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Sarcopenia Is Associated with Metabolic Syndrome in Korean Adults Aged over 50 Years: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031330. [PMID: 35162353 PMCID: PMC8835141 DOI: 10.3390/ijerph19031330] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 11/16/2022]
Abstract
This study assessed the association between sarcopenia and metabolic syndrome in Korean adults aged over 50 years. The study obtained data from the Korea National Health and Nutrition Examination Survey (KNHANES, 2008–2011), a cross-sectional and nationally representative survey conducted by the Korean Centers for Disease Control and Prevention. Among the 8363 participants included in this study, the prevalence rate of sarcopenia according to metabolic syndrome was stratified by sex. Crude odds ratios not adjusted for any variables were 1.827 (1.496–2.231) in males, 2.189 (1.818–2.635) in females, and 2.209 (1.766–2.331) in total participants compared with non-sarcopenia. Model 3, which was adjusted for all variables that could affect sarcopenia and metabolic syndrome, showed significant increases in the odds ratios, to 1.957 (1.587–2.413) in males, 1.779 (1.478–2.141) in females, and 1.822 (1.586–2.095) for total participants. The results suggest that the association between sarcopenia and metabolic syndrome is significant in Korean adults.
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Bovolini A, Garcia J, Andrade MA, Duarte JA. Metabolic Syndrome Pathophysiology and Predisposing Factors. Int J Sports Med 2020; 42:199-214. [PMID: 33075830 DOI: 10.1055/a-1263-0898] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors with high prevalence among adult populations and elevated costs for public health systems worldwide. Despite the lack of consensus regarding the syndrome definition and diagnosis criteria, it is characterized by the coexistence of risk factors such as abdominal obesity, atherogenic dyslipidemia, elevated blood pressure, a prothrombotic and pro-inflammatory state, insulin resistance (IR), and higher glucose levels, factors indubitably linked to an increased risk of developing chronic conditions, such as type 2 diabetes (T2D) and cardiovascular disease (CVD). The syndrome has a complex and multifaceted origin not fully understood; however, it has been strongly suggested that sedentarism and unbalanced dietary patterns might play a fundamental role in its development. The purpose of this review is to provide an overview from the syndrome epidemiology, costs, and main etiological traits from its relationship with unhealthy diet patterns and sedentary lifestyles.
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Affiliation(s)
| | - Juliana Garcia
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences, University of Trás-os-Montes and Alto Douro, Vila Real
| | | | - José Alberto Duarte
- CIAFEL Faculty of Sport, University of Porto, Porto.,University Institute of Health Sciences (IUCS), Rua Central de Gandra, 1317 4585-116 Gandra Paredes, Portugal
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Park SJ, Ryu SY, Park J, Choi SW. Association of Sarcopenia with Metabolic Syndrome in Korean Population Using 2009-2010 Korea National Health and Nutrition Examination Survey. Metab Syndr Relat Disord 2019; 17:494-499. [PMID: 31634043 PMCID: PMC6892432 DOI: 10.1089/met.2019.0059] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: Some studies have investigated the relationship between sarcopenia and metabolic syndrome, and they have focused mainly on older subjects. Therefore, we assessed the association between sarcopenia and metabolic syndrome in South Korean adults 20 years of age or older using data from the 2009–2010 Korean National Health and Nutrition Examination Survey (KNHANES). Methods: This study involved 12,256 (5350 males and 6906 females) participants from the 2009–2010 KNHANES 20 years of age or older. Appendicular skeletal muscle mass (ASM) was measured by dual X-ray absorptiometry. Sarcopenia index (SI) was calculated as ASM/body mass index and sarcopenia was defined as an SI of <0.789 in males and <0.521 in females. Metabolic syndrome was defined by the presence of at least three of the following abnormalities: abdominal obesity, high blood pressure, high blood glucose level, high triglyceride level, and low high-density lipoprotein cholesterol level. Results: After adjustment for covariates, the association between sarcopenia and metabolic syndrome was significant (odds ratio [OR] 2.06, 95% confidence interval [CI] 1.74–2.45). In addition, when stratified by age groups, the significant associations between sarcopenia and metabolic syndrome remained in all age groups (20–39 years: OR 2.13, 95% CI 1.08–4.19; 40–64 years: OR 2.13, 95% CI 1.68–2.71; ≥65 years: OR 1.98, 95% CI 1.54–2.54). Conclusion: The association between sarcopenia and metabolic syndrome was significant in South Korean adults. Moreover, the significant associations were present in every age group evaluated.
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Affiliation(s)
- Seong-Joon Park
- Department of Public Health, Graduate School of Chosun University, Gwangju, Republic of Korea
| | - So-Yeon Ryu
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Republic of Korea
| | - Jong Park
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Republic of Korea
| | - Seong-Woo Choi
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Republic of Korea
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Xi L, Qian Z. Pharmacological Properties of Crocetin and Crocin (Digentiobiosyl Ester of Crocetin) from Saffron. Nat Prod Commun 2019. [DOI: 10.1177/1934578x0600100112] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Functional plant foods and medicinal herbs provide a wide variety of natural products for new drug research and development. Crocetin and crocin (digentiobiosyl ester of crocetin) are the major bioactive ingredients of saffron which is used as a costly spice, food colorant and traditional herbal medicine. These particular carotenoids have gained much research attention for their extensive pharmacological activities. Following oral administration, crocetin is rapidly absorbed into the blood circulation and widely distributed into the extra-vascular tissues of the body, whereas the water-soluble compound crocin is hardly absorbed through the gastrointestinal tract. Crocetin and crocin have been shown to be effective in the prevention and/or treatment of several diseases such as atherosclerosis, myocardial ischemia, hemorrhagic shock, cancer and cerebral injury. The compounds exert their biological and pharmacological effects largely through their strong antioxidant activity. However, there seems to be substantial variation in the effectiveness of both phytochemicals when used in different diseases. The aim of this review is to discuss the pharmacokinetic and medicinal properties of crocetin and crocin based on related literature and our research results.
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Affiliation(s)
- Liang Xi
- Department of Pharmacology, China Pharmaceutical University, P.O. Box 46, 24 Tongjia Xiang, Nanjing 210009, PR China
| | - Zhiyu Qian
- Department of Pharmacology, China Pharmaceutical University, P.O. Box 46, 24 Tongjia Xiang, Nanjing 210009, PR China
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Damanhoury S, Newton AS, Rashid M, Hartling L, Byrne JLS, Ball GDC. Defining metabolically healthy obesity in children: a scoping review. Obes Rev 2018; 19:1476-1491. [PMID: 30156016 DOI: 10.1111/obr.12721] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 05/17/2018] [Accepted: 05/18/2018] [Indexed: 01/01/2023]
Abstract
We conducted a scoping review to identify definitions of metabolically healthy obesity (MHO), describe gaps in the literature, and establish a universal definition of MHO in children. We searched electronic databases from January 1980 to June 2017 and grey literature. Experimental, quasi-experimental, or observational studies were eligible for inclusion if they (i) included a definition of MHO that identified risk factors, cut-off values, and the number of criteria used to define MHO, and (ii) classified 2-18 year olds as overweight or obese. Two reviewers independently screened 1,711 papers for relevance and quality; we extracted data from 39 individual reports that met inclusion criteria. Most (31/39; 79%) definitions of MHO included an absence of cardiometabolic risk factors. Heterogeneity across MHO definitions, obesity criteria, and sample sizes/characteristics resulted in variable prevalence estimates (3-80%). Finally, we convened an international panel of 46 experts to complete a 4-round Delphi process to generate a consensus-based definition of MHO. Based on consensus (≥ 80% agreement), our definition of MHO included: high density lipoprotein-cholesterol > 40 mg/dl (or > 1.03 mmol/l), triglycerides ≤ 150 mg/dl (or ≤ 1.7 mmol/l), systolic and diastolic blood pressure ≤ 90th percentile, and a measure of glycemia. This definition of MHO holds potential universal value to enable comparisons between studies and inform clinical decision-making for children with obesity.
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Affiliation(s)
- S Damanhoury
- Department of Agricultural, Food, and Nutritional Science, Faculty of Agricultural, Life, and Environmental Sciences, University of Alberta, Edmonton, AB, Canada
| | - A S Newton
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - M Rashid
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - L Hartling
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - J L S Byrne
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - G D C Ball
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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Abstract
Diabetes mellitus (DM) is a critical and long-term disorder due to the insufficient production of insulin by the pancreas or ineffective use of insulin by the body. Importantly, cardiovascular disease (CVD) has long been thought to be linked with diabetes. Despite more diabetic individuals surviving from better medications and treatments, there has been significant rise in the morbidity and mortality from CVD. Indeed, the classification of DM based on the electrocardiogram signals of the heart will be an advantageous system. Further, computer-aided classification of DM with integrated algorithms may enhance the execution of the system. In this paper, we have reviewed various studies using heart rate variability signals for automated classification of diabetes. Furthermore, the different techniques used to extract the features and the efficiency of the classification systems are discussed.
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Affiliation(s)
- MUHAMMAD ADAM
- Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore
| | - JEN HONG TAN
- Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore
| | - EDDIE Y. K. NG
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore
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Nutrigenomic Functions of PPARs in Obesogenic Environments. PPAR Res 2016; 2016:4794576. [PMID: 28042289 PMCID: PMC5155092 DOI: 10.1155/2016/4794576] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 10/03/2016] [Indexed: 12/26/2022] Open
Abstract
Peroxisome proliferator-activated receptors (PPARs) are ligand-activated transcription factors that mediate the effects of several nutrients or drugs through transcriptional regulation of their target genes in obesogenic environments. This review consists of three parts. First, we summarize current knowledge regarding the role of PPARs in governing the development of white and brown/beige adipocytes from uncommitted progenitor cells. Next, we discuss the interactions of dietary bioactive molecules, such as fatty acids and phytochemicals, with PPARs for the modulation of PPAR-dependent transcriptional activities and metabolic consequences. Lastly, the effects of PPAR polymorphism on obesity and metabolic outcomes are discussed. In this review, we aim to highlight the critical role of PPARs in the modulation of adiposity and subsequent metabolic adaptation in response to dietary challenges and genetic modifications. Understanding the changes in obesogenic environments as a consequence of PPARs/nutrient interactions may help expand the field of individualized nutrition to prevent obesity and obesity-associated metabolic comorbidities.
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Kuo YH, Lin CH, Shih CC. Dehydroeburicoic Acid from Antrodia camphorata Prevents the Diabetic and Dyslipidemic State via Modulation of Glucose Transporter 4, Peroxisome Proliferator-Activated Receptor α Expression and AMP-Activated Protein Kinase Phosphorylation in High-Fat-Fed Mice. Int J Mol Sci 2016; 17:E872. [PMID: 27271603 PMCID: PMC4926406 DOI: 10.3390/ijms17060872] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 05/26/2016] [Accepted: 05/27/2016] [Indexed: 01/19/2023] Open
Abstract
This study investigated the potential effects of dehydroeburicoic acid (TT), a triterpenoid compound from Antrodia camphorata, in vitro and examined the effects and mechanisms of TT on glucose and lipid homeostasis in high-fat-diet (HFD)-fed mice. The in vitro study examined the effects of a MeOH crude extract (CruE) of A. camphorata and Antcin K (AnK; the main constituent of fruiting body of this mushroom) on membrane glucose transporter 4 (GLUT4) and phospho-Akt in C2C12 myoblasts cells. The in vitro study demonstrated that treatment with CruE, AnK and TT increased the membrane levels of glucose transporter 4 (GLUT4) and phospho-Akt at different concentrations. The animal experiments were performed for 12 weeks. Diabetic mice were randomly divided into six groups after 8 weeks of HFD-induction and treated with daily oral gavage doses of TT (at three dose levels), fenofibrate (Feno) (at 0.25 g/kg body weight), metformin (Metf) (at 0.3 g/kg body weight) or vehicle for another 4 weeks while on an HFD diet. HFD-fed mice exhibited increased blood glucose levels. TT treatment dramatically lowered blood glucose levels by 34.2%~43.4%, which was comparable to the antidiabetic agent-Metf (36.5%). TT-treated mice reduced the HFD-induced hyperglycemia, hypertriglyceridemia, hyperinsulinemia, hyperleptinemia, and hypercholesterolemia. Membrane levels of GLUT4 were significantly higher in CruE-treated groups in vitro. Skeletal muscle membrane levels of GLUT4 were significantly higher in TT-treated mice. These groups of mice also displayed lower mRNA levels of glucose-6-phosphatase (G6 Pase), an inhibitor of hepatic glucose production. The combination of these agents produced a net hypoglycemic effect in TT-treated mice. TT treatment enhanced the expressions of hepatic and skeletal muscle AMP-activated protein kinase (AMPK) phosphorylation in mice. TT-treated mice exhibited enhanced expression of hepatic fatty acid oxidation enzymes, including peroxisome proliferator-activated receptor α (PPARα) and increased mRNA levels of carnitine palmitoyl transferase Ia (CPT-1a). These mice also exhibited decreased expression levels of lipogenic fatty acid synthase (FAS) in liver and adipose tissue and reduced mRNA levels of hepatic adipocyte fatty acid binding protein 2 (aP2) and glycerol-3-phosphate acyltransferase (GPAT). These alterations resulted in a reduction in fat stores within the liver and lower triglyceride levels in blood. Our results demonstrate that TT is an excellent therapeutic approach for the treatment of type 2 diabetes and hypertriglyceridemia.
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Affiliation(s)
- Yueh-Hsiung Kuo
- Department of Chinese Pharmaceutical Sciences and Chinese Medicine Resources, China Medical University, Taichung City 40402, Taiwan.
- Department of Biotechnology, Asia University, Taichung City 41354, Taiwan.
| | - Cheng-Hsiu Lin
- Department of Internal Medicine, Fengyuan Hospital, Ministry of Health and Welfare, Fengyuan District, Taichung City 42055, Taiwan.
| | - Chun-Ching Shih
- Graduate Institute of Pharmaceutical Science and Technology, College of Health Science, Central Taiwan University of Science and Technology, No. 666 Buzih Road, Beitun District, Taichung City 40601, Taiwan.
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Hermans MP, Amoussou-Guenou KD, Bouenizabila E, Sadikot SS, Ahn SA, Rousseau MF. The normal-weight type 2 diabetes phenotype revisited. Diabetes Metab Syndr 2016; 10:S82-S88. [PMID: 26960924 DOI: 10.1016/j.dsx.2016.01.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Type 2 diabetes (T2DM) is associated with obesity, insulin resistance and the metabolic syndrome (MetS). In non-diabetic populations, features of metabolic obesity (MO) are observed in a minority of normal-weight (NW) subjects. The cardiometabolic status of metabolically obese but normal-weight (MONW) individuals has not yet been phenotyped in T2DM. PATIENTS AND METHODS Prevalence and features of MONW were analyzed in 1244 T2DM patients, in whom MONW was identified as a BMI <25.0 and a MetS score ≥3/5. Among NW (n=262; 21%), those without MetS (n=152; NW-MetS[-]) were compared to NW-MetS[+] (n=110; i.e. 42% of NW and 9% of all T2DM). RESULTS There were no differences between groups in age; gender; diabetes duration; smoking; BP; and LDL-C. NW-MetS[+] had higher BMI; waist; fat mass; visceral fat; liver steatosis and HbA1c, and lower insulin sensitivity. Non-right-handedness was twice-higher (18%) in NW-MetS[-]. NW-MetS[+] had higher apoB100 and triglycerides, and lower HDL-C and LDL size. Macroangiopathy was present in 39% of NW-MetS[+] vs. 22% of NW-MetS[-], as coronary (23% vs. 14%) or peripheral artery disease (14% vs. 5%) and TIA/stroke (15% vs. 7%). Microangiopathy was present in 54% of NW-MetS[+] vs. 32% of NW-MetS[-], as retinopathy (25% vs. 13%); neuropathy (29% vs. 18%); and albuminuria (39% vs. 20%). CONCLUSIONS MONW among T2DM represents a significant minority (about 1 in 10). Their cardiometabolic phenotype deserves attention due to multiple comorbidities, including a twice-higher prevalence of micro-/macrovascular damage in patients wrongly perceived at lower risk due to normal BMI. Unexpectedly, non-right-handedness was over-represented among metabolically healthy patients.
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Affiliation(s)
- Michel P Hermans
- Division of Endocrinology & Nutrition, Cliniques universitaires St-Luc and Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium.
| | - K Daniel Amoussou-Guenou
- Departmental Hospital and University Centre 1, Service de Médecine interne-Endocrinologie, CHUD/OP Porto-Novo, Université d'Abomey-Calavi, Benin
| | - Evariste Bouenizabila
- Service de Maladies Métaboliques et Endocriniennes, Centre Hospitalier et Universitaire de Brazzaville, Congo
| | - Shaukat S Sadikot
- International Diabetes Federation & Diabetes India, 50, Manoel Gonsalves Rd., Bandra (W), Mumbai 400050, India
| | - Sylvie A Ahn
- Division of Cardiology, Cliniques universitaires St-Luc and Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium
| | - Michel F Rousseau
- Division of Cardiology, Cliniques universitaires St-Luc and Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium
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Hermans MP, Bouenizabila E, Ahn SA, Rousseau MF. How to transform a metabolic syndrome score into an insulin sensitivity value? Diabetes Metab Res Rev 2016; 32:87-94. [PMID: 26111860 DOI: 10.1002/dmrr.2675] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 03/31/2015] [Accepted: 06/12/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND The metabolic syndrome (MetS) predicts cardiovascular risk and incident type 2 diabetes mellitus. The presence of a MetS is defined by the clustering of ≥3 out of 5 cardiometabolic criteria (hyperglycemia; hypertension; enlarged waist; low high-density lipoprotein-cholesterol; and hypertriglyceridemia), each of which is connected with insulin resistance. It is not known whether the severity of MetS, ranked from the sextet of scores range [0/5 to 5/5], is linearly related to reduced insulin sensitivity (IS) and/or lesser hyperbolic product across the glycemic spectrum. PATIENTS AND METHODS A total of 839 adults (54 normoglycemic; 785 with abnormal glucose homeostasis, among whom 711 type 2 diabetes mellitus) had insulin sensitivity assessed together with their cardiometabolic phenotype. RESULTS There was a significant gradient according to interval-scale MetS score in insulinemia; body mass index; (visceral) fat; hepatic steatosis; and macroangiopathy. There was an inverse linear relationship between increasing MetS scores and decreased insulin sensitivity, allowing to define an insulin resistance-predicting linear equation: IS (%) = [-15.1 × MetS score] + 109.4 (R(2) = 0.221). For each MetS category, mean IS values did not significantly differ between groups of patients across the glycemic spectrum. The hyperbolic product (β-cell function × IS) and/or its loss rate were inversely related to MetS severity. CONCLUSION Insulin sensitivity is linearly and inversely related to MetS severity across the 6 scores. This novel way to exploit information intrinsic to the MetS criteria provides an easy and low cost means to quantify insulin sensitivity across the glycemic spectrum. Moreover, a higher MetS score is associated with lesser residual insulin secretion, and faster B-cell function loss. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Michel P Hermans
- Division of Endocrinology and Nutrition, Cliniques universitaires St-Luc and Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium
| | - Evariste Bouenizabila
- Service des Maladies Métaboliques et Endocriniennes, Centre Hospitalier et Universitaire de Brazzaville, Congo
| | - Sylvie A Ahn
- Division of Cardiology, Cliniques universitaires St-Luc and Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium
| | - Michel F Rousseau
- Division of Cardiology, Cliniques universitaires St-Luc and Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium
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11
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Canoy D, Barber TM, Pouta A, Hartikainen AL, McCarthy MI, Franks S, Järvelin MR, Tapanainen JS, Ruokonen A, Huhtaniemi IT, Martikainen H. Serum sex hormone-binding globulin and testosterone in relation to cardiovascular disease risk factors in young men: a population-based study. Eur J Endocrinol 2014; 170:863-72. [PMID: 24670886 DOI: 10.1530/eje-13-1046] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Reduced sex hormone-binding globulin (SHBG) concentration predicts insulin resistance and type 2 diabetes, but its association with cardiovascular disease (CVD) risk is unclear. We examined the association between SHBG and cardiovascular risk factors, independently of total testosterone (TT), in young men. DESIGN Observational, cross-sectional study. SETTING General community. PARTICIPANTS The study included 2716 men aged 31 years in the Northern Finland Birth Cohort in 1996 with clinical examination data and fasting blood samples. OUTCOME VARIABLES Blood pressure (BP), lipids and C-reactive protein (CRP) as biological CVD risk markers. RESULTS SHBG concentration was significantly and inversely related to systolic and diastolic BP, triglycerides and CRP, but positively to HDL cholesterol after adjusting for insulin, BMI, waist circumference, smoking, education and physical activity (all P<0.05). These linearly graded associations persisted with additional adjustment for TT. SHBG was significantly associated with total cholesterol only with adjustment for covariates and TT (P<0.05). The direction and magnitude of associations between TT and risk factors were variable, but further adjustment for insulin, adiposity and SHBG showed positive associations between TT and BP, total and LDL-cholesterol and triglycerides and an inverse association with CRP (all P<0.05), but its relation with HDL-cholesterol was no longer significant. CONCLUSIONS In this cohort of young adult men, higher SHBG concentration was associated with a more favourable CVD risk profile, independently of TT. SHBG concentration modified the associations of TT with CVD risk factors.
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Affiliation(s)
- D Canoy
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| | - T M Barber
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| | - A Pouta
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| | - A L Hartikainen
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| | - M I McCarthy
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, FinlandCancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of
| | - S Franks
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| | - M R Järvelin
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, FinlandCancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of
| | - J S Tapanainen
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, FinlandCancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of
| | - A Ruokonen
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, FinlandCancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of
| | - I T Huhtaniemi
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| | - H Martikainen
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
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Shih CC, Shlau MT, Lin CH, Wu JB. Momordica charantia
Ameliorates Insulin Resistance and Dyslipidemia with Altered Hepatic Glucose Production and Fatty Acid Synthesis and AMPK Phosphorylation in High-fat-fed Mice. Phytother Res 2013; 28:363-71. [DOI: 10.1002/ptr.5003] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Revised: 03/23/2013] [Accepted: 03/25/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Chun-Ching Shih
- Graduate Institute of Pharmaceutical Science and Technology; Central Taiwan University of Science and Technology; No.666, Buzih Road Beitun District Taichung City 40601 Taiwan, ROC
| | - Min-Tzong Shlau
- College of Health Science; Central Taiwan University of Science and Technology; No.666, Buzih Road Beitun District Taichung City 40601 Taiwan, ROC
| | - Cheng-Hsiu Lin
- Department of Internal Medicine; Fong-Yuan Hospital, Department of Health, Executive Yuan; No.100, An-Kan Road Fongyuan District Taichung City 42055 Taiwan, ROC
| | - Jin-Bin Wu
- Graduate Institute of Pharmaceutical Chemistry; China Medical University; Taichung Taiwan, ROC
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Validation of the Antidiabetic and Hypolipidemic Effects of Hawthorn by Assessment of Gluconeogenesis and Lipogenesis Related Genes and AMP-Activated Protein Kinase Phosphorylation. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:597067. [PMID: 23690849 PMCID: PMC3652187 DOI: 10.1155/2013/597067] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 02/20/2013] [Indexed: 01/19/2023]
Abstract
Since with the increased use of antidiabetic and antihyperlipidemic effect of phytonutrients for daily supplement has gained considerable attention worldwide, we examine the effect and molecular mechanism of Crataegus pinnatifida Bge. var. major N.E. Br. (hawthorn) by quantifying the expression of hepatic gluconeogenesis and lipogenesis on diabetes and dyslipidemia in high-fat (HF)-fed C57BL/6J mice. Firstly, mice were divided randomly into two groups: the control (CON) group was fed with a low-fat diet, whereas the experimental group was fed a 45% HF diet for 8 weeks. Afterwards, the CON group was treated with vehicle, whereas the HF group was subdivided into five groups and was given orally hawthorn extract (including 0.2, 0.5, 1.0 g/kg/day extracts) or rosiglitazone (Rosi) or vehicle for 4 weeks afterward. Diabetic mice showed an increase in plasma glucose and insulin. Glucose lowering was comparable with Rosi-treated mice. This study demonstrated that hawthorn was effective in ameliorating the HF diet-induced hyperglycemia, hypertriglyceridemia and hypercholesterolaemia. Hawthorn extract significantly increases the hepatic protein contents of AMP-activated protein kinase (AMPK) phosphorylation and reduces expression of phosphenol pyruvate carboxykinase (PEPCK) and glucose production. Furthermore, hawthorn decreased in hepatic triacylglycerol and cholesterol synthesis (including sterol regulatory element binding protein-1c (SREBP-1c), fatty acid synthase (FAS), SREBP2). An increase in expressions of apoA-I gene and high-density lipoprotein cholesterol (HDL-C) was detected in HF-fed mice treated with high dose hawthorn. Our data suggest that hawthorn extract are capable of decreasing glucose production and triacylglycerol synthesis by inducing AMPK-phosphorylation and hawthorn is a candidate source of antidiabetic and antihyperlipidemic phytonutrients factors.
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Farah R, Shurtz-Swirski R, Khamisy-Farah R. Lercanidipine effect on polymorphonuclear leukocyte-related inflammation and insulin resistance in essential hypertension patients. Cardiol Ther 2012; 1:4. [PMID: 25135158 PMCID: PMC4107444 DOI: 10.1007/s40119-012-0004-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Inflammation, insulin resistance, and oxidative stress (OS) are among the mechanisms that have been implicated in the pathogenesis of essential hypertension (EH). Peripheral polymorphonuclear leukocytes (PMNLs) are primed in EH patients, releasing uncontrolled superoxide anions contributing to OS in these patients. PMNL priming correlates with insulin resistance and PMNL intracellular calcium ([Ca(2+)]i). Recent studies have attributed additional anti-ischemic and antioxidative characteristics to the antihypertensive drug, lercanidipine, a third-generation calcium-channel blocker. The purpose of this study was to evaluate the possible nontraditional effect of 2 months of lercanidipine treatment on insulin resistance and on PMNL-related inflammation in EH patients. METHODS Non-smoking EH patients with untreated mild-to-moderate high blood pressure (BP) were included. Low-grade inflammation was reflected by PMNL apoptosis and by white blood cell (WBC) and PMNL counts. Systemic inflammation was measured by plasma fibrinogen, C-reactive protein (CRP), and transferrin and albumin levels. Fasting serum insulin levels served as a marker of insulin resistance. RESULTS Two months of lercanidipine treatment showed a significant decrease in BP, WBC, and PMNL counts, PMNL apoptosis, CRP, and serum insulin levels, and a significant increase in serum albumin levels. Rates of superoxide release from PMNLs, WBC and PMNL counts, and insulin levels positively correlated with mean arterial BP values. CONCLUSION The use of lercanidipine can be favorable in EH patients due to its combined anti-PMNL priming and anti-inflammatory effects, in addition to its antihypertensive characteristics.
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Affiliation(s)
- Raymond Farah
- Department of Internal Medicine B, Ziv Medical Center, Safed, Israel,
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15
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Bauer S, Bala M, Kopp A, Eisinger K, Schmid A, Schneider S, Neumeier M, Buechler C. Adipocyte chemerin release is induced by insulin without being translated to higher levels in vivo. Eur J Clin Invest 2012; 42:1213-20. [PMID: 22924572 DOI: 10.1111/j.1365-2362.2012.02713.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Chemerin is an adipokine that regulates insulin sensitivity and insulin secretion. Prolonged hyperinsulinaemia is associated with higher systemic chemerin, and insulin induces adipose tissue chemerin release. These findings led us to hypothesize that systemic chemerin may be associated with post-prandial glucose metabolism and/or may even be induced after oral glucose load. Therefore, the effect of insulin on adipocyte chemerin levels and systemic chemerin in mice was analysed. Further, systemic levels of chemerin after oral glucose load in nondiabetic individuals were studied. DESIGN AND METHODS Chemerin levels were determined in adipocytes after short-term and long-term treatment with insulin. Effects of acute hyperinsulinaemia were studied in mice. Chemerin was measured during oral glucose tolerance test in 66 healthy, nondiabetic individuals stratified for established body mass index categories. RESULTS Insulin induces chemerin release from adipocytes within 24 h, while cellular levels are not affected. Short-term hyperinsulinaemia also upregulates adipocyte chemerin in vitro but has no effect on adipose tissue and chemerin serum levels of mice. Systemic chemerin is higher in overweight/obese than normal-weight controls and positively correlates with total cholesterol. Chemerin is not associated with markers of insulin sensitivity like fasting glucose or insulin. Fasting chemerin levels are similar to concentrations measured 1 and 2 h after oral glucose uptake in overweight and obese donors. CONCLUSIONS Post-prandial hyperinsulinaemia does not contribute to higher chemerin levels in nondiabetic individuals.
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Affiliation(s)
- Sabrina Bauer
- Department of Internal Medicine I, Regensburg University Hospital, Regensburg, Germany
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16
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Hsieh CH, Hung YJ, Wu LI, He CT, Lee CH, Hsiao FC, Chu NF. Interleukin-6 receptor gene 48892 A/C polymorphism is associated with metabolic syndrome in female Taiwanese adolescents. Genet Test Mol Biomarkers 2012; 16:1376-81. [PMID: 23094986 DOI: 10.1089/gtmb.2012.0188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study was to evaluate the relationship between the interleukin-6 receptor (IL-6R) 48892 A/C single-nucleotide polymorphism (SNP) (rs8192284) and the metabolic syndrome (MetS) and its components among young adolescents in Taiwan. METHODS We enrolled 925 adolescents (451 boys and 474 girls). Modified National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP-III) criteria were applied to define MetS (with age- and gender-specific 90th percentile cutoff point of variables). Subjects had three or more of the following cardiometabolic abnormalities that occur in MetS: high blood pressure, high fasting glucose, high triglyceride (TG), low high-density lipoprotein cholesterol (HDL-C), and obesity. The characteristics of the MetS components associated with different alleles and genotypes of the IL-6R rs8192284 SNP were compared. RESULTS Frequencies of alleles and genotypes of the IL-6R 48892 polymorphism were similar in both sexes. Boys with C-alleles had borderline lower TG levels than A-allele carriers (66.0±30.1 vs. 70.3±34.6 mg/dL, p=0.07). However, girls with C-alleles had higher waist circumference (WC) (68.0±7.9 vs. 67.0±7.7 cm) and lower HDL-C levels (50.7±11.1 vs. 52.2±11.7 g/dL) than A-allele carriers (p=0.05). The prevalence of MetS and its components, high WC and low HDL-C level, were higher in female C-allele carriers (all p<0.05) but not in boys. The odds ratios for high WC, low HDL-C levels, and MetS for female C-allele carriers were 1.54 (95% confidence interval [CI]: 1.01-2.34), 1.49 (95% CI: 1.01-2.18), and 2.19-2.39 (95% CI: 1.15-4.51), respectively, when compared with A-allele carriers. CONCLUSIONS The IL-6R 48892 A/C polymorphism is associated with high TG and WC, and low HDL-C levels in adolescents. Additionally, there is a gender difference in the incidence of MetS, indicating a possible gene-gender interaction of the IL-6R 48892 A/C polymorphism in MetS among Taiwanese adolescents.
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Affiliation(s)
- Chang-Hsun Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
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Chu NF, Shen MH, Wu DM, Lai CJ. Relationship between Plasma Adiponectin Levels and Metabolic Risk Profiles in Taiwanese Children. ACTA ACUST UNITED AC 2012; 13:2014-20. [PMID: 16339134 DOI: 10.1038/oby.2005.247] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Adiponectin, a novel adipokine with antiinflammatory and insulin-sensitizing properties, has an important role in glucose metabolism and is negatively correlated with body fat amount in adults. The purpose of this study was to evaluate the association of plasma adiponectin level with metabolic risk profiles and insulin resistance status among Taiwanese children. RESEARCH METHODS AND PROCEDURES We enrolled 1,248 children (608 boys and 640 girls) to ascertain their demographic, anthropometric, and cardiovascular risk factors distribution in Taipei. We measured plasma insulin, adiponectin, and leptin levels by radioimmunoassay (Linco Research Inc, St. Charles, MO). We calculated an insulin resistance index (IRI) using the Homeostasis Model Assessment model and also calculated an insulin resistance syndrome (IRS) summary score for each individual by adding the quartile ranks from the distribution of systolic blood pressure, serum triglyceride, high-density lipoprotein-cholesterol (HDL-C) (inverse), and insulin levels. RESULTS In general, the boys had larger BMI, higher systolic blood pressure, serum total cholesterol, and triglyceride, and lower plasma leptin and adiponectin levels than girls. Plasma adiponectin levels were correlated negatively with BMI, leptin, insulin, IRI, and IRS summary score but positively correlated with HDL-C in both boys and girls. In multivariate regression analyses, adiponectin was negatively associated with insulin (girls only), IRI (girls only), and IRS score, and positively associated with HDL-C in both genders even after adjusting for age, BMI, plasma leptin level, and other potential confounders. DISCUSSION These data suggest that plasma adiponectin levels were negatively associated with metabolic risk profiles that may have played a protective role in the development of insulin resistance among Taiwanese school children.
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Affiliation(s)
- Nain-Feng Chu
- Department of Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Number 325, Section 2, Cheng-Gong Road, Taipei, Taiwan, R.O.C.
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Caballero Corredor J. Análisis de la situación de los diabéticos tipo 2 en Cieza. Estudio DIABETCIEZA 2010. Semergen 2012. [DOI: 10.1016/j.semerg.2011.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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RETRACTED: Aerobic endurance training improves weight loss, body composition, and co-morbidities in patients after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis 2010; 6:260-6. [DOI: 10.1016/j.soard.2010.01.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2009] [Revised: 12/02/2009] [Accepted: 01/28/2010] [Indexed: 11/24/2022]
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Biomarkers of the metabolic syndrome and breast cancer prognosis. Cancers (Basel) 2010; 2:721-39. [PMID: 24281091 PMCID: PMC3835101 DOI: 10.3390/cancers2020721] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Revised: 04/13/2010] [Accepted: 04/26/2010] [Indexed: 12/28/2022] Open
Abstract
In spite of its public health importance, our understanding of the mechanisms of breast carcinogenesis and progress is still evolving. The metabolic syndrome (MS) is a constellation of biochemical abnormalities including visceral adiposity, hyperglycemia, hyperinsulinemia, dyslipidemia and high blood pressure. The components of the MS have all been related to late-stage disease and even to a poor prognosis of breast cancer through multiple interacting mechanisms. In this review, we aim to present a summary of recent advances in the understanding of the contribution of the MS to breast cancer with the emphasis on the role of biomarkers of the MS in the prognosis of breast cancer.
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Yun JE, Kimm H, Jo J, Jee SH. Serum leptin is associated with metabolic syndrome in obese and nonobese Korean populations. Metabolism 2010; 59:424-9. [PMID: 19846168 DOI: 10.1016/j.metabol.2009.08.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2009] [Revised: 08/08/2009] [Accepted: 08/14/2009] [Indexed: 02/08/2023]
Abstract
Leptin is mainly secreted from adipose tissue and is known to be associated with cardiovascular diseases. However, there are not many studies on the association between serum leptin and metabolic syndrome. The objective of this study was to determine the association between serum leptin and metabolic syndrome among the Korean adult population. The study population consisted of 3,272 Koreans (men: 1,915, women: 1,357) 30 to 84 years of age who had visited the Health Examination Center. Leptin levels were divided into quintiles and metabolic syndrome was defined by NCEP ATP III. The serum leptin levels increased as the number of components present for metabolic syndrome increased. Controlling for age, smoking, exercise, and LDL cholesterol, subjects with high leptin levels were more likely to have an elevated risk of metabolic syndrome than those with lower levels in both men and women. Subjects in the highest leptin quintile were found to have a higher risk of having metabolic syndrome than those in the lowest quintile (OR = 11.51 for men; OR = 4.65 for women). After further adjustment of the BMI, the risk of metabolic syndrome still increased slightly for men but not for women in increasing leptin categories. This association of leptin levels and metabolic syndrome did not change after stratification into obese and nonobese weight status. Serum leptin is associated with metabolic syndrome in Korean populations independent of body mass index. Thus, the reduction of circulating leptin may confer cardiovascular and metabolic protective effects regardless of weight status.
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Affiliation(s)
- Ji Eun Yun
- Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul 120-752, Republic of Korea
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Barr ELM, Cameron AJ, Balkau B, Zimmet PZ, Welborn TA, Tonkin AM, Shaw JE. HOMA insulin sensitivity index and the risk of all-cause mortality and cardiovascular disease events in the general population: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab) study. Diabetologia 2010; 53:79-88. [PMID: 19894029 DOI: 10.1007/s00125-009-1588-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2009] [Accepted: 09/24/2009] [Indexed: 02/07/2023]
Abstract
AIMS/HYPOTHESIS We assessed whether the relationships between insulin sensitivity and all-cause mortality as well as fatal or non-fatal cardiovascular disease (CVD) events are independent of elevated blood glucose, high blood pressure, dyslipidaemia and body composition in individuals without diagnosed diabetes. METHODS Between 1999 and 2000, baseline fasting insulin, glucose and lipids, 2 h plasma glucose, HbA(1c), anthropometrics, blood pressure, medication use, smoking and history of CVD were collected from 8,533 adults aged >35 years from the population-based Australian Diabetes, Obesity and Lifestyle study. Insulin sensitivity was estimated by HOMA of insulin sensitivity (HOMA-%S). Deaths and fatal or non-fatal CVD events were ascertained through linkage to the National Death Index and medical records adjudication. RESULTS After a median of 5.0 years there were 277 deaths and 225 CVD events. HOMA-%S was not associated with all-cause mortality. Compared with the most insulin-sensitive quintile, the combined fatal or non-fatal CVD HR (95% CI) for quintiles of decreasing HOMA-%S were 1.1 (0.6-1.9), 1.4 (0.9-2.3), 1.6 (1.0-2.5) and 2.0 (1.3-3.1), adjusting for age and sex. Smoking, CVD history, hypertension, lipid-lowering medication, total cholesterol and waist-to-hip ratio moderately attenuated this relationship. However, the association was rendered non-significant by adding HDL. Fasting plasma glucose, but not HOMA-%S significantly improved the prediction of CVD, beyond that seen with other risk factors. CONCLUSIONS/INTERPRETATION In this cohort, HOMA-%S showed no association with all-cause mortality and only a modest association with CVD events, largely explained by its association with HDL. Fasting plasma glucose was a better predictor of CVD than HOMA-%S.
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Affiliation(s)
- E L M Barr
- Department of Epidemiology and Clinical Diabetes, Baker IDI Heart and Diabetes Institute, Caulfield, 3162 VIC, Australia.
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Cytokine biomarkers, endothelial inflammation, and atherosclerosis in the metabolic syndrome: emerging concepts. Am J Med Sci 2009; 338:310-8. [PMID: 19726972 DOI: 10.1097/maj.0b013e3181a4158c] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
In recent years, an explosion of research related to the cellular and vascular accompaniments of the metabolic syndrome has generated intense interest and controversy. Attention has focused on the vascular endothelium, where heightened, low-grade inflammatory processes lead to a continuum of vascular insults ranging from early endothelial derangements to advanced atherosclerosis. Inflammatory biocytokines, such as C-reactive protein, have been speculated to be both markers and mediators of oxidative stress and endovascular toxicity. Adipocytokines originating from fatty tissue have reinforced the concept that fat is a metabolically active organ rather than inert tissue. To fully elucidate its complex pathogenetic mechanisms, further inquiry into the inflammatory components of the metabolic syndrome is warranted. Unraveling the role of emerging proinflammatory markers has the promising potential to shed light into the underlying pathophysiology of the epidemic of obesity and the metabolic syndrome and thus help devise effective therapies.
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Koskinen J, Kähönen M, Viikari JSA, Taittonen L, Laitinen T, Rönnemaa T, Lehtimäki T, Hutri-Kähönen N, Pietikäinen M, Jokinen E, Helenius H, Mattsson N, Raitakari OT, Juonala M. Conventional cardiovascular risk factors and metabolic syndrome in predicting carotid intima-media thickness progression in young adults: the cardiovascular risk in young Finns study. Circulation 2009; 120:229-36. [PMID: 19581494 DOI: 10.1161/circulationaha.108.845065] [Citation(s) in RCA: 133] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Conventional risk factors and metabolic syndrome (MetS) are cross-sectionally associated with subclinical atherosclerosis in young adults. We evaluated the relations of conventional risk factors and MetS to the 6-year progression of carotid intima-media thickness (IMT) in a population of young adults. RESULTS AND METHODS The study included 1809 subjects (aged 32+/-5 years) who had IMT measured in 2001 and 2007. Risk factor measurements included low-density lipoprotein cholesterol, body mass index, C-reactive protein, smoking, and family history of coronary disease in addition to MetS components. We used European Group for the Study of Insulin Resistance, revised National Cholesterol Education Program, and International Diabetes Federation definitions to diagnose MetS in 2001. Waist circumference (P<0.0001), low-density lipoprotein cholesterol (P=0.01), and insulin (P=0.003) were directly associated with IMT progression in a multivariable model adjusted for age, sex, and baseline IMT (model R(2)=24%). When the MetS/European Group for the Study of Insulin Resistance definition was included in the model, it was directly associated with IMT progression (P=0.03), but its inclusion did not improve the model's predictive value. IMT increased 79+/-7 mum (mean+/-SEM) in subjects with MetS according to the MetS/European Group for the Study of Insulin Resistance definition and 42+/-2 mum in subjects without MetS (P<0.0001). In addition, the number of MetS components was linearly associated with IMT progression (P<0.0001). Similar results were seen with MetS/revised National Cholesterol Education Program and MetS/International Diabetes Federation definitions. CONCLUSIONS Obesity, high low-density lipoprotein cholesterol, and high insulin level predicted IMT progression in young adults. All MetS definitions identified young adults with accelerated IMT progression, but we found no evidence that MetS would predict IMT progression more than expected from the sum of its risk components.
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Affiliation(s)
- Juha Koskinen
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
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Pop-Busui R, Oral E, Raffel D, Byun J, Bajirovic V, Vivekanandan-Giri A, Kellogg A, Pennathur S, Stevens MJ. Impact of rosiglitazone and glyburide on nitrosative stress and myocardial blood flow regulation in type 2 diabetes mellitus. Metabolism 2009; 58:989-94. [PMID: 19394661 DOI: 10.1016/j.metabol.2009.02.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2008] [Accepted: 02/03/2009] [Indexed: 10/20/2022]
Abstract
Cardiovascular disease, the leading cause of death in patients with type 2 diabetes mellitus (T2DM), is usually preceded by endothelial dysfunction and altered myocardial blood flow (MBF) regulation. Hyperglycemia, oxidative-nitrosative stress, systemic inflammation, and insulin resistance are implicated in the pathogenesis of abnormal MBF regulation, myocardial ischemia, and apoptosis. However, the impact of oral antihyperglycemic therapy on myocardial perfusion is controversial. Our objective was to explore the effect of rosiglitazone and glyburide on nitrosative stress and MBF regulation in subjects with T2DM. [(13)N]ammonia positron emission tomography and cold pressor testing were used in 27 diabetic subjects (mean age, 49 +/- 11 years; glycohemoglobin, 7% +/- 1.5%) randomized to either rosiglitazone 8 mg/d or glyburide 10 mg/d for 6 months. Isotope dilution gas chromatography-mass spectrometry was used to quantify plasma 3-nitrotyrosine, a stable marker of reactive nitrogen species. At 6 months, there were no significant differences between groups in the mean glycohemoglobin, blood pressure, or plasma lipids. Rosiglitazone significantly reduced plasma nitrotyrosine, high-sensitivity C-reactive protein, and von Willebrand antigen (P < .03 for all) and significantly increased plasma adiponectin (P < .05). No significant changes in these parameters were observed with glyburide. Treatment with glyburide, but not rosiglitazone, resulted in a significant deterioration in both resting and stress MBF. Rosiglitazone, but not glyburide, ameliorated markers of nitrosative stress and inflammation in subjects with T2DM without impairing myocardial perfusion.
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Affiliation(s)
- Rodica Pop-Busui
- Department of Internal Medicine, Division of Metabolism, University of Michigan, Ann Arbor, MI 48109, USA
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Shih CC, Lin CH, Lin WL, Wu JB. Momordica charantia extract on insulin resistance and the skeletal muscle GLUT4 protein in fructose-fed rats. JOURNAL OF ETHNOPHARMACOLOGY 2009; 123:82-90. [PMID: 19429344 DOI: 10.1016/j.jep.2009.02.039] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Revised: 11/12/2008] [Accepted: 02/14/2009] [Indexed: 05/27/2023]
Abstract
AIM OF THE STUDY We investigated the preventive effect of Momordica charantia Linn. (Cucurbitaceae) fruit, commonly known as bitter melon, on hyperglycemia and insulin resistance in rats fed with a fructose-enriched diet. MATERIALS AND METHODS First, rats were divided randomly into two groups: the control group was fed with control diet, whereas the experimental group was fed with a 60% high-fructose diet for 8 weeks. After the first 6 weeks, the fructose-treated rats were further subdivided into six groups and were orally fed with or without Momordica charantia L. or rosiglitazone (ROS) for 2 weeks while rats were still on fructose diet. RESULTS We demonstrated that bitter melon was effective in ameliorating the fructose diet-induced hyperglycemia, hyperleptinemia, hyperinsulinemia, and hypertriglyceridemia as well as in decreasing the levels of free fatty acid (FFA) (P<0.001, P<0.05, P<0.05, P<0.05, P<0.05, respectively). Bitter melon reversed fructose diet-induced hypoadiponectinemia (P<0.05), which provides a therapeutic advantage to insulin resistance in improving insulin sensitivity. Additionally, bitter melon decreased the weights of epididymal (P<0.05) and retroperitoneal white adipose tissue (WAT) (P<0.05). Bitter melon increased the expression of peroxisome proliferator-activated receptor gamma (PPAR gamma) in white adipose tissue (WAT). Conversely, bitter melon decreased the expression of leptin in WAT. Furthermore, we demonstrate that bitter melon significantly increases the mRNA expression and protein of glucose transporter 4 (GLUT4) in skeletal muscle. CONCLUSIONS This study demonstrates, for the first time, the beneficial effects of two different extracts of bitter melon on insulin resistance in rats fed a high-fructose diet thereby producing evidence of the role of changes in expression of PPAR gamma and GLUT4.
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Affiliation(s)
- Chun-Ching Shih
- Institute of Pharmaceutical Science and Technology, College of Health Science, Central Taiwan University of Science and Technology, 11, Po-Tze Lane, Takun, Taichung 406, Taiwan, ROC.
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Fasting insulin is a stronger cardiovascular risk factor in women than in men. Atherosclerosis 2009; 203:640-6. [DOI: 10.1016/j.atherosclerosis.2008.08.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Revised: 07/31/2008] [Accepted: 08/03/2008] [Indexed: 11/18/2022]
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Wiberg B, Sundström J, Zethelius B, Lind L. Insulin sensitivity measured by the euglycaemic insulin clamp and proinsulin levels as predictors of stroke in elderly men. Diabetologia 2009; 52:90-6. [PMID: 18949454 DOI: 10.1007/s00125-008-1171-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Accepted: 09/16/2008] [Indexed: 10/21/2022]
Abstract
AIMS/HYPOTHESIS Our aim was to investigate the predictive power of a panel of variables in glucose and insulin metabolism for the incidence of stroke or transient ischaemic attacks (TIA). We hypothesised that proinsulin and insulin resistance contributes to an increase of risk for fatal and non-fatal stroke/TIA, independently of diabetes and established risk factors. METHODS The study is based on the Uppsala Longitudinal Study of Adult Men cohort. The examinations were performed at age 70 years. RESULTS In 1,151 men free from stroke at baseline, 150 developed stroke or TIA during a median follow-up of 8.8 years. In unadjusted Cox proportional hazards analyses, a 1 SD increase of a predictor variable was associated with an increased risk for stroke/TIA, e.g. plasma insulin (HR 1.19, 95% CI 1.01-1.40), fasting intact proinsulin (HR 1.28, 95% CI 1.09-1.49); whereas a 1 SD increase in insulin sensitivity measured by the euglycaemic insulin clamp method decreased the risk for stroke/TIA (HR 0.81, 95% CI 0.68-0.96). The predictive values of fasting intact proinsulin and insulin sensitivity endured but not that of plasma insulin when adjusting for diabetes. In models adjusting for diabetes, hypertension, atrial fibrillation, electrocardiographic left ventricular hypertrophy, serum cholesterol and smoking, proinsulin remained as a significant predictor of later stroke/TIA (HR 1.22, 95% CI 1.00-1.48) whereas clamp insulin sensitivity did not (HR 0.87, 95% CI 0.71-1.07). CONCLUSIONS/INTERPRETATION Fasting intact proinsulin level and insulin sensitivity at clamp predicted subsequent fatal and non-fatal stroke/TIA, independently of diabetes in elderly men whereas fasting insulin did not.
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Affiliation(s)
- B Wiberg
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala Science Park, Uppsala, Sweden.
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The adipose triglyceride lipase, adiponectin and visfatin are downregulated by tumor necrosis factor-alpha (TNF-alpha) in vivo. Cytokine 2008; 45:12-9. [PMID: 19026557 DOI: 10.1016/j.cyto.2008.10.006] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2008] [Revised: 08/03/2008] [Accepted: 10/10/2008] [Indexed: 11/22/2022]
Abstract
Inflammatory cytokines have been linked to obesity-related insulin resistance. To investigate the effect of TNF-alpha, an inflammatory cytokine, on insulin action, C57BL/6J mice were treated with TNF-alpha for 7 days after which we examined the in vivo effects of TNF-alpha on glucose tolerance and insulin sensitivity with IV glucose tolerance tests and hyperinsulinemic-euglycemic clamps. In addition, we analyzed the in vivo effect of TNF-alpha on several metabolism-related genes and adipocytokines implicated in the development of insulin resistance. TNF-alpha treatment resulted in markedly increased fasting blood glucose, insulin and free fatty acids (FFA) levels and reduced glucose tolerance. During the clamps, the rates insulin-stimulated whole body (G(Rd)) and skeletal muscle glucose uptake (MGU) and insulin's ability to suppress hepatic glucose production (HGP) were decreased in TNF-alpha treated animals, indicating insulin resistance. In addition, both PPARgamma and ATGL mRNA expression in adipose tissues as well as ATGL protein levels in plasma were downregulated. Moreover, adipose mRNA expression and plasma protein levels of adiponectin and visfatin were significantly down-regulated. We conclude that the alterations of PPARgamma, ATGL, adiponectin and visfatin may contribute to the development of insulin resistance mediated by TNF-alpha.
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Renna NF, Vazquez MA, Lama MC, González ES, Miatello RM. Effect of chronic aspirin administration on an experimental model of metabolic syndrome. Clin Exp Pharmacol Physiol 2008; 36:162-8. [PMID: 18785983 DOI: 10.1111/j.1440-1681.2008.05042.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
1. The aim of the present study was to examine the effect of chronic administration of aspirin on metabolic and cardiovascular parameters in fructose-fed rats (FFR), an experimental model of metabolic syndrome. 2. Chronic treatment of FFR with aspirin (10 mg/kg per day for 6 weeks) partially reversed the increment in systolic blood pressure. In addition, chronic aspirin treatment normalized relative heart weight and vascular remodelling of renal and carotid arteries, measured as lumen diameter: medial thickness ratio. 3. Furthermore, chronic aspirin administration completely reversed glucose intolerance and decreased the oxidative status that characterizes the FFR model, as indicated by decreased plasma levels of thiobarbituric acid-reactive substances and aortic NAD(P)H oxidase activity. 4. Prevention of oxidative stress and vascular remodelling in FFR may contribute to the protective actions attributed to aspirin in the treatment of metabolic syndrome.
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Affiliation(s)
- Nicolás F Renna
- Department of Pathology, School of Medicine, National University of Cuyo and Institute of Experimental Medicine and Biology of Cuyo, National Council or Research, Mendoza, Argentina
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Hirai FE, Moss SE, Klein BEK, Klein R. Relationship of glycemic control, exogenous insulin, and C-peptide levels to ischemic heart disease mortality over a 16-year period in people with older-onset diabetes: the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR). Diabetes Care 2008; 31:493-7. [PMID: 18025409 PMCID: PMC2773445 DOI: 10.2337/dc07-1161] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The purpose of this study was to examine the relationship of glycemic control and exogenous and endogenous insulin levels with all-cause and cause-specific mortality (ischemic heart disease and stroke) in an older-onset diabetic population. RESEARCH DESIGN AND METHODS The Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) is an ongoing, prospective, population-based cohort study of individuals with diabetes first examined in 1980-1982. A stratified sample of all individuals with diabetes diagnosed at 30 years of age or older was labeled "older-onset" (n = 1,370). Those participating in the 1984-1986 examination phase (n = 1,007) were included in the analysis. Endogenous insulin was determined by measurements of plasma C-peptide (in nanomoles per liter), and exogenous insulin was calculated in units per kilogram per day. Glycemic control was determined by levels of glycosylated hemoglobin (HbA(1)). RESULTS After 16 years of follow-up, 824 individuals died (all-cause mortality); 358 deaths involved ischemic heart disease and 137 involved stroke. C-peptide and HbA(1) were significantly associated with all-cause and ischemic heart disease mortality in our study. The hazard ratio (95% CI) values for all-cause mortality were 1.12 (1.07-1.17) per 1% increase in HbA(1), 1.20 (0.85-1.69) per 1 unit x kg(-1) x day(-1) increase in exogenous insulin, and 1.15 (1.04-1.29) per 1 nmol/l increase in C-peptide and for ischemic heart disease mortality were 1.14 (1.06-1.22), 1.50 (0.92-2.46), and 1.19 (1.02-1.39) for HbA(1), exogenous insulin, and C-peptide, respectively, after adjusting for relevant confounders. C-peptide was associated with stroke mortality only among men (1.65 [1.07-2.53]). CONCLUSIONS Our results show that individuals with higher endogenous insulin levels are at higher risk of all-cause, ischemic heart disease, and stroke mortality.
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Affiliation(s)
- Flavio E Hirai
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53726, USA
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Biddinger SB, Hernandez-Ono A, Rask-Madsen C, Haas JT, Alemán JO, Suzuki R, Scapa EF, Agarwal C, Carey MC, Stephanopoulos G, Cohen DE, King GL, Ginsberg H, Kahn CR. Hepatic insulin resistance is sufficient to produce dyslipidemia and susceptibility to atherosclerosis. Cell Metab 2008; 7:125-34. [PMID: 18249172 PMCID: PMC4251554 DOI: 10.1016/j.cmet.2007.11.013] [Citation(s) in RCA: 341] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2007] [Revised: 10/15/2007] [Accepted: 11/20/2007] [Indexed: 12/18/2022]
Abstract
Insulin resistance plays a central role in the development of the metabolic syndrome, but how it relates to cardiovascular disease remains controversial. Liver insulin receptor knockout (LIRKO) mice have pure hepatic insulin resistance. On a standard chow diet, LIRKO mice have a proatherogenic lipoprotein profile with reduced high-density lipoprotein (HDL) cholesterol and very low-density lipoprotein (VLDL) particles that are markedly enriched in cholesterol. This is due to increased secretion and decreased clearance of apolipoprotein B-containing lipoproteins, coupled with decreased triglyceride secretion secondary to increased expression of Pgc-1 beta (Ppargc-1b), which promotes VLDL secretion, but decreased expression of Srebp-1c (Srebf1), Srebp-2 (Srebf2), and their targets, the lipogenic enzymes and the LDL receptor. Within 12 weeks on an atherogenic diet, LIRKO mice show marked hypercholesterolemia, and 100% of LIRKO mice, but 0% of controls, develop severe atherosclerosis. Thus, insulin resistance at the level of the liver is sufficient to produce the dyslipidemia and increased risk of atherosclerosis associated with the metabolic syndrome.
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Affiliation(s)
- Sudha B. Biddinger
- Research Division, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Christian Rask-Madsen
- Research Division, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Joel T. Haas
- Research Division, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | - José O. Alemán
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Ryo Suzuki
- Research Division, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Erez F. Scapa
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Chhavi Agarwal
- Department of Medicine, Columbia University, New York, New York, USA
| | - Martin C. Carey
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Gregory Stephanopoulos
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - David E. Cohen
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - George L. King
- Research Division, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Henry Ginsberg
- Department of Medicine, Columbia University, New York, New York, USA
| | - C. Ronald Kahn
- Research Division, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
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Dagli N, Yavuzkir M, Karaca I. The Effects of High Dose Pravastatin and Low Dose Pravastatin and Ezetimibe Combination Therapy on Lipid, Glucose Metabolism and Inflammation. Inflammation 2007; 30:230-5. [PMID: 17687635 DOI: 10.1007/s10753-007-9041-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2007] [Accepted: 07/16/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Coronary artery disease (CAD) is presently the major cause of mortality and morbidity. Anti-hyperlipidemic treatment is one of the main treatment steps in the management of CAD. Statins are the cornerstones in this treatment. Ezetimibe can be reliably used, when statins prove ineffective in treatment, or to reduce their side effects. In the present study we examined the effects of high-dose pravastatin (40 mg) and low-dose pravastatin (10 mg) + ezetimibe (10 mg) combination therapy on lipid and glucose mechanism, as well as inflammation. METHODS This study registered 100 cases. Of the cases, 50 [57.1 +/- 11.1 years (24 (48%) females and 26 (52%) males)] were administered 40 mg/day pravastatin (group 1) and 50 [53.2 +/- 12.2 years (27 (54%) females and 23 (46%) males)] were administered 10 mg pravastatin + 10 mg ezetimibe (group 2). RESULTS In group 1, total cholesterol fell from 231.1 +/- 83.5 mg/dl to 211.3 +/- 37.2 mg/dl (p = 0.03), triglyceride from 243.5 +/- 96.8 mg/dl to 190.9 +/- 55.2 mg/dl (p = 0.003), and LDL cholesterol from 165.7 +/- 29.7 mg/dl to 133.4 +/- 26.6 mg/dl (p = 0.02). In group 2, total cholesterol dropped from 250.9 +/- 51.8 mg/dl to 187.9 +/- 34.9 mg/dl (p = 0.001), triglyceride from 270.3 +/- 158.9 mg/dl to 154.6 +/- 60.7 mg/dl (p = 0.001), and LDL cholesterol from 158.1 +/- 47.5 mg/dl to 116.9 +/- 26.4 mg/dl (p = 0.001). Insulin resistance decreased from 4.05 +/- 2.31 to 3.16 +/- 1.90 (p = 0.07) in group 1 and from 2.96 +/- 1.50 to 2.05 +/- 0.55 (p = 0.009) in group 2. High sensitive C-reactive protein fell from 6.69 +/- 6.11 mg/l to 3.02 +/- 1.70 mg/l (p = 0.01) in group 1 and from 6.36 +/- 2.06 mg/l to 2.68 +/- 1.69 mg/l (p = 0.001) in group 2. CONCLUSION Both therapy regimes are effective. However, we found that low-dose pravastatin and ezetimibe combination therapy is more effective than high-dose pravastatin therapy on lipid metabolism, glucose metabolism and inflammation.
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Affiliation(s)
- Necati Dagli
- Departments of Cardiology, Firat University, School of Medicine, Elazig, Turkey
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Al-Daghri NM, Al-Attas OS, Al-Rubeaan K, Mohieldin M, Al-Katari M, Jones AF, Kumar S. Serum leptin and its relation to anthropometric measures of obesity in pre-diabetic Saudis. Cardiovasc Diabetol 2007; 6:18. [PMID: 17617917 PMCID: PMC1933413 DOI: 10.1186/1475-2840-6-18] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2007] [Accepted: 07/07/2007] [Indexed: 12/27/2022] Open
Abstract
Background Little information is available on leptin concentrations in individuals with IGT. This study aims to determine and correlate leptin levels to anthropometric measures of obesity in pre-diabetic, (IFG and IGT), type 2 diabetic and normoglycaemic Saudis. Methods 308 adult Saudis (healthy controls n = 80; pre-diabetes n = 86; Type 2 diabetes n = 142) participated. Anthropometric parameters were measured and fasting blood samples taken. Serum insulin was analysed, using a solid phase enzyme amplified sensitivity immunoassay and also leptin concentrations, using radio-immunoassay. The remaining blood parameters were determined using standard laboratory procedures. Results Leptin levels of diabetic and pre-diabetic men were higher than in normoglycaemic men (12.4 [3.2–72] vs 3.9 [0.8–20.0] ng/mL, (median [interquartile range], p = 0.0001). In females, leptin levels were significantly higher in pre-diabetic subjects (14.09 [2.8–44.4] ng/mL) than in normoglycaemic subjects (10.2 [0.25–34.8] ng/mL) (p = 0.046). After adjustment for BMI and gender, hip circumference was associated with log leptin (p = 0.006 with R2 = 0.086) among all subjects. Conclusion Leptin is associated with measures of adiposity, hip circumference in particular, in the non-diabetic state among Saudi subjects. The higher leptin level among diabetics and pre-diabetics is not related to differences in anthropometric measures of obesity.
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Affiliation(s)
- Nasser M Al-Daghri
- Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Omar S Al-Attas
- Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Al-Rubeaan
- Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Alan F Jones
- Clinical Biochemistry, Birmingham Heartlands Hospital, Birmingham, B9 5SS, UK
| | - Sudhesh Kumar
- Warwick Medical School, Diabetes & Metabolism Unit, University of Warwick, Coventry, CV4 7AL, UK
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Xi L, Qian Z, Xu G, Zhou C, Sun S. Crocetin attenuates palmitate-induced insulin insensitivity and disordered tumor necrosis factor-alpha and adiponectin expression in rat adipocytes. Br J Pharmacol 2007; 151:610-7. [PMID: 17471172 PMCID: PMC2013994 DOI: 10.1038/sj.bjp.0707276] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND AND PURPOSE A number of studies have implicated adipocyte-derived factors in the development of insulin resistance. Intracellular redox status has been reported to play a significant role in the modulation of insulin action. This study was designed to investigate the potential of crocetin, a potent antioxidant, to protect adipocytes against the induction of insulin insensitivity and disordered expression of tumor necrosis factor (TNF)-alpha and adiponectin in vitro. EXPERIMENTAL APPROACH We used palmitate to induce insulin resistance in freshly isolated rat adipocytes, and observed the effect of crocetin, N-acetylcysteine, diphenyleneiodonium, rotenone and oxypurinol. Insulin sensitivity was measured using 2-deoxy-D-[1-(3)H]-glucose uptake assay. Levels of glucose transporter 4, TNF-alpha and adiponectin were evaluated by immunoblot analysis, and levels of mRNA for TNF-alpha and adiponectin by reverse transcription-polymerase chain reaction analysis. Intracellular production of reactive oxygen species (ROS) was determined spectrofluorometrically using 2',7'-dichlorofluorescin diacetate. KEY RESULTS Palmitate induced a 45% decrease in insulin-stimulated glucose uptake in adipocytes. The mRNA and protein expression of TNF-alpha were enhanced by 64% and 59% respectively whereas the mRNA and protein expression of adiponectin were reduced by 43% and 36% respectively by palmitate treatment. These changes were accompanied by a 54% increase in intracellular ROS levels. Crocetin, N-acetylcysteine and diphenyleneiodonium were found to attenuate these abnormalities. CONCLUSIONS AND IMPLICATIONS Crocetin blocked the impaired insulin-stimulated glucose uptake and disordered TNF-alpha and adiponectin expression induced by palmitate in rat adipocytes. Inactivation of NADPH oxidase may account for these observations.
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Affiliation(s)
- L Xi
- Department of Pharmacology, China Pharmaceutical University Nanjing, PR China
| | - Z Qian
- Department of Pharmacology, China Pharmaceutical University Nanjing, PR China
- Author for correspondence:
| | - G Xu
- Center for New Drug Research and Development, College of Life Science, Nanjing Normal University Nanjing, PR China
| | - C Zhou
- Department of Pharmacology, China Pharmaceutical University Nanjing, PR China
| | - S Sun
- Department of Pharmacology, China Pharmaceutical University Nanjing, PR China
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Abstract
Cardiovascular disease (CVD) burden remains the predominant cause of mortality and morbidity in the United States and in most of the developed world. The ongoing twin epidemics of obesity and type 2 diabetes mellitus provide a groundswell source for sustaining this trend for the foreseeable future (increasing the prevalence of CVD by 2-4 times), unless radical changes are made in public health policy. Oral hypoglycemic agents (OHAs) remain a mainstay for management of type 2 diabetes in most practice settings. Although these agents are primarily prescribed to achieve better glycemic control, it is important to evaluate what effects they have on cardiovascular risk and whether there are significant differences in effects among the different OHAs. This review presents the available data on the effects of the various OHAs on cardiovascular risk surrogates and actual events in retrospective and prospective study design settings.
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Affiliation(s)
- Gabriel I Uwaifo
- Georgetown University College of Medicine, Washington, District of Columbia 20003, USA.
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Faure P, Barclay D, Joyeux-Faure M, Halimi S. Comparison of the effects of zinc alone and zinc associated with selenium and vitamin E on insulin sensitivity and oxidative stress in high-fructose-fed rats. J Trace Elem Med Biol 2007; 21:113-9. [PMID: 17499151 DOI: 10.1016/j.jtemb.2006.12.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2006] [Revised: 12/21/2006] [Accepted: 12/21/2006] [Indexed: 12/01/2022]
Abstract
PURPOSE In the present study, we investigated the effect of an association of micronutrients (zinc (Zn), selenium (Se) and vitamin E (vit E)) on insulin activity and antioxidant status in an animal model of insulin resistance, the high-fructose-fed rat. PROCEDURES Five experimental groups were compared: a control group (C) receiving a standard diet, a high-fructose-fed group (F) where 58% of the diet carbohydrate was fructose, a high-fructose-fed group supplemented with Zn alone (FZn group), a high-fructose-fed group supplemented micronutrients (Zn, Se and vit E) (FMicro group). A fifth group consumed a high-fructose diet and received metformin in the drinking water (200mg/day/rat) (FMet group). Insulin sensitivity was measured using the euglycemic hyperinsulinic glucose clamp technique. Metabolic parameters, trace elements and antioxidant parameters were measured in blood samples from all groups. RESULTS High-fructose-fed rats were resistant to insulin as indicated by the lower glucose infusion rate. The insulin sensitivity of FZn, FMicro and FMet groups was higher than that of F group, with the highest insulin sensitivity for the FMicro group. No statistically significant difference in glycemia between the groups was observed. The ratio of reduced to oxidized glutathione was higher in FZn and FMicro groups than in all other groups, as a consequence of decreased oxidized glutathione. CONCLUSION Our results provide direct evidence that micronutrients have a beneficial effect on insulin sensitivity and some components of the antioxidant defense system in an animal model of insulin resistance.
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Affiliation(s)
- Patrice Faure
- Laboratoire HP2, Hypoxie Physio-Pathologie Respiratoire et Cardiovasculaire, Inserm ERI 0017, Faculté de Médecine-Pharmacie, BP 217, 38043 Grenoble cedex 9, France.
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Xi L, Qian Z, Xu G, Zheng S, Sun S, Wen N, Sheng L, Shi Y, Zhang Y. Beneficial impact of crocetin, a carotenoid from saffron, on insulin sensitivity in fructose-fed rats. J Nutr Biochem 2007; 18:64-72. [PMID: 16713230 DOI: 10.1016/j.jnutbio.2006.03.010] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2005] [Revised: 03/06/2006] [Accepted: 03/23/2006] [Indexed: 01/24/2023]
Abstract
Crocetin, a unique carotenoid with potent antioxidative and anti-inflammatory activities, is a major ingredient of saffron which is used as an important spice and food colorant in various parts of the world. In the present study, the effect of crocetin on insulin resistance and its related abnormalities induced by high-fructose diet were investigated in male Wistar rats. Compared to the control rats fed on normal laboratory diet, fructose-fed rats developed a series of pathological changes including insulin resistance, hyperinsulinemia, dyslipidemia and hypertension. Although having no evident effect on the body weight, fructose feeding caused a marked increase in the weight of epididymal white adipose tissue. Furthermore, a significant reduction in the expression of both protein and mRNA of adiponectin (an insulin-sensitizing adipocytokine) was observed, whereas those of tumor necrosis factor (TNF)-alpha and leptin were enhanced in epididymal white adipose tissue in fructose-fed rats. These disorders were effectively normalized in crocetin-treated rats. Crocetin was also demonstrated here to alleviate free fatty acid (FFA)-induced insulin insensitivity and dysregulated mRNA expression of adiponectin, TNF-alpha and leptin in primary cultured rat adipocytes. These findings suggest the possibility of crocetin treatment as a preventive strategy of insulin resistance and related diseases. The favorable impact on adiponectin, TNF-alpha and leptin expression in white adipose tissue may be involved in the improvement of insulin sensitivity observed in crocetin-treated rats.
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Affiliation(s)
- Liang Xi
- Department of Pharmacology, China Pharmaceutical University, Nanjing 210009, PR China
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Baker KS, Ness KK, Steinberger J, Carter A, Francisco L, Burns LJ, Sklar C, Forman S, Weisdorf D, Gurney JG, Bhatia S. Diabetes, hypertension, and cardiovascular events in survivors of hematopoietic cell transplantation: a report from the bone marrow transplantation survivor study. Blood 2006; 109:1765-72. [PMID: 17047152 PMCID: PMC1794046 DOI: 10.1182/blood-2006-05-022335] [Citation(s) in RCA: 245] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
We ascertained the prevalence of self-reported late occurrence of diabetes, hypertension, and cardiovascular (CV) disease in 1089 hematopoietic cell transplantation (HCT) survivors who underwent HCT between 1974 and 1998, survived at least 2 years, and were not currently taking immunosuppressant agents and compared them with 383 sibling controls. All subjects completed a 255-item health questionnaire. The mean age at survey completion was 39.3 years for survivors and 38.6 years for siblings; mean follow-up was 8.6 years. Adjusting for age, sex, race, and body mass index (BMI), survivors of allogeneic HCT were 3.65 times (95% confidence interval [CI], 1.82-7.32) more likely to report diabetes than siblings and 2.06 times (95% CI, 1.39-3.04) more likely to report hypertension compared with siblings but did not report other CV outcomes with any greater frequency. Recipients of autologous HCTs were no more likely than siblings to report any of the outcomes studied. Allogeneic HCT survivors were also more likely to develop hypertension (odds ratio [OR]=2.31; 95% CI, 1.45-3.67) than autologous recipients. Total body irradiation (TBI) exposure was associated with an increased risk of diabetes (OR=3.42; 95% CI, 1.55-7.52). Thus, HCT survivors have a higher age- and BMI-adjusted risk of diabetes and hypertension, potentially leading to a higher than expected risk of CV events with age.
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Affiliation(s)
- K Scott Baker
- Department of Pediatrics, University of Minnesota, Minneapolis 55455, USA.
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40
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Zethelius B, Lithell H, Hales CN, Berne C. Insulin sensitivity, proinsulin and insulin as predictors of coronary heart disease. A population-based 10-year, follow-up study in 70-year old men using the euglycaemic insulin clamp. Diabetologia 2005; 48:862-7. [PMID: 15803331 DOI: 10.1007/s00125-005-1711-9] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2004] [Accepted: 12/12/2004] [Indexed: 10/25/2022]
Abstract
AIMS/HYPOTHESIS The association between CHD and insulin sensitivity (Si) measured by the euglycaemic insulin clamp has not been examined previously. Earlier studies found a relationship between CHD and elevated plasma insulin, an analysis that may have been confounded by co-determination of proinsulin, which has evolved as a stronger predictor of CHD. The aim was to determine the longitudinal relationships between Si, intact proinsulin, 32-33 split proinsulin, specific insulin and subsequent CHD. METHODS This was a population-based cohort study of 815 men in Uppsala, Sweden, aged 70 years at baseline with a follow-up of up to 10 years. Baseline insulin sensitivity was determined by euglycaemic insulin clamp. Fasting proinsulin, 32-33 split proinsulin and specific insulin concentrations were analysed using specific two-site immunometric assays. CHD was taken as diagnosed, if stated (in the event of death) on the Cause of Death Registry, or for subjects hospitalised for the first time with CHD, if CHD was recorded in the Hospital-Discharge Registry. The associations were analysed using Cox's proportional hazards, presented as hazard ratios (HRs) with their 95% CIs for a one-SD increase in the predictor. RESULTS In multivariate analysis, Si (HR:0.80, CI:0.65-0.97) adjusted for serum cholesterol, systolic blood pressure, fasting plasma glucose, BMI and smoking predicted CHD. Intact proinsulin (HR:1.18, CI:1.01-1.38), adjusted as the model above, predicted CHD, whereas 32-33 split proinsulin (HR:1.13, CI:0.95-1.35) or specific insulin (HR:1.07, CI:0.89-1.30) did not. CONCLUSIONS/INTERPRETATION Insulin resistance measured by the euglycaemic insulin clamp predicts subsequent CHD in elderly men. Proinsulin provides a better prediction of CHD than insulin.
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Affiliation(s)
- B Zethelius
- Department of Public Health and Caring Sciences/Geriatrics, P.O. Box 609, 75125 Uppsala, Sweden.
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Fujiwara T, Saitoh S, Takagi S, Takeuchi H, Isobe T, Chiba Y, Miura T, Shimamoto K. Development and Progression of Atherosclerotic Disease in Relation to Insulin Resistance and Hyperinsulinemia. Hypertens Res 2005; 28:665-70. [PMID: 16392771 DOI: 10.1291/hypres.28.665] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
It is unclear whether the role of insulin resistance in the development of atherosclerotic cardiovascular disease is similar in populations in which the incidence of atherosclerotic diseases significantly differs from that in Western countries. The aim of this study was to determine the relationship between insulin resistance and the development of cardiovascular disease in the Japanese population. We conducted 75 g-oral glucose tolerance tests (OGTTs) on 1,928 inhabitants of two towns in Hokkaido, Japan. Subjects using antihypertensive agents and known diabetic patients were excluded from the study. Data from the remaining 1,227 subjects (540 males and 687 females; mean age 56.0 +/- 10.8 years) were used for the analysis, and 1,051 subjects were seen in a follow-up care setting for a period of 8 years. The presence of insulin resistance was defined according to the guidelines reported our previous study: insulin levels of 64.0 mU/l or higher 2 h after the 75 g-OGTT. The insulin-resistant (IR) group had several risk factors such as hypertension, diabetes, treated or untreated hypercholesterolemia, hypertriglyceridemia, low high-density-lipoprotein (HDL) cholesterol levels, and obesity. During the follow-up period of 8 years, the incidence of coronary artery disease, which was adjusted for age, body mass index, sex, systolic blood pressure, fasting plasma glucose, total cholesterol, triglyceride, and HDL cholesterol was significantly (3.2 times) higher in the IR group than in the insulin non-resistant group. The results suggested that insulin resistance is an independent risk factor for coronary artery disease in Japanese subjects, as has also been demonstrated in the case of individuals in Europe and USA.
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Affiliation(s)
- Tadashi Fujiwara
- Second Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
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Nichols GA, Koro CE, Gullion CM, Ephross SA, Brown JB. The incidence of congestive heart failure associated with antidiabetic therapies. Diabetes Metab Res Rev 2005; 21:51-7. [PMID: 15386819 DOI: 10.1002/dmrr.480] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Increased risk for CHF in persons with type 2 diabetes is well established. Our objectives were to estimate the CHF risk associated with specific therapies for diabetes and to determine the differences in incidence rates of CHF associated with adding various antidiabetic agents. METHODS Subjects were members of the Kaiser Permanente Northwest (KPNW) diabetes registry as of 1 January 1998, with no prior history of CHF (n = 8063). We identified their therapy as of that date and then defined the start of the subject study period as the date when their drug regimen changed, either by switching to or by adding another antidiabetic drug. We defined the new therapy as the index therapy and the date of initiating the new therapy as the index date. Follow-up on the patients was done until the index therapy was discontinued or changed, or until 31 December 2002, whichever came earlier. We calculated the incidence rate of CHF in patients on various therapeutic regimens adjusting for age, gender, diabetes duration, existing ischemic heart disease, hypertension, renal insufficiency and glycemic control (HbA(1c)). RESULTS CHF incidence rates were highest in index therapy categories that included insulin and lowest in regimens that included metformin. When insulin was added to an initial therapy, CHF incidence was increased 2.33 times (p < 0.0001) and 2.66 times (p < 0.0001) compared to the addition of sulphonylurea or metformin respectively. CONCLUSIONS Our findings support the theory that elevated serum insulin levels promote the development of cardiac disease. Consistent with the UKPDS, metformin may offer some protection from incident CHF relative to sulphonylurea or insulin.
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Affiliation(s)
- Gregory A Nichols
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR 97227-1098, USA.
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Wang P, Lloyd SG, Zeng H, Bonen A, Chatham JC. Impact of altered substrate utilization on cardiac function in isolated hearts from Zucker diabetic fatty rats. Am J Physiol Heart Circ Physiol 2004; 288:H2102-10. [PMID: 15615844 DOI: 10.1152/ajpheart.00935.2004] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The goal of this study was to determine whether changes in cardiac metabolism in Type 2 diabetes are associated with contractile dysfunction or impaired response to ischemia. Hearts from Zucker diabetic fatty (ZDF) and lean control rats were isolated and perfused with glucose, lactate, pyruvate, and palmitate. The rates of glucose, lactate, pyruvate, and palmitate oxidation rates and glycolysis were determined during baseline perfusion and low-flow ischemia (LFI; 0.3 ml/min for 30 min) and after LFI and reperfusion. Under all conditions, ATP synthesis from palmitate was increased and synthesis from lactate was decreased in the ZDF group, whereas the contribution from glucose was unchanged. During baseline perfusion, the rate of glycolysis was lower in the ZDF group; however, during LFI and reperfusion, there were no differences between groups. Despite these metabolic shifts, there were no differences in oxygen consumption or ATP production rates between the groups under any perfusion conditions. Cardiac function was slightly depressed before LFI in the ZDF group, but during reperfusion, function was improved relative to the control group despite the increased dependence on fatty acids for energy production. These data suggest that in this model of diabetes, the shift from carbohydrates to fatty acids for oxidative energy production did not increase myocardial oxygen consumption and was not associated with impaired response to ischemia and reperfusion.
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Affiliation(s)
- Peipei Wang
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35294-0005, USA
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Kilic-Okman T, Guldiken S, Kucuk M. Relationship between homocysteine and insulin resistance in women with polycystic ovary syndrome. Endocr J 2004; 51:505-8. [PMID: 15516786 DOI: 10.1507/endocrj.51.505] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Hyperhomocysteinemia is a risk factor for atherosclerotic vascular diseases. It is known that plasma homocysteine levels are higher in polycystic ovary syndrome (PCOS) patients than in healthy subjects. The aim of our study was to determine the relationship between plasma homocysteine level and insulin resistance in women with PCOS. Twenty-nine patients (age, 23.90 +/- 5.86 years) and twenty-five healthy subjects (age, 25.24 +/- 4.28 years) were involved in the study. Plasma levels of fasting insulin, glucose, homocysteine, FSH, and LH levels were measured. A statistically significant difference in plasma concentrations of HOMA index, homocysteine, basal insulin levels and LH/FSH ratios was observed between groups (P = 0.001, P = 0.001, P = 0.001, and P = 0.01, respectively). There was no relationship between Hcy and the other variables. In multiple logistic regression analysis, age, BMI and insulin resistance were not predictors of Hcy.
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Affiliation(s)
- Tulay Kilic-Okman
- Department of Obstetrics and Gynecology, Trakya University Faculty of Medicine, Edirne, Turkey
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Nichols GA, Gullion CM, Koro CE, Ephross SA, Brown JB. The incidence of congestive heart failure in type 2 diabetes: an update. Diabetes Care 2004; 27:1879-84. [PMID: 15277411 DOI: 10.2337/diacare.27.8.1879] [Citation(s) in RCA: 552] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The aims of this study were to update previous estimates of the congestive heart failure (CHF) incidence rate in patients with type 2 diabetes, compare it with an age- and sex-matched nondiabetic group, and describe risk factors for developing CHF in diabetic patients over 6 years of follow-up. RESEARCH DESIGN AND METHODS We performed a retrospective cohort study of 8,231 patients with type 2 diabetes and 8,845 nondiabetic patients of similar age and sex who did not have CHF as of 1 January 1997, following them for up to 72 months to estimate the CHF incidence rate. In the diabetic cohort, we constructed a Cox regression model to identify risk factors for CHF development. RESULTS Patients with diabetes were much more likely to develop CHF than patients without diabetes (incidence rate 30.9 vs. 12.4 cases per 1,000 person-years, rate ratio 2.5, 95% CI 2.3-2.7). The difference in CHF development rates between persons with and without diabetes was much greater in younger age-groups. In addition to age and ischemic heart disease, poorer glycemic control (hazard ratio 1.32 per percentage point of HbA(1c)) and greater BMI (1.12 per 2.5 units of BMI) were important predictors of CHF development. CONCLUSIONS The CHF incidence rate in type 2 diabetes may be much greater than previously believed. Our multivariate results emphasize the importance of controlling modifiable risk factors for CHF, namely hyperglycemia, elevated blood pressure, and obesity. Younger patients may benefit most from risk factor modification.
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Affiliation(s)
- Gregory A Nichols
- Kaiser Permanente Center for Health Research, Portland, Oregon 97227-1098, USA.
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Zethelius B, Hales CN, Lithell HO, Berne C. Insulin resistance, impaired early insulin response, and insulin propeptides as predictors of the development of type 2 diabetes: a population-based, 7-year follow-up study in 70-year-old men. Diabetes Care 2004; 27:1433-8. [PMID: 15161800 DOI: 10.2337/diacare.27.6.1433] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Defects in insulin secretion and insulin action are the major abnormalities in the development of type 2 diabetes. In middle-aged subjects, elevated plasma proinsulin has been found to predict type 2 diabetes. Therefore, our aim was to study the longitudinal relationships between baseline determinations of insulin sensitivity index (S(i)) assessed by euglycemic insulin clamp, the early insulin response (EIR) at an oral glucose tolerance test (OGTT), fasting intact proinsulin, 32-33 split proinsulin and specific insulin, and the development of type 2 diabetes in a population-based cohort of 70-year-old nondiabetic men (n = 667) with 7-year follow-up. RESEARCH DESIGN AND METHODS A euglycemic insulin clamp study and a 75-g OGTT were performed at baseline, and fasting peptide concentrations were measured using specific two-site immunometric assays. Results from logistic regression models are presented as odds ratios (ORs) with 95% CIs for a 1-SD increase in the predictor variable. RESULTS In separate multivariate analyses adjusted for EIR (OR 0.72, 95% CI 0.59-0.89) and S(i) (0.68, 0.58-0.88), 32-33 split proinsulin (1.49, 1.18-1.88) or intact proinsulin (1.30, 1.04-1.63) were significantly associated with the development of type 2 diabetes, whereas specific insulin (1.24, 0.91-1.66) was not. The significant associations between 32-33 split or intact proinsulin and the development of type 2 diabetes were unaltered after adjustment for BMI and glucose tolerance. CONCLUSIONS Insulin propeptides predicted type 2 diabetes over a 7-year period in elderly men, independent of the EIR and S(i).
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Affiliation(s)
- Björn Zethelius
- Department of Public Health and Caring Sciences, Section of Geriatrics, Uppsala University, Box 609, SE-75125 Uppsala, Sweden.
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Jenkins DJ, Marchie A, Augustin LS, Ros E, Kendall CW. Viscous dietary fibre and metabolic effects. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.clnu.2004.09.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Uwaifo GI, Ratner RE. The roles of insulin resistance, hyperinsulinemia, and thiazolidinediones in cardiovascular disease. Am J Med 2003; 115 Suppl 8A:12S-19S. [PMID: 14678860 DOI: 10.1016/j.amjmed.2003.08.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although it is difficult to distinguish between the relative effects of insulin resistance and hyperinsulinemia, insulin resistance is clearly associated with significantly increased cardiovascular and cerebrovascular risk. This effect is consistent across the spectrum of worsening glycemic control, from the onset of impaired glucose tolerance to the development of clinical diabetes. It is more difficult to discriminate between the roles of elevated circulating insulin and proinsulin levels; the association between insulin levels and cardiovascular risk is weak. The thiazolidinediones (TZDs) significantly improve insulin sensitivity and exert numerous effects on the vascular bed, including improved endothelial function, decreased vascular inflammation, decreased plasma free fatty acid levels, improved dyslipidemic profiles, and inhibition of vascular smooth muscle proliferation. These findings provide increasing evidence to suggest that the TZDs may have a beneficial effect on atherosclerosis and may reduce the incidence and severity of adverse cardiovascular outcomes. These effects remain to be substantiated by the results of large outcomes studies to evaluate the impact of glycemic control and reversal of insulin resistance on cardiovascular events.
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Pantaleo A, Zonszein J. Using insulin as a drug rather than as a replacement hormone during acute illness: a new paradigm. ACTA ACUST UNITED AC 2003; 5:323-33. [PMID: 14503930 DOI: 10.1097/01.hdx.0000089839.13906.63] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The direct correlation between glucose levels and cardiovascular disease in individuals with type 2 diabetes can now be applied to individuals that share an abnormal metabolic milieu similar to that found in central obesity, the metabolic syndrome, and type 2 diabetes. Premature macrovascular complications with a very high morbidity and mortality rate can be found in these nondiabetic populations. The typical phenotype has visceral or central obesity, excess of free fatty acids, insulin resistance, increased insulin secretion, and hypertension. A more complex metabolic-cardiovascular syndrome develops that includes dyslipidemia, abnormal production of cytokines, chronic inflammatory state, and abnormal coagulation. The interplay of all these cardiovascular risk factors is responsible for the accelerated atherosclerotic process. The different terminologies used for populations sharing this common ground for premature cardiovascular disease now generally accepted as the metabolic syndrome, are also discussed. Aggressive insulin treatment during acute illness in individuals with the abnormal metabolic milieu is beneficial. Insulin treatment is changing from using insulin as a hormone to treat only severe hyperglycemia, to a new paradigm using insulin in high doses as a drug. Aggressive insulin regimens should be used to treat only minimal elevations of blood glucose or to prevent hyperglycemia. The newly observed properties of insulin are reviewed which include suppression of inflammatory cytokines and adhesion molecules, improved hemostasis, and other cardiac beneficial effects. The concomitant administration of intravenous glucose and insulin permits the administration of higher insulin doses that can result in improved outcome due to its nonglycemic-related benefits. The use of aggressive insulin therapy requires both better and more cost-effective algorithms to successfully treat this high-risk population during acute illness.
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Affiliation(s)
- Antonio Pantaleo
- Division of Endocrinology and Metabolism, Montefiore Medical Center/Albert Einstein College of Medicine, 1825 Eastchester Road, Bronx, NY 10461, USA
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Steinberger J, Steffen L, Jacobs DR, Moran A, Hong CP, Sinaiko AR. Relation of leptin to insulin resistance syndrome in children. OBESITY RESEARCH 2003; 11:1124-30. [PMID: 12972683 DOI: 10.1038/oby.2003.153] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To examine the relation of leptin to insulin resistance, as measured by euglycemic insulin clamp, and insulin resistance syndrome factors in thin and heavy children. RESEARCH METHODS AND PROCEDURES Anthropometrics, insulin, blood pressure, and leptin were measured in 342 11- to 14-year-old children (189 boys, 153 girls, 272 white, 70 black). Insulin sensitivity (M) was determined by milligrams glucose uptake per kilogram per minute and expressed as M/lean body mass (Mlbm). Children were divided by median BMI (boys = 20.5 kg/m(2); girls = 21.4 kg/m(2)) into below-median (thin) and above-median (heavy) groups. Correlation coefficients between log-leptin and components of insulin resistance syndrome were adjusted for Tanner stage, gender, and race. RESULTS BMI was related to leptin in boys (r = 0.70, p < 0.001) and girls (r = 0.75, p < 0.001). Leptin was higher in girls than boys (32.6 vs. 12.3 ng/mL, p = 0.0001). Leptin levels increased in girls and decreased in boys during puberty, paralleling the changes in body fat. Leptin was significantly correlated with insulin, Mlbm, triglycerides, and blood pressure in heavy children and only with insulin in thin children. After adjustment for body fat, the correlations remained significant for insulin and Mlbm in heavy children and with insulin in thin children. DISCUSSION Significant associations were found between leptin and insulin resistance in children, and these associations were attenuated by adjustment for adiposity. These findings at age 13 likely have long-term consequences in the development of the obesity-insulin resistance-related cardiovascular risk profile.
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Affiliation(s)
- Julia Steinberger
- Department of Pediatrics, University of Minnesota Medical School, University of Minnesota School of Public Health, Minneapolis, Minnesota 55455, USA.
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