Search

Background: Not many large‐sample investigations are available that compare the potency of the relationship of remnant cholesterol (RC) and other lipid parameters with diabetes and prediabetes. The goals of our study are to discover the relationship between RC and prediabetes, diabetes, and insulin resistance (IR) and to investigate RC, high‐density lipoprotein cholesterol (HDL‐C), non‐HDL‐C, triglycerides (TG), low‐density lipoprotein cholesterol (LDL‐C), total cholesterol (TC), TC/HDL‐C, LDL‐C/HDL‐C, and TG/HDL‐C, which are the lipid parameters that are most positively related to diabetes, prediabetes, and IR. Methods: This research enrolled 36 684 subjects from China's eight provinces. We employed multiple logistic regression analysis for testing the relationship between lipid parameters and diabetes, prediabetes, and IR. Results: After adjusting for potential confounders, and comparing the results with other lipid parameters, the positive relationship between RC and diabetes (odds ratio [OR] 1.417, 95% confidence interval [CI]: 1.345–1.492), prediabetes (OR 1.555, 95% CI: 1.438–1.628), and IR (OR 1.488, 95% CI: 1.404–1.577) was highest. RC was still related to diabetes, prediabetes, and IR even when TG <2.3 mmol/L (diabetes: OR 1.256, 95% CI: 1.135–1.390; prediabetes: OR 1.503, 95% CI: 1.342–1.684; and IR: OR 1.278, 95% CI: 1.140–1.433), LDL‐C <2.6 mmol/L (diabetes: OR 1.306, 95% CI: 1.203–1.418; prediabetes: OR 1.597, 95% CI: 1.418–1.798; and IR: OR 1.552, 95% CI: 1.416–1.701), or HDL‐C ≥1 mmol/L (diabetes: OR 1.456, 95% CI: 1.366–1.550; prediabetes: OR 1.553, 95% CI: 1.421–1.697; and IR: OR 1.490, 95% CI: 1.389–1.598). Conclusion: RC is more positively related to diabetes, prediabetes, and IR than conventional lipids and lipid ratios in the general population, the relationships between RC and diabetes, prediabetes, and IR are stable, even if HDL‐C, LDL‐C, or TG are at appropriate levels. [ABSTRACT FROM AUTHOR]

Background: Novel diabetes phenotypes were proposed by the Europeans through cluster analysis, but Chinese community diabetes populations might exhibit different characteristics. This study aims to explore the clinical characteristics of novel diabetes subgroups under data‐driven analysis in Chinese community diabetes populations. Methods: We used K‐means cluster analysis in 6369 newly diagnosed diabetic patients from eight centers of the REACTION (Risk Evaluation of cAncers in Chinese diabeTic Individuals) study. The cluster analysis was performed based on age, body mass index, glycosylated hemoglobin, homeostatic modeled insulin resistance index, and homeostatic modeled pancreatic β‐cell functionality index. The clinical features were evaluated with the analysis of variance (ANOVA) and chi‐square test. Logistic regression analysis was done to compare chronic kidney disease and cardiovascular disease risks between subgroups. Results: Overall, 2063 (32.39%), 658 (10.33%), 1769 (27.78%), and 1879 (29.50%) populations were assigned to severe obesity‐related and insulin‐resistant diabetes (SOIRD), severe insulin‐deficient diabetes (SIDD), mild age‐associated diabetes mellitus (MARD), and mild insulin‐deficient diabetes (MIDD) subgroups, respectively. Individuals in the MIDD subgroup had a low risk burden equivalent to prediabetes, but with reduced insulin secretion. Individuals in the SOIRD subgroup were obese, had insulin resistance, and a high prevalence of fatty liver, tumors, family history of diabetes, and tumors. Individuals in the SIDD subgroup had severe insulin deficiency, the poorest glycemic control, and the highest prevalence of dyslipidemia and diabetic nephropathy. Individuals in MARD subgroup were the oldest, had moderate metabolic dysregulation and the highest risk of cardiovascular disease. Conclusion: The data‐driven approach to differentiating the status of new‐onset diabetes in the Chinese community was feasible. Patients in different clusters presented different characteristics and risks of complications. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Diabetes is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Diabetes is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Diabetes is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The optimal adiposity index that is strongly associated with hypertension or prehypertension remains inconclusive in Chinese population. This study aimed to investigate the relationship between Chinese visceral adiposity index (CVAI) and hypertension and prehypertension, as well as to compare the discriminative power of CVAI, visceral adiposity index (VAI), body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), low-density lipoprotein cholesterol (LDL-C), and waist-to-hip ratio (WHR) with hypertension and prehypertension in Chinese general population. Patients and Methods: A total of 34732 participants from REACTION study were recruited. Multiple logistic regression analyses were performed to detect the association between adiposity indices (CVAI, VAI, BMI, WC, WHtR, WHR, LDL-C) and hypertension and prehypertension. Results: Multivariate logistic regression analysis showed that compared with other obesity indices, CVAI remained significantly associated with hypertension and prehypertension (Hypertension: odds ratio (OR) 3.475, 95% confidence interval (CI) 3.158-3.824, p<0.001 in total subjects; OR 2.762, 95% CI 2.369–3.221, p<0.001 in men; OR 3.935, 95% CI 3.465–4.469, p<0.001 in women, Prehypertension: OR 2.747, 95% CI 2.460-3.068, p<0.001 in total subjects; OR 2.605, 95% CI 2.176–3.119, p<0.001 in men; OR 2.854, 95% CI 2.465–3.304, p<0.001 in women).In a stratified analysis, CVAI was significantly associated with hypertension and prehypertension at any level of blood glucose, age or estimated glomerular filtration rate(eGFR). Conclusion: CVAI is significantly associated with hypertension and prehypertension. CVAI shows the superior discriminative ability for hypertension and prehypertension compared with VAI, BMI, WC, WHtR, WHR and LDL-C in Chinese general population. [ABSTRACT FROM AUTHOR]

Aims: The aims of this study were to evaluate the associations of metabolic abnormalities with incident diabetic kidney disease (DKD) and to explore whether dyslipidaemia, particularly high fasting triglyceride (TG), was associated with the development of DKD. Methods: In total, 11 142 patients with new‐onset type 2 diabetes with baseline estimated glomerular filtration rates (eGFR) ≥60 mL/min/1.73 m2 were followed up during 2011‐2016. Incident DKD was defined as eGFR <60 mL/min/1.73 m2 at follow‐up. Multiple logistic regression analysis was conducted to explore the relationship of metabolic abnormalities at baseline and at follow‐up with risks of DKD. High TG was defined by TG ≥1.70 mmol/L. Low high‐density lipoprotein cholesterol (HDL‐c) was defined by HDL‐c <1.0 mmol/L for men or <1.3 mmol/L for women. Results: Participants who developed DKD had higher levels of waist circumference and systolic blood pressure, and lower levels of HDL‐c at both baseline and follow‐up visits. The DKD group also had higher levels of post‐load plasma glucose and TG at follow‐up. Multivariate logistic regression analysis revealed that both high TG at baseline [odds ratio (OR) = 1.37, p =.012) and high TG at follow‐up (OR = 1.71, p <.001) were significantly associated with increased risks of DKD. Patients with high TG levels at both baseline and follow‐up had higher risk of DKD compared with constantly normal TG (OR = 1.65, p <.001) after adjustment for covariates. Conclusions: In a large population of patients with new‐onset type 2 diabetes, a high TG level was an independent risk factor for the development of DKD. Tight TG control might delay the occurrence of DKD. [ABSTRACT FROM AUTHOR]

Background: Lipid accumulation product (LAP) as a powerful marker of visceral obesity is an independent risk factor of chronic kidney disease. The present study attempted to explore the association between LAP and albuminuria in prediabetic individuals. Methods: We conducted a cross-sectional study and enrolled 26,529 participants with prediabetes over 40 years old with prediabetes from seven provinces in China. LAP was calculated from waist circumference and fasting triglycerides. Elevated albuminuria was defined by urinary albumin-creatinine ratio (uACR) ≥ 30 mg/g. Propensity score matching was applied to reduce bias, comparison between LAP and other traditional visceral obesity indices was performed and multiple logistic regression models were conducted to assess the association between LAP and albuminuria in the prediabetic population. Results: Individuals with uACR ≥ 30 mg/g were older and had higher BP, BMI, WC, TG, fasting insulin, glycohemoglobin and LAP, as well as lower eGFR and HDL level. Multiple logistic regression analysis showed elevated LAP was associated with increased odds of albuminuria (OR [95%CI]Q2 vs Q1 1.09 [0.94, 1.27], OR [95%CI]Q3 vs Q1 1.13 [0.97, 1.31], OR [95%CI]Q4 vs Q1 1.42 [1.21, 1.67], P for trend=0.018), and superior over waist-to-hip ratio or waist-to-height ratio. Stratification indicated that the prediabetic population with higher LAP level and characterized by female gender, middle age, being overweight, and rise in blood pressure were more likely to have increased uACR. Conclusion: Elevated level of LAP was associated with increased albuminuria in the prediabetic population in China. [ABSTRACT FROM AUTHOR]

Background: Both lipid and glucose abnormalities are associated with hypertension (HTN). However, it is unclear whether the triglyceride-glucose (TyG) index is associated with HTN. Therefore the aim of this study is to investigate the association of the TyG index and HTN and to compare the discriminative power of the TyG index, lipid, glycemic parameters for the risk of HTN in elderly individuals. Methods: The present study was nested in a longitudinal (REACTION) study from May 2011 to December 2011, which was designed to demonstrate the association of abnormal glucose metabolism with the risk of cancer in the Chinese population. In total, 47,808 participants were recruited in this cross-sectional study. The TyG index was divided into five groups: the < 20% group, the 20–39% group, the 40–59% group, the 60–79% group and the ≥ 80% group, according to quintile division of the subjects. Three multivariate logistic regression models were used to evaluate the association between the TyG vs. lipid parameters, glycemic parameters and HTN. Results: Multivariate logistic regression analysis shows that compared with lipid and glycemic parameters, the TyG index remains significantly associated with HTN in either total subjects or subjects separated into men and women (odds ratio (OR) 1.33, 95% confidence interval (CI) 1.18–1.51, p < 0.0001 in total subjects; OR 1.39, 95% CI 1.11–1.74, p = 0.0042 in men; OR 1.28, 95% CI 1.11–1.49, p = 0.0010 in women). In a stratified analysis, an elevated TyG index is significantly associated with HTN in the subgroup of the oldest age (≥ 65) (OR 1.67, 95% CI 1.30–2.14, p < 0.0001), as well as with obesity (Body mass index (BMI) ≥ 28 kg/m2) (OR 1.85, 95% CI 1.29–2.66, p = 0.0009) or lower estimated glomerular filtration rate (eGFR) (< 90 mL/(min·1.73 m2)) (OR 1.72, 95% CI 1.33–2.21, p < 0.0001). Conclusion: The TyG index is significantly associated with HTN and shows the superior discriminative ability for HTN compared with lipid and glycemic parameters in the Chinese elderly population. [ABSTRACT FROM AUTHOR]

Background: Sleep duration affects health in various ways. The objective of the present study was to investigate the relationships among sleep duration, daytime napping and kidney function in a middle-aged apparently healthy Chinese population. Methods: According to self-reported total sleep and daytime napping durations, 33,850 participants who were 38–90 years old and recruited from eight regional centers were divided into subgroups. Height, weight, waist circumference, hip circumference, blood pressure, biochemical indexes, fasting blood glucose (FBG), postprandial blood glucose (PBG), HbA1c, creatinine and urinary albumin-creatinine ratio (UACR) were measured and recorded for each subject. Microalbuminuria was defined as UACR ≥30 mg/g, chronic kidney disease (CKD) was defined as eGFR <60 ml/min, and hyperfiltration was defined as eGFR ≥135 ml/min. Multiple logistic regression was applied to investigate the association between sleep and kidney function. Results: Compared to sleeping for 7–8 h/day, the ORs for microalbuminuria for sleeping for >9 h/day, 8–9 h/day 6–7 h/day and <6 h/day were 1.343 (1.228–1.470, P<0.001), 1.223 (1.134–1.320, P<0.001), 1.130 (1.003–1.273, P = 0.045) and 1.140 (0.908–1.431, P = 0.259), respectively. The eGFR levels exhibited a U-shaped association with sleep duration among subjects with an eGFR ≥90 ml/min and an N-shaped association with sleep duration among subjects with an eGFR <90 ml/min. The OR for hyperfiltration for >9 h/day of sleep was 1.400 (1.123–1.745, P = 0.003) among participants with an eGFR ≥90 ml/min. Daytime napping had a negative effect on renal health. Compared to the absence of a napping habit, the ORs for microalbuminuria for 0–1 h/day, 1–1.5 h/day and >1.5 h/day of daytime napping were 1.552 (1.444–1.668, P<0.001), 1.301 (1.135–1.491, P<0.001) and 1.567 (1.353–1.814, P<0.001), respectively. Conclusion: The association of total sleep duration with renal health outcomes is U-shaped. Daytime napping has a negative effect on renal health. [ABSTRACT FROM AUTHOR]

Background. Physical activity is effective in preventing chronic diseases. However, the impact of different durations of exercise on human health is unknown, especially among people with diabetes or prediabetes. Objective. To explore the relationship between high MET hours per week and the change in glomerular filtration rate (eGFR) in the total population and different subgroups. Methods. A total of 43767 individuals from eight provinces, in China, were recruited. Logistic analysis was used to investigate the association. Participants were divided into 3 groups based on MET hours per week. The primary outcome was an eGFR≤90 mL/min/1.73 m2. Results. The average eGFR was 100.10 (92.43-106.43) mL/min/1.732. Logistic regression analysis revealed that more than 7.5 MET hours per week (equivalent to more than 150 minutes of moderate-intensity of exercise) was associated with the higher risk of the decreased eGFR even after adjusting for confounding factors (7.5 to <21: OR=1.18, 95% CI [1.09, 1.29]; ≥21: OR=1.12, 95% CI [1.05, 1.19], p for trend: 0.0047). After adjusting for confounding factors, in stratified analyses, there still existed a significant relationship among participants aged from 55 to less than 65 years, but not among participants younger than 55 or older than 65 years. Similarly, there existed a positive association between high MET hours per week and the decreased eGFR in participants without diabetes and prediabetes, but not in participants with diabetes or prediabetes, and the interactions of age and diabetic states were found. However, there was no significant difference in women or men. Conclusions. More than 7.5 MET hours per week (equivalent to more than 150 minutes per week or 60 minutes per day of moderate-intensity exercise) was associated with decreased eGFR among participants aged from 55 to less than 65 years and participants without diabetes and prediabetes, but not among participants aged younger than 55 years and older than 65 years and participants with diabetes or prediabetes. The importance of planning individualized physical activities is highlighted. [ABSTRACT FROM AUTHOR]

Background: Thyroid nodules are highly prevalent, but a robust, feasible method for malignancy differentiation has not yet been well documented. This study aimed to establish a practical model for thyroid nodule discrimination. Methods: Records for 2984 patients who underwent thyroidectomy were analyzed. Clinical, laboratory, and US variables were assessed retrospectively. Multivariate logistic regression analysis was performed and a mathematical model was established for malignancy prediction. Results: The results showed that the malignant group was younger and had smaller nodules than the benign group (43.5 ± 11.6 vs. 48.5 ± 11.5 y, p < 0.001; 1.96 ± 1.16 vs. 2.75 ± 1.70 cm, p < 0.001, respectively). The serum thyrotropin (TSH) level (median = 1.63 mIU/L, IQR (0.89–2.66) vs. 1.19 (0.59–2.10), p < 0.001) was higher in the malignant group than in the benign group. Patients with malignancies tested positive for anti-thyroglobulin antibody (TGAb) and anti-thyroid peroxidase antibody (TPOAb) more frequently than those with benign nodules (TGAb, 30.3% vs. 15.0%, p < 0.001; TPOAb, 25.6% vs. 18.0%, p = 0.028). The prevalence of ultrasound (US) features (irregular shape, ill-defined margin, solid structure, hypoechogenicity, microcalcifications, macrocalcifications and central intranodular flow) was significantly higher in the malignant group. Multivariate logistic regression analysis confirmed that age (OR = 0.963, 95% CI = 0.934–0.993, p = 0.017), TGAb (OR = 4.435, 95% CI = 1.902–10.345, p = 0.001), hypoechogenicity (OR = 2.830, 95% CI = 1.113–7.195, p = 0.029), microcalcifications (OR = 4.624, 95% CI = 2.008–10.646, p < 0.001), and central intranodular flow (OR = 2.155, 95% CI = 1.011–4.594, p < 0.05) were independent predictors of thyroid malignancy. A predictive model including four variables (age, TGAb, hypoechogenicity and microcalcification) showed an optimal discriminatory accuracy (area under the curve, AUC) of 0.808 (95% CI = 0.761–0.855). The best cut-off value for prediction was 0.52, achieving sensitivity and specificity of 84.6% and 76.3%, respectively. Conclusion: A predictive model of malignancy that combines clinical, laboratory and sonographic characteristics would aid clinicians in avoiding unnecessary procedures and making better clinical decisions. [ABSTRACT FROM AUTHOR]