BackgroundMetformin protection against cancer risk in Orientals is uncertain. We examined the possible metformin effect on total, esophageal, gastric, colorectal (CRC), hepatocellular (HCC) and pancreatic cancers in a Taiwanese cohort.MethodsA representative sample of 800,000 was drawn from the Taiwanese National Health Insurance data of 2000. A cohort of 480,984 participants 20 years or older, diabetes-cancer-free on 1st January 2000 was formed and categorized as four groups by DM and metformin usage status. Eligible incident cancer events had to occur one year after the index date until the end of 2007. The Cox proportional-hazards model evaluated relative risk of cancer for treated DM patients with or without metformin. The covariates included age, gender, other oral anti-hyperglycemic medication, Charlson comorbidity index (CCI) score and metformin exposure dosage and duration.ResultsWith diabetes but no anti-hyperglycemic medication, cancer incidence density increased at least 2-fold for total, CRC and HCC. On metformin, total, CRC and HCC incidences decreased to near non-diabetic levels but to varying degrees depending on gender and cancer type (CRC in women, liver in men). Adjustment for other oral anti-hyperglycemic agents usage and CCI made the benefit of metformin more evident [hazard ratios (95% confidence intervals): total 0.12 (0.08-0.19), CRC 0.36 (0.13-0.98), liver 0.06 (0.02-0.16), pancreas 0.15 (0.03-0.79)]. There was a significant gender interaction with metformin in CRC which favored women. Metformin dosage for a significant decrease in cancer incidence was ≤500 mg/day.ConclusionsMetformin can reduce the incidences of several gastroenterological cancers in treated diabetes.

The human amygdala is a key structure for processing emotional facial expressions, but it remains unclear what aspects of emotion are processed. We investigated this question with three different approaches: behavioural analysis of 3 amygdala lesion patients, neuroimaging of 19 healthy adults, and single-neuron recordings in 9 neurosurgical patients. The lesion patients showed a shift in behavioural sensitivity to fear, and amygdala BOLD responses were modulated by both fear and emotion ambiguity (the uncertainty that a facial expression is categorized as fearful or happy). We found two populations of neurons, one whose response correlated with increasing degree of fear, or happiness, and a second whose response primarily decreased as a linear function of emotion ambiguity. Together, our results indicate that the human amygdala processes both the degree of emotion in facial expressions and the categorical ambiguity of the emotion shown and that these two aspects of amygdala processing can be most clearly distinguished at the level of single neurons.

Aims/hypothesis The results from prospective cohort studies of prediabetes (impaired fasting glucose and/or impaired glucose tolerance) and risk of cancer are controversial. We conducted a meta-analysis to evaluate the risk of cancer in association with impaired fasting glucose and impaired glucose tolerance. Methods The PubMed, EMBASE and Cochrane Library databases were searched for prospective cohort studies with data on prediabetes and cancer. Two independent reviewers assessed the reports and extracted the data. Prospective studies were included if they reported adjusted RRs with 95% CIs for the association between cancer and prediabetes. Subgroup analyses were conducted according to endpoint, age, sex, ethnicity, duration of follow-up and study characteristics. Results Data from 891,426 participants were derived from 16 prospective cohort studies. Prediabetes was associated with an increased risk of cancer overall (RR 1.15; 95% CI 1.06, 1.23).The results were consistent across cancer endpoint, age, duration of follow-up and ethnicity. There was no significant difference for the risk of cancer with different definitions of prediabetes. In a site-specific cancer analysis, prediabetes was significantly associated with increased risks of cancer of the stomach/colorectum, liver, pancreas, breast and endometrium (all p<0.05), but not associated with cancer of the bronchus/ lung, prostate, ovary, kidney or bladder. The risks of sitespecific cancer were significantly different (p=0.01) and were highest for liver, endometrial and stomach/colorectal cancer. Conclusions/interpretation Overall, prediabetes was associated with an increased risk of cancer, especially liver, endometrial and stomach/colorectal cancer.

Background:Overweight and obesity are related to maternal and infant physical health, such as gestational diabetes, preeclampsia, and macrosomia. The purpose of this meta-analysis was to assess the effect of physical exercise on maternal and infant outcomes in overweight and obese pregnant women. Methods: Two researchers independently searched Cochrane Library, Embase, PubMed, Web of Science, and ClinicalTrials.gov. for English-language articles based on randomized controlled trials examining physical exercise in overweight and obese pregnant women and its effect on maternal and infant outcomes. Primary outcomes were gestational weight gain and a relative risk of gestational diabetes. Secondary outcomes were gestational hypertension, preeclampsia, cesarean delivery, birthweight, large for gestational age, small for gestational age, macrosomia, and preterm birth. Risk bias was evaluated by Cochrane Collaboration's tool. The results of integration were reported as relative risks (RR), mean difference, or standard mean difference with 95% confidence intervals (CI). This meta-analysis was registered on PROSPERO on November 18, 2017, with registration number CRD42017081565. Results: Thirteen studies involving 1439 participants were included. Physical exercise reduced gestational weight gain (mean difference = −1.14 kg, 95% CI = [−1.67 to −0.62], P < 0.0001) and the risk of gestational diabetes (RR = 0.71, 95% CI = [0.57-0.89], P = 0.004) in overweight and obese pregnant women. There were no significant differences in other outcomes such as gestational hypertension, preeclampsia, cesarean delivery, birthweight, large for gestational age, small for gestational age, macrosomia, and preterm birth. Conclusions: Prenatal exercise interventions reduced gestational weight gain and the risk of gestational diabetes for overweight and obese pregnant women, which reinforced the benefits of exercise during pregnancy. However, no evidence was found with respect to benefits and/or harm for infants. Consideration should be taken when interpreting these findings as a result of the relative small sample size in this meta-analysis.Further larger well-designed randomized trials may be helpful to assess the short-term and long-term effects of prenatal exercise on maternal and infant outcomes. K E Y W O R D Sexercise, infant health outcomes, maternal health outcomes, meta-analysis, overweight and obesity 212 | DU et al.

No abstract

Prediabetes, defined as IFG 110, IGT, or combined IFG 110 and/or IGT, was associated with increased all-cause and cardiovascular mortality.

No abstract

No abstract