​University students can't stop their mouths, and the risk of diabetes increases by 65%!

*It is only for medical professionals to read and refer to Weekly News No.
209.
If you have cardiovascular disease, just be careful? The risk of diabetes has tripled! Relying on being young? Eating super-processed food indiscriminately, the risk of diabetes is still rising! This week’s summary is that college students should not eat indiscriminately.
Ultra-processed foods increase the risk of diabetes by 65%! Elimination of β-cell development obstacles may delay or even treat type 1 diabetes in the future! Be careful with cardiovascular patients, your diabetes risk is 3 times that of the general population! 1 College students can't eat indiscriminately, ultra-processed foods increase the risk of diabetes by 65%! DOI: 10.
1016/j.
clnu.
2021.
03.
039.
Ultra-processed food intake is associated with the risk of type 2 diabetes, but many young people still have a fluke mentality.
They rely on their young body to eat more and they will not get it.
diabetes.

However, the recent research published in "Clin Nutr" shattered people's illusion that the risk of diabetes increased by 65% ​​if college students eat more ultra-processed food! Figure 1.
1 Research published in "Clin Nutr" This research from the University of Navarre in Spain "sourced locally", recruited through the alumni association of more than 20,000 students who had attended the school, of which 61.
5% were women.

At the beginning of the study, the participants received a food frequency questionnaire that included 136 types of foods and beverages, and then the participants were followed up every 2 years.

After starting the follow-up for 10 years, the participants took the diet survey again.

The researchers assessed the degree of processing of the diet based on the NOVA criteria, and participants were divided into three groups based on the intake of ultra-processed foods.

 Figure 1.
2 The more you eat ultra-processed foods, the higher your diabetes risk.
Although the participants in the study are still relatively young, with an average age of only 37.
4 years, there are still many patients with type 2 diabetes.

During the follow-up of 215,149 person-years, a total of 175 people were diagnosed with type 2 diabetes.

The analysis found that the 1/3 of the participants who consumed the most ultra-processed food had a significantly increased risk of type 2 diabetes (p=0.
024), which was a 53% increase (HR 1.
53, 95% CI 1.
06-2.
22).

Among them, the risk of men increased by 59% (HR 1.
59, 95% CI 1.
03-2.
43), while the risk of women did not increase significantly (HR 1.
32, 95% CI 0.
59-2.
94).

According to the analysis of the results of the second dietary survey, the risk of type 2 diabetes increased by 65% ​​(HR 1.
65, 95% CI 1.
14-2.
38) of the 1/3 participants with the highest intake of ultra-processed food, which further proves that eating more Ultra-processed foods are prone to type 2 diabetes.

 Figure 1.
3 Examples of the four types of food in the NOVA classification system Researchers pointed out that although the overall risk of type 2 diabetes in young people is relatively low, but eating more ultra-processed food is as easy to get type 2 diabetes, but you must not rely on your young age Just eat it! In addition, higher intake of ultra-processed foods may also increase the risk of obesity and cancer. According to NOVA's food classification standards, the researchers divided food into four categories, namely unprocessed or minimally processed foods, processed cooking ingredients, processed foods, and super processed foods.
Everyday, we still try to choose unprocessed or minimally processed foods.
For good! Related Articles Super-processed foods that make people fatter in life, we have made a list for you.
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.
What can't you eat to lose weight? Ultra-processed food makes you fat! Get shot! BMJ tells you that these "super processed foods" will increase the risk of cancer! Eat carefully, super processed foods increase the risk of death REF: Llavero-Valero M, San Martín JE, Martínez-González MA, et al.
Ultra-processed foods and type-2 diabetes risk in the sun project: a prospective cohort study.
Clin Nutr.
doi: 10.
1016/j.
clnu.
2021.
03.
039.
2 Cardiovascular patients, be careful, your diabetes risk is 3 times that of the general population! DOI: 10.
1093/eurjpc/zwab011.
The increased risk of cardiovascular disease in patients with diabetes is almost universally known, but what about the risk of diabetes in patients with cardiovascular disease? A recent study published in "Eur J Prev Cardiol" analyzed the risk of diabetes in cardiovascular disease patients around the world.

This study surprisingly found that the risk of diabetes in patients with cardiovascular disease has reached three times that of the general population! Figure 3.
1 Study published in "Eur J Prev Cardiol" This CLARIFY registry study included 32,694 patients with chronic coronary syndromes from 45 countries in Europe, Asia, America, the Middle East, Australia and Africa, including Patients with a history of myocardial infarction, patients with coronary artery stenosis >50%, patients with myocardial ischemia and symptomatic patients, and patients who have received revascularization therapy.

 The study followed up all patients participating in the study for at least 5 years, and found that 9502 patients had diabetes at the same time, accounting for nearly 30%, while the prevalence of diabetes in the general population was about 9%.

The prevalence of diabetes in cardiovascular disease patients varies greatly around the world, ranging from about 20% in Northern Europe to 60% in Gulf countries.

Not only will the risk of cardiovascular disease in diabetic patients increase, but the risk of diabetes in cardiovascular disease patients should also not be underestimated! Figure 3.
2 Diabetes prevalence of cardiovascular disease patients varies across the world The analysis shows that cardiovascular disease and diabetes are really a pair of "good brothers".

Diabetes can also increase the adverse outcomes of cardiovascular patients.
The overall risk of cardiovascular death, myocardial infarction, and stroke increased by 28% (HR 1.
28, 95% CI 1.
18-1.
39).

The risk of all-cause death (HR 1.
38, 95%CI 1.
27-1.
50), cardiovascular death risk (HR 1.
39, 95%CI 1.
25-1.
54), myocardial infarction risk (HR1.
26, 95%CI 1.
10-1.
43), The risk of stroke (HR 1.
29, 95%CI 1.
09-1.
52), the risk of hospitalization for heart failure (HR 1.
15, 95%CI 1.
03-1.
28), and the risk of coronary revascularization (HR 1.
14, 95%CI 1.
04- 1.
25) also increased across the board.

Figure 3.
3 The prevalence of diabetes among cardiovascular disease patients in China is about 27%.
This is also true in East Asia, including China.

In patients with chronic coronary syndrome with diabetes, the overall risk of cardiovascular death, myocardial infarction, and stroke increased by 32% (HR 1.
32, 95% CI 1.
05-1.
66), cardiovascular death (59%), and overall risk.
The increase in risk of death (55%) and hospitalization due to heart failure (57%) is even higher than the global average.

 Researchers pointed out that obesity and lack of exercise are common risk factors for diabetes and heart disease.
The results of the study highlight the urgent need to improve eating habits and improve exercise levels on a global scale.

Studies have found that countries with the most severe diabetes are also at the center of the obesity epidemic, which may be related to the acceleration of urbanization and changes in sports activities and food intake habits.

Researchers believe that the management of these patients at high risk of heart disease and diabetes should be improved.
Each country needs to identify these patients and provide tailored education and prevention programs.

 REF: Mak KH, Vidal-Petiot E, Young R, et al.
Prevalence of diabetes and impact on cardiovascular events and mortality in patients with chronic coronary syndromes, across multiple geographical regions and ethnicities.
Eur J Prev Cardiol.
doi: 10.
1093/eurjpc /zwab011.
3 Eliminates β-cell developmental disorders, and may delay or even treat type 1 diabetes in the future! DOI: 10.
1126/scitranslmed.
abf1587.
Patients with type 1 diabetes have insufficient beta cells to produce enough insulin to meet the body's physiological needs.

If the obstacles in the development of human β-cells can be eliminated, there is hope to delay the onset of type 1 diabetes and even cure type 1 diabetes.

A recent study published in "Sci Transl Med" evaluated the potential of autoantibodies against the protease inhibitor SerpinB 13.

 Figure 2.
1 Research published in "Sci Transl Med" The development of human pancreatic endocrine cells depends on the recovery of Notch's inhibition of neuron 3 (Ngn3) transcription factor.
The signal pathway that only prevents Notch signaling and allows pancreatic endocrine cells to form is still unclear.

However, previous studies have found that autoantibodies against the protease inhibitor SerpinB 13 are associated with the delayed onset of human type 1 diabetes.

If the specific mechanism behind this phenomenon can be clarified, will the problem of type 1 diabetes be easily solved? Recently, researchers from the University of Minnesota in the United States have made relevant attempts.

 Figure 2.
2 SerpinB13 expression in embryonic pancreas.
This study used mouse pancreatic explant cultures and used cathepsin L protease inhibitor SerpinB 13, which is expressed in pancreatic epithelial cells, to regulate Notch signaling involved in pancreatic development.

This protease inhibitor can cause the cleavage of the extracellular domain of Notch1, which subsequently doubles the number of Ngn3-positive progenitor cells and enhances the ability of these cells to transform into insulin.

Conversely, both recombinant SerpinB 13 protein and CatL deficiency down-regulated the production of pancreatic Ngn3+ cells.

This result suggests that inhibition of SerpinB 13 may indeed be the key to the development of pancreatic cells.

 The researchers then upgraded the mouse pancreas explant culture to the mouse pancreas.

Studies in mice found that when mouse embryos were exposed to the anti-cathepsin L protease inhibitor SerpinB 13 antibody, the number of islet cells in the pancreas of the mouse increased.

Even if the mice develop diabetes under the induction of streptozotocin, the disease outcome of the mice will be improved.

In addition, anti-serpinB 13 autoantibodies can stimulate the formation of Ngn3-positive endocrine progenitor cells in the pancreas.

 Figure 2.
3 SerpinB13's natural autoantibodies keep high-risk groups away from type 1 diabetes.
This process is believed to be related to the delay of the onset of type 1 diabetes in children, and it has also been supported by certain evidence in humans.

Studies in young people at high risk of type 1 diabetes have shown that natural autoantibodies against SerpinB 13 can to a certain extent keep these high-risk people away from the clinical onset of diabetes.

In some young people at high risk of type 1 diabetes after birth, pancreatic exocrine duct cells or cells nearby may promote the production of Ngn3-positive endocrine progenitor cells under the stimulation of injury and inflammation, and can also protect pancreatic islet cells from autoimmune inflammation.
Troubles.

Researchers believe that this discovery may become a target of intervention to delay the onset of type 1 diabetes in the future, and even lead to therapies for the treatment of type 1 diabetes.

 REF: Kryvalap Y, Jiang ML, Kryvalap N, Hendrickson C, Czyzyk J.
SerpinB13 antibodies promote β cell development and resistance to type 1 diabetes.
Sci Transl Med.
2021;13(588):eabf1587.
doi: 10.
1126/scitranslmed.
abf1587 .