OBJECTIVE: Gestational diabetes mellitus (GDM) is defined as glucose intolerance first detected during pregnancy. It can result in pregnancy complications such as birth injury, stillbirth. Fatty acid-binding protein 4 (FABP4), found in adipose tissue, is associated with insulin resistance, and type 2 diabetes. The aim of this study was to investigate whether FABP4 in the placenta and decidua of pregnant women with GDM is higher than that in normal pregnant women, and whether serum from pregnant women with GDM may cause adipocytes to secrete more FABP4 than does serum from a normal pregnant group. METHODS: We obtained placentas, deciduas, and serum from 12 pregnant women with GDM and 12 normal pregnant women and performed enzyme-linked immunosorbent assay, real time quantitative-polymerase chain reaction. We cultured human pre-adipocytes for 17 days with GDM and non-GDM serum and performed western blot, real time quantitative-polymerase chain reaction, and oil red O staining. RESULTS: Expression of FABP4 in serum, placenta and decidua of pregnant women with GDM was significantly higher than that in normal pregnant women. Serum from pregnant women with GDM increased the expression of FABP4 mRNA and decreased the expression of adiponectin mRNA in human pre-adipocytes significantly. Adipocyte cultured in GDM serum showed significantly greater lipid accumulation than those cultured in normal serum. CONCLUSION: Our results suggest that FABP4 is higher in placenta and decidua from pregnant women with GDM. Increased circulating FABP4 in maternal serum from pregnant women with GDM may originate from adipocytes and the placenta. Circulating FABP4 can induce increased insulin resistance and decreased insulin sensitivity.
Adipocytes ; Adiponectin ; Adipose Tissue ; Birth Injuries ; Blotting, Western ; Decidua ; Diabetes, Gestational* ; Enzyme-Linked Immunosorbent Assay ; Female ; Glucose Intolerance ; Humans ; Humans* ; Insulin Resistance ; Placenta ; Pregnancy ; Pregnancy Complications ; Pregnancy in Diabetics ; Pregnant Women* ; RNA, Messenger* ; Stillbirth

BACKGROUNDSeveral previous studies have shown that snoring is associated with glucose metabolism and the development of diabetes, but rare study has shown the association between snoring frequency and prediabetes, particularly in China. We hypothesized that individuals who snore might have a higher risk of prediabetes. This study aimed to investigate the association between self-reported snoring and prediabetes in a Chinese population.

METHODSA cross-sectional study was performed in three large communities of Beijing from December 2011 to August 2012 by recruiting individuals aged ≥40 years old. All participants were requested to complete a detailed questionnaire and undergo anthropometric measurements. A 75 g oral glucose tolerance test was performed in individuals without diabetes. Blood samples of all participants were collected; blood glucose and blood fat levels were measured. Multivariate logistic regression models were built to assess the association between snoring frequency and prediabetes.

RESULTSA total of 13,592 participants (female: 66.56%; mean age: 56.8 ± 7.9 years; mean body mass index: 25.5 ± 3.4 kg/m2) were included in the final analysis. Of these, 30.9% were diagnosed with prediabetes, while 41.3% and 25.4% had occasional and habitual snoring, respectively. Habitual snoring was associated with an increased risk of prediabetes (odds ratio [OR]: 1.3, 95% confidence interval [CI]: 1.1-1.4, P< 0.001), after adjusting for diabetes and sleep-related confounders in the multivariable models. Habitual snoring was also associated with isolated impaired fasting glucose (IFG; OR: 1.3, 95% CI: 1.0-1.6; P< 0.001) and isolated impaired glucose tolerance (IGT; OR: 1.3, 95% CI: 1.2-1.5; P< 0.001), but not IFG + IGT (OR: 1.1, 95% CI: 0.9-1.4; P = 0.281). When stratified by total cholesterol (TC) levels, this association between habitual snoring and prediabetes was observed only in individuals with TC <5.6 mmol/L (OR: 1.4, 95% CI: 1.2-1.6; P< 0.001).

CONCLUSIONSHabitual snoring is associated with prediabetes, but only in individuals with TC <5.6 mmol/L. Further prospective studies are needed to confirm this finding.

Adult ; Blood Glucose ; metabolism ; Cholesterol ; blood ; Cross-Sectional Studies ; Diabetes Mellitus ; blood ; epidemiology ; Fasting ; blood ; Female ; Glucose Intolerance ; blood ; epidemiology ; etiology ; Humans ; Male ; Middle Aged ; Odds Ratio ; Prediabetic State ; blood ; epidemiology ; etiology ; Self Report ; Snoring ; blood ; complications ; epidemiology

Objective: To investigate the prevalence of erectile dysfunction (ED) in men with pre-diabetes. METHODS: This study included 500 men with impaired fasting glycaemia (IFG), 500 with impaired glucose tolerance (IGT), and another 500 with normal blood glucose (NBG), all from Lanzhou. We conducted a questionnaire investigation among the subjects using the International Index of Erectile Dysfunction 5 (IIEF-5). RESULTS: The prevalence rates of ED in the IFG, IGT, and NBG groups were 14.8%, 29.2%, and 33.2%, respectively. After controlling for age, nationality, occupation, education, income, obesity, and blood pressure, the incidence rate was markedly higher in the IFG and IGT than in the NBG group (29.2% and 33.2% vs 14.8%, P <0.05), but showed no statistically significant difference between the IFG and IGT groups (P >0.05). CONCLUSIONS The prevalence of ED is higher in men with pre-diabetes than in those with normal blood glucose in Lanzhou.
Blood Glucose ; Blood Pressure ; China ; epidemiology ; Diabetes Mellitus ; Erectile Dysfunction ; epidemiology ; etiology ; Ethnic Groups ; Glucose Intolerance ; epidemiology ; Humans ; Male ; Obesity ; epidemiology ; Prediabetic State ; complications ; Prevalence ; Surveys and Questionnaires

Objective: To investigate the correlation of intermittent androgen-deprivation therapy (IADT) and continuous androgen-deprivation therapy (CADT) for advanced prostate cancer (PCa) with the risks of secondary diabetes mellitus (DM) and impaired glucose tolerance (IGT). METHODS: We conducted a retrospective case-control study of the advanced PCa patients treated by IADT or CADT in our hospital from January 2013 to December 2015. Based on the levels fasting blood glucose and 2-hour postprandial blood glucose, results of oral glucose tolerance test, and clinical symptoms of the patients, we statistically analyzed the IADT- or CADT-related risk factors for DM and IGT and the relationship of the body mass index (BMI), hypertension, smoking, and alcohol consumption with secondary DM and IGT. RESULTS: IADT was given to 53 (46.5%) of the patients, aged (69.1 ± 4.3) years, and CADT to 61 (53.5%), aged (70.2 ± 5.7) years. No statistically significant differences were observed in clinical characteristics between the two groups of patients (P > 0.05). BMI, blood pressure, smoking and drinking exhibited no significant influence on the development of DM or IGT either in the IADT (P > 0.05) or the CADT group. The incidence of IGT was significantly lower in the IADT than in the CADT group (P = 0.03), but that of DM showed no statistically significant difference between the two groups (P = 0.64). CONCLUSIONS Compared with CADT, IADT has a lower risk of IGT and a higher safety in the treatment of advanced prostate cancer.
Aged ; Alcohol Drinking ; adverse effects ; Androgen Antagonists ; adverse effects ; therapeutic use ; Blood Glucose ; metabolism ; Body Mass Index ; Case-Control Studies ; Diabetes Mellitus ; chemically induced ; Glucose Intolerance ; chemically induced ; Glucose Tolerance Test ; Humans ; Hypertension ; complications ; Male ; Prostatic Neoplasms ; drug therapy ; pathology ; Retrospective Studies ; Risk Factors ; Smoking ; adverse effects

PURPOSE: The association of ischemic stroke and metabolic syndrome (MetSyn) with or without diabetes mellitus (DM) is not clear. The present study aimed to identify the impact of diabetes or hyperglycemia on the risk of MetSyn-associated ischemic stroke. MATERIALS AND METHODS: This study comprised an Asian population of 576 patients with acute nonembolic cerebral infarction and 500 controls. MetSyn was defined according to the criteria of the International Diabetes Federation. MetSyn patients were further subgrouped according to their glucose levels: MetSyn with DM, MetSyn with impaired fasting glucose (IFG) and MetSyn with normal glucose tolerance (NGT). The impact of MetSyn on cerebral infarction was then evaluated. RESULTS: At baseline, the prevalence of MetSyn in patients with cerebral infarction was higher than that of the controls (57.29% vs. 10.00%, p<0.01). In the stroke group, the prevalences of MetSyn with DM, IFG, and NGT were 25.69%, 8.85% and 22.74%, respectively, all of which were higher than that of the controls (all p-values <0.05). By multiple logistic regression analysis, we discovered that MetSyn was associated with an increased risk of cerebral infarction (odds ratio: 5.73, p<0.01). After adjustment for all the components of MetSyn, the odds ratios of MetSyn with DM, IFG, and NGT were 5.70, 2.24 and 2.19 (all p-values <0.05), respectively. CONCLUSION: In Asian population, patients with MetSyn accompanied by T2DM are at the greatest risk for acute non-embolic stroke. Additionally, IFG was not observed to be associated with an increased risk for MetSyn-related ischemic stroke.
Aged ; Cerebral Infarction/*complications ; Diabetes Complications/epidemiology ; Female ; Glucose Intolerance/complications/epidemiology ; Humans ; Hyperglycemia/*complications ; Logistic Models ; Male ; Metabolic Syndrome X/*complications/epidemiology ; Middle Aged ; Odds Ratio ; Prevalence ; Risk Factors

OBJECTIVETo investigate glycometabolism of patients with depression at first episode.

METHODSOral glucose tolerance test (OGTT) was performed in 100 patients with depression at first episode and 50 healthy subjects; the levels of fast blood plasma insulin were also measured.

RESULTThere were no statistically significant differences in fast blood plasma insulin levels and postprandial blood glucose levels at 0 h, 1 h and 3 h (P>0.05); the fasting blood glucose (FBS), postprandial blood glucose levels in 2 h and area under OGTT curve of depression patients were significantly higher than those of healthy controls. The frequency of impaired glucose tolerance (IGT) in depression patients was higher than that in controls (P<0.05).

CONCLUSIONDepression patients at the first episode are abnormal in glycometabolism, which may have clinical implication.

Adolescent ; Adult ; Aged ; Blood Glucose ; metabolism ; Case-Control Studies ; Depressive Disorder ; blood ; complications ; Female ; Glucose Intolerance ; complications ; Glucose Tolerance Test ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVEAbnormal glucose metabolism during pregnancy can result in significant adverse outcomes for newborns. This study was designed to investigate the effect of different degrees of impaired glucose tolerance on newborns.

METHODSGlucose challenge test (GCT) and oral glucose tolerance test (OGTT) were performed in pregnant women at 24-28 weeks of gestation. Based on the results of the two tests, their newborn infants were classified into five groups: gestational diabetes mellitus (GDM, n=182), gestational impaired oral glucose tolerance [GIGT, subdividing into GIGT 1 h (n=57) and GIGT 2-3 h groups (n=156)based on the occurrence time of abnormal blood glucose after glucose load], GCT abnormal but OGTT normal (only GCT abnormal, n=38) and normal glucose tolerance (control, n=1 025). The perinatal outcomes were compared among the five groups.

RESULTSThe incidences of macrosomia, large for gestational age (LGA), small for gestational age (SGA), neonatal hypoglycemia and premature birth in the GIGT (1 h) group were significantly higher than those in the control group, but similar to those in the GDM group. The incidences of macrosomia, SGA, neonatal hypoglycemia and premature birth in the GIGT (2-3 h) and the only GCT abnormal groups significantly decreased as compared with those in the GDM group, and similar to those in the control group. GIGT (1 h ) group showed higher incidence of neonatal hypoglycemia and premature birth than the GIGT (2-3 h) and the only GCT abnormal groups.

CONCLUSIONSDifferent degrees of maternal impaired glucose tolerance have different effects on newborns. As maternal GDM, maternal GIGT (1 h) may increase the risk of macrosomia, LGA, SGA, neonatal hypoglycemia and premature birth.

Diabetes, Gestational ; metabolism ; Female ; Fetal Macrosomia ; etiology ; Glucose ; metabolism ; Glucose Intolerance ; complications ; Glucose Tolerance Test ; Humans ; Hypoglycemia ; etiology ; Infant, Newborn ; Male ; Pregnancy ; Premature Birth ; etiology ; Retrospective Studies

OBJECTIVE: To investigate the clinical significance of the determination of glycosylated hemoglobin (HbAlc) in gestational abnormal glucose metabolism. METHODS: The level of fasting plasma glucose (FPG) and HbAlc in 540 normal gravida and 387 pregnant women with abnormal glucose metabolism was determined. Glucose challenge test (GCT) with 50 g glucose was done to those whose level of FPG was normal and 75 g glucose tolerance test (OGTT) was done to those whose GCT was abnormal. The levels of HbAlc of all subjects were assessed. And all subjects were divided into some groups according to the levels of HbA1c, to investigate the relationship between the complication and the levels of HbAlc. RESULTS: The positive rate of HbAlc in abnormal glucose metabolism pregnant women was 20.9%. It was not sensitive if diagnosed only by this sign. Diagnosis by both FPG and this sign could solve this problem. The incidence of complication was increasing with the rise of HbA1c titre in the study group. CONCLUSION The determination of HbAlc is important in the screening, diagnosing and assessing the prognoses of the gestational abnormal glucose metabolism.
Adult ; Blood Glucose ; analysis ; Diabetes, Gestational ; blood ; Female ; Glucose Intolerance ; blood ; Glucose Tolerance Test ; Glycated Hemoglobin A ; analysis ; Humans ; Predictive Value of Tests ; Pregnancy ; Pregnancy Complications ; blood

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

BACKGROUNDThe concentration of serum fructosamine is correlated with plasma glucose level. The aim of this study was to determine whether the level of serum fructosamine can be diagnostic for abnormal glucose tolerance in pregnant women.

METHODSSerum samples were collected from 161 pregnant women between November 2004 and April 2005. The women were divided into three groups according to the gestational age (16 - 20 weeks group, 56 patients; 28 - 34 weeks group, 72; and 37 - 41 weeks group, 33). Each group was subdivided into normal and abnormal glucose tolerance subgroups. The levels of serum fructosamine were measured. Differences among the groups were assessed by ANOVA and Student-Newman-Keuls test. Correlations between the level of fructosamine and other variables including the results of glucose challenge test (GCT), oral glucose tolerance test (OGTT), and glycosylated hemoglobin (HbA1c) test, and infant's birth weight were analyzed by Pearson correlation.

RESULTSThe level of serum fructosamine decreased with gestational age [(223.25 +/- 48.90) micromol/L, (98.44 +/- 29.57) micromol/L, and (53.99 +/- 29.94) micromol/L, respectively. P < 0.05]. It was higher in women with abnormal glucose tolerance than that in women with normal glucose tolerance, however, the difference reached statistical significance only in the 28 - 34 weeks group (P < 0.05). In this group, the level of serum fructosamine correlated positively with the GCT result (r = 0.28, P < 0.05). No correlation was found between fructosamine level and OGTT result, HbA1c level, or neonatal weight.

CONCLUSIONSFructosamine can be used to monitor the glucose level of pregnant women with abnormal glucose tolerance, and to identify the patients at high risk of abnormal glucose tolerance, but can not be used to predict gestational diabetes mellitus (GDM) in early stage of pregnancy.

Adult ; Case-Control Studies ; Diabetes, Gestational ; blood ; Female ; Fructosamine ; blood ; Glucose Intolerance ; blood ; Glucose Tolerance Test ; Humans ; Pregnancy ; Pregnancy Complications ; blood