|
| ||
|
|
||
Abnormal Glucose Tolerance (abnormal + glucose_tolerance)
Selected AbstractsAbnormal glucose tolerance in young male patients with nonalcoholic fatty liver diseaseLIVER INTERNATIONAL, Issue 4 2009Jung Won Yun Abstract Objective: The association of nonalcoholic fatty liver disease (NAFLD) with insulin resistance and metabolic syndrome has been documented for obese men and middle-aged men. This study was designed to determine the relationship between NAFLD and the oral glucose tolerance test (OGTT) to predict preclinical diabetes in nondiabetic young male patients (<30 years old). Methods: A total of 75 male patients who had elevated liver enzymes and who were diagnosed with NAFLD were enrolled in this study. A standard 75 g OGTT was carried out on all patients. Impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) were defined as a fasting plasma glucose (FPG) level ,100 mg/dl but <126 mg/dl, and a 2-h post-load glucose on the OGTT of ,140 mg/dl, but <200 mg/dl respectively. Results: According to the OGTT results, 24 (32%) patients were diagnosed as having IGT and 12 (16%) patients were diagnosed as having diabetes. Among the 48 patients with normal fasting glucose, 18 (37.6%) patients showed abnormal glucose tolerance (15 had IGT and three had diabetes). The NAFLD patients with abnormal glucose tolerance showed significant differences in age, weight, body mass index, waist,hip ratio, alanine aminotransferase, total bilirubin, total cholesterol, low-density lipoprotein cholesterol, triglyceride, insulin, FPG and homeostasis model for insulin resistance (HOMA-IR). Multiple regression analysis showed that age, FPG and HOMA-IR were independent predictors of abnormal glucose tolerance. Conclusions: Although the patients were young men, an OGTT should be recommended for NAFLD patients with elevated liver enzymes and IFG to predict the risk of type 2 diabetes. [source] Abnormal glucose tolerance in CF,when should we offer diabetes treatment?PEDIATRIC DIABETES, Issue 3 2009Antoinette Moran No abstract is available for this article. [source] Cardiovascular drugs as antidiabetic agents: evidence for the prevention of type 2 diabetesDIABETES OBESITY & METABOLISM, Issue 7 2008D. P. Macfarlane Given the long-term health consequences and increasing incidence of type 2 diabetes, there is great interest to potentially prevent or delay its onset. Primary prevention studies have demonstrated that intensive exercise and weight reduction, and to a lesser extent certain antidiabetic agents, can reduce new onset diabetes in at-risk individuals. Results from post hoc analyses and secondary end-point outcomes of large randomized controlled trials of cardiovascular drugs suggest that these may also have beneficial effects, reducing the incidence of new onset diabetes in addition to their proven cardiovascular benefits. Multiple meta-analyses confirm that drugs primarily acting on the renin,angiotensin system (RAS) reduce the incidence of diabetes in the populations studied, perhaps via improved insulin sensitivity and/or effects on pancreatic beta cells. However, results from the recent Diabetes REduction Approaches with Medication study specifically failed to show a significant reduction in the incidence of diabetes with ramipril in individuals with abnormal glucose tolerance at baseline. There is only limited evidence that statins improve glucose tolerance, and although beta-blockers tend to have detrimental effects on glucose tolerance, newer agents with vasodilatory properties may confer benefits. With current guidelines, the use of cardiovascular drugs modifying the RAS will increase in at-risk individuals, but at present, they cannot be recommended to prevent diabetes. [source] Leptin,a predictor of abnormal glucose tolerance and prognosis in patients with myocardial infarction and without previously known Type 2 diabetesDIABETIC MEDICINE, Issue 8 2008M. Wallander Abstract Aims High levels of leptin and low adiponectin are associated with Type 2 diabetes mellitus (T2DM) and cardiovascular (CV) disease. We studied the prognostic implications of leptin and adiponectin in patients with acute myocardial infarction (AMI) without previously known Type 2 DM. Methods One hundred and eighty-one patients were included. Based on an oral glucose tolerance test at hospital discharge (day 4,5), 168 (67% men) had normal or abnormal glucose tolerance (AGT), defined as impaired glucose tolerance or T2DM. Sex- and age-matched healthy persons served as control subjects (n = 185). The associations between fasting serum leptin and adiponectin (day 2) and newly discovered AGT and CV events (CV mortality, non-fatal stroke, reinfarction or severe heart failure) during a median follow-up of 34 months were investigated. Results Compared with control subjects, patients of both genders had significantly higher levels of leptin 2 days after an AMI. These levels were higher than those obtained at hospital discharge and 3 months later. Circulating levels of (ln) leptin 2 days after the AMI predicted AGT at discharge (odds ratio 2.03, P = 0.042). Ln leptin at day 2 was the only biochemical variable that significantly predicted CV events both on univariate [hazard ratio (HR) 1.60, P = 0.018] and on multivariate analysis (HR 1.75, P = 0.045). Adiponectin levels did not differ between patients and control subjects and did not relate to AGT or CV events. Conclusions Elevated circulating levels of leptin on the first morning after an AMI are associated with the presence of AGT at discharge and with a poorer long-term prognosis. [source] Glucose intolerance and associated factors in Mongolia: results of a national surveyDIABETIC MEDICINE, Issue 6 2002J. Suvd Abstract Aims Prevalence of glucose intolerance,diabetes and impaired glucose tolerance (IGT),and of related conditions such as obesity and hypertension, was studied in six population samples in Mongolia in 1999. Methods Diagnosis of glucose intolerance was made on the basis of 2-h blood glucose concentration, according to criteria recommended by the latest report of a WHO Expert Group. Results Crude prevalence of diabetes was 2.9% (2.6% in men and 3.2% in women). Prevalence of IGT was 10.2% (9.3% in men and 10.8% in women). Age standardization to the standard world population of Segi resulted in a total sample prevalence of 3.1% for diabetes and 9.2% for IGT. Prevalence of abnormal glucose tolerance differed according to district of residence. Approximately one-third of the subjects with diabetes were diagnosed prior to the survey. Of those who were diagnosed previously, approximately one-half were not under any form of treatment. Subjects with abnormal glucose tolerance were older, more obese and had higher blood pressure and prevalence of hypertension than those with normoglycaemia. One-half of men and almost one-half of women were hypertensive. Three-quarters of the diabetic subjects were hypertensive. One-third of all subjects were centrally obese. Considering the conditions of principal interest,glucose intolerance, hypertension and obesity,one-half of all subjects demonstrated one or more of these conditions. Central obesity was the most common condition, followed by hypertension and then glucose intolerance. Central obesity and hypertension was the most common combination (17% of all subjects) and 4% exhibited all three conditions. Conclusions Non-communicable diseases are already a threat to public health in Mongolia. Although the prevalence of diabetes is not high by international standards, the relatively high prevalence of IGT suggests that the situation may deteriorate in the future in the absence of concerted action to prevent and control diabetes and related conditions. [source] Metabolic syndrome and mitochondrial function: Molecular replacement and antioxidant supplements to prevent membrane peroxidation and restore mitochondrial function,JOURNAL OF CELLULAR BIOCHEMISTRY, Issue 6 2007Garth L. Nicolson Abstract Metabolic syndrome consists of a cluster of metabolic conditions, such as hypertriglyeridemia, hyper-low-density lipoproteins, hypo-high-density lipoproteins, insulin resistance, abnormal glucose tolerance and hypertension, that,in combination with genetic susceptibility and abdominal obesity,are risk factors for type 2 diabetes, vascular inflammation, atherosclerosis, and renal, liver and heart disease. One of the defects in metabolic syndrome and its associated diseases is excess cellular oxidative stress (mediated by reactive oxygen and nitrogen species, ROS/RNS) and oxidative damage to mitochondrial components, resulting in reduced efficiency of the electron transport chain. Recent evidence indicates that reduced mitochondrial function caused by ROS/RNS membrane oxidation is related to fatigue, a common complaint of MS patients. Lipid replacement therapy (LRT) administered as a nutritional supplement with antioxidants can prevent excess oxidative membrane damage, restore mitochondrial and other cellular membrane functions and reduce fatigue. Recent clinical trials have shown the benefit of LRT plus antioxidants in restoring mitochondrial electron transport function and reducing moderate to severe chronic fatigue. Thus LRT plus antioxidant supplements should be considered for metabolic syndrome patients who suffer to various degrees from fatigue. J. Cell. Biochem. 100: 1352,1369, 2007. © 2007 Wiley-Liss, Inc. [source] Original Article: A prospective study of uric acid by glucose tolerance status and survival: the Rancho Bernardo StudyJOURNAL OF INTERNAL MEDICINE, Issue 6 2010C. K. Kramer Abstract., Kramer CK, von Mühlen D, Jassal SK, Barrett-Connor E (University of California, La Jolla, CA; and Hospital de Clinicas de Porto Alegre, RS, Brazil). A prospective study of uric acid by glucose tolerance status and survival: the Rancho Bernardo Study. J Intern Med 2010. Objectives., Little is known about uric acid (UA) levels and mortality in the context of glycaemia. We examined whether serum UA levels predict all-cause and cardiovascular disease (CVD) mortality differentially in older adults by glucose tolerance status. Design and methods., Between 1984 and 1987, 2342 community-dwelling men and women had an oral glucose tolerance test, UA measurement, and assessment of traditional CVD risk factors. We defined glucose tolerance status as normoglycaemia (NG), pre-diabetes (pre-DM), and type 2 diabetes mellitus (T2DM). Ninety per cent were followed for vital status up to 23 years. Death certificates were coded using the Ninth International Classification of Diseases. Results., Baseline age was 69.5 years; 44.4% were men. At baseline 939 had NG, 957 pre-DM, and 446 T2DM. The mean UA by glucose tolerance status was 327.1, 362.8, and 374.7 ,mol L,1. During follow-up, there were 1318 deaths 46.8% attributed to CVD. In Cox-regression analysis, each 119 ,mol L,1 (2 mg dL,1) increment in UA levels predicted an increased hazard ratio (HR) for all-cause deaths independent of age, smoking, body mass index, alcohol, physical activity, diuretic use and estimated glomerular filtration rate in all groups (NG: HR 1.25 95% CI 1.06,1.47, P =0.005; pre-DM: HR 1.20 95% CI 1.06,1.37, P = 0.04; T2DM: HR 1.20 95% CI 1.01,1.47, P = 0.04). After adjusting for CVD risk factors, the UA association with CVD mortality was significant only in the pre-DM and T2DM groups. Conclusion., All-cause mortality was independently associated with UA in all groups, but UA predicted CVD mortality only in those with abnormal glucose tolerance. [source] Hyperglycaemia and cardiovascular diseaseJOURNAL OF INTERNAL MEDICINE, Issue 2 2007M. Bartnik Abstract. Coronary artery disease and type 2 diabetes are chronic diseases of substantial and growing prevalence. Their coincidence is common, markedly enhancing mortality and morbidity. The risk for cardiovascular disease increases along a spectrum of blood glucose concentrations already apparent at levels regarded as normal. Accordingly, strategies for the early detection of glucometabolic disturbances are needed to find ways to prevent the occurrence of cardiovascular complications or to treat them already at an early stage. More specifically, abnormal glucose tolerance is almost twice as common amongst patients with a myocardial infarction as in population-based controls and a normal glucose regulation is indeed less common than abnormal glucose metabolism also amongst patients with stable coronary artery disease. Already an abnormal glucose tolerance is a strong risk factor for future cardiovascular events after an acute myocardial infarction. An oral glucose tolerance test should, therefore, be a part of the evaluation of total risk in all patients with coronary artery disease. As glucose disturbances are common and easy to detect, they may be suitable targets for novel secondary preventive efforts. [source] Abnormal glucose tolerance in young male patients with nonalcoholic fatty liver diseaseLIVER INTERNATIONAL, Issue 4 2009Jung Won Yun Abstract Objective: The association of nonalcoholic fatty liver disease (NAFLD) with insulin resistance and metabolic syndrome has been documented for obese men and middle-aged men. This study was designed to determine the relationship between NAFLD and the oral glucose tolerance test (OGTT) to predict preclinical diabetes in nondiabetic young male patients (<30 years old). Methods: A total of 75 male patients who had elevated liver enzymes and who were diagnosed with NAFLD were enrolled in this study. A standard 75 g OGTT was carried out on all patients. Impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) were defined as a fasting plasma glucose (FPG) level ,100 mg/dl but <126 mg/dl, and a 2-h post-load glucose on the OGTT of ,140 mg/dl, but <200 mg/dl respectively. Results: According to the OGTT results, 24 (32%) patients were diagnosed as having IGT and 12 (16%) patients were diagnosed as having diabetes. Among the 48 patients with normal fasting glucose, 18 (37.6%) patients showed abnormal glucose tolerance (15 had IGT and three had diabetes). The NAFLD patients with abnormal glucose tolerance showed significant differences in age, weight, body mass index, waist,hip ratio, alanine aminotransferase, total bilirubin, total cholesterol, low-density lipoprotein cholesterol, triglyceride, insulin, FPG and homeostasis model for insulin resistance (HOMA-IR). Multiple regression analysis showed that age, FPG and HOMA-IR were independent predictors of abnormal glucose tolerance. Conclusions: Although the patients were young men, an OGTT should be recommended for NAFLD patients with elevated liver enzymes and IFG to predict the risk of type 2 diabetes. [source] | ||||||||||