Association of Stress Hyperglycemia Ratio With Acute Ischemic Stroke Outcomes Post-thrombolysis

Background and Purpose: The association between stress hyperglycemia and clinical outcomes in patients with acute ischemic stroke treated with intravenous thrombolysis (IVT) is uncertain. We sought to analyze the association between the stress hyperglycemia ratio (SHR) using different definitions and clinical outcomes in acute patients with ischemic stroke undergoing IVT.Methods: A total of 341 patients with ischemic stroke receiving IVT were prospectively enrolled in this study. The SHR was evaluated using different equations: SHR1, fasting glucose (mmol/L)/glycated hemoglobin (HbA1c) (%); SHR2, fasting glucose (mmol/L)/[(1.59 × HbA1c)−2.59]; SHR3, admission blood glucose (mmol/L)/[(1.59 × HbA1c)−2.59]. A poor functional outcome was defined as a modified Rankin scale score of 3–6 at 3 months. Multivariate logistic regression analysis was used to identify the relationship between different SHRs and clinical outcomes after IVT.Results: A total of 127 (37.2%) patients presented with poor functional outcomes at 3 months. The predictive value of SHR1 for poor functional outcomes was better than that of SHR2 and SHR3 in receiver operating characteristic analyses. On multivariate analysis, SHR1 [odds ratio (OR) 14.639, 95% CI, 4.075–52.589; P = 0.000] and SHR2 (OR, 19.700; 95% CI; 4.475–86.722; P = 0.000) were independently associated with an increased risk of poor functional outcome but not SHR3.Conclusions: Our study confirmed that the SHR, as measured by SHR1 and SHR2, is independently associated with worse clinical outcomes in patients with ischemic stroke after intravenous thrombolysis. Furthermore, SHR1 has a better predictive performance for outcomes than other SHR definitions.

Sub-chronic effects of Baccharis dracunculifolia treatment on biochemical, oxidative, and histopathological parameters in diabetic rats

Background: Oxidative stress and the mild inflammatory process present in diabetes play a critical role in the pathogenesis of the disease and its comorbidities. This understanding has opened new avenues and targets for developing improved treatments since the risk factors associated with diabetes may be reduced through non-pharmacological interventions. In this sense, plant extracts could be efficient in preventing or assisting these pathological conditions treatment. Methods: Diabetes mellitus was induced in 24 rats, which were allocated in 4 groups: Control (CT), Control+Baccharis (CT-B), Diabetes (DB), and Diabetes+Baccharis (DB-B). For 28 days, the animals of CT-B and DB-B groups were treated, via gavage, with B. dracunculifolia extract at 50 mg.kg-1. Results: The DB group presented higher values than the DB-B group on parameters such as creatinine (26.42%), urea (31.42%), and triglycerides (60.80%). Creatinine and triglycerides values of DB-B group (0.39±0.01 e 75.0±8.4, receptively) were equivalent to the values of CT group (0.32±0.01 e 71.7±5.4) and of CT-B group (0.39±0.01, and 58.8±4.5). The treatment with B. dracunculifolia improved the levels of fasting glucose and response of glucose tolerance (32%), insulin (52,17%) and lipid peroxidation (liver 33.33%, kidney 38.77%) when compared to the DB group. Conclusions: The phenolic compounds and the anti-inflammatory activity of the extract of Baccharis dracunculifolia may be responsible for the hypoglycemic effect observed in the study.

Impact of Impaired Glucose Metabolism on Periodontitis Progression over Three Years

We evaluated the relationship between glucose abnormalities and periodontitis in overweight/obese individuals. Eight hundred and seventy (870) diabetes-free participants aged 40–65 years completed the three-year follow-up in the San Juan Overweight Adults Longitudinal Study. The ADA thresholds for fasting and 2-h post-load glucose and HbA1c were used to define prediabetes. The NHANES methods were used to assess periodontitis. Multivariable linear regression was used to evaluate the relationship between baseline glucose metabolism measures and periodontitis at follow-up, adjusting for potential confounders. There was no association between impaired glucose measures and mean pocket depth (PD), mean clinical attachment loss (CAL), or mean percent of sites ≥5 mm PD. Impaired glucose tolerance (IGT) was associated with a lower mean percent of sites ≥5 mm CAL (β = −1.6, p = 0.037). Prediabetes and impaired fasting glucose (IFG) were associated with improvement in mean percent of sites ≥5 mm PD (β = −1.4, p = 0.022; β = −1.6, p = 0.032; respectively). IFG and IGT were associated with improvement in mean percent of sites with ≥5 mm CAL (β = −1.6, p = 0.038; β = −1.9, p = 0.020; respectively). In conclusion, there were no consistent associations between baseline prediabetes or insulin resistance and periodontitis progression over a three-year period.

Association Between Serum Furin and Fasting Glucose: A Cross-Sectional Study in Chinese Adults

BackgroundFurin has been associated with glucose metabolic phenotypes in small sampled clinical studies. However, this association has not yet been studied in Chinese. Here, we aimed to examine the association between serum furin and fasting glucose in Chinese adults.MethodsSerum furin and fasting plasma glucose were assayed for 2,172 participants (mean aged 53 years, 38% men) in the Gusu cohort. A median regression model was applied to examine the association between serum furin and fasting glucose, adjusting for age, sex, education level, cigarette smoking, alcohol drinking, obesity, blood pressure, and lipids. To facilitate data interpretation, the association between serum furin and prevalent diabetes was also examined.ResultsSerum furin was negatively associated with fasting glucose (β=-0.18, P<0.001 for log-furin). In participants with diabetes, serum furin was significantly lower than those with normal glucose (median: 0.90 ng/mL vs. 1.05 ng/mL, P=0.001). Compared with participants in the highest quartile of serum furin, those in the lowest quartile had 42% and 80% increased risk of prevalent prediabetes (OR=1.42, 95%CI: 1.05-1.92, P=0.023) and diabetes (OR=1.80, 95%CI: 1.13-2.91, P=0.015), respectively.ConclusionsSerum furin was negatively associated with prediabetes and diabetes in Chinese adults. Our findings suggest that serum furin may be a risk factor or a biomarker of diabetes.

Антропометричні, біохімічні та актиграфічні характеристики популяційного зразка випадково відібраних дорослих сільських мешканців України, у яких раніше не було встановлено діагнозу «цукровий діабет»

Класичні «польові» епідеміологічні дослідження щодо факторів ризику розвитку цукрового діабету (ЦД) та серцево-судинної патології все ще рідкісні в Україні, через що оцінка поширеності ЦД 2-го типу (ЦД2) базується на екстраполяції з іноземних досліджень. Об’єктивні методи вимірювання фізичної активності (ФА), яку вважають одним із головних чинників профілактики ЦД2, в Україні мало відомі. Зокрема не з’ясовано, наскільки поширеним є серед дорослого населення України виконання рекомендацій Всесвітньої організації охорони здоров’я (ВООЗ) щодо мінімальної кількості помірної фізичної активності (150 хв/тиждень). Залишається недостатньо дослідженим питання про зв’язок композиції тіла та характеристик, що впливають на ризик розвитку ЦД2. Матеріал і методи. Наше дослідження представляє аналіз біохімічних, антропометричних та актиграфічних характеристик 50 рандомізовано відібраних сільських мешканців Київської області України (16 чоловіків із медіанним віком 63,5 року, 34 жінки з медіанним віком 58,0 року), у яких раніше не було діагностовано ЦД2. Після отриманої інформованої згоди всім досліджуваним проведено оральний тест толерантності до глюкози (ОТТГ) за методом ВООЗ (1999). Вимірювали рівні глюкози плазми крові натщесерце (fasting plasma glucose, FPG), глюкози плазми через 2 год після стандартного навантаження (2 hours plasma glucose, 2hPG), тригліцеридів (ТГ), холестерину ліпопротеїнів високої щільності (ХСЛВЩ), глікованого гемоглобіну (glycated hemoglobin, HbA1c), індекс маси тіла (ІМТ), окружність шиї (ОШ), окружність талії (ОТ) та окружність стегон (ОС). Визначили показники композиції тіла за допомогою методу біоелектричного імпедансу: пропорцію жиру тіла (body fat, %) та загальної води тіла (total body water, %). Актиграфічні вимірювання було проведено шляхом акселерометрії за допомогою програмного забезпечення ActiGraph. Моніторинг ФА відбувався протягом 7 днів за такими показниками: середня кількість метаболічних еквівалентів (metabolic equivalents, MET’s), частка ФА помірної інтенсивності за весь час носіння та записування акселерометра (moderate physical activity, ModPA, %) і показник помірної ФА — кількість хв/тиждень, накопичених у періодах тривалістю не менше 10 хв (ModPA, хв/тиждень). Статистичну обробку результатів проведено за пакетом MedStat. Результати. Серед досліджених осіб за даними ОТТГ та вимірювання HbA1c ЦД виявлено в 4 осіб (8%). Порушена глікемія натщесерце (impaired fasting glucose, IFG) за критеріями Американської діабетичної асоціації (АДА) (FPG: 5,6-6,9 ммоль/л) виявлена у 21 особи, а за критеріями ВООЗ (FPG: 6,1-6,9 ммоль/л) — у 7 осіб. IFG незалежно від застосованого критерію не виявляє зв’язку з рівнем ФА. Порушена толерантність до глюкози (impaired glucose tolerance, IGT: 2hPG 7,8-11,0 ммоль/л) виявлена в 5 осіб. За рівнем глікемії, HbA1c та ліпідів не виявлено зв’язку з ФА. Жінки не відрізнялися від чоловіків за віком, мали більший ІМТ (35,08±5,53 проти 27,43±4,98, р<0,001) і більшу частку жиру тіла (45,8±5,7% проти 26,3±5,5%, р<0,001). Водночас, показники ФА у чоловіків і жінок не відрізнялися, були дуже низькими й мали помірну негативну кореляцію з віком (р<0,05). Результати наведені як середнє арифметичне та стандартне відхилення (M±SD). Лише в одного чоловіка та двох жінок було досягнуто рекомендований рівень помірної ФА (150 хв/тиждень). Серед осіб з IGT кількість ФА виявилась меншою: MET’s — 1,22±0,07 проти 1,32±0,19, р=0,023; помірна ФА — 6,95±2,3% проти 10,41±6,43%, р=0,020. Висновки. Виявлена поширеність раніше не діагностованого ЦД2 близька до результатів наших попередніх досліджень та сучасних оцінок поширеності ЦД2 серед дорослого населення у світі. Рівень ФА, оціненої об’єктивним методом актиграфії, виявився нижчим у групі осіб з IGT. Подальші дослідження зможуть прояснити питання профілактичної ефективності ФА в різних групах ризику ЦД2.

Dietary Intake in Early Pregnancy and Glycemia in Late Pregnancy among Women with Obesity

Women with obesity have increased risk for hyperglycemia during pregnancy, with negative health consequences for mother and child. We aimed to investigate adherence to nutritional recommendations in early pregnancy and to examine associations between early pregnancy dietary intake and late pregnancy glycemia among women with obesity. We included 120 women with pre-pregnancy body mass index (BMI) ≥30 kg/m2 who participated in one of two randomized controlled trials. The participants completed a food frequency questionnaire in early pregnancy (gestational weeks 12–22). Fasting and 120 min glucose tolerance after ingestion of 75 g glucose were assessed in late pregnancy (gestational weeks 32–37). About 90% of the participants reported early pregnancy diary intake within the recommendations. Average intakes of vitamin D, iron, and folate were below recommended levels. High intakes of dairy products and protein in early pregnancy were associated with lower fasting glucose in late pregnancy, whereas high intake of bread was associated with lower 120 min glucose. There were no clear associations between single dietary variables and gestational diabetes mellitus (GDM) diagnosis in late pregnancy. In conclusion, some early pregnancy dietary variables were associated with late pregnancy glycemia. Potential causality of these findings should be investigated in future studies.

The Association between Fasting Glucose and Sugar Sweetened Beverages Intake Is Greater in Latin Americans with a High Polygenic Risk Score for Type 2 Diabetes Mellitus

Chile has the highest per capita intake of sugar-sweetened beverages (SSB) world-wide. However, it is unknown whether the effects from this highly industrialized food will mimic those reported in industrialized countries or whether they will be modified by local lifestyle or population genetics. Our goal was to evaluate the association between SSB intake and fasting glucose in the Chilean population. We calculated a weighted genetic risk score (GRSw) based on 16 T2D risk SNPs in 2828 non-diabetic participants of the MAUCO cohort. SSB intake was categorized in four levels using a food frequency questionnaire. Log-fasting glucose was regressed on SSB and GRSw tertiles while accounting for socio-demography, lifestyle, obesity, and Amerindian ancestry. Fasting glucose increased systematically per unit of GRSw (β = 0.02 ± 0.006, p = 0.00002) and by SSB intake (β[cat4] = 0.04 ± 0.009, p = 0.0001), showing a significant interaction, where the strongest effect was observed in the highest GRSw-tertile and in the highest SSB consumption category (β = 0.05 ± 0.02, p = 0.02). SNP-wise, SSB interacted with additive effects of rs7903146 (TCF7L2) (β = 0.05 ± 0.01, p = 0.002) and with the G/G genotype of rs10830963 (MTNRB1B) (β = 0.19 ± 0.05, p = 0.001). Conclusions: The association between SSB intake and fasting glucose in the Chilean population without diabetes is modified by T2D genetic susceptibility.

Systematic Review and Meta-analysis of the Association Between Metabolic Syndrome and Androgenetic Alopecia

The association of androgenetic alopecia with metabolic syndrome has been investigated in several studies, with conflicting results. We conducted a meta-analysis to quantitatively evaluate the risk grade of metabolic syndrome and the metabolic profile in patients with androgenetic alopecia as compared with controls. In total, 19 articles (2,531 participants) satisfied the inclusion criteria. The pooled odds ratio for the prevalence rate of metabolic syndrome between the group with androgenetic alopecia and controls was 3.46 (95% CI: 2.38–5.05; p<0.001). Female sex, early onset, and African ethnicity were associated with an increased risk of metabolic syndrome. Furthermore, patients with androgenetic alopecia had significantly poorer metabolic profiles, such as body mass index, waist circumference, fasting glucose, blood lipids, and blood pressure. It is important for physicians to screen metabolism-related indicators in patients with androgenetic alopecia. More rigorously designed studies and larger sample sizes are required in future studies.

Fasting Glucose Variability as a Risk Indicator for End-Stage Kidney Disease in Patients with Diabetes: A Nationwide Population-Based Study

Given the fact that diabetes remains a leading cause of end-stage kidney disease (ESKD), multi-aspect approaches anticipating the risk for ESKD and timely correction are crucial. We investigated whether fasting glucose variability (FGV) could anticipate the development of ESKD and identify the population prone to the harmful effects of GV. We included 777,192 Koreans with diabetes who had undergone health examinations more than three times in 2005–2010. We evaluated the risk of the first diagnosis of ESKD until 2017, according to the quartile of variability independent of the mean (VIM) of FG using multivariate-adjusted Cox proportional hazards analyses. During the 8-year follow-up, a total of 7290 incidents of ESKD were found. Subjects in the FG VIM quartile 4 had a 27% higher risk for ESKD compared to quartile 1, with adjustment for cardiovascular risk factors and the characteristics of diabetes. This effect was more distinct in patients aged <65 years; those with a long duration of diabetes; the presence of hypertension or dyslipidemia; and prescribed angiotensin-converting enzyme inhibitors, metformin, sulfonylurea, α-glucosidase inhibitors, and insulin. In contrast, the relationship between baseline FG status and ESKD risk showed a U-shaped association. FGV is an independent risk factor for kidney failure regardless of FG.