Journal of Diabetes Research最新文献

Background: Studies have shown that prepregnancy overweight and obesity can increase the risk of gestational complications. However, research on the medium- to short-term impact on mothers and their offspring is limited. This study is aimed at investigating the association between prepregnancy overweight and obesity and subsequent weight issues in mothers and their children, specifically focusing on the period spanning 4-7 years postpartum.

Methods: This prospective cohort study included 112 mother-child pairs recruited from Peking University International Hospital between 2017 and 2019. Anthropometric and metabolic parameters were assessed in mothers and their offspring 4-7 years postpartum. Mothers also underwent an oral glucose tolerance test (OGTT) and assays for lipid, inflammatory, and adipokine markers. Based on prepregnancy body mass index (BMI), participants were classified into an overweight and obese group (n = 28) or an underweight and normal weight group (n = 84).

Results: At 4-7 years postpartum, a higher proportion of mothers with prepregnancy overweight and obesity remained overweight (39.29%) or obese (39.29%), compared to mothers who were underweight and normal weight before pregnancy (13.10% overweight, 0% obese). Among offspring, the prevalence of obesity was higher in children of the overweight and obese maternal group (17.86% vs. 7.14%). After adjusting for various factors such as parity, gestational age, gestational weight gain, and gestational diabetes mellitus (GDM), logistic regression analysis indicated that prepregnancy overweight and obesity were strongly associated with maternal overweight and obesity at follow-up (OR = 30.70, 95% CI: 8.69-108.51, p < 0.01) but not with offspring overweight and obesity (OR = 1.49, 95% CI: 0.54-4.06, p = 0.440).

Conclusions: This study demonstrates a strong association between prepregnancy overweight and obesity and lasting weight issues 4-7 years postpartum, underscoring the importance of preconception weight management as a key preventive health strategy.

Aims: The study is aimed at identifying the shared metabolites in early-mid pregnancy associated with prepregnancy body mass index (pBMI) and subsequent gestational diabetes mellitus (GDM) risk and at exploring the mediating role of metabolites.

Methods: One hundred pregnant women with GDM and 100 matched controls were enrolled in the study. Serum samples were collected in 10-20 weeks' gestation and used for targeted metabolomic assay measurement. The associations among pBMI, metabolites, and GDM were investigated using linear regression and logistic regression models. Mediation analysis was conducted to evaluate the mediating effect of individual metabolite and clustered latent variable (LV) on the association of pBMI with GDM.

Results: We identified eight metabolites significantly associated with both pBMI and GDM, which contained three organic acids, three acylcarnitines, and two fatty acids. Mediation analysis found five individual metabolites and two clustered LVs exhibited significant mediation effects in the association between pBMI and GDM risk. LV1 showed mediated proportions of 24.0%, which represented as organic acids and enriched in branched-chain amino acid biosynthesis. LV2 showed mediated proportions of 19.1%, which represented as acylcarnitines and enriched in linoleic acid metabolism. Furthermore, we validated the mediating role of branched-chain amino acids during the OGTT period.

Conclusion: The association between pBMI and GDM risk was attributed to serum metabolites in early-mid pregnancy, especially metabolites related to branched-chain amino acid biosynthesis.

Objective: To examine the association between albumin-corrected fructosamine (AlbF) levels and the presence of diabetic retinopathy (DR) in adults with Type 2 diabetes mellitus (T2DM).

Methods: This cross-sectional study retrospectively analyzed 1263 inpatients with T2DM. After applying exclusion criteria, 415 patients were included and categorized into DR (n = 174) and non-DR (n = 241) groups based on fundus examination. The association between the AlbF-analyzed both continuously (per 10 μmol/g increment) and categorically (by tertiles)-and DR was assessed using multivariable logistic regression with progressive adjustment for sociodemographic, clinical, and laboratory confounders. Supplementary analyses, including receiver operating characteristic (ROC) curve assessment and interaction testing across predefined subgroups, evaluated the association's robustness and consistency.

Results: The prevalence of DR was 41.9%. Following full adjustment, each 10 μmol/g increment in AlbF was associated with higher odds of having DR (adjusted OR = 1.88, 95% CI: 1.36-2.60; p < 0.001). A significant dose-response relationship was observed (p for trend < 0.001), with patients in the highest AlbF tertile exhibiting 7.20 times the odds of DR (95% CI: 2.82-18.40) compared to the lowest tertile. Furthermore, the association remained consistent across all predefined subgroups (p for interaction > 0.05 for all).

Conclusions: Elevated AlbF was independently associated with the presence of DR in adults with T2DM, demonstrating a significant dose-response relationship. AlbF shows promise as a biomarker candidate for DR identification and stratification. Its potential clinical utility requires validation in larger prospective studies.

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder and typically develops later in life due to systemic dysfunction in metabolic homeostasis and various factors related to β-cell inflammation. Interestingly, recent studies have proposed that intra-islet expression of inflammatory cytokines, particularly interleukin (IL)-1β, contributes to the pathogenesis of T2DM and have shown that blockade of IL-1β signaling improves glycemia and β-cell secretory function. We recently successfully constructed a genetically modified lactic acid bacteria (gmLAB) strain that hypersecretes recombinant mouse IL-1 receptor antagonist (rmIL-1Ra), that is, NZ-IL1Ra. In this study, we investigated how NZ-IL1Ra affects glucose metabolism using a mouse pancreatic β-cell line and diet-induced obese mouse model. We found that rmIL-1Ra purified from NZ-IL1Ra suppresses the expression of mouse pancreatic β-cell genes related to inflammation. In addition, the results of oral glucose tolerance tests revealed that administration of NZ-IL1Ra improves glucose metabolism, but the extent depends on the route of administration. Finally, microbiota analyses revealed increases in the abundances of two genera of Lachnospiraceae. These microbiota changes might also affect glucose metabolism in mice. Taken together, our results suggest that administration of NZ-IL1Ra may be a useful tool for improving glucose metabolism.

In 2021, global T2DM prevalence among WCBAs reached 73.86 million (95% UI: 63.43-85.32 million), with China, India, and the United States leading. Greenland exhibited the largest rise in age-standardized prevalence (7.93%), with an annual increase of 11.32% (95% UI: 8.33%-14.39%). From 1992 to 2021, prevalence rose in 195 countries, declined in eight, and remained stable in one. Prevalence increased with age, peaking in women aged 45-49, and was higher in low-SDI regions, which also experienced sharper increases. Period and cohort effects worsened globally, particularly in low-SDI regions. Population growth drove burden increases in low-SDI areas, while epidemiological factors dominated in high-SDI regions. T2DM-related visual impairment was more severe in low- and medium-SDI regions. Projections for 2022-2030 predict unfavorable increasing trends. T2DM prevalence among WCBAs has steadily risen since 1992, with worsening inequalities and healthcare disparities. Projections to 2030 underscore the need for targeted prevention and treatment strategies, particularly in low- and medium-SDI regions.

Sirtuin-1-gene (SIRT1) plays a key role in regulating metabolic and inflammatory processes. This review is aimed at evaluating the association between SIRT1-polymorphisms and diabetic nephropathy susceptibility. Observational-cohort and case-control studies were included. Data extraction followed PRISMA 2020 guidelines, and study quality was assessed using the Newcastle-Ottawa Scale. Meta-analysis was done using a random-effects model, with heterogeneity and publication bias assessed using I ² statistics and funnel plots. Subgroup analyses were done by ethnicity and genotyping methods. Meta-analysis showed SIRT1-polymorphisms rs7895833 (OR: 2.71, 95% CI: 2.67-2.76) and rs2273773 (OR: 1.51, 95% CI: 1.16-1.97) to be significantly associated with increased DN risk. rs7069102 was not significantly associated (OR: 1.12, 95% CI: 0.80-1.59). Subgroup analysis showed population-specific variations with stronger associations in Chinese and Indian populations. Sensitivity analysis maintained results' robustness, though funnel plot analysis suggested potential publication bias. Conclusively, SIRT1 polymorphisms, particularly rs7895833 and rs2273773, are associated with DN susceptibility, confirming their potential as genetic markers for DN risk stratification.

Background: Diabetic wounds are challenging and lack efficient therapeutic solutions. Bletilla striata polysaccharide (BSP) has garnered interest for its bioactivity and antioxidant ability in wound healing. This research explores the mechanisms through which BSP alleviates oxidative stress (OS) in L929 cells and prevents cell apoptosis under high-glucose (HG) conditions. Furthermore, the research evaluates its promise as a novel therapeutic approach for facilitating recovery in diabetic wounds.

Methods: Various doses of glucose and BSP were administered to L929 cells to evaluate their effects on cell viability, OS, activation of the PI3K/Akt/Nrf2 signaling pathway, and apoptosis. These effects were assessed using CCK-8 assays, commercial kits, and western blots (WBs). For in vivo validation in diabetic mice with skin wounds, Masson's trichrome staining, hematoxylin and eosin (H&E) staining, and WB were employed. Additionally, inhibitors of the PI3K/Akt/Nrf2 signaling pathway were used in both in vitro and in vivo experiments.

Results: In vitro, L929 cells exposed to HG stimuli exhibited OS and apoptosis. However, BSP mitigated these effects by promoting Nrf2 nuclear translocation through the phosphorylation of PI3K and Akt. In diabetic mice, BSP treatment enhanced wound healing rates compared to the control in vivo. This improvement was clear from a substantial reduction in wound areas, decreased inflammation, robust collagen deposition, and extensive reepithelization, which resulted from the inhibition of the intrinsic apoptosis process mediated through the activation of the PI3K/Akt/Nrf2 signaling pathway.

Conclusion: Our research emphasizes that BSP serves as a potential therapeutic resolution targeting diabetic wounds for its excellent OS-relieving and antiapoptosis properties. Our findings reveal the value of natural polysaccharides in the treatment of the complications of diabetes and indicate that BSP promotes the healing of diabetic wounds via the PI3K/Akt/Nrf2 signaling pathway.

Diabetic retinopathy (DR) is the leading cause of blindness in the working-age population, yet many underserved communities lack access to screening programmes that would facilitate earlier diagnosis and access to treatment. This study is aimed at evaluating the feasibility of embedding digital fundoscopy (DF) for routine screening of patients with diabetes mellitus (DM) in Masvingo, Zimbabwe; assessing the prevalence and progression of DR among this previously unstudied population; and determining the baseline variables associated with DR and its progression. An observational study was conducted at Masvingo Provincial Hospital. Eligible participants were aged ≥ 18 and routinely attended the clinic. Participants (N = 202) were assessed for the presence and severity of DR using DF at baseline and again at 1 year. Images were sent to a remote ophthalmologist for diagnosis. Logistic regression was used to investigate the association of the participants' demographics and medical history with DR. At baseline, 84 (41.6%) participants were diagnosed with DR. Among participants without DR at baseline, eight had DR at Year 1, translating to an annual incidence of 6.8%. Higher levels of haemoglobin A1c (HbA1c) were associated with increased odds of DR at baseline (p = 0.03) compared with normal HbA1c. The mean turnaround between image capture and clinical report availability at baseline (36.16 days) and at Year 1 (18.89 days) was aligned with global guidelines. High DR rates in Masvingo provide compelling evidence of the need for increased healthcare resources for DR screening in underserved settings; our study demonstrates the feasibility of embedding DF into standard practice for this purpose. Patients with poorly managed DM, as indicated by elevated HbA1c, should be prioritised for DF screening programmes and monitoring to facilitate early diagnosis and prevent avoidable blindness. Further investigation is needed into factors associated with DR progression.

Diabetic retinopathy (DR) with media opacity presents a diagnostic challenge for retinal evaluation. This study investigated whether conjunctival microvascular assessment using swept-source optical coherence tomography angiography (SS-OCTA) can serve as a potential indicator of retinal pathology. We conducted a comparative study of 163 patients with diabetes (110 with DR, subdivided into 55 nonproliferative and 55 proliferative cases) and 49 age-matched healthy controls. All participants underwent SS-OCTA for conjunctival vessel density (VD) measurement and standard retinal OCTA for retinal VD and ganglion cell complex (GCC) analysis. Statistical correlations were performed to evaluate the relationship between the conjunctival and retinal parameters. Conjunctival VD showed a progressive reduction in DR severity, most prominently in the temporal region (70.7% in controls vs. 55.6% in patients with proliferative diabetic retinopathy [PDR]). Temporal conjunctival VD correlated well with retinal damage, and lower conjunctival density was linked to reduced retinal blood flow (r = 0.21-0.26) and thinner nerve layers (r = 0.22). No significant differences in VD were found between controls and patients with diabetes without DR, suggesting a specificity for retinopathic changes. SS-OCTA assessment of conjunctival VD may provide clinically useful information regarding the retinal status in patients with DR with compromised fundus visualization. This approach is a practical alternative when traditional retinal imaging is obstructed by media opacities.

Background: Inconsistencies exist in the literature regarding the associations among age at menarche (AAM), prepregnancy menstrual characteristics, and the risk of gestational diabetes mellitus (GDM). These discrepancies may be attributable to variations in population demographics. The aim of this study was to investigate the impact of prepregnancy menstrual characteristics and AAM on the likelihood of developing GDM among Chinese women.

Methods: A 1:1 age-matched case-control study was conducted that included 2289 patients with GDM and 2289 normoglycemic pregnant women as controls at Wuhan Union Hospital from September 2020 to August 2022. Fasting blood samples were collected during 24-28 weeks of gestation. AAM and menstrual cycle characteristics were categorized and incorporated into a conditional logistic regression model that was adjusted for potential confounders. Additionally, restricted cubic spline curves were employed to assess the trend in GDM risk associated with AAM.

Results: The final analysis included 4578 participants. The AAM in the GDM group presented significantly earlier than that in the normoglycemic group (p < 0.05). After adjusting for confounding factors, we found that women with an AAM of 12 years (aOR = 1.44, 95% CI: 1.25-1.67) or 14 years (aOR = 1.36, 95% CI: 1.15-1.61) had a significantly higher risk of developing GDM compared with those with an AAM of 13 years. Furthermore, analysis of the data by means of restricted cubic splines revealed an L-shaped association that linked AAM to GDM (p < 0.001). The association between prolonged and irregular menstrual cycles and GDM risk remained statistically significant, albeit attenuated, after multivariable adjustment. Irregular menstrual cycles (classified as "usually irregular" or "always irregular") were significantly associated with an increased risk of GDM, with aORs of 2.36 (95% CI: 1.47-3.79) and 2.40 (95% CI: 1.01-5.71), respectively. Moreover, menstrual cycle durations of 32-39 days or more than 50 days were significantly associated with an increased risk of GDM (aORs: 1.20 and 1.37; 95% CIs: 1.10-1.41 and 1.03-1.83, respectively).

Conclusion: Early AAM, irregular menstrual cycles, and prolonged menstrual cycle length were associated with an increased risk of GDM. Among women with menarche occurring before the age of 13, there was an association with a higher risk of GDM. These indicators may help identify women at high risk and facilitate preconception interventions to prevent GDM.

Trial registration: ClinicalTrials.gov identifier: ChiCTR2200063189.