization.This ensured comparability between groups and reduced potential confounding in outcome evaluation.RESULTS This study included 318544 females aged 21-45 with and without PIH.Females with PIH had higher risks of T2DM[hazard ratio(HR):1.907,95%confidence interval(CI):1.821-1.998),prediabetes(HR:1.610,95%CI:1.537-1.687),and mortality(HR:1.501,95%CI:1.361-1.655)over a follow-up of up to 18 years.Incidence rates for T2DM,prediabetes,and mortality were 3.2%,2.7%,and 0.6%,respectively.Subgroup analyses showed that the presence of gestational hypertension,preeclampsia,and eclampsia increased risks across all outcomes.Persistent hypertension beyond 12 weeks postpartum was linked to more than a 3-fold increase in mortality.Preventative aspirin use during pregnancy did not reduce the risks of T2DM,prediabetes,or mortality among those with PIH.CONCLUSION PIH significantly increases the long-term risks of T2DM,prediabetes,and mortality,highlighting the urgent need for improved long-term management strategies to enhance overall health in such individuals.展开更多
BACKGROUND Prediabetes is a high-risk precursor for diabetes development and is associated with increased psychological distress.Conventional pharmacological treatments for prediabetes have limitations,including adver...BACKGROUND Prediabetes is a high-risk precursor for diabetes development and is associated with increased psychological distress.Conventional pharmacological treatments for prediabetes have limitations,including adverse effects and poor patient compliance.Tuina’s abdominal vibration technique,a traditional non-pharmacological intervention,has shown promising results in glycemic regulation.However,its effects on psychological well-being remain largely unexplored.AIM To investigate efficacy of abdominal vibration at varying frequencies in Tuina for alleviating psychological and metabolic effects in prediabetes patients.METHODS A prospective cohort study(April 2025 to April 2026)at Dongfang Hospital of Beijing University of Chinese Medicine included 120 prediabetes patients.Participants were allocated to three groups based on vibration frequency:(1)Lowfrequency(400 times/minute,n=40);(2)Medium-frequency(500 times/minute,n=40);and(3)High-frequency(600 times/minute,n=40).All participants received 30-minute sessions three times weekly for 3 months,with follow-up at 6 months and 12 months.Primary outcomes included changes in depression(Beck Depression Inventory-Ⅱ),anxiety(State-Trait Anxiety Inventory),and stress(Perceived Stress Scale)levels.RESULTS After a 3-month intervention period,with follow-ups at 6 months and 12 months,patients in all three groups showed significant improvements in depression,anxiety,and stress scores compared to baseline(P<0.001).The high-frequency group demonstrated the most substantial psychological improvements(mean reduction in depression scores:9.2±2.3 points;anxiety:8.7±2.1 points;stress:10.4±2.5 points).These psychological improvements correlated significantly with reductions in insulin resistance(r=0.68,P<0.001).The high-frequency group also showed the most significant improvements in glycemic parameters,with mean reductions in fasting plasma glucose,2-hour postprandial glucose,and glycosylated hemoglobin concentrations of 0.92 mmol/L,1.87 mmol/L,and 0.51%,respectively.Correlation analysis revealed significant associations between improved psychological parameters and enhanced glycemic control.CONCLUSION Tuina’s abdominal vibration technique,especially at high frequency reduces depression,anxiety,and stress in prediabetes patients,correlating with enhanced glycemic control and insulin sensitivity,suggesting a bidirectional relationship between psychological and metabolic health.展开更多
Gestational diabetes mellitus(GDM)is the most common metabolic abnormality of pregnancy and is associated with early and late adverse outcomes for both mothers and fetuses.Conventionally,GDM is diagnosed between 24 an...Gestational diabetes mellitus(GDM)is the most common metabolic abnormality of pregnancy and is associated with early and late adverse outcomes for both mothers and fetuses.Conventionally,GDM is diagnosed between 24 and 28 gestational weeks(GW)(late-onset GDM).With the increasing prevalence of prediabetes among women of reproductive age,GDM is increasingly being diagnosed before 24 GW in high-risk populations(early-onset GDM).Compared with late-onset GDM pregnancies,early-onset GDM pregnancies are at greater risk for neonatal adverse events,such as perinatal mortality,neonatal hypoglycemia,neonatal respiratory distress syndrome,and macrosomia.The TOBOGM study revealed that the initiation of treatment before 20 GW can modestly reduce composite neonatal outcomes,mainly due to a reduction in the rate of neonatal respiratory distress syndrome.The benefit was greater when treatment was initiated before 14 GW.The probable mechanisms for early-onset hyper-glycemiainduced neonatal adverse events are decidual and placental defects,interference with fetal lung development,and fetal glucose steal.There is no international consensus on the GDM screening strategy in early pregnancy,and its cost-effectiveness is questioned by several professional bodies.Further prospective randomized controlled studies are strongly recommended to alleviate confusion in clinical practice regarding the management of mild hyperglycemia in early pregnancy.展开更多
BACKGROUND Epigenetic regulation of leptin(LEP)plays a critical role in metabolic disorders,yet its promoter methylation patterns in lean diabetic populations remain poorly characterized.Emerging evidence suggests DNA...BACKGROUND Epigenetic regulation of leptin(LEP)plays a critical role in metabolic disorders,yet its promoter methylation patterns in lean diabetic populations remain poorly characterized.Emerging evidence suggests DNA methylation may precede clinical hyperglycemia,offering potential for early risk stratification.While obesity-associated LEP methylation is well-studied,lean Asian populations who exhibit high diabetes prevalence despite lower adiposity,represent an underexplored cohort.This study hypothesizes that LEP promoter methylation in peripheral leukocytes decreases progressively from normoglycemia to prediabetes and type 2 diabetes mellitus(T2DM),correlating inversely with serum LEP levels in lean Chinese adults[body mass index(BMI)<24 kg/m^(2)].AIM To investigate LEP promoter methylation status and its association with serum LEP levels across glycemic states in lean Chinese adults.METHODS We enrolled 392 participants including 120 normoglycemic controls,94 prediabetes[44 impaired fasting glucose(IFG)/50 impaired glucose tolerance(IGT)],178 T2DM aged 40-60 years with BMI<24 kg/m^(2).Genomic DNA from peripheral leukocytes underwent bisulfite conversion followed by methylation-specific PCR to assess CpG methylation in the LEP promoter.Serum LEP was quantified via enzyme-linked immunosorbent assay,with other parameters measured through standard assays.Statistical analyses included analysis of variance,χ²tests,and Pearson correlation(Bonferroni-corrected P value).RESULTS Methylation frequencies declined progressively:59.2%(controls)reduced to 43.6%(prediabetes;IFG:38.6%,IGT:48%)reduced to 31.5%(T2DM)(all P<0.05 vs controls;T2DM vs IGT:P=0.030).Serum LEP levels increased significantly in T2DM(16.94±4.19μg/L)vs controls(11.33±3.10μg/L;P=0.002),with intermediate values in prediabetes(IFG:13.79±3.32μg/L;IGT:12.62±4.81μg/L).A near-perfect inverse correlation between methylation and LEP levels was observed(r=-0.95,95%CI:-0.97 to-0.92,P<0.001),persisting after adjusting for age and BMI(β=-0.91,P<0.001).CONCLUSION LEP promoter hypomethylation parallels worsening glycemic status in lean Chinese adults,suggesting its potential as a blood-based epigenetic biomarker for diabetes progression,pending validation in longitudinal cohorts.展开更多
基金Supported by National Natural Science Foundation of China,No.82370818 and No.82270862the Natural Science Foundation of Guangdong Province,No.2024A1515012744+1 种基金the Guangzhou Science and Technology Project,No.2025A04J3541the National Undergraduate Training Program for Innovation and Entrepreneurship,Southern Medical University,No.202312121031 and No.S202312121167.
文摘BACKGROUND Patients with prediabetes are at increased risk of developing cardiovascular disease.The Life's Essential 8(LE8)score,updated by the American Heart Association in 2022,is a tool used to quantify cardiovascular health(CVH).Quantifying healthy living status on the basis of the uniform standard LE8 will be useful for confirming whether health interventions can reduce the risk of death in prediabetic patients.AIM To investigate the associations between all-cause mortality risk and CVH status(as quantified by the LE8 score)in prediabetic patients.METHODS This study included 5344 participants with prediabetes(age:52.9±15.8 years;51.6%men).The LE8 score includes four health indicators and four health behaviors.Cox proportional hazard ratios were calculated for all-cause mortality in the high CVH(LE8≥80),low CVH(LE8≤50),and moderate CVH(LE850-79)subgroups,and restricted cubic spline analyses were performed.Separate analyses of the associations of all-cause mortality risk with each LE8 component and CVH health behaviors and indicators were also performed.RESULTS In the median follow-up period of 8.33 years,658 deaths occurred.Compared with those among participants with high CVH,the covariate-adjusted HRs(95%confidence intervals)for mortality among participants with moderate and low CVH were 2.55(1.23-5.31)and 3.92(1.70-9.02),respectively.There was a linear relationship between an improvement in CVH status and a reduction in all-cause mortality risk(P-overall<0.0001,P-nonlinear=0.7989).Improved CVH health behaviors had a more significant protective effect on patients with prediabetes than did the improvement in CVH health indicators.CONCLUSION High CVH status(as quantified by the LE8 score)is significantly associated with reduced mortality risk in prediabetic adults in the United States.
基金Supported by A PSC-CUNY Award,jointly funded by The Professional Staff Congress and The City University of New York
文摘AIM:To investigate normoglycemic,prediabetic and diabetic A1c levels in those with prediabetes;and prediabetic and diabetic A1c levels in those with non-prediabetes.METHODS:The National Health and Nutritional Examination Survey(NHANES)2007-2008 and NHANES2009-2010 were utilized to examine and compare trends and differences among five different ethnic groups(Mexican Americans,Other Hispanics,NonHispanic Whites,Non-Hispanic Blacks,Other/Multiracials)with normoglycemic,prediabetic and diabetic A1c levels with self-reported prediabetes and prediabetic and diabetic A1c levels in those with self-reported non-prediabetes.Sample participants of the five ethnic groups were limited to those 20 years of age and older,who had completed the diabetes questionnaire and had A1c measured.Descriptive statistics were computed for all variables.χ2were performed on all five ethnic groups to examine significant differences of normoglycemic,prediabetic and diabetic A1c levels in those with self-reported prediabetes,and prediabetic and diabetic A1c levels in those with self-reported non-prediabetes.RESULTS:This study demonstrates that of the five different ethnic groups from NHANES 2007-2008 to NHANES 2009-2010,Non-Hispanic Whites(6.5%increase)and Non-Hispanic Blacks(0.2%increase)were the only two groups with an increase in the number of self-reported prediabetes.Although the overall percentage of Mexican Americans who self-reported prediabetes had remained the same(5%)from NHANES2007-2008 to NHANES 2009-2010,χ2analysis showed significant differences when examining the different ranges of A1c levels(normoglycemic,prediabetic and diabetic).Among Mexican Americans who self-reported prediabetes,normoglycemic(P=0.0001)and diabetic(P=0.0001)A1c levels from NHANES 2007-2008 to NHANES 2009-2010.For Non-Hispanic Whites who self-reported prediabetes,prediabetic(P=0.0222);and diabetic(P≤0.0001)A1c levels from NHANES2007-2008 to NHANES 2009-2010.For Non-Hispanic Blacks who self-reported prediabetes,there were significant differences(P=0.0001)for all A1c levels(normoglycemic,prediabetic and diabetic A1c levels).For Other/Multi-racials with self-reported prediabetes there was significant differences in those with normoglycemic(P=0.0104)and diabetic(P=0.0067)A1c levels from NHANES 2007-2008 to NHANES 2009-2010.For all combined ethnic groups who self-reported not having prediabetes(non-prediabetes),19.9%of those in NHANES 2007-2008 and 22.4%in the NHANES2009-2010 showed to have prediabetic A1c levels.When separately examining each of the five ethnic groups who self-reported not having prediabetes,all showed an increase in those with prediabetic A1c levels from NHANES 2007-2008 to NHANES 2009-2010.Throughχ2analysis,all five ethnic groups who selfreported not having prediabetes showed significant differences(P<0.0001)in all A1c levels(normoglycemic,prediabetic and diabetic)from NHANES 2007-2008 to NHANES 2009-2010.CONCLUSION:The findings highlight the need of prediabetes awareness and of education in the community as ways to reduce the number of people with prediabetes.
文摘Sedentary lifestyles promote adipose tissue accumulation that generates systemic inflammation and oxidative damage. Physical activity induces cardiovascular fitness, increases muscle mass, and healthy blood glucose regulation, while reducing visceral fat, triglycerides and low-density lipoproteins. It is theoretically possible to develop a long-term multi-exercise regimen for health management and enhancement. Pragmatically, time and career restraints, individual choices, genetic factors, or demoralization due to the draconian commitment involved in weight loss, have rendered over a billion of individuals obese, or overweight, burdened by excess lipids, insulin resistance, elevated glucose levels, and inflammation, that foster a number of medical conditions including diabetes. Strenuous overtraining has ensued adverse effects, including an upsurge of proinflammatory cytokines, and hyperglycemia. We implemented an one-month long innovative method with 20 diabetic and prediabetic patients. Results demonstrated a statistically significant reduction of both fasting and PP blood glucose. Fasting and PP insulin reached optimal levels. There was a substantial decline in dyslipidemia, reflecting a reverse relationship of elevated HDL versus triglycerides descending towards the normal range. The notable visceral fat reduction was validated by sonography reports that indicated no evidence of fatty liver in seven patients previously diagnosed with hepatic steatosis. These findings have important implications in improving the health status of obese diabetic and prediabetic individuals, by helping them jumpstart an active lifestyle, or by serving as an exercise alternative to reduce lipids, blood glucose levels and insulin resistance.
文摘There is shortage of organs,including kidneys,worldwide.Along with deceased kidney transplantation,there is a significant rise in live kidney donation.The prevalence of prediabetes(PD),including impaired fasting glucose and impaired glucose tolerance,is on the rise across the globe.Transplant teams frequently come across prediabetic kidney donors for evaluation.Prediabetics are at risk of diabetes,chronic kidney disease,cardiovascular events,stroke,neuropathy,retinopathy,dementia,depression and nonalcoholic liver disease along with increased risk of all-cause mortality.Unfortunately,most of the studies done in prediabetic kidney donors are retrospective in nature and have a short follow up period.There is lack of prospective long-term studies to know about the real risk of complications after donation.Furthermore,there are variations in recommendations from various guidelines across the globe for donations in prediabetics,leading to more confusion among clinicians.This increases the responsibility of transplant teams to take appropriate decisions in the best interest of both donors and recipients.This review focuses on pathophysiological changes of PD in kidneys,potential complications of PD,other risk factors for development of type 2 diabetes,a review of guidelines for kidney donation,the potential role of diabetes risk score and calculator in kidney donors and the way forward for the evaluation and selection of prediabetic kidney donors.
基金Supported by The Project Foundation of Chongqing Science and Technology Commission of China,No.cstc2018jcyjAX0798.
文摘BACKGROUND Retinal microcirculation alterations are early indicators of diabetic microvascular complications.Optical coherence tomography angiography(OCTA)is a noninvasive method to assess these changes.This study analyzes changes in retinal microcirculation in prediabetic patients during short-term increases in blood glucose using OCTA.AIM To investigate the changes in retinal microcirculation in prediabetic patients experiencing short-term increases in blood glucose levels using OCTA.METHODS Fifty volunteers were divided into three groups:Group 1[impaired fasting glucose(IFG)or impaired glucose tolerance(IGT)],Group 2(both IFG and IGT),and a control group.Retinal microcirculation parameters,including vessel density(VD),perfusion density(PD),and foveal avascular zone(FAZ)metrics,were measured using OCTA.Correlations between these parameters and blood glucose levels were analyzed in both the fasting and postprandial states.RESULTS One hour after glucose intake,the central VD(P=0.023),central PD(P=0.026),and parafoveal PD(P<0.001)were significantly greater in the control group than in the fasting group.In Group 1,parafoveal PD(P<0.001)and FAZ circularity(P=0.023)also increased one hour after glucose intake.However,no significant changes were observed in the retinal microcirculation parameters of Group 2 before or after glucose intake(P>0.05).Compared with the control group,Group 1 had a larger FAZ area(P=0.032)and perimeter(P=0.018),whereas Group 2 had no significant differences in retinal microcirculation parameters compared with the control group(P>0.05).Compared with Group 1,Group 2 had greater central VD(P=0.013)and PD(P=0.008)and a smaller FAZ area(P=0.012)and perimeter(P=0.010).One hour after glucose intake,Group 1 had a larger FAZ area(P=0.044)and perimeter(P=0.038)than did the control group,whereas Group 2 showed no significant differences in retinal microcirculation parameters compared with the control group(P>0.05).Group 2 had greater central VD(P=0.042)and PD(P=0.022)and a smaller FAZ area(P=0.015)and perimeter(P=0.016)than Group 1.At fasting,central PD was significantly positively correlated with blood glucose levels(P=0.044),whereas no significant correlations were found between blood glucose levels and OCTA parameters one hour after glucose intake.CONCLUSION A short-term increase in blood glucose has a more pronounced effect on retinal microcirculation in prediabetic patients with either IFG or IGT.
文摘It is well known that Diabetes Specific Nutritional Supplements (DSNSs) are linked to improved glycemic control in individuals with diabetes. However, data on efficacy of DSNSs in prediabetics is limited. This was a two-armed, open-labelled, randomized controlled six-week study on 199 prediabetics [30 - 65 years;Glycosylated Hemoglobin (HbA1c) 5.7% - 6.4% and/or Fasting Blood Glucose (FBG) 100-125 mg/dl]. Two parallel phases were conducted: Acute Blood Glucose Response (ABGR) and Intervention phase. Prediabetic participants were randomized into test (n = 100) and control (n = 99). The primary objective was to assess the ABGR of DSNS versus an isocaloric snack, measured by incremental Area under the Curve (iAUC). Test and control received 60 g of DSNS and 56 g of isocaloric snack (cornflakes) respectively, both in 250 ml double-toned milk on visit days 1, 15, 29 and 43. Postprandial Blood Glucose (PPG) was estimated at 30, 60, 90, 120, 150 and 180 minutes. During the 4 weeks intervention phase, the test group received DSNS with lifestyle counselling (DSNS + LC) and was compared with the control receiving lifestyle counselling alone (LC alone). Impact was studied on FBG, HbA1C, anthropometry, body composition, blood pressure, nutrient intake, and physical activity. The impact of DSNS was also studied using CGM between two 14-day phases: CGM1 baseline (days 1 - 14) and CGM2 endline (days 28 - 42). DSNS showed significantly lower PPG versus isocaloric snack at 30 (p 12, and chromium were reported by DSNS + LC versus LC alone. No other significant changes were reported between groups. It may be concluded that DSNS may be considered as a snack for prediabetic or hyperglycemic individuals requiring nutritional support for improved glycemic control.
文摘Diabetes Mellitus is one of the most prevalent diseases in the world. In Brazil, 8.7% of the population between 20 and 79 years of age has diabetes, estimating 11.6 million diabetics. It is commonly associated with other co-morbidities such as hypertension, dyslipidemia and obesity, which put these patients into a high cardiovascular risk profile. This study was performed using the medical records of enrolled population attending a Family Health Unit of Alto do Coqueirinho, Salvador, Northeastern Brazil, consisting of one doctor, one nurse, one dentist, one nursing technician and six community health workers. Medical records and data provided by the system of the Primary Care Information (SIAB), showed total of 2495 patients. Considering the prevalence morbidities in this population, hypertension was present in 9.8% of patients and Type 2 Diabetes in only 3.6%. Since the prevalence of morbidities is the key indicator to the development of public health policies, it seems important a better knowledge on the prevalence rates of diabetes, prediabetes and its co-morbidities of this population. Future plans and projects for health professionals will be based on a consistent medical record.
文摘Type 2 diabetes(T2D)is an insidious disease associated with neural and vascular complications,acceleration of cardiovascular disease,changes in heart function,and premature death.In the newly released article of the Journal of Sport and Health Science,Liang et al.1 describe results from the UK Biobank data showing the benefits of moderate-to-vigorous intensity physical activity(MVPA)on reducing the risks for vascular events in 11,474 adults with T2D and prediabetes.
文摘Patients admitted with prediabetes and atrial fibrillation are at high risk for major adverse cardiac or cerebrovascular events independent of confounding variables.The shared pathophysiology between these three serious but common diseases and their association with atherosclerotic cardiovascular risk factors establish a vicious circle culminating in high atherogenicity.Because of that,it is of paramount importance to perform risk stratification of patients with prediabetes to define phenotypes that benefit from various interventions.Furthermore,stress hyperglycemia assessment of hospitalized patients and consensus on the definition of prediabetes is vital.The roles lifestyle and metformin play in prediabetes are well established.However,the role of glucagon-like peptide agonists and metabolic surgery is less clear.Prediabetes is considered an intermediate between normoglycemia and diabetes along the blood glucose continuum.One billion people are expected to suffer from prediabetes by the year 2045.Therefore,realworld randomized controlled trials to assess major adverse cardiac or cerebrovascular event risk reduction and reversal/prevention of type 2 diabetes among patients are needed to determine the proper interventions.
基金Supported by the Open Bidding for Selecting the Best Candidates for Xin’an Medicine and the Modernization of Traditional Chinese Medicine of IHM,No.2023CXMMTCM024 and No.2023CXMMTCM003the Anhui University Collaborative Innovation Project,No.GXXT-2020-025+2 种基金the Scientific Research Project of Health and Wellness in Anhui Province,No.AHWJ2023BAc10002the Anhui Province New Era Education Quality Project,No.2023gjxslt014and the Clinical and Translational Research Project of Anhui Province,No.202427b10020046.
文摘BACKGROUND Prediabetes mellitus(PDM)is receiving increasing attention as a precursor to type 2 diabetes mellitus.Lifestyle and traditional Chinese medicine(TCM)inter-ventions are effective for PDM prevention and treatment.Therefore,we con-ducted a preliminary investigation and an exploratory randomised controlled trial to assess the effects of a combined lifestyle and TCM intervention on PDM indicators.AIM To study the effectiveness of Xiaokeqing granules(XQG)and lifestyle inter-ventions in PDM participants while using metabolomics to identify potential markers.METHODS Forty PDM participants with yin deficiency syndrome with excessive heat were recruited and randomly allocated to the control(Con)group or the XQG group(20 per group).The Con group underwent lifestyle interventions,whereas the XQG group underwent lifestyle and XQG interventions.The follow-up duration was 2 months.Fasting blood glucose,2-hour postprandial glucose(2hPG),gly-cated haemoglobin A1c,fasting insulin,homeostasis model assessment-insulin resistance levels,and serum metabolomics characteristics were compared via liquid chromatography-tandem mass spectrometry analysis.RESULTS There were significant differences in 2hPG between the two groups(P<0.05)in the intention-to-treat analysis and per-protocol analysis.The intervention method used in this study was safe(P>0.05).Groenlandicine,kaempferol,isomangiferin,etc.,are the XQG constituents absorbed in the blood.N-Nervonoyl methionine and 5-hydroxy-L-tryptophan are core potential metabolomic biomarkers for the effectiveness of XQG and lifestyle interventions.HTR1A,HTR2C,SLC6A4,etc.,are the core targets of XQG and lifestyle interventions,as well as the reason for their clinical efficacy.Possible mechanistic pathways include tryptophan metabolism,pantothenate and certificate of analysis biosynthesis,lysine degradation and biosynthesis of cofactors.CONCLUSION This pilot study provides evidence that a combined XQG and lifestyle intervention can improve 2hPG in par-ticipants with PDM.The mechanism of action is related to multiple constituents,targets and pathways.
基金supported by Key Medical Research Projects of Jiangsu Commission of Health(Grant No.ZD2022023).
文摘The current study aims to identify potential metabolic biomarkers that predict the progression to prediabetes in women with a history of gestational diabetes mellitus(GDM).We constructed a prediabetes group(n=42)and a control group(n=40)based on a 2-h 75 g oral glucose tolerance test for women with a history of GDM from six weeks to six months postpartum,and collected their clinical data and biochemical test results.We performed the plasma metabolomics analysis of the subjects at the fasting and 2-h post-load time points using ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UHPLC-Q-TOF-MS/MS).We found that the prediabetes group was older and had higher 2-h post-load glucose levels during pregnancy than the control group.The metabolomic analysis identified 164 differential metabolites between the groups.Compared with the control group,15 metabolites in the prediabetes group exhibited consistent change trends at both time points,including three increased and 12 decreased metabolites.By building a prediction model of the progression from GDM to prediabetes,we found that a combination of three clinical markers yielded an area under the curve(AUC)of 0.71(95%confidence interval[CI],0.60–0.82).We also assessed the discriminative power of the panel of 15 metabolites for distinguishing between postpartum prediabetes and normal glucose tolerance of the subjects at the fasting(AUC,0.98;95%CI,0.94–1.00)and 2-h post-load(AUC,0.99;95%CI,0.97–1.00)time points.The metabolic pathway analysis indicated that energy metabolism and branched-chain amino acids played a role in prediabetes development in women with a history of GDM during the early postpartum period.In conclusion,this study identified potential metabolic biomarkers and pathways associated with the progression from GDM to prediabetes in the early postpartum period.A panel of 15 metabolites showed promising discriminative power for distinguishing between postpartum prediabetes and normal glucose tolerance.These findings provide insights into the underlying pathophysiology of this transition and suggest the feasibility of developing a metabolic profiling test for the early identification of women at high risk of prediabetes following GDM.
文摘Objective We examined the associations between obesity-related indices and the risk of diabetes progression from prediabetes in older adults,comparing the differences in using the American Diabetes Association(ADA)and World Health Organization(WHO)criteria.Methods Data were obtained from the Healthy Aging Evaluation Longitudinal Study conducted in China.At baseline,prediabetes(in participants without diabetes)was classified based on fasting plasma glucose(FPG)levels using both criteria.Body mass index(BMI)and waist circumference(WC)were categorized according to data distribution and diagnostic cut-off values,respectively.Cox proportional hazards regression models were used to estimate the adjusted hazard ratios(aHRs)with 95%confidence intervals(CIs)for obesity-related indices and diabetes progression from prediabetes.Results Among the 1,127 participants classified as prediabetic according to the ADA criteria,474 met the WHO criteria.Under ADA-defined prediabetes,the highest WC quartile(≥93 cm)was significantly associated with an increased diabetes risk(aHR 1.93[1.06,3.53,P<0.05]),whereas BMI-related and cut-off-based abdominal obesity demonstrated no significant associations(P>0.05).Under WHOdefined prediabetes,both the high tertile of WC(≥90 cm)and general obesity(BMI≥28.0 kg/m^(2))were significantly associated with progression to diabetes(P<0.05),with aHR 2.13(1.06,4.27)and 2.44(1.19,5.01),respectively.However,cut-off-based abdominal obesity and the high BMI tertile(≥25.75 kg/m^(2))were not significantly associated with diabetes progression(P>0.05).Conclusion Elevated WC,rather than BMI-based indices or cut-off-based abdominal obesity,was significantly associated with diabetes progression according to the ADA-defined prediabetes criteria.However,both the evaluated WC and general obesity predicted progression to diabetes according to the WHO criteria.
基金Supported by National High Level Hospital Clinical Research Funding,No.2023-NHLHCRF-YXHZ-ZRMS-06.
文摘BACKGROUND Previous research yielded conflicting results regarding the association between prediabetes and colorectal cancer(CRC).AIM To systematically assess the incidence of CRC in individuals with prediabetes compared with individuals with normoglycemia via a meta-analysis.METHODS Relevant cohort studies were acquired by searching MEDLINE,Web of Science,and EMBASE.A random-effects model was applied to combine the findings after accounting for heterogeneity.Several subgroup analyses were conducted to assess the impact of study characteristics on the results.RESULTS Eleven cohort studies involving 4996352 participants,including 383917(7.7%)with prediabetes at baseline,were analyzed in this meta-analysis.Over a mean follow-up period of 6.5 years,the combined findings revealed that individuals with prediabetes at baseline had a higher likelihood of developing CRC than those with normoglycemia[risk ratio(RR)=1.18,95%confidence interval=1.11 to 1.25,P<0.001]with low statistical heterogeneity(I2=27%).Subgroup analyses indicated that the association between prediabetes and an increased risk of CRC was mainly observed in studies defining prediabetes using impaired fasting glucose(RR=1.24)and slightly elevated hemoglobin A1c levels(RR=1.18)but not in those that defined prediabetes using impaired glucose tolerance(RR=1.06).Other study characteristics such as design,country,participant age and sex,the duration of follow-up,or adjustment for body mass index did not significantly impact the results(all P>0.05).CONCLUSION People with prediabetes might have a higher likelihood of developing CRC than individuals with normoglycemia.
文摘Objective:To explore the relationship between obesity,body fat percentage(BF%),blood lipid levels,and prediabetes.Methods:A total of 91 patients with prediabetes who visited the hospital from February 2024 to February 2025 were included in the observation group,and 90 healthy individuals with normal blood glucose levels during the same period were included in the control group.Physical examination,body fat percentage,and biochemical indicators were checked,and the relationship between these indicators and prediabetes was analyzed.Results:The observation group had higher body weight(BW),waist circumference(WC),body mass index(BMI),fat mass(FM),total cholesterol(TC),low-density lipoprotein(LDL),triglycerides(TG),fasting blood glucose(FBG),and 2-hour postprandial blood glucose(2hPG)compared to the control group,with P<0.05.The detection rates of obesity,abnormal WC,abnormal body fat percentage(BF%),abnormal TC,abnormal TG,and abnormal LDL were higher in the observation group than in the control group,with P<0.05.Multivariate logistic regression analysis showed that WC,TC,TG,BF%,and BMI were independent high-risk factors for prediabetes,with P<0.05.Conclusion:Obesity and dyslipidemia are high-risk factors for prediabetes.Scientific dietary planning and weight management should be implemented to reduce the incidence of diabetes.
文摘BACKGROUND The dietary index for gut microbiota(DI-GM)demonstrates associations with diabetes prevalence and related mortality outcomes,serving as a nutritional assessment tool for microbial community evaluation.AIM To investigate connections between DI-GM values and survival endpoints in populations with impaired glucose metabolism,incorporating both total mortality and cardiovascular-related fatal events.METHODS Cox proportional hazards modeling through survival analysis evaluated the relationship between DI-GM quartile classifications and fatal event probabilities.Restricted cubic spline modeling evaluated non-linear associations between con-tinuous DI-GM values and mortality endpoints.Stratified analyses and robustness checks ensured the validity of the results.RESULTS Higher DI-GM values showed a statistically significant negative correlation with total mortality risk[hazard ratio(HR)=0.96,95%CI:0.93-1.00]and cardiovas-cular-related fatal outcomes(HR=0.93,95%CI:0.87-0.99).When comparing quartiles,analysis indicated that participants in the upper quartile(Q4)had 17%decreased likelihood of all-cause death(HR=0.83,95%CI:0.69-0.99)and 25%lower probability of cardiovascular mortality(HR=0.75,95%CI:0.54-1.00)relative to those in the lowest quartile(Q1).CONCLUSION These findings position DI-GM as a protective determinant against mortality in glucose metabolism disorders.Dietary pattern optimization targeting DI-GM enhancement could constitute a strategic intervention in diabetes care protocols.
基金Supported by Chung Shan Medical University,No.CSMU-INT-113-14.
文摘BACKGROUND The impact of varying degrees of pregnancy-induced hypertension(PIH)on the risk of developing diabetes later in life is currently unknown.AIM To assess the long-term risks of type 2 diabetes mellitus(T2DM),prediabetes,and mortality that are associated with hypertensive disorders of pregnancy.METHODS This retrospective cohort study used the TriNetX United States Collaborative Network to examine outcomes,especially T2DM,prediabetes and mortality,related to hypertensive disorders of pregnancy in females aged 21-45.Participants had no history of hypertension or diabetes before pregnancy or before 20 weeks of gestation.Propensity score matching was applied to balance covariates such as gestational diabetes,polycystic ovarian syndrome,chronic kidney disease,hy-perlipidemia,overweight/obesity,nicotine dependence,alcohol abuse,and healthcare utilization.This ensured comparability between groups and reduced potential confounding in outcome evaluation.RESULTS This study included 318544 females aged 21-45 with and without PIH.Females with PIH had higher risks of T2DM[hazard ratio(HR):1.907,95%confidence interval(CI):1.821-1.998),prediabetes(HR:1.610,95%CI:1.537-1.687),and mortality(HR:1.501,95%CI:1.361-1.655)over a follow-up of up to 18 years.Incidence rates for T2DM,prediabetes,and mortality were 3.2%,2.7%,and 0.6%,respectively.Subgroup analyses showed that the presence of gestational hypertension,preeclampsia,and eclampsia increased risks across all outcomes.Persistent hypertension beyond 12 weeks postpartum was linked to more than a 3-fold increase in mortality.Preventative aspirin use during pregnancy did not reduce the risks of T2DM,prediabetes,or mortality among those with PIH.CONCLUSION PIH significantly increases the long-term risks of T2DM,prediabetes,and mortality,highlighting the urgent need for improved long-term management strategies to enhance overall health in such individuals.
基金Supported by National High Level Chinese Medicine Hospital Clinical Research Funding,No.DFGZRA-2024GJRC010The Fundamental Research Funds for the Central Universities,No.2024-JYB-JBZD-031.
文摘BACKGROUND Prediabetes is a high-risk precursor for diabetes development and is associated with increased psychological distress.Conventional pharmacological treatments for prediabetes have limitations,including adverse effects and poor patient compliance.Tuina’s abdominal vibration technique,a traditional non-pharmacological intervention,has shown promising results in glycemic regulation.However,its effects on psychological well-being remain largely unexplored.AIM To investigate efficacy of abdominal vibration at varying frequencies in Tuina for alleviating psychological and metabolic effects in prediabetes patients.METHODS A prospective cohort study(April 2025 to April 2026)at Dongfang Hospital of Beijing University of Chinese Medicine included 120 prediabetes patients.Participants were allocated to three groups based on vibration frequency:(1)Lowfrequency(400 times/minute,n=40);(2)Medium-frequency(500 times/minute,n=40);and(3)High-frequency(600 times/minute,n=40).All participants received 30-minute sessions three times weekly for 3 months,with follow-up at 6 months and 12 months.Primary outcomes included changes in depression(Beck Depression Inventory-Ⅱ),anxiety(State-Trait Anxiety Inventory),and stress(Perceived Stress Scale)levels.RESULTS After a 3-month intervention period,with follow-ups at 6 months and 12 months,patients in all three groups showed significant improvements in depression,anxiety,and stress scores compared to baseline(P<0.001).The high-frequency group demonstrated the most substantial psychological improvements(mean reduction in depression scores:9.2±2.3 points;anxiety:8.7±2.1 points;stress:10.4±2.5 points).These psychological improvements correlated significantly with reductions in insulin resistance(r=0.68,P<0.001).The high-frequency group also showed the most significant improvements in glycemic parameters,with mean reductions in fasting plasma glucose,2-hour postprandial glucose,and glycosylated hemoglobin concentrations of 0.92 mmol/L,1.87 mmol/L,and 0.51%,respectively.Correlation analysis revealed significant associations between improved psychological parameters and enhanced glycemic control.CONCLUSION Tuina’s abdominal vibration technique,especially at high frequency reduces depression,anxiety,and stress in prediabetes patients,correlating with enhanced glycemic control and insulin sensitivity,suggesting a bidirectional relationship between psychological and metabolic health.
文摘Gestational diabetes mellitus(GDM)is the most common metabolic abnormality of pregnancy and is associated with early and late adverse outcomes for both mothers and fetuses.Conventionally,GDM is diagnosed between 24 and 28 gestational weeks(GW)(late-onset GDM).With the increasing prevalence of prediabetes among women of reproductive age,GDM is increasingly being diagnosed before 24 GW in high-risk populations(early-onset GDM).Compared with late-onset GDM pregnancies,early-onset GDM pregnancies are at greater risk for neonatal adverse events,such as perinatal mortality,neonatal hypoglycemia,neonatal respiratory distress syndrome,and macrosomia.The TOBOGM study revealed that the initiation of treatment before 20 GW can modestly reduce composite neonatal outcomes,mainly due to a reduction in the rate of neonatal respiratory distress syndrome.The benefit was greater when treatment was initiated before 14 GW.The probable mechanisms for early-onset hyper-glycemiainduced neonatal adverse events are decidual and placental defects,interference with fetal lung development,and fetal glucose steal.There is no international consensus on the GDM screening strategy in early pregnancy,and its cost-effectiveness is questioned by several professional bodies.Further prospective randomized controlled studies are strongly recommended to alleviate confusion in clinical practice regarding the management of mild hyperglycemia in early pregnancy.
文摘BACKGROUND Epigenetic regulation of leptin(LEP)plays a critical role in metabolic disorders,yet its promoter methylation patterns in lean diabetic populations remain poorly characterized.Emerging evidence suggests DNA methylation may precede clinical hyperglycemia,offering potential for early risk stratification.While obesity-associated LEP methylation is well-studied,lean Asian populations who exhibit high diabetes prevalence despite lower adiposity,represent an underexplored cohort.This study hypothesizes that LEP promoter methylation in peripheral leukocytes decreases progressively from normoglycemia to prediabetes and type 2 diabetes mellitus(T2DM),correlating inversely with serum LEP levels in lean Chinese adults[body mass index(BMI)<24 kg/m^(2)].AIM To investigate LEP promoter methylation status and its association with serum LEP levels across glycemic states in lean Chinese adults.METHODS We enrolled 392 participants including 120 normoglycemic controls,94 prediabetes[44 impaired fasting glucose(IFG)/50 impaired glucose tolerance(IGT)],178 T2DM aged 40-60 years with BMI<24 kg/m^(2).Genomic DNA from peripheral leukocytes underwent bisulfite conversion followed by methylation-specific PCR to assess CpG methylation in the LEP promoter.Serum LEP was quantified via enzyme-linked immunosorbent assay,with other parameters measured through standard assays.Statistical analyses included analysis of variance,χ²tests,and Pearson correlation(Bonferroni-corrected P value).RESULTS Methylation frequencies declined progressively:59.2%(controls)reduced to 43.6%(prediabetes;IFG:38.6%,IGT:48%)reduced to 31.5%(T2DM)(all P<0.05 vs controls;T2DM vs IGT:P=0.030).Serum LEP levels increased significantly in T2DM(16.94±4.19μg/L)vs controls(11.33±3.10μg/L;P=0.002),with intermediate values in prediabetes(IFG:13.79±3.32μg/L;IGT:12.62±4.81μg/L).A near-perfect inverse correlation between methylation and LEP levels was observed(r=-0.95,95%CI:-0.97 to-0.92,P<0.001),persisting after adjusting for age and BMI(β=-0.91,P<0.001).CONCLUSION LEP promoter hypomethylation parallels worsening glycemic status in lean Chinese adults,suggesting its potential as a blood-based epigenetic biomarker for diabetes progression,pending validation in longitudinal cohorts.
