Risk Factors Of Diabetes And Related Metabolic Diseases In Chinese Adults

Backgroud:The true cause of the metabolic disorders epidemic in Asia remains elusive.Based on previous studies,we hypothesize that rapid nutritional transition from under-nutrition to subsequent nutritional restoration in adulthood is one of the most critical contributing factors in this scenario.To testify this,the relocatees from the Three Gorges in China who experienced such transition,were selected to serve as the optimal population in our study.Method:From October 2011 to December 2011,in Yi-Ling district of Yi-Chang area of China,6,549 participants out of 6,898 enrolled individuals were included in this analysis,excluding those with incomplete data(n=349).Basic anthropometric parameters,oral glucose tolerance test,serum fasting insulin level,HbA1c and the serum lipid profile were measured.Results:Regardless of the gender,the relocation was associated with increased BMI,waist circumference,hip circumference,WHtR,WHR,HOMAIR and decreased HDL(all P<0.05).Multivariate adjusted general linear model revealed the same associations.Logistic regression analysis further indicated,male relocatees tend to have higher risk for overweight(OR 1.463,CI:1.212-1.767),general obesity(OR 1.556,CI:1.103-2.1975),abdominal obesity(OR 1.622,CI:1.264-2.082),insulin resistance(OR 1.617,CI:1.269-2.059),Low-HDL(OR 1.669,CI:1.003-2.778).In contrast,the trend was slightly less robust in female but the relationships between relocation and metabolic diseases were still basically statistically significant.Conclusions:So the relocation,which involve rapid nutrition transition in adulthood,is closely associated with obesity and other cardiovascular risk.BackgroundNeuregulin4(Nrg4)is a novel adipokine expressed in adipose tissues,enriched in brown adipose tissue,and able to improve whole-body metabolism in rodent,thus having the potential to treat obesity-associated disorders such as diabetes.However,the association between serum Nrg4 levels and diabetes risk in human remains unclear.This study was designed to examine circulating Nrg4 levels in subjects with different glucose tolerance status.MethodsAge-,sex-,and body mass index-matched subjects(n = 310:83 normal glucose tolerance[NGT],129 prediabetes,and 96 diabetes)from the Risk Evaluation of Cancers in Chinese Diabetic Individuals:A Longitudinal study(Reaction study)were included.Serum Nrg4 was measured via enzyme-linked immunosorbent assay.Basic anthropometric parameters,fasting plasma glucose and 2-hours postload plasma glucose,hemoglobin Alc,and serum lipid profile were also measured.ResultsThe serum Nrg4 levels were higher in patients with diabetes than those with NGT and prediabetes(diabetes:396.8[65.9,709.4],NGT:80.1[0,554.1],prediabetes:168.0[32.9,463.9]pg/mL[median(interquartile range),bothP<0.05]).The Nrg4 concentration was correlated with fasting plasma glucose.When the top versus bottom quartiles of serum Nrg4 concentrations were compared with adjustment for age and sex,an odds ratio of 3.005 was observed in diabetes prevalence,which persisted after adjusting other potential confounding variables.Other nonglucose parameters as body mass index;waist,hip,and neck circumferences;alanine aminotransferase;triglyceride;high-density lipoprotein;uric acid;and estimated glomerular filtration rate were also correlated with serum Nrg4(P<0.05).ConclusionsThe circulating Nrg4 level is elevated in diabetic patients compared to control and the prediabetic.It is also an independent risk factor associated with diabetes.BackgroundThe relationship between alcohol consumption and diabetes risk has been debated for decades.Some observational studies suggested inverse correlation,and more studies indicated U shaped relationships with a protective effect of light to moderate daily alcohol intake and merely a non-significant deleterious effect or null effect of heavy consumption when compared with lifetime abstinence.So the attitude of clinical guidelines and physicians towards drinking,especially moderate drinking is ambiguous.Observational studies are prone to inherent limitation such as confounding and reverse causality.Mendelian randomization(MR)analysis could minimize those biases and infer causality with more accuracy.MethodsThe present study was grounded on the baseline data of the Risk Evaluation of cAncers in Chinese diabeTic Individuals:a LONgitudinal(REACTION)study in Hubei,China.Rs671 in Aldehyde dehydrogenase 2 gene of all participants were genotyped as the instrumental variable.Diabetes was diagnosed based on OGTT and HbA1c.We assessed the causal effects through MR analysis methods for not only linear but also curvilinear causality.Results4536 participants aged>40 years old are included in the final analysis.The carriage of A-alleles decreased weekly alcohol consumption(GA:-44.63%units/week,95%CI:-49.44%to-39.37%;AA:-69.52%(-76.19%,-60.98%);P<0.001).No curvilinear causality was identified by neither stratification genetic analysis nor Local Average Treatment Effects.In the standard IV analysis,alcohol consumption causally increased fasting and 2h-post-load plasma glucose and HOMA-IR,but did not significantly influence the level of HOMA-beta.The causal hazard ratio of diabetes for a one-unit genetic increase of natural log transformed alcohol consumption(approximately increasing the consumption by 1.7 folds)was 1.32(95%CI:1.06 to 1.67,P=0.014)in males,and remain significant with adjustment for BMI,waist circumference,family history of diabetes,physical activity and education.The prevalence of weekly alcohol consumption was low in females(15.2%)and no causality was found in them.ConclusionsWe provided evidence supporting that alcohol consumption was linearly,causally connected to higher diabetes risk.