The purpose of the present overview of meta-analysis is to summarize and critically assess the effect of isoflavones and genistein on glucose metabolism among the peri- and post-menopausal women. Two independent authors searched the databases of MEDLINE, Scopus and Cochrane Library for meta-analysis. Three databases were searched from inception to January 2018. Methodological quality of each meta-analysis of randomized controlled trials was evaluated using the AMSTAR (a measurement tool used to assess systematic reviews). Four meta-analyses were included to the current overview. Fasting insulin levels and homeostatic model assessment of insulin resistance (HOMA-IR) values were significantly lower in peri-menopausal and postmenopausal. Two meta-analyses showed that treatment with isoflavones could not alter fasting blood glucose. However, one meta-analysis depicted that isoflavones significantly improved blood glucose levels in non-Asian postmenopausal women. Treatment with genistein could have significant beneficial effects on fasting insulin, blood glucose and HOMA-IR in comparison to the control group. Regardless of the population, the treatment with genistein is effective in improving fasting insulin, HOMA-IR and glucose levels. Nevertheless, the high heterogeneity among studies and poor methodology of reviews made it difficult to draw a definite conclusion on the positive impacts of soy on glucose metabolism.
Blood Glucose ; Fasting ; Female ; Genistein ; Glucose Metabolism Disorders ; Glucose ; Humans ; Insulin ; Insulin Resistance ; Insulins ; Isoflavones ; Menopause ; Metabolism ; Population Characteristics

OBJECTIVETo characterize unknown glycometabolic state in patients with essential hypertension (EHT) and normotensive patients and determine which EHT patients are candidates for oral glucose tolerance tests (OGTTs).

METHODSThis cross-sectional study consecutively recruited 895 EHT patients and 486 normotensive patients. The data including blood glucose, blood pressure, blood lipids, angiography profiles, and left ventricular parameters were collected.

RESULTSOGTTs performed in all patients revealed that the prevalence of abnormal glucose metabolism (AGM) was significantly higher in EHT patients than in normotensive patients at both baseline (P<0.001) and post-OGTT analysis (P<0.001). In total, 76.4% of the individuals with impaired glucose tolerance and 78.2% of individuals with newly diagnosed diabetes would have remained undetected if OGTTs had not been performed. Newly diagnosed AGM was significantly correlated with the presence and severity of coronary stenosis and left ventricular structure abnormalities and dysfunction. EHT patients with fasting glucose ≥5.6 mmol/L, hypertension duration exceeding 10 years, coronary artery disease, high-sensitivity C-reactive protein >3 mg/L, or high levels of apoB/apoA-1 ratio were at high risk of AGM.

CONCLUSIONSAGM is more common in patients with EHT than in normotensive patients, and OGTTs is a cost-effective strategy to detect AGM in EHT patients.

Aged ; Blood Glucose ; metabolism ; Blood Pressure ; Cross-Sectional Studies ; Female ; Glucose Metabolism Disorders ; metabolism ; physiopathology ; Glucose Tolerance Test ; Humans ; Hypertension ; metabolism ; physiopathology ; Male ; Middle Aged

OBJECTIVETo investigate glucose metabolism status and its relationship with blood pressure, obesity, renal function and cardio-cerebral vascular events in Chinese essential hypertensive patients.

METHODSEssential hypertensive patients without diabetic history were enrolled in this cross-sectional survey. All patients filled in questionnaires and received physical examination and laboratory tests. Oral glucose tolerance test (OGTT, fasting and 2 hours glucose level after drinking the 75 g glucose solution) was performed in patients who signed the informed consent.

RESULTS(1) The control rate of systolic BP was lower in patients with dysglycemia than in patients without dysglycemia (41.0% vs. 46.4%, P = 0.000). (2) The albuminuria detection rate and the abnormal rate of estimated glumerular filtration rate (eGFR) increased significantly with the deterioration of glucose metabolism. (3) Multifactor-analysis showed that abnormal waist circumference, decreased eGFR and presence of albuminuria were independent risk factors for abnormal glucose metabolism. Cardiovascular events was significantly higher in patients with abnormal glucose metabolism than patients with normal glucose metabolism.

CONCLUSIONAbnormal glucose metabolism is common in Chinese essential hypertensive patients. When complicated with abnormal glucose metabolism, essential hypertensive patients had poor blood pressure control rate and were related to higher cardiovascular risk.

Aged ; Blood Glucose ; metabolism ; Cross-Sectional Studies ; Essential Hypertension ; Female ; Glucose Metabolism Disorders ; complications ; diagnosis ; Glucose Tolerance Test ; Humans ; Hypertension ; blood ; complications ; Male ; Middle Aged ; Risk Factors

BACKGROUND: An early identification of the risk groups might be beneficial in reducing morbidities in patients with gestational diabetes mellitus (GDM). Therefore, this study aimed to assess the biochemical predictors of glycemic conditions, in addition to fasting indices of glucose disposal, to predict the development of GDM in later stage and the need of glucose-lowering medication.METHODS: A total of 574 pregnant females (103 with GDM and 471 with normal glucose tolerance [NGT]) were included. A metabolic characterization was performed before 15+6 weeks of gestation by assessing fasting plasma glucose (FPG), fasting insulin (FI), fasting C-peptide (FCP), and glycosylated hemoglobin (HbA1c). Thereafter, the patients were followed-up until the delivery.RESULTS: Females with NGT had lower levels of FPG, FI, FCP, or HbA1c at the early stage of pregnancy, and therefore, showed an improved insulin action as compared to that in females who developed GDM. Higher fasting levels of FPG and FCP were associated with a higher risk of developing GDM. Moreover, the predictive accuracy of this metabolic profiling was also good to distinguish the patients who required glucose-lowering medications. Indices of glucose disposal based on C-peptide improved the predictive accuracy compared to that based on insulin. A modified quantitative insulin sensitivity check index (QUICKIc) showed the best differentiation in terms of predicting GDM (area under the receiver operating characteristics curve [ROC-AUC], 72.1%) or need for pharmacotherapy (ROC-AUC, 83.7%).CONCLUSION: Fasting measurements of glucose and C-peptide as well as the surrogate indices of glycemic condition could be used for stratifying pregnant females with higher risk of GDM at the beginning of pregnancy.
Blood Glucose ; C-Peptide ; Diabetes, Gestational ; Drug Therapy ; Fasting ; Female ; Glucose Metabolism Disorders ; Glucose ; Hemoglobin A, Glycosylated ; Humans ; Insulin ; Insulin Resistance ; Metabolic Diseases ; Metabolism ; Pregnancy ; ROC Curve

OBJECTIVETo explore the effect of different nutrition therapies on abnormal glucose metabolism during pregnancy and pregnancy outcomes.

METHODSThe 83 cases of pregnant women with abnormal glucose metabolism who came to nutrition clinic were randomly divided into two groups before 30 weeks pregnancy: 42 cases in traditional food exchange serving group (FES) and 41 cases in food exchange serving based on glycemic load group (FES + GL). Traditional food exchange serving and food exchange serving based on glycemic load were used as the different nutrition therapies for two groups respectively until the time of delivery. The influence of two nutrition therapies on the blood glucose and pregnancy outcomes were observed.

RESULTSThe daily food glucose load (GL) after nutrition therapy in the FES + GL group (145.9 ± 26.3) were significantly decreased than that of the FES group (179.9 ± 28.9, t = 5.602, P < 0.01). Fasting plasma glucose (FPG) and 2 h postprandial glucose (2 h PG) ((4.63 ± 0.97) and (6.15 ± 1.07) mmol/L, respectively) after nutrition therapy in the FES + GL group were significantly lower than that in pre-nutrition therapy ((4.96 ± 0.81) and (9.13 ± 1.61) mmol/L, t = 2.237, 11.202, respectively, all P values < 0.05). The 2 h PG in the FES + GL group ((6.15 ± 1.07) mmol/L) after nutrition therapy was significantly lower than that of the FES group ((6.86 ± 1.26) mmol/L, t = 2.760, P < 0.05). 19.51% (8/41) of the total incidence of complications in the FES + GL group was lower than that (11/42, 26.19%) in the FES group, but the difference was not significant (χ² = 0.524, P > 0.05).

CONCLUSIONFES based on GL was much easier to reduce blood glucose compared with FES. Two nutrition therapies can improve maternal and neonatal outcomes in pregnant women with abnormal glucose metabolism.

Adult ; Blood Glucose ; metabolism ; Diabetes, Gestational ; diet therapy ; metabolism ; Female ; Glucose Metabolism Disorders ; diet therapy ; metabolism ; Humans ; Nutritional Support ; methods ; Pregnancy

OBJECTIVETo investigate the features of regional cerebral metabolic rate of glucose (rCMRglc) in patients with mild cognitive impairment (MCI) by positron emission-tomography and its relationship with neuropsychological test.

METHODSPositron emission tomography, mini-mental state examination and Wechsler memory scale were applied in 10 patients with MCI and 10 healthy volunteers as the control group.

RESULTSScores of mini-mental state examination and Wechsler memory scale in MCI patients were lower than those in the control group (P < 0.01). rCMRglc of the left orbital gyrus, right middle temporal gyrus and right putamen was lower in the MCI group than in the control group (P < 0.05). Correlation analysis in the MCI group indicated that rCMRglc of many brain regions such as the orbital gyrus, putamen, left hippocampus and parahippocampal gyrus, cingulate gyrus, left amygdaloid body, precentral gyrus, postcentral gyrus, and medial occipitotemporal gyrus in MCI patients, were correlated negatively with age; while the rCMRglc of many parts of the brain such as the left putamen, temporal lobe, anterior cingulate gyrus, left insular lobe, amygdaloid body, precentral gyrus, postcentral gyrus and medial occipitotemporal gyrus were correlated positively with mini-mental state examination; and rCMRglc of the left putamen, temporal lobe, left insular lobe, precentral gyrus and postcentral gyrus were correlated positively with Wechsler memory scale. The right putamen, the right inferior temporal gyrus, precentral gyrus, and left postcentral gyrus were correlated positively with the length of education. However, only rCMRglc of the left amygdaloid body were correlated positively with gender.

CONCLUSIONThe rCMRglc was lower in the orbital gyrus and putamen of MCI patients. Their rCMRglc were correlated with their cognitive impairment severity, age, length of education and sex.

Aged ; Brain ; metabolism ; Cognition Disorders ; metabolism ; psychology ; Female ; Glucose ; metabolism ; Humans ; Male ; Middle Aged ; Neuropsychological Tests ; Tomography, Emission-Computed

Atherosclerosis ; complications ; epidemiology ; Carotid Artery Diseases ; complications ; epidemiology ; Glucose Metabolism Disorders ; complications ; epidemiology ; Humans ; Tibet ; epidemiology

This study explored the molecular mechanism underlying the Gegen Qinlian Decoction(GQD) promoting the differentiation of brown adipose tissue(BAT) to improve glucose and lipid metabolism disorders in diabetic rats. After the hypoglycemic effect of GQD on diabetic rats induced by high-fat diet combined with a low dose of streptozotocin was confirmed, the total RNA of rat BAT around scapula was extracted. Nuclear transcription genes Prdm16, Pparγc1α, Pparα, Pparγ and Sirt1, BAT marker genes Ucp1, Cidea and Dio2, energy expenditure gene Ampkα2 as well as BAT secretion factors Adpn, Fndc5, Angptl8, IL-6 and Rbp4 were detected by qPCR, then were analyzed by IPA software. Afterward, the total protein from rat BAT was extracted, and PRDM16, PGC1α, PPARγ, PPARα, SIRT1, ChREBP, AMPKα, UCP1, ADPN, NRG4, GLUT1 and GLUT4 were detected by Western blot. The mRNA expression levels of Pparγc1α, Pparα, Pparγ, Ucp1, Cidea, Ampkα2, Dio2, Fndc5, Rbp4 and Angptl8 were significantly increased(P<0.05) and those of Adpn and IL-6 were significantly decreased(P<0.05) in the GQD group compared with the diabetic group. In addition, Sirt1 showed a downward trend(P=0.104), whereas Prdm16 tended to be up-regulated(P=0.182) in the GQD group. IPA canonical pathway analysis and diseases-and-functions analysis suggested that GQD activated PPARα/RXRα and SIRT1 signaling pathways to promote the differentiation of BAT and reduce the excessive lipid accumulation. Moreover, the protein expression levels of PRDM16, PGC1α, PPARα, PPARγ, SIRT1, ChREBP, AMPKα, UCP1, GLUT1, GLUT4 and NRG4 were significantly decreased in the diabetic group(P<0.01), which were elevated after GQD intervention(P<0.05). Unexpectedly, the expression of ADPN protein in the diabetic group was up-regulated(P<0.01) as compared with the control group, which was down-regulated after the administration with GQD(P<0.01). This study indicated that GQD promoted BAT differentiation and maturity to increase energy consumption, which reduced the glucose and lipid metabolism disorders and thereby improved diabetes symptoms.
Adipose Tissue, Brown ; Animals ; Diabetes Mellitus, Experimental/genetics* ; Drugs, Chinese Herbal ; Fibronectins ; Glucose ; Lipid Metabolism ; Lipid Metabolism Disorders ; Rats

OBJECTIVE: The concerns about significant weight gain induced by antipsychotics have been recently increased. It raised an issue about the possible effect of antipsychotics on the glucose and lipid metabolism. To address this issue, we investigated the prevalence of abnormal glucose metabolism (impaired fasting glucose (110 mg/dl glucose glucose >or= 126 mg/dl)) in patients taking antipsychotics and also compared the prevalence of abnormal glucose metabolism between typical and atypical antipsychotics. METHODS: The subjects included 76 outpatients and 109 inpatients with schizophrenia by DSM-IV diagnostic criteria who had been taking antipsychotics regularly for at least 1 month. We measured fasting glucose, total cholesterol level after midnight NPO. Information about demographic and clinical characteristics of patients was gathered from interview with patients, family members, and the medical records. RESULTS: 24 of 185 schizophrenia patients (13.0%) showed abnormal glucose metabolism. 6 of 47 patients taking olanzapine (12.8%) and 2 of 34 patients taking haloperidol (5.9%) showed abnormal glucose metabolism. The prevalence of abnormal glucose metabolism was higher with olanzapine than with haloperidol, although the difference did not reach statistical significance. However, patients with olanzapine showed higher fasting glucose level than those with haloperidol. There was no significant correlation between medication dose and fasting glucose, total cholesterol level. CONCLUSION: The prevalence of abnormal glucose metabolism was higher in patients with antipsychotics. Olanzapine was more likely to raise fasting blood glucose to higher level than haloperidol.
Antipsychotic Agents* ; Blood Glucose ; Cholesterol* ; Diagnostic and Statistical Manual of Mental Disorders ; Fasting* ; Glucose* ; Haloperidol ; Humans ; Inpatients ; Lipid Metabolism ; Medical Records ; Metabolism ; Outpatients ; Prevalence ; Schizophrenia* ; Weight Gain

OBJECTIVETo study the prevalence of hypertension and glucose/lipid metabolism induced by chronic obstructive pulmonary disease (COPD) in hospitalized patients and their correlations to age and gender.

METHODSA retrospectively prevalence survey was conducted among the in-patients with COPD treated in General Hospital of PLA, Peking Union Medical College Hospital and Beijing Hospital between January 1st, 2000 and March 20th, 2010.

RESULTSA total of 4960 COPD patients were selected, including 3570 male and 1390 female patients with a mean age of 72.2∓10.4 years. Among these patients, hypertension had the highest prevalence (40.3%), followed by diabetes/impaired glucose tolerance (18.8%) and then by hyperlipidemia/fat protein metabolism (6.9%). The prevalence of hyperlipidemia/lipoprotein metabolism in the COPD patients over 80 years old decreased significantly with age. The prevalence of hypertension increased with age. In patients over 50 years old, the prevalence of hypertension was significantly higher in female than in male patients (P<0.05). The prevalence of diabetes/impaired glucose tolerance increased with age in male patients but decreased in female patients aged :80 years (P<0.05). Female patients in 60-69.9 and 70-79.9 years groups had significantly higher incidence of diabetes/impaired glucose tolerance than male patients (P<0.05), but not at older ages. The incidence of hyperlipidemia/lipoprotein metabolism disorder increased with age in both male and female patients aged below 80 years (P<0.05), but in 60-69.9 and 70-79.9 year groups, female patients had a significantly higher incidence than male patients (P<0.05); at the ages :80 years, the incidences was lowered in both women and men without a gender-specific differences (P>0.05).

CONCLUSIONSThe data we obtained concerning the prevalence of hypertension and glucose/lipid metabolism disorder, age distribution, and gender characteristics of the COPD patients provide a clear target for secondary prevention of COPD.

Aged ; Aged, 80 and over ; Female ; Glucose Metabolism Disorders ; complications ; Humans ; Hypertension ; complications ; Lipid Metabolism Disorders ; complications ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; complications ; Retrospective Studies