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Objective: Impaired fasting glucose is a prediabetic condition defined as glucose levels of 100–125 mg/dL and is considered a risk factor for type 2 diabetes. However, this definition does not confer to pregnancy. The significance of first‐trimester fasting glucose and future progression to diabetes is not well defined. Therefore, we aimed to evaluate the progression to type 2 diabetes according to first‐ trimester fasting plasma glucose levels, as compared with gestational diabetes, a well‐established risk factor for diabetes, in up to 5‐year follow‐up postpartum. Methods: A retrospective analysis of 69 001 parturients, evaluating fasting plasma glucose levels measured during the first trimester. The primary outcome was the incidence of type 2 diabetes within 5 years post‐delivery. Fasting plasma glucose levels were categorized in 10 mg/dL increments. Receiver operating characteristic‐area under the curve (ROC‐AUC) statistics and the Youden index were employed to identify the optimal fasting plasma glucose cutoff for progression to type 2 diabetes. Survival analysis was applied to calculate the adjusted hazard ratios (aHRs) for type 2 diabetes progression with further stratification to maternal obesity status. Results: The identified fasting plasma glucose cutoff for progression to type 2 diabetes was 86.5 mg/dL. This cut‐off demonstrated superior performance compared with gestational diabetes diagnosis. Stratification by maternal obesity revealed enhanced predictive capabilities for type 2 diabetes, particularly among patients without obesity. Conclusions: Increased first‐trimester fasting plasma glucose levels are associated with progression to type 2 diabetes, at least as gestational diabetes. For patients without obesity, first‐trimester fasting plasma glucose has a more pronounced impact on progression to diabetes. Synopsis: First‐trimester fasting plasma glucose levels exceeding 86.5 mg/dL carry at least a comparable risk for type 2 diabetes progression as gestational diabetes, regardless of obesity status. [ABSTRACT FROM AUTHOR]

Purpose: Diabetes mellitus (DM) is a global health concern linked to various complications, including cardiovascular disease (CVD). However, long-term follow-up studies on the risk of DM and CVD using different blood glucose assessment methods in the general Korean population are lacking. This study aimed to assess the predictive abilities of fasting plasma glucose (FPG), 2-h oral glucose tolerance test (OGTT), and glycosylated hemoglobin (HbA1c) for new-onset DM and high CVD risk in a middle-aged and older Korean population. Methods: This study used data from the Korean Genome and Epidemiology Study, a population-based prospective cohort. Blood sugar measures (FPG, OGTT, and HbA1c) were examined. The primary endpoint was the development of new-onset DM, and CVD risk was evaluated using the Framingham risk score. The predictive abilities for new-onset DM based on glycemic values were evaluated using Harrell's Concordance index and 95% confidence intervals. Results: Among the 10,030 participants, data of 6813 participants without DM at baseline were analyzed. The study revealed that OGTT outperformed FPG and HbA1c in predicting new-onset DM. The combination of FPG and HbA1c did not significantly enhance predictions for DM compared with OGTT alone. OGTT also outperformed FPG and HbA1c in predicting high CVD risk, and this difference remained significant even after adjusting for additional confounders. Conclusion: OGTT has superior predictive capabilities in identifying new-onset DM and high CVD risk in the Korean population. This suggests that relying solely on individual blood sugar measures may be insufficient for assessing DM and CVD risks. [ABSTRACT FROM AUTHOR]

Background/Objectives: Traditional glycemic monitoring in type 2 diabetes is limited, whereas continuous glucose monitoring (CGM) offers better insights into glucose fluctuations. This study aimed to determine the correlations and relative contributions of fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) levels to hyperglycemia. Methods: We utilized CGM and recorded carbohydrate intake data from lifestyle diaries of 59 patients enrolled in the Diabetes and Lifestyle Cohort Twente (DIALECT-2). Correlations between FPG and the glucose management indicator (GMI), FPG and Time Above Range (TAR), PPG and GMI, and PPG and TAR were conducted. Daily and mealtime relative contributions of PPG and FPG to glycated hemoglobin (HbA1c) and GMI were determined, considering two ranges: on target (<7.0%, 53 mmol/mol) and not on target (≥7.0%, 53 mmol/mol). Correlations between mealtime PPG and carbohydrate consumption were examined. Results: FPG and PPG correlated with GMI (r = 0.82 and 0.41, respectively, p < 0.05). The relative contribution of PPG in patients with HbA1c, GMI, and TAR values not on target was lower than in patients with HbA1c, GMI, and TAR values on target. When analyzing different mealtimes, patients with target GMI values had a higher PPG (73 ± 21%) than FPG after breakfast (27 ± 21%, p < 0.001). Individuals with elevated GMI levels had lower PPG after lunch (30 ± 20%), dinner (36 ± 23%), and snacks (34 ± 23%) than FPG. PPG after breakfast positively correlated (r = 0.41, p < 0.01) with breakfast carbohydrate intake. Conclusions: Both PPG and FPG contribute to hyperglycemia, with PPG playing a larger role in patients with better glycemic control, especially after breakfast. Targeting PPG may be crucial for optimizing glucose management. [ABSTRACT FROM AUTHOR]

Background: The triglyceride-glucose (TyG) index, recognized for its costefficiency and simplicity, serves as an accessible indicator of insulin resistance. Yet, its correlation with the risk of prediabetes and diabetes (Pre-DM/DM) in the Chinese demographic remains uncertain. Consequently, our study explored the association between the TyG index and the development of Pre-DM/DM within the Chinese population. Methods: The retrospective cohort study was carried out utilizing data from a health screening initiative. The study included 179541 adults over 20 who underwent medical examinations at the Rich Healthcare Group over a period spanning from 2010 to 2016. The correlation between the TyG index and Pre-DM/DM risk was investigated using Cox regression analysis. Furthermore, Cox proportional hazards regression with cubic spline functions and smooth curve fitting was incorporated to explore their non-linear connection. Results: The mean age of study participants was 41.18 ± 12.20 years old, and 95255 (53.05%) were male. During a median follow-up of 3.01 years, 21281 (11.85%) participants were diagnosed with Pre-DM/DM. After adjusting the potential confounding factors, the results showed that the TyG index was positively correlated with incident Pre-DM/DM (HR: 1.67, 95%CI: 1.62-1.71, P< 0.001). Additionally, a non-linear association was observed between the TyG index and the onset of Pre-DM/DM, with an inflection point identified at 8.73. Hazard ratios (HR) to the left and right of this inflection point were 1.95 (95%CI: 1.86-2.04) and 1.34 (95%CI: 1.27-1.42), respectively. Furthermore, sensitivity analyses confirmed the stability of these findings. Conclusion: The TyG index exhibited a non-linear positive relationship with the risk of Pre-DM/DM. These findings imply that maintaining the TyG index at a lower, specified threshold may be beneficial in mitigating the onset of Pre-DM/DM. [ABSTRACT FROM AUTHOR]

AbstractThermal treatment of food may undergo Maillard reactions and produce harmful substances, e.g., advanced glycation end products (AGEs). Current studies show different results about the effects of dietary AGE intake on the biomarkers of type 2 diabetes mellitus (T2DM). Therefore, this work conducted a systematic review and meta-analysis to explore the effect of dietary AGE intake on the biomarkers of T2DM, the available evidence, and the bias of this evidence. This meta-analysis focused on the association between high AGE intake and fasting plasma glucose, fasting plasma insulin, HbA1c, and HOMA-IR. Thirteen parallel studies and 4 randomized crossover studies were finally included. In the pooled analysis, fasting glucose (SMD: 0.98; 95% CI: 0.23, 1.73; p = .011), fasting insulin (SMD: 1.44; 95% CI: 0.63, 2.25; p < .01), and HOMA-IR (SMD: 1.47; 95% CI: 0.59, 2.34; p < .01) significantly increased after dietary intake with high AGEs. In the subgroup analyses, high-AGE diets and healthy participants were associated with changes in the biomarkers of T2DM. Taken together, the intake of high dietary AGE was related to the development of T2DM. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion Lack of accessibility to oral glucose tolerance tests (OGTTs) in South Africa means many pregnant women go without testing for gestational diabetes mellitus (GDM). This study evaluated point‐of‐care (POC) glucometers against the laboratory‐based glucose method in pregnant women.This was a cross‐sectional study on pregnant women attending the prenatal clinic in Johannesburg who were recommended for the OGTT. OGTTs were conducted as per International Association of Diabetes and Pregnancy Study Groups (IADPSG) guidelines. Women who consented to the study donated both venous and capillary blood for laboratory‐based and POC glucose measurements using seven POC glucometers: I‐STAT, Xpress, LDX, VivaChek‐Ino, Accu‐Chek Active, StatStrip, and Codefree. By assessing sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) and comparing Bland–Altman plots, the diagnostic accuracy of each glucose meter was compared with the reference method, the laboratory‐based glucose method.Data were analyzed for 1076 pregnant women. Based on OGTT testing, 83 women had GDM (7.7%). Overall, the POC glucometers performed poorly, with sensitivity ranging from 17.6% to 87.18% and specificity ranging between 62.7% and 99.8%. The AUC ranged from 0.59 to 0.79. All POC glucometers showed moderate to poor reliability. Laboratory‐based fasting plasma glucose (FPG) surpassed the POC glucometers in sensitivity, specificity, and AUC, with values of 94.0%, 100%, and 0.98, respectively.We demonstrated that laboratory‐based FPG has the potential to be used as a diagnostic test for GDM and that the POC glucometers cannot replace OGTT laboratory‐based measurements. [ABSTRACT FROM AUTHOR]

Background: It remains unclear which early gestational biomarkers can be used in predicting later development of gestational diabetes mellitus (GDM). We sought to identify the optimal combination of early gestational biomarkers in predicting GDM in machine learning (ML) models. Methods: This was a nested case-control study including 100 pairs of GDM and euglycemic (control) pregnancies in the Early Life Plan cohort in Shanghai, China. High sensitivity C reactive protein, sex hormone binding globulin, insulin-like growth factor I, IGF binding protein 2 (IGFBP-2), total and high molecular weight adiponectin and glycosylated fibronectin concentrations were measured in serum samples at 11–14 weeks of gestation. Routine first-trimester blood test biomarkers included fasting plasma glucose (FPG), serum lipids and thyroid hormones. Five ML models [stepwise logistic regression, least absolute shrinkage and selection operator (LASSO), random forest, support vector machine and k-nearest neighbor] were employed to predict GDM. The study subjects were randomly split into two sets for model development (training set, n = 70 GDM/control pairs) and validation (testing set: n = 30 GDM/control pairs). Model performance was evaluated by the area under the curve (AUC) in receiver operating characteristics. Results: FPG and IGFBP-2 were consistently selected as predictors of GDM in all ML models. The random forest model including FPG and IGFBP-2 performed the best (AUC 0.80, accuracy 0.72, sensitivity 0.87, specificity 0.57). Adding more predictors did not improve the discriminant power. Conclusion: The combination of FPG and IGFBP-2 at early gestation (11–14 weeks) could predict later development of GDM with moderate discriminant power. Further validation studies are warranted to assess the utility of this simple combination model in other independent cohorts. Novelty statements: It remains unclear which early gestational biomarkers can be used in predicting later development of gestational diabetes mellitus. The present study demonstrates that the combination of fasting plasma glucose and insulin-like growth factor binding protein 2 at early gestation can predict later development of gestational diabetes with moderate discriminant power. [ABSTRACT FROM AUTHOR]

Background and purpose: Due to specific metabolic changes during pregnancy, identifying pregnancy risks and timely intervention can improve the health of the mother and baby. The best results for preventing gestational diabetes are achieved through lifestyle measures early in pregnancy. Today, abnormal fasting plasma glucose (FBS) is routinely measured in early pregnancy, but its association with pregnancy outcomes is ambiguous. This study aims to investigate the incidence of gestational diabetes mellitus and other pregnancy outcomes in women with FBS levels in the first trimester of pregnancy. Materials and methods: This prospective descriptive study was conducted on 230 women with singleton pregnancies at the clinic of Imam Khomeini Hospital in Sari in 2022. After obtaining informed consent, blood samples were collected from pregnant women in the first trimester of pregnancy, and FBS levels were recorded. Additionally, between the 24th and 28th weeks of pregnancy, women underwent a re-examination based on the results of the 75g glucose tolerance test (OGTT). Based on FBS levels, women were divided into two groups: normal (92-100 mg/dL) and abnormal (101-126 mg/dL). All mothers were followed up during pregnancy, and on average, 2 days after giving birth, the pregnancy outcomes of both the mother and the baby were recorded. Data were analyzed using SPSS version 22 software. Results: The mean and standard deviation of mothers' age in the mothers of the normal FBS group were 31.05 ± 5.61 years, and in the mothers of the abnormal FBS group, it was 32.46 ± 6.24 years. The number of pregnancies in 64% (n=80) and 51.4% (n=54) of mothers was less than or equal to two pregnancies, and the number of deliveries was less than or equal to 2 births in 75.2% (n=94) and 66.7% (n=70) respectively. The most common underlying disease was hypothyroidism, which was present in 20% of mothers with normal FBS and 21% of mothers with abnormal FBS. The results showed that in weeks 24 to 28 of pregnancy, 56.5% (n=130) of mothers had impaired oral glucose tolerance tests, which was statistically significant (P=0.048). The relationship between stillbirth (P=0.593), IUGR fetus (P=0.392), blood pressure disorders related to pregnancy (P=0.904), neonatal hypoglycemia (P=1), liquid ammonia level in the 28th week of pregnancy (P=0.915) and the 36th week of pregnancy (P=0.537), and the Apgar score of the first minute (P=0.514) and the fifth minute (P=0.296) were not significant with abnormal FBS in the first pregnancy. There was a substantial relationship between impaired OGTT and first-pregnancy FBS, and 69.5% of mothers with first-pregnancy FBS in the range of 101-126 mg/dL had impaired OGTT (P<0.0001). Also, the type of cesarean delivery (P=0.037) insulin intake (P=0.031), and gestational age less than 37 weeks at the time of delivery (P=0.047), had a significant relationship with the first FBS of pregnancy. Conclusion: The results showed that FBS in the first trimester is related to gestational diabetes and pregnancy outcomes and can be used as a simple and low-cost screening test to identify pregnancies at risk of GDM and some adverse pregnancy outcomes, including the type of delivery. Insulin and gestational age should be assessed at the time of delivery. [ABSTRACT FROM AUTHOR]

Background and purpose: Due to specific metabolic changes during pregnancy, identifying pregnancy risks and timely intervention can improve the health of the mother and baby. The best results for preventing gestational diabetes are achieved through lifestyle measures early in pregnancy. Today, abnormal fasting plasma glucose (FBS) is routinely measured in early pregnancy, but its association with pregnancy outcomes is ambiguous. This study aims to investigate the incidence of gestational diabetes mellitus and other pregnancy outcomes in women with FBS levels in the first trimester of pregnancy. Materials and methods: This prospective descriptive study was conducted on 230 women with singleton pregnancies at the clinic of Imam Khomeini Hospital in Sari in 2022. After obtaining informed consent, blood samples were collected from pregnant women in the first trimester of pregnancy, and FBS levels were recorded. Additionally, between the 24th and 28th weeks of pregnancy, women underwent a re-examination based on the results of the 75g glucose tolerance test (OGTT). Based on FBS levels, women were divided into two groups: normal (92-100 mg/dL) and abnormal (101-126 mg/dL). All mothers were followed up during pregnancy, and on average, 2 days after giving birth, the pregnancy outcomes of both the mother and the baby were recorded. Data were analyzed using SPSS version 22 software. Results: The mean and standard deviation of mothers' age in the mothers of the normal FBS group were 31.05 ± 5.61 years, and in the mothers of the abnormal FBS group, it was 32.46 ± 6.24 years. The number of pregnancies in 64% (n=80) and 51.4% (n=54) of mothers was less than or equal to two pregnancies, and the number of deliveries was less than or equal to 2 births in 75.2% (n=94) and 66.7% (n=70) respectively. The most common underlying disease was hypothyroidism, which was present in 20% of mothers with normal FBS and 21% of mothers with abnormal FBS. The results showed that in weeks 24 to 28 of pregnancy, 56.5% (n=130) of mothers had impaired oral glucose tolerance tests, which was statistically significant (P=0.048). The relationship between stillbirth (P=0.593), IUGR fetus (P=0.392), blood pressure disorders related to pregnancy (P=0.904), neonatal hypoglycemia (P=1), liquid ammonia level in the 28th week of pregnancy (P=0.915) and the 36th week of pregnancy (P=0.537), and the Apgar score of the first minute (P=0.514) and the fifth minute (P=0.296) were not significant with abnormal FBS in the first pregnancy. There was a substantial relationship between impaired OGTT and first-pregnancy FBS, and 69.5% of mothers with first-pregnancy FBS in the range of 101-126 mg/dL had impaired OGTT (P

Abstract Background It remains unclear which early gestational biomarkers can be used in predicting later development of gestational diabetes mellitus (GDM). We sought to identify the optimal combination of early gestational biomarkers in predicting GDM in machine learning (ML) models. Methods This was a nested case-control study including 100 pairs of GDM and euglycemic (control) pregnancies in the Early Life Plan cohort in Shanghai, China. High sensitivity C reactive protein, sex hormone binding globulin, insulin-like growth factor I, IGF binding protein 2 (IGFBP-2), total and high molecular weight adiponectin and glycosylated fibronectin concentrations were measured in serum samples at 11–14 weeks of gestation. Routine first-trimester blood test biomarkers included fasting plasma glucose (FPG), serum lipids and thyroid hormones. Five ML models [stepwise logistic regression, least absolute shrinkage and selection operator (LASSO), random forest, support vector machine and k-nearest neighbor] were employed to predict GDM. The study subjects were randomly split into two sets for model development (training set, n = 70 GDM/control pairs) and validation (testing set: n = 30 GDM/control pairs). Model performance was evaluated by the area under the curve (AUC) in receiver operating characteristics. Results FPG and IGFBP-2 were consistently selected as predictors of GDM in all ML models. The random forest model including FPG and IGFBP-2 performed the best (AUC 0.80, accuracy 0.72, sensitivity 0.87, specificity 0.57). Adding more predictors did not improve the discriminant power. Conclusion The combination of FPG and IGFBP-2 at early gestation (11–14 weeks) could predict later development of GDM with moderate discriminant power. Further validation studies are warranted to assess the utility of this simple combination model in other independent cohorts.

Objective: Osteoporosis is a common complication of type 2 diabetes. This study aimed to provide a basis for the clinical prevention and treatment of osteoporosis as a complication of type 2 diabetes. Methods: We retrospectively analyzed patients hospitalized with type 2 diabetes with or without osteoporosis. Binary logistic regression was performed to assess the relationship between the assessed indexes and the risk of type 2 diabetes with osteoporosis. Receiver operating characteristic curves were created to evaluate the efficacy of these indexes in predicting osteoporosis in patients with type 2 diabetes. Results: The cohort comprised 1,811 patients with type 2 diabetes and 1,758 with type 2 diabetes combined with osteoporosis. The basic indexes (height and weight) and glucose metabolism indexes (glycated hemoglobin A (HbA1c) and fasting plasma glucose/fasting blood glucose) were positively correlated with the bone metabolism indexes. Receiver operating characteristic curve analysis showed that HbA1c was an effective predictor of osteoporosis risk, with an area under the curve of 70.1%. When the HbA1c of patients with type 2 diabetes was between 6% and 6.45% or reached 6.45% at a long-term stable state, the risk of osteoporosis was increased. The risk of osteoporosis was also increased in patients with type 2 diabetes who were older than 59.5 years. Conclusion: HbA1c and fasting plasma glucose/fasting blood glucose were significantly correlated with bone metabolism in patients with type 2 diabetes with and without osteoporosis. Clinical monitoring of the HbA1c may be useful in preventing osteoporosis in patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Objective: During an oral glucose tolerance test (OGTT), typically fasting plasma glucose is lower than 2-h postprandial plasma glucose. However, postprandial plasma glucose (PPG) levels lower than fasting plasma glucose (FPG) levels may also occur. This study aims to describe the prevalence, clinical characteristics and contributing risk factors for PPG ≤ FPG in a large diverse Chinese population. Methods: We conducted a cross-sectional analysis of baseline data from a nationwide cohort study conducted in China. In addition to sociodemographic and anthropometric data collection, individuals had OGTT and blood chemistry tests. We determined the prevalence of PPG ≤ FPG ('Low Post Load' group) and PPG > FPG ('High Post Load' group) and used logistic regression to evaluate the association of risk factors with the occurrence of Low Post Load. Results: The prevalence of Low Post Load was 26.04% (n = 3773) and High Post Load was 73.96% (n = 10,714). Low Post Load was found to be related to younger age, male, lower BMI, lower blood pressure, higher HDL cholesterol levels and lower triglycerides levels. Compared with participants in the High Post Load group, participants in Low Post Load group had lower PPG (4.59 ± 0.83 mmol/L vs 7.15 ± 1.41 mmol/L) and HbA1c (5.30 ± 0.43% vs 5.39 ± 0.45%). People in Low Post Load group were more likely to have hypoglycaemic episodes (2.12% vs 0.01%) and impaired fasting glucose (12.30% vs 4.81%) compared with people with High Post Load, all p < 0.001. Conclusions: We found a high prevalence of people with Low Post Load glucose (26.04%) in a Chinese population cohort. The relationship between Low Post Load and the progression to or protection from diabetes and related complications and future incidence of cardiovascular disease needs further exploration in longitudinal analyses. [ABSTRACT FROM AUTHOR]

Abstract Aims/Introduction Our aim was to investigate the optimal fasting glucose (FPG) range in Chinese older adults with type 2 diabetes, and to clarify whether the optimal range varies according to the control of risk factors. Materials and Methods The baseline survey for the cohort study began in 2018, with follow up ending in 2022. Our study enrolled 59,030 older diabetes patients with no history of cardiovascular disease (CVD). Participants were divided into nine groups based on their baseline glycemic status. The association between FPG and the risk of adverse outcomes was mainly estimated by multivariate Cox proportional risk models and restricted spline analysis. Results During the 4‐year follow‐up period, a total of 5,637 deaths and 4,904 CVD events occurred. The associations of FPG with mortality and CVD events showed J‐shaped curves. Among all‐cause deaths, the hazard ratios for FPG ≤4.50 and >11.50 mmol/L were 1.50 (95% confidence interval [CI] 1.31–1.71) and 1.84 (95% CI 1.67–2.02). Among CVD, the hazard ratios for FPG ≤4.50 and >11.50 mmol/L were 1.31 (95% CI 1.13–1.53) and 1.71 (95% CI 1.54–1.89), respectively. The optimal FPG ranges of all‐cause mortality and CVD were 5.50–7.50 and 4.50–7.50 mmol/L, respectively. For participants with at least two risk factors, the optimal FPG levels were higher than those with fewer risk factors. Conclusions In older Chinese diabetes patients, the FPG ranges related to the minimum death and CVD event rates were 5.50–7.50 and 4.50–7.50 mmol/L, respectively. Patients with more cardiovascular risk factors had higher optimal blood glucose ranges than those with fewer risk factors.

This study aimed to evaluate the associations of fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) levels at

Introduction: Waist circumference (WC) and fasting plasma glucose (FPG) have been demonstrated as risk factors for type 2 diabetes mellitus (T2DM). Evidence is limited regarding the association of the combination of WC and FPG (WyG) with the risk of T2DM. The primary aim of the study was to investigate the relationship between WyG and T2DM. Research design and methods: The current study was a population-based cohort study using data from the NAGALA database. Participants were divided into tertiles based on WyG. Cox proportional hazard regression model was applied to identify the association of WyG with T2DM. Results: During a median follow-up of 6.19 years in the normoglycemia group and 5.58 years in the prediabetes group, respectively, 88 and 285 individuals in the two groups received a diagnosis of T2DM. After full adjustment, risk of T2DM increased in step-wise fashion with increasing tertiles of WyG. For a per-SD increase in WyG, the hazard ratios for T2DM were 3.05 (95% CI 2.64 - 3.51) in all populations, 1.94 (95% CI 1.46 - 2.58) in the normoglycemia group and 1.63 (95% CI 1.40 - 1.90) in the prediabetes group. The interaction between WyG and fatty liver on T2DM was statistically significant in the prediabetes group (P for interaction = 0.034). Conclusions: Elevated WyG was independently associated with incident T2DM in Japan. Baseline WyG help identify individuals at high risk of T2DM and implement effective preventive measures. [ABSTRACT FROM AUTHOR]

An increasing number of studies have reported the close relation of the hemoglobin glycation index (HGI) with metabolism, inflammation, and disease prognosis. However, the prognostic relationship between the HGI and patients with sepsis remains unclear. Thus, this study aimed to analyze the association between the HGI and all-cause mortality in patients with sepsis using data from the MIMIC-IV database. In this study, 2605 patients with sepsis were retrospectively analyzed. The linear regression equation was established by incorporating glycated hemoglobin (HbA1c) and fasting plasma glucose levels. Subsequently, the HGI was calculated based on the difference between the predicted and observed HbA1c levels. Furthermore, the HGI was divided into the following three groups using X-tile software: Q1 (HGI ≤ − 0.50%), Q2 (− 0.49% ≤ HGI ≤ 1.18%), and Q3 (HGI ≥ 1.19%). Kaplan–Meier survival curves were further plotted to analyze the differences in 28-day and 365-day mortality among patients with sepsis patients in these HGI groups. Multivariate corrected Cox proportional risk model and restricted cubic spline (RCS) were used. Lastly, mediation analysis was performed to assess the factors through which HGI affects sepsis prognosis. This study included 2605 patients with sepsis, and the 28-day and 365-day mortality rates were 19.7% and 38.9%, respectively. The Q3 group had the highest mortality risk at 28 days (HR = 2.55, 95% CI: 1.89–3.44, p < 0.001) and 365 days (HR = 1.59, 95% CI: 1.29–1.97, p < 0.001). In the fully adjusted multivariate Cox proportional hazards model, patients in the Q3 group still displayed the highest mortality rates at 28 days (HR = 2.02, 95% CI: 1.45–2.80, p < 0.001) and 365 days (HR = 1.28, 95% CI: 1.08–1.56, p < 0.001). The RCS analysis revealed that HGI was positively associated with adverse clinical outcomes. Finally, the mediation effect analysis demonstrated that the HGI might influence patient survival prognosis via multiple indicators related to the SOFA and SAPS II scores. There was a significant association between HGI and all-cause mortality in patients with sepsis, and patients with higher HGI values had a higher risk of death. Therefore, HGI can be used as a potential indicator to assess the prognostic risk of death in patients with sepsis. [ABSTRACT FROM AUTHOR]

Aims/Introduction: Our aim was to investigate the optimal fasting glucose (FPG) range in Chinese older adults with type 2 diabetes, and to clarify whether the optimal range varies according to the control of risk factors. Materials and Methods: The baseline survey for the cohort study began in 2018, with follow up ending in 2022. Our study enrolled 59,030 older diabetes patients with no history of cardiovascular disease (CVD). Participants were divided into nine groups based on their baseline glycemic status. The association between FPG and the risk of adverse outcomes was mainly estimated by multivariate Cox proportional risk models and restricted spline analysis. Results: During the 4‐year follow‐up period, a total of 5,637 deaths and 4,904 CVD events occurred. The associations of FPG with mortality and CVD events showed J‐shaped curves. Among all‐cause deaths, the hazard ratios for FPG ≤4.50 and >11.50 mmol/L were 1.50 (95% confidence interval [CI] 1.31–1.71) and 1.84 (95% CI 1.67–2.02). Among CVD, the hazard ratios for FPG ≤4.50 and >11.50 mmol/L were 1.31 (95% CI 1.13–1.53) and 1.71 (95% CI 1.54–1.89), respectively. The optimal FPG ranges of all‐cause mortality and CVD were 5.50–7.50 and 4.50–7.50 mmol/L, respectively. For participants with at least two risk factors, the optimal FPG levels were higher than those with fewer risk factors. Conclusions: In older Chinese diabetes patients, the FPG ranges related to the minimum death and CVD event rates were 5.50–7.50 and 4.50–7.50 mmol/L, respectively. Patients with more cardiovascular risk factors had higher optimal blood glucose ranges than those with fewer risk factors. [ABSTRACT FROM AUTHOR]

Abstract The association between fasting plasma glucose (FPG), an important indicator of overall glycemic status, and the risk of cardiovascular mortality has been well investigated. The longitudinal study can repeatedly collect measured results for the variables to be studied and then consider the potential effects of intraindividual changes in measurement. This study aimed to identify long-term FPG trajectories and investigate the association between trajectory groups and cardiovascular and all-cause mortality. A latent class growth mixture modeling (LCGMM) was used to identify FPG trajectories. Cox proportional hazard models were used to estimate associations between FPG trajectories and the risk of all-cause and cardiovascular mortality. A U-shaped relationship between FPG and all-cause and cardiovascular mortality was observed in the restricted cubic spline regression models. Two FPG longitudinal trajectories of low-level (mean FPG = 5.12mmol/L) and high-level (mean FPG = 6.74mmol/L) were identified by LCGMM. After being adjusted for potential confounders, compared with the low-level category, the hazard ratios (HRs) for all-cause and cardiovascular mortality were 1.23(1.16–1.30) and 1.25(1.16–1.35), respectively, for the high-level group. Long-term FPG trajectories are significantly associated with and potentially impact the risk of all-cause and cardiovascular mortality.

Qinzheng Chen,1 Zhen He,1 Yaxin Wang,2 Xuanjin Yang,2 Nana Liu,2 Suhan Zhang,2 Liangkun Ma,2 Xuezhong Shi,1 Xiaocan Jia,1 Yongli Yang,1 Yin Sun,2 Yuan He3 1Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, People’s Republic of China; 2Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences (CAMS) and PUMC, Beijing, People’s Republic of China; 3National Human Genetic Resources Center, National Research Institute for Family Planning, Beijing, People’s Republic of ChinaCorrespondence: Yin Sun, Department of Obstetrics and Gynecology, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences (CAMS) and PUMC, Beijing, 100730, People’s Republic of China, Email yinsun_pumch@163.com Yongli Yang, Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, People’s Republic of China, Email ylyang377@zzu.edu.cnPurpose: To assess the impact of maternal pre-pregnancy body mass index (BMI) on longitudinal fetal growth, and the potential mediation effect of the maternal fasting plasma glucose in first trimester.Methods: In this retrospective cohort study, we collected pre-pregnancy BMI data and ultrasound measurements during pregnancy of 3879 singleton pregnant women who underwent antenatal examinations and delivered at Peking Union Medical College Hospital. Generalized estimation equations, linear regression, and logistic regression were used to examine the association between pre-pregnancy BMI with fetal growth and adverse neonatal outcomes. Mediation analyses were also used to examine the mediating role of maternal fasting plasma glucose (FPG) in first trimester.Results: A per 1 Kg/m² increase in pre-pregnancy BMI was associated with increase fetal body length Z-score (β 0.010, 95% CI 0.001, 0.019) and fetal body weight (β 0.017, 95% CI 0.008, 0.027). In mid pregnancy, pre-pregnancy BMI also correlated with an increase Z-score of fetal abdominal circumference, femur length (FL). Pre-pregnancy BMI was associated with an increased risk of large for gestational age and macrosomia. Mediation analysis indicated that the associations between pre-pregnancy BMI and fetal weight in mid and late pregnancy, and at birth were partially mediated by maternal FPG in first trimester (mediation proportion: 5.0%, 8.3%, 1.6%, respectively).Conclusion: Maternal pre-pregnancy BMI was associated with the longitudinal fetal growth, and the association was partly driven by maternal FPG in first trimester. The study emphasized the importance of identifying and managing mothers with higher pre-pregnancy BMI to prevent fetal overgrowth.Keywords: body mass index, fetal growth, adverse neonatal outcomes, fasting plasma glucose, mediation analysis, cohort study

ABSTRACT Objective This study was designed to examine the correlation between serum uric acid (SUA) and fasting plasma glucose (FPG) levels across non‐diabetic, pre‐diabetic, and diabetic adults from Northwest China. Materials and Methods This study utilized data from a cross‐sectional survey conducted in Ningxia Hui Autonomous Region, which investigated the prevalence and risk factors of cardiovascular disease. All subjects underwent tests for SUA and FPG levels. Generalized additive models and two‐piecewise linear regression models were applied to explore the relationships between SUA and FPG level. The triglyceride–glucose (TyG) index was examined as a measure of insulin resistance, with an analysis of its mediating effects on the association between SUA and FPG level. Results A total of 10,217 individuals aged 18 and over were included. Generalized additive models verified the inverted U‐shaped association between SUA and FPG levels, and the inflection points of FPG levels in the curves were 6.5 mmol/L in males and 8.8 mmol/L in females. The TyG index is an intermediate variable in the relationship between SUA levels and elevated FPG levels, with mediating effects of 12.82% (P

Objective To investigate the efficacy of single drug treatment of dapagliflozin and combination of dapagliflozin and sitagliptin in the treatment of type 2 diabetes mellitus (T2DM). Methods Sixty-two patients with T2DM admitted to Luhe District Hospital of Chinese Medicine from January 2022 to December 2023 were selected as research subjects, and the patients were randomly divided into two groups, with 31 cases in each group. The control group only received treatment with dapagliflozin (10 mg/d oral), while the observation group received both dapagliflozin (10 mg/d oral) and sitagliptin (100 mg/d oral) treatment. Both groups were treated for 3 months. The post-treatment blood glucose control effects ［fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c)］, blood glucose fluctuations, inflammatory markers ［C-reactive protein (CRP)］, and cardiac function ［left ventricular ejection fraction (LVEF)］ were compared between two groups. Results After 3 months of treatment, compared with before treatment, both groups showed a significant decrease in FPG and HbA1c after treatment (P＜0.05). Compared with the control group, FPG ［(6.96±0.87) mmol/L vs (7.91±0.96) mmol/L, t=4.083, P＜0.01］ and HbA1c ［(6.54±0.33)% vs (7.65±0.58)%, t=9.261, P＜0.01］ of patients in the observation group were significantly decreased, and the standard deviation of mean blood glucose (SDBG) and amplitude of postprandial blood glucose fluctuation (PPGE) were lower (P

The association between fasting plasma glucose (FPG), an important indicator of overall glycemic status, and the risk of cardiovascular mortality has been well investigated. The longitudinal study can repeatedly collect measured results for the variables to be studied and then consider the potential effects of intraindividual changes in measurement. This study aimed to identify long-term FPG trajectories and investigate the association between trajectory groups and cardiovascular and all-cause mortality. A latent class growth mixture modeling (LCGMM) was used to identify FPG trajectories. Cox proportional hazard models were used to estimate associations between FPG trajectories and the risk of all-cause and cardiovascular mortality. A U-shaped relationship between FPG and all-cause and cardiovascular mortality was observed in the restricted cubic spline regression models. Two FPG longitudinal trajectories of low-level (mean FPG = 5.12mmol/L) and high-level (mean FPG = 6.74mmol/L) were identified by LCGMM. After being adjusted for potential confounders, compared with the low-level category, the hazard ratios (HRs) for all-cause and cardiovascular mortality were 1.23(1.16–1.30) and 1.25(1.16–1.35), respectively, for the high-level group. Long-term FPG trajectories are significantly associated with and potentially impact the risk of all-cause and cardiovascular mortality. [ABSTRACT FROM AUTHOR]

Objective: This study was designed to examine the correlation between serum uric acid (SUA) and fasting plasma glucose (FPG) levels across non‐diabetic, pre‐diabetic, and diabetic adults from Northwest China. Materials and Methods: This study utilized data from a cross‐sectional survey conducted in Ningxia Hui Autonomous Region, which investigated the prevalence and risk factors of cardiovascular disease. All subjects underwent tests for SUA and FPG levels. Generalized additive models and two‐piecewise linear regression models were applied to explore the relationships between SUA and FPG level. The triglyceride–glucose (TyG) index was examined as a measure of insulin resistance, with an analysis of its mediating effects on the association between SUA and FPG level. Results: A total of 10,217 individuals aged 18 and over were included. Generalized additive models verified the inverted U‐shaped association between SUA and FPG levels, and the inflection points of FPG levels in the curves were 6.5 mmol/L in males and 8.8 mmol/L in females. The TyG index is an intermediate variable in the relationship between SUA levels and elevated FPG levels, with mediating effects of 12.82% (P < 0.001) for males and 34.02% (P < 0.001) for females. Conclusions: An inverted U‐shaped association between FPG and SUA levels was observed in both genders. The threshold of FPG level was lower in males than in females. The relationship between these variables seems to be partially mediated by serum insulin levels. [ABSTRACT FROM AUTHOR]

The pathophysiology of gestational diabetes mellitus (GDM) comprises clinical and genetic factors. In fact, GDM is associated with several single nucleotide polymorphisms (SNPs). This study aimed to build a prediction model of GDM combining clinical and genetic risk factors. A total of 1588 pregnant women from the San Carlos Cohort participated in the present study, including 1069 (67.3%) Caucasian (CAU) and 519 (32.7%) Latin American (LAT) individuals, and 255 (16.1%) had GDM. The incidence of GDM was similar in both groups (16.1% CAU and 16.0% LAT). Genotyping was performed via IPLEX Mass ARRAY PCR, selecting 110 SNPs based on literature references. SNPs showing the strongest likelihood of developing GDM were rs10830963, rs7651090, and rs1371614 in CAU and rs1387153 and rs9368222 in LAT. Clinical variables, including age, pre-pregnancy body mass index, and fasting plasma glucose (FPG) at 12 gestational weeks, predicted the risk of GDM (AUC 0.648, 95% CI 0.601–0.695 in CAU; AUC 0.688, 95% CI 0.628–9.748 in LAT), and adding SNPs modestly improved prediction (AUC 0.722, 95%CI 0.680–0.764 in CAU; AUC 0.769, 95% CI 0.711–0.826 in LAT). In conclusion, adding genetic variants enhanced the prediction model of GDM risk in CAU and LAT pregnant women. [ABSTRACT FROM AUTHOR]

Objective To explore the association of different glycemic measures and the risk of cancer. Methods A prospective cohort study conducted in Pudong New Area was used to solve the question, Cox proportional hazard model and Restricted cubic spline (RCS) regression model were used to explore the associations between different glycemic measures and the risk of cancer. Results A total of 411 new cancer patients were observed after median 7.78 years follow 一 up, accumulative person - year incidence rates were 7. 12/1 000. After multi - variable adjustment, the HR (95% Cf) of elevated FPG and 2hPG were 1. 10 (1.03 〜1.18) and 1.11 (1.02~1.20), respectively. The association between FPG and cancer risk showed a linear dose 一 response relationship; the association between 2hPG and cancer risk showed a trend toward a U - shaped dose 一 response relationship. Conclusion FPG and 2hPG are important risk factors for cancer, attention should be paid in the prevention and intervention of cancer. [ABSTRACT FROM AUTHOR]

Aim: To explore the risk of major adverse cardiovascular events (MACE) associated with exposure to bexagliflozin. Methods: The analysis included 4090 participants with type 2 diabetes (T2D) enrolled in nine phase 2 and 3 double‐blind randomized controlled trials. All potential MACE were adjudicated by a blinded committee. The primary endpoint for the meta‐analysis was the hazard ratio (HR) for the time to first occurrence of non‐fatal stroke, non‐fatal myocardial infarction (MI), cardiovascular (CV) death or hospitalization for unstable angina (MACE+), tested for non‐inferiority to a ratio of 1.8. The secondary endpoints were time to first occurrence of (i) non‐fatal stroke, non‐fatal MI or CV death (MACE), tested for non‐inferiority to a ratio of 1.3; and (ii) CV death or hospitalization for heart failure, tested for superiority. Results: The HR for the primary endpoint of MACE+ was 0.80 (95% confidence interval [CI] 0.58, 1.09), which fulfilled the non‐inferiority objective with a P value of less than 0.0001. Non‐inferiority for the first key secondary endpoint of MACE was also shown (HR = 0.82; 95% CI 0.59, 1.13; P = 0.0023). Superiority for time to CV death or first hospitalization for heart failure was not shown. Conclusions: Bexagliflozin did not increase the risk of MACE in participants with T2D when compared with placebo or active control. Both the preapproval and postapproval thresholds for CV safety were met and bexagliflozin has been approved by the US Food and Drug Administration. [ABSTRACT FROM AUTHOR]

Abstract Background Elevated fasting plasma glucose (FPG) and 2-hour post-challenge glucose (2hPG) levels are known to be independent risk factors for cardiovascular disease (CVD). However, there is limited data on the association of the difference between these measures and the risk of CVD. This study aims to investigate this association in normoglycemic Iranian adults, particularly in those with low-normal FPG levels. Methods This prospective cohort study included 4,594 30-65-year-old participants from the Tehran Lipid and Glucose Study. Using multivariable Cox proportional hazards regression models adjusting for age, sex, body mass index, hypertension, hypercholesterolemia, smoking, education level and FPG, hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated for the association between 2hPG-FPG, both as continuous and categorical variables, and the CVD risk. Analyses of receiver operating characteristic curves were undertaken to determine the optimal 2hPG-FPG cut-off value. Results During a median of 17.9 years of follow-up, 459 CVD events occurred. A one-unit increase in 2hPG-FPG was significantly associated with an elevated risk of cardiovascular disease in both normoglycemic (HR 1.10, 95% CI (1.01–1.19)) and low-normal FPG individuals (HR 1.16, 95% CI (1.04–1.30)); this association resisted adjustment for Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) among normoglycemic individuals. However, those with 2hPG levels greater than FPG levels had a non-significant increased risk of incident CVD compared to those with 2hPG levels of less than or equal to FPG, with corresponding HR values of 1.18 (95% CI: 0.95–1.46) in normoglycemic and 1.32 (95% CI: 0.98–1.79) in low-normal FPG, respectively. For incident CVD, the optimal cut-off value for the 2hPG-FPG was found to be 1.06 mmol/L, which was applicable for both normoglycemic and low FPG populations; using this criterion, the corresponding risks for incident CVD were 1.36 (95% CI: 1.12–1.64) and 1.57 (95% CI: 1.22–2.03), respectively. Conclusions The difference between 2hPG and FPG levels within the normoglycemic range is related to an increased risk of CVD, an issue that was independent of HOMA-IR. A cut-off point for 2hPG-FPG > 1.06 mmol/L may stratify persons at higher risk. These findings were particularly notable in those with low-normal FPG.

Abstract Background Risk analysis is an important area of research in diabetes and cardiovascular disease (CVD), both of which have significant global health burdens. Although there is evidence that patients with prediabetes and diabetes mellitus may have an increased risk of CVD, few studies have been conducted in mainland China. Methods This retrospective cohort study utilized data from the Quzhou City Resident Health Information System and the Zhejiang Province Chronic Disease Surveillance System in China. Prediabetes and diabetes mellitus were the exposure interests, and the outcome event was defined as the onset of cardiovascular and cerebrovascular disease (including coronary heart disease and stroke). The start date of the study was January 1, 2015, and the follow-up deadline was December 31, 2020. Multivariate Cox proportional hazard model were used to assess the associations among prediabetes, diabetes, and CVD risk. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Our study used follow-up time as the time scale, while adjusting for age, sex, physical activity, smoking, alcohol consumption, BMI in the models Sensitivity analyses were conducted to assess the stability of the results, by excluding participants who smoked and drank alcohol, participants who developed CVD in the first year of follow-up. Results In total, 138,970 participants were included in our study, with a mean follow-up of 5.8 years. The mean age of the participants was 58.82 ± 14.44 years, with 42.79% (n = 59,466) males and 57.21% (n = 79,504) females. During the study period 4357 cases of CVD were recorded. Participants with prediabetes (P = 0.003) and diabetes (P

Abstract Objective Metabolic risks play a key role in the progression of pancreatic cancer. This study aimed to present global, regional and national data on mortality and disability-adjusted life-year (DALY) for pancreatic cancer attributable to metabolic risk and to forecast mortality to 2030 using data from the Global Burden of Disease (GBD). Methods Data on mortality and DALYs due to pancreatic cancer attributable to metabolic risks were obtained from GBD 2019. Metabolic risks include high fasting plasma glucose (FPG) and high body mass index (BMI). Total numbers and age-standardized rates per 100,000 people for mortality and DALYs were reported by age, sex, region and country/territory from 1990 to 2019. The “Bayes age-period-cohort” method was used for projections of mortality to 2030. Results Globally, there was a 3.5-fold increase in the number of pancreatic cancer deaths attributable to metabolic risk, from 22,091 in 1990 to 77,215 in 2019. High-income North America and Central Europe had the highest age-standardized mortality rates (ASMRs) of pancreatic cancer attributable to high FPG and high BMI in 2019, respectively. From 1990 to 2019, the global ASMR of pancreatic cancer attributable to high FPG and high BMI increased. Countries with high healthcare access quality had much higher age-standardized DALY rates. In the next 10 years, the ASMR of pancreatic cancer attributable to high FPG and high BMI will continue to increase. Conclusion Pancreatic cancer mortality and DALYs attributable to metabolic factors remain high, particularly in high-income regions or countries. Studies on the metabolic mechanism of pancreatic cancer and effective treatment strategies are needed.

Background Coronary heart disease (CHD) is one of the major public health burdens in the world. Although treatment strategies have been developed, but CHD remains a leading cause of morbidity and mortality worldwide. The diagnosis of CHD mainly relies on coronary angiography or contrast-enhanced computed tomography. However, due to the lack of equipment in primary hospitals, early diagnosis and prognosis judgment are relatively difficult. Therefore, the search for relatively simple and easy-to-obtain laboratory indicators is conducive to providing basis for primary care physicians to diagnose and treat CHD. Objective To investigate the correlation of serum interleukin-6 (IL-6) and fasting blood glucose (FPG) levels with the degree and clinical classification of coronary stenosis, number of lesions and adverse cardiovascular events in patients with CHD. Methods CHD patients admitted to the Fifth Affiliated Hospital of Xinjiang Medical University from September to November 2020 were included as the study objects, and their general data and laboratory test results were collected. According to Gensini score criteria, the patients were divided into the mild stenosis group (group A, Gensini score≤33.25 points, n=40) and moderate and severe stenosis group (group B, Gensini score>33.25 points, n=40) based on the Gensini scoring criteria. According to the results of coronary angiography results, patients were divided into the single-vessel lesion group (n=28), double-vessel lesion group (n=21) and multi-vessel lesion group (number of lesion branch≥3, n=31) based on the number of lesions. According to the clinical classification, patients were divided into stable angina group (n=34) and acute coronary syndrome group (n=46). Spearman rank correlation analysis was used to explore the relationship of serum IL-6, FPG with relevant data of patients. Survival curves of patients were plotted using the Kaplan-Meier method, and the comparison of survival curves was performed by Log-rank test. Univariate and multivariate Cox proportional hazard regression analyses were used to explore the factors influencing the risk of adverse cardiovascular events in patients with CHD. The receiver operating characteristic (ROC) curve of IL-6 predicting the occurrence of adverse events was plotted. Results IL-6 and FPG in group A were lower than those in group B, IL-6 in the multi-vessel lesion group was higher than that in the single-vessel lesion group, FPG was higher than that in double-vessel lesion group, and IL-6 and FPG in acute coronary syndrome group was higher than that in stable angina group, with statistical significance (P45.8 ng/L group (n=39) and IL-6≤45.8 ng/L group (n=41) according to the median IL-6 expression level (45.8 ng/L), and the upper limit of normal FPG (6.1 mmol/L) was used as the grouping standard to divide the patients into FPG>6.1 mmol/L group (n=36) and FPG≤6.1 mmol/L group (n=44). Log-rank test results showed that the incidence of adverse cardiovascular events in IL-6>45.8 ng/L group was higher than that in IL-6≤45.8 ng/L group (76.9% vs. 36.6%; χ2=16.075, P < 0.001), FPG>6.1 mmol/L group had a higher incidence of adverse cardiovascular events than FPG≤6.1 mmol/L group (69.4% vs. 45.5%; χ2=4.292, P=0.038). Multivariate Cox proportional hazard regression analysis showed that IL-6 was a significant factor in adverse cardiovascular events in patients with CHD (HR=2.396, 95%CI=1.203-6.054, P

Jian Liu,1,&ast; Yuhua Ma,2,&ast; Geping Yu,3 Weiming Wang1 1Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, People’s Republic of China; 2Department of Nephrology, Traditional Chinese Medicine Hospital of Kunshan, Jiangsu, People’s Republic of China; 3Department of Nephrology, Tonglu First People’s Hospital, Hangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Weiming Wang, Department of Nephrology, RuiJin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, People’s Republic of China, Tel/Fax +86 021-64370045 Ext 665232, Email wwm11120@rjh.com.cnAim: To investigate the association between longitudinal changing patterns of fasting plasma glucose (FPG), and kidney function change in the general population.Methods: We conducted a retrospective, longitudinal cohort study of a health examination center database in China. Subjects who had at least three visits from 2011 to 2018 with baseline eGFR ≥ 60 mL/min/1.73 m2 were enrolled. The FPG trajectories were identified by group-based trajectory modeling (GBTM). We examined the association of eGFR slopes and FPG trajectories by Cox analysis.Results: Totally, 8114 participants were identified. Three heterogeneous FBP trajectories were detected by GBTM as low-stable group (n=7294), moderate-stable group (n=657) and high-stable group (n=163). The high-stable group had lower baseline eGFR, a higher percentage of fast eGFR slope, lower HDL-c, higher LDL-c, higher cholesterol, and higher Lg(triglyceride). Cox analysis showed that the high-stable trajectory was a risk factor for fast eGFR decline (for eGFR slope

Background: Body mass index (BMI) and fasting plasma glucose (FPG) are known risk factors for type 2 diabetes mellitus (T2DM), but data on the prospective association of the combination of BMI and FPG with T2DM are limited. This study sought to characterize the association of the combination of BMI and FPG (ByG) with T2DM. Methods: The current study used the NAGALA database. We categorized participants by tertiles of ByG. The association of ByG with T2DM was expressed with hazard ratios (HRs) with 95% confidence intervals (CIs) after adjustment for potential risk factors. Results: During a median follow-up of 6.19 years in the normoglycemia cohort and 5.58 years in the prediabetes cohort, the incidence of T2DM was 0.75% and 7.79%, respectively. Following multivariable adjustments, there were stepwise increases in T2DM with increasing tertiles of ByG. After a similar multivariable adjustment, the risk of T2DM was 2.57 (95% CI 2.26 - 2.92), 1.97 (95% CI 1.53 - 2.54) and 1.50 (95% CI 1.30 - 1.74) for a per-SD change in ByG in all populations, the normoglycemia cohort and the prediabetes cohort, respectively. Conclusion: ByG was associated with an increased risk of T2DM in Japan. The result reinforced the importance of the combination of BMI and FPG in assessing T2DM risk. [ABSTRACT FROM AUTHOR]

Background: Elevated fasting plasma glucose (FPG) and 2-hour post-challenge glucose (2hPG) levels are known to be independent risk factors for cardiovascular disease (CVD). However, there is limited data on the association of the difference between these measures and the risk of CVD. This study aims to investigate this association in normoglycemic Iranian adults, particularly in those with low-normal FPG levels. Methods: This prospective cohort study included 4,594 30-65-year-old participants from the Tehran Lipid and Glucose Study. Using multivariable Cox proportional hazards regression models adjusting for age, sex, body mass index, hypertension, hypercholesterolemia, smoking, education level and FPG, hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated for the association between 2hPG-FPG, both as continuous and categorical variables, and the CVD risk. Analyses of receiver operating characteristic curves were undertaken to determine the optimal 2hPG-FPG cut-off value. Results: During a median of 17.9 years of follow-up, 459 CVD events occurred. A one-unit increase in 2hPG-FPG was significantly associated with an elevated risk of cardiovascular disease in both normoglycemic (HR 1.10, 95% CI (1.01–1.19)) and low-normal FPG individuals (HR 1.16, 95% CI (1.04–1.30)); this association resisted adjustment for Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) among normoglycemic individuals. However, those with 2hPG levels greater than FPG levels had a non-significant increased risk of incident CVD compared to those with 2hPG levels of less than or equal to FPG, with corresponding HR values of 1.18 (95% CI: 0.95–1.46) in normoglycemic and 1.32 (95% CI: 0.98–1.79) in low-normal FPG, respectively. For incident CVD, the optimal cut-off value for the 2hPG-FPG was found to be 1.06 mmol/L, which was applicable for both normoglycemic and low FPG populations; using this criterion, the corresponding risks for incident CVD were 1.36 (95% CI: 1.12–1.64) and 1.57 (95% CI: 1.22–2.03), respectively. Conclusions: The difference between 2hPG and FPG levels within the normoglycemic range is related to an increased risk of CVD, an issue that was independent of HOMA-IR. A cut-off point for 2hPG-FPG > 1.06 mmol/L may stratify persons at higher risk. These findings were particularly notable in those with low-normal FPG. [ABSTRACT FROM AUTHOR]

The role of medical diagnosis is essential in patient care and healthcare. Established diagnostic practices typically rely on predetermined clinical criteria and numerical thresholds. In contrast, Bayesian inference provides an advanced framework that supports diagnosis via in-depth probabilistic analysis. This study's aim is to introduce a software tool dedicated to the quantification of uncertainty in Bayesian diagnosis, a field that has seen minimal exploration to date. The presented tool, a freely available specialized software program, utilizes uncertainty propagation techniques to estimate the sampling, measurement, and combined uncertainty of the posterior probability for disease. It features two primary modules and fifteen submodules, all designed to facilitate the estimation and graphical representation of the standard uncertainty of the posterior probability estimates for diseased and non-diseased population samples, incorporating parameters such as the mean and standard deviation of the test measurand, the size of the samples, and the standard measurement uncertainty inherent in screening and diagnostic tests. Our study showcases the practical application of the program by examining the fasting plasma glucose data sourced from the National Health and Nutrition Examination Survey. Parametric distribution models are explored to assess the uncertainty of Bayesian posterior probability for diabetes mellitus, using the oral glucose tolerance test as the reference diagnostic method. [ABSTRACT FROM AUTHOR]

Background: Risk analysis is an important area of research in diabetes and cardiovascular disease (CVD), both of which have significant global health burdens. Although there is evidence that patients with prediabetes and diabetes mellitus may have an increased risk of CVD, few studies have been conducted in mainland China. Methods: This retrospective cohort study utilized data from the Quzhou City Resident Health Information System and the Zhejiang Province Chronic Disease Surveillance System in China. Prediabetes and diabetes mellitus were the exposure interests, and the outcome event was defined as the onset of cardiovascular and cerebrovascular disease (including coronary heart disease and stroke). The start date of the study was January 1, 2015, and the follow-up deadline was December 31, 2020. Multivariate Cox proportional hazard model were used to assess the associations among prediabetes, diabetes, and CVD risk. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Our study used follow-up time as the time scale, while adjusting for age, sex, physical activity, smoking, alcohol consumption, BMI in the models Sensitivity analyses were conducted to assess the stability of the results, by excluding participants who smoked and drank alcohol, participants who developed CVD in the first year of follow-up. Results: In total, 138,970 participants were included in our study, with a mean follow-up of 5.8 years. The mean age of the participants was 58.82 ± 14.44 years, with 42.79% (n = 59,466) males and 57.21% (n = 79,504) females. During the study period 4357 cases of CVD were recorded. Participants with prediabetes (P = 0.003) and diabetes (P < 0.001) had a higher risk of CVD than those who were Normal (HR [95% CI]: 1.14 [1.05–1.24]; 1.68 [1.55–1.81], respectively). Prediabetes and patients living with diabetes had a 14% and 68% increased risk of CVD, respectively. The results of the sensitivity analyses were consistent with those of the main analyses after excluding those who developed CVD within one year of follow-up and those who were concurrent smokers or alcohol drinkers. Conclusions: Our research found that prediabetes is significantly associated with the risk of diabetes and CVD. [ABSTRACT FROM AUTHOR]

Background/objective: There is no international consensus about the optimal approach to screening and diagnosis of gestational diabetes mellitus (GDM). Fasting plasma glucose (FPG) has been proposed as an alternative universal screening test to simplify the diagnosis of GDM. We investigate the ability of the FPG to predict a 2-hour glucose value below the cut-off for GDM, thereby “ruling out” the necessity of a full OGTT and assess the proportion of GDM-related complications associated with the identified FPG level. Materials and methods: This study included secondary data from four Norwegian pregnancy cohorts (2002-2013), encompassing 2960 women universally screened with late mid-pregnancy 75g OGTT measuring FPG and 2-hour glucose. For a range of FPG thresholds, we calculated sensitivity to predict elevated 2-hour glucose, number of OGTTs needed and percentage of GDM cases missed, applying modified World Health Organization (WHO) 2013 criteria (2013WHO) and 2017 Norwegian criteria (2017Norwegian). We analyzed pregnancy outcomes for women above and below our selected threshold. Results: The prevalence of GDM was 16.6% (2013WHO) and 10.1% (2017Norwegian). A FPG threshold of 4.7 mmol/L had a sensitivity of 76% (2013WHO) and 80% (2017Norwegian) for detecting elevated 2-hour glucose, with few missed GDM cases (2.0% of those ruled out and 7.5% of all GDM cases for 2013WHO, and 1.1% of those ruled out and 7% of all GDM cases for 2017Norwegian). When excluding women with FPG <4.7mmol/l and those with GDM based on FPG, only 24% (2013WHO) and 29% (2017Norwegian) would require OGTT. Women with FPG <4.7mmol/l, including missed GDM cases, had low risk of large-for-gestational-age newborns, cesarean section and operative vaginal delivery. Conclusion: A FPG threshold of 4.7mmol/l as a first step when screening for GDM could potentially eliminate the need for OGTT in 70-77% of pregnancies. Women with FPG below this threshold appear to carry low risk of GDM-associated adverse pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Background: Guillain-Barré syndrome (GBS) is an immune-mediated acute peripheral neuropathy in which up to 20% patients remain unable to walk independently after 6 months of onset. This study aimed to develop a clinical prognostic model based on the modified Erasmus GBS Outcome Score (mEGOS) for predicting the prognosis of GBS patients at 6 months of onset. Methods: The clinical data of 201 GBS patients were retrospectively analyzed. According to the GBS disability score (GBS-DS) at 6 months of onset, patients were divided into a good prognosis group (GBS-DS < 3 points) and a poor prognosis group (GBS-DS≥3 points). Univariate and multivariate analysis was used to screen out independent risk factors for poor prognosis, and a prediction model was accordingly constructed for GBS prognosis. Results: The mEGOS score, serum albumin (ALB) and fasting plasma glucose (FPG) were independent risk factors for poor prognosis in patients with GBS, and the above risk factors were used to construct a prognostic model of mEGOSI and a nomogram. The receiver operating characteristic (ROC) curve showed that the area under curve (AUC) of mEGOS-I at admission and at 7 days of admission to predict poor prognosis at 6 months of GBS onset was 0.891 and 0.916, respectively, with sensitivities of 82.7% and 82.6% and specificities of 86.5% and 86.6%, respectively. Decision curve analysis showed that the nomogram had a very high clinical benefit. Conclusion: To our knowledge, this is the first report of the construction of a prognostic prediction model based on the mEGOS score, ALB, and FPG that can accurately and stably predict the prognosis of GBS patients at 6 months of onset. [ABSTRACT FROM AUTHOR]

Background: Accumulation of saturated fatty acids (SFAs) in the liver is known to induce hepatic steatosis and inflammation causing non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). Although SFAs have been shown to affect the epigenome in whole blood, pancreatic islets, and adipose tissue in humans, and genome-wide DNA methylation studies have linked epigenetic changes to NAFLD and NASH, studies focusing on the association of SFAs and DNA methylation in human liver are missing. We, therefore, investigated whether human liver SFA content associates with DNA methylation and tested if SFA-linked alterations in DNA methylation associate with NAFLD-related clinical phenotypes in obese individuals. Results: We identified DNA methylation (Infinium HumanMethylation450 BeadChip) of 3169 CpGs to be associated with liver total SFA content (q-value < 0.05) measured using proton NMR spectroscopy in participants of the Kuopio Obesity Surgery Study (n = 51; mean ± SD:49.3 ± 8.5 years old; BMI:43.7 ± 6.2 kg/m2). Of these 3169 sites, 797 overlapped with previously published NASH-associated CpGs (NASH-SFA), while 2372 CpGs were exclusively associated with SFA (Only-SFA). The corresponding annotated genes of these only-SFA CpGs were found to be enriched in pathways linked to satiety and hunger. Among the 54 genes mapping to these enriched pathways, DNA methylation of CpGs mapping to PRKCA and TSPO correlated with their own mRNA expression (HumanHT-12 Expression BeadChip). In addition, DNA methylation of another ten of these CpGs correlated with the mRNA expression of their neighboring genes (p value < 0.05). The proportion of CpGs demonstrating a correlation of DNA methylation with plasma glucose was higher in NASH-SFA and only-SFA groups, while the proportion of significant correlations with plasma insulin was higher in only-NASH and NASH-SFA groups as compared to all CpGs on the Illumina 450 K array (Illumina, San Diego, CA, USA). Conclusions: Our results suggest that one of the mechanisms how SFA could contribute to metabolic dysregulation in NAFLD is at the level of DNA methylation. We further propose that liver SFA-related DNA methylation profile may contribute more to hyperglycemia, while insulin-related methylation profile is more linked to NAFLD or NASH. Further research is needed to elucidate the molecular mechanisms behind these observations. [ABSTRACT FROM AUTHOR]

Introduction: Magnesium (Mg) has an important role in glucose metabolism and acts as a cofactor for many enzymatic reactions. However, Mg deficiency frequently goes unnoticed. The aim of this study was to determine the association between serum Mg and type 2 diabetes mellitus (T2DM). Methods: A cross-sectional study was done among T2DM patients who were followed-up at the Diabetic Clinic at Hospital Melaka. Serum Mg test was added to the routine investigations of all patients with diabetes who participated. Results: Prevalence of hypomagnesaemia was 21.5%. There was a significant difference in age, duration of T2DM and diabetic complications that include retinopathy, neuropathy, nephropathy, coronary heart disease and cerebrovascular accident as well as all laboratory parameters except high-density lipoprotein cholesterol between the hypomagnesaemia and normomagnesaemia groups. Glycated haemoglobin (HbA1c), fasting plasma glucose and duration of diabetes independently predicted serum Mg levels in T2DM patients. Conclusion: These findings support the use of serum Mg as an indirect biomarker of glycaemic control in T2DM patients, whereby hypomagnesaemia indicates poor control. [ABSTRACT FROM AUTHOR]

Simple Summary: This study aims to explore the effects of short-term exposure to nitrogen dioxide on blood lipids and fasting plasma glucose, as well as the interaction effects with genetic factors. This topic is important as it can reveal changes in gene expressions across different environmental levels, providing insights for subsequent analyses of loci-specific interaction effects and facilitating the interpretation of published studies on specific gene interactions. The results provide new evidence on the associations between nitrogen dioxide and blood lipids or fasting plasma glucose, which are crucial risk factors for cardiovascular disease and diabetes. In addition, we found a potential interaction between genotype and nitrogen dioxide in lipids and fasting plasma glucose, suggesting that future studies could prioritize nitrogen dioxide exposure if they can identify specific genetic variants behind the genotype–environment interactions that affect lipids and fasting plasma glucose. (1) Background: Previous studies suggest that exposure to nitrogen dioxide (NO2) has a negative impact on health. But few studies have explored the association between NO2 and blood lipids or fasting plasma glucose (FPG), as well as gene–air pollution interactions. This study aims to fill this knowledge gap based on a pedigree cohort in southern China. (2) Methods: Employing a pedigree-based design, 1563 individuals from 452 families participated in this study. Serum levels of triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDLC), high-density lipoprotein cholesterol (HDLC), and FPG were measured. We investigated the associations between short-term NO2 exposure and lipid profiles or FPG using linear mixed regression models. The genotype–environment interaction (GenoXE) for each trait was estimated using variance component models. (3) Results: NO2 was inversely associated with HDLC but directly associated with TG and FPG. The results showed that each 1 μg/m3 increase in NO2 on day lag0 corresponded to a 1.926% (95%CI: 1.428–2.421%) decrease in HDLC and a 1.400% (95%CI: 0.341–2.470%) increase in FPG. Moreover, we observed a significant genotype–NO2 interaction with HDLC and FPG. (4) Conclusion: This study highlighted the association between NO2 exposure and blood lipid profiles or FPG. Additionally, our investigation suggested the presence of genotype–NO2 interactions in HDLC and FPG, indicating potential loci-specific interaction effects. These findings have the potential to inform and enhance the interpretation of studies that are focused on specific gene–environment interactions. [ABSTRACT FROM AUTHOR]

Cataract is a leading cause of vision loss in the world. Several factors are involved in the development of cataracts, of them; diabetes and uncontrolled plasma glucose have great importance. Therefore, controlling glycemic reduces the risk of related to microvascular complications of diabetes diseases such as cataract. This study aimed to compare fasting plasma glucose (FPG), HgbA1c, and oral glucose tolerance test (OGTT) between Diabetic patients with and without cataract in comparison with the healthy group as control. Among 150 subjects, 50 diabetic patients, 50 diabetic cataracts, and 50 healthy individuals without a history of specific disease were compared with each other. Fasting plasma glucose, OGTT, and HgbA1c were measured by colorimetric methods. SPSS23 software was used to analyze data. P-values less than 5% or lower were considered to be statistically significant. In this study, the mean fasting plasma glucose, HgbA1c, and OGTT in the group of diabetic patients, diabetic with cataract, and healthy groups fasting plasma glucose were as follow, 162.46 mg dL -1 and 184.76 mg dL -1, 92.88 mg dL -1 (P˂0.05), HgbA1c: 7.8, 8.0, 5.8% (P˂0.05) and OGTT: 228 mg dL -1, 246.12 mg dL -1 and 114.32 mg dL -1 (P˂0.05) respectively. Our findings showed that in diabetic patients with and without cataract, fasting plasma levels, HgbA1C, and OGTT are higher than the healthy group. There was a significant relationship between the studied factors and cataracts. As a result, high blood glucose has a definitive role in the development of cataracts. [ABSTRACT FROM AUTHOR]

Background and Aims: Diabetes mellitus, characterized by high blood glucose, is an overwhelming public health concern globally, including in Bangladesh. The implication of this trend may pose a significant challenge to the health systems due to the lack of awareness and improper management of this chronic disease. To formulate strategies for public health planning, this study aims to explore the potential risk factors for elevated blood glucose levels among Bangladeshi individuals using advanced statistical methods and a nationally representative data set. Methods: This study utilized data from the 2017−18 Bangladesh Demographic and Health Survey and included 11,863 individuals. A nonparametric Kruskal−Wallis test assessed the significant association between fasting plasma glucose levels and various risk factors. Additionally, a robust quantile regression model was applied to examine the net effects of each risk factor at different quantiles of the distribution. Results: The prevalence of diabetes is 8.1% among individuals in the study population, with variations observed across different administrative divisions in the country. Respondents from the Dhaka division respondents had a higher likelihood (24.1%) of having elevated plasma glucose and the Rangpur division had a lower risk (10.3%) of developing diabetes disease. This study identified several potential risk factors associated with elevated blood glucose levels, including hypertensive disease, overweight and obese body mass index, higher economic status, reduced physical activities, and older age, significantly contributing to develop diabetes mellitus. Conclusion: This study recommends promoting healthy lifestyles, increased physical activity, effective hypertension management, obesity reduction, and nationwide screening programs to control diabetes and noncommunicable diseases in Bangladesh. These preventive measures are crucial for reducing the existing prevalence of diabetes and working toward achieving the Sustainable Development Goals by 2030. [ABSTRACT FROM AUTHOR]

Aim: In this study, we aimed to evaluate the effectiveness of long-acting insulin analogs in the treatment of type 2 diabetes mellitus (T2DM) in our clinic. Methods: Patients with T2DM who were prescribed long-acting insulin analog therapy in our internal medicine outpatient clinic between November 2017 and December 2019 were included in the study. Patients' age, gender, duration of diabetes, HbA1c values, insulin doses and injections in previous treatment, and fasting blood glucose levels before the initiation of long-acting insulin analog were recorded. Fasting blood glucose levels after the initiation of long-acting insulin analog therapy, HbA1c values, total insulin doses in the new treatment and the number of injections, and follow-up times were also recorded from the institutional database. Data of the patients during previous treatment and novel treatment were compared. Results: Forty patients were included in our study. Six patients who did not attend their controls and two patients who were observed to be non-compliant even though they presented to control visit were excluded from the study. The remaining 32 patients were enrolled in the study. The average treatment follow-up period of the patients was 6 (3–8) months. Fasting blood glucose (p = 0.014) and HbA1c (p = 0.004) values were significantly reduced after long-acting insulin analog therapy compared to the values during previous treatment. Similarly, total daily insulin dose was decreased after long-acting insulin analog treatment compared to the insulin dose before long-acting insulin analog treatment (p < 0.001). The decrease in the number of daily insulin injections after long-acting insulin analogs treatment compared to the number of injections before long-acting insulin analog treatment was statistically significant (p < 0.001). Conclusion: We think that the addition of new long-acting insulin analogs to the treatment in patients with T2DM may be beneficial in achieving the target blood glucose, A1c, and may also be associated with treatment compliance. [ABSTRACT FROM AUTHOR]

Objective: To compare differences in CA-19.9 levels among participants with and without Type 2 diabetes mellitus and to correlate increasing glycemia levels and HbA1c with CA-19.9 Study Design: Comparative cross-sectional study Place and Duration of Study: Department of Chemical Pathology, Combined Military Hospital, Multan Pakistan, from Feb to Aug 2022. Methodology: One hundred thirty-one patients with diabetes and without diabetes were enrolled. CA-19.9, fasting plasma glucose, HbA1c, amylase, lipase, and anthropometric parameters were assessed. Patients with diabetes were divided into three groups based on FPG and HbA1c levels to investigate the relationship between CA-19.9 and glycemic status. Results: There was no significant difference among CA-19.9 of Controls and patients with diabetes (19.45±14.89 versus 15.83±13.98, p=0.155). FPG and HbA1c showed a moderate positive correlation to CA-19.9 (r = 0.283, p= 0.001 and r= = 0.305, p7.0% (p=0.020), HbA1c 7.0%(p=0.037) and with increasing FPG in groups with FPG 5.6-7.0 mmol/L Vs >7.0 mmol/L (p=0.005). Conclusion: The glycemic status of patients with diabetes can influence their serum CA-19.9 levels, and glycemic control should be considered while interpreting these levels in such patients. T2DM patients with poor glycemic control have a higher CA of 19.9 than those with better control.

Very little is known about the diagnostic performance of the American Diabetes Association glycated haemoglobin (HbA1c) cut-off of 6.5% in resource-limited settings. This study, conducted between February 2023 and May 2023, aimed to determine the optimal HbA1c cut-off for the diagnosis of diabetes mellitus by measuring HbA1c and fasting plasma glucose levels in 120 adults attending care at a tertiary hospital in Harare, Zimbabwe. The optimal HbA1c cut-off was 6.1% and glucose levels were strongly correlated with HbA1c values. The prevalence of diabetes mellitus was higher (28.3%) at our derived HbA1c cut-off than with the American Diabetes Association criterion (21.6%). What this study adds: This study highlights the need for population-specific cut-off HbA1c values in the diagnosis of diabetes mellitus

Yue Liu,1,&ast; Huijun Zhuang,1,&ast; Na Han,1 Yuxing Yang,1 Qiao Zhang,1 Nianchun Peng,1 Ying Hu,1 Lixin Shi,1 Hong Li1,2 On behalf of REACTION Study Group. REACTION Study Group of author information is available at the end of the article1Department of Endocrinology and Metabolism, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, 550004, People’s Republic of China; 2School Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hong Li, Department of Endocrinology and Metabolism, Affiliated Hospital of Guizhou Medical University, No. 28 Guiyi Road, Guiyang, Guizhou, 550001, People’s Republic of China, Tel +8618685136016, Fax +86-851-86770523, Email lee-helen@sjtu.edu.cnPurpose: This study aimed to investigate the incidence of metabolic syndrome (MS) in people over 40 years of age with normal blood glucose levels in Guiyang’s urban areas and determine the effective glycemic cutoff value for predicting MS.Methods: The analysis was based on anthropometric and biochemical indicators of residents aged 40 years or older in urban areas of Guiyang City who participated in the “Epidemiological Study of Tumor Risk in Chinese Patients with Type 2 Diabetes” in 2011. This study included 3509 patients (2567 females and 942 males) with normal fasting plasma glucose (FPG) and no MS. Multivariate logistic regression was used to analyze the correlation between FPG and MS ROC was used to analyze the effective cutoff value of FPG for the incidence of MS.Results: After 3-year follow-up, 675 patients had MS (567 females and 108 males). MS incidence in the total population was 19.24%, 11.46% in males, and 22.09% in females, and it increased with FPG. After multivariate logistic regression analysis, the risk of MS corresponding to FPG in females and males was OR=4.607,95% CI (3.477– 6.105) and OR=2.944, 95% CI (1.785– 4.855), respectively. ROC results demonstrated that FPG could predict the onset of MS (AUC: 0.720 in males and 0.666 in females).Conclusion: Increased FPG correlated with the incidence of metabolic syndrome. Subjects with FPG in the normal range still had a high incidence of MS. The population cutoff value for predicting effective FPG for metabolic syndrome was 5.545 mmol/L in men and 5.605 mmol/L in women. Epidemiological investigations are needed to determine whether a lower FPG cutoff value is required to diagnose MS. FPG not only diagnoses diabetes but also serves as a cost-effective and convenient screening method for developing of MS in the general Chinese population.Keywords: metabolic syndrome, incidence, fasting plasma glucose, cutoff value

Abstract Background This study aimed to investigate the relationship between fasting plasma glucose (FPG) and human serum albumin (HSA) in a large health checkup population in China. Methods In this cross-sectional health checkup study, we enrolled a population of 284,635 subjects from Wuhu between 2011 and 2016. All participants completed the physical examination, blood biochemical examination, and blood routine examination. Results The prevalence of diabetes in men and women was 6.11% and 2.98%, respectively. The average level of HSA and FPG was significantly higher in men than in women (48.44 ± 3.25 vs. 47.14 ± 3.22, P

Abstract Background Higher fasting plasma glucose (FPG) levels were associated with an increased risk of all-cause mortality; however, the associations between long-term FPG trajectory groups and mortality were unclear, especially among individuals with a normal FPG level at the beginning. The aims of this study were to examine the associations of FPG trajectories with the risk of mortality and identify modifiable lifestyle factors related to these trajectories. Methods We enrolled 50,919 individuals aged ≥ 20 years old, who were free of diabetes at baseline, in the prospective MJ cohort. All participants completed at least four FPG measurements within 6 years after enrollment and were followed until December 2011. FPG trajectories were identified by group-based trajectory modeling. We used Cox proportional hazards models to examine the associations of FPG trajectories with mortality, adjusting for age, sex, marital status, education level, occupation, smoking, drinking, physical activity, body mass index, baseline FPG, hypertension, dyslipidemia, cardiovascular disease or stroke, and cancer. Associations between baseline lifestyle factors and FPG trajectories were evaluated using multinomial logistic regression. Results We identified three FPG trajectories as stable (n = 32,481), low-increasing (n = 17,164), and high-increasing (n = 1274). Compared to the stable group, both the low-increasing and high-increasing groups had higher risks of all-cause mortality (hazard ratio (HR) = 1.18 (95% CI 0.99–1.40) and 1.52 (95% CI 1.09–2.13), respectively), especially among those with hypertension. Compared to participants with 0 to 1 healthy lifestyle factor, those with 6 healthy lifestyle factors were more likely to be in the stable group (ORlow-increasing = 0.61, 95% CI 0.51–0.73; ORhigh-increasing = 0.20, 95% CI 0.13–0.32). Conclusions Individuals with longitudinally increasing FPG had a higher risk of mortality even if they had a normal FPG at baseline. Adopting healthy lifestyles may prevent individuals from transitioning into increasing trajectories.