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 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
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
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
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
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
Prediabetes is an intermediate state of hyperglycemia with glycemic parameters above normal but below the diabetes threshold. While, the diagnostic criteria of prediabetes are not uniform across various international ...Prediabetes is an intermediate state of hyperglycemia with glycemic parameters above normal but below the diabetes threshold. While, the diagnostic criteria of prediabetes are not uniform across various international professional organizations, it remains a state of high risk for developing diabetes with yearly conversion rate of 5%-10%. Observational evidence suggests as association between prediabetes and complications of diabetes such early nephropathy, small fiber neuropathy, early retinopathy and risk of macrovascular disease. Several studies have shown efficacy of lifestyle interventions with regards to diabetes prevention with a relative risk reduction of 40%-70% in adults with prediabetes. While there is increasing evidence to prove the efficacy of pharmacotherapy in prevention of diabetes in adults with prediabetes, pharmaceutical treatment options other than metformin are associated with adverse effects that limit their use for prediabetes. There are no reports of systematic evaluation of health outcomes related to prediabetes in children. The effects of pharmacotherapy of prediabetes on growth and pubertal development in children remains unknown. Secondary intervention with pharmacotherapy with metformin is advocated for high-risk individuals but criteria for such consideration benefit of early intervention, long term cost effectiveness of such interventions and the end point of therapy remain unclear. Pharmacotherapy must be used with caution in children with prediabetes. Prediabetes is a condition defined as having blood glucose levels above normal but below the defined threshold of diabetes. It is considered to be an at risk state, with high chances of developing diabetes. While, prediabetes is commonly an asymptomatic condition, there is always presence of prediabetes before the onset of diabetes. The elevation of blood sugar is a continuum and hence prediabetes can not be considered an entirely benign condition. This aim of this review is to describe the challenges associated with diagnosis of prediabetes, the possible adverse medical outcomes associated with prediabetes and the treatment options and rationale for their use in context of prediabetes.展开更多
Background:Traditional Chinese exercises(TCEs)have a positive effect on glycemic control and hemoglobin A1 c(HbA1 c),but there is no consensus on the benefits of TCEs for patients with prediabetes.Objective:The object...Background:Traditional Chinese exercises(TCEs)have a positive effect on glycemic control and hemoglobin A1 c(HbA1 c),but there is no consensus on the benefits of TCEs for patients with prediabetes.Objective:The objective of this study was to systematically investigate the effects of TCEs on blood glucose control in patients with prediabetes.Search strategy:Comprehensive retrieval of randomized controlled trials(RCTs)was carried out using PubMed,Cochrane Library,Embase,China National Knowledge Infrastructure,VIP Database for Chinese Technical Periodicals,Wanfang Data Knowledge Service Platform,China Biology Medicine disc,Google Scholar and Baidu academic databases.The retrieval window ranged from the establishment of the database to December 2018,and references related to the included trials were searched without language restrictions.Inclusion criteria:The study included RCTs with a clinical diagnosis of prediabetes that was also treated with TCEs.Data extraction and analysis:Literature screening,data extraction and literature quality assessment were performed independently by two researchers.In the case of disagreement,a third party was invited to negotiate and make a decision.Standardized mean difference(SMD)was used to estimate the therapeutic effect.Meta-analysis was performed using Review Manager 5.3.5 and Stata 15.0.Heterogeneity was assessed using Q test and I2,and the source of heterogeneity was determined using Galbraith diagram and sensitivity analysis.A Q test resulting in P<0.1 and I2>50%indicated significant difference and random effect model analysis was performed.Otherwise,a fixed effect model was applied.Begg’s and Egger’s tests were used to assess publication bias.Results:Nine RCTs involving 485 participants were included in this study.The results showed that TCEs could reduce fasting blood glucose(FBG),2 h blood glucose(2 hPBG)and HbA1 c in patients with prediabetes.The treatment subgroup showed that an intervention of 6 months had better results,while the Gongfa subgroup showed that the TCE Baduanjin yielded better results.(1)FBG:SMD=à0.73,95%confidence interval(CI)[à0.97,à0.50],P<0.00001;Baduanjin:SMD=à0.83,95%CI[à1.13,à0.53],P<0.00001;6-month treatment:SMD=à0.73,95%CI[à1.20,à0.26],P=0.002.(2)2 hPBG:SMD=à0.75,95%CI[à0.94,à0.57],P<0.00001;Baduanjin:SMD=à0.62,95%CI[à0.91,à0.32],P<0.00001;6-month treatment:SMD=à0.91,95%CI[à1.39,à0.44],P=0.0002.(3)HbA1 c:SMD=à0.56,95%CI[à0.89,à0.23],P=0.00008;Baduanjin:SMD=à0.46,95%CI[à0.83,à0.08],P=0.02;6-month treatment:SMD=à0.77,95%CI[à1.24,à0.29],P=0.002.Conclusion:TCEs had positive effects in improving blood glucose levels in patients with prediabetes.Hence,TCEs may be of potential therapeutic value for patients with prediabetes,as an adjuvant therapy along with other treatments.Although the evidence suggests that the intervention is effective for6 months,the mechanism of TCEs on glycemic control,the minimum exercise dose and their safety remain to be further studied.展开更多
Progression of normal glucose tolerance(NGT) to overt diabetes is mediated by a transition state called impaired glucose tolerance(IGT). Beta cell dysfunction and insulin resistance are the main defects in type 2 diab...Progression of normal glucose tolerance(NGT) to overt diabetes is mediated by a transition state called impaired glucose tolerance(IGT). Beta cell dysfunction and insulin resistance are the main defects in type 2 diabetes mellitus(type 2 DM) and even normoglycemic IGT patients manifest these defects. Beta cell dysfunction and insulin resistance also contribute to the progression of IGT to type 2 DM. Improving insulin sensitivity and/or preserving functions of beta-cells can be a rational way to normalize the GT and to control transition of IGT to type 2 DM. Loosing weight, for example, improves whole body insulin sensitivity and preserves beta-cell function and its inhibitory effect on progression of IGT to type 2 DM had been proven. But interventions aiming weight loss usually not applicable in real life. Pharmacotherapy is another option to gain better insulin sensitivity and to maintain beta-cell function. In this review, two potential treatment options(lifestyle modification and pharmacologic agents) that limits the IGT-type 2 DM conversion in prediabetic subjects are discussed.展开更多
The prevalence of type 2 diabetes(T2D) is evolving globally at an alarming rate. Prediabetes is an intermediate state of glucose metabolism that exists between normal glucose tolerance(NGT) and the clinical entity of ...The prevalence of type 2 diabetes(T2D) is evolving globally at an alarming rate. Prediabetes is an intermediate state of glucose metabolism that exists between normal glucose tolerance(NGT) and the clinical entity of T2 D. Relentless β-cell decline and failure is responsible for the progression from NGT to prediabetes and eventually T2 D. The huge burden resulting from the complications of T2 D created the need of therapeutic strategies in an effort to prevent or delay its development. The beneficial effects of incretin-based therapies, dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1(GLP-1) receptor agonists, on β-cell function in patients with T2 D, together with their strictly glucose-depended mechanism of action, suggested their possible use in individuals with prediabetes when greater β-cell mass and function are preserved and the possibility of β-cell salvage is higher. The present paper summarizes the main molecular intracellular mechanisms through which GLP-1 exerts its activity on β-cells. It also explores the current evidence of incretin based therapies when administered in a prediabetic state, both in animal models and in humans. Finally it discusses the safety of incretin-based therapies as well as their possible role in order to delay or prevent T2 D.展开更多
AIM To determine the predictive role of body mass index(BMI) and waist circumference(WC) for diabetes and prediabetes risk in future in total sample as well as in men and women separately. METHODS In a population base...AIM To determine the predictive role of body mass index(BMI) and waist circumference(WC) for diabetes and prediabetes risk in future in total sample as well as in men and women separately. METHODS In a population based cohort study, 1765 with mean ± SD age: 42.32 ± 6.18 healthy participants were followed up from 2003 till 2013(n = 960). Anthropometric and biochemical measures of participants were evaluated regularly during the follow up period. BMI and WC measures at baseline and diabetes and prediabetes status of participants at 2013 were determined. Multivariable logistic regression analysis was used for determining the risk of diabetes and prediabetes considering important potential confounding variables. Receiver operatingcharacteristic curve analysis was conducted to determine the best cut of values of BMI and WC for diabetes and prediabetes. RESULTS At 2013, among participants who had complete data, 45 and 307 people were diabetic and prediabetic, respectively. In final fully adjusted model, BMI value was a significant predictor of diabetes(RR = 1.39, 95%CI: 1.06-1.82 and AUC = 0.68, 95%CI: 0.59-0.75; P < 0.001) however not a significant risk factor for prediabetes. Also, WC was a significant predictor for diabetes(RR = 1.2, 95%CI: 1.05-1.38 and AUC = 0.67, 95%CI: 0.6-0.75) but not significant risk factor for prediabetes. Similar results were observed in both genders.CONCLUSION General and abdominal obesity are significant risk factors for diabetes in future.展开更多
BACKGROUND Prediabetes is a well-established risk factor for major adverse cardiac and cerebrovascular events(MACCE).However,the relationship between prediabetes and MACCE in atrial fibrillation(AF)patients has not be...BACKGROUND Prediabetes is a well-established risk factor for major adverse cardiac and cerebrovascular events(MACCE).However,the relationship between prediabetes and MACCE in atrial fibrillation(AF)patients has not been extensively studied.Therefore,this study aimed to establish a link between prediabetes and MACCE in AF patients.AIM To investigate a link between prediabetes and MACCE in AF patients.METHODS We used the National Inpatient Sample(2019)and relevant ICD-10 CM codes to identify hospitalizations with AF and categorized them into groups with and without prediabetes,excluding diabetics.The primary outcome was MACCE(all-cause inpatient mortality,cardiac arrest including ventricular fibrillation,and stroke)in AF-related hospitalizations.RESULTS Of the 2965875 AF-related hospitalizations for MACCE,47505(1.6%)were among patients with prediabetes.The prediabetes cohort was relatively younger(median 75 vs 78 years),and often consisted of males(56.3%vs 51.4%),blacks(9.8%vs 7.9%),Hispanics(7.3%vs 4.3%),and Asians(4.7%vs 1.6%)than the non-prediabetic cohort(P<0.001).The prediabetes group had significantly higher rates of hypertension,hyperlipidemia,smoking,obesity,drug abuse,prior myocardial infarction,peripheral vascular disease,and hyperthyroidism(all P<0.05).The prediabetes cohort was often discharged routinely(51.1%vs 41.1%),but more frequently required home health care(23.6%vs 21.0%)and had higher costs.After adjusting for baseline characteristics or comorbidities,the prediabetes cohort with AF admissions showed a higher rate and significantly higher odds of MACCE compared to the non-prediabetic cohort[18.6%vs 14.7%,odds ratio(OR)1.34,95%confidence interval 1.26-1.42,P<0.001].On subgroup analyses,males had a stronger association(aOR 1.43)compared to females(aOR 1.22),whereas on the race-wise comparison,Hispanics(aOR 1.43)and Asians(aOR 1.36)had a stronger association with MACCE with prediabetes vs whites(aOR 1.33)and blacks(aOR 1.21).CONCLUSION This population-based study found a significant association between prediabetes and MACCE in AF patients.Therefore,there is a need for further research to actively screen and manage prediabetes in AF to prevent MACCE.展开更多
Objective To study the association between metal exposure and risk of diabetes and prediabetes among Chinese workers exposed to metals.Methods We used data obtained from the baseline survey of the Jinchang Cohort Stud...Objective To study the association between metal exposure and risk of diabetes and prediabetes among Chinese workers exposed to metals.Methods We used data obtained from the baseline survey of the Jinchang Cohort Study of workers in Jinchang Industry,the largest nickel production company in China.A total of 42,122 workers ≥20 years of age were included in the study.A standardized,structured questionnaire was used to collect epidemiological information.Physical examinations and laboratory tests were conducted to evaluate the health status of the participants and to measure various biomarkers including blood sugar,lipids,and urinary metal concentrations.Logistic regression was used to study the association between occupational groups categorized according to the measured metal levels(office workers,low-level;mining/production workers,mid-level;and smelting/refining workers,high-level)and risk of diabetes and prediabetes.Results The overall prevalence of diabetes and prediabetes was 7.5% and 16.8%,respectively.The adjusted odds ratios for diabetes among mining/production workers and smelting/refining workers compared to office workers were 1.5(95% CI:1.3,1.7)and 3.8(95% CI:3.4,4.3),respectively.No association was observed between these occupational groups and prediabetes in this study.Conclusion Occupations associated with higher levels of metal exposure were associated with an increased risk of diabetes in this cohort.More studies are needed to confirm this observed association.展开更多
BACKGROUND The risk of developing prediabetes based on the metabolic/obesity phenotypes has been poorly investigated. AIM To examine the association of baseline metabolic/obesity phenotypes and their changes over time...BACKGROUND The risk of developing prediabetes based on the metabolic/obesity phenotypes has been poorly investigated. AIM To examine the association of baseline metabolic/obesity phenotypes and their changes over time with the risk of prediabetes development. METHODS In a population-based cohort study, 1741 adults (aged > 19 years) with normal blood glucose were followed for 14 years. Anthropometric and biochemical measures were evaluated regularly during the follow-up period. According to body mass index and metabolic health status, participants were categorized into four groups: Metabolically healthy normal weight (MHNW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUNW) and metabolically unhealthy obese (MUO). Multivariable Cox regression analysis was used to measure the risk of prediabetes according to the baseline metabolic/obesity phenotype and their changes during the follow-up. RESULTS In the whole population with a mean (95CCI for mean) follow up duration of 12.7 years (12.6-12.9), all three MUNW, MHO, MUO groups were at higher risk for developing prediabetes compared to the MHNW group (P = 0.022). The MUNW group had the highest risk for developing prediabetes (hazard ratio (HR): 3.84, 95%CI: 1.20, 12.27). In stratified analysis by sex, no significant association was found in men, while women in the MUNW group were at the greatest risk for prediabetes (HR: 6.74, 95%CI: 1.53, 29.66). Transforming from each phenotype to MHNW or MHO was not related to the risk of prediabetes development, whereas transforming from each phenotype to MUO was associated with an increased risk of prediabetes (HR > 1;P < 0.05). CONCLUSION Our findings indicate that MHO is not a high risk, unless it transforms into MUO over time. However, people in the MUNW group have the greatest risk for developing prediabetes, and therefore, they should be screened and treated.展开更多
Bone fragility has been recognized as a complication of diabetes,both type 1 diabetes(T1D)and type 2 diabetes(T2D),whereas the relationship between prediabetes and fracture risk is less clear.Fractures can deeply impa...Bone fragility has been recognized as a complication of diabetes,both type 1 diabetes(T1D)and type 2 diabetes(T2D),whereas the relationship between prediabetes and fracture risk is less clear.Fractures can deeply impact a diabetic patient’s quality of life.However,the mechanisms underlying bone fragility in diabetes are complex and have not been fully elucidated.Patients with T1D generally exhibit low bone mineral density(BMD),although the relatively small reduction in BMD does not entirely explain the increase in fracture risk.On the contrary,patients with T2D or prediabetes have normal or even higher BMD as compared with healthy subjects.These observations suggest that factors other than bone mass may influence fracture risk.Some of these factors have been identified,including disease duration,poor glycemic control,presence of diabetes complications,and certain antidiabetic drugs.Nevertheless,currently available tools for the prediction of risk inadequately capture diabetic patients at increased risk of fracture.Aim of this review is to provide a comprehensive overview of bone health and the mechanisms responsible for increased susceptibility to fracture across the spectrum of glycemic status,spanning from insulin resistance to overt forms of diabetes.The management of bone fragility in diabetic patient is also discussed.展开更多
[Objectives]To study the clinical effect of Zishenwan on elderly patients with prediabetes based on the method of Sweet-Bitter Therapeutic.[Methods]Total 64 elderly patients with prediabetes in Suzhou TCM Hospital Aff...[Objectives]To study the clinical effect of Zishenwan on elderly patients with prediabetes based on the method of Sweet-Bitter Therapeutic.[Methods]Total 64 elderly patients with prediabetes in Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine from April,2020 to July,2021 were randomly divided into control group(32 cases)and Zishenwan group(32 cases).The control group received basic treatment(diet control and regular luck exercise),while the Zishenwan group was treated with Zishenwan on the basic treatment.[Results]The results of intragroup comparisons after treatment show that both of the groups improved plasma glucose,insulin,plasma lipid metabolism and other related indexes.The results of inter-group comparisons were as follows.(i)The FPG and 2hPG of the Zishenwan group were significantly lower than the control group(P<0.05).(ii)The FINS and HOMA-IR of the Zishenwan group were significantly lower than the control group(P<0.05).(iii)The LDL-C of the Zishenwan group were significantly lower than the control group(P<0.05).(iv)The ADP,hs-CRP,and GLP-1 of the Zishenwan group were significantly improved compared to those of the control group(P<0.05).Although there was no significant difference in other indicators,the improvement trend is better than that of the control group.[Conclusions]Zishenwan can further improve plasma glucose level of the elderly patients with prediabetes on the basis of basic treatment,and to a certain extent,reduce the plasma glucose to normal,which is beneficial to the benign outcome of the elderly patients with prediabetes.In addition,it can improve insulin secretion and reduce insulin resistance,which provides a basis for the disease control of elderly patients with prediabetes.It can also improve the lipid metabolism of elderly patients with prediabetes,and the effect on LDL-C is significant.It is speculated that its mechanism may be closely related to the changes of ADP,hs-CRP and GLP-1 in the body of elderly patients with prediabetes.展开更多
BACKGROUND Type 2 diabetes mellitus(T2DM)has high morbidity and mortality worldwide,therefore there is of paramount importance to identify the risk factors in the populations at risk early in the course of illness.A s...BACKGROUND Type 2 diabetes mellitus(T2DM)has high morbidity and mortality worldwide,therefore there is of paramount importance to identify the risk factors in the populations at risk early in the course of illness.A strong correlation between severity of metabolic syndrome(MetS)and HbA1c,fasting insulin and insulin resistance has been reported.Accordingly,the MetS severity score(or MestS Zscore)can potentially be used to predict the risk of T2DM progression over time.AIM To evaluate the association the of MestS Z-score in first degree relatives(FDRs)of T2DM with the risk of prediabetes and type 2 diabetes in future.METHODS A prospective open cohort study was conducted between 2003-2018.At baseline,the sample comprised of 1766 FDRs of patients with T2DM who had a normal glucose tolerance test.Relative risk(RR)and 95%confidence interval were calculated based on logistic regression.The receiver-operator characteristic analysis and area under the curve based on MetS Z-score were used to evaluate the risk of prediabetes and diabetes among the FDR population.RESULTS Baseline MetS Z-scores were associated with the its latest values(P<0.0001).Compared with individuals who were T2DM free at the end of follow up,those who developed T2DM had higher MetS Z-score at baseline(P<0.001).In multivariable logistic regression analyses for every unit elevation in MetS Z-score at the baseline,the RR for developing future T2DM and prediabetes was(RR=1.94,RR=3.84),(RR=1.5,RR=2.17)in total population and female group,respectively(P<0.05).The associations remained significant after adjusting the potential confounding variables.A cut off value of 0.97 and 0.94 was defined in the receiver-operator characteristic curve based on the MetS Z-score for differentiating female patients with diabetes and prediabetes from the normal population,respectively.CONCLUSION The MetS Z-score was associated with an increased risk of future T2DM.Appropriate interventions at earlier stages for preventing and attenuating MetS effects may be considered as an effective strategy for FDR as at-risk population.展开更多
Atrial fibrillation(AF)and prediabetes share common pathophysiological mechanisms with endothelial dysfunction and inflammation playing a key role.The resultant vicious cycle which sets in culminates in a higher ather...Atrial fibrillation(AF)and prediabetes share common pathophysiological mechanisms with endothelial dysfunction and inflammation playing a key role.The resultant vicious cycle which sets in culminates in a higher atherogenicity and thermogenicity of the vascular system resulting in increased major adverse cardiac or cerebrovascular event(MACCE)events.However,the same has not convincingly been verified in real-world settings.In the recent retrospective study by Desai et al amongst AF patients being admitted to hospitals following MACCE,prediabetes emerged as an independent risk factor for MACCE after adjusting for all confounding variables.However,certain questions like the role of metformin,quantifying the risk for MACCE amongst prediabetes compared to diabetes,the positive impact of reversion to normoglycemia remain unanswered.We provide our insights and give future directions for dedicated research in this area to clarify the exact relationship between the two.展开更多
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 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.
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.
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.
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Prediabetes is an intermediate state of hyperglycemia with glycemic parameters above normal but below the diabetes threshold. While, the diagnostic criteria of prediabetes are not uniform across various international professional organizations, it remains a state of high risk for developing diabetes with yearly conversion rate of 5%-10%. Observational evidence suggests as association between prediabetes and complications of diabetes such early nephropathy, small fiber neuropathy, early retinopathy and risk of macrovascular disease. Several studies have shown efficacy of lifestyle interventions with regards to diabetes prevention with a relative risk reduction of 40%-70% in adults with prediabetes. While there is increasing evidence to prove the efficacy of pharmacotherapy in prevention of diabetes in adults with prediabetes, pharmaceutical treatment options other than metformin are associated with adverse effects that limit their use for prediabetes. There are no reports of systematic evaluation of health outcomes related to prediabetes in children. The effects of pharmacotherapy of prediabetes on growth and pubertal development in children remains unknown. Secondary intervention with pharmacotherapy with metformin is advocated for high-risk individuals but criteria for such consideration benefit of early intervention, long term cost effectiveness of such interventions and the end point of therapy remain unclear. Pharmacotherapy must be used with caution in children with prediabetes. Prediabetes is a condition defined as having blood glucose levels above normal but below the defined threshold of diabetes. It is considered to be an at risk state, with high chances of developing diabetes. While, prediabetes is commonly an asymptomatic condition, there is always presence of prediabetes before the onset of diabetes. The elevation of blood sugar is a continuum and hence prediabetes can not be considered an entirely benign condition. This aim of this review is to describe the challenges associated with diagnosis of prediabetes, the possible adverse medical outcomes associated with prediabetes and the treatment options and rationale for their use in context of prediabetes.
基金Major Natural Science Project of Anhui Province Universities(No.KJ2018ZD029)National Clinical Key Specialist(Chinese Medicine Nursing)Open Foundation Project(No.2017zkkfzd001)。
文摘Background:Traditional Chinese exercises(TCEs)have a positive effect on glycemic control and hemoglobin A1 c(HbA1 c),but there is no consensus on the benefits of TCEs for patients with prediabetes.Objective:The objective of this study was to systematically investigate the effects of TCEs on blood glucose control in patients with prediabetes.Search strategy:Comprehensive retrieval of randomized controlled trials(RCTs)was carried out using PubMed,Cochrane Library,Embase,China National Knowledge Infrastructure,VIP Database for Chinese Technical Periodicals,Wanfang Data Knowledge Service Platform,China Biology Medicine disc,Google Scholar and Baidu academic databases.The retrieval window ranged from the establishment of the database to December 2018,and references related to the included trials were searched without language restrictions.Inclusion criteria:The study included RCTs with a clinical diagnosis of prediabetes that was also treated with TCEs.Data extraction and analysis:Literature screening,data extraction and literature quality assessment were performed independently by two researchers.In the case of disagreement,a third party was invited to negotiate and make a decision.Standardized mean difference(SMD)was used to estimate the therapeutic effect.Meta-analysis was performed using Review Manager 5.3.5 and Stata 15.0.Heterogeneity was assessed using Q test and I2,and the source of heterogeneity was determined using Galbraith diagram and sensitivity analysis.A Q test resulting in P<0.1 and I2>50%indicated significant difference and random effect model analysis was performed.Otherwise,a fixed effect model was applied.Begg’s and Egger’s tests were used to assess publication bias.Results:Nine RCTs involving 485 participants were included in this study.The results showed that TCEs could reduce fasting blood glucose(FBG),2 h blood glucose(2 hPBG)and HbA1 c in patients with prediabetes.The treatment subgroup showed that an intervention of 6 months had better results,while the Gongfa subgroup showed that the TCE Baduanjin yielded better results.(1)FBG:SMD=à0.73,95%confidence interval(CI)[à0.97,à0.50],P<0.00001;Baduanjin:SMD=à0.83,95%CI[à1.13,à0.53],P<0.00001;6-month treatment:SMD=à0.73,95%CI[à1.20,à0.26],P=0.002.(2)2 hPBG:SMD=à0.75,95%CI[à0.94,à0.57],P<0.00001;Baduanjin:SMD=à0.62,95%CI[à0.91,à0.32],P<0.00001;6-month treatment:SMD=à0.91,95%CI[à1.39,à0.44],P=0.0002.(3)HbA1 c:SMD=à0.56,95%CI[à0.89,à0.23],P=0.00008;Baduanjin:SMD=à0.46,95%CI[à0.83,à0.08],P=0.02;6-month treatment:SMD=à0.77,95%CI[à1.24,à0.29],P=0.002.Conclusion:TCEs had positive effects in improving blood glucose levels in patients with prediabetes.Hence,TCEs may be of potential therapeutic value for patients with prediabetes,as an adjuvant therapy along with other treatments.Although the evidence suggests that the intervention is effective for6 months,the mechanism of TCEs on glycemic control,the minimum exercise dose and their safety remain to be further studied.
文摘Progression of normal glucose tolerance(NGT) to overt diabetes is mediated by a transition state called impaired glucose tolerance(IGT). Beta cell dysfunction and insulin resistance are the main defects in type 2 diabetes mellitus(type 2 DM) and even normoglycemic IGT patients manifest these defects. Beta cell dysfunction and insulin resistance also contribute to the progression of IGT to type 2 DM. Improving insulin sensitivity and/or preserving functions of beta-cells can be a rational way to normalize the GT and to control transition of IGT to type 2 DM. Loosing weight, for example, improves whole body insulin sensitivity and preserves beta-cell function and its inhibitory effect on progression of IGT to type 2 DM had been proven. But interventions aiming weight loss usually not applicable in real life. Pharmacotherapy is another option to gain better insulin sensitivity and to maintain beta-cell function. In this review, two potential treatment options(lifestyle modification and pharmacologic agents) that limits the IGT-type 2 DM conversion in prediabetic subjects are discussed.
文摘The prevalence of type 2 diabetes(T2D) is evolving globally at an alarming rate. Prediabetes is an intermediate state of glucose metabolism that exists between normal glucose tolerance(NGT) and the clinical entity of T2 D. Relentless β-cell decline and failure is responsible for the progression from NGT to prediabetes and eventually T2 D. The huge burden resulting from the complications of T2 D created the need of therapeutic strategies in an effort to prevent or delay its development. The beneficial effects of incretin-based therapies, dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1(GLP-1) receptor agonists, on β-cell function in patients with T2 D, together with their strictly glucose-depended mechanism of action, suggested their possible use in individuals with prediabetes when greater β-cell mass and function are preserved and the possibility of β-cell salvage is higher. The present paper summarizes the main molecular intracellular mechanisms through which GLP-1 exerts its activity on β-cells. It also explores the current evidence of incretin based therapies when administered in a prediabetic state, both in animal models and in humans. Finally it discusses the safety of incretin-based therapies as well as their possible role in order to delay or prevent T2 D.
文摘AIM To determine the predictive role of body mass index(BMI) and waist circumference(WC) for diabetes and prediabetes risk in future in total sample as well as in men and women separately. METHODS In a population based cohort study, 1765 with mean ± SD age: 42.32 ± 6.18 healthy participants were followed up from 2003 till 2013(n = 960). Anthropometric and biochemical measures of participants were evaluated regularly during the follow up period. BMI and WC measures at baseline and diabetes and prediabetes status of participants at 2013 were determined. Multivariable logistic regression analysis was used for determining the risk of diabetes and prediabetes considering important potential confounding variables. Receiver operatingcharacteristic curve analysis was conducted to determine the best cut of values of BMI and WC for diabetes and prediabetes. RESULTS At 2013, among participants who had complete data, 45 and 307 people were diabetic and prediabetic, respectively. In final fully adjusted model, BMI value was a significant predictor of diabetes(RR = 1.39, 95%CI: 1.06-1.82 and AUC = 0.68, 95%CI: 0.59-0.75; P < 0.001) however not a significant risk factor for prediabetes. Also, WC was a significant predictor for diabetes(RR = 1.2, 95%CI: 1.05-1.38 and AUC = 0.67, 95%CI: 0.6-0.75) but not significant risk factor for prediabetes. Similar results were observed in both genders.CONCLUSION General and abdominal obesity are significant risk factors for diabetes in future.
文摘BACKGROUND Prediabetes is a well-established risk factor for major adverse cardiac and cerebrovascular events(MACCE).However,the relationship between prediabetes and MACCE in atrial fibrillation(AF)patients has not been extensively studied.Therefore,this study aimed to establish a link between prediabetes and MACCE in AF patients.AIM To investigate a link between prediabetes and MACCE in AF patients.METHODS We used the National Inpatient Sample(2019)and relevant ICD-10 CM codes to identify hospitalizations with AF and categorized them into groups with and without prediabetes,excluding diabetics.The primary outcome was MACCE(all-cause inpatient mortality,cardiac arrest including ventricular fibrillation,and stroke)in AF-related hospitalizations.RESULTS Of the 2965875 AF-related hospitalizations for MACCE,47505(1.6%)were among patients with prediabetes.The prediabetes cohort was relatively younger(median 75 vs 78 years),and often consisted of males(56.3%vs 51.4%),blacks(9.8%vs 7.9%),Hispanics(7.3%vs 4.3%),and Asians(4.7%vs 1.6%)than the non-prediabetic cohort(P<0.001).The prediabetes group had significantly higher rates of hypertension,hyperlipidemia,smoking,obesity,drug abuse,prior myocardial infarction,peripheral vascular disease,and hyperthyroidism(all P<0.05).The prediabetes cohort was often discharged routinely(51.1%vs 41.1%),but more frequently required home health care(23.6%vs 21.0%)and had higher costs.After adjusting for baseline characteristics or comorbidities,the prediabetes cohort with AF admissions showed a higher rate and significantly higher odds of MACCE compared to the non-prediabetic cohort[18.6%vs 14.7%,odds ratio(OR)1.34,95%confidence interval 1.26-1.42,P<0.001].On subgroup analyses,males had a stronger association(aOR 1.43)compared to females(aOR 1.22),whereas on the race-wise comparison,Hispanics(aOR 1.43)and Asians(aOR 1.36)had a stronger association with MACCE with prediabetes vs whites(aOR 1.33)and blacks(aOR 1.21).CONCLUSION This population-based study found a significant association between prediabetes and MACCE in AF patients.Therefore,there is a need for further research to actively screen and manage prediabetes in AF to prevent MACCE.
基金supported by the Project of Employees Health Status and Disease Burden Trend Study in Jinchuan Nonferrous Metals Corporation,Grant JKB20120013Fogarty training grants D43TW 008323 and D43TW 007864-01 from the US National Institutes of Health
文摘Objective To study the association between metal exposure and risk of diabetes and prediabetes among Chinese workers exposed to metals.Methods We used data obtained from the baseline survey of the Jinchang Cohort Study of workers in Jinchang Industry,the largest nickel production company in China.A total of 42,122 workers ≥20 years of age were included in the study.A standardized,structured questionnaire was used to collect epidemiological information.Physical examinations and laboratory tests were conducted to evaluate the health status of the participants and to measure various biomarkers including blood sugar,lipids,and urinary metal concentrations.Logistic regression was used to study the association between occupational groups categorized according to the measured metal levels(office workers,low-level;mining/production workers,mid-level;and smelting/refining workers,high-level)and risk of diabetes and prediabetes.Results The overall prevalence of diabetes and prediabetes was 7.5% and 16.8%,respectively.The adjusted odds ratios for diabetes among mining/production workers and smelting/refining workers compared to office workers were 1.5(95% CI:1.3,1.7)and 3.8(95% CI:3.4,4.3),respectively.No association was observed between these occupational groups and prediabetes in this study.Conclusion Occupations associated with higher levels of metal exposure were associated with an increased risk of diabetes in this cohort.More studies are needed to confirm this observed association.
文摘BACKGROUND The risk of developing prediabetes based on the metabolic/obesity phenotypes has been poorly investigated. AIM To examine the association of baseline metabolic/obesity phenotypes and their changes over time with the risk of prediabetes development. METHODS In a population-based cohort study, 1741 adults (aged > 19 years) with normal blood glucose were followed for 14 years. Anthropometric and biochemical measures were evaluated regularly during the follow-up period. According to body mass index and metabolic health status, participants were categorized into four groups: Metabolically healthy normal weight (MHNW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUNW) and metabolically unhealthy obese (MUO). Multivariable Cox regression analysis was used to measure the risk of prediabetes according to the baseline metabolic/obesity phenotype and their changes during the follow-up. RESULTS In the whole population with a mean (95CCI for mean) follow up duration of 12.7 years (12.6-12.9), all three MUNW, MHO, MUO groups were at higher risk for developing prediabetes compared to the MHNW group (P = 0.022). The MUNW group had the highest risk for developing prediabetes (hazard ratio (HR): 3.84, 95%CI: 1.20, 12.27). In stratified analysis by sex, no significant association was found in men, while women in the MUNW group were at the greatest risk for prediabetes (HR: 6.74, 95%CI: 1.53, 29.66). Transforming from each phenotype to MHNW or MHO was not related to the risk of prediabetes development, whereas transforming from each phenotype to MUO was associated with an increased risk of prediabetes (HR > 1;P < 0.05). CONCLUSION Our findings indicate that MHO is not a high risk, unless it transforms into MUO over time. However, people in the MUNW group have the greatest risk for developing prediabetes, and therefore, they should be screened and treated.
文摘Bone fragility has been recognized as a complication of diabetes,both type 1 diabetes(T1D)and type 2 diabetes(T2D),whereas the relationship between prediabetes and fracture risk is less clear.Fractures can deeply impact a diabetic patient’s quality of life.However,the mechanisms underlying bone fragility in diabetes are complex and have not been fully elucidated.Patients with T1D generally exhibit low bone mineral density(BMD),although the relatively small reduction in BMD does not entirely explain the increase in fracture risk.On the contrary,patients with T2D or prediabetes have normal or even higher BMD as compared with healthy subjects.These observations suggest that factors other than bone mass may influence fracture risk.Some of these factors have been identified,including disease duration,poor glycemic control,presence of diabetes complications,and certain antidiabetic drugs.Nevertheless,currently available tools for the prediction of risk inadequately capture diabetic patients at increased risk of fracture.Aim of this review is to provide a comprehensive overview of bone health and the mechanisms responsible for increased susceptibility to fracture across the spectrum of glycemic status,spanning from insulin resistance to overt forms of diabetes.The management of bone fragility in diabetic patient is also discussed.
基金Supported by Jiangsu Provincial Health Commission of China(M2021094)Youth Medical Talents Project of Jiangsu Province(QNRC2016252)Suzhou Science and Technology Development Plan:Key Technology Project of Medical and Health Technology Innovation(SKY2021058).
文摘[Objectives]To study the clinical effect of Zishenwan on elderly patients with prediabetes based on the method of Sweet-Bitter Therapeutic.[Methods]Total 64 elderly patients with prediabetes in Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine from April,2020 to July,2021 were randomly divided into control group(32 cases)and Zishenwan group(32 cases).The control group received basic treatment(diet control and regular luck exercise),while the Zishenwan group was treated with Zishenwan on the basic treatment.[Results]The results of intragroup comparisons after treatment show that both of the groups improved plasma glucose,insulin,plasma lipid metabolism and other related indexes.The results of inter-group comparisons were as follows.(i)The FPG and 2hPG of the Zishenwan group were significantly lower than the control group(P<0.05).(ii)The FINS and HOMA-IR of the Zishenwan group were significantly lower than the control group(P<0.05).(iii)The LDL-C of the Zishenwan group were significantly lower than the control group(P<0.05).(iv)The ADP,hs-CRP,and GLP-1 of the Zishenwan group were significantly improved compared to those of the control group(P<0.05).Although there was no significant difference in other indicators,the improvement trend is better than that of the control group.[Conclusions]Zishenwan can further improve plasma glucose level of the elderly patients with prediabetes on the basis of basic treatment,and to a certain extent,reduce the plasma glucose to normal,which is beneficial to the benign outcome of the elderly patients with prediabetes.In addition,it can improve insulin secretion and reduce insulin resistance,which provides a basis for the disease control of elderly patients with prediabetes.It can also improve the lipid metabolism of elderly patients with prediabetes,and the effect on LDL-C is significant.It is speculated that its mechanism may be closely related to the changes of ADP,hs-CRP and GLP-1 in the body of elderly patients with prediabetes.
基金Supported by Isfahan Endocrine and Metabolism Research Center,No. 95017.
文摘BACKGROUND Type 2 diabetes mellitus(T2DM)has high morbidity and mortality worldwide,therefore there is of paramount importance to identify the risk factors in the populations at risk early in the course of illness.A strong correlation between severity of metabolic syndrome(MetS)and HbA1c,fasting insulin and insulin resistance has been reported.Accordingly,the MetS severity score(or MestS Zscore)can potentially be used to predict the risk of T2DM progression over time.AIM To evaluate the association the of MestS Z-score in first degree relatives(FDRs)of T2DM with the risk of prediabetes and type 2 diabetes in future.METHODS A prospective open cohort study was conducted between 2003-2018.At baseline,the sample comprised of 1766 FDRs of patients with T2DM who had a normal glucose tolerance test.Relative risk(RR)and 95%confidence interval were calculated based on logistic regression.The receiver-operator characteristic analysis and area under the curve based on MetS Z-score were used to evaluate the risk of prediabetes and diabetes among the FDR population.RESULTS Baseline MetS Z-scores were associated with the its latest values(P<0.0001).Compared with individuals who were T2DM free at the end of follow up,those who developed T2DM had higher MetS Z-score at baseline(P<0.001).In multivariable logistic regression analyses for every unit elevation in MetS Z-score at the baseline,the RR for developing future T2DM and prediabetes was(RR=1.94,RR=3.84),(RR=1.5,RR=2.17)in total population and female group,respectively(P<0.05).The associations remained significant after adjusting the potential confounding variables.A cut off value of 0.97 and 0.94 was defined in the receiver-operator characteristic curve based on the MetS Z-score for differentiating female patients with diabetes and prediabetes from the normal population,respectively.CONCLUSION The MetS Z-score was associated with an increased risk of future T2DM.Appropriate interventions at earlier stages for preventing and attenuating MetS effects may be considered as an effective strategy for FDR as at-risk population.
文摘Atrial fibrillation(AF)and prediabetes share common pathophysiological mechanisms with endothelial dysfunction and inflammation playing a key role.The resultant vicious cycle which sets in culminates in a higher atherogenicity and thermogenicity of the vascular system resulting in increased major adverse cardiac or cerebrovascular event(MACCE)events.However,the same has not convincingly been verified in real-world settings.In the recent retrospective study by Desai et al amongst AF patients being admitted to hospitals following MACCE,prediabetes emerged as an independent risk factor for MACCE after adjusting for all confounding variables.However,certain questions like the role of metformin,quantifying the risk for MACCE amongst prediabetes compared to diabetes,the positive impact of reversion to normoglycemia remain unanswered.We provide our insights and give future directions for dedicated research in this area to clarify the exact relationship between the two.
