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Volume 44(2); April 2020
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Special Editorial
COVID-19
The Outbreak of COVID-19 and Diabetes in Korea: “We Will Find a Way as We Have Always Done”
Kyu Chang Won, Kun Ho Yoon
Diabetes Metab J. 2020;44(2):211-212.   Published online April 23, 2020
DOI: https://doi.org/10.4093/dmj.2020.0092
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  • 72 Download
  • 3 Web of Science
  • 3 Crossref
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  • Effects of a DPP-4 Inhibitor and RAS Blockade on Clinical Outcomes of Patients with Diabetes and COVID-19
    Sang Youl Rhee, Jeongwoo Lee, Hyewon Nam, Dae-Sung Kyoung, Dong Wook Shin, Dae Jung Kim
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  • Dissection of non-pharmaceutical interventions implemented by Iran, South Korea, and Turkey in the fight against COVID-19 pandemic
    Mohammad Keykhaei, Sogol Koolaji, Esmaeil Mohammadi, Reyhaneh Kalantar, Sahar Saeedi Moghaddam, Arya Aminorroaya, Shaghayegh Zokaei, Sina Azadnajafabad, Negar Rezaei, Erfan Ghasemi, Nazila Rezaei, Rosa Haghshenas, Yosef Farzi, Sina Rashedi, Bagher Larijan
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  • Diabetes and COVID-19: Global and regional perspectives
    In-Kyung Jeong, Kun Ho Yoon, Moon Kyu Lee
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Reviews
Drug/Regimen
Fibrates Revisited: Potential Role in Cardiovascular Risk Reduction
Nam Hoon Kim, Sin Gon Kim
Diabetes Metab J. 2020;44(2):213-221.   Published online April 23, 2020
DOI: https://doi.org/10.4093/dmj.2020.0001
  • 7,581 View
  • 309 Download
  • 41 Web of Science
  • 41 Crossref
AbstractAbstract PDFPubReader   

Fibrates, peroxisome proliferator-activated receptor-α agonists, are potent lipid-modifying drugs. Their main effects are reduction of triglycerides and increase in high-density lipoprotein levels. Several randomized controlled trials have not demonstrated their benefits on cardiovascular risk reduction, especially as an “add on” to statin therapy. However, subsequent analyses by major clinical trials, meta-analyses, and real-world evidence have proposed their potential in specific patient populations with atherogenic dyslipidemia and metabolic syndrome. Here, we have reviewed and discussed the accumulated data on fibrates to understand their current status in cardiovascular risk management.

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Basic Research
The Role of CD36 in Type 2 Diabetes Mellitus: β-Cell Dysfunction and Beyond
Jun Sung Moon, Udayakumar Karunakaran, Elumalai Suma, Seung Min Chung, Kyu Chang Won
Diabetes Metab J. 2020;44(2):222-233.   Published online April 23, 2020
DOI: https://doi.org/10.4093/dmj.2020.0053
  • 7,306 View
  • 168 Download
  • 17 Web of Science
  • 15 Crossref
AbstractAbstract PDFPubReader   

Impaired β-cell function is the key pathophysiology of type 2 diabetes mellitus, and chronic exposure of nutrient excess could lead to this tragedy. For preserving β-cell function, it is essential to understand the cause and mechanisms about the progression of β-cells failure. Glucotoxicity, lipotoxicity, and glucolipotoxicity have been suggested to be a major cause of β-cell dysfunction for decades, but not yet fully understood. Fatty acid translocase cluster determinant 36 (CD36), which is part of the free fatty acid (FFA) transporter system, has been identified in several tissues such as muscle, liver, and insulin-producing cells. Several studies have reported that induction of CD36 increases uptake of FFA in several cells, suggesting the functional interplay between glucose and FFA in terms of insulin secretion and oxidative metabolism. However, we do not currently know the regulating mechanism and physiological role of CD36 on glucolipotoxicity in pancreatic β-cells. Also, the downstream and upstream targets of CD36 related signaling have not been defined. In the present review, we will focus on the expression and function of CD36 related signaling in the pancreatic β-cells in response to hyperglycemia and hyperlipidemia (ceramide) along with the clinical studies on the association between CD36 and metabolic disorders.

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Basic Research
Histone Deacetylase 9: Its Role in the Pathogenesis of Diabetes and Other Chronic Diseases
Siqi Hu, Eun-Hee Cho, Ji-Young Lee
Diabetes Metab J. 2020;44(2):234-244.   Published online March 24, 2020
DOI: https://doi.org/10.4093/dmj.2019.0243
  • 6,313 View
  • 160 Download
  • 20 Web of Science
  • 21 Crossref
AbstractAbstract PDFPubReader   

As a member of the class IIa histone deacetylases (HDACs), HDAC9 catalyzes the deacetylation of histones and transcription factors, commonly leading to the suppression of gene transcription. The activity of HDAC9 is regulated transcriptionally and post-translationally. HDAC9 is known to play an essential role in regulating myocyte and adipocyte differentiation and cardiac muscle development. Also, recent studies have suggested that HDAC9 is involved in the pathogenesis of chronic diseases, including cardiovascular diseases, osteoporosis, autoimmune disease, cancer, obesity, insulin resistance, and liver fibrosis. HDAC9 modulates the expression of genes related to the pathogenesis of chronic diseases by altering chromatin structure in their promotor region or reducing the transcriptional activity of their respective transcription factors. This review summarizes the current knowledge of the regulation of HDAC9 expression and activity. Also, the roles of HDAC9 in the pathogenesis of chronic diseases are discussed, along with potential underlying mechanisms.

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Editorial
Biomarker Score in Risk Prediction: Beyond Scientific Evidence and Statistical Performance
Heejung Bang
Diabetes Metab J. 2020;44(2):245-247.   Published online April 23, 2020
DOI: https://doi.org/10.4093/dmj.2020.0073
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PDFPubReader   

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  • Performance of Diabetes and Kidney Disease Screening Scores in Contemporary United States and Korean Populations
    Liela Meng, Keun-Sang Kwon, Dae Jung Kim, Yong-ho Lee, Jeehyoung Kim, Abhijit V. Kshirsagar, Heejung Bang
    Diabetes & Metabolism Journal.2022; 46(2): 273.     CrossRef
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    Frontiers in Neuroscience.2022;[Epub]     CrossRef
Original Articles
Drug/Regimen
Glucagon-Like Peptide-1 Receptor Agonist Differentially Affects Brain Activation in Response to Visual Food Cues in Lean and Obese Individuals with Type 2 Diabetes Mellitus
Jae Hyun Bae, Hyung Jin Choi, Kang Ik Kevin Cho, Lee Kyung Kim, Jun Soo Kwon, Young Min Cho
Diabetes Metab J. 2020;44(2):248-259.   Published online November 4, 2019
DOI: https://doi.org/10.4093/dmj.2019.0018
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

To investigate the effects of a glucagon-like peptide-1 receptor agonist on functional brain activation in lean and obese individuals with type 2 diabetes mellitus (T2DM) in response to visual food cues.

Methods

In a randomized, single-blinded, crossover study, 15 lean and 14 obese individuals with T2DM were administered lixisenatide or normal saline subcutaneously with a 1-week washout period. We evaluated brain activation in response to pictures of high-calorie food, low-calorie food, and nonfood using functional magnetic resonance imaging and measured appetite and caloric intake in participants who were given access to an ad libitum buffet.

Results

Obese individuals with T2DM showed significantly greater activation of the hypothalamus, pineal gland, parietal cortex (high-calorie food vs. low-calorie food, P<0.05), orbitofrontal cortex (high-calorie food vs. nonfood, P<0.05), and visual cortex (food vs. nonfood, P<0.05) than lean individuals with T2DM. Lixisenatide injection significantly reduced the functional activation of the fusiform gyrus and lateral ventricle in obese individuals with T2DM compared with that in lean individuals with T2DM (nonfood vs. high-calorie food, P<0.05). In addition, in individuals who decreased their caloric intake after lixisenatide injection, there were significant interaction effects between group and treatment in the posterior cingulate, medial frontal cortex (high-calorie food vs. low-calorie food, P<0.05), hypothalamus, orbitofrontal cortex, and temporal lobe (food vs. nonfood, P<0.05).

Conclusion

Brain responses to visual food cues were different in lean and obese individuals with T2DM. In addition, acute administration of lixisenatide differentially affected functional brain activation in these individuals, especially in those who decreased their caloric intake after lixisenatide injection.

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  • Altered Metabolic Phenotypes and Hypothalamic Neuronal Activity Triggered by Sodium-Glucose Cotransporter 2 Inhibition (Diabetes Metab J 2023;47:784-95)
    Jae Hyun Bae
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  • Diabetes remission and relapse following an intensive metabolic intervention combining insulin glargine/lixisenatide, metformin and lifestyle approaches: Results of a randomised controlled trial
    Natalia McInnes, Stephanie Hall, Heather A. Lochnan, Stewart B. Harris, Zubin Punthakee, Ronald J. Sigal, Irene Hramiak, Mohammed Azharuddin, Joanne F. Liutkus, Jean‐François Yale, Farah Sultan, Ada Smith, Rose E. Otto, Diana Sherifali, Yan Yun Liu, Hertz
    Diabetes, Obesity and Metabolism.2023; 25(11): 3347.     CrossRef
  • Glucagon-like peptide-1 analog therapy in rare genetic diseases: monogenic obesity, monogenic diabetes, and spinal muscular atrophy
    Hussein Zaitoon, Ronit Lubetzky, Achiya Z. Amir, Hadar Moran-Lev, Liora Sagi, Michal Yacobi-Bach, Ophir Borger, Efrat Chorna, Yael Lebenthal, Avivit Brener
    Acta Diabetologica.2023; 60(8): 1099.     CrossRef
  • What can functional brain imaging teach us about remission of type 2 diabetes?
    Dhruti Hirani, Shahd Alabdulkader, Alexander. D. Miras, Victoria Salem
    Diabetic Medicine.2023;[Epub]     CrossRef
  • Fasting oxyntomodulin, glicentin, and gastric inhibitory polypeptide levels are associated with activation of reward‐ and attention‐related brain centres in response to visual food cues in adults with obesity: A cross‐sectional functional MRI study
    Nikolaos Perakakis, Olivia M. Farr, Christos S. Mantzoros
    Diabetes, Obesity and Metabolism.2021; 23(5): 1202.     CrossRef
  • Aberrant Brain Functional Connectivity Strength and Effective Connectivity in Patients with Type 2 Diabetes Mellitus
    Xi Guo, Su Wang, Yu-Chen Chen, Heng-Le Wei, Gang-Ping Zhou, Yu-Sheng Yu, Xindao Yin, Kun Wang, Hong Zhang, Eusebio Chiefari
    Journal of Diabetes Research.2021; 2021: 1.     CrossRef
Technology/Device
Glutamic Acid Decarboxylase Autoantibody Detection by Electrochemiluminescence Assay Identifies Latent Autoimmune Diabetes in Adults with Poor Islet Function
Yuxiao Zhu, Li Qian, Qing Liu, Jing Zou, Ying Zhou, Tao Yang, Gan Huang, Zhiguang Zhou, Yu Liu
Diabetes Metab J. 2020;44(2):260-266.   Published online November 12, 2019
DOI: https://doi.org/10.4093/dmj.2019.0007
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AbstractAbstract PDFPubReader   
Background

The detection of glutamic acid decarboxylase 65 (GAD65) autoantibodies is essential for the prediction and diagnosis of latent autoimmune diabetes in adults (LADA). The aim of the current study was to compare a newly developed electrochemiluminescence (ECL)-GAD65 antibody assay with the established radiobinding assay, and to explore whether the new assay could be used to define LADA more precisely.

Methods

Serum samples were harvested from 141 patients with LADA, 95 with type 1 diabetes mellitus, and 99 with type 2 diabetes mellitus, and tested for GAD65 autoantibodies using both the radiobinding assay and ECL assay. A glutamic acid decarboxylase antibodies (GADA) competition assay was also performed to assess antibody affinity. Furthermore, the clinical features of these patients were compared.

Results

Eighty-eight out of 141 serum samples (62.4%) from LADA patients were GAD65 antibody-positive by ECL assay. Compared with ECL-GAD65 antibody-negative patients, ECL-GAD65 antibody-positive patients were leaner (P<0.0001), had poorer β-cell function (P<0.05), and were more likely to have other diabetes-associated autoantibodies. The β-cell function of ECL-GAD65 antibody-positive patients was similar to that of type 1 diabetes mellitus patients, whereas ECL-GAD65 antibody-negative patients were more similar to type 2 diabetes mellitus patients.

Conclusion

Patients with ECL-GAD65 antibody-negative share a similar phenotype with type 2 diabetes mellitus patients, whereas patients with ECL-GAD65 antibody-positive resemble those with type 1 diabetes mellitus. Thus, the detection of GADA using ECL may help to identify the subtype of LADA.

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    Nuha A. ElSayed, Grazia Aleppo, Raveendhara R. Bannuru, Dennis Bruemmer, Billy S. Collins, Laya Ekhlaspour, Jason L. Gaglia, Marisa E. Hilliard, Eric L. Johnson, Kamlesh Khunti, Ildiko Lingvay, Glenn Matfin, Rozalina G. McCoy, Mary Lou Perry, Scott J. Pil
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  • 2. Classification and Diagnosis of Diabetes:Standards of Medical Care in Diabetes—2022

    Diabetes Care.2022; 45(Supplement): S17.     CrossRef
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Metabolic Risk/Epidemiology
Association between Non-Alcoholic Steatohepatitis and Left Ventricular Diastolic Dysfunction in Type 2 Diabetes Mellitus
Hokyou Lee, Gyuri Kim, Young Ju Choi, Byung Wook Huh, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha, Eun Jig Lee, Yong-ho Lee, Kap Bum Huh
Diabetes Metab J. 2020;44(2):267-276.   Published online February 28, 2019
DOI: https://doi.org/10.4093/dmj.2019.0001
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AbstractAbstract PDFPubReader   
Background

Impaired diastolic heart function has been observed in persons with non-alcoholic fatty liver disease (NAFLD) and/or with type 2 diabetes mellitus (T2DM). However, it is unclear whether NAFLD fibrotic progression, i.e., non-alcoholic steatohepatitis, poses an independent risk for diastolic dysfunction in T2DM. We investigated the association between liver fibrosis and left ventricular (LV) diastolic dysfunction in T2DM.

Methods

We analyzed 606 patients with T2DM, aged ≥50 years, who had undergone liver ultrasonography and pulsed-wave Doppler echocardiography. Insulin sensitivity was measured by short insulin tolerance test. Presence of NAFLD and/or advanced liver fibrosis was determined by abdominal ultrasonography and NAFLD fibrosis score (NFS). LV diastolic dysfunction was defined according to transmitral peak early to late ventricular filling (E/A) ratio and deceleration time, using echocardiography.

Results

LV diastolic dysfunction was significantly more prevalent in the NAFLD versus non-NAFLD group (59.7% vs. 49.0%, P=0.011). When NAFLD was stratified by NFS, subjects with advanced liver fibrosis exhibited a higher prevalence of diastolic dysfunction (49.0%, 50.7%, 61.8%; none, simple steatosis, advanced fibrosis, respectively; P for trend=0.003). In multivariable logistic regression, liver fibrosis was independently associated with diastolic dysfunction (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.07 to 2.34; P=0.022) after adjusting for insulin resistance and cardiometabolic risk factors. This association remained significant in patients without insulin resistance (OR, 4.32; 95% CI, 1.73 to 11.51; P=0.002).

Conclusions

Liver fibrosis was associated with LV diastolic dysfunction in patients with T2DM and may be an independent risk factor for diastolic dysfunction, especially in patients without systemic insulin resistance.

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  • Response: Association between Non-Alcoholic Steatohepatitis and Left Ventricular Diastolic Dysfunction in Type 2 Diabetes Mellitus (Diabetes Metab J 2020;44:267–76)
    Hokyou Lee, Gyuri Kim, Yong-ho Lee
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Metabolic Risk/Epidemiology
Intra-Abdominal Fat and High Density Lipoprotein Cholesterol Are Associated in a Non-Linear Pattern in Japanese-Americans
Sun Ok Song, You-Cheol Hwang, Steven E. Kahn, Donna L. Leonetti, Wilfred Y. Fujimoto, Edward J. Boyko
Diabetes Metab J. 2020;44(2):277-285.   Published online March 10, 2020
DOI: https://doi.org/10.4093/dmj.2019.0008
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AbstractAbstract PDFPubReader   
Background

We describe the association between high density lipoprotein cholesterol (HDL-C) concentration and computed tomography (CT)-measured fat depots.

Methods

We examined the cross-sectional associations between HDL-C concentration and intra-abdominal (IAF), abdominal subcutaneous (SCF), and thigh fat (TF) areas in 641 Japanese-American men and women. IAF, SCF, and TF were measured by CT at the level of the umbilicus and mid-thigh. The associations between fat area measurements and HDL-C were examined using multivariate linear regression analysis adjusting for age, sex, diabetes family history, homeostasis model assessment of insulin resistance (HOMA-IR), and body mass index (BMI). Non-linearity was assessed using fractional polynomials.

Results

Mean±standard deviation of HDL-C concentration and IAF in men and women were 1.30±0.34 mg/dL, 105±55.3 cm2, and 1.67±0.43 mg/dL, 74.4±46.6 cm2 and differed significantly by gender for both comparisons (P<0.001). In univariate analysis, HDL-C concentration was significantly associated with CT-measured fat depots. In multivariate analysis, IAF was significantly and non-linearly associated with HDL-C concentration adjusted for age, sex, BMI, HOMA-IR, SCF, and TF (IAF: β=−0.1012, P<0.001; IAF2: β=0.0008, P<0.001). SCF was also negatively and linearly associated with HDL-C (β=−0.4919, P=0.001).

Conclusion

HDL-C does not linearly decline with increasing IAF in Japanese-Americans. A more complex pattern better fits this association.

Citations

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  • Associations of Serum Uric Acid to High-Density Lipoprotein Cholesterol Ratio with Trunk Fat Mass and Visceral Fat Accumulation
    Yansu Wang, Yiting Xu, Tingting Hu, Yunfeng Xiao, Yufei Wang, Xiaojing Ma, Haoyong Yu, Yuqian Bao
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  • Obesity-related parameters in carriers of some BDNF genetic variants may depend on daily dietary macronutrients intake
    Urszula Miksza, Edyta Adamska-Patruno, Witold Bauer, Joanna Fiedorczuk, Przemyslaw Czajkowski, Monika Moroz, Krzysztof Drygalski, Andrzej Ustymowicz, Elwira Tomkiewicz, Maria Gorska, Adam Kretowski
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    Kai-Yuan Cheng, Tsung-Hsien Yen, Jay Wu, Pei-Hsuan Li, Tian-Yu Shih
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  • Lower High-Density Lipoprotein Cholesterol Concentration Is Independently Associated with Greater Future Accumulation of Intra-Abdominal Fat
    Sun Ok Song, You-Cheol Hwang, Han Uk Ryu, Steven E. Kahn, Donna L. Leonetti, Wilfred Y. Fujimoto, Edward J. Boyko
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Metabolic Risk/Epidemiology
Glucose Effectiveness from Short Insulin-Modified IVGTT and Its Application to the Study of Women with Previous Gestational Diabetes Mellitus
Micaela Morettini, Carlo Castriota, Christian Göbl, Alexandra Kautzky-Willer, Giovanni Pacini, Laura Burattini, Andrea Tura
Diabetes Metab J. 2020;44(2):286-294.   Published online January 13, 2020
DOI: https://doi.org/10.4093/dmj.2019.0016
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AbstractAbstract PDFPubReader   
Background

This study aimed to design a simple surrogate marker (i.e., predictor) of the minimal model glucose effectiveness (SG), namely calculated SG (CSG), from a short insulin-modified intravenous glucose tolerance test (IM-IVGTT), and then to apply it to study women with previous gestational diabetes mellitus (pGDM).

Methods

CSG was designed using the stepwise model selection approach on a population of subjects (n=181) ranging from normal tolerance to type 2 diabetes mellitus (T2DM). CSG was then tested on a population of women with pGDM (n=57). Each subject underwent a 3-hour IM-IVGTT; women with pGDM were observed early postpartum and after a follow-up period of up to 7 years and classified as progressors (PROG) or non-progressors (NONPROG) to T2DM. The minimal model analysis provided a reference SG.

Results

CSG was described as CSG=1.06×10−2+5.71×10−2×KG/Gpeak, KG being the mean slope (absolute value) of loge glucose in 10–25- and 25–50-minute intervals, and Gpeak being the maximum of the glucose curve. Good agreement between CSG and SG in the general population and in the pGDM group, both at baseline and follow-up (even in PROG and NONPROG subgroups), was shown by the Bland-Altman plots (<5% observations outside limits of agreement), and by the test for equivalence (equivalence margin not higher than one standard deviation). At baseline, the PROG subgroup showed significantly lower SG and CSG values compared to the NONPROG subgroup (P<0.03).

Conclusion

CSG is a valid SG predictor. In the pGDM group, glucose effectiveness appeared to be impaired in women progressing to T2DM.

Citations

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    So-Yeon Kim, Young Shin Song, Soo-Kyung Kim, Yong-Wook Cho, Kyung-Soo Kim
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  • Unraveling the Factors Determining Development of Type 2 Diabetes in Women With a History of Gestational Diabetes Mellitus Through Machine-Learning Techniques
    Ludovica Ilari, Agnese Piersanti, Christian Göbl, Laura Burattini, Alexandra Kautzky-Willer, Andrea Tura, Micaela Morettini
    Frontiers in Physiology.2022;[Epub]     CrossRef
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    Kyung-Soo Kim, Sangmo Hong, Kyungdo Han, Cheol-Young Park
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Metabolic Risk/Epidemiology
Multiple Biomarkers Improved Prediction for the Risk of Type 2 Diabetes Mellitus in Singapore Chinese Men and Women
Yeli Wang, Woon-Puay Koh, Xueling Sim, Jian-Min Yuan, An Pan
Diabetes Metab J. 2020;44(2):295-306.   Published online November 22, 2019
DOI: https://doi.org/10.4093/dmj.2019.0020
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

Multiple biomarkers have performed well in predicting type 2 diabetes mellitus (T2DM) risk in Western populations. However, evidence is scarce among Asian populations.

Methods

Plasma triglyceride-to-high density lipoprotein (TG-to-HDL) ratio, alanine transaminase (ALT), high-sensitivity C-reactive protein (hs-CRP), ferritin, adiponectin, fetuin-A, and retinol-binding protein 4 were measured in 485 T2DM cases and 485 age-and-sex matched controls nested within the prospective Singapore Chinese Health Study cohort. Participants were free of T2DM at blood collection (1999 to 2004), and T2DM cases were identified at the subsequent follow-up interviews (2006 to 2010). A weighted biomarker score was created based on the strengths of associations between these biomarkers and T2DM risks. The predictive utility of the biomarker score was assessed by the area under receiver operating characteristics curve (AUC).

Results

The biomarker score that comprised of four biomarkers (TG-to-HDL ratio, ALT, ferritin, and adiponectin) was positively associated with T2DM risk (P trend <0.001). Compared to the lowest quartile of the score, the odds ratio was 12.0 (95% confidence interval [CI], 5.43 to 26.6) for those in the highest quartile. Adding the biomarker score to a base model that included smoking, history of hypertension, body mass index, and levels of random glucose and insulin improved AUC significantly from 0.81 (95% CI, 0.78 to 0.83) to 0.83 (95% CI, 0.81 to 0.86; P=0.002). When substituting the random glucose levels with glycosylated hemoglobin in the base model, adding the biomarker score improved AUC from 0.85 (95% CI, 0.83 to 0.88) to 0.86 (95% CI, 0.84 to 0.89; P=0.032).

Conclusion

A composite score of blood biomarkers improved T2DM risk prediction among Chinese.

Citations

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    Xiaomeng Tan, Han Zhang, Limin Liu, Zengli Yu, Xinxin Liu, Lingling Cui, Yao Chen, Huanhuan Zhang, Zhan Gao, Zijian Zhao
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    Ji Hye Huh, Eun Roh, Seong Jin Lee, Sung-Hee Ihm, Kyung-Do Han, Jun Goo Kang
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  • A FRAMEWORK FOR THE ANALYSIS OF COMORBID CONDITIONS USING INTELLIGENT EXTRACTION OF MULTIPLE FLUID BIOMARKERS
    PRIYANKA JADHAV, VINOTHINI SELVARAJU, SARITH P SATHIAN, RAMAKRISHNAN SWAMINATHAN
    Journal of Mechanics in Medicine and Biology.2023;[Epub]     CrossRef
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    Sally Sonia Simmons
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  • Association of IL-16 rs11556218 T/G polymorphism with the risk of developing type 2 diabetes mellitus
    Dalia Ghareeb Mohammad, Hamdy Omar, Taghrid B. El-Abaseri, Wafaa Omar, Shaymaa Abdelraheem
    Journal of Diabetes & Metabolic Disorders.2021; 20(1): 649.     CrossRef
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    Heejung Bang
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Cardiovascular Risk/Epidemiology
Pre-existing Depression among Newly Diagnosed Dyslipidemia Patients and Cardiovascular Disease Risk
Jihoon Andrew Kim, Seulggie Choi, Daein Choi, Sang Min Park
Diabetes Metab J. 2020;44(2):307-315.   Published online November 1, 2019
DOI: https://doi.org/10.4093/dmj.2019.0002
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

Whether depression before diagnosis of dyslipidemia is associated with higher cardiovascular disease (CVD) risk among newly diagnosed dyslipidemia patients is yet unclear.

Methods

The study population consisted of 72,235 newly diagnosed dyslipidemia patients during 2003 to 2012 from the National Health Insurance Service–Health Screening Cohort of South Korea. Newly diagnosed dyslipidemia patients were then detected for pre-existing depression within 3 years before dyslipidemia diagnosis. Starting from 2 years after the diagnosis date, patients were followed up for CVD until 2015. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD were calculated by Cox proportional hazards regression.

Results

Compared to dyslipidemia patients without depression, those with depression had higher risk for CVD (aHR, 1.24; 95% CI, 1.09 to 1.41). Similarly, pre-existing depression was associated with increased risk for stroke (aHR, 1.27; 95% CI, 1.06 to 1.53). The risk for CVD among depressed dyslipidemia patients for high (aHR, 1.42; 95% CI, 1.06 to 1.90), medium (aHR, 1.17; 95% CI, 0.91 to 1.52), and low (aHR, 1.25; 95% CI, 1.05 to 1.50) statin compliance patients tended to be increased compared to patients without pre-existing dyslipidemia. The risk-elevating effect of depression on CVD tended to be preserved regardless of subgroups of smoking, alcohol consumption, physical activity, and body mass index.

Conclusion

Dyslipidemia patients with pre-existing depression had increased risk for CVD. Future studies that determine CVD risk after management of depression among dyslipidemia patients are needed.

Citations

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    Kyung-Soo Kim, Sangmo Hong, Kyungdo Han, Cheol-Young Park
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Lifestyle
Body Fat Is Related to Sedentary Behavior and Light Physical Activity but Not to Moderate-Vigorous Physical Activity in Type 2 Diabetes Mellitus
Keun Hee An, Kyung Ah Han, Tae Seo Sohn, Ie Byung Park, Hae Jin Kim, Sung Dae Moon, Kyung Wan Min
Diabetes Metab J. 2020;44(2):316-325.   Published online November 12, 2019
DOI: https://doi.org/10.4093/dmj.2019.0029
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AbstractAbstract PDFPubReader   
Background

Sedentary behavior (SB) has emerged as a new risk factor for cardiovascular accidents. We investigated whether physical activity levels or SB were related to percent body fat (%BF) in type 2 diabetes mellitus (T2DM).

Methods

In this cross sectional study, we measured the duration of SB, light physical activity (LPA), moderate to vigorous physical activity (MVPA), total energy expenditure, and step counts using a wireless activity tracker (Fitbit HR; FB) for 7 days in free-living conditions, along with %BF using a bio impedance analyzer (Inbody; Biospace) in 120 smartphone users with T2DM. Subjects were divided into exercise (Exe, n=68) and non-exercise (nonExe, n=52) groups based on self-reports of whether the recommended exercises (30 min/day, 3 days/week for 3 months) were performed. SBt, LPAt, MVPAt were transformed from SB, LPA, MVPA for normally distributed variables.

Results

Participants were: female, 59.2%; age, 59.3±8.4 years; body mass index, 25.5±3.4 kg/m2; glycosylated hemoglobin (HbA1c), 7.6%±1.2%; %BF, 30.4%±7.1%. They performed SB for 15.7±3.7 hr/day, LPA for 4.4±1.7 hr/day, and MVPA for 0.9±0.8 hr/day. The %BF was related to SBt and LPAt, but not to MVPA after adjustments for age, gender, and HbA1c. VPA was significantly higher in the Exe group than in the nonExe group, but SB, LPA, and moderate physical activity were not different. Predicted %BF was 89.494 to 0.105 (age), −13.047 (gender), −0.507 (HbA1c), −7.655 (LPAt) (F[4, 64]=62.929, P<0.001), with an R2 of 0.785 in multiple linear regression analysis.

Conclusion

Reduced body fat in elderly diabetic patients might be associated with reduced inactivity and increased LPA.

Citations

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    Lotte Bogaert, Iris Willems, Patrick Calders, Eveline Dirinck, Manon Kinaupenne, Marga Decraene, Bruno Lapauw, Boyd Strumane, Margot Van Daele, Vera Verbestel, Marieke De Craemer
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Basic Research
Higher Plasma Sclerostin and Lower Wnt Signaling Gene Expression in White Adipose Tissue of Prediabetic South Asian Men Compared with White Caucasian Men
Laura G.M. Janssen, Andrea D. van Dam, Mark J.W. Hanssen, Sander Kooijman, Kimberly J. Nahon, Hanneke Reinders, Ingrid M. Jazet, Wouter D. van Marken Lichtenbelt, Patrick C.N. Rensen, Natasha M. Appelman-Dijkstra, Mariëtte R. Boon
Diabetes Metab J. 2020;44(2):326-335.   Published online October 31, 2019
DOI: https://doi.org/10.4093/dmj.2019.0031
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

South Asians generally have an unfavourable metabolic phenotype compared with white Caucasians, including central obesity and insulin resistance. The Wnt protein family interacts with insulin signaling, and impaired Wnt signaling is associated with adiposity and type 2 diabetes mellitus. We aimed to investigate Wnt signaling in relation to insulin signaling in South Asians compared with white Caucasians.

Methods

Ten Dutch South Asian men with prediabetes and overweight or obesity and 10 matched Dutch white Caucasians were included. Blood samples were assayed for the Wnt inhibitor sclerostin. Subcutaneous white adipose tissue (WAT) and skeletal muscle biopsies were assayed for Wnt and insulin signaling gene expression with quantitative reverse transcription polymerase chain reaction (Clinicaltrials.gov NCT02291458).

Results

Plasma sclerostin was markedly higher in South Asians compared with white Caucasians (+65%, P<0.01). Additionally, expression of multiple Wnt signaling genes and key insulin signaling genes were lower in WAT in South Asians compared with white Caucasians. Moreover, in WAT in both ethnicities, Wnt signaling gene expression strongly positively correlated with insulin signaling gene expression. In skeletal muscle, WNT10B expression in South Asians was lower, but expression of other Wnt signaling and insulin signaling genes was comparable between ethnicities. Wnt and insulin signaling gene expression also positively correlated in skeletal muscle, albeit less pronounced.

Conclusion

South Asian men with overweight or obesity and prediabetes have higher plasma sclerostin and lower Wnt signaling gene expression in WAT compared with white Caucasians. We interpret that reduced Wnt signaling could contribute to impaired insulin signaling in South Asians.

Citations

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    Ruchi Yadav, Bhumika Patel
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Basic Research
Combination of Probiotics and Salvia miltiorrhiza Polysaccharide Alleviates Hepatic Steatosis via Gut Microbiota Modulation and Insulin Resistance Improvement in High Fat-Induced NAFLD Mice
Wei Wang, Ai-Lei Xu, Zheng-Chao Li, Yi Li, Shun-Fu Xu, Hua-Chao Sang, Fachao Zhi
Diabetes Metab J. 2020;44(2):336-348.   Published online December 3, 2019
DOI: https://doi.org/10.4093/dmj.2019.0042
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

Nonalcoholic fatty liver disease (NAFLD) increases the risk of hepatocellular carcinoma, which is currently the leading cause of obesity-related cancer deaths in middle-aged men.

Methods

Probiotics with lipid-lowering function were screened from the fecal microbiota of healthy adults. Polysaccharide from different sources was screened for improving insulin resistance. The combination of probiotics and Salvia miltiorrhiza polysaccharide (LBM) was investigated for alleviating hepatic steatosis.

Results

First, Bifidobacterium bifidum V (BbV) and Lactobacillus plantarum X (LpX) were obtained from the fecal microbiota of healthy adults. Second, to improve insulin resistance, a Salvia miltiorrhiza Bunge polysaccharide showing good performance in reducing insulin resistance was obtained. The liver total cholesterol (TC) and total triglyceride (TG) levels and the serum levels of free fatty acid, alanine transaminase, aspartate transaminase, low density lipoprotein cholesterol, TG, and TC can be significantly reduced through supplementation with LpX-BbV (LB) in NAFLD mice. Interestingly, the function of the probiotic LB can be enhanced by S. miltiorrhiza Bunge polysaccharide. Furthermore, the gut microbiota was modulated by LpX-BbV+S. miltiorrhiza Bunge polysaccharide (LBM). The lipopolysaccharide concentration of the LBM group was decreased by 73.6% compared to the NAFLD group. Ultimately, the mRNA concentrations of the proinflammatory cytokines (tumor necrosis factor α, interleukin 1β [IL-1β], and IL-6) decreased with LB and LBM treatment.

Conclusion

The results of this this study indicate that the LBM combination can be used as a therapeutic for ameliorating NAFLD via modulating the gut microbiota and improving insulin resistance.

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Diabetes Metab J : Diabetes & Metabolism Journal