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Severe impairment of patient-reported outcomes in patients with chronic hepatitis C virus infection seen in real-world practices across the world: Data from the global liver registry

Younossi ZM, Yu ML, El-Kassas M, Esmat G, Castellanos Fernández MI, Buti M, et al.

J Viral Hepat, 2022 Nov;29(11):1015-1025.
PMID: 36036096 DOI: 10.1111/jvh.13741

Cure of chronic hepatitis C (CHC) can lead to improvement of health-related quality of life and other patient-reported outcomes (PROs). While extensive PRO data for CHC patients who were enrolled in clinical trials are available, similar data for patients seen in real-world practices are scarce. Our aim was to assess PROs of CHC patients enrolled from real-world practices from different regions and to compare them with those enrolled in clinical trials. CHC patients seen in clinical practices and not receiving treatment were enrolled in the Global Liver Registry (GLR). Clinical and PRO (FACIT-F, CLDQ-HCV, WPAI) data were collected and compared with the baseline data from CHC patients enrolled in clinical trials. N = 12,171 CHC patients were included (GLR n = 3146, clinical trial subjects n = 9025). Patients were from 30 countries from 6 out of 7 Global Burden of Disease (GBD) super-regions. Compared with clinical trial enrollees, patients from GLR were less commonly enrolled from High-Income GBD super-region, older, more commonly female, less employed, had more type 2 diabetes, anxiety and clinically overt fatigue but less cirrhosis (all p 0.05). In conclusion, hepatitis C patients seen in the real-world practices have PRO impairment driven by fatigue and psychiatric comorbidities.

Matched MeSH terms: Diabetes Mellitus, Type 2*
Long-term impact of bariatric surgery in diabetic nephropathy

Young L, Nor Hanipah Z, Brethauer SA, Schauer PR, Aminian A

Surg Endosc, 2019 05;33(5):1654-1660.
PMID: 30251143 DOI: 10.1007/s00464-018-6458-8

BACKGROUND: Bariatric surgery has been shown to improve and resolve diabetes. However, limited literature about its impact on end-organ complications of diabetes is available. The aim of this study was to examine the long-term effect of bariatric surgery on albuminuria.
METHODS: We studied 101 patients with pre-operative diabetes and albuminuria [defined as urine albumin:creatinine ratio (uACR) > 30 mg/g] who underwent bariatric surgery at an academic center from 2005 to 2014.
RESULTS: Fifty-seven patients (56%) were female with a mean age of 53 (± 11) years. The mean pre-operative BMI and glycated hemoglobin (HbA1c) were 43.1 (± 7.6) kg/m2 and 8.4 (± 1.8)%, respectively. The median pre-operative uACR was 80.0 (45.0-231.0) mg/g. Bariatric procedures included Roux-en-Y gastric bypass (n = 75, 74%) and sleeve gastrectomy (n = 26, 26%). The mean follow-up period was 61 (± 29) months. At last follow-up, the mean BMI was 33.8 (± 8.3) kg/m2. The overall glycemic control improved after bariatric surgery. At last follow-up, 73% had good glycemic control (HbA1c

Matched MeSH terms: Diabetes Mellitus, Type 2/complications
Fulltext Foot sensation status of Malay women with type 2 diabetes mellitus

Yong SP, Kamaralzaman S, Budin SB

Jurnal Sains Kesihatan Malaysia, 2012;10(2):43-47.
MyJurnal

This study aimed to identify the foot sensory status of Malay women with type 2 diabetes mellitus and to determine its relation with: demographic factors, glycated haemoglobin level in plasma, and body mass index. A cross-sectional study was conducted on 71 Malay women with type 2 diabetes mellitus who attend three health clinics in Hulu Langat District, Selangor. Foot sensation was assessed using the Semmes-Weinstein Monofilament 5.07 in nine locations on the plantar and dorsal of the feet. Loss of protective sensation was defined as inability to sense the monofilament in one or more sites of either foot. This study found that 56.3% of women had loss of protective sensation, with common sites being the heel, fifth metatarsal head, lateral mid-foot and little toe. Duration of diabetes mellitus were significantly related to foot sensation. The age, HbA1C level and body mass index did not show any significant correlation. Loss of protective sensation may lead to serious foot complication and therefore early screening involving multidisciplinary team is essential for prevention.

Matched MeSH terms: Diabetes Mellitus, Type 2*
Fulltext Potential of medicinal plants to ameliorate neovascularization activities in diabetes: A systematic review

Yong PH, New SY, Azzani M, Wu YS, Chia VV, Ng ZX

Endocr Regul, 2023 Jan 01;58(1):26-39.
PMID: 38345496 DOI: 10.2478/enr-2024-0004

Hyperglycemia in diabetes mediates the release of angiogenic factors, oxidative stress, hypoxia, and inflammation, which in turn stimulate angiogenesis. Excessive angiogenesis can cause diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy. All of these complications are debilitating, which may lead to an increased susceptibility to lower-limb amputations due to ulcerations and infections. In addition, microvascular alterations, segmental demyelination, and endoneurial microangiopathy may cause progressive deterioration ultimately leading to kidney failure and permanent blindness. Some medicinal plants have potent anti-angiogenic, antioxidant or anti-inflammatory properties that can ameliorate angiogenesis in diabetes. The purpose of this systematic review is to demonstrate the potential of medicinal plants in ameliorating the neovascularization activities in diabetes. Manuscripts were searched from PubMed, Science Direct, and Scopus databases, and Google Scholar was used for searching additional papers. From 1862 manuscripts searched, 1854 were excluded based on inclusion and exclusion criteria and 8 were included into this systematic review, whereas the required information was extracted and summarized. All identified medicinal plants decreased the high blood glucose levels in diabetes, except the aqueous extract of Lonicerae japonicae flos (FJL) and Vasant Kusumakar Ras. They also increased the reduced body weight in diabetes, except the aqueous extract of FL and total lignans from Fructus arctii. However, methanolic extract of Tinospora cordifolia and Vasant Kusumakar Ras were not tested for their ability to affect the body weight. Besides, all medicinal plants identified in this systematic review decreased the vascular endothelial growth factor (VEGF) protein expression and vasculature activity demonstrated by histopathological examination indicating promising anti-angiogenic properties. All medicinal plants identified in this systematic review have a potential to ameliorate neovascularization activities in diabetes by targeting the mechanistic pathways related to oxidative stress, inflammation, and angiogenesis.

Matched MeSH terms: Diabetes Mellitus*
Fulltext Mind, body and cancer

Yip, C.H

JUMMEC, 2010;13(1):1-2.
MyJurnal

Many researchers studies have shown that stressful life events, from the death of a loved one to the loss of a job, are linked to an increase in certain health problems, particularly heart disease, diabetes, and hypertension. Many people assume that stress leads to cancer as well. Evidence for this, however, is not clear. However, the significance of mind-body interactions in medicine is now increasingly being recognised.(Copied from article.)

Matched MeSH terms: Diabetes Mellitus
Nonalcoholic Fatty Liver Disease: A Unique Entity or Part of the Metabolic Syndrome or Both

Yip TC, Wong GL, Wong VW, Goh GB, Chan WK

Med Clin North Am, 2023 May;107(3):449-463.
PMID: 37001947 DOI: 10.1016/j.mcna.2022.12.003

Nonalcoholic fatty liver disease (NAFLD) is a global public health problem. NAFLD is bidirectionally correlated with metabolic syndrome, which includes obesity, type 2 diabetes, hypertension, and dyslipidemia as major components. The presence of metabolic syndrome is associated with a higher prevalence of NAFLD, and vice versa. Also, the presence of metabolic syndrome in patients with NAFLD has been linked to a higher risk of cardiovascular diseases, liver-related complications, extrahepatic malignancies, and mortality, and possibly vice versa. Multidisciplinary care pathways including lifestyle modifications, control of metabolic risk, and potentially beneficial treatments are important to improve the clinical outcomes of patients with NAFLD.

Matched MeSH terms: Diabetes Mellitus, Type 2*
Reorienting Health Services to People with Chronic Health Conditions: Diabetes and Stroke Services in Malaysia, Sri Lanka and Thailand

Yiengprugsawan V, Healy J, Kendig H, Neelamegam M, Karunapema P, Kasemsup V

Health Syst Reform, 2017 Jul 03;3(3):171-181.
PMID: 31157585 DOI: 10.1080/23288604.2017.1356428

This paper explores whether middle-income Asian countries are reorienting their health services in response to non-communicable diseases (NCDs). Malaysia, Sri Lanka, and Thailand were selected as case studies of Asian societies experiencing rapid increases both in NCDs and an aging population. While NCD programs, especially those related to diabetes and stroke, are well-established in Thailand, health services struggle to respond to increasing numbers of people with chronic health problems. Health services at all levels must plan ahead for more patients with chronic and often multiple conditions who require better integrated health care.

Matched MeSH terms: Diabetes Mellitus
Fulltext A Retrospective Cohort Study of Epidemiology and Clinical Outcome in Lichen Planus

Yew YW, Lai YC, Chan R

Ann Acad Med Singap, 2016 Nov;45(11):516-519.
PMID: 27922146
Matched MeSH terms: Diabetes Mellitus/epidemiology
Assessing 10-Year Cardiovascular Disease Risk in Malaysians With Type 2 Diabetes Mellitus: Framingham Cardiovascular Versus United Kingdom Prospective Diabetes Study Equations

Yew SQ, Chia YC, Theodorakis M

Asia Pac J Public Health, 2019 10;31(7):622-632.
PMID: 31535566 DOI: 10.1177/1010539519873487

In this study, we evaluated the performance of the Framingham cardiovascular disease (CVD) and the United Kingdom Prospective Diabetes Study (UKPDS) risk equations to predict the 10-year CVD risk among type 2 diabetes mellitus (T2DM) patients in Malaysia. T2DM patients (n = 660) were randomly selected, and their 10-year CVD risk was calculated using both the Framingham CVD and UKPDS risk equations. The performance of both equations was analyzed using discrimination and calibration analyses. The Framingham CVD, UKPDS coronary heart disease (CHD), UKPDS Fatal CHD, and UKPDS Stroke equations have moderate discrimination (area under the receiver operating characteristic [aROC] curve = 0.594-0.709). The UKPDS Fatal Stroke demonstrated a good discrimination (aROC curve = 0.841). The Framingham CVD, UKPDS Stroke, and UKPDS Fatal Stroke equations showed good calibration (P = .129 to .710), while the UKPDS CHD and UKPDS Fatal CHD are poorly calibrated (P = .035; P = .036). The UKPDS is a better prediction equation of the 10-year CVD risk among T2DM patients compared with the Framingham CVD equation.

Matched MeSH terms: Diabetes Mellitus, Type 2/epidemiology*
Fulltext Challenges in the classification and management of Asian youth-onset diabetes mellitus- lessons learned from a single centre study

Yeow TP, Aun ES, Hor CP, Lim SL, Khaw CH, Aziz NA

PLoS One, 2019;14(1):e0211210.
PMID: 30682116 DOI: 10.1371/journal.pone.0211210

It remains widely perceived that early-onset Type 2 Diabetes (T2D) in children and adolescents is rare and clinically distinct from Type 1 Diabetes (T1D). We studied the challenges of classifying subtypes of early-onset diabetes using clinical features and biomarkers, and management of these patients. We reviewed retrospectively the record of patients < 25 years old who attended the diabetes clinic in Penang General Hospital, Malaysia between 1st December 2012 and 30th June 2015. We examined their clinical features, C-peptide and pancreatic autoantibodies. Comparisons were made between T1D and T2D for magnitude, demographics, metabolic status and complications. We studied 176 patients with a mean age of 20 ± 3.7 years, 43.2% had T1D, 13.6% had T2D, and 13.6% had mixed features of both. When tested, pancreatic autoantibodies were positive in 59.4% of the T1D. T2D presented two years later than T1D at 14.3 years, 20% were asymptomatic at presentation, and 50% required insulin supplementation despite fasting c-peptide of > 250 pmol/L. HbA1C of ≤ 8.0% (64 mmol/mol) was achieved in 30.3% of T1D, 58.3% of T2D on OAD and 16.7% of T2D on insulin. The T2D had greater cardiovascular risk with higher body mass index, more dyslipidaemia, higher blood pressure and earlier onset of nephropathy. The overlapping clinical features, variable autoimmunity, and beta-cell loss complicate classification of young diabetes. Pancreatic autoantibodies and C-peptide did not always predict diabetes subtypes nor respond to insulin. The poor metabolic control and high cardiovascular risk burden among the T2D highlight the need for population-based study and focused intervention.

Matched MeSH terms: Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2
Fulltext Preserved glucagon-like peptide-1 responses to oral glucose, but reduced incretin effect, insulin secretion and sensitivity in young Asians with type 2 diabetes mellitus

Yeow TP, Pacini G, Tura A, Hor CP, Lim SL, Tan FH, et al.

BMJ Open Diabetes Res Care, 2017;5(1):e000352.
PMID: 28321312 DOI: 10.1136/bmjdrc-2016-000352

OBJECTIVE: Youth onset type 2 diabetes mellitus (YT2DM) is a globally rising phenomenon with substantial Asians representation. The understanding of its pathophysiology is derived largely from studies in the obese African-American and Caucasian populations, while studies on incretin effect are scarce. We examined the insulin resistance, β-cell function (BC), glucagon-like peptide (GLP)-1 hormone and incretin effect in Asian YT2DM.

RESEARCH DESIGN AND METHODS: This case-control study recruited 25 Asian YT2DM and 15 healthy controls, matched for gender, ethnicity and body mass index. Serum glucose, insulin, C peptide and GLP-1 were sampled during 2-hour oral glucose tolerance tests (OGTTs) and 1-hour intravenous glucose tolerance tests (IVGTTs). Insulin sensitivity was derived from the Quantitative Insulin Sensitivity Check Index (QUICKI), Oral Glucose Insulin Sensitivity Index (OGIS) in OGTT and surrogate index of SI from the minimal model (calculated SI, CSI). Acute insulin response (AIR) was obtained from IVGTT. Total BC was computed as incremental area under the curve of insulin/incremental area under the curve of glucose, during OGTT (BCOG) and IVGTT (BCIV), respectively. Disposition index (DI) was calculated using the product of insulin sensitivity and insulin secretion. GLP-1 response to oral glucose was calculated as incremental area under the curve of GLP-1 (ΔAUCGLP-1). Per cent incretin effect was estimated as 100×(BCOG-BCIV)/BCOG).

RESULTS: The YT2DM had marked impairment in BC (>80% reduction in AIR and BCOG, p<0.001) and lower QUICKI (p<0.001), OGIS (p<0.001) and CSI (p=0.015) compared with controls. There was no difference in GLP-1 at all time points and ΔAUCGLP-1 but the per cent incretin effect was reduced in the YT2DM compared with controls (12.1±8.93 vs 70.0±4.03, p<0.001).

CONCLUSIONS: Asian YT2DM showed similar GLP-1 response to oral glucose as controls but reduced incretin effect, BC and insulin sensitivity. The lack of compensatory mechanisms, as shown by the DI may be partly ascribed to the impaired incretin effect, similar to that of adult T2DM.

TRIAL REGISTRATION NUMBER: NMRR-12-1042-13254.

Matched MeSH terms: Diabetes Mellitus, Type 2
Discovery of gamma-mangostin from Garcinia mangostana as a potent and selective natural SIRT2 inhibitor

Yeong KY, Khaw KY, Takahashi Y, Itoh Y, Murugaiyah V, Suzuki T

Bioorg Chem, 2020 01;94:103403.
PMID: 31711765 DOI: 10.1016/j.bioorg.2019.103403

Studies have suggested that sirtuin inhibition may have beneficial effects on several age-related diseases such as neurodegenerative disorders and cancer. Garcinia mangostana is a well-known tropical plant found mostly in South East Asia with several positive health effects. Some of its phytochemicals such as α-mangostin was found to be able to modulate sirtuin activity in mice and was implicated with inflammation, diabetes and obesity. However, comprehensive studies on sirtuin activity by the prenylated xanthones extracted from Garcinia mangostana have yet to be reported. The present study led to the discovery and identification of γ-mangostin as a potent and selective SIRT2 inhibitor. It was demonstrated that γ-mangostin was able to increase the α-tubulin acetylation in MDA-MD-231 and MCF-7 breast cancer cells. It was also found to possess potent antiproliferative activity against both cell lines. In addition, it was able to induce neurite outgrowth in the N2a cells.

Matched MeSH terms: Diabetes Mellitus
Fulltext Antihypertensive properties of plant-based prebiotics

Yeo SK, Ooi LG, Lim TJ, Liong MT

Int J Mol Sci, 2009 Oct;10(8):3517-30.
PMID: 20111692 DOI: 10.3390/ijms10083517

Hypertension is one of the major risk factors for cardiovascular disease. Although various drugs for its treatment have been synthesized, the occurring side effects have generated the need for natural interventions for the treatment and prevention of hypertension. Dietary intervention such as the administration of prebiotics has been seen as a highly acceptable approach. Prebiotics are indigestible food ingredients that bypass digestion and reach the lower gut as substrates for indigenous microflora. Most of the prebiotics used as food adjuncts, such as inulin, fructooligosaccharides, dietary fiber and gums, are derived from plants. Experimental evidence from recent studies has suggested that prebiotics are capable of reducing and preventing hypertension. This paper will discuss some of the mechanisms involved, the evidence generated from both in-vitro experiments and in-vivo trials and some controversial findings that are raised.

Matched MeSH terms: Diabetes Mellitus/prevention & control
World Health Organization (WHO) new diagnostic criteria for diabetes mellitus: the 75g oral glucose tolerance test

Yeo PPB, Cheah JS

Family Practitioner, 1982;5:11-14.

Matched MeSH terms: Diabetes Mellitus
Ethnicity modifies the association between diabetes mellitus and ischaemic heart disease in Chinese, Malays and Asian Indians living in Singapore

Yeo KK, Tai BC, Heng D, Lee JM, Ma S, Hughes K, et al.

Diabetologia, 2006 Dec;49(12):2866-73.
PMID: 17021918 DOI: 10.1007/s00125-006-0469-z

AIMS/HYPOTHESIS: The aim of the study was to determine whether the risk of ischaemic heart disease (IHD) associated with diabetes mellitus differs between ethnic groups.

METHODS: Registry linkage was used to identify IHD events in 5707 Chinese, Malay and Asian Indian participants from three cross-sectional studies conducted in Singapore between the years 1984 and 1995. The study provided a median of 10.2 years of follow-up with 240 IHD events experienced. We assessed the interaction between diabetes mellitus and ethnicity in relation to the risk of IHD events using Cox proportional hazards regression.

RESULTS: Diabetes mellitus was more common in Asian Indians. Furthermore, diabetes mellitus was associated with a greater risk of IHD in Asian Indians. The hazard ratio when comparing diabetes mellitus with non-diabetes mellitus was 6.41 (95% CI 5.77-7.12) in Asian Indians and 3.07 (95% CI 1.86-5.06) in Chinese (p = 0.009 for interaction). Differences in the levels of established IHD risk factors among diabetics from the three ethnic groups did not appear to explain the differences in IHD risk.

CONCLUSIONS/INTERPRETATION: Asian Indians are more susceptible to the development of diabetes mellitus than Chinese and Malays. When Asian Indians do develop diabetes mellitus, the risk of IHD is higher than for Chinese and Malays. Consequently, the prevention of diabetes mellitus amongst this ethnic group is particularly important for the prevention of IHD in Asia, especially given the size of the population at risk. Elucidation of the reasons for these ethnic differences may help us understand the pathogenesis of IHD in those with diabetes mellitus.

Matched MeSH terms: Diabetes Mellitus/mortality; Diabetes Mellitus/epidemiology*; Diabetes Mellitus/physiopathology
Exploring the mechanism of endothelial involvement in acidosis-induced vasodilatation of aortic tissues from normal and diabetic rats

Yeo JL, Tan BT, Achike FI

Eur J Pharmacol, 2010 Sep 10;642(1-3):99-106.
PMID: 20553918 DOI: 10.1016/j.ejphar.2010.05.040

Acidosis modulates physiologic and pathophysiologic processes but the mechanism of acidotic vasodilatation remains unclear. We therefore explored this in aortic rings from normal and streptozotocin-induced diabetic Sprague-Dawley rats. Phenylephrine (PE)-induced contraction in endothelium-intact and -denuded rings were recorded under normal and acidotic pH with or without drug probes. Acidosis exerted a relaxant effect in endothelium-intact and -denuded euglycaemic and diabetic tissues. l-NAME or methylene blue partially inhibited acidotic relaxation in these endothelium-intact but not the -denuded tissues, with greater inhibition in the diabetic tissues, indicating that acidosis induces relaxation by endothelium-dependent and -independent mechanisms, the former being EDNO-cGMP mediated. Indomethacin had no effect on the tissues, indicating that cyclooxygenase products are neither involved in acidosis-induced vasodilatation nor in the modulation of phenylephrine-contraction. In euglycaemic tissues under normal pH, no K(+) channel blocker altered phenylephrine-contraction, but all (except glibenclamide) enhanced diabetic tissue contraction, indicating that normally, these channels (K(ir), K(V), BK(Ca), K(ATP)) do not modulate phenylephrine-contraction, but they (except K(ATP)) are expressed in diabetes where they attenuate phenylephine-induced contraction and modulate acidosis. Only the K(ir) channel modulates acidotic relaxation in euglycaemic tissues. Only tetraethylammonium and iberiotoxin enhanced phenylephrine-induced contraction in endothelium-denuded diabetic tissues indicating that BK(Ca) attenuates phenylephrine-contraction and that acidotic relaxation in this condition is modulated by a tetraethylammonium-sensitive mechanism. In conclusion, acidosis causes vasodilatation in normal and diabetic tissues via endothelium-dependent and -independent mechanisms differentially modulated by a combination of a NO-cGMP process and K(+) channels, some of which are dormant in the normal state but activated in diabetes mellitus.

Matched MeSH terms: Diabetes Mellitus/pathology; Diabetes Mellitus/physiopathology*
Fulltext The comparison of QT dispersion and 24 hour ambulatory blood pressure monitoring amongst diabetic patients with and without microalbuminuria

Yeo CK, Hapizah MN, Khalid BAK, Wan Nazainimoon WM, Khalid Y

Med J Malaysia, 2004 Jun;59(2):185-9.
PMID: 15559168

Diabetes mellitus is an important coronary artery disease risk factor. The presence of microalbuminuria, which indicates renal involvement in diabetic patients, is associated with an increased cardiovascular risk. There are suggestions that diabetic patients with microalbuminuria have more adverse risk profile such as higher ambulatory blood pressure and total cholesterol levels to account for the increased cardiovascular morbidity and mortality. QT dispersion is increasingly being recognized as a prognostic factor for coronary artery disease and sudden death. Some studies have suggested that QT dispersion is an important predictor of mortality in Type II diabetic patients. Our cross sectional study was to compare the QT dispersion and 24 hour ambulatory blood pressure monitoring between diabetic patients with microalbuminuria and those without microalbuminuria. Diabetic patients with overt coronary artery disease were excluded from the study. A total of 108 patients were recruited of which 57 patients had microalbuminuria and 51 were without microalbuminuria. The mean value of QT dispersion was significantly higher in patients with microalbuminuria than in patients without microalbuminuria (58.9 +/- 27.9 ms vs. 47.1 +/- 25.0 ms, p < 0.05). The mean 24 hour systolic and diastolic blood pressures were significantly higher in patients with microalbuminuria than in patients without microalbuminuria (129.5 +/- 12.3 mm Hg vs 122.3 +/- 10.2 mm Hg, p < 0.05 and 78.4 +/- 6.9 mm Hg vs 75.3 +/- 6.8 mm Hg, p < 0.05, respectively). Our study suggests that QT dispersion prolongation, related perhaps to some autonomic dysfunction, is an early manifestation of cardiovascular aberration in diabetic patients with microalbuminuria. The higher blood pressure levels recorded during a 24-hour period min diabetics with microalbuminuria could also possibly account for the worse cardiovascular outcome in this group of patients.

Matched MeSH terms: Diabetes Mellitus/physiopathology*
Fulltext In vivo antidiabetic and acute toxicity of spray-dried Vernonia amygdalina water extract

Yeap, S.K., Beh, B.K., Liang, W.S., Ho, W.Y., Yousr, A.N., Alitheen, N.B.

International Food Research Journal, 2013;20(2):613-616.
MyJurnal

The spray-dried Vernonia amygdalina water extract was evaluated for antidiabetic effect using normoglycaemic, glucose induced hyperglycaemic and streptozotocin induced diabetic mice. This effect was compared with an oral dose of Momordica charantia. Besides, acute toxicity of the extract was also evaluated at concentration 2000 and 5000 mg/kg body weight. The extract was able to reduce blood glucose level in glucose and streptozotocin induced hyperglycaemic mice without causing hypoglycemic effect on fasting normoglycaemic mice. Moreover, mice appeared to be normal and no mortality was observed in the acute toxicity study after treated with up to 5000mg/kg of extract. These results indicated that the spray-dried Vernonia amygdalina water extract was a potential antidiabetic agent which does not induce hypoglycemic and acute toxicity on normal subject.

Matched MeSH terms: Diabetes Mellitus, Experimental
Fulltext Antihyperglycemic effects of fermented and nonfermented mung bean extracts on alloxan-induced-diabetic mice

Yeap SK, Mohd Ali N, Mohd Yusof H, Alitheen NB, Beh BK, Ho WY, et al.

J Biomed Biotechnol, 2012;2012:285430.
PMID: 23091343 DOI: 10.1155/2012/285430

Mung bean was reported as a potential antidiabetic agent while fermented food has been proposed as one of the major contributors that can reduce the risk of diabetes in Asian populations. In this study, we have compared the normoglycemic effect, glucose-induced hyperglycemic effect, and alloxan-induced hyperglycemic effect of fermented and nonfermented mung bean extracts. Our results showed that fermented mung bean extracts did not induce hypoglycemic effect on normal mice but significantly reduced the blood sugar levels of glucose- and alloxan-induced hyperglycemic mice. The serum levels of cholesterol, triglyceride (TG), and low-density lipoprotein (LDL) were also lowered while insulin secretion and antioxidant level as measured by malonaldehyde (MDA) assays were significantly improved in the plasma of the fermented mung bean-treated group in alloxan-induced hyperglycemic mouse. These results indicated that fermentation using Mardi Rhizopus sp. strain 5351 inoculums could enhance the antihyperglycemic and the antioxidant effects of mung bean in alloxan-treated mice. The improvement in the antihyperglycemic effect may also be contributed by the increased content of GABA and the free amino acid that are present in the fermented mung bean extracts.

Matched MeSH terms: Diabetes Mellitus, Experimental/chemically induced; Diabetes Mellitus, Experimental/drug therapy*
Global prevalence, incidence, and outcomes of non-obese or lean non-alcoholic fatty liver disease: a systematic review and meta-analysis

Ye Q, Zou B, Yeo YH, Li J, Huang DQ, Wu Y, et al.

Lancet Gastroenterol Hepatol, 2020 08;5(8):739-752.
PMID: 32413340 DOI: 10.1016/S2468-1253(20)30077-7

BACKGROUND: Although non-alcoholic fatty liver disease (NAFLD) is commonly associated with obesity, it is increasingly being identified in non-obese individuals. We aimed to characterise the prevalence, incidence, and long-term outcomes of non-obese or lean NAFLD at a global level.
METHODS: For this systematic review and meta-analysis, we searched PubMed, Embase, Scopus, and the Cochrane Library from inception to May 1, 2019, for relevant original research articles without any language restrictions. The literature search and data extraction were done independently by two investigators. Primary outcomes were the prevalence of non-obese or lean people within the NAFLD group and the prevalence of non-obese or lean NAFLD in the general, non-obese, and lean populations; the incidence of NAFLD among non-obese and lean populations; and long-term outcomes of non-obese people with NAFLD. We also aimed to characterise the demographic, clinical, and histological characteristics of individuals with non-obese NAFLD.
FINDINGS: We identified 93 studies (n=10 576 383) from 24 countries or areas: 84 studies (n=10 530 308) were used for the prevalence analysis, five (n=9121) were used for the incidence analysis, and eight (n=36 954) were used for the outcomes analysis. Within the NAFLD population, 19·2% (95% CI 15·9-23·0) of people were lean and 40·8% (36·6-45·1) were non-obese. The prevalence of non-obese NAFLD in the general population varied from 25% or lower in some countries (eg, Malaysia and Pakistan) to higher than 50% in others (eg, Austria, Mexico, and Sweden). In the general population (comprising individuals with and without NAFLD), 12·1% (95% CI 9·3-15·6) of people had non-obese NAFLD and 5·1% (3·7-7·0) had lean NAFLD. The incidence of NAFLD in the non-obese population (without NAFLD at baseline) was 24·6 (95% CI 13·4-39·2) per 1000 person-years. Among people with non-obese or lean NALFD, 39·0% (95% CI 24·1-56·3) had non-alcoholic steatohepatitis, 29·2% (21·9-37·9) had significant fibrosis (stage ≥2), and 3·2% (1·5-5·7) had cirrhosis. Among the non-obese or lean NAFLD population, the incidence of all-cause mortality was 12·1 (95% CI 0·5-38·8) per 1000 person-years, that for liver-related mortality was 4·1 (1·9-7·1) per 1000 person-years, cardiovascular-related mortality was 4·0 (0·1-14·9) per 1000 person-years, new-onset diabetes was 12·6 (8·0-18·3) per 1000 person-years, new-onset cardiovascular disease was 18·7 (9·2-31·2) per 1000 person-years, and new-onset hypertension was 56·1 (38·5-77·0) per 1000 person-years. Most analyses were characterised by high heterogeneity.
INTERPRETATION: Overall, around 40% of the global NAFLD population was classified as non-obese and almost a fifth was lean. Both non-obese and lean groups had substantial long-term liver and non-liver comorbidities. These findings suggest that obesity should not be the sole criterion for NAFLD screening. Moreover, clinical trials of treatments for NAFLD should include participants across all body-mass index ranges.
FUNDING: None.

Matched MeSH terms: Diabetes Mellitus/epidemiology

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