Amylase intrapancreatic infusion delays insulin release during an intravenous glucose tolerance test,proof of acini–islet–acinar interactions

BACKGROUND The possible existence of an acini–islet–acinar(AIA)reflex,involving mutual amylase and insulin interactions,was investigated in the current acute experiment on pigs.AIM To confirm the existence of an AIA reflex and justify the placement of the exocrine and endocrine pancreatic components within the same organ.METHODS The study was performed on six pigs under general anesthesia.An intravenous glucose tolerance test was performed,with a bolus infusion of 50%glucose to the jugular vein,while amylase(5000 U/kg)or vehicle intrapancreatic infusions were administered via the pancreaticoduodenalis cranialis artery during 30 min with a 1 mL/min flow rate.RESULTS The amylase infusion to pancreatic arterial circulation inhibited and delayed the insulin release peak which is usually associated with the highest value of blood glucose and is typically observed at 15 min after glucose infusion,for>1 h.The intrapancreatic infusion of the vehicle(saline)did not have any effect on the time frame of insulin release.Infusion of 1%bovine serum albumin changed the insulin release curve dramatically and prolonged the high range of insulin secretion,far beyond the glucose peak.CONCLUSION Intrapancreatic arterial infusion of amylase interrupted the integrated glucose–insulin interactions.This confirms an AIA reflex and justifies placement of the exocrine and endocrine pancreatic components within the same organ.

Hypoglycaemia in screening oral glucose tolerance test in pregnancy with low birth weight fetus

Maternal hypoglycemia,a condition characterized by lower than normal blood glucose levels in pregnant women,has been increasingly associated with adverse pregnancy outcomes,including low birth weight(LBW)in neonates.LBW,defined as a birth weight of less than 2500 g,can result from various factors,including maternal nutrition,health status,and metabolic conditions like hypoglycemia.Maternal hypoglycemia may affect fetal growth by altering the supply of essential nutrients and oxygen to the fetus,leading to restricted fetal development and growth.This condition poses significant risks not only during pregnancy but also for the long-term health of the child,increasing the likelihood of developmental delays,health issues,and chronic conditions later in life.Research in this area has focused on understanding the mechanisms through which maternal hypoglycemia influences fetal development,with studies suggesting that alterations in placental blood flow and nutrient transport,as well as direct effects on fetal insulin levels and metabolism,may play a role.Given the potential impact of maternal hypoglycemia on neonatal health outcomes,early detection and management are crucial to minimize risks for LBW and its associated complications.Further investigations are needed to fully elucidate the complex interactions between maternal glucose levels and fetal growth,as well as to develop targeted interventions to support the health of both mother and child.Understanding these relationships is vital for improving prenatal care and outcomes for pregnancies complicated by hypoglycemia.

Changes of ghrelin following oral glucose tolerance test in obese children with insulin resistance

AIM： To characterize changes in ghrelin levels in response to oral glucose tolerance test （OGTT） and to correlate changes in ghrelin levels with changes in insulin and glucose following OGTT in Chinese obese children of Tanner Ⅰ and Ⅱ stage with insulin resistance. METHODS： 22 obese children with insulin resistance state were divided into four groups according to their Tanner stage and gender： boys of Tanner Ⅰ （fir- Ⅰ ）, boys of Tanner Ⅱ（BT-Ⅱ ）, girls of Tanner Ⅰ （GT- Ⅰ ）, girls of Tanner Ⅱ （GT-Ⅱ）. Ghrelin, insulin and glucose were measured at 0, 30, 60 and 120 rain following OGTT. The control children with normal BMI were divided into control boys of Tanner Ⅰ （CBT- Ⅰ, n = 6）, control boys of Tanner Ⅱ （CBT-Ⅱ, n = 5）, control girls of Tanner Ⅰ （CGT- Ⅰ, n = 6）, control girls of Tanner Ⅱ （CGT-Ⅱ, n = 5）. Fasting serum ghrelin levels were analyzed. RESULTS： Ghrelin levels were lower in obese groups. Ghrelin levels of control group decreased in Tanner Ⅱ stage （CGT- Ⅰ vs CGT-Ⅱ t = -4.703, P = 0.001; CBT- Ⅰ vs CBT- Ⅱ t = -4.794, P = 0.001）. Basal ghrelin levels in fir-Ⅱ decreased more significantly than that in BT- Ⅰ group （t = 2.547, P = 0.029）. Ghrelin levels expressed a downward trend after OGTT among obese children. The decrease in ghrelin levels at 60 min with respect to basal values was 56.9% in BT- Ⅰ. Ghrelin concentrations at 0 min correlated directly with glucose level at 0 min in fir- Ⅰ （r = 0.898, P = 0.015）. There wasn＇t a significant correlation of ghrelin changes with glucose changes and insulin changes during OGTT in obese children with insulin resistance. CONCLUSION： In conclusion, in obese children with insulin resistance, ghrelin levels decreased with advancing pubertal stage. Ghrelin secretion suppression following OGTT was influenced by gender and pubertal stage. Baseline ghrelin levels and ghrelin suppression after OGTT did not significantly correlate with the degree of insulin resistance and insulin sensitivity.

Oral glucose tolerance test in diabetes,the old method revisited

The oral glucose tolerance test(OGTT)has been widely used both in clinics and in basic research for a long time.It is applied to diagnose impaired glucose tolerance and/or type 2 diabetes mellitus in individuals.Additionally,it has been employed in research to investigate glucose utilization and insulin sensitivity in animals.The main aim of each was quite different,and the details are also somewhat varied.However,the time or duration of the OGTT was the same,using the 2-h post-glucose load glycemia in both,following the suggestions of the American Diabetes Association.Recently,the use of 30-min or 1-h post-glucose load glycemia in clinical practice has been recommended by several studies.In this review article,we describe this new view and suggest perspectives for the OGTT.Additionally,quantification of the glucose curve in basic research is also discussed.Unlike in clinical practice,the incremental area under the curve is not suitable for use in the studies involving animals receiving repeated treatments or chronic treatment.We discuss the potential mechanisms in detail.Moreover,variations between bench and bedside in the application of the OGTT are introduced.Finally,the newly identified method for the OGTT must achieve a recommendation from the American Diabetes Association or another official unit soon.In conclusion,we summarize the recent reports regarding the OGTT and add some of our own perspectives,including machine learning and others.

Central sensibility of human cases with different body mass during oral glucose tolerance test using functional magnetic resonance imaging

BACKGROUND： Because of the limitation of technique, there are few researches on regulating function o central hypothalamus by metabolism, especially the researches on real-time function. OBJECTIVE： To evaluate the response of hypothalamus to oral glucose tolerance test （OGTT） in differen body-weighted subjects by using functional magnetic resonance imaging （fMRI） so as to investigate th relationship between the sensitivity of hypothalamus in glycoregulation and disturbance of carbohydrate metabolism. DESIGN： Paired design. SETTING： Department of Radiology and Beijing Geriatrics Institute, Beijing Hospital, National Publi Health Bureau. PARTICIPANTS： A total of twenty healthy volunteers were selected from Beijing Geriatrics Institute National Public Health Bureau, including 10 subjects with obesity （5 males and 5 females; body mass 〉 28.0 kg/m2） and 10 subjects with normal body mass （5 males and 5 females; body mass from 18.5 to 23.9 kg/m2）. All subjects gave written informed consent before participating in the study. METHODS： fMRI study was performed on GE 1.5 T Signa Twinspeed Infinity with Excite. Each voluntee was ingested of glucose during the fMRI scan. T2＊ images were acquired using a single-shot gradient echo （EPI） technique. The parameters of EPI included： TR 3 000 ms, TE 40 ms, Flip angle 90°, field of view （FOV） 24 cm × 24 cm, thickness 5 mm, gap 0 mm, matrix 64 × 64, number of excitation 1. All 10 subjects with normal body mass underwent a repeat fMRI scan after consuming an equivalent amount o water without glucose on a separate day. The procedure for the fMRI scan with water intake was the same a for glucose ingestion. fMRI data were processed with Intensity Averaging Method. MAIN OUTCOME MEASURES： The central response of hypothalamus and feedback orientation during OGTT in different body-weighted subjects. RESULTS： An acute transient decrease of fMRI intensity in posterior inferior and anterior inferior o hypothalamus was observed in all subjects within 2 minutes after oral glucose intake. This decrease wa followed by a recovery to the baseline. However, obese subjects had a delayed intensity decrease [（1.96± 1.06） minutes vs. （1.04±0.71） minutes, t =2.14, P 〈 0.05] and longer recovery time [（26.62±7.35 minutes vs. （16.29±6.42） minutes, t =3.67, P 〈 0.01] as compared with normal body-weight subjects Furthermore, decreased fMRI intensity was significant different from baseline intensity [（5.7±2.5）% vs （14.3±5.5）%, t =2.56, P 〈 0.05] in obese subjects, but not in normal body-weight subjects. The area o hypothalamus in normal body-weight volunteers demonstrated no significant signal change before and afte oral water ingestion （P 〉 0.05）. CONCLUSION： Hypothalamus response to glucose loading is different in normal body-weighted and obes subjects. This suggests that fMRI is a useful tool to evaluate the central regulation of glucose metabolism.

Utility of oral glucose tolerance test in predicting type 2 diabetes following gestational diabetes:Towards personalized care

BACKGROUND Women with gestational diabetes mellitus(GDM)are at a seven-fold higher risk of developing type 2 diabetes(T2D)within 7-10 years after childbirth,compared with those with normoglycemic pregnancy.Although raised fasting blood glucose(FBG)levels has been said to be the main significant predictor of postpartum progression to T2D,it is difficult to predict who among the women with GDM would develop T2D.Therefore,we conducted a cross-sectional retrospective study to examine the glycemic indices that can predict postnatal T2D in Emirati Arab women with a history of GDM.AIM To assess how oral glucose tolerance test(OGTT)can identify the distinct GDM pathophysiology and predict possible distinct postnatal T2D subtypes.METHODS The glycemic status of a cohort of 4603 pregnant Emirati Arab women,who delivered in 2007 at both Latifa Women and Children Hospital and at Dubai Hospital,United Arab Emirates,was assessed retrospectively,using the International Association of Diabetes and Pregnancy Study Groups(IADPSG)criteria.Of the total,1231 women were followed up and assessed in 2016.The FBG and/or the 2-h blood glucose(2hrBG)levels after a 75-g glucose load were measured to assess the prevalence of GDM and T2D,according to the IADPSG and American Diabetes Association(ADA)criteria,respectively.The receiver operating characteristic curve for the OGTT was plotted and sensitivity,specificity,and predictive values of FBG and 2hrBG for T2D were determined.RESULTS Considering both FBG and 2hrBG levels,according to the IADPSG criteria,the prevalence of GDM in pregnant Emirati women in 2007 was 1057/4603(23%),while the prevalence of pre-pregnancy T2D among them,based on ADA criteria,was 230/4603(5%).In the subset of women(n=1231)followed up in 2016,the prevalence of GDM in 2007 was 362/1231(29.6%),while the prevalence of prepregnancy T2D was 36/1231(2.9%).Of the 362 pregnant women with GDM in 2007,96/362(26.5%)developed T2D;142/362(39.2%)developed impaired fasting glucose;29/362(8.0%)developed impaired glucose tolerance,and the remaining 95/362(26.2%)had normal glycemia in 2016.The prevalence of T2D,based on ADA criteria,stemmed from the prevalence of 36/1231(2.9%)in 2007 to 141/1231(11.5%),in 2016.The positive predictive value(PPV)for FBG suggests that if a woman tested positive for GDM in 2007,the probability of developing T2D in 2016 was approximately 24%.The opposite was observed when 2hrBG was used for diagnosis.The PPV value for 2hrBG suggests that if a woman was positive for GDM in 2007 then the probability of developing T2D in 2016 was only 3%.CONCLUSION FBG and 2hrBG could predict postpartum T2D,following antenatal GDM.However,each test reflects different pathophysiology and possible T2D subtype and could be matched with a relevant T2D prevention program.

Repetitiveness of the oral glucose tolerance test in children and adolescents

BACKGROUND Data regarding the most suitable diagnostic method for the diagnosis of glucose impairment in asymptomatic children and adolescents are inconclusive.Furthermore,limited data are available on the reproducibility of the oral glucose tolerance test(OGTT)in children and adolescents who are obese(OB).AIM To investigate the usefulness of the OGTT as a screening method for glucose dysregulation in children and adolescents.METHODS Eighty-one children and adolescents,41 females,either overweight(OW),OB or normal weight(NW)but with a strong positive family history of type 2 diabetes mellitus(T2DM),were enrolled in the present observational study from the Outpatient Clinic of Paediatric Endocrinology of the University Hospital of Patras in Greece.One or two 3-h OGTTs were performed and glucose,insulin and Cpeptide concentrations were measured at several time points(t=0 min,t=15 min,t=30 min,t=60 min,t=90 min,t=120 min,t=180 min).RESULTS Good repetitiveness was observed in the OGTT response with regard to T2DM,while low repetitiveness was noted in the OGTT response with regard to impaired glucose tolerance(IGT)and no repetitiveness with regard to impaired fasting glucose(IFG).In addition,no concordance was observed between IFG and IGT.During the 1st and 2nd OGTTs,no significant difference was found in the glucose concentrations between NW,OW and OB patients,whereas insulin and C-peptide concentrations were higher in OW and OB compared to NW patients at several time points during the OGTTs.Also,OW and OB patients showed a worsening insulin and C-peptide response during the 2nd OGTT as compared to the 1st OGTT.CONCLUSION In mild or moderate disorders of glucose metabolism,such as IFG and IGT,a diagnosis may not be reached using only one OGTT,and a second test or additional investigations may be needed.When glucose metabolism is profoundly impaired,as in T2DM,one OGTT is probably more reliable and adequate for establishing the diagnosis.Excessive weight and/or a positive family history of T2DM possibly affect the insulin and C-peptide response in the OGTT from a young age.

Relationship between Oral Glucose Tolerance Test Characteristics and Adverse Pregnancy Outcomes among Women with Gestational Diabetes Mellitus

Background： Hyperglycemia is associated with adverse pregnancy outcomes. However, the relationships between them remain ambiguous. This study aimed to analyze the effect of different oral glucose tolerance test （OGTT） results on adverse perinatal outcomes. Methods： This retrospective cohort study included data from 15 hospitals in Beijing from June 20, 2013 to November 30, 2013. Women with gestational diabetes mellitus （GDM） were categorized according to the number and distribution of abnormal OGTT values, and the characteristics of adverse pregnancy outcomes were evaluated. Chi-square test and logistic regression analysis were used to determine the associations. Results： in total, 14,741 pregnant women were included in the study population, 2927 （19.86%） of whom had G DM. As the number of hyperglycemic values in the OGTT increased, the risk of cesarean delivery, preterm births, large-for-gestational age （LGA）, macrosomia, and neonatal complications significantly increased. Fasting hyperglycemia bad clear associations with macrosomia （odds ratios [ORs]：1.84, 95% confidence intervals [CIs]： 1.39-2.42, P 〈 0.001）, L（SA （OR： 1.70, 95% CI： 1.29-2.25. P 〈 0.001）, and cesarean delivery （OR： 1.33, 95% CI： 1.15-1.55, P 〈 0.001）. The associations were stronger as tasting glucose increased. GDM diagnosed by hyperglycemia at OGTT-2 h was more likely to lead to preterm birth （OR： 1.50, 95% Cl： 1. 11-2.03, P 〈 0.01）. Conclusions： Various characteristics of OGTTs are associated with different adverse outcomes. A careful reconsideration ofGDM wiih hierarchical and individualized management according to OGTT characteristics is needed.

Analysis of oral glucose tolerance test in pregnant women with abnormal glucose metabolism

Background Due to the controversy of the oral glucose tolerance test (OGTT), diagnostic criteria for gestational diabetes mellitus (GDM) in the world and researches on GDM remain undeveloped in China. American Diabetes Association recently recommended the clinicians to diagnose GDM by OGTT results without the third-hour glucose value. This new criteria has not been used in China. Research on the value and sensitivity of the criteria in detecting GDM is rare. The aim of our study is to analyze the characteristics of OGTT in Chinese women with GDM or gestational impaired glucose tolerance (GIGT) and to evaluate the effect of omission of the third-hour plasma glucose (PG) level in OGTT on the sensitivity of diagnosing GDM and GIGT, and the relationship between PG values of 50 g GCT or OGTT and insulin therapy. Methods A retrospective analysis was performed on medical records of 647 cases with GDM from January 1, 1989 to December 31, 2002, and 233 with GIGT. Among 647 cases of GDM, 535 cases were diagnosed by 75 g OGTT. All OGTT results including 535 cases of GDM and 233 patients with GIGT were evaluated. Results There were 112 cases of GDM diagnosed by elevated fasting PG (FPG) without OGTT performed. Of 535 cases of GDM diagnosed by OGTT, 49.2% (263/535) women had FPG value ≥5.8 mmol/L; 90.1% (482/535) women with 1-hour PG values ≥10.6 mmol/L; 64.7% (359/535) with 2-hour PG levels ≥9.2 mmol/L. There were only 114 cases (21.3%) with abnormal 3-hour PG levels among 535 women with OGTT. Among those with abnormal 3-hour PG level, 49.1% (56/114) had abnormal glucose values in the other three points of OGTT, and 34.2% (39/114) with two other abnormal values of OGTT. Our study showed that omission of the 3-hour PG of OGTT only missed 19 cases of GDM and they would be diagnosed as GIGT. Among the 233 women with GIGT, only 4 cases had abnormal 3-hour PG. So, omission of the third-hour glucose value of OGTT only resulted in failure to diagnose 3.6% (19/535) women with GDM diagnosed by OGTT, which means 2.9% (19/647) of all the GDM and 1.7% (4/233) of GIGT in Chinese women. PG levels ≥11.2 mmol/L following 50 g GCT was highly associated with GDM necessitating insulin therapy (75.4%). An elevated FPG level was also associated with insulin therapy (59.7%). Conclusions Omission of the third-hour glucose tolerance test value still yield a higher sensitivity in diagnosing GDM and GIGT. In Chinese women, it is practicable to omit third-hour post-glucose ingestion value of the OGTT in Chinese women. PG levels ≥11.2 mmol/L following 50 g GCT mostly indicates that the requirement of insulin therapy.

The role of oral glucose tolerance test in screening for diabetes mellitus in the elderly of Harbin, China

Though diabetes is common worldwide, the proportion of cases diagnosed is not high. Nearly fifty percent of patients with diabetes mellitus (DM) in US are undiagnosed.~1 The ratio might be higher in China. It has been suggested that diabetes may be present 4 to 7 years before diagnosis.~2 (Many of) the complications appear to be present at the time of diagnosis of the diabetic status.~1 (Screening for) diabetes in early stage of diabetes is thus a worthwhile exercise.

Effects of Acarbose on incretins in newly diagnosed type 2 diabetic patients in different carbohydrate tolerance test

Objective To evaluate the effects of Acarbose on incretin level(glucagon-like peptide 1(GLP-1)and gastric inhibitory polypeptide(GIP)of type 2 diabetes mellitus(T2DM)patients after different kinds of glucose load.Methods A total of 32 newly diagnosed T2DM patients were enrolled in this study and randomly divided into

Difference between 2 h and 3 h 75 g glucose tolerance test in the diagnosis of gestational diabetes mellitus(GDM):Results from a national survey on prevalence of GDM

The possibility of the 2 h oral glucose tolerance test(OGTT)as an alternative to the 3 h OGTT was investigated based on data from a national survey on pregnancy-associated diabetes.Data were retrieved from 4179 pregnant women who had OGTT performed after an abnormal 50 g glucose challenge test(GCT).All of the 4 glucose levels during their OGTT were collected and analyzed.According to American Diabetes Association(ADA)gestational diabetes mellitus(GDM)diagnostic criteria,among the 4179 pregnant women who required OGTT,3429(82.1%)were normal and 750(17.9%)were diagnosed as GDM.If the 3rd h glucose levels were omitted from OGTT,79 cases of GDM(10.5%)would be overlooked.No trend was shown where women with more risk factors were more likely to be overlooked if the 3rd h test was omitted(χ^(2) for trend=0.038,P>0.05).No significant differences were found in the rate of cesarean section(CS),preterm births or macrosomia between the 79 cases and those with normal OGTT results and in the gestational weeks when OGTT was performed.It shows that in order to diagnose one woman with GDM,another 52 pregnant women would have an innocent 3rd h glucose test.Omission of the 3rd h glucose test in OGTT might be reasonable due to its convenience,better compliance and a small number of possibly miss-diagnosed cases,and their pregnancy outcomes have no significant difference from those of normal pregnant women.

The Use of Glycated Albumin in the Diagnosis of Gestational Diabetes Mellitus

Gestational diabetes mellitus is the most common endocrine disorder in pregnancy and a cause of maternal and fetal morbidities and mortalities. The oral glucose tolerance test is the gold standard for diagnosing gestational diabetes mellitus. Nevertheless, the oral glucose tolerance test is time-consuming and requires patient preparation. On the contrary, Glycated albumin does not require patient preparation or administration of any substance. Most studies on glycated albumin in pregnancy were among the non-African population, and black Americans have higher glycated albumin levels than Caucasians. This study determined the use of glycated albumin in diagnosing gestational diabetes mellitus among pregnant women. The study was a prospective study of 160 pregnant women between 24 and 28 weeks of gestation at the University of Port Harcourt Teaching Hospital. The diagnosis of gestational diabetes mellitus was based on the World Health Organization 2013 criteria. The diagnostic value of glycated albumin was determined using the area under the receiver operator characteristic curve. The prevalence of gestational diabetes mellitus was 9.4% and the mean glycated albumin was 16.91% (±2.77). The area under the receiver operator characteristic curve for glycated albumin was 0.845 (95% CI 0.733 - 0.956;p = 0.0001). The optimal cut-off value of glycated albumin in the diagnosis of gestational diabetes mellitus was 18.9%. Glycated albumin was useful in the diagnosis of gestational diabetes mellitus at 24 to 28 weeks of gestation.

Subclinical abnormal glucose tolerance is a predictor of death in liver cirrhosis

AIM: To determine if subclinical abnormal glucose tolerance (SAGT) has influence on survival of non-diabetic patients with liver cirrhosis.

EFFECT OF CHRONIC ACE INHIBITIONONGLUCOSE TOLERANCE AND INSULIN SENSITIVITY IN HYPERTENSIVE TYPE 2 DIABETIC PATIENTS

We studied 14 moderately overweight Typo 2 diabetic patients with essential hypertension in stable metabolic control after a run-in period , and again after 3 months of antihypertensive treatment with the angiotensin-converting enzyme (ACF) inhibitor captopril. Glucose tolerance was tested with a 75g oral glucose load (OGTT) and insulin sensitivity was measured by the insulin suppression test (IST) while dietary and drug treatment of the hyperglycemia was maintained constant. In the whole group. mean blood pressure (MBP) fell progressively over 3months from a baseline value of 123± 3 mmHg (1 mmHg= 0. 133 kpa) to a final value of 115± 2 mmHg(P<0. 005). After treatment, fasting plasma glucose, insulin, free fatty acid (FFA). potassium, and glycosylated hemoglobin concentrations were unchanged from baseline. There were no significant differences in glucose tolerance and insulin sensitivity between pre- and post-trearment values. Neither endogenous (oral glucose) nor exogenous (IST) insulin caused any change in plasma potassium concentration. This resistance to the hypokalemic action of insulin was not affected by captopril.

Antidiabetic effects of chitooligosaccharides on pancreatic islet cells in streptozotocin-induced diabetic rats

AIM: To investigate the effect of chitooligosaccharides on proliferation of pancreatic islet cells, release of insulin and 2 h plasma glucose in streptozotocin-induced diabetic rats.METHODS: In vitro, the effect of chitooligosaccharides on proliferation of pancreatic islet cells and release of insulin was detected with optical microscopy, colorimetric assay, and radioimmunoassay respectively. In vivo, the general clinical symptoms, 2 h plasma glucose, urine glucose, oral glucose tolerance were examined after sixty days of feeding study to determine the effect of chitooligosaccharides in streptozotocin-induced diabetic rats. RESULTS: Chitooligosaccharides could effectively accelerate the proliferation of pancreatic islet cells. Chitooligosaccharides (100 mg/L) had direct and prominent effect on pancreastic β cells and insulin release from islet cells. All concentrations of chitooligosaccharides could improve the general clinical symptoms of diabetic rats, decrease the 2 h plasma glucose and urine glucose, and normalize the disorders of glucose tolerance.CONCLUSION: Chitooligosaccharides possess various biological activities and can be used in the treatment of diabetes mellitus.

Prevalence and characteristics of MAFLD in Chinese adults aged 40 years or older:A community-based study

Background: Nonalcoholic fatty liver disease(NAFLD) was recently proposed to be renamed metabolic dysfunction-associated fatty liver disease(MAFLD) with the diagnostic criteria revised. We investigated the similarities and differences in the prevalence and clinical characteristics of MAFLD and NAFLD in Chinese adults. Methods: A cross-sectional study of 9980 Chinese individuals aged 40 years or older was performed between 2011 and 2012 using randomized, stratifed cluster sampling in Shanghai, China. A detailed questionnaire and the results of abdominal ultrasonography, a standardized 2-h 75-g oral glucose tolerance test and blood biochemical examinations were collected. Results: A total of 9927 subjects were included in this study. The prevalence of MAFLD(40.3%) was significantly higher than that of NAFLD(36.9%)( P < 0.05). MAFLD was highly prevalent in type 2 diabetes mellitus(T2DM)(53.8%), impaired fasting glucose(35.7%) and impaired glucose tolerance(40.9%). High risk of advanced fbrosis based on fbrosis-4 was highly prevalent(14.7%) in lean MAFLD with T2DM. Among 9927 subjects, 3481(35.1%) fulflled the diagnostic criteria for MAFLD and NAFLD(MAFLD + NAFLD +), 521(5.2%) MAFLD + NAFLD-, and 181(1.8%) MAFLD-NAFLD +. The MAFLD + NAFLD-group had more signifcant metabolic disorders than those in the MAFLD + NAFLD + group(all P < 0.05). Among MAFLD-NAFLD + subjects, 82.9% had metabolic disorders. Conclusions: The new defnition of MAFLD may better reflect the pathogenesis related to metabolism. Future research should focus on studying the natural history, pathogenesis and treatment effectivity of the overlap and non-overlap of NAFLD and MAFLD subjects.

Triptolide prolonged allogeneic islet graft survival in chemically induced and spontaneously diabetic mice without impairment of islet function

BACKGROUND: Triptolide (TPT) is a diterpenoid triepoxide extracted from the Chinese herb Tripterygium wilfordii Hook. F. It exhibits potent immunosuppressive and anti-inflammatory properties. This study was undertaken to investigate its effects on prolongation of islet allograft survival in rodents. Additionally, we investigated whether TPT would be toxic to islet function in vivo. METHODS: We transplanted BALB/c islets to either chemically induced diabetic C57BL/6 mice or spontaneously diabetic non-obese diabetic (NOD) mice. TPT was injected within 2 weeks or continuously, until rejection, in the two combinations. Then, we evaluated the toxicity of TPT on islet function by daily injection to naive BALB/c or diabetic BALB/c that was cured by syngeneic islet transplantation under the kidney capsule. Mice injected with cyclosporine A (CsA) or vehicle served as controls. Intraperitoneal glucose tolerance tests (IPGTTs) performed at 4 and 8 weeks in the naive BALB/c group, and at 2, 4, 6, and 8 weeks in the syngeneic transplanted group. RESULTS: The medium survival time of islets allograft from TPT treated C57BL/6 and NOD recipients were 28.5 days (range 24-30 days, n=10) and 33.0 days (range 15-47 days, n=6), respectively, and they were significantly different from those of the vehicle treated controls, which were 14.0 days (range 13-16 days, n=6) and 5.0 days (range 4-10 days, n=6), respectively (all P<0.0001). The IPGTT demonstrated that there was no difference between the TPT treated and vehicle treated groups, either in the normal or syngeneic transplanted islet BALB/c mice. However, CsA injection impaired islet function in both normal and syngeneic transplanted mice as early as 4 weeks. CONCLUSION: TPT prolonged islets allograft survival in a chemically induced diabetic or an autoimmune diabetic murine model without impairment of islet function. (Hepatobiliary Pancreat Dis Int 2010; 9: 312-318)

Insulin Expression in Rats Exposed to Cadmium

To investigate the effects of cadmium exposure on insulin expression in rats. Methods Eighteen adult SD rats were administered cadmium subcutaneously （0.5, 1.0, and 2.0 mg/kg bw）. The effects on endocrine of pancreas were assessed. The levels of cadmium and zinc in pancreas, blood and urine glucose, serum insulin and urine NAG （N-acyetyl-β-glucosaminidase） were determined. The gene expressions of metallothionein （MT） and insulin were also measured, and the oral glucose tolerance tests （OGTT） were carried out. Results The contents of cadmium in pancreas in cadmium-treated rats were higher than that in the control group, which was associated with slight increase of zinc in pancreas. Cadmium-exposed rats （1.0 and 2.0 mg/kg bw） demonstrated a marked glucose intolerance. But the levels of serum insulin did not change significantly after cadmium administration, and the UNAG had no change in Cd-treated group. The gene expression of insulin decreased in 1.0 and 2.0 mg/kg bw cadmium-exposed groups, compared with the control group. The expression of MT-I was higher in the groups exposed to 1.0 and 2.0 mg/kg bw cadmium while the expression of MT-II was higher in the group exposed to 2.0 mg/kg bw cadmium. Conclusions Cadmium may be accumulated in the pancreas, resulting in the change of the expression of insulin, MT-I and MT-Ⅱ genes. Cadmium can influence the biosynthesis of insulin, but does not induce the release of insulin. The dysfunction of pancreas occurs earlier than that of kidney after administration of cadmium.