Changes in t-PA and PAI-1 levels after exercise in patients with diabetes mellitus: A sex and age-matched control study.
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Design Abnormalities in glucose homeostasis have been described in patients with primary aldosteronism (PA) but most studies show inconsistent results. Therefore, we aimed to compare the prevalence of type 2 diabetes mellitus and metabolic syndrome (MetS) in newly diagnosed PA patients to a matched control cohort of the background population. Methods In total, 305 PA patients of the prospective German Conn's Registry were compared to the population-based Study of Health In Pomerania (SHIP1; n =2454). A 1:1 match regarding sex, age, and BMI resulted in 269 matched pairs regarding type 2 diabetes and 183 matched pairs regarding MetS. Of the total, 153 PA patients underwent oral glucose tolerance testing (OGTT) at diagnosis and 38 PA patients were reevaluated at follow-up. Results Type 2 diabetes and MetS were significantly more frequent in PA patients than in the control population (17.2% vs 10.4%, P =0.03; 56.8% vs 44.8%, P =0.02 respectively). Also, HbA1c levels were higher in PA patients than in controls ( P <0.01). Of the total, 35.3% of non-diabetic PA patients showed an abnormal OGTT (¼ newly diagnosed type 2 diabetes and ¾ impaired glucose tolerance). PA patients with an abnormal OGTT at baseline presented with significantly improved 2 h OGTT glucose ( P =0.01) at follow-up. We detected a negative correlation between 2 h OGTT glucose levels and serum potassium ( P <0.01). Conclusions Type 2 diabetes and MetS are more prevalent in patients with PA than in controls matched for sex, age, BMI, and blood pressure. This may explain in part the increased cardiovascular disease morbidity and mortality in PA patients.
Primary Aldosteronism
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Physical exercise
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Objective
To investigate the relationship between early onset diabetes mellitus and atherosclerosis in patients with type 2 diabetic kidney disease.
Methods
Total 240 hospitalized patients (91 females and 149 males ) in our hospital with type 2 diabetic kidney disease from January 2017 to December 2017 were enrolled. According to the age of newly diagnosed diabetes mellitus, the patients were divided into early onset group (the age at first diagnosis of diabetes was <40 years old, n=46) and late onset group (the age at first diagnosis of diabetes was ≥ 40 years old, n=194). The clinical data, anthropological measurements were collected. The relationships between early onset diabetes mellitus and atherosclerosis were analyzed by t test, u test, and Chi square test for statistical analysis. Logistic regression analysis was performed to obtain odds ratios (OR) for early versus late onset of T2DM.
Results
Compared with the late onset group, the early onset group was younger, less complicated with hypertension, shorter duration of hypertension, less use of renin-angiotensin-aldosterone system (RAAS) inhibitors and other types of antihypertensive drugs and lipid-lowering drugs (P<0.05). However, the prevalence of atherosclerosis in early onset group was increased (76.1% vs 59.3%, P=0.034). There were no significant difference in disease duration, smoking, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), low density lipoprotein (LDL-C) and glycosylated hemoglobin (HbA1c) between the two groups. Univariate logistics regression analysis showed early onset type 2 diabetes mellitus , age and duration of diabetes were predictors of atherosclerosis (P<0.05). With the use of multivariate logistic regression, patients with early onset diabetes had higher risks for atherosclerosis when adjusted by gender, age, metabolic factors and disease duration (OR 2.93, 95% CI: 1.24, 6.93, P=0.014).
Conclusions
Early onset diabetes mellitus increases the risk of atherosclerosis in patients with type 2 diabetic kidney disease.
Key words:
Diabetic nephropathies; Diabetes mellitus, Type 2; Atherosclerosis; Risk factors
Univariate analysis
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Abstract To investigate the characteristics of newly diagnosed early-onset diabetes in the Chinese population, 2801 newly diagnosed diabetes participants without known diabetes or pre-diabetes in a national cross-sectional survey were analysed. Participants were divided into quartiles (22–43, 44–52, 53–61 and >61 years) according to age of diabetes onset and the first group were defined as early-onset diabetes group. Early-onset diabetes group had lower systolic blood pressure (SBP), total cholesterol, low density lipoprotein cholesterol, 2-hour post prandial blood glucose and urine albumin creatinine ratio. There was no difference in body mass index, Homeostasis model assessment (HOMA) of beta cell function and diabetes family history between early-onset diabetes participants and any other age groups. HOMA of insulin resistance (IR) scores and disposition index 30 minutes after glucose load (DI 30 ) were increased in early-onset diabetes participants. The beta cell function declination was more deteriorated in early-onset diabetes participants. Male gender, triglycerides, HOMA-IR and DI 30 were positively associated with an earlier age at diagnosis. In conclusion, patients diagnosed with diabetes at a younger age are characterized by a similar cardiovascular risk profile with increased insulin resistance and more severe beta cell failure than patients diagnosed at a later age.
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Cross-sectional study
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The relationship between triglyceridemia and diabetes mellitus remains unclear. This study evaluated the risk of diabetes and impaired fasting glucose associated with a wide range of triglyceride levels. A longitudinal retrospective study was carried out employing data from a screening center between the years 2000 and 2012. Inclusion criteria were absence of diabetes at baseline and attendance at the center at least twice over a 5-year period. Participants were divided by fasting blood glucose level (normal/impaired) at the first visit. A total of 5085 participants were eligible for the study. Of the 4164 normoglycemic participants at baseline, 40 (0.96%) had diabetes and 998 (24%) had impaired fasting glucose by the end of the study. On stepwise logistic regression analysis, every 10 mg/dL increase in triglyceride level significantly increased the risk of diabetes by 4% and of impaired fasting glucose by 2% (p<0.001). This association held true even when rising triglyceride levels remained within the accepted normal range (<150 mg/dL, p<0.001). Sustained increments in serum triglyceride level, even within the accepted normal range, are an independent risk factor for diabetes mellitus and impaired fasting glucose in normoglycemic participants.
Impaired fasting glucose
Fasting glucose
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Objectives : To determine the relationship between exercise and the incidence of type 2 diabetes in an impaired fasting glucose group.Methods : This prospective cohort study was conducted in 19,440 men and 4,297 women, aged 30-69 years, with impaired fasting glucose at baseline who had undergone biennial medical evaluation through the National Health Insurance Corporation from 2000 to 2004.Impaired fasting glucose was defined as fasting glucose of 100 to 125 mg/dl and the subjects were divided into 3 groups depending on weekly exercise frequency.Multivariate logistic regression analysis was used to evaluate the association between the baseline exercise status and incidence of type 2 diabetes.Results : During the 4-year follow-up, a total of 3,239 men and 283 women developed type 2 diabetes, a cumulative incidence of 16.6% for men, and 6.5% for women.Also, 1,688 men (21.2%) and 127 women (15.2%) developed type 2 diabetes in the obese group.The adjusted relative risk (RR) of developing type 2 diabetes in non-exercising men was significantly higher than exercising men regularly (RR= 1.375, 95% CI=1.236-1.529)(p<0.0001),and the RR for non-exercising women was higher than exercising women regularly (RR=1.124,95% CI=0.711-1.778).The RR for non-exercise men/women in the obese group was 1.571 (95% CI=1.351-1.827)(p<0.0001)/1.869(95% CI=0.846-4.130).Conclusions : Regular exercise is effective in preventing type 2 diabetes in people with impaired fasting glucose, and particularly in obese people.People with risk factors for diabetes should participate in a regular exercise program.
Impaired fasting glucose
Fasting glucose
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Introduction: Diabetes mellitus is a multifactorial disease which is characterised by hyperglycaemia, dyslipidaemia, involves various organ systems, and results in various long-term complications. Several studies have suggested that men with low testosterone levels are at a greater risk of developing type 2 diabetes mellitus, and that low testosterone levels may even predict the onset of diabetes. Recent studies have shown that a low serum testosterone level is strongly associated with an increased likelihood of the metabolic syndrome. Aim: To compare the serum total testosterone levels in type 2 diabetes mellitus patients with that of non-diabetic healthy controls. Material and Methods: The study was conducted in OPD of Medical College, Kolkata. In the present study 50 men aged 35-55 years who were diagnosed as type 2 diabetes mellitus patients and confirmed by the estimation of fasting plasma glucose (≥126mg/dl), post prandial blood glucose (≥200mg/dl) and HbA1C (≥6.5%) were selected, 50 healthy age and BMI matched individuals, were selected as controls. Patients with a known history of hypogonadism, panhypopituitarism, hyperthyroidism, patients taking exogenous testosterone and glucocorticoids, patients suffering from chronic debilitating disease, such as renal failure, cardiac failure, liver cirrhosis, or HIV, were excluded from the study. The laboratory investigations included evaluation of serum testosterone levels, fasting and postprandial blood glucose, with the levels of HbA1c and Creatinine. Statistical analysis was performed using SPSS 20.0. Results are represented as mean±SD and number (%). Pearson’s correlation test was performed to measure the linear dependence of the study parameters. Results: Serum Total Testosterone level of diabetic group was 3.51±1.26ng/ml, which was found significantly lower than control group with serum total testosterone level 5.88±2.34ng/ml, (p-value < 0.0001). Conclusion: This study has shown that there is a significant reduction in serum total testosterone levels in type 2 diabetes mellitus patients.
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Metabolic control analysis
Plasminogen activator inhibitor-1
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