Parabens, a widely exposed environmental endocrine disruptor, were reported to disturb glucose metabolism through various pathways in animal models, but epidemiologic studies are limited. Therefore, ...this study aimed to investigate the plasma parabens level in rural populations and their effects of single and mixed paraben exposure on T2DM based on the Henan Rural Cohort.
A total of 1713 participants (880 T2DM and 833 controls) from the Henan Rural Cohort Study were included in this case-control study. Generalized linear regression models were performed to assess the single and joint effects of parabens on T2DM and glucose metabolism indicators. In addition, the dose-response relationship of plasma parabens with T2DM and glucose metabolism indicators were explored by the restricted cubic splines. Bayesian kernel machine regression (BKMR) and quantile g-computation models were utilized to assess overall associations of paraben mixtures with T2DM and glucose metabolism indicators.
Σparabens and methylparaben (MeP) exposure significantly increased the risk of T2DM (P < 0.01). However, ethylparaben (EtP) and butylparaben (BuP) were negatively related to T2DM (P < 0.01). Notably, non-linear relationships of EtP and BuP with T2DM were observed. When the level of EtP or BuP was above the inflection point observed in dose-response curve, the ORs and 95% CIs were 1.453 (1.252, 1.686) and 1.982 (1.444, 2.721), respectively. Moreover, the result of quantile g-computation also showed that exposure to high concentration of parabens mixture was positively related to the risk of T2DM. BKMR model indicated that parabens mixture was associated with glycometabolism following a U-shape and parabens mixture increased the risk of dysglycemia when all parabens concentrations were at or above their 55th percentile compared with the median.
MeP or paraben mixture exposure levels showed a linear positive association with risk of T2DM. EtP and BuP were nonlinearly associated with glucose metabolism and moderate-high exposure contributed to T2DM.
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•Various models were used to evaluate effects of parabens' single and mixed exposure.•Methylparaben and parabens mixture exposure may increase the risk of dysglycemia.•Ethylparaben and Butylparaben were nonlinearly associated with type 2 diabetes mellitus.
Cardiovascular disease is a leading cause of morbidity and mortality in individuals with type 2 diabetes mellitus. These high-risk patients benefit from aggressive risk factor management, with blood ...pressure and low-density lipoprotein-cholesterol treatment, glycemic control, kidney protection, and lifestyle intervention. There are several recommendation and guideline documents across cardiology, endocrinology, nephrology, and general medicine professional societies from the United States and Europe with recommendations for cardiovascular risk reduction in patients with type 2 diabetes mellitus. Although there are some noteworthy differences, particularly in risk stratification, low-density lipoprotein-cholesterol and blood pressure treatment targets, and the use of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists, overall there is considerable alignment across recommendations from different professional societies.
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•Subspecialty society guidelines in the United States and Europe include similar recommendations for cardiovascular risk reduction in patients with T2DM, but there are a number of clinically important differences.•The guidelines are generally aligned in recommending lifestyle interventions, aggressive management of blood pressure, LDL-C and blood glucose, and providing renal protection.•The main differences involve risk stratification criteria, lipid and blood pressure treatment targets, and indications for addition of SGLT2i and GLP-1RA.
The aim of this trial was to characterize the beneficial effects of probiotics on decreasing endotoxin levels and other cardiometabolic parameters in Arab patients with type 2 diabetes mellitus ...(T2DM).
Saudi adults with naïve T2DM (n = 30; 12 males and 18 females) were randomly allocated to receive twice daily placebo or 2.5 × 109 cfu/g of Ecologic®Barrier (multi-strain probiotics; n = 31; 14 males and 17 females) in a double-blind manner over a 6 month period, respectively. Anthropometrics were measured and fasting blood samples were collected to analyze endotoxin, glycemic parameters glucose, insulin, c-peptide and homeostasis model assessment for insulin resistance (HOMA-IR), lipids triglycerides, total cholesterol, low and high-density lipoprotein (LDL and HDL, respectively) cholesterol and total/HDL-cholesterol ratio, inflammatory markers tumor-necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) and adipocytokines leptin, adiponectin and resistin at baseline and after 3 and 6 months of intervention.
Multi-strain probiotics supplementation for 6 months caused a significant decrease in circulating levels of endotoxin by almost 70% over 6 months, as well as glucose (38%), insulin (38%), HOMA-IR (64%), triglycerides (48%), total cholesterol (19%), total/HDL-cholesterol ratio (19%), TNF-α (67%), IL-6 (77%), CRP (53%), resistin (53%), and a significant increase in adiponectin (72%) as compared with baseline. Only HOMA-IR had a clinically significant reduction (−3.4, 64.2%) in the probiotics group as compared to placebo group at all time points. No other clinically significant changes were observed between the probiotic or placebo group at 3 and 6 months in other markers.
Multi-strain probiotic supplementation over 6 months as a monotherapy significantly decreased HOMA-IR in T2DM patients, with the probiotic treatment group highlighting reduced inflammation and improved cardiometabolic profile. As such, multi-strain probiotics is a promising adjuvant anti-diabetes therapy.
ClinicalTrials.gov Identifier: NCT01765517.
Background: Myocardial infarction (MI), often associated with diabetes mellitus (DM), lacks detailed subtype data. Liraglutide, administered to high-risk Type 2 DM individuals, reduced major CV ...events, including CV mortality, non-fatal MI, and non-fatal stroke, based on the LEADER trial (8,240 participants). It notably lowered MI risk (192 liraglutide vs. 239 placebo). This post-hoc analysis examines MI differences, outcomes, subtypes, and troponin levels in LEADER. Methods: LEADER trial data were used to assess MI occurrences in the liraglutide and placebo groups, considering MI subtype, troponin levels, and baseline patient characteristics. Results: Reports of 680 MIs (both first and recurrent) were made; the liraglutide group had fewer than the placebo group (259 vs. 321). With liraglutide, the number of MIs linked to CV death was significantly reduced (7 vs. 18 fatal MIs). The majority of MIs with symptoms were spontaneous MIs (418/541) and non-ST-segment elevation MIs (455/541). Baseline data displayed that a greater proportion of MI individuals treated with liraglutide had previously undergone a coronary artery bypass graft, whereas a smaller proportion had peripheral arterial disease in the lower limbs and more than 50% stenosis in different arteries (coronary, carotid, etc.). Conclusion: According to this investigation, liraglutide may affect the clinical results of MI and lower the incidence of myocardial infarction in high-risk type 2 DM patients. Recommendation: This study supports considering liraglutide therapy for high-risk Type 2 diabetes mellitus patients, especially those with a history of cardiovascular issues or heightened MI risk. Healthcare providers should assess patient risk factors and discuss liraglutide's potential benefits in reducing MI and related major adverse cardiovascular events. Regular troponin level monitoring and MI subtype evaluation can guide personalized treatment. Ongoing research may offer further insights into liraglutide's long-term impact on MI outcomes in Type 2 DM patients.
Diabetes is an endocrine deficiency disease, a logical treatment of which is hormone replacement therapy1. The 20-year UK Prospective Diabetes Study (UKPDS) ran from 1977 to 1997 and enrolled 5,102 ...people with newly-diagnosed type 2 diabetes (T2D) from 23 UK hospital centres. It was a factorial-design, randomised, controlled, outcome trial that assigned 3,867 participants to conventional glucose control (primarily with diet) or intensive glucose control with sulfonylurea, basal insulin or metformin (if overweight). The 1,148 participants found to be hypertensive were randomised to less-tight or tight blood pressure control. In 1997, all surviving participants were returned to primary care and entered a 10-year observational post-trial monitoring study. Key within-trial findings showed that T2D is not a “mild” disease as at diagnosis 50% of patients had complications, highlighting the need to find them earlier. Hyperglycaemia was shown to be an independent modifiable risk factor for coronary heart disease and progressive hyperglycaemia was identified as a fundamental underlying pathology that was shown to be secondary to declining beta cell function over time. Participants with hypertension and T2D were found to be at “doublé jeopardy” with a 45% greater risk of any diabetes related endpoint, compared with normotensive participants, and worsening kidney function was shown to substantially increase the risk of death.
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Epidemiological studies have implied that diabetes mellitus (DM) will become an epidemic accompany with metabolic and endocrine disorders worldwide. Most of DM patients are affected ...by type 2 diabetes mellitus (T2DM) with insulin resistance and insulin secretion defect. Generally, the strategies to treat T2DM are diet control, moderate exercise, hypoglycemic and lipid-lowing agents. Despite the therapeutic benefits for the treatment of T2DM, most of the drugs can produce some undesirable side effects. Considering the pathogenesis of T2DM, natural products (NPs) have become the important resources of bioactive agents for anti-T2DM drug discovery. Recently, more and more natural components have been elucidated to possess anti-T2DM properties, and many efforts have been carried out to elucidate the possible mechanisms. The aim of this paper was to overview the activities and underlying mechanisms of NPs against T2DM. Developments of anti-T2DM agents will be greatly promoted with the increasing comprehensions of NPs for their multiple regulating effects on various targets and signal pathways.
Type 2 diabetes mellitus has become one of the fastest growing public health problems worldwide. The disease is believed to involve a complex process involving genetic susceptibility and ...environmental factors. The human intestine harbors hundreds of trillions of bacteria, as well as bacteriophage particles, viruses, fungi, and archaea, which constitute a complex and dynamic ecosystem referred to as the gut microbiota. Increasing evidence has indicated changes in the gut microbiota composition or function in type 2 diabetic patients. An analysis of ‘dysbiosis’ enables the detection of alterations in the specific bacteria, clusters of bacteria, or bacterial functions associated with the occurrence of type 2 diabetes. These bacteria are involved predominantly in the control of inflammation and energy homeostasis. This review attempts to show that the gut microbiota are important factors for the occurrence of type 2 diabetes and are important for the treatment of gut microbiota dysbiosis through bariatric surgery, fecal microbiota transplantation, prebiotics, and probiotics.
The incidence of type 2 diabetes mellitus (T2DM) has increased worldwide. One of the first actions to reduce the risk of this disease is to implement healthy dietary models; however, no universal ...dietary strategies have so far been established. In addition, MicroRNAs (miRNAs) are emerging as new biomarkers to predict disease. We aimed to study whether miRNAs could be used to select the nutritional therapy to prevent T2DM development in patients with cardiovascular disease.
All patients from the CORDIOPREV study without T2DM at baseline according to the American Diabetes Association (ADA) diagnostic criteria (n = 462) were included in the present study. Of them, after a median dietary intervention period of 60 months with two diets (Low fat or Mediterranean diets), 107 developed T2DM and 355 subjects did not develop the disease. The plasma levels of 24 miRNAs were measured at baseline by qRT-PCR. The risk of T2DM was evaluated by Cox regression analysis based on the plasma levels of the miRNAs at baseline and according to the dietary intervention. Finally, pathways analyses were carried out to identify target genes regulated by the miRNAs studied and cellular processes which could be associated with T2DM development.
Cox regression analyses showed that patients with low plasma levels of miR-145 at baseline showed a higher risk of developing T2DM after consumption of an LFHCC diet. In addition, patients with low levels of miR-29a, miR-28-3p and miR-126 and high plasma levels of miR-150 at baseline showed a higher risk of developing T2DM after consumption of the Med diet. Finally, pathways analysis showed an interaction of miR-126 and miR-29a in the modulation of FoxO, TNF-α, PI3K-AKT, p53 and mTOR signaling, associated with T2DM development.
Our results suggest that circulating miRNAs could be used in clinical practice as a new tool for selecting the most suitable diet to prevent type 2 diabetes mellitus development in patients with cardiovascular disease.
NCT00924937.
We aim to analyze trends in mortality rates among adults with diabetic kidney disease (DKD) in the US from 1999 to 2020.
We queried the Centers for Disease Control Wide-Ranging Online Data for ...Epidemiologic Research database for mortality statistics from 1999 to 2020 associated with DKD in adults aged ≥25 years. Age-adjusted mortality rates (AAMRs) were calculated and trends were analyzed using the Joinpoint Regression Program.
From 1999 to 2020, a total of 528,430 deaths were reported among adults with DKD. The mortality rates increased over time with males consistently exhibiting higher AAMR than females. NH American Indian or Alaska Native individuals had the highest AAMR, followed by NH Blacks, Hispanics, NH Whites, and NH Asians. The West region had the highest AAMR, followed by the Midwest, South, and Northeast. Rural regions had higher AAMR than urban areas, and mortality rates increased with age.
This study reveals notable disparities in DKD mortality rates across demographic groups and geographic regions. NH American Indians or Alaska Natives, males, elderly individuals, rural residents, and those in the West region were disproportionately affected. Understanding these trends is crucial for developing targeted interventions to reduce DKD-related mortality and address healthcare disparities.
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