Nutrition & Diabetes最新文献

{"title":"Unmet needs in the treatment of type 1 diabetes: why is it so difficult to achieve an improvement in metabolic control?","authors":"Francesco Antonio Mazzotta, Lorenzo Lucaccini Paoli, Alessandro Rizzi, Linda Tartaglione, Maria Laura Leo, Valentina Popolla, Annarita Barberio, Luca Viti, Mauro Di Leo, Alfredo Pontecorvi, Dario Pitocco","doi":"10.1038/s41387-024-00319-w","DOIUrl":"10.1038/s41387-024-00319-w","url":null,"abstract":"<p><p>The development of advanced diabetes technology has permitted persons with type 1 diabetes mellitus to improve metabolic control significantly, particularly with the development of advanced hybrid closed-loop systems which have improved the quality of life by reducing hypoglycemia, decreasing macroangiopathy and microangiopathy-related complications, ameliorating HbA1c and improving glycemic variability. Despite the progression made over the past few decades, there is still significant margin for improvement to be made in terms of attaining appropriate metabolic control. Various factors are responsible for poor glycemic control including inappropriate carbohydrate counting, repeated bouts of hypoglycemia, hypoglycemia unawareness, cutaneous manifestations due to localized insulin use and prolonged use of diabetes technology, psychosocial comorbidities such as eating disorders or 'diabulimia', the coexistence of insulin resistance among people with type 1 diabetes and the inability to mirror physiological endogenous pancreatic insulin secretion appropriately. Hence, the aim of this review is to highlight and overcome the barriers in attaining appropriate metabolic control among people with type 1 diabetes by driving research into adjunctive treatment for coexistent insulin resistance and developing new advanced diabetic technologies to preserve β cell function and mirror as much as possible endogenous pancreatic functions.</p>","PeriodicalId":19339,"journal":{"name":"Nutrition & Diabetes","volume":"14 1","pages":"58"},"PeriodicalIF":4.6,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11297181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flavor and taste recognition impairments in people with type 1 diabetes.","authors":"Immacolata Cristina Nettore, Giuseppe Palatucci, Paola Ungaro, Giuseppe Scidà, Alessandra Corrado, Rosa De Vito, Marilena Vitale, Anna Maria Rivieccio, Giovanni Annuzzi, Lutgarda Bozzetto, Annamaria Colao, Paolo Emidio Macchia","doi":"10.1038/s41387-024-00322-1","DOIUrl":"10.1038/s41387-024-00322-1","url":null,"abstract":"<p><strong>Background/objectives: </strong>Adherence to dietary recommendations is a critical component in the management of type 1 diabetes (T1D). Taste and flavor significantly influence food choices. The aim of this study was to investigate taste sensitivity and flavor recognition ability in adults with T1D compared to healthy individuals.</p><p><strong>Subjects/methods: </strong>Seventy-two people with T1D and 72 matched healthy controls participated in the study. Participants underwent the gustometry test for sweet, sour, salty, and bitter tastes and the flavor test, which consisted of oral administration of aqueous aromatic solutions identifying 21 different compounds.</p><p><strong>Results: </strong>Participants with T1D had significantly lower flavor scores and gustometry scores than controls (p < 0.0001 and p = 0.0063, respectively). T1D individuals showed a lower perception of sour, bitter and salty tastes than controls, while the perception of sweet taste was similar. The sex differences and age-related decline in flavor perception observed in controls were not present in the participants with T1D. Neither BMI nor disease-related parameters such as fasting blood glucose on the day of the study, glycosylated hemoglobin, age at onset of diabetes, duration of diabetes, or type of insulin treatment (insulin pump or multiple daily injections) correlated with flavor and taste perception in the T1D participants.</p><p><strong>Conclusions: </strong>Flavor and taste perception are impaired in adults with T1D, potentially affecting dietary adherence and food choices. This highlights the need for further research into the mechanisms underlying sensory changes in T1D and emphasizes the importance of targeted dietary interventions to improve health outcomes and quality of life in this population.</p>","PeriodicalId":19339,"journal":{"name":"Nutrition & Diabetes","volume":"14 1","pages":"57"},"PeriodicalIF":4.6,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11297142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to Mediterranean dietary pattern and the risk of gestational diabetes mellitus: a systematic review and meta-analysis of observational studies.","authors":"Saeede Jafari Nasab, Matin Ghanavati, Cain C T Clark, Maryam Nasirian","doi":"10.1038/s41387-024-00313-2","DOIUrl":"10.1038/s41387-024-00313-2","url":null,"abstract":"<p><strong>Background and aim: </strong>Gestational diabetes mellitus (GDM) is one of the most prevalent disorders occurring during pregnancy, which confers significant risk of short and long-term adverse outcomes in both mothers and offspring. Recently, more attention has been paid to the association of pre-pregnancy and early pregnancy healthy dietary patterns, such as Mediterranean dietary pattern with GDM. However, there is a lack of systematic review and meta-analysis summarizing findings in this regard. Hence, we sought to assess the association of MedDiet and GDM in observational studies by performing a systematic review and meta-analysis.</p><p><strong>Methods: </strong>A comprehensive systematic literature search of observational studies was conducted via PubMed, Scopus, and Google Scholar, up to August 2023. Studies were included in our review if they evaluated the association of MedDiet and GDM, following an observational study design.</p><p><strong>Results: </strong>Ten studies were included in this study. Combining effect sizes, we found that adherence to MedDiet was inversely associated with GDM risk (OR = 0.64; CI: 0.52-0.78); implying that higher adherence to the MedDiet could reduce the risk of GDM by about 36%. Stratification by the geographic area, Mediterranean countries, time of dietary assessment and study design, showed a consistent significant association between MedDiet and GDM.</p><p><strong>Conclusion: </strong>We conclude that adhering to diets resembling MedDiet, before or in early pregnancy, could be associated with lower risks or odds of GDM.</p>","PeriodicalId":19339,"journal":{"name":"Nutrition & Diabetes","volume":"14 1","pages":"55"},"PeriodicalIF":4.6,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrauterine hyperglycaemia during late gestation caused mitochondrial dysfunction in skeletal muscle of male offspring through CREB/PGC1A signaling.","authors":"Yi-Shang Yan, Jia-Ying Mo, Yu-Tong Huang, Hong Zhu, Hai-Yan Wu, Zhong-Liang Lin, Rui Liu, Xuan-Qi Liu, Ping-Ping Lv, Chun Feng, Jian-Zhong Sheng, Min Jin, He-Feng Huang","doi":"10.1038/s41387-024-00299-x","DOIUrl":"10.1038/s41387-024-00299-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Maternal diabetes mellitus can influence the development of offspring. Gestational diabetes mellitus (GDM) creates a short-term intrauterine hyperglycaemic environment in offspring, leading to glucose intolerance in later life, but the long-term effects and specific mechanism involved in skeletal muscle dysfunction in offspring remain to be clarified.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Pregnant mice were divided into two groups: The GDM group was intraperitoneally injected with 100 mg/kg streptozotocin on gestational days (GDs) 6.5 and 12.5, while the control (CTR) group was treated with vehicle buffer. Only pregnant mice whose random blood glucose level was higher than 16.8 mmol/L beginning on GD13.5 were regarded as the GDM group. The growth of the offspring was monitored, and the glucose tolerance test was performed at different time points. Body composition analysis and immunohistochemical methods were used to evaluate the development of lean mass at 8 weeks. The exercise capacity and grip strength of the male mouse offspring were assessed at the same period. Transmission electron microscopy was used to observe the morphology inside skeletal muscle at 8 weeks and as a foetus. The genes and proteins associated with mitochondrial biogenesis and oxidative metabolism were investigated. We also coanalyzed RNA sequencing and proteomics data to explore the underlying mechanism. Chromatin immunoprecipitation and bisulfite-converted DNA methylation detection were performed to evaluate this phenomenon.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Short-term intrauterine hyperglycaemia inhibited the growth and reduced the lean mass of male offspring, leading to decreased endurance exercise capacity. The myofiber composition of the tibialis anterior muscle of GDM male offspring became more glycolytic and less oxidative. The morphology and function of mitochondria in the skeletal muscle of GDM male offspring were destroyed, and coanalysis of RNA sequencing and proteomics of foetal skeletal muscle showed that mitochondrial elements and lipid oxidation were consistently impaired. In vivo and in vitro myoblast experiments also demonstrated that high glucose concentrations impeded mitochondrial organisation and function. Importantly, the transcription of genes associated with mitochondrial biogenesis and oxidative metabolism decreased at 8 weeks and during the foetal period. We predicted Ppargc1α as a key upstream regulator with the help of IPA software. The proteins and mRNA levels of Ppargc1α in the skeletal muscle of GDM male offspring were decreased as a foetus (CTR vs. GDM, 1.004 vs. 0.665, p = 0.002), at 6 weeks (1.018 vs. 0.511, p = 0.023) and 8 weeks (1.006 vs. 0.596, p = 0.018). In addition, CREB phosphorylation was inhibited in GDM group, with fewer activated pCREB proteins binding to the CRE element of Ppargc1α (1.042 vs. 0.681, p = 0.037), Pck1 (1.091 vs. 0.432, p = 0.014) and G6pc (1.118 vs. 0.472, p = 0.027), resulting in their d","PeriodicalId":19339,"journal":{"name":"Nutrition & Diabetes","volume":"14 1","pages":"56"},"PeriodicalIF":4.6,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11266655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Joint association of sleep quality and physical activity with metabolic dysfunction-associated fatty liver disease: a population-based cross-sectional study in Western China.","authors":"Ying Wang, Qian Zhao, Jialu Yang, Yushan Wang, Lei Deng, Hamulati Xieyire, Tuerxun Gulijiehere, Mutalifu Munire, Fen Liu, Xiaomei Li, Min Xia, Yan Liu, Yining Yang","doi":"10.1038/s41387-024-00312-3","DOIUrl":"10.1038/s41387-024-00312-3","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated fatty liver disease (MAFLD) is a growing threat leading to substantial disease burden globally. Poor sleep and physical inactivity are common in modern societies and independently associated with MAFLD, however, their joint effects on MAFLD remains unclear.</p><p><strong>Methods: </strong>This population-based cross-sectional study was conducted in Xinjiang Uygur Autonomous Region, China, between July 2019 and September 2021. Self-reported sleep behaviors and physical activity (PA) were assessed using validated questionnaires. The primary outcome was radiological diagnosis of MAFLD.</p><p><strong>Results: </strong>Of the 10 089 participants aged 47.0 (9.1) years (51.6% men), 3854 (38.2%) individuals had MAFLD. Poor sleep quality and physical inactivity were independently and jointly associated with an increased prevalence of MAFLD, independent of traditional risk factors (P < 0.05). Compared to subjects with guideline-recommended moderate-to-vigorous PA (MVPA) and good sleep quality, individuals with no recommended MVPA and poor sleep had the highest possibility of MAFLD (odds ratio = 2.36, 95% confidence interval: 1.81 - 3.08). Enhancing sleep quality substantially attenuated MAFLD prevalence regardless of the volume of PA, whereas, engaging in PA well above current guidelines did not adequately counteract the adverse impacts of poor sleep on MAFLD.</p><p><strong>Conclusions: </strong>Public health awareness and strategies concurrently targeting both sleep quality and PA should be encouraged to curb the climbing prevalence of MAFLD.</p>","PeriodicalId":19339,"journal":{"name":"Nutrition & Diabetes","volume":"14 1","pages":"54"},"PeriodicalIF":4.6,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging-based body fat distribution and diabetic retinopathy in general US population with diabetes: an NHANES analysis (2003–2006 and 2011–2018)","authors":"Chenxin Li, Yili Zhang, Yujie Wang, Chufeng Gu, Bo Li, Mingming Ma, Xiaoyin Xu, Yongdong Chen, Zhi Zheng","doi":"10.1038/s41387-024-00308-z","DOIUrl":"https://doi.org/10.1038/s41387-024-00308-z","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Limited studies have investigated the correlation between fat distribution and the risk of diabetic retinopathy (DR) in the general population with diabetes. The relationship between obesity and DR remains inconclusive, possibly due to using simple anthropometric measures to define obesity. This study investigates the relationships between the android-to-gynoid fat ratio (A/G ratio, measured using dual-energy X-ray absorptiometry) and DR within the US population with diabetes.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>The study used a population-based, cross-sectional approach based on the 2003–2006 and 2011–2018 data of the National Health and Nutrition Examination Survey (NHANES). Multivariable logistic regression analyses were performed on participants with diabetes to evaluate the contribution of body mass index (BMI), waist-to-height ratio (WHtR), and A/G ratio to the prevalence of DR.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The prevalence of DR was 22.2, 21.2, and 17.6% among participants with A/G ratios &lt;1.0, 1.0–1.2, and ≥1.2, respectively. After adjusting sex, age, ethnicity, diabetes duration, hemoglobin A1c level, blood pressure level, and non-high-density lipoprotein cholesterol level, a higher A/G ratio (≥1.2) was independently associated with decreased odds of DR (odds ratio [OR], 0.565; 95% CI: 0.372–0.858) compared with the A/G ratio of 1.0–1.2. Associations between a higher A/G ratio and DR remained statistically significant after adjusting for BMI (OR, 0.567; 95% CI: 0.373–0.861) and WHtR (OR, 0.586; 95% CI: 0.379–0.907). Moreover, these associations remained statistically significant in analyses using the ethnic-specific tertiles for the A/G ratio. In sex-stratified models, these correlations remained in males. There was a significant inverse association between the A/G ratio and diabetes duration in males, which persisted after multivariable adjustments (<i>p</i> &lt; 0.05).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>A novel finding indicates that a higher A/G ratio is associated with a reduced likelihood of DR in males with diabetes. The results from NHANES underscore the importance of considering imaging-based fat distribution as a critical indicator in clinical practice.</p>","PeriodicalId":19339,"journal":{"name":"Nutrition & Diabetes","volume":"43 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141614611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between follicle-stimulating hormone and metabolic dysfunction-associated fatty liver disease in men","authors":"Dong-Hua Bin, Fang Liu, Ke-Ping Peng, Min Zhan, Yan Tan, Qiao Liu, Wang Tang, Zeng-Nan Mo, Xiong-Jun Peng, Gui-Xiang Tian","doi":"10.1038/s41387-024-00314-1","DOIUrl":"https://doi.org/10.1038/s41387-024-00314-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>The present study aimed to investigate the relationship between male hormones and metabolic dysfunction-associated fatty liver disease (MAFLD) in males.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Data from the Fangchenggang Area Male Health and Examination Survey (FAMHES) were used to analyze the male hormone levels between MAFLD patients and controls. Univariate and multivariate logistic regression analyses were performed to identify risk factors for MAFLD. Receiver operating characteristic curve analysis was used to assess the diagnostic performance of male hormones for MAFLD.</p><h3 data-test=\"abstract-sub-heading\">Result</h3><p>A total of 1578 individuals were included, with 482 individuals (30.54%) of MAFLD, including 293 (18.57%) with mild disease and 189 (11.98%) with moderate-to-severe disease. The MAFLD patients were significantly older than those without MAFLD. The LH, FSH, and SHBG levels in the MAFLD patients were significantly greater than those in the control group. Age, FSH, LH, SHBG, and estradiol were all risk factors for MAFLD. Age, FSH, and LH were risk factors for moderate-to-severe MAFLD. FSH was an independent risk factor for MAFLD and moderate-to-severe MAFLD. FSH showed an excellent diagnostic value, with an AUC of 0.992 alone and 0.996 after adjusting age.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Our findings indicate that FSH may be a potential diagnostic and predictive biomarker for MAFLD.</p>","PeriodicalId":19339,"journal":{"name":"Nutrition & Diabetes","volume":"24 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141585514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urine biomarkers in type 2 diabetes mellitus with or without microvascular complications.","authors":"Chanyuan Zhang, Tiebing Liu, Xiaoqian Wang, Jing Yang, Dongfang Qin, Yin Liang, Xuejing Wang","doi":"10.1038/s41387-024-00310-5","DOIUrl":"10.1038/s41387-024-00310-5","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the distribution of nine (9) urine biomarkers in people living with type 2 diabetes mellitus (T2DM), with or without microvascular complications.</p><p><strong>Methods: </strong>In total, 407 people with T2DM were enrolled from 2021 to 2022. According to diabetic retinopathy (DR) and urinary albumin-creatinine ratio (UACR), the 407 people were divided into four (4) groups, DR(-)UACR(-), DR(+)UACR(-), DR(-)UACR(+), and DR( + )UACR(+). In addition, 112 healthy volunteers were enrolled during the same period. The nine (9) urine markers included α1-microglobulin (u-α1MG), immunoglobulin G (u-IgG), neutrophil gelatinase-associated lipid carrier protein (u-NGAL), cystatin C (u-CysC), retinol-binding protein (u-RBP), β2-microglobulin (u-β2MG), N-acetyl-β-D-glucosaminidase (u-NAG), transferrin (u-Trf), and collagen type IV (u-Col). For each marker, the respective level of 97.5 percentile in healthy volunteers was taken as an upper reference limit.</p><p><strong>Results: </strong>Among the 407 people, 248 individuals (61%) were DR(-)UACR(-), 100 (25%) were DR(-)UACR(+), 37 (9%) were DR(+)UACR(-), and 22 (5%) were DR(+)UACR(+). The u-NAG/Cr biomarker level showed a significant difference between healthy participants and people with T2DM. In the DR(-)UACR(-)group, u-Trf/Cr showed the highest positive rate (21.37%), followed by u-IgG/Cr (14.52%); u-NAG/Cr (10.48%); u-β2MG/Cr (4.44%); u-CysC/Cr (4.03%); u-NGAL/Cr (4.03%); u-RBP/Cr (2.82%); u-α1MG/Cr (2.42%); 17.34% of people with T2DM showed multiple biomarkers positive (≥2 biomarkers). The positive rates of one biomarker (21.33%) and two biomarkers (18.67%) in people who have less than five (5) years of T2DM were almost close to those of the DR(-)UACR(-) group (21.37%, and 12.10%, respectively).</p><p><strong>Conclusion: </strong>Renal tubule biomarkers may be used as an indicator in the early detection and monitoring of renal injury in diabetes mellitus. The u-NAG biomarker should be measured for the people with T2DM of the first-time diagnosis.</p>","PeriodicalId":19339,"journal":{"name":"Nutrition & Diabetes","volume":"14 1","pages":"51"},"PeriodicalIF":4.6,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11236963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141580446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mixed meal tolerance test predicts onset of type 2 diabetes in Southwestern Indigenous adults.","authors":"Cassie M Mitchell, Emma J Stinson, Douglas C Chang, Jonathan Krakoff","doi":"10.1038/s41387-024-00269-3","DOIUrl":"10.1038/s41387-024-00269-3","url":null,"abstract":"<p><strong>Background/objective: </strong>To identify predictors of incident type 2 diabetes using a mixed meal tolerance test (MMTT).</p><p><strong>Methods: </strong>Adult Indigenous Americans without diabetes (n = 501) from a longitudinal cohort underwent at baseline a 4-h MMTT, measures of body composition, an oral glucose tolerance test, an intravenous glucose tolerance test for acute insulin response (AIR), and a hyperinsulinemic-euglycemic clamp for insulin action (M). Plasma glucose responses from the MMTT were quantified by the total and incremental area under the curve (AUC/iAUC).</p><p><strong>Results: </strong>At follow-up (median time 9.6 [inter-quartile range: 5.6-13.5] years), 169 participants were diagnosed with diabetes. Unadjusted Cox proportional hazards models, glucose AUC_180-min (HR: 1.98, 95% CI: 1.67, 2.34, p < 0.0001), AUC_240-min (HR: 1.93, 95% CI: 1.62, 2.31, p < 0.0001), and iAUC_180-min (HR: 1.43, 95% CI: 1.20, 1.71, p < 0.0001) were associated with an increased risk of diabetes. After adjustment for covariates (age, sex, body fat percentage, M, AIR, Indigenous American heritage) in three subsequent models, AUC_180-min (HR: 1.44, 95% CI: 1.10, 1.88, p = 0.007) and AUC_240-min (HR: 1.41, 95% CI: 1.09, 1.84, p < 0.01) remained associated with increased risk of diabetes.</p><p><strong>Conclusions: </strong>Glucose responses to a mixed meal predicted the development of type 2 diabetes. This indicates that a mixed nutritional challenge provides important information on disease risk.</p><p><strong>Clinical trial registry: </strong>ClinicalTrials.gov identifier : NCT00340132, NCT00339482.</p>","PeriodicalId":19339,"journal":{"name":"Nutrition & Diabetes","volume":"14 1","pages":"50"},"PeriodicalIF":4.6,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11237083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141580445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in the association between vitamin D and prediabetes in adults: A cross-sectional study.","authors":"Ali H Ziyab, Anwar Mohammad, Zainab Almousa, Talal Mohammad","doi":"10.1038/s41387-024-00311-4","DOIUrl":"10.1038/s41387-024-00311-4","url":null,"abstract":"<p><strong>Background/objectives: </strong>Vitamin D status has been shown to be associated with prediabetes risk. However, epidemiologic evidence on whether sex modulates the association between vitamin D and prediabetes is limited. The present study investigated sex-specific associations between vitamin D and prediabetes.</p><p><strong>Subjects/methods: </strong>The Kuwait Wellbeing Study, a population-based cross-sectional study, enrolled nondiabetic adults. Prediabetes was defined as 5.7 ≤ HbA1c% ≤6.4; 25-hydroxyvitamin D (25(OH)D) was measured in venous blood and analyzed as a continuous, dichotomous (deficiency: <50 nmol/L vs. insufficiency/sufficiency ≥50 nmol/L), and categorical (tertiles) variable. Associations were evaluated by estimating adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs), while stratifying by sex.</p><p><strong>Results: </strong>A total of 384 participants (214 males and 170 females) were included in the current analysis, with a median age of 40.5 (interquartile range: 33.0-48.0) years. The prevalence of prediabetes was 35.2%, and 63.0% of participants had vitamin D deficiency. Assessments of statistical interaction between sex and 25(OH)D status were statistically significant (P_{Sex × 25(OH)D Interaction} < 0.05). In the sex-stratified analysis, after adjustment for confounding factors, decreased 25(OH)D levels were associated with increased prevalence of prediabetes in males (aPR_{Deficiency vs. In-/Sufficiency}: 2.35, 95% CI: 1.36-4.07), but not in females (aPR_{Deficiency vs. In-/Sufficiency}: 1.03, 95% CI: 0.60-1.77). Moreover, the prevalence of prediabetes differed between males and females at 25(OH)D levels of ≤35 nmol/L, with a higher prevalence of prediabetes in males compared to females. Such a sex-specific difference was not observed at 25(OH)D levels of >35 nmol/L.</p><p><strong>Conclusions: </strong>Sex modified the association between vitamin D levels and prediabetes, with an inverse association observed among males, but not among females. Moreover, the observed sex-disparity in the prevalence of prediabetes was only pronounced at 25(OH)D levels of ≤35 nmol/L.</p>","PeriodicalId":19339,"journal":{"name":"Nutrition & Diabetes","volume":"14 1","pages":"49"},"PeriodicalIF":4.6,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11219834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141492879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}