Poor In Utero Growth and Reduced β-Cell Compensation and High Fasting Glucose from Childhood Are Harbingers of Glucose Intolerance in Young Indians

<i>Objective</i> <p>India is a double world capital for early life undernutrition and type 2 diabetes. We aimed to characterise lifecourse growth and metabolic trajectories in those developing glucose intolerance as young adults, in the Pune Maternal Nutrition Study (PMNS). </p> <p><i>Research design and Methods</i></p> <p>PMNS is a community-based intergenerational birth cohort established in 1993, with serial information on parents and children through pregnancy, childhood and adolescence. We compared normal glucose tolerant and glucose intolerant participants for serial growth, estimates of insulin sensitivity and secretion (HOMA and dynamic indices) and beta cell compensation accounting for prevailing insulin sensitivity. <b><i></i></b></p> <p><i>Results</i></p> <p>At 18 years (N=619) 37% men and 20% women were glucose intolerant (184 prediabetes, 1 diabetes) despite 48% being underweight (BMI<18.5 kg/m²). Glucose intolerant participants had higher fasting glucose from childhood. Mothers of glucose intolerant participants had higher glycemia in pregnancy. Glucose intolerant participants were shorter at birth. Insulin sensitivity decreased with age in all participants, and the glucose intolerant had consistently lower compensatory insulin secretion from childhood. Participants in the highest quintile of fasting glucose at 6 and 12 years had a 2.5- and 4.0-fold higher risk respectively of 18-year glucose intolerance; this finding was replicated in two other cohorts. <b><i></i></b></p> <p><i>Conclusion</i></p> Inadequate compensatory insulin secretory response to decreasing insulin sensitivity from early life is the major pathophysiology underlying glucose intolerance in thin rural Indians. Smaller birth size, maternal pregnancy hyperglycemia, and higher glycemia in childhood herald future glucose intolerance, mandating a strategy for diabetes prevention from early life, preferably intergenerationally.

Poor In Utero Growth and Reduced β-Cell Compensation and High Fasting Glucose from Childhood Are Harbingers of Glucose Intolerance in Young Indians

<i>Objective</i> <p>India is a double world capital for early life undernutrition and type 2 diabetes. We aimed to characterise lifecourse growth and metabolic trajectories in those developing glucose intolerance as young adults, in the Pune Maternal Nutrition Study (PMNS). </p> <p><i>Research design and Methods</i></p> <p>PMNS is a community-based intergenerational birth cohort established in 1993, with serial information on parents and children through pregnancy, childhood and adolescence. We compared normal glucose tolerant and glucose intolerant participants for serial growth, estimates of insulin sensitivity and secretion (HOMA and dynamic indices) and beta cell compensation accounting for prevailing insulin sensitivity. <b><i></i></b></p> <p><i>Results</i></p> <p>At 18 years (N=619) 37% men and 20% women were glucose intolerant (184 prediabetes, 1 diabetes) despite 48% being underweight (BMI<18.5 kg/m²). Glucose intolerant participants had higher fasting glucose from childhood. Mothers of glucose intolerant participants had higher glycemia in pregnancy. Glucose intolerant participants were shorter at birth. Insulin sensitivity decreased with age in all participants, and the glucose intolerant had consistently lower compensatory insulin secretion from childhood. Participants in the highest quintile of fasting glucose at 6 and 12 years had a 2.5- and 4.0-fold higher risk respectively of 18-year glucose intolerance; this finding was replicated in two other cohorts. <b><i></i></b></p> <p><i>Conclusion</i></p> Inadequate compensatory insulin secretory response to decreasing insulin sensitivity from early life is the major pathophysiology underlying glucose intolerance in thin rural Indians. Smaller birth size, maternal pregnancy hyperglycemia, and higher glycemia in childhood herald future glucose intolerance, mandating a strategy for diabetes prevention from early life, preferably intergenerationally.

Prevalence of Metabolic Syndrome and Its Parameters and Their Correlations With Psoriasis Duration, Severity, and Sleep Quality In Psoriasis Patients: A Cross-Sectional Study

Background: Psoriasis is an inflammatory skin disease that may lead to comorbidities, including metabolic syndrome (MS). Objective: We determined the prevalence of MS and its correlation with psoriasis duration, severity, and sleep quality in psoriasis patients. Methods: A total of 112 subjects with chronic plaque psoriasis were studied. Demographics, MS parameters, disease duration, severity, and sleep quality were examined. The Psoriasis Area and Severity Index (PASI)and the Pittsburgh Sleep Quality Index (PSQI) were used to assess psoriasis severity and sleep quality, respectively. Presence of MS and its correlations with psoriasis duration, severity and sleep quality were investigated. Results: Of 112 patients, 76 (67.8%) were diagnosed with MS. Of all patients, 74.1% had a high PASI, and 84.8% had a high PSQI. The mean values of psoriasis duration, body mass index, waist circumference, fasting glucose, HOMA-IR, triglyceride levels, blood pressure, PSQI, sleep latency, and daytime sleep dysfunction were significantly higher in the MS group than non-MS group, whereas the mean HDL level was lower. The prevalences of MS, high fasting glucose, and low HDL were significantly higher among female, but not male, patients with severe psoriasis (PASI >10) than those without severe psoriasis. Disease duration, high body mass index, waist circumference, blood pressure, fasting glucose, HOMA-IR, triglyceride levels, low HDL, and poor sleep quality were significantly correlated with the presence of MS. However, only waist circumference, fasting glucose, blood pressure, and low HDL were predictive of the development of MS. Conclusions: MS is common among psoriasis patients, and especially in females with advanced psoriasis, high fasting glucose, and low HDL levels. Besides diagnostic criteria of MS, a long duration of psoriasis, poor sleep quality and high-HOMA-IR correlate with the development of MS. High fasting glucose and low HDL levels may facilitate MS development in association with psoriasis severity in females.

Prevalence of the Metabolic Syndrome in Patients With Type B Aortic Dissection

Background/Objective: The aim of this study is to detect the prevalence of metabolic syndrome (MS) and its components in type B aortic dissection patients. This study assessed the association of MS and its component with type B aortic dissection in Chinese patients.Methods: This cross-sectional prospective observation study consisted of 445 patients who were first diagnosed with type B aortic dissection. Demographic information, clinical symptoms and laboratory parameters were collected using a standard form.Results: Among the 445 TBAD patients 38.4% had MS. Hypertension was present in 78.2% of all TBAD patients. Hypertension, high fasting glucose and obesity were the most common combination of metabolic abnormalities (93%, 79.5% and 63.2%) in the TBAD patients, and a same phenomenon was seen in acute TBAD patients. But among chronic TBAD patients the most frequent individual components were hypertension, hyper- triglyceride and high fasting glucose (92.6%, 75%, and 70.6%). Presence of two or more components of the metabolic syndrome was common: 22.7% had one component, 31.9% had two components, 24.9% had three components, 10.8% had four components and 3.1% had five components. In TBAD, hypertension, obesity, triglycerides and FBG (fasting blood-glucose) were main risk factors for MS.ConclusionThis is the first study provided information on the prevalence and components of MS in the initial TBAD patients. Hypertension, high fasting glucose and obesity were the most common combination of metabolic abnormalities in TBAD patients.

Patterns of change in cardiovascular risks of Korean male workers: a 10-year cohort analysis using the National Health Insurance Service–National Sample Cohort (NHIS-NSC) 2.0 database

ObjectiveHealth behaviour is one of the major determinants of cardiovascular diseases in working population. This study was tried to investigate the trend of cardiovascular health level, the relationship between continuous health behaviours, and changes in the risk of cardiovascular diseases of male workers by using a nationwide database.DesignThis study is a retrospective cohort study.Setting and participantsThe study analysed data of 57 837 male workers whose personal health examination data were continuously traced using Korea’s National Health Insurance Service–National Sample Cohort 2.0 database.Primary outcome measuresA 10-year trend for all cardiovascular risks and change for the risks according to the consistent performance of healthy behaviours.ResultsThe results showed that the risk of being overweight (adjusted OR (aOR) 1.63, 95% CI 1.59 to 1.68) and obese (aOR 1.51, 95% CI 1.47 to 1.56) increased. The index of cardiovascular risk also increased for high fasting glucose (aOR 1.77, 95% CI 1.62 to 1.95) and high total cholesterol (aOR 1.68, 95% CI 1.60 to 1.76), respectively. The risks of high fasting glucose (aOR 2.09, 95% CI 1.40 to 3.13), high triglycerides (aOR 1.27, 95% CI 1.14 to 1.42) and high low-density lipoprotein cholesterol (aOR 1.38, 95% CI 1.14 to 1.66) were increased among high-risk smokers. Similarly, the risk of high total cholesterol (aOR 2.20, 95% CI 1.35 to 3.58) and high triglycerides (aOR 1.42, 95% CI 1.09 to 1.85) were increased among high-risk drinkers. In addition, the increase in the risk of being overweight (aOR 2.20, 95% CI 1.83 to 2.65) and obese (aOR 1.90, 95% CI 1.59 to 2.27) were analysed among who had not consistently exercised.ConclusionsSince the pattern of change in the level of cardiovascular risk related to the continuous health behaviours of male workers was identified, the findings of the present study can be used as basic data to develop health promotion policies for the population.

Association Between Serum Retinol and α-Tocopherol Levels and Metabolic Syndrome in Korean General Population: Analysis of Population-Based Nationally Representative Data

This study aimed to evaluate the association between serum retinol and α-tocopherol levels and metabolic syndrome (MetS) using data from the Korea National Health and Nutrition Examination Survey. Of the 24,269 individuals, 5885 adults (2672 men and 3213 women) were included. The prevalence of MetS and its components according to quartiles of serum retinol and α-tocopherol levels was calculated. Multivariate linear regression model was used to calculate the number of metabolic components according to serum vitamin levels. The association between serum vitamin levels and MetS with its components was assessed using multivariate logistic regression model. The prevalence of MetS was highest in Q4 and lowest in Q1 for both vitamins, regardless of sex. A dose-dependent association between serum retinol and α-tocopherol levels and MetS was observed. After adjustment for covariates, the odds ratio (OR) for MetS in Q4 compared to Q1 was 2.351 (95% CI: 1.748–3.163, Ptrend < 0.001) in the retinol group and 2.559 (95% CI: 1.953–3.353, Ptrend < 0.001) in α-tocopherol group. Among metabolic components, hypertriglyceridemia, high fasting glucose, and high blood pressure was positively associated with serum retinol and α-tocopherol levels. In conclusion, high serum retinol and α-tocopherol levels were associated with increased risk of MetS.

THE IMPACT OF OCCUPATIONAL AND LIFESTYLE FACTORS ON STATE OF ARTERIAL VESSELS IN COPPER INDUSTRY WORKERS

Introduction. Cardiovascular diseases (CVDs) are the leading cause of death in working-age population, including mortality occurring through occupational fatalities. The core principle in fighting CVDs is having special consideration for individuals with a high risk of its development. In order to identify those individuals, the SCORE (Systematic Coronary Risk Evaluation) system is advised. The realizations (i.e. the effects of exposure) with respect to the same risk factors may vary across individuals. Therefore, it is of urging importance to conduct an assessment of the integral cardiovascular risk estimates that are informative of coming-to-an-effect long-term exposures to adverse factors and helpful in identifying changes at early reversible stages of CVD. Material and methods. A cross-sectional study included 108 male workers aged 27-63 years, without apparent health disorders who been working in unsafe conditions over from 4 to 40 years, employed as occupational staff (converter furnace operators, charge workers, burners, smelters) in copper production enterprises of the Sverdlovsk region. Clinical examination and laboratory tests were conducted at the Yekaterinburg Medical Research Center in 2017-2018. The evaluated indices included: total cholesterol (TC), glucose, Pb and Cu level in blood. A 3D-sphygmography with CAVI assessment and aa. carotides ultrasound with intima-media thickness (IMT) assessment were performed. Cardiovascular risk (CVR) was evaluated according to the SCORE assessment. Results. The following CVR factors were identified: smoking (72.2%), obesity of various classes (33.3%), TC > 4.9 mmol/l (57.9%), high fasting glucose (73.9%) and arterial hypertension stages 1-2 (40.7%). An arterial vessel stiffness increase by CAVI (>8.0) was found in 28.7% of subjects. Associations were found between CAVI index and (i) total CVR level as evaluated by SCORE (p=0.00105), (ii) blood Cu level (r=0.33). Therefore, further research is needed.

Clinical Predictors Implicated in the Incidence of Acute Pyelonephritis during the Antepartum Period: A Population-Based Cohort Study

Introduction: Acute pyelonephritis (APN) is a common infection during pregnancy that increases the risk of unfavorable maternal and fetal outcomes. However, it has not been clearly elucidated which demographic and clinical characteristics are associated with the incidence of APN during pregnancy. Objective: This population-based cohort study aimed to determine the risk factors for APN during pregnancy. Methods: Using the database of the Health Insurance Review and Assessment Service of South Korea, we enrolled Korean women who delivered infants between 2010 and 2014 in Korea and had complete health examination records within 1 year of pregnancy. We performed multivariate logistic regression analysis to evaluate the risk factors for APN during pregnancy. Results: Of 370,248 women, 2,526 (0.7% of the total participants) were treated for APN while in hospitalization during pregnancy. Younger age, history of previous APN within 1 year of pregnancy, and abnormal results of health examination before pregnancy, such as high fasting glucose level (>100 mg/dL) and proteinuria, were associated with an increased risk of APN during pregnancy. Conclusion: Certain maternal demographic and clinical characteristics were associated with the incidence of APN during pregnancy, and these should be monitored closely during antenatal care.

Association between the prevalence of metabolic syndrome and coffee consumption among Korean adults: results from the Health Examinees study

The aim of this study was to evaluate the association between the frequency and quantity of coffee consumption and metabolic syndrome (MetS) in the Health Examinees study. A total of 130 420 participants (43 682 men and 86 738 women) were included in our study. Coffee consumption was categorized into 5 categories (0, <1, 1, 2–3, and ≥4 cups/day). We calculated odds ratios (ORs) and 95% confidence intervalS (CIs) using multivariate logistic regression. In this study population, the prevalence of MetS was 12 701 (29.1%) in men and 21 338 (24.6%) in women. High coffee consumption (≥4 cups/day) was associated with a lower prevalence of MetS compared with non-coffee consumers (OR = 0.79, 95% CI = 0.70–0.90, p for trend <0.0001 in men; OR = 0.70, 95% CI = 0.62–0.78, p for trend <0.0001 in women). The multivariable-adjusted ORs for high fasting glucose decreased with increasing levels of coffee consumption in men (OR = 0.60, 95% CI = 0.54–0.67, p for trend <0.0001) and women (OR = 0.70, 95% CI = 0.63–0.79, p for trend <0.0001). For women, the multivariable-adjusted ORs for hypertriglyceridemia (OR = 0.84, 95% CI = 0.75–0.93, p for trend = 0.0007) decreased with increasing levels of coffee consumption. We found that coffee consumption was inversely associated with the prevalence of metabolic syndrome among Korean men and women. Our study warrants further prospective cohort studies.