To evaluate the effect of sibutramine on weight loss, insulin sensitivity and serum adiponectin l... more To evaluate the effect of sibutramine on weight loss, insulin sensitivity and serum adiponectin levels in obese patients with Type 2 diabetes. This study is a randomized, double-blind, placebo-controlled parallel comparison study of sibutramine 15 mg/day and placebo. Forty-eight eligible obese patients with Type 2 diabetes (age between 30 and 75 years with body mass index > or = 27 kg/m(2)) were randomly assigned to receive either placebo (n = 24) or sibutramine (15 mg/day) (n = 24) for 6 months. Fifteen subjects in each group underwent meal tests and modified insulin suppression tests before and after 6 months' treatment. After 6 months of sibutramine treatment statistically significant changes from baseline were observed for body weight (85.4 +/- 2.5 vs. 82.9 +/- 2.4 kg, P < 0.005) and body mass index (32.0 +/- 0.7 vs. 31.4 +/- 0.6 kg/m(2), P < 0.05) without a significant alteration of waist-hip ratio (W/H), blood pressure, heart rate, glycaemic parameters or lipid profiles. The steady-state plasma glucose (SSPG) level during the modified insulin suppression test was significantly reduced in the sibutramine group (17.33 +/- 2.92 vs. 14.29 +/- 4.19 mmol/l, P < 0.05) despite similar steady-state plasma insulin (SSPI) concentrations. In addition, serum adiponectin and C-reactive protein (CRP) levels remained unchanged, although modest weight reduction was achieved after sibutramine treatment. There were also no significant correlations between changes in serum adiponectin and reduction of SSPG or body weight. Daily ambient plasma insulin and glucose concentrations in response to a test meal were not significantly different in subjects receiving sibutramine treatment. We conclude that treatment with sibutramine 15 mg once daily effectively reduces weight and enhances insulin sensitivity without alteration of serum adiponectin levels in obese patients with Type 2 diabetes.
Metabolic Syndrome and Related Disorders, Nov 1, 2019
Background: This study evaluated the relative influence of insulin resistance (IR), first-phase i... more Background: This study evaluated the relative influence of insulin resistance (IR), first-phase insulin secretion (FPIS), second-phase insulin secretion (SPIS), and glucose effectiveness (GE) in determining the difference between fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) (ΔPG), in a Chinese population with type 2 diabetes (T2D) mellitus. Methods: In total, we enrolled 1213 participants with T2D (479 women). IR, FPIS, SPIS, and GE were estimated by using equations we built previously. ΔPG was defined as FPG - PPG. Results: The relative contribution of the four diabetogenic factors (DFs) was analyzed by multiple linear regression, and GE was the greatest contributor in the ΔPG value (β = 0.171, P < 0.001), whereas IR had the least influence on ΔPG (β = -0.040, P = 0.439). DFs were analyzed by using binary logistic regression to ascertain if ΔPG ≥0 (high fasting plasma glucose, HFG). Three models were built: Model 0: SPIS, Model 1: SPIS + FPIS, and Model 2: Model 1 + GE. Model 2 had the most accurate predictive power; the equation for Model 2 is P = 1/(1 - e-x), where x = -11.88 + 312.89 × (GE) -1.22 × log(SPIS) +1.63 × log(FPIS). In this equation, P refers to the risk of HFG. Conclusions: For Chinese patients, GE had the most profound effect in determining ΔPG, followed by FPIS, SPIS, and IR. The model suggested that participants with high FPIS, SPIS, and GE would have a high incidence of HFG.
Glucose homeostasis in the body is determined by four diabetes factors (DFs): insulin resistance ... more Glucose homeostasis in the body is determined by four diabetes factors (DFs): insulin resistance (IR), glucose effectiveness (GE), and the two phases of insulin secretion—first phase (FPIS) and second phase (SPIS). Previous research points to a correlation between elevated levels of gamma-glutamyl transferase (γGT) and an increased risk of type 2 diabetes. This study investigates the relationship between γGT and the four DFs in older Chinese individuals. This study involved 2644 men and 2598 women, all of whom were relatively healthy Chinese individuals aged 60 years or more. The DFs were calculated using formulas developed by our research, based on demographic data and factors related to metabolic syndrome. Pearson’s correlation was utilized to assess the relationship between γGT and the four DFs. The findings suggested a positive correlation between γGT and IR, FPIS, and SPIS, but a negative correlation with GE in men. Among women, only SPIS and GE were significantly correlated wi...
Objective To evaluate the relationship between alanine transaminase (ALT) level and biphasic insu... more Objective To evaluate the relationship between alanine transaminase (ALT) level and biphasic insulin secretion (BPIS) in healthy elderly Han Chinese individuals. Methods This cross-sectional study enrolled healthy elderly participants aged ≥60 years that were part of a health examination programme. In order to explore the correlation and severity of the clinical condition, those with any possible confounding factors known to affect insulin secretion or liver function were excluded from the study. BPIS was calculated using an equation developed previously by this research team. Results This study enrolled 39 845 healthy elderly individuals (19 058 males and 20 787 females). Participants were stratified into four quartile groups according to their ALT level. In both males and females, the increasing ALT quartiles (ordinal variable) were associated with greater values of log-transformed first-phase insulin secretion (FPIS) and second-phase insulin secretion (SPIS). The correlation and ...
Type 2 diabetes mellitus (T2DM) patients have a high risk of coronary artery disease (CAD). Thall... more Type 2 diabetes mellitus (T2DM) patients have a high risk of coronary artery disease (CAD). Thallium-201 myocardial perfusion scan (Th-201 scan) is a non-invasive and extensively used tool in recognizing CAD in clinical settings. In this study, we attempted to compare the predictive accuracy of evaluating abnormal Th-201 scans using traditional multiple linear regression (MLR) with four machine learning (ML) methods. From the study, we can determine whether ML surpasses traditional MLR and rank the clinical variables and compare them with previous reports.In total, 796 T2DM, including 368 men and 528 women, were enrolled. In addition to traditional MLR, classification and regression tree (CART), random forest (RF), stochastic gradient boosting (SGB) and eXtreme gradient boosting (XGBoost) were also used to analyze abnormal Th-201 scans. Stress sum score was used as the endpoint (dependent variable). Our findings show that all four root mean square errors of ML are smaller than with ...
Background: High platelet count was noted in people with metabolic syndrome. A significant associ... more Background: High platelet count was noted in people with metabolic syndrome. A significant association between platelet count and various metabolic parameters had also been reported. However, all the studies hypothesized that these associations are linear relationships. This work investigated the potential non-linear relationships between platelet count and various metabolic parameters.Methods: A cross-sectional analysis of data from 11198 non-diabetic, non-obese elderly in a Health Screening Center was undertaken to explore the relationship between platelet count and metabolic parameters, including metabolic syndrome, body mass index, waist circumference, body fat, systolic and diastolic blood pressure, fasting plasma glucose, cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, C-reactive protein, insulin resistance, glucose effectiveness, and first-phase and second-phase insulin secretion. The linear relationship between platelet c...
Objective: The aim of this study was to assess prevalence of overweight adolescents and associate... more Objective: The aim of this study was to assess prevalence of overweight adolescents and associated factors in the public junior high schools first grade students in Hualien city. Materials and Methods: Of the 1,826 students who were eligible for the study, 1,724 (94.4%) children were recruited for analysis. Questionnaires consisted of two parts, the one for the parents included socio-demographic variables and self-reported height and weight and the one for the children included self-perceived health status, eating habits, and lifestyle. The nurses obtained the children's body height and body weight. Definition of being overweight was based on body mass index recommended by the Department of Health in Taiwan. Multiple logistic regression was used to examine factors associated with being overweight. Results: The overall prevalence of overweight adolescents was 28.5%, with 35.4% for the boys and 21.8% for the girls, respectively. A further 20.0% of the boys and 11.0% of the girls w...
The objectives of this study were to assess the efficacy, tolerability and treatment satisfaction... more The objectives of this study were to assess the efficacy, tolerability and treatment satisfaction of a prandial glucose regulator (repaglinide, NovoNorm) in type 2 diabetes in a clinical setting. The study was conducted as an open-label, prospective, longitudinal, 16-week investigation. A total of 1060 patients with type2 diabetes were prescribed with NovoNorm in a flexible prandial regimen. The dose was at the discretion of the physician, but the number and timing of main meals were the choice of the patient. Patients’ demographic data, glycemic control, body weight, meal frequency and quality of life outcomes were recorded at three outpatient visits. After treatment, significant improvements in HbA1c, fasting and 2-hour postprandial blood glucose concentrations from baseline baseline were demonstrated, as indicated by a mean decrease of 0.7%,17.3 mg/dl and 64.1 mg/dl, respectively(p<0.00001). NovoNorm was well tolerated, while mean body weight and meal frequency remained unchanged...
QJM : monthly journal of the Association of Physicians, Jan 16, 2015
Hyperglycemia increases prevalence of metabolic syndrome (MetS), type 2 diabetes (T2D) and cardio... more Hyperglycemia increases prevalence of metabolic syndrome (MetS), type 2 diabetes (T2D) and cardiovascular disease (CVD). But the role of normoglycemia on the development of T2D and CVD in elderly population remains unclear. To determine an optimal cut-off for fasting plasma glucose (FPG) to predict MetS and subsequent risk of T2D and CVD in an elderly Taiwanese population with normal FPG levels. Two stages included cross-sectional (stage 1) and prospective (stage 2) cohort study. In stage 1 18,287 subjects aged ≥ 60 years were enrolled; of these, 5,039 without T2D and CVD advanced to stage 2 and a mean follow-up of 3.8 years. MetS components were analyzed, and in stage 1, FPG cut-offs for MetS risk were calculated using receiver operating characteristic (ROC) curve analyses. In stage 2, subjects without T2D and CVD in stage 1 were classified into high-FPG and low-FPG groups based on cut-offs, and sex specific differences in incidence for T2D and CVD were calculated. ROC curve analys...
To evaluate the effect of sibutramine on weight loss, insulin sensitivity and serum adiponectin l... more To evaluate the effect of sibutramine on weight loss, insulin sensitivity and serum adiponectin levels in obese patients with Type 2 diabetes. This study is a randomized, double-blind, placebo-controlled parallel comparison study of sibutramine 15 mg/day and placebo. Forty-eight eligible obese patients with Type 2 diabetes (age between 30 and 75 years with body mass index &gt; or = 27 kg/m(2)) were randomly assigned to receive either placebo (n = 24) or sibutramine (15 mg/day) (n = 24) for 6 months. Fifteen subjects in each group underwent meal tests and modified insulin suppression tests before and after 6 months&#39; treatment. After 6 months of sibutramine treatment statistically significant changes from baseline were observed for body weight (85.4 +/- 2.5 vs. 82.9 +/- 2.4 kg, P &lt; 0.005) and body mass index (32.0 +/- 0.7 vs. 31.4 +/- 0.6 kg/m(2), P &lt; 0.05) without a significant alteration of waist-hip ratio (W/H), blood pressure, heart rate, glycaemic parameters or lipid profiles. The steady-state plasma glucose (SSPG) level during the modified insulin suppression test was significantly reduced in the sibutramine group (17.33 +/- 2.92 vs. 14.29 +/- 4.19 mmol/l, P &lt; 0.05) despite similar steady-state plasma insulin (SSPI) concentrations. In addition, serum adiponectin and C-reactive protein (CRP) levels remained unchanged, although modest weight reduction was achieved after sibutramine treatment. There were also no significant correlations between changes in serum adiponectin and reduction of SSPG or body weight. Daily ambient plasma insulin and glucose concentrations in response to a test meal were not significantly different in subjects receiving sibutramine treatment. We conclude that treatment with sibutramine 15 mg once daily effectively reduces weight and enhances insulin sensitivity without alteration of serum adiponectin levels in obese patients with Type 2 diabetes.
Metabolic Syndrome and Related Disorders, Nov 1, 2019
Background: This study evaluated the relative influence of insulin resistance (IR), first-phase i... more Background: This study evaluated the relative influence of insulin resistance (IR), first-phase insulin secretion (FPIS), second-phase insulin secretion (SPIS), and glucose effectiveness (GE) in determining the difference between fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) (ΔPG), in a Chinese population with type 2 diabetes (T2D) mellitus. Methods: In total, we enrolled 1213 participants with T2D (479 women). IR, FPIS, SPIS, and GE were estimated by using equations we built previously. ΔPG was defined as FPG - PPG. Results: The relative contribution of the four diabetogenic factors (DFs) was analyzed by multiple linear regression, and GE was the greatest contributor in the ΔPG value (β = 0.171, P < 0.001), whereas IR had the least influence on ΔPG (β = -0.040, P = 0.439). DFs were analyzed by using binary logistic regression to ascertain if ΔPG ≥0 (high fasting plasma glucose, HFG). Three models were built: Model 0: SPIS, Model 1: SPIS + FPIS, and Model 2: Model 1 + GE. Model 2 had the most accurate predictive power; the equation for Model 2 is P = 1/(1 - e-x), where x = -11.88 + 312.89 × (GE) -1.22 × log(SPIS) +1.63 × log(FPIS). In this equation, P refers to the risk of HFG. Conclusions: For Chinese patients, GE had the most profound effect in determining ΔPG, followed by FPIS, SPIS, and IR. The model suggested that participants with high FPIS, SPIS, and GE would have a high incidence of HFG.
Glucose homeostasis in the body is determined by four diabetes factors (DFs): insulin resistance ... more Glucose homeostasis in the body is determined by four diabetes factors (DFs): insulin resistance (IR), glucose effectiveness (GE), and the two phases of insulin secretion—first phase (FPIS) and second phase (SPIS). Previous research points to a correlation between elevated levels of gamma-glutamyl transferase (γGT) and an increased risk of type 2 diabetes. This study investigates the relationship between γGT and the four DFs in older Chinese individuals. This study involved 2644 men and 2598 women, all of whom were relatively healthy Chinese individuals aged 60 years or more. The DFs were calculated using formulas developed by our research, based on demographic data and factors related to metabolic syndrome. Pearson’s correlation was utilized to assess the relationship between γGT and the four DFs. The findings suggested a positive correlation between γGT and IR, FPIS, and SPIS, but a negative correlation with GE in men. Among women, only SPIS and GE were significantly correlated wi...
Objective To evaluate the relationship between alanine transaminase (ALT) level and biphasic insu... more Objective To evaluate the relationship between alanine transaminase (ALT) level and biphasic insulin secretion (BPIS) in healthy elderly Han Chinese individuals. Methods This cross-sectional study enrolled healthy elderly participants aged ≥60 years that were part of a health examination programme. In order to explore the correlation and severity of the clinical condition, those with any possible confounding factors known to affect insulin secretion or liver function were excluded from the study. BPIS was calculated using an equation developed previously by this research team. Results This study enrolled 39 845 healthy elderly individuals (19 058 males and 20 787 females). Participants were stratified into four quartile groups according to their ALT level. In both males and females, the increasing ALT quartiles (ordinal variable) were associated with greater values of log-transformed first-phase insulin secretion (FPIS) and second-phase insulin secretion (SPIS). The correlation and ...
Type 2 diabetes mellitus (T2DM) patients have a high risk of coronary artery disease (CAD). Thall... more Type 2 diabetes mellitus (T2DM) patients have a high risk of coronary artery disease (CAD). Thallium-201 myocardial perfusion scan (Th-201 scan) is a non-invasive and extensively used tool in recognizing CAD in clinical settings. In this study, we attempted to compare the predictive accuracy of evaluating abnormal Th-201 scans using traditional multiple linear regression (MLR) with four machine learning (ML) methods. From the study, we can determine whether ML surpasses traditional MLR and rank the clinical variables and compare them with previous reports.In total, 796 T2DM, including 368 men and 528 women, were enrolled. In addition to traditional MLR, classification and regression tree (CART), random forest (RF), stochastic gradient boosting (SGB) and eXtreme gradient boosting (XGBoost) were also used to analyze abnormal Th-201 scans. Stress sum score was used as the endpoint (dependent variable). Our findings show that all four root mean square errors of ML are smaller than with ...
Background: High platelet count was noted in people with metabolic syndrome. A significant associ... more Background: High platelet count was noted in people with metabolic syndrome. A significant association between platelet count and various metabolic parameters had also been reported. However, all the studies hypothesized that these associations are linear relationships. This work investigated the potential non-linear relationships between platelet count and various metabolic parameters.Methods: A cross-sectional analysis of data from 11198 non-diabetic, non-obese elderly in a Health Screening Center was undertaken to explore the relationship between platelet count and metabolic parameters, including metabolic syndrome, body mass index, waist circumference, body fat, systolic and diastolic blood pressure, fasting plasma glucose, cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, C-reactive protein, insulin resistance, glucose effectiveness, and first-phase and second-phase insulin secretion. The linear relationship between platelet c...
Objective: The aim of this study was to assess prevalence of overweight adolescents and associate... more Objective: The aim of this study was to assess prevalence of overweight adolescents and associated factors in the public junior high schools first grade students in Hualien city. Materials and Methods: Of the 1,826 students who were eligible for the study, 1,724 (94.4%) children were recruited for analysis. Questionnaires consisted of two parts, the one for the parents included socio-demographic variables and self-reported height and weight and the one for the children included self-perceived health status, eating habits, and lifestyle. The nurses obtained the children's body height and body weight. Definition of being overweight was based on body mass index recommended by the Department of Health in Taiwan. Multiple logistic regression was used to examine factors associated with being overweight. Results: The overall prevalence of overweight adolescents was 28.5%, with 35.4% for the boys and 21.8% for the girls, respectively. A further 20.0% of the boys and 11.0% of the girls w...
The objectives of this study were to assess the efficacy, tolerability and treatment satisfaction... more The objectives of this study were to assess the efficacy, tolerability and treatment satisfaction of a prandial glucose regulator (repaglinide, NovoNorm) in type 2 diabetes in a clinical setting. The study was conducted as an open-label, prospective, longitudinal, 16-week investigation. A total of 1060 patients with type2 diabetes were prescribed with NovoNorm in a flexible prandial regimen. The dose was at the discretion of the physician, but the number and timing of main meals were the choice of the patient. Patients’ demographic data, glycemic control, body weight, meal frequency and quality of life outcomes were recorded at three outpatient visits. After treatment, significant improvements in HbA1c, fasting and 2-hour postprandial blood glucose concentrations from baseline baseline were demonstrated, as indicated by a mean decrease of 0.7%,17.3 mg/dl and 64.1 mg/dl, respectively(p<0.00001). NovoNorm was well tolerated, while mean body weight and meal frequency remained unchanged...
QJM : monthly journal of the Association of Physicians, Jan 16, 2015
Hyperglycemia increases prevalence of metabolic syndrome (MetS), type 2 diabetes (T2D) and cardio... more Hyperglycemia increases prevalence of metabolic syndrome (MetS), type 2 diabetes (T2D) and cardiovascular disease (CVD). But the role of normoglycemia on the development of T2D and CVD in elderly population remains unclear. To determine an optimal cut-off for fasting plasma glucose (FPG) to predict MetS and subsequent risk of T2D and CVD in an elderly Taiwanese population with normal FPG levels. Two stages included cross-sectional (stage 1) and prospective (stage 2) cohort study. In stage 1 18,287 subjects aged ≥ 60 years were enrolled; of these, 5,039 without T2D and CVD advanced to stage 2 and a mean follow-up of 3.8 years. MetS components were analyzed, and in stage 1, FPG cut-offs for MetS risk were calculated using receiver operating characteristic (ROC) curve analyses. In stage 2, subjects without T2D and CVD in stage 1 were classified into high-FPG and low-FPG groups based on cut-offs, and sex specific differences in incidence for T2D and CVD were calculated. ROC curve analys...
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