Frank B. Hu

Bio: Frank B. Hu is an academic researcher from Harvard University. The author has contributed to research in topics: Type 2 diabetes & Diabetes mellitus. The author has an hindex of 250, co-authored 1675 publications receiving 253464 citations. Previous affiliations of Frank B. Hu include Southwest University & Brigham and Women's Hospital.

Associations of erythrocyte palmitoleic acid with adipokines, inflammatory markers, and the metabolic syndrome in middle-aged

Abstract: Background: Palmitoleic acid has been shown to regulate adipokine expression and systemic metabolic homeostasis in animal studies. However, its association with human metabolic diseases remains controversial. Objective: We aimed to investigate associations of erythrocyte palmitoleic acid with adipokines, inflammatory markers, and metabolic syndrome (MetS) in a Chinese population. Design: Erythrocyte fatty acids were measured in a populationbased sample of 3107 men and women aged 50‐70 y, for whom plasma glucose, insulin, lipid profile, adiponectin, retinol binding protein 4 (RBP-4), plasminogen activator inhibitor type 1, and highsensitivity C-reactive protein (hsCRP) were measured. MetS was defined according to the updated National Cholesterol Education Program Adult Treatment Panel III criteria for Asian Americans. Results: The mean (6SD) erythrocyte palmitoleic acid value was 0.41 6 0.20% of total fatty acids. Palmitoleic acid was positively correlated with RBP-4 (r = 0.14, P , 0.001) and inversely correlated with adiponectin (r = 20.15, P , 0.001). After multivariable adjustment, palmitoleic acid was strongly associated with MetS and its components. ORs (95% CIs) for comparisons of extreme quartiles of palmitoleic acid were 3.50 (2.66, 4.59) for MetS, 7.88 (5.90, 10.52) for hypertriglyceridemia, 2.13 (1.66, 2.72) for reduced HDL cholesterol, 1.99 (1.60, 2.48) for central obesity, and 1.86 (1.41, 2.44) for elevated blood pressure (all P , 0.001). Further control for adipokines and hsCRP abolished the association of palmitoleic acid with central obesity but not with other MetS components. Conclusion: Erythrocyte palmitoleic acid is associated with an adverse profile of adipokines and inflammatory markers and an increased risk of MetS in this Chinese population. Am J Clin Nutr doi: 10.3945/ajcn.112.040204.

Association of Tryptophan Metabolites with Incident Type 2 Diabetes in the PREDIMED Trial: A Case-Cohort Study.

Abstract: Background: Metabolites of the tryptophan–kynurenine pathway (i.e., tryptophan, kynurenine, kynurenic acid, quinolinic acid, 3-hydroxyanthranilic) may be associated with diabetes development. Using a case–cohort design nested in the Prevencion con Dieta Mediterranea (PREDIMED) study, we studied the associations of baseline and 1-year changes of these metabolites with incident type 2 diabetes (T2D). Methods: Plasma metabolite concentrations were quantified via LC-MS for n = 641 in a randomly selected subcohort and 251 incident cases diagnosed during 3.8 years of median follow-up. Weighted Cox models adjusted for age, sex, body mass index, and other T2D risk factors were used. Results: Contrary to our hypothesis, baseline tryptophan was associated with higher risk of incident T2D (hazard ratio = 1.29; 95% CI, 1.04–1.61 per SD). Positive changes in quinolinic acid from baseline to 1 year were associated with a higher risk of T2D (hazard ratio = 1.39; 95% CI, 1.09–1.77 per SD). Baseline tryptophan and kynurenic acid were directly associated with changes in homeostatic model assessment for insulin resistance (HOMA-IR) from baseline to 1 year. Concurrent changes in kynurenine, quinolinic acid, 3-hydroxyanthranilic acid, and kynurenine/tryptophan ratio were associated with baseline-to-1-year changes in HOMA-IR. Conclusions: Baseline tryptophan and 1-year increases in quinolinic acid were positively associated with incident T2D. Baseline and 1-year changes in tryptophan metabolites predicted changes in HOMA-IR.

Consumption of Meals Prepared at Home and Risk of Type 2 Diabetes: An Analysis of Two Prospective Cohort Studies

Abstract: Background There has been a trend towards increased dining out in many countries. Consuming food prepared out of the home has been linked to poor diet quality, weight gain, and diabetes risk, but whether having meals prepared at home (MPAH) is associated with risk of type 2 diabetes (T2D) remains unknown. Methods and Findings We followed 58,051 women (from 1986 to 2012) and 41,676 men (from 1986 to 2010) in two prospective cohort studies of health professionals. Frequencies of consuming midday or evening MPAH were assessed at baseline and during follow-up. Incident T2D was identified through self-report and confirmed using a validated supplementary questionnaire. During 2.1 million person-years of follow-up, 9,356 T2D cases were documented. After adjusting for demographic, socioeconomic, and lifestyle factors, hazard ratios (HRs) and 95% confidence intervals (95% CIs) of T2D were 1 (reference), 0.93 (0.88–0.99), 0.96 (0.90–1.03), and 0.86 (0.81–0.91) for those eating 0–6, 7–8, 9–10, and 11–14 MPAH (p-trend < 0.001) per week, respectively. Participants eating 5–7 midday MPAH had 9% lower T2D risk than those with 0–2 midday MPAH, and participants having 5–7 evening MPAH had 15% lower risk than those with 0–2 evening MPAH (both p-trend < 0.001). In the first 8 y of follow-up, women and men who consumed 11–14 MPAH per week had 0.34 kg (95% CI: 0.15–0.53; p < 0.001) and 1.23 kg (95% CI: 0.92–1.54) less weight gain than those with 0–6 MPAH, respectively. Among participants who were nonobese (body mass index [BMI] < 30 kg/m2) at baseline, pooled HR (95% CI) of developing obesity (BMI ≥ 30 kg/m2) was 0.86 (0.82–0.91; p-trend < 0.001) when extreme MPAH groups (11–14 MPAH versus 0–6 MPAH) were compared. When midday and evening MPAH were analyzed separately, HRs comparing extreme groups (5–7 MPAH versus 0–2 MPAH) were 0.93 (95% CI: 0.89–0.97, p-trend = 0.003) for midday MPAH and 0.76 (95% CI: 0.70–0.83; p-trend < 0.001) for evening MPAH. Further adjusting for BMI during follow-up attenuated the association between MPAH and T2D risk: the HR (95% CI) for participants with 11–14 MPAH was 0.95 (0.89–1.01, p-trend = 0.13). The main limitations of our study were that it lacked assessments on individual foods constituting the MPAH and that the findings were limited to health professionals with a relatively homogeneous socioeconomic status. Conclusions In two large prospective cohort studies, frequent consumption of MPAH is associated with a lower risk of developing T2D, and this association is partly attributable to less weight gain linked with this dining behavior.

Dietary Intakes and Circulating Concentrations of Branched-Chain Amino Acids in Relation to Incident Type 2 Diabetes Risk Among High-Risk Women with a History of Gestational Diabetes Mellitus.

Abstract: Background: Circulating branched-chain amino acids (BCAAs; isoleucine, leucine, valine) are consistently associated with increased type 2 diabetes (T2D) risk, but the relationship with dietary intake of BCAAs is less clear. Methods: The longitudinal Nurses9 Health Study II cohort conducted a blood collection from 1996 to 1999. We profiled plasma metabolites among 172 incident T2D cases and 175 age-matched controls from women reporting a history of gestational diabetes before blood draw. We estimated dietary energy-adjusted BCAAs from food frequency questionnaires. We used conditional logistic regression models to estimate odds ratios (OR) and 95% CI of T2D risk across quartiles (Q1–Q4) of BCAAs, adjusting for age, body mass index (BMI), physical activity, family history, and other established risk factors. We also assessed joint exposure to below/above medians of diet and plasma concentrations, with lower diet/lower plasma as reference. Results: Dietary and plasma BCAA concentrations were positively associated with incident T2D (diet Q4 vs Q1 OR = 4.6, CI = 1.6, 13.4; plasma Q4 vs Q1 OR = 4.4, CI = 1.4, 13.4). Modeling the joint association indicated that higher diet BCAAs were associated with T2D when plasma concentrations were also higher (OR = 6.0, CI = 2.1, 17.2) but not when concentrations were lower (OR = 1.6, CI = 0.61, 4.1). Conversely, higher plasma BCAAs were associated with increased T2D for either lower or higher diet. Conclusions: Independent of BMI and other risk factors, higher diet and plasma BCAA concentrations were associated with an increased incident T2D risk among high-risk women with a history of gestational diabetes, supporting impaired BCAA metabolism as conferring T2D risk.

Vitamin D Deficiency

Abstract: Once foods in the United States were fortified with vitamin D, rickets appeared to have been conquered, and many considered major health problems from vitamin D deficiency resolved. But vitamin D deficiency is common. This review considers the role of vitamin D in skeletal and nonskeletal health and suggests strategies for the prevention and treatment of vitamin D deficiency.

Diagnosis and Management of the Metabolic Syndrome An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement

Abstract: The metabolic syndrome has received increased attention in the past few years. This statement from the American Heart Association (AHA) and the National Heart, Lung, and Blood Institute (NHLBI) is intended to provide up-to-date guidance for professionals on the diagnosis and management of the metabolic syndrome in adults. The metabolic syndrome is a constellation of interrelated risk factors of metabolic origin— metabolic risk factors —that appear to directly promote the development of atherosclerotic cardiovascular disease (ASCVD).1 Patients with the metabolic syndrome also are at increased risk for developing type 2 diabetes mellitus. Another set of conditions, the underlying risk factors , give rise to the metabolic risk factors. In the past few years, several expert groups have attempted to set forth simple diagnostic criteria to be used in clinical practice to identify patients who manifest the multiple components of the metabolic syndrome. These criteria have varied somewhat in specific elements, but in general they include a combination of both underlying and metabolic risk factors. The most widely recognized of the metabolic risk factors are atherogenic dyslipidemia, elevated blood pressure, and elevated plasma glucose. Individuals with these characteristics commonly manifest a prothrombotic state and a pro-inflammatory state as well. Atherogenic dyslipidemia consists of an aggregation of lipoprotein abnormalities including elevated serum triglyceride and apolipoprotein B (apoB), increased small LDL particles, and a reduced level of HDL cholesterol (HDL-C). The metabolic syndrome is often referred to as if it were a discrete entity with a single cause. Available data suggest that it truly is a syndrome, ie, a grouping of ASCVD risk factors, but one that probably has more than one cause. Regardless of cause, the syndrome identifies individuals at an elevated risk for ASCVD. The magnitude of the increased risk can vary according to which components of the syndrome are …