scholarly journals Association between high-density lipoprotein cholesterol and type 2 diabetes mellitus among Chinese: the Beijing longitudinal study of aging

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Xue Cao ◽  
Zhe Tang ◽  
Jie Zhang ◽  
Haibin Li ◽  
Manjot Singh ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Density Lipoprotein ◽  
Hazards Model ◽  
New Onset

Abstract Background Some previous studies on different populations have yielded inconsistent findings with respect to the relationship between levels of high-density lipoprotein cholesterol (HDL-C) and future type 2 diabetes mellitus (T2DM) incidence. This study was designed to gain further insight into this relationship through a cohort study with a 25-year follow-up duration. Methods In total, 1462 individuals that were 55 years of age or older and were free of T2DM at baseline were enrolled in the present study. T2DM incidence among this study population was detected through self-reported diagnoses or the concentration of fasting plasma glucose. The data were derived from nine surveys conducted from 1992 to 2017. The correlation between HDL-C levels and the T2DM risk was assessed through Cox proportional-hazards model and proportional hazards model for the sub-distribution with time-dependent variables. Results Over the follow-up period, 120 participants were newly diagnosed with new-onset T2DM. When research participants were separated into four groups on the basis for quartiles of their levels of HDL-C measured at baseline, and incidence of diabetes declined with higher baseline HDL-C levels at 12.60, 9.70, 5.38, and 5.22 per 1000 person-years, respectively. Adjusted hazard ratios (HRs) were 0.98 (95% confidence interval [CI]: 0.62–1.55), 0.48 (95% CI: 0.27–0.85) and 0.44 (95% CI: 0.25–0.80) for individuals with HDL-C levels within the 1.15–1.39, 1.40–1.69, and ≥ 1.70 mmol/L ranges relative to participants with HDL-C levels < 1.15 mmol/L. Multiple sensitivity analyses similarly revealed reduced risk of diabetes incidence with increased HDL-C levels. Incorporating the levels of HDL-C into a multivariate model significantly enhanced the overall power of the predictive model (P values were 0.0296, 0.0011, respectively, for 5- and 10-year risk of diabetes). Conclusions Levels of HDL-C were independently and negatively associated with the risk of the new-onset T2DM among middle-aged and elderly Chinese.

Improved Clinical Outcomes with Dulaglutide as Add-on Medication to Oral Antidiabetic Drugs with or Without Insulin in Overweight Indian Patients with Type 2 Diabetes Mellitus: Retrospective Study in a Real-World Setting

2020 ◽  
Vol 16 (5) ◽  
pp. 490-496 ◽  
Author(s):  
Aneesh Ghosh ◽  
Rakhee Nair
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Clinical Effectiveness ◽  
Indian Patients

Aim: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated several extra-pancreatic benefits in addition to glycemic control. This study retrospectively evaluates the realworld clinical effectiveness of dulaglutide as add-on therapy in overweight patients with inadequately controlled type 2 diabetes mellitus (T2DM). Materials and Methods: This single-center study included overweight adult patients (N, 85; women, 45) with inadequately controlled T2DM (mean glycated hemoglobin [HbA1c] (standard deviation [SD]), 7.55 [0.43] %; and body mass index [BMI] [SD], 29.01 [2.30] kg/m2) treated with dulaglutide (1.5 mg) once weekly as an add-on therapy. Follow-up improvements in outcomes were analyzed using the paired t-test. Subgroup analysis was performed for selected outcomes. Safety parameters were also evaluated. Results: At the 20-week follow-up, dulaglutide based therapy demonstrated a significant reduction (P<.001) in HbA1c, body weight and BMI, with a mean reduction (MR [SD]) of 0.45 [0.38] %, 5.06 [2.33] kg, and 1.82 [0.81] kg/m2, respectively, in the overall population. Similarly, reduction in urine albumin/creatinine ratio [U-ACR] (6.04 [15.53] mg/g), cholesterol (3.24 [4.14] mg/dL), triglycerides (16.60 [12.39] mg/dL), very-low-density lipoprotein [VLDL] (3.31 [2.48] mg/dL), serum glutamicoxaloacetic transaminase (1.80 [2.92] U/L) and glutamic-pyruvic transaminase (8.00 [5.64] U/L) was also significant (P<.05). Target HbA1c of <7% was achieved in 40% of patients. Reduction in HbA1c and body weight was significant across all subgroups analyzed. Predominantly, gastrointestinal adverse events were reported. Conclusion: Dulaglutide as an add-on therapy was well tolerated with significant improvement in HbA1c, body weight, BMI, U-ACR, lipid fractions and serum transaminases in overweight Indian patients with T2DM.

scholarly journals Dipstick proteinuria and risk of type 2 diabetes mellitus: a nationwide population-based cohort study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jimin Jeon ◽  
Jinkwon Kim
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Significant Risk ◽  
Health Screening ◽  
Increased Risk ◽  
New Onset

Abstract Background Proteinuria has been recognized as a marker of systemic inflammation and endothelial dysfunction associated with insulin resistance and β-cell impairment, which can contribute to the development of type 2 diabetes mellitus (T2DM). However, it is unknown whether the dipstick proteinuria test has a predictive value for new-onset T2DM. Methods This retrospective cohort study analyzed 239,287 non-diabetic participants who participated in the Korean nationwide health screening program in 2009–2010. Proteinuria was determined by the urine dipstick test at the baseline health screening. We performed multivariate Cox proportional regression analyses for the development of new-onset T2DM. Follow-up was performed until December 2015. Results During the mean follow-up period of 5.73 years, 22,215 participants were diagnosed with new-onset T2DM. The presence of proteinuria was significantly associated with an increased risk of T2DM (adjusted hazard ratio: 1.19, 95% confidence interval: 1.10, 1.29). There was a positive dose–response relationship between the degree of dipstick proteinuria and T2DM risk. This significant association between proteinuria and T2DM risk was consistent regardless of the fasting glucose level at baseline. Conclusions Dipstick proteinuria is a significant risk factor for new-onset T2DM. Therefore, proteinuria might be a useful biomarker to identify those at a high risk for developing T2DM.

scholarly journals Increased Arterial Stiffness as a Predictor for Onset and Progression of Diabetic Retinopathy in Type 2 Diabetes Mellitus

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Yaxin An ◽  
Yuxian Yang ◽  
Bin Cao ◽  
Huan Dong ◽  
Aihua Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Logistic Regression ◽  
Diabetic Retinopathy ◽  
Regression Analysis ◽  
Arterial Stiffness ◽  
New Onset

Introduction. Brachial–ankle pulse wave velocity (baPWV), an indicator of arterial stiffness, has been demonstrated to be associated with type 2 diabetes mellitus (T2DM) and its vascular complications. This study was aimed at investigating the correlations of baPWV with both the presence and severity of diabetic retinopathy (DR) at baseline and at exploring the predictive role of baPWV in the new onset/progression of DR in the follow-up analysis. Methods. The prospective cohort study recruited 2,473 Chinese patients with T2DM, of whom 663 participants were finally included in the follow-up analysis. The presence and grading of DR were performed by the modified Early Treatment Diabetic Retinopathy Study. Uni- or multivariate linear and logistic regression models and Cox proportional-hazards regression analysis were conducted. Results. Of 2,473 patients with T2DM at baseline, 734 individuals were assessed to have DR and further categorized into 630 with non-sight-threatening DR (NSTDR) and 104 with STDR. In addition to the positive relationship between increased baPWV and the presence of DR, multinominal logistic regression analysis revealed that higher tertiles of baPWV were significantly related to the NSTDR (T2: OR = 1.62 (1.22, 2.15), p < 0.001 , and T3: OR = 2.58 (1.86, 3.58), p < 0.001 ) and STDR group (T3: OR = 3.87 (1.87, 8.02), p < 0.001 ). During a follow-up (mean period of 16.4 months), 111 participants had new onset/progression of DR. The cox regressions showed that high baseline baPWV was correlated with increased risk of development/progression of DR ( HR = 2.24 , 95% CI (1.24, 4.03), p = 0.007 , for T2 baPWV and HR = 2.90 , 95% CI (1.49, 5.64), p = 0.002 , for T3 baPWV) after adjustments for multiple factors. Conclusions. Our results demonstrated that baseline baPWV might be an independent predictor in new onset/worsening of DR, suggesting that increased arterial stiffness might be involved in the development of DR. Follow-up studies with a longer duration are needed.

scholarly journals Metformin use is associated with a lower risk of osteoporosis/vertebral fracture in Taiwanese patients with type 2 diabetes mellitus

2021 ◽  
Vol 184 (2) ◽  
pp. 299-310
Author(s):  
Chin-Hsiao Tseng
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Vertebral Fracture ◽  
Lower Risk ◽  
Sensitivity Analyses ◽  
Incident Cases ◽  
New Onset

Objectives To investigate the metformin effect on the risk of osteoporosis (OS) and/or vertebral fracture (VF). Methods We enrolled 14 611 pairs of metformin ever and never users matched on propensity score (PS) from Taiwan’s National Health Insurance database. All patients had new-onset type 2 diabetes mellitus (T2DM) during 1999–2005 and were free from OS and/or any fracture at the start of follow-up on January 1, 2006. They were followed up until December 31, 2011 for the incidence of OS/VF. Cox regression incorporated with the inverse probability of treatment weighting using PS was used in the main analyses. Results New-onset OS/VF was diagnosed in 1757 never users (median follow-up 5.0 years) and 1143 ever users (median follow-up 5.3 years). The respective incidence rates were 2870.97 and 1713.20 per 100 000 person-years. Two-thirds of the incident cases had OS without VF and the other third had VF. In main analyses, the hazard ratio for ever vs never users was 0.592 (95% CI: 0.550–0.638). In either sex, a dose–response pattern was noted and metformin therapy > 2 years was consistently associated with a lower risk. The protective effect attenuated with increasing age but remained significant in patients aged ≥ 80 years. In sensitivity analyses, metformin significantly reduced the risk of both OS and VF (with or without a prior OS) by 30–40%. Additional analyses showed a null association for other antidiabetic drugs, but significant interactions between metformin and insulin, sulfonylurea and pioglitazone, respectively, were noted. Conclusion Metformin use is associated with a lower risk of OS/VF.

scholarly journals Effects of Aspirin or Clopidogrel on Colorectal Cancer Chemoprevention in Patients with Type 2 Diabetes Mellitus

Cancers ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 1468 ◽  
Author(s):  
Yi-Chun Kuan ◽  
Kuang-Wei Huang ◽  
Cheng-Li Lin ◽  
Jiing-Chyuan Luo ◽  
Chia-Hung Kao
Keyword(s):  
Diabetes Mellitus ◽  
Colorectal Cancer ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Proportional Hazards ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Research Database

Background: The effect of clopidogrel, whose mechanism of action differs from that of aspirin, on CRC risk remains unknown. We investigated the effects of clopidogrel and aspirin, either as monotherapy or combined, on colorectal cancer (CRC) risk in patients with Type 2 diabetes mellitus (T2DM). Methods: We conducted a cohort study using Taiwan National Health Insurance Research Database. Four groups comprising 218,903 patients using aspirin monotherapy, 20,158 patients using clopidogrel monotherapy, 42,779 patients using dual antiplatelet therapy, and 281,840 nonuser matched controls were created using propensity score matching. Cox proportional hazards regression was used to evaluate the CRC risk during follow-up. Results: During the 13-year follow-up period, we found 9431 cases of CRC over 3,409,522 person-years. The overall incidence rates of CRC were 2.04, 3.45, 1.55, and 3.52 per 1000 person-years in the aspirin, clopidogrel, dual antiplatelet, and nonuser cohorts, respectively. The adjusted hazard ratios (aHRs) were 0.59 (95% confidence interval [CI], 0.56–0.61), 0.77 (95% CI, 0.68–0.87), and 0.37 (95% CI, 0.33–0.40) for the aspirin, clopidogrel, and dual antiplatelet cohorts, respectively. Dose- and duration-dependent chemopreventive effects were observed in the three cohorts.

scholarly journals Association Between High-Density Lipoprotein Cholesterol and Type 2 Diabetes Mellitus Among Chinese: The Beijing Longitudinal Study of Aging

2020 ◽  
Author(s):  
Xue Cao ◽  
Zhe Tang ◽  
Jie Zhang ◽  
Haibin Li ◽  
Manjot Singh ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
High Density Lipoprotein ◽  
High Density Lipoprotein Cholesterol ◽  
Cox Regression ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol

Abstract Background: Contradictory conclusions of association between high-density lipoprotein cholesterol (HDL-C) levels and type 2 diabetes mellitus (T2DM) were reported in different populations. This study aimed to clarify the effect of HDL-C on the risk of T2DM incidence using a cohort lasting for 25-year follow-up.Methods: This study included 1462 community residents aged 55 or above, excluding subjects with diabetes at baseline. Incident cases of T2DM were ascertained by self-reported T2DM or fasting plasma glucose testing. The data were collected in nine surveys held between the years 1992 to 2017. Cox regression and the Fine-Gray model were applied to evaluate the relationship between HDL-C levels and the risk of T2DM incidence.Results: 120 participants developed new diabetes during follow-up period. There was a significant negative association between HDL-C levels and the risk of newly on-set T2DM. The incidences of T2DM decreased with the increasing quartile ranges of HDL-C levels, which were 12.60, 9.70, 5.38 and 5.22 per 1000 person-years, respectively. The adjusted hazard ratios (HRs) and 95% confidence intervals were 0.78 (0.50-1.23), 0.51 (0.29-0.90) and 0.47 (0.26-0.84) for subjects with baseline HDL-C levels in ranges of 1.15-1.39, 1.40-1.69 and ≥ 1.70 mmol/L, compared with ones in the range of < 1.15 mmol/L. Similar decreased HRs of T2DM for elevated HDL-C levels were observed in time-dependent Cox regression and other sensitivity analyses.Conclusion: Higher HDL-C levels were independently related to the lower risk of the newly-onset T2DM among the elderly in China.

scholarly journals Associations of LDL-C-to-HDL-C and TG-to-HDL-C Ratios with Type 2 Diabetes Mellitus and Cardiovascular Disease: A Prospective Cohort Study with 6 years’ Follow-Up

2020 ◽  
Author(s):  
Jinjian Xu ◽  
Yiyan Hu ◽  
Qiaohui Wei ◽  
Qiong Wu ◽  
Ziqi Jin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Disease Surveillance ◽  
Density Lipoprotein ◽  
Hazard Ratio ◽  
Lipoprotein Cholesterol

Abstract Background: Traditional blood lipids play an important role in diabetes and cardiovascular diseases, but the evidences were not enough . The lipoprotein indices of low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratios may be the predictive parameters to diabetes and cardiovascular disease. Methods: A 6-year follow-up study was performed in 22,649 subjects (were aged 18–95 years old) without a history of cardiovascular disease (CVD) or diabetes. The information about cardiovascular disease and T2DM was extracted from the Disease Surveillance Points (DSP) system in 2019. Biochemical and demographic variables were acquired by laboratory test and the face-to-face interview with structured questionnaire, the response rate was 88.9%. Lipid ratios were stratified by tertile to ascertain the hazard ratio (HR) of diseases by Cox proportional hazard model. Results: The mean age of subjects was 54.9(14.5) years, 41.9% were males. LDL-C /HDL-C was strongly associated with coronary heart disease (CHD) ( second vs. first tertile: HR, 1.86; 95% CI, 1.03-3.37, p =0.04 ; third vs. first tertile: HR, 3.29; 95% CI, 1.91-5.69, p< 0.001), meanwhile the TG/HDL-C was specifically associated with type 2 diabetes mellitus (T2DM) (second vs. first tertile: HR, 1.56; 95% CI, 1.2-2.02, p =0.001; third vs. first tertile: HR, 2.7; 95% CI, 2.13-3.43, p< 0.001). Moreover, the HR, of diseases was increased with LDL-C, TG/HDL-C ratios. The results of sensitivity analysis revealed the associations of LDL-C, TG/HDL-C ratios with CHD and T2DM were independent on confounders. Conclusion: Our findings suggested that the LDL-C/HDL-C ratio and TG/HDL-C ratio associated with CHD and T2DM , and hazard ratio of disease increased with lipoprotein derived indices.

Vitamin D Supplementation and Serum Levels of Magne-sium and Selenium in Type 2 Diabetes Mellitus Patients: Gender Dimorphic Changes

2014 ◽  
Vol 84 (1-2) ◽  
pp. 27-34 ◽  
Author(s):  
Nasser M. Al-Daghri ◽  
Khalid M. Alkharfy ◽  
Nasiruddin Khan ◽  
Hanan A. Alfawaz ◽  
Abdulrahman S. Al-Ajlan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Type 2 Diabetes Mellitus ◽  
Serum Levels ◽  
Vitamin D Supplementation ◽  
Serum Selenium ◽  
Dependent Manner

The aim of our study was to evaluate the effects of vitamin D supplementation on circulating levels of magnesium and selenium in patients with type 2 diabetes mellitus (T2DM). A total of 126 adult Saudi patients (55 men and 71 women, mean age 53.6 ± 10.7 years) with controlled T2DM were randomly recruited for the study. All subjects were given vitamin D3 tablets (2000 IU/day) for six months. Follow-up mean concentrations of serum 25-hydroxyvitamin D [25-(OH) vitamin D] significantly increased in both men (34.1 ± 12.4 to 57.8 ± 17.0 nmol/L) and women (35.7 ± 13.5 to 60.1 ± 18.5 nmol/L, p < 0.001), while levels of parathyroid hormone (PTH) decreased significantly in both men (1.6 ± 0.17 to 0.96 ± 0.10 pmol/L, p = 0.003) and women (1.6 ± 0.17 to 1.0 ± 0.14 pmol/L, p = 0.02). In addition, there was a significant increase in serum levels of selenium and magnesium in men and women (p-values < 0.001 and 0.04, respectively) after follow-up. In women, a significant correlation was observed between delta change (variables at six months-variable at baseline) of serum magnesium versus high-density lipoprotein (HDL)-cholesterol (r = 0.36, p = 0.006) and fasting glucose (r = - 0.33, p = 0.01). In men, there was a significant correlation between serum selenium and triglycerides (r = 0.32, p = 0.04). Vitamin D supplementation improves serum concentrations of magnesium and selenium in a gender-dependent manner, which in turn could affect several cardiometabolic parameters such as glucose and lipids.

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