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1.
Elevated glucose level leads to rapid COVID-19 progression and high fatality.
Wang, W, Shen, M, Tao, Y, Fairley, CK, Zhong, Q, Li, Z, Chen, H, Ong, JJ, Zhang, D, Zhang, K, et al
BMC pulmonary medicine. 2021;(1):64
Abstract
OBJECTIVES We aimed to identify high-risk factors for disease progression and fatality for coronavirus disease 2019 (COVID-19) patients. METHODS We enrolled 2433 COVID-19 patients and used LASSO regression and multivariable cause-specific Cox proportional hazard models to identify the risk factors for disease progression and fatality. RESULTS The median time for progression from mild-to-moderate, moderate-to-severe, severe-to-critical, and critical-to-death were 3.0 (interquartile range: 1.8-5.5), 3.0 (1.0-7.0), 3.0 (1.0-8.0), and 6.5 (4.0-16.3) days, respectively. Among 1,758 mild or moderate patients at admission, 474 (27.0%) progressed to a severe or critical stage. Age above 60 years, elevated levels of blood glucose, respiratory rate, fever, chest tightness, c-reaction protein, lactate dehydrogenase, direct bilirubin, and low albumin and lymphocyte count were significant risk factors for progression. Of 675 severe or critical patients at admission, 41 (6.1%) died. Age above 74 years, elevated levels of blood glucose, fibrinogen and creatine kinase-MB, and low plateleta count were significant risk factors for fatality. Patients with elevated blood glucose level were 58% more likely to progress and 3.22 times more likely to die of COVID-19. CONCLUSIONS Older age, elevated glucose level, and clinical indicators related to systemic inflammatory responses and multiple organ failures, predict both the disease progression and the fatality of COVID-19 patients.
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2.
Effect of a single bout of morning or afternoon exercise on glucose fluctuation in young healthy men.
Tanaka, Y, Ogata, H, Park, I, Ando, A, Ishihara, A, Kayaba, M, Yajima, K, Suzuki, C, Araki, A, Osumi, H, et al
Physiological reports. 2021;(7):e14784
Abstract
The timing of exercise plays an important role in the effect of the exercise on physiological functions, such as substrate oxidation and circadian rhythm. Exercise exerts different effects on the glycemic response to exercise and meal intake depending on when the exercise performed. Here, we comprehensively investigated the effects of the timing (morning or afternoon) of exercise on glucose fluctuation on the basis of several indices: glycemic variability over 24 h (24-h SD), J-index, mean amplitude of glucose excursions (MAGE), continuous overall net glycemic action (CONGA), and detrended fluctuation analysis (DFA). Eleven young men participated in 3 trials in a repeated measures design in which they performed a single bout of exercise at 60% of their maximal oxygen uptake for 1 h beginning either at 7:00 (morning exercise), 16:00 (afternoon exercise), or no exercise (control). Glucose levels were measured using a continuous glucose monitoring system (CGMs). Glucose fluctuation was slightly less stable when exercise was performed in the afternoon than in the morning, indicated by higher CONGA at 2 h and α2 in DFA in the afternoon exercise trial than in the control trial. Additionally, decreased stability in glucose fluctuation in the afternoon exercise trial was supported by the descending values of the other glucose fluctuation indices in order from the afternoon exercise, morning exercise, and control trials. Meal tolerance following exercise was decreased after both exercise trials. Glucose levels during exercise were decreased only in the afternoon exercise trial, resulting in less stable glucose fluctuations over 24 h.
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3.
Elevated fasting glucose as a potential predictor for asymptomatic cerebral artery stenosis: a cross-sectional study in Chinese adults.
Wang, J, Wu, J, Zhang, S, Zhang, L, Wang, C, Gao, X, Zhou, Y, Wang, A, Wu, S, Zhao, X
Atherosclerosis. 2014;(2):661-5
Abstract
BACKGROUND AND PURPOSE Cerebral artery stenosis is known as an important cause of stroke, and elevated fasting glucose level is also considered as a risk factor for stroke. Our aim was to exam whether elevated fasting glucose is associated with cerebral artery stenosis, especially asymptomatic cerebral artery stenosis. METHODS The current study included 5309 participants who were age of 40 years or older, and free of stroke, transient ischemic attack, and coronary artery disease. Cerebral artery stenosis was assessed by Doppler ultrasound. Participants were classified into four subtypes: no cerebral artery stenosis (NCS), intracranial artery stenosis (ICAS), extracranial carotid artery stenosis (ECCS) and combined intracranial artery and extracranial carotid artery stenosis (IECS). Fasting blood glucose concentrations were grouped into: normal fasting glucose (<5.60 mmol/l), impaired fasting glucose 1 (IFG1) (5.60-6.09 mmol/l), IFG2 (6.10-6.99 mmol/l) and diabetes (≥ 7.00 mmol/l). A multinomial logistic regression was used to examine the association between fasting glucose and cerebral artery stenosis, after adjusting for potential confounders. RESULTS Fasting glucose level was significantly higher in ICAS and IECS groups than the other two groups. In the multinomial logistic regression analysis, IFG2 was the risk factor for ICAS (odds ratio (OR) 1.53, 95% confidential interval (CI), 1.12-2.10), and diabetes was a strong predictor for both ICAS (OR 1.75, 95% CI, 1.38-2.22) and IECS (OR 2.14, 95% CI 1.31-3.49). However, fasting glucose level was not significantly associated with ECCS. CONCLUSIONS Our results showed that elevated fasting glucose levels are associated with asymptomatic cerebral artery stenosis, especially ICAS and IECS.
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4.
Influence of vitamin E supplementation on glycaemic control: a meta-analysis of randomised controlled trials.
Xu, R, Zhang, S, Tao, A, Chen, G, Zhang, M
PloS one. 2014;(4):e95008
Abstract
Observational studies have revealed that higher serum vitamin E concentrations and increased vitamin E intake and vitamin E supplementation are associated with beneficial effects on glycaemic control in type 2 diabetes mellitus (T2DM). However, whether vitamin E supplementation exerts a definitive effect on glycaemic control remains unclear. This article involves a meta-analysis of randomised controlled trials of vitamin E to better characterise its impact on HbA1c, fasting glucose and fasting insulin. PubMed, EMBASE and the Cochrane Library were electronically searched from the earliest possible date through April 2013 for all relevant studies. Weighted mean difference (WMD) was calculated for net changes using fixed-effects or random-effects models. Standard methods for assessing statistical heterogeneity and publication bias were used. Fourteen randomised controlled trials involving individual data on 714 subjects were collected in this meta-analysis. Increased vitamin E supplementation did not result in significant benefits in glycaemic control as measured by reductions in HbA1c, fasting glucose and fasting insulin. Subgroup analyses revealed a significant reduction in HbA1c (-0.58%, 95% CI -0.83 to -0.34) and fasting insulin (-9.0 pmol/l, 95% CI -15.90 to -2.10) compared with controls in patients with low baseline vitamin E status. Subgroup analyses also demonstrated that the outcomes may have been influenced by the vitamin E dosage, study duration, ethnic group, serum HbA1c concentration, and fasting glucose control status. In conclusion, there is currently insufficient evidence to support a potential beneficial effect of vitamin E supplementation on improvements of HbA1c and fasting glucose and insulin concentrations in subjects with T2DM.
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5.
Differences in the metabolic status of healthy adults with and without active brown adipose tissue.
Zhang, Q, Ye, H, Miao, Q, Zhang, Z, Wang, Y, Zhu, X, Zhang, S, Zuo, C, Zhang, Z, Huang, Z, et al
Wiener klinische Wochenschrift. 2013;(21-22):687-95
Abstract
BACKGROUND Previous studies have proven the existence of active brown adipose tissue (BAT) in adults; however, its effect on systematic metabolism remains unclear. AIM: The current study was designed to investigate the differences in the metabolic profiles of healthy adults with and without active BAT using positron emission tomography-computed tomography (PET-CT) scans in the un-stimulated state. METHODS A cross-sectional analysis was performed to assess the health of adults using PET-CT whole-body scans at Huashan Hospital Medical Centre between November 2009 and May 2010. A total of 62 healthy adults with active BAT were enrolled in the BAT-positive group. For each positive subject, a same-gender individual who underwent PET-CT the same day and who had no detectable BAT was chosen as the negative control. Body composition was measured, and blood samples were collected for assays of metabolic profiles and other biomarkers. RESULTS In both the male and female groups, BAT-positive individuals were younger and had lower body mass indexes, fasting insulin, insulin resistance, and leptin, but a greater level of high-density lipoprotein cholesterol compared with the negative controls. In the male group, body fat content and levels of tumor necrosis factor-α were significantly lower in the BAT-positive than in the negative control group. CONCLUSIONS The healthy adults with active BAT in an un-stimulated state had favorable metabolic profiles suggesting that active BAT may be a potential target for preventing and treating obesity and other metabolic disorders.
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6.
Metabolic effects of bariatric surgery in type 2 diabetic patients with body mass index < 35 kg/m2.
Li, Q, Chen, L, Yang, Z, Ye, Z, Huang, Y, He, M, Zhang, S, Feng, X, Gong, W, Zhang, Z, et al
Diabetes, obesity & metabolism. 2012;(3):262-70
Abstract
AIM: The aim of this meta-analysis is to assess the metabolic effects of bariatric surgery in type 2 diabetes mellitus (T2DM) patients with body mass index (BMI) < 35 kg/m(2) . METHODS We performed an electronic literature search of published articles to identify relevant evidence since inception to June 2011. Primary outcome measures were metabolic improvement and resolution diabetes after bariatric surgery. The weighted mean difference (WMD) and its 95% confidence interval (CI) were calculated from the raw data extracted from the original literature. The software Review Manager (version 4.3.1) was applied for meta-analysis. RESULTS Thirteen trials involving 357 patients were included in the meta-analysis. The follow-up interval ranged from 6 months to 18 years. According to WMD calculation, bariatric surgery led to 5.18 kg/m(2) of BMI lowering (95% CI, 3.79-6.57, p < 0.00001), 4.8 mmol/l of fasting plasma glucose (FPG) decrement (95% CI, 3.88-5.71 mmol/l, p < 0.00001), 2.59% of HbA1c decreasing (95% CI, 2.12-3.07%, p < 0.00001), 56.67 mg/dl of triglyceride decrement (95% CI 11.53-101.82, p = 0.01) and 48.38 mg/dl of total cholesterol reduction (95% CI 21.08-75.68, p = 0.0005). Moreover, the procedures produced an increased high-density lipoprotein cholesterol by 5.37 mg/dl (95% CI -11.37-0.63, p = 0.08). However, this effect was not statistically significant. Overall, 80.0% of the patients achieved adequate glycaemic control (HbA1c < 7%) without antidiabetic medication. The surgeries produced a low incidence of major complications (3.2%) with no mortality. CONCLUSIONS Bariatric surgery is effectual and safe in the treatment of non-severely obese (BMI < 35 kg/m(2) ) T2DM patients. Moreover, the metabolic benefits acquired from the procedures can be long sustained after the surgery.