China ; epidemiology ; Diabetes Mellitus ; diagnosis ; epidemiology ; metabolism ; Glycated Hemoglobin A ; metabolism ; Humans ; Prevalence

OBJECTIVETo investigate the prevalence of chronic kidney disease (CKD) in subjects with different glucose metabolism status.

METHODSBetween January, 2015 and October, 2015, a total of 934 subjects without a previous diagnosis of diabetes visiting the Department of Endocrinology or Health Examination Center underwent oral glucose tolerance test (OGTT), which identified 266 subjects with normal glucose tolerance (NGT group), 243 pre-diabetic subjects, and 425 patients with diabetes mellitus group. The baseline characteristics and laboratory test data of the subjects were collected. The diagnosis of CKD was established for an eGFR <60 mL/min/1.73 m(2) or a ACR≥30 mg/g, and the prevalence of CKD were compared among the 3 groups. Logistic regression model was used to analyze the OR value of the risk factors of CKD.

RESULTSThe prevalences of CKD in NGT, pre-diabetic and diabetic groups were 10.2%, 26.3% and 32.5%, respectively. Pairwise comparisons showed that the prevalence of CKD was significantly higher in pre-diabetic group (P<0.001, OR=3.17, 95% CI 1.94-5.17) and diabetic group (P<0.001, OR=4.27, 95% CI 2.72-6.65) than in NGT group, and was comparable between the pre-diabetic and diabetic groups (P=0.115, OR=1.35, 95% CI 0.95-1.91). Logistic regression analysis, after adjustment for age, gender, blood pressure, hypertension, blood lipids and uric acid, showed that pre-diabetes (OR=2.03, P=0.044) and diabetes mellitus (OR=2.22, P=0.016) were independently associated with CKD.

CONCLUSIONGlucose metabolism status has a significant independent impact on the incidence of CKD, suggesting the importance of early detection of pre-diabetes and timely interventions in pre-diabetic subjects in prevention CKD.

Diabetes Mellitus ; epidemiology ; Glucose ; metabolism ; Glucose Tolerance Test ; Humans ; Incidence ; Prediabetic State ; epidemiology ; Prevalence ; Renal Insufficiency, Chronic ; epidemiology ; Risk Factors

OBJECTIVEThe aim of this study is to determine whether the SUMO4 M55V polymorphism is associated with susceptibility to type 2 diabetes mellitus (T2DM).

METHODSA meta-analysis was performed to detect the potential association of the SUMO4 M55V polymorphism and susceptibility to T2DM under dominant, recessive, co-dominant (homogeneous and heterogeneous), and additive models.

RESULTSA total of eight articles including 10 case-control studies, with a total of 2932 cases and 2679 controls, were included in this meta-analysis. The significant association between the SUMO4 M55V polymorphism and susceptibility to T2DM was observed in the dominant model (GG + GA versus AA: OR = 1.21, 95% CI = 1.05-1.40, P = 0.009), recessive model (GG versus GA + AA: OR = 1.29, 95% CI = 1.07-1.356, P = 0.010), homozygous model (GG versus AA: OR = 1.41, 95% CI = 1.06-1.56, P = 0.001), and additive model (G versus A: OR = 1.18, 95% CI = 1.08-1.29, P = 0.001), and marginally significant in the heterozygous model (GA versus AA: OR = 1.16, 95% CI = 0.98-1.36, P = 0.080). In subgroup analyses, significant associations were observed in the Chinese population under four genetic models excluding the heterozygous model, whereas no statistically significant associations were observed in the Japanese population under each of the five genetic models.

CONCLUSIONThe meta-analysis demonstrated that the G allele of the SUMO4 M55V polymorphism could be a susceptible risk locus to T2DM, mainly in the Chinese population, while the association in other ethnic population needs to be further validated in studies with relatively large samples.

Diabetes Mellitus, Type 2 ; epidemiology ; genetics ; Genetic Predisposition to Disease ; epidemiology ; genetics ; Humans ; Small Ubiquitin-Related Modifier Proteins ; genetics ; metabolism

OBJECTIVETo explore the relationship between level of glucose metabolism and risk of cancer incidents.

METHODS10 079 aged ≥ 40, local residents in Jiashan were enrolled by stratified cluster sampling method in 2011. All the subjects accepted retrospective investigation on incidents of diabetes mellitus and cancers plus blood testing for level of glucose metabolism. Differences between glucose metabolism level and cancer incidence were analyzed by trend Chi-square test.

RESULTSThe prevalence of cancers in female diabetes mellitus patients was 268.79 per 100 000, higher than in males-124.31 per 100 000 (χ² = 4.012 2, P < 0.05). The incidence rates of cancers in groups of normal glucose regulation (NGR), impaired glucose regulation (IGR), and diabetes mellitus (DM) patients were 77.32 per 100 000, 115.40 per 100 000 and 204.08 per 100 000, respectively. The incidence of cancers in local residents who were older than 40 years had increased with the decrease of glucose regulation ability. The subjects were divided into three groups by FPG, 2h-PG and HbA1c levels respectively and the incident risks on cancers under each index increased 30.0%, 39.0% and 62.4%, respectively. Compared to the general population, the cancer incidence in DM group increased 1.67 times and 2.62 times increase in women but did not show significant difference in men (χ² = 0.524 0, P > 0.05). Breast and colorectal cancers were the most common tumors that accompanied with DM, and their incidence increased along with the decrease of glucose regulation ability. The incidence rates of breast and colorectal cancer in T2DM were 2.36 and 1.87 times more than in general population, and the incidence rates of female patients had an increase of 2.53 and 6.74 times, respectively.

CONCLUSIONThe cancer incidence was higher in DM group than in the non-DM group while the incidence rates of both breast and colorectal cancer were relevant to the levels of glucose metabolism.

Adult ; Aged ; Blood Glucose ; metabolism ; Diabetes Mellitus ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Neoplasms ; epidemiology ; Prevalence ; Retrospective Studies ; Risk Factors

PURPOSE: We investigated associations between family history of diabetes (FHD) and hemoglobin A1c (HbA1c) level, among people with and without diabetes. MATERIALS AND METHODS: In total, 7031 people without diabetes and 1918 people with diabetes who participated in the Dong-gu Study were included. Data on FHD in first-degree relatives (father, mother, and siblings) were obtained. Elevated HbA1c levels in people without diabetes and high HbA1c levels in people with diabetes were defined as the highest quintiles of HbA1c ≥5.9% and ≥7.9%, respectively. RESULTS: In people without diabetes, the odds of elevated HbA1c levels [odds ratio (OR) 1.34, 95% confidence interval (CI) 1.13−1.59] were significantly greater in people with any FHD than in those without. Specifically, the odds of elevated HbA1c levels in people without diabetes with an FHD involving siblings were greater than in those without an FHD involving siblings. Additionally, in people with diabetes, the odds of high HbA1c levels (OR 1.33, 95% CI 1.02−1.72) were greater in people with any FHD than in those without such history. Moreover, people with diabetes with maternal FHD had increased odds of high HbA1c levels. CONCLUSION: FHD was associated not only with high HbA1c levels in people with diabetes, but also with elevated HbA1c levels in people without diabetes.
Aged ; Blood Glucose/metabolism ; Diabetes Mellitus/blood ; Diabetes Mellitus/epidemiology ; Family ; Female ; Glycated Hemoglobin A/analysis ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Prevalence ; Risk Factors

BACKGROUND: Gestational diabetes mellitus (GDM) brings health issues for both mothers and offspring, and GDM prevention is as important as GDM management. It was shown that a history of GDM was significantly associated with a higher maternal risk for GDM recurrence. The incidence of GDM recurrence was unclear because of the incidence of second-child was low before 2016 in China. We aim to investigate the prevalence of GDM recurrence and its associated high-risk factors which may be useful for the prediction of GDM recurrence in China. METHODS: A retrospective study was conducted which enrolled participants who underwent regular prenatal examination and delivered twice in the same hospital of 18 research centers. All participants were enrolled from January 2018 to October 2018, where they delivered the second baby during this period. A total of 6204 women were enrolled in this study, and 1002 women with a history of GDM were analyzed further. All participants enrolled in the study had an oral glucose tolerance test (OGTT) result at 24 to 28 weeks and were diagnosed as GDM in the first pregnancy according to the OGTT value (when any one of the following values is met or exceeded to the 75-g OGTT: 0 h [fasting], ≥5.10 mmol/L; 1 h, ≥10.00 mmol/L; and 2 h, ≥8.50 mmol/L). The prevalence of GDM recurrence and development of type 2 diabetes mellitus were calculated, and its related risk factors were analyzed. RESULTS: In 6204 participants, there are 1002 women (1002/6204,16.15%) with a history of GDM and 5202 women (5202/6204, 83.85%) without a history of GDM. There are significant differences in age (32.43 ± 4.03 years vs. 33.00 ± 3.34 years vs. 32.19 ± 3.37 years, P  < 0.001), pregnancy interval (4.06 ± 1.44 years vs. 3.52 ± 1.43 years vs. 3.38 ± 1.35 years, P  = 0.004), prepregnancy body mass index (BMI) (27.40 ± 4.62 kg/m2vs. 23.50 ± 3.52 kg/m2vs. 22.55 ± 3.47 kg/m2, P < 0.001), history of delivered macrosomia (22.7% vs. 11.0% vs. 6.2%, P < 0.001) among the development of diabetes mellitus (DM), recurrence of GDM, and normal women. Moreover, it seems so important in the degree of abnormal glucose metabolism in the first pregnancy to the recurrence of GDM and the development of DM. There are significant differences in OGTT levels of the first pregnancy such as area under the curve of OGTT value (18.31 ± 1.90 mmol/L vs. 16.27 ± 1.93 mmol/L vs. 15.55 ± 1.92 mmol/L, P < 0.001), OGTT fasting value (5.43 ± 0.48 mmol/L vs. 5.16 ± 0.49 mmol/L vs. 5.02 ± 0.47 mmol/L, P < 0.001), OGTT 1-hour value (10.93 ± 1.34 mmol/L vs. 9.69 ± 1.53 mmol/L vs. 9.15 ± 1.58 mmol/L, P < 0.001), OGTT 2-hour value (9.30 ± 1.66 mmol/L vs. 8.01 ± 1.32 mmol/L vs. 7.79 ± 1.38 mmol/L, P < 0.001), incidence of impaired fasting glucose (IFG) (fasting plasma glucose ≥5.6 mmol/L) (31.3% vs. 14.6% vs. 8.8%, P < 0.001), and incidence of two or more abnormal OGTT values (68.8% vs. 39.7% vs. 23.9%, P < 0.001) among the three groups. Using multivariate analysis, the factors, such as age (1.07 [1.02-1.12], P = 0.006), prepregnancy BMI (1.07 [1.02, 1.12], P  = 0.003), and area under the curve of OGTT in the first pregnancy (1.14 [1.02, 1.26], P  = 0.02), have an effect on maternal GDM recurrence; the factors, such as age (1.28 [1.01-1.61], P  = 0.04), pre-pregnancy BMI (1.26 [1.04, 1.53], P = 0.02), and area under the curve of OGTT in the first pregnancy (1.65 [1.04, 2.62], P = 0.03), have an effect on maternal DM developed further. CONCLUSIONS The history of GDM was significantly associated with a higher maternal risk for GDM recurrence during follow-up after the first pregnancy. The associated risk factors for GDM recurrence or development of DM include age, high pre-pregnancy BMI, history of delivered macrosomia, the OGTT level in the first pregnancy, such as the high area under the curve of OGTT, IFG, and two or more abnormal OGTT values. To prevent GDM recurrence, women with a history of GDM should do the preconception counseling before preparing next pregnancy.
Adult ; Blood Glucose/metabolism* ; China/epidemiology* ; Diabetes Mellitus, Type 2/epidemiology* ; Diabetes, Gestational ; Female ; Fetal Macrosomia ; Glucose Intolerance ; Humans ; Male ; Pregnancy ; Retrospective Studies

The prevalence of diabetes mellitus (DM) and associated diseases such as cancers are substantially increasing worldwide. About 80% of the patients with pancreatic cancer have glucose metabolism alterations. This suggests an association between type 2 DM and pancreatic cancer risk and progression. There are hypotheses that show metabolic links between the diseases, due to insulin resistance, hyperglycemia, hyperinsulinemia, low grade chronic inflammation, and alteration in the insulin-insulin-like growth factor axis. The use of diabetes medications can influence the extent of carcinogenesis of the pancreas. This study briefly reviews recent literature on investigation of metabolic link of type 2 DM, risk of carcinogenesis of the pancreas and their association, as well as the current understanding of metabolic pathways implicated in metabolism and cellular growth. The main finding of this review, although there are discrepancies, is that according to most research long-term DM does not raise the risk of pancreatic cancer. The longest duration of DM may reflect hypoinsulinemia due to treatment for hyperglycemia, but recent onset diabetes was associated with increased risk for pancreatic cancer due to hyperinsulinemia and hyperglycemia. In conclusion, the review demonstrates that type 2 DM and the duration of diabetes pose a risk for pancreatic carcinogenesis, and that there is biological link between the diseases.
Diabetes Mellitus, Type 2/complications/epidemiology/metabolism/*pathology ; Humans ; Hyperglycemia/pathology ; Insulin/metabolism ; Insulin Resistance ; Insulin-Like Growth Factor I/metabolism ; Pancreatic Neoplasms/epidemiology/*etiology ; Risk Factors

OBJECTIVENo previous studies have evaluated the association between dyslipidemia, alcohol drinking, and diabetes in an Inner Mongolian population. We aimed to evaluate the co-effects of drinking and dyslipidemia on diabetes incidence in this population.

METHODSThe present study was based on 1880 participants from a population-based prospective cohort study among Inner Mongolians living in China. Participants were classified into four subgroups according to their drinking status and dyslipidemia. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curves were used to evaluate the association between alcohol drinking, dyslipidemia, and diabetes.

RESULTSDuring the follow-up period, 203 participants were found to have developed diabetes. The multivariable-adjusted odds ratios (95% confidence interval) for the incidence of non-dyslipidemia/drinkers, dyslipidemia/non-drinkers, and dyslipidemia/drinkers in diabetic patients were 1.40 (0.82-2.37), 1.73 (1.17-2.55), and 2.31 (1.38-3.87), respectively, when compared with non-dyslipidemia/non-drinkers. The area under the ROC curve for a model containing dyslipidemia and drinking status along with conventional factors (AUC=0.746) was significantly (P=0.003) larger than the one containing only conventional factors (AUC=0.711).

CONCLUSIONThe present study showed that dyslipidemia was an independent risk factor for diabetes, and that drinkers with dyslipidemia had the highest risk of diabetes in the Mongolian population. These findings suggest that dyslipidemia and drinking status may be valuable in predicting diabetes incidence.

Adult ; Alcohol Drinking ; adverse effects ; epidemiology ; China ; epidemiology ; Cholesterol, HDL ; metabolism ; Cholesterol, LDL ; metabolism ; Diabetes Mellitus ; epidemiology ; etiology ; metabolism ; Dyslipidemias ; complications ; epidemiology ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Middle Aged ; Mongolia ; epidemiology ; Prospective Studies ; ROC Curve ; Risk Factors

OBJECTIVETo study the clinical features of liver disease patients with abnormal glucose metabolism.

METHODSLiver functions and levels of FPG, PPG, FINS, PINS, FCP, and PCP in 91 chronic hepatitis B patients with abnormal glucose metabolism (62 had liver cirrhosis) were analyzed.

RESULTS(1) The incidence of hepatogenic impaired glucose tolerance (IGT) and of diabetes mellitus (DM) in hepatitis B patients with liver cirrhosis (20.53%; 24.11%) were higher than those without cirrhosis (3.82%; 1.64%; P<0.05, P<0.01). (2) There were no diabetic symptoms among any of the hepatogenic IGT and DM patients. 12 of 19 chronic hepatitis B patients with primary DM and 6 of 12 hepatitis B associated liver cirrhosis patients with primary DM had diabetic symptoms. (3) The levels of FPG and PPG in chronic hepatitis B patients with hepatogenic IGT and DM were lower than those in the patients with primary DM (P<0.05), but the levels of PINS and PCP in chronic hepatitis B patients with hepatogenic IGT and DM were higher than those in the patients with primary DM (P<0.05). (4) There were no differences in the levels of FPG and PPG between the hepatitis B associated liver cirrhosis patients with hepatogenic DM and those with primary DM (P<0.05). The levels of FINS, PINS, FCP, and PCP were higher in the hepatitis B associated liver cirrhosis patients with hepatogenic DM than those in the hepatitis B associated liver cirrhosis patients with primary DM (P<0.05). The levels of FPG and PPG in the hepatogenic DM patients were higher than those in the hepatogenic IGT patients (P<0.05), but their levels of FINS, PINS, FCP and PCP were lower than those in the hepatogenic IGT patients (P<0.05, P<0.01).

CONCLUSIONHepatogenic IGT and DM are always secondary in severe liver cirrhosis patients, who always showed no diabetic symptoms. The chronic hepatitis B patients with hepatogenic DM had increased insulin secretion, while the hepatitis B associated liver cirrhosis patients with hepatogenic DM had decreased insulin secretion.

Blood Glucose ; metabolism ; Diabetes Mellitus ; epidemiology ; etiology ; metabolism ; Female ; Glucose Intolerance ; Hepatitis B, Chronic ; complications ; metabolism ; Humans ; Liver Cirrhosis ; complications ; metabolism ; Male

OBJECTIVETo investigate the prevalence of diabetes mellitus (DM) and glucose abnormalities in patients with ischemic chronic heart failure (CHF).

METHODSA total of 1004 hospitalized eligible patients from 52 hospitals in 7 Chinese cities were included in this study.

RESULTSIn this survey, 420 out of 1004 patients had DM history (41.8%), 175 patients were newly diagnosed as DM (17.4%), 208 patients (20.7%) had impaired glucose tolerance (IGT). NYHA grade increases in proportion to severity of abnormal glucose metabolism [(r(s)) = 0.17, P = 0.001]. After adjustment of age and other factors, logistic regression analyses showed risk of suffering severe CHF symptoms (NYHA III/IV) increases with the severity of abnormal glucose metabolism: OR, 1.2, 95% CI: 0.7 - 1.7 in patients with IGT; 1.4, 95% CI: 0.9 - 2.1 in the newly diagnosed DM patients and 1.7, 95% CI: 1.2 - 2.4 in the DM history group, respectively.

CONCLUSIONSHigh prevalence of abnormal glucose metabolism was observed in patients with chronic ischemic hear failure and the severity of abnormal glucose metabolism was closely related to NYHA symptom grade.

Aged ; Aged, 80 and over ; Blood Glucose ; metabolism ; China ; Coronary Disease ; complications ; epidemiology ; metabolism ; Diabetes Mellitus ; epidemiology ; Female ; Glucose Intolerance ; epidemiology ; Heart Failure ; complications ; epidemiology ; metabolism ; Humans ; Male ; Middle Aged ; Prevalence ; Risk Factors