Early Predictors in the Onset of Type 2 Diabetes at Different Fasting Blood Glucose Levels

Abstract

This study investigates the possible roles and potential prediction ability of metabolic parameters in the early development of T2D by detecting their serum levels at different fasting blood glucose (FBG) levels. Methods: The subjects were included and divided into normal glucose tolerance (NGT), prediabetes (PD), and T2Dsubgroups. Apart from detecting the levels of routine biochemical parameters, fasting serum insulin (FINS), 25(OH)D, thioredoxin-interacting protein (TXNIP), thioredoxin (TRX), and NOD-like receptor family, pyrin domain-containing 3 (NLRP3) were detected. β-cell dysfunction (HOMA-β) and insulin resistance (HOMA-IR) were assessed by homeostasis model assessment. Both univariate and multivariate logistic regression analyses were used to estimate the risk of metabolic parameters, and their optimal cut-off values were obtained in the receiver operating characteristic (ROC) curve analysis and the Youden index. Results: Among the 207 subjects, aged from 20 to 60 years (44.62+12.92) contain 118 males and 89 females. There was a significantly lower trend of TRX, HOMA-β, and 25(OH) D following the higher FBG level among these three subgroups, while a significantly higher trend of all the other metabolic parameters. The multivariate analysis showed that subjects with higher values of TRX, HOMA-β, and 25(OH)D had a significantly lower risk for patients to be diagnosed as PD (aOR: 0.945, 0.961, and 0.543) and T2D (aOR: 0.912, 0.947, 0.434). Under the reliable 95% CI, TXNIP with a cut-off value of 119.27 showed the highest AUC value, sensitivity, and specificity (AUC: 0.981, 95% CI: 0.8524-0.9839, 91.49%, and 83.33%) to diagnose PD. FINS with a cut-off value of 28.1 also showed the highest ones (AUC=0.9872, 95% CI: 0.9753-0.9992, 100%, and 92.91%) to diagnose T2D. Conclusion: Early prediction of T2D is vital for timely intervention. Based on the FBG ≥100.8 mg/dl, the results provide evidence that 25(OH)D might be the protective factor in the early development of T2D. Besides, TXNIP and FINS might be the predictor for PD and T2D, respectively.

Changes in plasma IRAK-M in patients with prediabetes and its relationship with related metabolic indexes: a cross-sectional study

“…Previously, we reported changes in the level of various metabolic parameters and several physical characteristics with increasing FBG levels. 46 Here, with newly enrolled subjects, we showed similar trends in SBP, DBP, BMI, WC, WHR, TG, LDL, FPG, FINS, HOMA-IR, and HOMA-β. In addition, to further classify the subjects with prediabetes into the PD-A (5.6 mmol/L ≤ FPG < 6.1 mmol/L) and PD-B (6.1 mmol/L ≤ FPG < 7.0 mmol/L) groups, we examined HbA1c, Cr, ALT, and AST in this study.…”

“…41,44,45 In addition, TXNIP was shown to be highly positively correlated with NLRP3, caspase-1, and IL-1b, and TXNIP was abnormally expressed as the FPG level increased, suggesting that TXNIP augments the body's inflammatory response to oxidative stress. 46 TXNIP inhibits insulin expression and glucose uptake, and insulin resistance can lead to elevated TXNIP levels in islet b-cells. 40,47 Accordingly, we speculate that IRAK-M/ TLR-related diabetes may be associated with the ROS/TXNIP signaling pathway.…”

Lipid Accumulation Product Index Predicts New-Onset Type 2 Diabetes Among Non-Obese Koreans: A 12-Year Longitudinal Study

“… 32 , 33 As the number of non-obese T2DM patients increased, studies have aimed to find a more comprehensive index for predicting T2DM. 23 , 34 Further studies have shown that the LAP index was an effective tool in predicting T2DM incidence, with the capacity to include visceral fat as well as subcutaneous fat. 12 , 19 Second, although there are several mechanisms proposed to explain high triglyceride levels in diabetes, one specifically addresses muscle-related insulin resistance.…”

Health consequences of early-onset compared with late-onset type 2 diabetes mellitus

“…The soaring prevalence of early-onset T2DM among adolescents and young adults has become a global public health threat. 29 , 30 Fully understanding this trend, and systematic identification of the characteristics of subsequent complications, is crucial for developing effective interventions. In this large, matched cohort study based on the UK Biobank, in contrast to the traditional view that early-onset T2DM mainly involves macrovascular and microvascular complications, our study initially found that the complications of early-onset T2DM extensively involved a wide range of body systems even at the very early stage of the disease, although there were shared comorbidity patterns with late-onset T2DM.…”