OBJECTIVE: To evaluate the effects of moderate-intensity regular exercise on serum levels of tumor necrosis factor-a a (TNF-a a) and glucose and lipid metabolism parameters. DESIGN: Longitudinal intervention study of a 5 month exercise training program (30 ± 45 minaday, 4 ± 5 daysaweek). SUBJECTS: Forty-one healthy Japanese women aged 41 ± 69 y at baseline; 27 participants in the exercise program. MEASUREMENTS: Body mass index (BMI), waist-to-hip ratio (WHR), percentage body fat, and fasting levels for serum TNF-a a, serum soluble TNF receptor p55 (TNF-RI) and TNF receptor p75 (TNF-RII), serum lipids, HbA 1c , and serum insulin before and after exercise. RESULTS: In overweight to obese subjects, serum levels of TNF-a a, TNF-RI and TNF-RII were signi®cantly higher than those in lean subjects. There were signi®cant correlations between log serum TNF-a a and BMI, percentage body fat, WHR, HbA 1c and log insulin. TNF-RI was signi®cantly correlated with BMI, percentage body fat, WHR and HbA 1c . TNF-RII was also associated with BMI, percentage body fat and WHR. However, the correlation between TNF-RII and HbA 1c did not reach statistical signi®cance. Neither TNF-RI nor TNF-RII was correlated with log insulin. In contrast, TNF-a a, TNF-RI and TNF-RII were negatively correlated with HDL cholesterol. Regular exercise decreased BMI, percentage body fat, HbA 1c , serum TNF-a a, TNF-RI and TNF-RII and increased HDL cholesterol levels. In addition, exercise-induced change in serum TNF-a a was independently correlated with changes in HbA 1c and serum insulin, after being adjusted for the change in fat-free mass. CONCLUSION: Changes in serum TNF-a a that occur with exercise may play an important role in improving glucose metabolism parameters.

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Angiotensin-converting enzyme (ACE) gene polymorphism is thought to be a potent risk

The diagnostic accuracy of glycated haemoglobin (HbA1c) and 1,5-anhydroglucitol (AG) and their association with age and obesity in the community screening for Type 2 diabetes were investigated. HbA1c and AG were measured in 368 subjects at the time of an oral glucose tolerance test (OGTT) based on WHO criteria. The impact of age and obesity on the probability of diabetes was evaluated by multivariate logistic regression analysis. Receiver operating characteristic (ROC) analysis was used to assess diagnostic accuracy of each method. The areas under ROC curves were compared for subjects aged 30-59 and 60-82 years. In the logistic analysis, age was associated with the probability of diabetes, while body mass index did not contribute to the model. The paired ROC analyses indicated that HbA1c was superior to AG only in the younger subjects. When the areas for two age groups were compared, both HbA1c and AG performed better in the younger than older subjects. We conclude that for the younger subjects, HbA1c value is highly sensitive (100.0%) and specific (90.4%) and is helpful for the diagnosis of Type 2 diabetes. On the other hand for the older subjects, both HbA1c and AG are poor screening tests in reference to the OGTT standard.

Serum AG is related to glycosuria even among nondiabetic subjects, and its concentrations are decreased in those with a family history of NIDDM. Our results suggest that serum AG rather than HbAlc reflects early metabolic abnormalities in these subjects.