Life Extension Magazine®
Cleveland Clinic Journal Supports Non-Fasting Blood (Lipid) Testing
An article in the prestigious Cleveland Clinic Journal of Medicine has taken a stand in support of performing lipid blood tests without fasting.*
This stance echoes the opinion of Life Extension® as expressed in the As We See It column of our May 2017 issue.
What you need to know
Non-fasting blood tests gain validity; metformin's action on glucose reduces cancer risk; a meta-analysis finds significant vitamin deficiencies among those suffering from psychosis; and researchers have found a relationship between vitamin D levels and ED among diabetics.
The authors, Dr. Zareen Farukhi and Dr. Samia Mora, say that while fasting was for many years the standard practice, nonfasting testing has been gaining acceptance in medical institutions around the world.
They point out that past concerns—such as that an increase in triglyceride concentrations after consuming a fatty meal could reduce the validity of the results—haven't been borne out by research.
As well, the authors write that recent studies "suggest that postprandial effects do not diminish and may even strengthen the risk associations of lipids with cardiovascular disease, in particular for triglycerides."
Moreover, in some patients, such as those with diabetes or metabolic syndrome, fasting could mask abnormalities in high-triglyceride metabolism that can only be detected with a non-fasting test.
The doctors conclude: "For most patients, non-fasting lipid testing is appropriate. It is evidence-based, safe, valid, and convenient."
Editor's Note: The study authors believe that more widespread adoption of nonfasting lipid blood tests by U.S. healthcare providers would improve quality of care and patient and clinician satisfaction.
*Cleve Clin J Med. 2017 Dec;84(12):919-922.
Metformin Reduces Cancer Risk in Type II Diabetics
Recent research has demonstrated an association between metformin use and a reduced risk of cancer in patients with type II diabetes.*
Existing medical research indicates that type II diabetics are at a higher risk of cancer due to insulin resistance and higher blood levels of both insulin and insulin-like growth factors. In order to investigate the relationship between the diabetes medication metformin and cancer incidence, researchers conducted a large-scale, nationwide, prospective, multicenter cohort study in Korea.
In an average follow-up period of 5.8 years, 164 of the 1,918 study subjects developed cancer. In that time, subjects using metformin were almost half as likely to develop cancer as those who did not take the medication.
The reduced risk held true even after controlling for other factors, such as other diabetic medications, various demographic characteristics, and metabolic parameters.
Editor's Note: An analysis of subgroups in the study also showed reduced cancer risk for nonsmokers, non-obese patients, males, and patients with good glycemic control.
*Medicine (Baltimore). 2018 Feb;97(8):e0036.
First Episode Psychosis and Vitamin Deficiencies
Findings from a meta-analysis reveal significantly lower levels of folate and vitamin D among individuals experiencing their first psychotic episode in comparison with control subjects.*
Joseph Firth, Ph.D., of NICM Health Research Institute at Western Sydney University in Australia, and his colleagues analyzed 28 studies that examined blood levels of six vitamins and 10 minerals in 1,221 subjects who presented with first episode psychosis and 1,391 control subjects. They found significantly lower levels of the B vitamin folate and vitamin D in those with first episode psychosis compared to the controls.
Rising levels of both vitamins were associated with decreases in symptoms. The authors remarked that there was also limited evidence for an association between first episode psychosis and reductions in vitamin C.
Editor's Note: "Our research has found vitamin D and folate deficiencies, previously observed in long-term schizophrenia, exist right from illness onset, and are associated with worse symptoms among young people with psychosis," Dr. Firth observed. "Since both of these nutrients are vital for physical and psychological wellbeing, this finding emphasizes the importance of promoting a healthy diet for young people with psychosis, and potentially suggests adding targeted nutritional supplementation to standard treatment could improve recovery, although this theory has yet to be tested."
*Schizophr Bull. 2017 Nov 30.
Low Vitamin D Levels Predict Erectile Dysfunction in Diabetics
An article published in The Aging Male reveals an association between decreased serum vitamin D levels and a greater risk of erectile dysfunction (ED) in diabetics.*
The study included 98 diabetic men. International Index of Erectile Function (IIEF-5) questionnaire scores determined the presence and severity of ED, with higher scores indicative of no ED.
Among the 77 participants with the condition, 45 had moderate ED and 32 had severe ED. Blood samples were analyzed for 25-hydroxyvitamin D levels, hormones and other factors.
A moderate correlation was observed between increased vitamin D levels and higher IIEF scores, particularly among those between 45 and 65 years of age. Men whose IIEF-5 scores were indicative of severe ED had vitamin D blood levels that averaged only 10.51 ng/mL, which was significantly lower than the average levels of participants with no or moderate ED. (Optimal blood levels of 25-hydroxyvitamin D are considered 50-80 ng/mL.)
Editor's Note: "There is a significant relationship between 25(OH)D deficiency and ED in male patients with type II diabetes mellitus," the authors write. "This relationship is considered to be mediated by increased nitric oxide production by 25(OH)D in endothelial cells through various pathways, inhibition of apoptosis and prevention of endothelial dysfunction by preventing against oxidative stress."
*Aging Male. 2017 Sep 23:1-5.