[Anthropometric parameters as predictors of insulin resistance in overweight and obese adults]

The expected changes with different periods of home-based resistance exercise in patients with chronic kidney disease

BACKGROUND

The comprehensive impact of prolonged home-based resistance training on individuals grappling with chronic kidney disease (CKD) have yet to be fully elucidated. This study aimed to explore the outcomes of varying exercise durations on physical performance, nutritional status, and kidney function within this specific population, encompassing patients undergoing dialysis and those affected by severe sarcopenia.

METHODS

This was a 1-year observational double cohort study following a 52-week longitudinal design, we enrolled 101 adult CKD outpatients. These participants were divided into two groups: the continuous group, comprising individuals who consistently exercised for over 6 months, and the interrupted group, which included those who did not sustain regular exercise for the same duration. The exercise regimen involved resistance exercises conducted at least 3 to 5 days per week, involving activities like lifting dumbbells and executing weighted wall squats. Physical activity assessments and biochemical blood tests were conducted at weeks 0, 4, 16, 28, 40, and 52 for all participants.

RESULTS

The continuous exercise group exhibited better handgrip strength and sit-to-stand movement compared to the interrupted group. Their estimated glomerular filtration rate stayed steady while the interrupted group was declined. Additionally, those who exercised consistently had better metabolism: higher carbon dioxide levels, increased albumin, better nutritional scores, and lower levels of blood urea nitrogen, creatinine, fasting blood glucose, and body weight. Subsequent adjustments for potential confounding factors continued to show improved physical performance and kidney function over time.

CONCLUSION

Our findings indicate the advantageous impact of extended resistance exercise training on overall health of CKD patients, even those on dialysis or with severe sarcopenia. Dedication to this exercise routine could improve kidney function, metabolism, and physical abilities in these patients.

Genetic risk score for insulin resistance based on gene variants associated to amino acid metabolism in young adults

Circulating concentration of arginine, alanine, aspartate, isoleucine, leucine, phenylalanine, proline, tyrosine, taurine and valine are increased in subjects with insulin resistance, which could in part be attributed to the presence of single nucleotide polymorphisms (SNPs) within genes associated with amino acid metabolism. Thus, the aim of this work was to develop a Genetic Risk Score (GRS) for insulin resistance in young adults based on SNPs present in genes related to amino acid metabolism. We performed a cross-sectional study that included 452 subjects over 18 years of age. Anthropometric, clinical, and biochemical parameters were assessed including measurement of serum amino acids by high performance liquid chromatography. Eighteen SNPs were genotyped by allelic discrimination. Of these, ten were found to be in Hardy-Weinberg equilibrium, and only four were used to construct the GRS through multiple linear regression modeling. The GRS was calculated using the number of risk alleles of the SNPs in HGD, PRODH, DLD and SLC7A9 genes. Subjects with high GRS (≥ 0.836) had higher levels of glucose, insulin, homeostatic model assessment- insulin resistance (HOMA-IR), total cholesterol and triglycerides, and lower levels of arginine than subjects with low GRS (p < 0.05). The application of a GRS based on variants within genes associated to amino acid metabolism may be useful for the early identification of subjects at increased risk of insulin resistance.

Mid-upper arm circumference is associated with liver steatosis and fibrosis in patients with metabolic-associated fatty liver disease: A population based observational study

Metabolic-associated fatty liver disease (MAFLD) is a series of liver diseases based on liver steatosis and metabolic disorders. Steatosis, as the core factor in MAFLD diagnosis, and fibrosis, as the major determinant of adverse outcomes of MAFLD, need to be assessed simply and accurately. In this study, we explored the significance of mid-upper arm circumference (MUAC) in evaluating liver steatosis and fibrosis in patients with MAFLD. We included 2397 cases with MAFLD from the 2017-2018 National Health and Nutrition Examination Surveys (NHANES) database. Liver steatosis and fibrosis were measured by vibration controlled transient elastography. Anthropometric parameters and demographic and serological data were obtained from the NHANES database. The association between MUAC and liver steatosis and fibrosis were evaluated by a multivariable linear regression model, a weighted generalized additive model, and smooth curve fitting using R. MUAC was positively associated with liver steatosis in every multivariate linear regression model (model 1: β = 3.3513; 95% confidence interval [CI], 2.7722-3.9304; model 2: β = 3.8492; 95% CI, 3.2441-4.4542; model 3: β = 2.4987; 95% CI, 1.8371-3.1604), and this positive association was consistent in both men and women and among different race groups (Mexican American, other Hispanic, non-Hispanic White, Black, Asian, and other race). On the other hand, MUAC was positively associated with liver fibrosis in every multivariate linear regression model, and this positive association also was consistent in both men and women and among non-Hispanic White and Black populations. Increased MUAC was positively associated with liver steatosis and fibrosis in patients with MAFLD. This was particularly true for MUAC ≥ 42.0 cm. MUAC might be a simple and convenient evaluation tool for MAFLD.

Mid-upper arm circumference as a simple tool for identifying central obesity and insulin resistance in type 2 diabetes

BACKGROUND

Our research aimed to explore the correlation between mid-upper arm circumference (MUAC) and central obesity and insulin resistance (IR) in Chinese subjects with type 2 diabetes.

MATERIALS

A total of 103 participants (60 men) were recruited in our study. MUAC was measured around the mid-arm between the shoulder and elbow. Waist circumference (WC) was obtained as central obesity parameter, and the IR parameter of Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) was calculated. The subjects were divided into three groups according to the tertiles cut-points of MUAC level.

RESULTS

Body mass index (BMI), WC, the percentages of central obesity and HOMA-IR were significantly higher in the groups with higher MUAC than those in the group with lower MUAC (all P < 0.05). Pearson analysis showed that MUAC was correlated with BMI, WC, waist-to-hip ratio (WHR), logHOMA-IR, low density lipoprotein cholesterol (LDL-C), uric acid (UA) and high density lipoprotein cholesterol (HDL-C) in all subjects. Multivariate linear regression analysis revealed that MUAC was independently associated with logHOMA-IR (β = 0.036, P<0.001) after adjusting for age, gender, WHR, UA, TG, LDL-C and HDL-C. Binary logistic regression analysis revealed that MUAC was an independent predictor of central obesity (OR: 2.129, 95%CI: 1.311-3.457, P = 0.002). Furthermore, MUAC≥30.9cm for male and ≥30.0cm for female were the optimal cutoff values for identifying central obesity.

CONCLUSIONS

Our study indicated that among Chinese subjects with type 2 diabetes, MUAC is a simple and effective tool for the determination of central obesity and IR. Additionally, the larger MUAC is proved to be more associated with metabolic risk factors of higher UA and LDL-C and lowever HDL-C.

Utilization of anthropometric parameters as a novel tool for detection of insulin resistance

BACKGROUND

Anthropometric parameters have been widely applied in evaluating muscle mass, insulin resistance (IR), and cardiometabolic diseases. Arm circumference (AC) and calf circumference (CC) are used as informative markers for sarcopenia. However, few studies concern the correlation between AC, CC and IR. The aim of the present survey is to investigate the relationship between AC, CC and homeostatic model assessment of insulin resistance (HOMA-IR).

METHODS

This cross-sectional observational study included 11,527 participants aged 40-85 years from the National Health and Nutrition Examination Survey (NHANES), 1999 to 2006. We divided the participants into male and female groups. Each group was then divided into four subgroups depending on their AC and CC levels.

RESULTS

After adjustment for multiple covariates, we observed a significant negative correlation between the CC and HOMA-IR. This study showed a significant positive correlation between the AC and HOMA-IR after multiple adjustments. Subjects in the highest CC quartiles tended to have the lowest HOMA-IR in both male and female group (P for trend <0.001 in all models).

CONCLUSIONS

CC may be a novel tool to guide public health policy and clinical predictor of IR in middle-aged and older people.

The rs4285184 polymorphism of the MGAT1 gene as a risk factor for obesity in the Mexican population

BACKGROUND AND OBJECTIVE

Obesity is a factor that contributes to the morbidity of certain diseases and to worldwide mortality. MGAT1 is a glycosyltransferase involved in the synthesis of protein-bound and lipid-bound oligosaccharides and its polymorphisms are possibly involved in the etiology of obesity. We investigated the association of the rs4285184 polymorphism of the MGAT1 gene with obesity in adults in the State of Colima, Mexico.

METHODS

A case-control study was conducted that included 244 subjects. All of them were grouped according to their percentage of body fat, determined through bioelectrical impedance, and they were genotyped for the rs4285184 polymorphism of the MGAT1 gene through PCR-RFLP. The results were analyzed for their association with the percentage of body fat.

RESULTS

The G allele had a frequency of 49.19 and 38.75% for the cases and controls, respectively (P=.020) (OR 1.53; 95% CI 1.068-2.193). The frequency of the A/G+G/G genotype was 75% in the obese patients, which was significantly higher compared with the 57.5% of the control group (P=.004) (OR 2.217; 95% CI 1.287-3.821).

CONCLUSIONS

The presence of the rs4285184 polymorphism of the MGAT1 gene increased the risk for developing body fat associated with obesity in the Mexican population.