Postprandial glucagon-like peptide 1 secretion is associated with urinary albumin excretion in newly diagnosed type 2 diabetes patients

BACKGROUND Microalbuminuria is an early and informative marker of diabetic nephropathy.Our study found that microalbuminuria developed in patients with newly diagnosed type 2 diabetes mellitus(T2DM).AIM To investigate the association between glucagon-like peptide 1(GLP-1)and microalbuminuria in newly diagnosed T2DM patients.METHODS In total,760 patients were recruited for this cross-sectional study.The GLP-1 levels during a standard meal test and urinary albumin-creatinine ratio(UACR)were determined.RESULTS Patients with microalbuminuria exhibited lower GLP-1 levels at 30 min and 120 min during a standard meal test than patients with normal albuminuria(30 min GLP-1,16.7±13.3 pmol vs 19.9±15.6 pmol,P=0.007;120 min GLP-1,16.0±14.1 pmol vs 18.4±13.8 pmol,P=0.037).The corresponding area under the curve for active GLP-1(AUCGLP-1)was also lower in microalbuminuria patients(2257,1585 to 3506 vs 2896,1763 to 4726,pmol×min,P=0.003).Postprandial GLP-1 levels at 30 min and 120 min and AUCGLP-1 were negatively correlated with the UACR(r=0.159,r=0.132,r=0.206,respectively,P<0.001).The prevalence of microalbuminuria in patients with newly diagnosed T2DM was 21.7%,which decreased with increasing quartiles of AUCGLP-1 levels(27.4%,25.3%,18.9%and 15.8%).After logistic regression analysis adjusted for sex,age,hemoglobin A1c,body mass index,systolic blood pressure,estimated glomerular filtration rate,homeostasis model assessment of insulin resistance,AUC_(glucose)and AUC_(glucagon)patients in quartile 4 of the AUCGLP-1 presented a lower risk of microalbuminuria compared with the patients in quartile 1(odds ratio=0.547,95%confidence interval:0.325-0.920,P=0.01).A consistent association was also found between 30 min GLP-1 or 120 min GLP-1 and microalbuminuria.CONCLUSION Postprandial GLP-1 levels were independently associated with microalbuminuria in newly diagnosed Chinese T2DM patients.

Factors associated with improvement in waist-to-height ratio among newly diagnosed type 2 diabetes patients treated with acarbose or metformin:A randomized clinical trial study

BACKGROUND The waist-to-height ratio(WHtR)is a promising anthropometric measure used to evaluate cardiovascular risk in diabetes and metabolic syndrome patients.The metformin and acarbose in Chinese as the initial hypoglycaemic treatment trial demonstrated that acarbose and metformin reduced the WHtR after 24 wk of treatment.AIM To investigate the factors associated with a decrease in the WHtR in newly diagnosed Chinese type 2 diabetes patients receiving acarbose or metformin monotherapy.METHODS At 24 wk,343 patients in the acarbose treatment and 333 patients in the metformin treatment were included in this analysis.On the basis of the reduction in the WHtR,these participants were divided into the following two groups:LowΔWHtR group and highΔWHtR group.Metabolic and related parameters associated with a highΔWHtR were investigated using univariate and multivariate logistic regression analyses.RESULTS A significant decrease in the WHtR was observed in both treatment groups(acarbose:-0.015,95%confidence interval[CI]:-0.018 to-0.012,P<0.001;metformin:-0.013,95%CI:-0.016 to-0.010,P<0.001).In both the acarbose and metformin groups,the WHtR of the women was more likely to be reduced than that of the men.In the acarbose group,a lower baseline area under the curve of glucagon-like peptide 1(AUCGLP-1)was associated with a highΔWHtR(odds ratio[OR]=0.796,P<0.001),while a higher baseline AUCGLP-1 was associated with a highΔWHtR in the patients treated with metformin(OR=1.133,P=0.025).Regarding the changes from baseline,an increase in AUCGLP-1 was associated with a highΔWHtR in the acarbose(OR=1.121,P=0.016)but not metformin group.A higher reduction in high-density lipoprotein cholesterol/non-highdensity lipoprotein cholesterol was also associated with a highΔWHtR in the acarbose arm(OR=20.735,P=0.001).In the metformin arm,a higher reduction in fasting plasma glucose(OR=0.843,P=0.039)and total cholesterol was associated with a highΔWHtR(OR=0.743,P=0.013).CONCLUSION A lower glucagon-like peptide 1 level and higher increase in glucagon-like peptide 1 are associated with a high reduction in the WHtR in newly diagnosed Chinese diabetes patients receiving treatment with acarbose.

Development and validation of a risk assessment model for prediabetes in China national diabetes survey

BACKGROUND Prediabetes risk assessment models derived from large sample sizes are scarce.AIM To establish a robust assessment model for prediabetes and to validate the model in different populations.METHODS The China National Diabetes and Metabolic Disorders Study(CNDMDS)collected information from 47325 participants aged at least 20 years across China from 2007 to 2008.The Thyroid Disorders,Iodine Status and Diabetes Epidemiological Survey(TIDE)study collected data from 66108 participants aged at least 18 years across China from 2015 to 2017.A logistic model with stepwise selection was performed to identify significant risk factors for prediabetes and was internally validated by bootstrapping in the CNDMDS.External validations were performed in diverse populations,including populations of Hispanic(Mexican American,other Hispanic)and non-Hispanic(White,Black and Asian)participants in the National Health and Nutrition Examination Survey(NHANES)in the United States and 66108 participants in the TIDE study in China.C statistics and calibration plots were adopted to evaluate the model’s discrimination and calibration performance.RESULTS A set of easily measured indicators(age,education,family history of diabetes,waist circumference,body mass index,and systolic blood pressure)were selected as significant risk factors.A risk assessment model was established for prediabetes with a C statistic of 0.6998(95%CI:0.6933 to 0.7063)and a calibration slope of 1.0002.When externally validated in the NHANES and TIDE studies,the model showed increased C statistics in Mexican American,other Hispanic,Non-Hispanic Black,Asian and Chinese populations but a slightly decreased C statistic in non-Hispanic White individuals.Applying the risk assessment model to the TIDE population,we obtained a C statistic of 0.7308(95%CI:0.7260 to 0.7357)and a calibration slope of 1.1137.A risk score was derived to assess prediabetes.Individuals with scores≥7 points were at high risk of prediabetes,with a sensitivity of 60.19%and specificity of 67.59%.CONCLUSION An easy-to-use assessment model for prediabetes was established and was internally and externally validated in different populations.The model had a satisfactory performance and could screen individuals with a high risk of prediabetes.

The role of non-coding RNAs in drug resistance of oral squamous cell carcinoma and therapeutic potential

Oral squamous cell carcinoma(OSCC),the eighth most prevalent cancer in the world,arises from the interaction of multiple factors including tobacco,alcohol consumption,and betel quid.Chemotherapeutic agents such as cisplatin,5-fluorouracil,and paclitaxel have now become the first-line options for OSCC patients.Nevertheless,most OSCC patients eventually acquire drug resistance,leading to poor prognosis.With the discovery and identification of non-coding RNAs(ncRNAs),the functions of dysregulated ncRNAs in OSCC development and drug resistance are gradually being widely recognized.The mechanisms of drug resistance of OSCC are intricate and involve drug efflux,epithelial-mesenchymal transition,DNA damage repair,and autophagy.At present,strategies to explore the reversal of drug resistance of OSCC need to be urgently developed.Nano-delivery and self-cellular drug delivery platforms are considered as effective strategies to overcome drug resistance due to their tumor targeting,controlled release,and consistent pharmacokinetic profiles.In particular,the combined application of new technologies(including CRISPR systems)opened up new horizons for the treatment of drug resistance of OSCC.Hence,this review explored emerging regulatory functions of ncRNAs in drug resistance of OSCC,elucidated multiple ncRNA-meditated mechanisms of drug resistance of OSCC,and discussed the potential value of drug delivery platforms using nanoparticles and self-cells as carriers in drug resistance of OSCC.

Sound quality evaluation of high-speed train interior noise by adaptive Moore loudness algorithm

An online experiment to acquire the interior noise of a China Railways High-speed （CRH） train showed that it wasmainly composed of middle-low frequency components and could not be described properly by linear or A-weighted soundpressure level （SPL）. Thus, the appropriate way to evaluate the high-speed train interior noise is to use sound quality parameters,and the most important is loudness. To overcome the disadvantages of the existing loudness algorithms, a novel signal-adaptiveMoore loudness algorithm （AMLA） based on the equivalent rectangular bandwidth （ERB） spectrum was introduced. The valida-tion reveals that AMLA can obtain higher accuracy and efficiency, and the simulated dark red noise conforms best to thehigh-speed train interior noise by loudness and auditory assessment. The main loudness component of the interior noise is below27.6 ERB rate （erbr）, and the sound quality of the interior noise is relatively stable between 300-350 km/h. The specific loudnesscomponents among 12-15 erbr stay invariable throughout the acceleration or deceleration process while components among20-27 erbr are evidently speed related. The unusual random noise is effectively identified, which indicates that AMLA is anappropriate method for sound quality assessment of the high-speed train under both steady and transient conditions.