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Swan P, Johnson B, le Roux CW, Miras AD. Harnessing the melanocortin system in the control of food intake and glucose homeostasis. Peptides 2024; 179:171255. [PMID: 38834138 DOI: 10.1016/j.peptides.2024.171255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/27/2024] [Accepted: 05/28/2024] [Indexed: 06/06/2024]
Abstract
The central and peripheral melanocortin system, comprising of five receptors and their endogenous ligands, is responsible for a wide array of physiological functions such as skin pigmentation, sexual function and development, and inflammation. A growing body of both clinical and pre-clinical research is demonstrating the relevance of this system in metabolic health. Disruption of hypothalamic melanocortin signalling is the most common cause of monogenic obesity in humans. Setmelanotide, an FDA-approved analogue of alpha-melanocyte stimulating hormone (α-MSH) that functions by restoring central melanocortin signalling, has proven to be a potent pharmacological tool in the treatment of syndromic obesity. As the first effective therapy targeting the melanocortin system to treat metabolic disorders, its approval has sparked research to further harness the links between these melanocortin receptors and metabolic processes. Here, we outline the structure of the central and peripheral melanocortin system, discuss its critical role in the regulation of food intake, and review promising targets that may hold potential to treat metabolic disorders in humans.
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Affiliation(s)
- Patrick Swan
- Diabetes Research Centre, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom; Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland.
| | - Brett Johnson
- Division of Diabetes, Endocrinology and Metabolism, Imperial College London, United Kingdom
| | - Carel W le Roux
- Diabetes Research Centre, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom; Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland
| | - Alexander D Miras
- Diabetes Research Centre, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom; Division of Diabetes, Endocrinology and Metabolism, Imperial College London, United Kingdom
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2
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Anyiam O, Phillips B, Quinn K, Wilkinson D, Smith K, Atherton P, Idris I. Metabolic effects of very-low calorie diet, Semaglutide, or combination of the two, in individuals with type 2 diabetes mellitus. Clin Nutr 2024; 43:1907-1913. [PMID: 38996661 DOI: 10.1016/j.clnu.2024.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 06/26/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND & AIMS Very-low calorie diets (VLCD) and the glucagon-like peptide-1 receptor agonist (GLP1RA) Semaglutide induce significant weight loss and improve glycaemic control in individuals with type 2 diabetes (T2D). This pilot study was conducted to explore the comparative short-term effects of these interventions individually, and in combination, on weight, body composition and metabolic outcomes. METHODS Thirty individuals with T2D (age 18-75 years, BMI 27-50 kg m-2) were randomly assigned to receive Semaglutide (SEM), 800 kilocalorie/day VLCD (VLCD), or both in combination (COMB) for 12 weeks. Measurement of weight and glycated haemoglobin (HbA1c), dual energy X-ray absorptiometry, and intravenous glucose tolerance tests (IVGTT) were performed at baseline and post-intervention. Diet diaries were utilised to assess compliance. Insulin first phase response during IVGTT provided a marker of pancreatic beta-cell function, and insulin sensitivity was estimated using HOMA-IR. RESULTS Significantly greater reductions in body weight and fat mass were observed in VLCD and COMB, than SEM (p < 0.01 v both). VLCD and COMB resulted in a 5.4 and 7 percentage-point greater weight loss than SEM, respectively. HbA1c and fasting glucose reduced significantly in all groups, however fasting insulin and HOMA-IR improved in VLCD and COMB only. Insulin first phase response during IVGTT increased in SEM and COMB, and this increase was significantly greater in COMB than VLCD (p < 0.01). CONCLUSION VLCD elicited greater short-term losses of weight and fat mass than Semaglutide. Adding VLCD to Semaglutide stimulated further weight loss than Semaglutide alone. The combination did not yield any additive effects on weight and body composition above VLCD alone, but did provoke greater improvements in pancreatic beta-cell function. Thus, combination of Semaglutide and VLCD warrants further exploration as a novel approach to T2D management.
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Affiliation(s)
- Oluwaseun Anyiam
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Derby, DE22 3DT, UK; Department of Endocrinology and Diabetes, University Hospitals Derby and Burton NHS Foundation Trust, Derby, DE22 3NE, UK
| | - Bethan Phillips
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Derby, DE22 3DT, UK
| | - Katie Quinn
- College of Agriculture, Food & Nutrition, University College Dublin, Ireland
| | - Daniel Wilkinson
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Derby, DE22 3DT, UK
| | - Kenneth Smith
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Derby, DE22 3DT, UK
| | - Philip Atherton
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Derby, DE22 3DT, UK.
| | - Iskandar Idris
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Derby, DE22 3DT, UK; Department of Endocrinology and Diabetes, University Hospitals Derby and Burton NHS Foundation Trust, Derby, DE22 3NE, UK.
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3
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Zhou Y, Tang P, Wang Y, Tang Y, Yang Y. Joint association of weight-adjusted-waist index and physical activity with insulin resistance in adolescents: a cross-sectional study. BMC Endocr Disord 2024; 24:100. [PMID: 38951821 PMCID: PMC11218192 DOI: 10.1186/s12902-024-01633-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/25/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND The weight-adjusted waist index (WWI) is a recently developed obesity metric, and the aim of this study was to investigate the relationship between physical activity (PA) and WWI and the homeostasis model assessment of insulin resistance (HOMA-IR) in adolescents, as well as the joint association of HOMA-IR. METHODS This study was based on the National Health and Nutrition Survey conducted between 2013 and 2016 and included 1024 adolescents whose median age was 15.4. Multivariate linear regression was used to examine the associations between HOMA-IR and PA and WWI. Using generalized additive models, a potential nonlinear link between WWI and HOMA-IR was evaluated. Subgroup analysis was also carried out. RESULTS The fully adjusted model revealed a positive association (β: 0.48, 95% CI: 0.43, 0.53) between the WWI and HOMA-IR. The HOMA-IR was lower in physically active (β: -0.16, 95% CI: -0.26, -0.05) participants versus inactive participants. Participants who had higher WWI and were not physically active (β: 0.69; 95% CI: 0.56, 0.82) had the highest levels of HOMA-IR compared to participants who had lower WWI and were physically active. Subgroup analysis revealed that these correlations were similar in males and females. CONCLUSION Our results demonstrated that higher WWI and PA were associated with a lower HOMA-IR and that WWI and PA had a combined association with HOMA-IR. The findings of this study are informative for the preventing insulin resistance in adolescents.
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Affiliation(s)
- Yong Zhou
- School of Public Health, Xiangnan University, Chenzhou, Hunan, 423000, China
| | - Peng Tang
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Yican Wang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road Hefei 230000, Hefei, Anhui, 230000, China.
| | - Ying Tang
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, 530021, China.
| | - Yujian Yang
- Department of Thoracic Surgery, Changsha Hospital of Traditional Chinese Medicine, Hunan University of Traditional Chinese Medicine, No. 22 Xingsha Road, Changsha, Hunan, 410100, China.
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Kiptoo J, Mekuriya Yadesa T, Ajayi CO, Kushemererwa O, Kantengwa A, Muyingo A. Effectiveness of Jena DM® Herbal Formulation as Complementary Therapy to Conventional Oral Hypoglycemic Agents in Type-2 Diabetes Mellitus: A Quasi-experimental Study. Cureus 2024; 16:e62649. [PMID: 39036260 PMCID: PMC11258422 DOI: 10.7759/cureus.62649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND There is vast preclinical evidence that indicates that extracts from several Artemisia plant species have significant antidiabetic benefits. However, clinical evidence is limited to this effect. OBJECTIVE We sought to evaluate the effectiveness of Jena DM® (an Artemisia annua-based poly-herbal formulation) on glycemic control (Hb A1C) and insulin metabolism (HOMA), when administered as a complementary therapy in type-2 diabetes mellitus (T2DM). This study was supported by a research grant (JRD005) from Jena Herbals (U) Ltd, which is a local herbal medicines manufacturing facility in Uganda. METHODS We conducted a 12-week quasi-experimental study, involving 118 patients under routine follow-up at a diabetes and endocrinology clinic. Random assignment to either conventional or experimental study groups was done using a random number generator (Microsoft Excel version 16.0). Participant sociodemographic and clinical data as well as whole blood samples (3-5 mL) were obtained at scheduled clinic visits. Medication adherence was assessed using the Hill-Bone Scale, and adverse drug events (ADEs) using the Naranjo causality and the National Institute of Allergy and Infectious Diseases, Division of AIDS (DAIDS) scales. Group differences in glycemic control (HbA1C), fasting serum insulin (FSI) indices (% HOMA2-B, HOMA-IR), and other cardiometabolic parameters were assessed using independent samples t-test, and Pearson chi-square statistical tests were used. A p-value <0.05 was considered statistically significant. Ethical approvals were obtained before the study commencement. RESULTS 12-week daily complementary therapy with Jena DM® showed no significant effect on Hb A1C reduction (0.1 (95% CI: -0.56, 0.80) %; p=0.798); however, we observed a significant reduction in total body weight (2.0 (95% CI: 0.73, 3.28) kg; p=0.002). The overall frequency of self-reported ADEs including dizziness was significantly higher among patients that used Jena DM® (p=0.001). Epigastric pain was the most severe ADE necessitating clinical management. There was no significant difference in the homeostatic model assessment for insulin resistance (HOMA2-IR) between study groups. CONCLUSION In contrast to a few studies that previously showed significant hypoglycemic effects of Artemisia-based extracts, this study did not show a statistically significant reduction on HbA1C during a 12-week complementary use of Jena DM® in patients with T2DM. Based on the findings of this study, future research should evaluate the long-term effects of Jena DM® on body weight, overall insulin metabolism, and the subsequent effect on glycemic control in T2DM.
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Affiliation(s)
- Joshua Kiptoo
- Pharmacy, Mbarara University of Science and Technology, Mbarara, UGA
| | | | | | | | - Adellah Kantengwa
- Diabetes & Endocrinology, Mbarara Regional Referral Hospital, Mbarara, UGA
| | - Anthony Muyingo
- Internal Medicine, Mbarara University of Science and Technology, Mbarara, UGA
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Fatahi A, Doosti-Irani A, Cheraghi Z. Prevalence and Incidence of Metabolic Syndrome in Iran: A Systematic Review and Meta-Analysis. Int J Prev Med 2020; 11:64. [PMID: 32577194 PMCID: PMC7297433 DOI: 10.4103/ijpvm.ijpvm_489_18] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 08/08/2019] [Indexed: 12/15/2022] Open
Abstract
Metabolic syndrome (MetS) is a predictor of several diseases such as cardiovascular diseases, diabetes, dyslipidemia, stroke, osteoarthritis, certain cancers, and death leading to public health concern in most societies. We aimed to estimate the pooled prevalence and incidence of MetS in Iranian population through a meta-analysis study. We included cross-sectional and cohort studies to estimate the overall prevalence and incidence rates of MetS in Iran National databases including MagIran, Science Information Database, IranMedex, and international databases including Medline, Web of Sciences, and Scopus were searched up to October 2017. Finally, 125 studies were included. The total sample size was 472,401 with a mean age of 38 ± 7.8 years. The overall pooled prevalence and incidence rate among the general population of Iran was 0.26 (95% CI: 0.26, 0.29) and 97.96 (95% CI: 75.98, 131.48), respectively. The pooled prevalence of MetS was higher in females and in urban areas. The highest and lowest prevalence of MetS was obtained by the Iranian definition criteria (0.43) and the NHANES III (0.12). The highest and lowest incidence rates of MetS were obtained by IDF (144.07 per 1000) and the JIS (89.73 per 1000). The prevalence of MetS was higher in women and those living in urban areas. Furthermore, the prevalence of MetS increased with increasing age in both genders.
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Affiliation(s)
- Azad Fatahi
- Department of Epidemiology, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amin Doosti-Irani
- Department of Epidemiology, School of Public Health, Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Zahra Cheraghi
- Department of Epidemiology, School of Public Health, Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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Harit VK, Ramesh NG. A common strategy towards the synthesis of 1,4-dideoxy-1,4-imino-l-xylitol, deacetyl (+)-anisomycin and amino-substituted piperidine iminosugars. Carbohydr Res 2020; 492:107988. [PMID: 32387805 DOI: 10.1016/j.carres.2020.107988] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/17/2020] [Accepted: 03/17/2020] [Indexed: 12/15/2022]
Abstract
A strategy towards the synthesis of three different target molecules, namely 1,4-dideoxy-1,4-imino-l-xylitol, deacetyl (+)-anisomycin and amino-substituted piperidine iminosugars, molecules of potential biological and medicinal significance, is reported from a common amino-vicinal diol intermediate derived from tri-O-benzyl-d-glucal. Construction of the key pyrrolidine ring present in 1,4-dideoxy-1,4-imino-l-xylitol and (+)-anisomycin was a consequence of thermodynamically driven concomitant intramolecular nucleophilic addition reaction of the amino group to the resultant aldehyde obtained by oxidative cleavage of the amino-vicinal diol. Alternatively, double nucleophilic substitution on an amino-diol, after mesylation, with various amines delivered amino-substituted piperidine iminosugars in good yields.
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Affiliation(s)
- Vimal Kant Harit
- Department of Chemistry, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110016, India
| | - Namakkal G Ramesh
- Department of Chemistry, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110016, India.
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Doucet GE, Moser DA, Rodrigue A, Bassett DS, Glahn DC, Frangou S. Person-Based Brain Morphometric Similarity is Heritable and Correlates With Biological Features. Cereb Cortex 2020; 29:852-862. [PMID: 30462205 PMCID: PMC6319174 DOI: 10.1093/cercor/bhy287] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 10/25/2018] [Indexed: 11/29/2022] Open
Abstract
The characterization of the functional significance of interindividual variation in brain morphometry is a core aim of cognitive neuroscience. Prior research has focused on interindividual variation at the level of regional brain measures thus overlooking the fact that each individual brain is a person-specific ensemble of interdependent regions. To expand this line of inquiry we introduce the person-based similarity index (PBSI) for brain morphometry. The conceptual unit of the PBSI is the individual person’s brain structural profile which considers all relevant morphometric measures as features of a single vector. In 2 independent cohorts (total of 1756 healthy participants), we demonstrate the foundational validity of this approach by affirming that the PBSI scores for subcortical volume and cortical thickness in healthy individuals differ between men and women, are heritable, and robust to variation in neuroimaging parameters, sample composition, and regional brain morphometry. Moreover, the PBSI scores correlate with age, body mass index, and fluid intelligence. Collectively, these results suggest that the person-based measures of brain morphometry are biologically and functionally meaningful and have the potential to advance the study of human variation in multivariate brain imaging phenotypes in healthy and clinical populations.
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Affiliation(s)
- Gaelle E Doucet
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dominik A Moser
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Amanda Rodrigue
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Danielle S Bassett
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA.,Department of Electrical & Systems Engineering, University of Pennsylvania, Philadelphia, PA, USA.,Department of Physics & Astronomy, University of Pennsylvania, Philadelphia, PA, USA.,Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - David C Glahn
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Olin Neuropsychiatric Institute, Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Baseline brain structural and functional predictors of clinical outcome in the early course of schizophrenia. Mol Psychiatry 2018; 25:863-872. [PMID: 30283030 PMCID: PMC6447492 DOI: 10.1038/s41380-018-0269-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 07/30/2018] [Accepted: 09/10/2018] [Indexed: 11/13/2022]
Abstract
Although schizophrenia is considered a brain disorder, the role of brain organization for symptomatic improvement remains inadequately defined. We investigated the relationship between baseline brain morphology, resting-state network connectivity and clinical response after 24-weeks of antipsychotic treatment in patients with schizophrenia (n = 95) using integrated multivariate analyses. There was no significant association between clinical response and measures of cortical thickness (r = 0.37, p = 0.98) and subcortical volume (r = 0.56, p = 0.15). By contrast, we identified a strong mode of covariation linking functional network connectivity to clinical response (r = 0.70; p = 0.04), and particularly to improvement in positive (weight = 0.62) and anxious/depressive symptoms (weight = 0.49). Higher internal cohesiveness of the default mode network was the single most important positive predictor. Key negative predictors involved the functional cohesiveness of central executive subnetworks anchored in the frontoparietal cortices and subcortical regions (including the thalamus and striatum) and the inter-network integration between the default mode and sensorimotor networks. The present findings establish links between clinical response and the functional organization of brain networks involved both in perception and in spontaneous and goal-directed cognition, thereby advancing our understanding of the pathophysiology of schizophrenia.
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Ching YK, Chin YS, Appukutty M, Gan WY, Ramanchadran V, Chan YM. Prevalence of Metabolic Syndrome and Its Associated Factors among Vegetarians in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15092031. [PMID: 30227682 PMCID: PMC6164423 DOI: 10.3390/ijerph15092031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/03/2018] [Accepted: 09/05/2018] [Indexed: 12/25/2022]
Abstract
The prevalence and factors associated with metabolic syndrome (MetS) remain unknown in Malaysian vegetarians. This cross-sectional study aimed to determine the prevalence of MetS among vegetarians in Kuala Lumpur and Selangor and its associated factors. The data on socio-demographic characteristics, vegetarianism practises, lifestyle behaviours, body weight, height, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), and blood lipid profiles were collected from 273 vegetarians. A majority of the respondents were lacto-ovo vegetarians (44.0%), females (64.8%) and Chinese (54.9%). The prevalence of MetS was 24.2%. High BP (48.7%) and high WC (43.6%) were the most common MetS components. Females had lower WC, SBP, DBP, FBG, TG and higher HDL-c (p < 0.05) as compared to males. Multiple logistic regression analysis showed that being overweight and obese (Odds Ratio (OR) = 7.74, 95% Confidence Interval (CI): 4.04–14.82) was the main risk factor of MetS after being adjusted for sex and age. This study found that one in four vegetarians had MetS. An intervention programme should be developed to reduce Body Mass Index (BMI) among vegetarians, especially among those who are found to be overweight and obese.
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Affiliation(s)
- Yuan Kei Ching
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Seri Kembangan, Selangor, Malaysia.
| | - Yit Siew Chin
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Seri Kembangan, Selangor, Malaysia.
- Research Centre of Excellence, Nutrition and Non-Communicable Diseases, Universiti Putra Malaysia, 43400 Seri Kembangan, Selangor, Malaysia.
| | - Mahenderan Appukutty
- Programme of Sports Science, Faculty of Sports Science and Recreation, Universiti Teknologi MARA, 40450 Shah Alam, Selangor, Malaysia.
| | - Wan Ying Gan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Seri Kembangan, Selangor, Malaysia.
| | - Vasudevan Ramanchadran
- Malaysia Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, 43400 Seri Kembangan, Selangor, Malaysia.
| | - Yoke Mun Chan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Seri Kembangan, Selangor, Malaysia.
- Research Centre of Excellence, Nutrition and Non-Communicable Diseases, Universiti Putra Malaysia, 43400 Seri Kembangan, Selangor, Malaysia.
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Moser DA, Doucet GE, Lee WH, Rasgon A, Krinsky H, Leibu E, Ing A, Schumann G, Rasgon N, Frangou S. Multivariate Associations Among Behavioral, Clinical, and Multimodal Imaging Phenotypes in Patients With Psychosis. JAMA Psychiatry 2018; 75. [PMID: 29516092 PMCID: PMC5875357 DOI: 10.1001/jamapsychiatry.2017.4741] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
IMPORTANCE Alterations in multiple neuroimaging phenotypes have been reported in psychotic disorders. However, neuroimaging measures can be influenced by factors that are not directly related to psychosis and may confound the interpretation of case-control differences. Therefore, a detailed characterization of the contribution of these factors to neuroimaging phenotypes in psychosis is warranted. OBJECTIVE To quantify the association between neuroimaging measures and behavioral, health, and demographic variables in psychosis using an integrated multivariate approach. DESIGN, SETTING, AND PARTICIPANTS This imaging study was conducted at a university research hospital from June 26, 2014, to March 9, 2017. High-resolution multimodal magnetic resonance imaging data were obtained from 100 patients with schizophrenia, 40 patients with bipolar disorder, and 50 healthy volunteers; computed were cortical thickness, subcortical volumes, white matter fractional anisotropy, task-related brain activation (during working memory and emotional recognition), and resting-state functional connectivity. Ascertained in all participants were nonimaging measures pertaining to clinical features, cognition, substance use, psychological trauma, physical activity, and body mass index. The association between imaging and nonimaging measures was modeled using sparse canonical correlation analysis with robust reliability testing. MAIN OUTCOMES AND MEASURES Multivariate patterns of the association between nonimaging and neuroimaging measures in patients with psychosis and healthy volunteers. RESULTS The analyses were performed in 92 patients with schizophrenia (23 female [25.0%]; mean [SD] age, 27.0 [7.6] years), 37 patients with bipolar disorder (12 female [32.4%]; mean [SD] age, 27.5 [8.1] years), and 48 healthy volunteers (20 female [41.7%]; mean [SD] age, 29.8 [8.5] years). The imaging and nonimaging data sets showed significant covariation (r = 0.63, P < .001), which was independent of diagnosis. Among the nonimaging variables examined, age (r = -0.53), IQ (r = 0.36), and body mass index (r = -0.25) were associated with multiple imaging phenotypes; cannabis use (r = 0.23) and other substance use (r = 0.33) were associated with subcortical volumes, and alcohol use was associated with white matter integrity (r = -0.15). Within the multivariate models, positive symptoms retained associations with the global neuroimaging (r = -0.13), the cortical thickness (r = -0.22), and the task-related activation variates (r = -0.18); negative symptoms were mostly associated with measures of subcortical volume (r = 0.23), and depression/anxiety was associated with measures of white matter integrity (r = 0.12). CONCLUSIONS AND RELEVANCE Multivariate analyses provide a more accurate characterization of the association between brain alterations and psychosis because they enable the modeling of other key factors that influence neuroimaging phenotypes.
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Affiliation(s)
- Dominik A. Moser
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Gaelle E. Doucet
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Won Hee Lee
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Alexander Rasgon
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Hannah Krinsky
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Evan Leibu
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Alex Ing
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Gunter Schumann
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Natalie Rasgon
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California,Center for Neuroscience in Women’s Health, Stanford University, Palo Alto, California
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
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Kostovski M, Simeonovski V, Mironska K, Tasic V, Gucev Z. Metabolic Profiles in Obese Children and Adolescents with Insulin Resistance. Open Access Maced J Med Sci 2018; 6:511-518. [PMID: 29610610 PMCID: PMC5874375 DOI: 10.3889/oamjms.2018.097] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 03/04/2018] [Accepted: 03/05/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND: In the past several decades, the increasing frequency of overweight and obese children and adolescents in the world has become a public health problem. It has contributed significantly to the already high tide of diabetes, cardiovascular and cerebrovascular diseases. AIM: To investigate the frequency of insulin resistance and to evaluate the metabolic profile of insulin resistant and non-insulin resistant obese children and adolescents. SUBJECTS AND METHODS: The study included 96 (45 boys, 51 girls) obese children and adolescents aged 4-17 years old (10.50 ± 2.87 years). Only participants with Body Mass Index ≥ 95 percentile were included. We analysed sera for fasting insulin levels (FI), fasting serum triglycerides (TG), total serum cholesterol (TC), fasting plasma glucose (FPG) and plasma glucose 2 hours after the performance of the oral glucose tolerance test (2-h G). Homeostatic model assessment for insulin resistance (HOMA-IR) index was calculated as fasting insulin concentration (microunits per millilitre) x fasting glucose concentration (millimolar)/22.5. The value of HOMA-IR above 3.16 was used as a cut-off value for both genders. RESULTS: Insulin resistance was determined in 58.33% of study participants. Insulin resistant participants had significantly higher level of 2-h G (p = 0.02), FI level (p = 0.000) as well as TG levels (p = 0.01), compared to non-insulin resistant group. Strikingly, 70.73% of the pubertal adolescents were insulin resistant in comparison to 49.09% of the preadolescents (p = 0.03). Significantly higher percentage of insulin-resistant participants were girls (p = 0.009). Moreover, a higher percentage of the girls (70.59%) than boys (44.44%) had HOMA-IR above 3.16 and had elevated FI levels (70.59% vs 48.89%). The difference in the frequency of insulin resistance among obese versus severely obese children and adolescents was not significant (p = 0.73, p > 0.05). Our study results also showed positive, but weak, correlation of HOMA-IR with age, FPG, TG and BMI of the participants (p < 0.05). CONCLUSION: Higher percentage of insulin-resistant participants was of female gender and was adolescents. In general, insulin resistant obese children and adolescents tend to have a worse metabolic profile in comparison to individuals without insulin resistance. It is of note that the highest insulin resistance was also linked with the highest concentrations of triglycerides.
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Affiliation(s)
- Marko Kostovski
- Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Viktor Simeonovski
- Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Kristina Mironska
- University Clinic of Child Diseases, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Velibor Tasic
- University Clinic of Child Diseases, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Zoran Gucev
- University Clinic of Child Diseases, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
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Önnerfält J, Erlanson-Albertsson C, Montelius C, Thorngren-Jerneck K. Obese children aged 4-6 displayed decreased fasting and postprandial ghrelin levels in response to a test meal. Acta Paediatr 2018; 107:523-528. [PMID: 29172246 DOI: 10.1111/apa.14165] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 11/21/2017] [Indexed: 12/26/2022]
Abstract
AIM Ghrelin is a hunger hormone that plays a role in glucose homoeostasis and its levels increase before a meal and decrease during and after eating. This study compared the fasting ghrelin and insulin levels of obese children aged 4-6 with those of normal weight children and tested postprandial ghrelin levels in the obese children after a standard breakfast. METHODS We recruited 67 children at Lund University Hospital from 2008 to 2011. They comprised 30 obese children from a weight study and 37 normal weight children receiving minor elective surgery. Their mean ages were 4.7 ± 0.6 and 4.3 ± 0.8 years, respectively. The obese children ate a standard breakfast, and postprandial ghrelin was measured after 60 minutes. RESULTS The obese children had lower ghrelin levels than the controls (p < 0.01). A significant inverse relation was found between body mass index and fasting ghrelin levels. Obese children had significantly lower fasting ghrelin levels after a standard breakfast (p < 0.01), but there were no gender-related differences. CONCLUSION Obese children aged 4-6 years had reduced ghrelin and increased insulin levels in the fasting state and postprandial ghrelin was suppressed, suggesting that their energy metabolism was already dysregulated at this young age. Early obesity interventions are essential.
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Affiliation(s)
- Jenny Önnerfält
- Department of Paediatrics; Clinical Sciences in Lund; Lund University; Lund Sweden
| | | | - Caroline Montelius
- Department of Experimental Medical Science; Appetite Regulation Unit; Lund University; Lund Sweden
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Philips L, Visser J, Nel D, Blaauw R. The association between tuberculosis and the development of insulin resistance in adults with pulmonary tuberculosis in the Western sub-district of the Cape Metropole region, South Africa: a combined cross-sectional, cohort study. BMC Infect Dis 2017; 17:570. [PMID: 28810840 PMCID: PMC5556352 DOI: 10.1186/s12879-017-2657-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 08/01/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The existence of a bi-directional relationship between tuberculosis (TB) and insulin resistance (IR)/diabetes has been alluded to in literature. Although diabetes has been linked to increased tuberculosis risk, the relationship between tuberculosis as a causative factor for IR remains unclear. The study aimed to determine if an association existed between tuberculosis and IR development in adults with newly diagnosed pulmonary tuberculosis at baseline. It was additionally aimed to document changes in IR status during TB follow-up periods. METHODS This cross-sectional study evaluated ambulatory participants at baseline for IR prevalence via anthropometry, biochemistry and diagnostic IR tests [homeostasis model assessment-IR (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI)]. A prospective cohort sub-section study was additionally performed on approximately half of the baseline study population, who were followed-up at two and five months whilst on tuberculosis treatment. Summary statistics, correlation co-efficients and appropriate analysis of variance were used to describe and analyse data. Participants were excluded if they presented with other forms of tuberculosis, were HIV-positive, obese or had any pre-disposing IR conditions such as diabetes or metabolic syndrome. RESULTS Fifty-nine participants were included from August 2013 until December 2014 (33.95 ± 12.02 years old; 81.4% male). IR prevalence was 25.4% at baseline, determined by a calculated HOMA-IR cut-off point of 2.477. Patients with IR were younger (p = 0.04). Although the difference between IR levels in participants between baseline and follow-up was not significant, a decrease was observed over time. The majority of participants (61.0%) presented with a normal BMI at baseline. Mean baseline values of fasting glucose were within normal ranges (4.82 ± 0.80 mmol/L), whereas increased mean CRP levels (60.18 ± 50.92 mg/L) and decreased mean HDL-cholesterol levels (males: 0.94 ± 0.88 mmol/L; females: 1.14 ± 0.88 mmol/L) were found. CONCLUSIONS The study found an association between tuberculosis and IR development in newly diagnosed pulmonary tuberculosis patients. Although not significant, IR levels decreased over time, which could be indicative of a clinical improvement. A high prevalence of IR amongst young tuberculosis patients therefore highlights the need for early identification in order to facilitate a reversal of IR and prevent possible IR-related complications.
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Affiliation(s)
- Lauren Philips
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Janicke Visser
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Daan Nel
- Centre for Statistical Consultation, Stellenbosch University, Cape Town, South Africa
| | - Renée Blaauw
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Gaur A, Naidu CS, Rao PP, Sharma S, Singh AK, Trehan V, Kulkarni SV, Pathak N, Singh A, Goyal B. The effect of laparoscopic sleeve gastrectomy (LSG) on glycemic control in morbidly obese patients. Int J Surg 2016; 28:131-5. [PMID: 26902533 DOI: 10.1016/j.ijsu.2016.02.063] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 02/16/2016] [Accepted: 02/17/2016] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Bariatric procedures have become popular in treating not only the morbid obesity but also the metabolic derangements. Sleeve Gastrectomy has recently become popular as a standalone procedure and its usefulness as a metabolic procedure especially glycemic control is still under investigation. One of the most commonly used measure of insulin resistance is statistically derived 'Homeostatic model assessment of insulin resistance (HOMA-IR). AIM The effect of Laparoscopic Sleeve Gastrectomy (LSG) on clinical and measurable change in glycemic control as seen by reduction of insulin resistance ie HOMA-IR levels in morbidly obese patients. MATERIAL AND METHODS All the patients with BMI ≥35 kg/m(2) with co morbidities and BMI ≥40 kg/m(2) even without co morbidities were included in the study. The period of the study was from Feb 2013 to Sep 2014. Fasting (FBS), post prandial blood sugar (PPBS) and Insulin levels were checked before the surgery, 1month and 3 month after the surgery. We also recorded BMI and diabetic status. HOMA-IR was calculated and trends were recorded. STATISTICAL ANALYSIS Statistical analysis was carried out using SPSS 16.0. RESULTS Out of 28 patients 8 were males and 20 were females. The mean age was 43 yrs. 11 (39%) patients were diabetic and mean BMI was 44 kg/m(2) and a range of (35-61.3) kg/m(2). 11 patients had BMI > 45 kg/m(2). The HOMA-IR values decreased significantly after the surgery both in diabetics and non diabetics. CONCLUSION LSG results in improvement in glycemic control in both diabetics and non diabetics.
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Affiliation(s)
- Amit Gaur
- Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India.
| | - C S Naidu
- Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India
| | - P P Rao
- Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India
| | - Sanjay Sharma
- Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India
| | - A K Singh
- Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India
| | - V Trehan
- Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India
| | - S V Kulkarni
- Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India
| | - Nishant Pathak
- Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India
| | - Amit Singh
- Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India
| | - Balram Goyal
- Department of Gastrointestinal Surgery, Army Hospital (R&R), New Delhi, India
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Bulut C, Helvaci A, Adas M, Ozsoy N, Bayyigit A. The relationship between left ventricular mass and insulin resistance in obese patients. Indian Heart J 2016; 68:507-12. [PMID: 27543473 PMCID: PMC4990728 DOI: 10.1016/j.ihj.2015.11.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 11/06/2015] [Accepted: 11/18/2015] [Indexed: 01/19/2023] Open
Abstract
Objective In this study, we investigated the relationship between left ventricular mass and insulin resistance in obese patients. Methods A total of 90 subjects, 66 women, and 24 men, with an age range from 24 to 56 years, were enrolled in the study. Forty-nine patients were in the obesity group whose body mass index (BMI) was >29.9 kg/m2 and 41 subjects were in the control group with a BMI <25 kg/m2. All of them were normotensive, nondiabetic, and did not have any cardiovascular disease. They were not taking any medication. Weight, height, and waist circumference were measured and BMI was calculated. Plasma glucose, insulin, serum total, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, and triglyceride levels were measured, and insulin resistance was calculated via homeostasis model of assessment-estimated insulin resistance (HOMA-IR). Subjects were examined by echocardiography and left ventricular mass (LVM) and index (LVMI) were calculated with Devereux formula. Results Insulin levels, HOMA-IR, LVM, and LVMI were significantly higher in obesity group (p < 0.01). Fasting glucose, triglyceride, fasting insulin levels, and waist circumference did not correlate with LVMI. Conclusion In conclusion, though findings of the present study suggest increased left ventricular hypertrophy (LVH) in obese subjects compared to controls, it appears that the increased LVM or LVH is not linked to BMI and insulin resistance in this study population.
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Affiliation(s)
- Cengiz Bulut
- 2nd Clinic of Internal Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Aysen Helvaci
- 2nd Clinic of Internal Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Mine Adas
- 2nd Clinic of Internal Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Neslihan Ozsoy
- 2nd Clinic of Internal Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Akif Bayyigit
- 2nd Clinic of Internal Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey.
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Fish oil supplemented for 9 months does not improve glycaemic control or insulin sensitivity in subjects with impaired glucose regulation: a parallel randomised controlled trial. Br J Nutr 2015; 115:75-86. [DOI: 10.1017/s0007114515004274] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AbstractThe effects of fish oil (FO) supplementation on glycaemic control are unclear, and positive effects may occur only when the phospholipid content of tissue membranes exceeds 14 % asn-3 PUFA. Subjects (n36, thirty-three completed) were paired based on metabolic parameters and allocated into a parallel double-blind randomised trial with one of each pair offered daily either 6 g of FO (3·9 gn-3 PUFA) or 6 g of maize oil (MO) for 9 months. Hyperinsulinaemic–euglycaemic–euaminoacidaemic (HIEGEAA) clamps (with [6,62H2glucose]) were performed at the start and end of the intervention. Endogenous glucose production (EGP) and whole-body protein turnover (WBPT) were each measured after an overnight fast. The primary outcome involved the effect of oil type on insulin sensitivity related to glycaemic control. The secondary outcome involved the effect of oil type on WBPT. Subjects on FO (n16) had increased erythrocyten-3 PUFA concentrations >14 %, whereas subjects on MO (n17) had unalteredn-3 PUFA concentrations at 9 %. Type of oil had no effect on fasting EGP, insulin sensitivity or total glucose disposal during the HIEGEAA clamp. In contrast, under insulin-stimulated conditions, total protein disposal (P=0·007) and endogenous WBPT (P=0·001) were both increased with FO. In an associated pilot study (n4, three completed), althoughn-3 PUFA in erythrocyte membranes increased to >14 % with the FO supplement, the enrichment in muscle membranes remained lower (8 %;P<0·001). In conclusion, long-term supplementation with FO, at amounts near the safety limits set by regulatory authorities in Europe and the USA, did not alter glycaemic control but did have an impact on WBPT.
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Anderson RA, Zhan Z, Luo R, Guo X, Guo Q, Zhou J, Kong J, Davis PA, Stoecker BJ. Cinnamon extract lowers glucose, insulin and cholesterol in people with elevated serum glucose. J Tradit Complement Med 2015; 6:332-336. [PMID: 27774415 PMCID: PMC5067830 DOI: 10.1016/j.jtcme.2015.03.005] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 03/12/2015] [Accepted: 03/13/2015] [Indexed: 01/22/2023] Open
Abstract
Cinnamon (肉桂 ròu guì) has in vitro insulin potentiating activity, and proanthocyanidins from cinnamon prevent in vitro formation of advanced glycation end products. Some human studies were equivocal, but several have shown beneficial effects of cinnamon supplementation on circulating glucose, lipids, and/or insulin. This placebo-controlled double-blind trial tested the effects of a dried water extract of cinnamon (Cinnamomum cassia) on circulating glucose, lipids, insulin, and insulin resistance. Men and women from Beijing and Dalian, China, were invited to participate if they had fasting serum glucose >6.1 mmol/L or 2-h glucose >7.8 mmol/L. Participants, (173 were enrolled and 137 completed the study) were randomly assigned to receive either a spray-dried, water extract of cinnamon (CinSulin®), 250 mg/capsule, or a placebo, twice a day for two months. Mean ± SEM age of participants was 61.3 ± 0.8 years, BMI was 25.3 ± 0.3 and M/F ratio was 65/72. After 2 mo, fasting glucose decreased (p < 0.001) in the cinnamon extract-supplemented group (8.85 ± 0.36 to 8.19 ± 0.29 mmol/L) compared with the placebo group (8.57 ± 0.32 to 8.44 ± 0.34 mmol/L, p = 0.45). Glucose 2 h after a 75 g carbohydrate load, fasting insulin, and HOMA-IR also decreased with cinnamon extract compared with placebo. Total and LDL-cholesterol decreased with cinnamon extract and HDL-cholesterol decreased in both the cinnamon-extract and placebo groups. In conclusion, supplementation with 500 mg of water-extract of cinnamon for two months reduced fasting insulin, glucose, total cholesterol, and LDL cholesterol and enhanced insulin sensitivity of subjects with elevated blood glucose.
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Affiliation(s)
| | - Zhiwei Zhan
- The General Hospital of 2nd Artillery, Beijing, China
| | | | - Xiuhua Guo
- Beijing Capital Medical University, Beijing, China
| | - Qingqing Guo
- Beijing Capital Medical University, Beijing, China
| | - Jin Zhou
- Dalian Dakang Clinic, Dalian, China
| | | | - Paul A Davis
- Department of Nutrition, University of Calif-Davis, Davis, CA, USA
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Li XX, Li CB, Xiao J, Gao HQ, Wang HW, Zhang XY, Zhang C, Ji XP. Berberine Attenuates Vascular Remodeling and Inflammation in a Rat Model of Metabolic Syndrome. Biol Pharm Bull 2015; 38:862-8. [DOI: 10.1248/bpb.b14-00828] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Xiao-Xing Li
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Qilu Hospital, Shandong University
- Department of Geriatrics, Qilu Hospital, Shandong University
| | - Chuan-Bao Li
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Qilu Hospital, Shandong University
- Department of Emergency, Qilu Hospital, Shandong University
| | - Jie Xiao
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Qilu Hospital, Shandong University
| | - Hai-Qing Gao
- Department of Geriatrics, Qilu Hospital, Shandong University
| | - He-Wen Wang
- Department of Paediatrics, Rizhao People’s Hospital
| | - Xin-Yu Zhang
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Qilu Hospital, Shandong University
| | - Cheng Zhang
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Qilu Hospital, Shandong University
| | - Xiao-Ping Ji
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Qilu Hospital, Shandong University
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Jafari-Adli S, Jouyandeh Z, Qorbani M, Soroush A, Larijani B, Hasani-Ranjbar S. Prevalence of obesity and overweight in adults and children in Iran; a systematic review. J Diabetes Metab Disord 2014; 13:121. [PMID: 25610814 PMCID: PMC4301060 DOI: 10.1186/s40200-014-0121-2] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Accepted: 12/06/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Obesity is one of the most important underlying risk factors for chronic disease. Dramatically increasing and following complication of obesity should be alerted to health politicians and practitioners to prevent associated health risks. This review aimed to give a better insight into the prevalence of obesity and overweight in different areas of Iran. METHOD All published internal (SID, Irandoc, Iranmedex), and international (Web of Knowledge, Pubmed, Scopus) source studies, reported the prevalence of overweight/obesity among normal population samples, during Jan 2005 through Jan 2014, were assessed in this review. Paper selection processes were done by two researchers separately. Studies which met the eligible criteria were included in this review. RESULT One hundred ninety three eligible studies enter into our review. Of 193 final selected studies, 86 (15 national, 71 sub national) of them were reported the prevalence of obesity/overweight in adult, and 107 studies (11 national, 96 sub national) in under-18 by individual. The range of overweight and obesity prevalence in national studies in adult, was 27.0-38.5 (95% CI: 26.8-27.1, 37.2-39.8), and 12.6-25.9 (95% CI: 12.2-13.0, 24.9-26.8), separately. In under-18 the range of overweight and obesity prevalence in national studies were 5.0-13.5 (95% CI: 4.5-5.5, 13.4-13.6), and 3.2-11.9 (95% CI: 3.0-3.4, 11.3-12.4). CONCLUSION Obesity as an important public health problem has been discussed in recent few decades worldwide. Although the national reported prevalence of obesity in Iran was not considerably diverse, but remarkable differences were seen in the sub national prevalence which must be noticed more in political health programs especially among women and children.
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Affiliation(s)
- Shahrzad Jafari-Adli
- />Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Jouyandeh
- />Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- />Department of Community Medicine, Alborz University of Medical Sciences, Karaj, Iran
- />Non communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Soroush
- />Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- />Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, 5th floor of Shariati Hospital, North Karegar St., P.O Box 1411413137, Tehran, Iran
| | - Shirin Hasani-Ranjbar
- />Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- />Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, 5th floor of Shariati Hospital, North Karegar St., P.O Box 1411413137, Tehran, Iran
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Ashraf H, Rashidi A, Noshad S, Khalilzadeh O, Esteghamati A. Epidemiology and risk factors of the cardiometabolic syndrome in the Middle East. Expert Rev Cardiovasc Ther 2014; 9:309-20. [DOI: 10.1586/erc.11.9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Concia AL, Gómez L, Bujons J, Parella T, Vilaplana C, Cardona PJ, Joglar J, Clapés P. Chemo-enzymatic synthesis and glycosidase inhibitory properties of DAB and LAB derivatives. Org Biomol Chem 2013; 11:2005-21. [PMID: 23381224 DOI: 10.1039/c3ob27343a] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
A chemo-enzymatic strategy for the preparation of 2-aminomethyl derivatives of (2R,3R,4R)-2-(hydroxymethyl)pyrrolidine-3,4-diol (also called 1,4-dideoxy-1,4-imino-D-arabinitol, DAB) and its enantiomer LAB is presented. The synthesis is based on the enzymatic preparation of DAB and LAB followed by the chemical modification of their hydroxymethyl functionality to afford diverse 2-aminomethyl derivatives. This strategy leads to novel aromatic, aminoalcohol and 2-oxopiperazine DAB and LAB derivatives. The compounds were preliminarily explored as inhibitors of a panel of commercial glycosidases, rat intestinal disaccharidases and against Mycobacterium tuberculosis, the causative agent of tuberculosis. It was found that the inhibitory profile of the new products differed considerably from the parent DAB and LAB. Furthermore, some of them were active inhibiting the growth of M. tuberculosis.
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Affiliation(s)
- Alda Lisa Concia
- Dept Química Biológica y Modelización Molecular, Instituto de Química Avanzada de Cataluña, IQAC-CSIC, Jordi Girona 18-26, 08034 Barcelona, Spain
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Phillips CM, Tierney AC, Perez-Martinez P, Defoort C, Blaak EE, Gjelstad IMF, Lopez-Miranda J, Kiec-Klimczak M, Malczewska-Malec M, Drevon CA, Hall W, Lovegrove JA, Karlstrom B, Risérus U, Roche HM. Obesity and body fat classification in the metabolic syndrome: impact on cardiometabolic risk metabotype. Obesity (Silver Spring) 2013; 21:E154-61. [PMID: 23505198 DOI: 10.1002/oby.20263] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Accepted: 05/31/2012] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Obesity is a key factor in the development of the metabolic syndrome (MetS), which is associated with increased cardiometabolic risk. We investigated whether obesity classification by BMI and body fat percentage (BF%) influences cardiometabolic profile and dietary responsiveness in 486 MetS subjects (LIPGENE dietary intervention study). DESIGN AND METHODS Anthropometric measures, markers of inflammation and glucose metabolism, lipid profiles, adhesion molecules, and hemostatic factors were determined at baseline and after 12 weeks of four dietary interventions (high saturated fat (SFA), high monounsaturated fat (MUFA), and two low fat high complex carbohydrate (LFHCC) diets, one supplemented with long chain n-3 polyunsaturated fatty acids (LC n-3 PUFAs)). RESULTS About 39 and 87% of subjects classified as normal and overweight by BMI were obese according to their BF%. Individuals classified as obese by BMI (≥ 30 kg/m(2)) and BF% (≥ 25% (men) and ≥ 35% (women)) (OO, n = 284) had larger waist and hip measurements, higher BMI and were heavier (P < 0.001) than those classified as nonobese by BMI but obese by BF% (NOO, n = 92). OO individuals displayed a more proinflammatory (higher C reactive protein (CRP) and leptin), prothrombotic (higher plasminogen activator inhibitor-1 (PAI-1)), proatherogenic (higher leptin/adiponectin ratio) and more insulin resistant (higher HOMA-IR) metabolic profile relative to the NOO group (P < 0.001). Interestingly, tumor necrosis factor-α (TNF-α) concentrations were lower post-intervention in NOO individuals compared with OO subjects (P < 0.001). CONCLUSIONS In conclusion, assessing BF% and BMI as part of a metabotype may help to identify individuals at greater cardiometabolic risk than BMI alone.
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Affiliation(s)
- Catherine M Phillips
- Nutrigenomics Research Group, UCD School of Public Health and Population Science, UCD Conway Institute, University College Dublin, Dublin, Ireland
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Oliveira AC, Oliveira AM, Oliveira N, Oliveira A, Almeida M, Veneza LM, Oliveira AL, Adan L, Ladeia AM. Is triglyceride to high-density lipoprotein cholesterol ratio a surrogates for insulin resistance in youth? Health (London) 2013. [DOI: 10.4236/health.2013.53066] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Zandieh A, Esteghamati A, Morteza A, Noshad S, Khalilzadeh O, Gouya MM, Nakhjavani M. Appropriate BMI cut-off values for identification of metabolic risk factors: Third national surveillance of risk factors of non-communicable diseases in Iran (SuRFNCD-2007). Ann Hum Biol 2012; 39:484-9. [DOI: 10.3109/03014460.2012.716860] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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High Prevalence of Metabolic Syndrome in Iran in Comparison with France: What Are the Components That Explain This? Metab Syndr Relat Disord 2012; 10:181-8. [DOI: 10.1089/met.2011.0097] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Yue F, Zhang X, Zhang H, Jiang X, Gao L, Zhao J. Association of alcohol consumption with the impaired β-cell function independent of body mass index among Chinese men. Endocr J 2012; 59:425-33. [PMID: 22447141 DOI: 10.1507/endocrj.ej12-0003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Alcohol consumption is associated with type 2 diabetes. However, the relationship between alcohol consumption and β-cell function is still unclear. The aim of this study is to investigate the association between them. 675 Chinese men aged 20-75 years were recruited. The subjects were first classified into never drinkers, abstainers, light drinkers (0.1-19.9 g/day) , moderate drinkers (20.0-39.9 g/day) and heavy drinkers (≥ 40.0 g/day) and then, were further divided into two subgroups according to body mass index (BMI) (BMI<25kg/m² and BMI ≥ 25kg/m²). Analysis procedure was adjusted by the confounders including age, smoking status, BMI, waist circumference (WC), blood pressure, lipids and blood uric acid. Compared with never drinkers, alcohol consumption was associated with decreased homeostasis model assessment of β-cell function (HOMA-β) independent of BMI. The homeostasis model assessment of insulin resistance (HOMA-IR) was significantly correlated with alcohol consumption history in the group of BMI<25kg/m² and was significantly correlated with alcohol consumption in the group of BMI ≥ 25kg/m². The results suggest that alcohol consumption is associated with the β-cell dysfunction independent of BMI in Chinese community dwelling men.
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Affiliation(s)
- Feng Yue
- Department of Endocrinology, Provincial Hospital Affiliated to Shandong University, Jinan 250021, China
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Zhao J, Zhao Y, Wang H, Gu X, Ji J, Gao C. Association between metabolic abnormalities and HBV related hepatocelluar carcinoma in Chinese: a cross-sectional study. Nutr J 2011; 10:49. [PMID: 21569630 PMCID: PMC3118330 DOI: 10.1186/1475-2891-10-49] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Accepted: 05/15/2011] [Indexed: 02/07/2023] Open
Abstract
Background Previous studies suggested that the abnormality of metabolism is a newly identified risk factor in HBV-related hepatocellular carcinoma (HCC). The association between metabolic factors and hepatocellular carcinoma (HCC) has not been clarified up to now. This study was conducted to investigate the prevalence of metabolic abnormalities in HCC and to probe the association between metabolic parameters and liver function as well, so as to evaluate the interactions between metabolism and the development of HBV-related HCC. Methods Totally 179 cases of HBV-related HCC, who were surgically treated and pathologically confirmed were enrolled. HBV carriers (n = 100) and healthy controls (n = 150) were recruited from routine physical examination during the same period. Body mass index (BMI) was obtained from medical documentation. All the metabolic-related parameters and liver function tests were determined with routine biochemical or immunological analytic methods. Malondialdehyde (MDA) and total antioxidant capacity(TAOC)were detected by chemical analytic methods. A stratified analysis was conducted according to BMI, glycated albumin (GA), free fatty acids (FFA), and the relationships between the metabolic-related parameters and liver functions were analyzed in HCC and control subjects. Results HCC group showed significantly high levels of mean BMI, serum glucose, low serum lipids levels than controls (P < 0.05). Acquired by stratified analysis, the higher the BMI, the higher level of insulin and homeostasis model assessment for insulin resistance (HOMA-IR) (P < 0.01) were found in HCC patients. Elevated level of MDA and γ-glutamyltransferase (GGT) were revealed in those with high serum FFA level for the first time. Strong associations between metabolic factors and liver function were shown in HCC (P < 0.05). Higher GA level was strongly associated with increased risk of cancer compared to healthy controls (OR = 9.87, 95% confidence interval: 1.86~52.29). Serum triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) levels were negative contributory factors for HCC (OR = 0.05, 95% confidence interval: 0.01~0.27 and OR = 0.32, 95% confidence interval, 0.11~0.95: respectively). Conclusions Metabolic abnormalities are closely associated with the occurrence and development of HBV-related HCC. Oxidative stress and/or lipid peroxidation might be involved in the pathogenesis and acceleration of liver function impairments in HCC.
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Affiliation(s)
- Jinyan Zhao
- Department of Laboratory Medicine, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
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Shea JL, Randell EW, Sun G. The prevalence of metabolically healthy obese subjects defined by BMI and dual-energy X-ray absorptiometry. Obesity (Silver Spring) 2011; 19:624-30. [PMID: 20706202 DOI: 10.1038/oby.2010.174] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Nearly one-third of obese (OB) people are reported to be metabolically healthy based on BMI criteria. It is unknown whether this holds true when more accurate adiposity measurements are applied such as dual-energy X-ray absorptiometry (DXA). We compared differences in the prevalence of cardiometabolic abnormalities among adiposity groups classified using BMI vs. DXA criteria. A total of 1,907 adult volunteers from Newfoundland and Labrador participated. BMI and body fat percentage (%BF; measured using DXA) were measured following a 12-h fasting period. Subjects were categorized as normal weight (NW), overweight (OW), or OB based on BMI and %BF criteria. Cardiometabolic abnormalities considered included elevated triglyceride, glucose, and high-sensitivity C-reactive protein (hsCRP) levels, decreased high-density lipoprotein (HDL) cholesterol levels, insulin resistance, and hypertension. Subjects were classified as metabolically healthy (0 or 1 cardiometabolic abnormality) or abnormal (≥ 2 cardiometabolic abnormalities). We found low agreement in the prevalence of cardiometabolic abnormalities between BMI and %BF classifications (κ = 0.373, P < 0.001). Among NW and OW subjects, the prevalence of metabolically healthy individuals was similar between BMI and %BF (77.6 vs. 75.7% and 58.8 vs. 62.5%, respectively) however, there was a pronounced difference among OB subjects (34.0 vs. 47.7%, P < 0.05). Similar trends were evident using three additional definitions to characterize metabolically healthy individuals. Our findings indicate that approximately one-half of OB people are metabolically healthy when classified using %BF criteria which is significantly higher than previously reported using BMI. Caution should therefore be taken when making inferences about the metabolic health of an OB population depending on the method used to measure adiposity.
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Affiliation(s)
- Jennifer L Shea
- Discipline of Genetics, Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada
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Garrabou X, Gómez L, Joglar J, Gil S, Parella T, Bujons J, Clapés P. Structure-guided minimalist redesign of the L-fuculose-1-phosphate aldolase active site: expedient synthesis of novel polyhydroxylated pyrrolizidines and their inhibitory properties against glycosidases and intestinal disaccharidases. Chemistry 2011; 16:10691-706. [PMID: 20661960 DOI: 10.1002/chem.201000714] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A minimalist active site redesign of the L-fuculose-1-phosphate aldolase from E. coli FucA was envisaged, to extend its tolerance towards bulky and conformationally restricted N-Cbz-amino aldehyde acceptor substrates (Cbz=benzyloxycarbonyl). Various mutants at the active site of the FucA wild type were obtained and screened with seven sterically demanding N-Cbz-amino aldehydes including N-Cbz-prolinal derivatives. FucA F131A showed an aldol activity of 62 μmol h(-1) mg(-1) with (R)-N-Cbz-prolinal, whereas no detectable activity was observed with the FucA wild type. For the other substrates, the F131A mutant gave aldol activities from 4 to about 25 times higher than those observed with the FucA wild type. With regard to the stereochemistry of the reactions, the (R)-amino aldehydes gave exclusively the anti configured aldol adducts whereas their S counterparts gave variable ratios of anti/syn diastereoisomers. Interestingly, the F131A mutant was highly stereoselective both with (R)- and with (S)-N-Cbz-prolinal, exclusively producing the anti and syn aldol adducts, respectively. Molecular models suggest that this improved activity towards bulky and more rigid substrates, such as N-Cbz-prolinal, could arise from a better fit of the substrate into the hydrophobic pocket created by the F131A mutation, due to an additional π-cation interaction with the residue K205' and to efficient contact between the substrate and the mechanistically important Y113' and Y209' residues. An expedient synthesis of novel polyhydroxylated pyrrolizidines related to the hyacinthacine and alexine types was accomplished through aldol additions of dihydroxyacetone phosphate (DHAP) to hydroxyprolinal derivatives with the hyperactive FucA F131A as catalyst. The iminocyclitols obtained were fully characterised and found to be moderate to weak inhibitors (relative to 1,4-dideoxy-1,4-imino-L-arabinitol (LAB) and 1,4-dideoxy-1,4-imino-D-arabinitol (DAB)) against glycosidases and rat intestinal saccharidases.
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Affiliation(s)
- Xavier Garrabou
- Biotransformation and Bioactive Molecules Group, Instituto de Química Avanzada de Cataluña-CSIC, Jordi Girona 18-26, 08034 Barcelona, Spain
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Engel A, Helfrich J, Manderscheid N, Musholt PB, Forst T, Pfützner A, Dahmen N. Investigation of insulin resistance in narcoleptic patients: dependent or independent of body mass index? Neuropsychiatr Dis Treat 2011; 7:351-6. [PMID: 21822386 PMCID: PMC3148926 DOI: 10.2147/ndt.s18455] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Narcolepsy is a severe sleep-wake cycle disorder resulting in most cases from a lack of orexin, the energy balance-regulating hormone. Narcoleptic patients have been reported to suffer from an excess morbidity of Type 2 diabetes, even after correction for their often elevated body mass index. METHODS To explore whether narcolepsy is specifically associated with a propensity to develop insulin resistance, we measured fasting glucose, insulin, and intact proinsulin levels in 43 narcoleptic patients and 47 controls matched for body mass index and age. The proinsulin-to-insulin ratio was calculated. Insulin resistance was determined using the homeostatic model assessment method. RESULTS Narcoleptic patients did not show elevated insulin resistance parameters. CONCLUSION In contrast with earlier reports, we found no evidence that narcolepsy specifically elevates the risk of insulin resistance (and consequently of type 2 diabetes) independently of body mass index.
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Affiliation(s)
- Alice Engel
- Department of Psychiatry, University of Mainz, Germany
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Hack EE, Siemens DR, Groome PA. The relationship between adiposity and gleason score in men with localized prostate cancer. Prostate 2010; 70:1683-91. [PMID: 20564314 DOI: 10.1002/pros.21203] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND We investigated the relationship between body mass index (BMI) at the time of cancer diagnosis and malignant phenotype as measured by Gleason score. METHODS This was a population-based cross-sectional study conducted on 1,096 prostate cancer patients treated for cure in Ontario, Canada between 1990 and 1998. An electronic-linked data set was enhanced by retrospective chart review. BMI was categorized as: normal (BMI <25.0), overweight (BMI 25.0-29.9), and obese (BMI ≥30). We also investigated the role of diabetic status. Gleason scores were categorized as: 2-4, 5-6, 7, and 8-10. We assessed the effect modification by patient age. RESULTS BMI was not associated with Gleason score; 9.7% of those with normal BMI had a Gleason score ≥8, and 9.4% fell into this Gleason category in both the overweight and obese groups (P = 0.73). 11.7% of diabetics had a Gleason score ≥8 compared to 9.3% in the non-diabetic group (P = 0.79). Both of these results persisted in a multivariate analysis controlling for age and diagnosis year. When stratified by age, only the Gleason score distribution in the youngest cohort (50- to 59-year olds) indicated higher Gleason scores in the obese group, with marginally significant results (P = 0.16). CONCLUSIONS With a possible exception in younger men, elevated BMI at the time of diagnosis does not appear to be associated with aspects of aggressive behavior associated with Gleason grade. The effect of adiposity on prostate cancer outcome is complex, requiring further study that includes attention to factors such as length of exposure, concomitant co-morbidities, and ethnicity.
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Affiliation(s)
- Erica E Hack
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
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Spagnuolo MI, Cicalese MP, Caiazzo MA, Franzese A, Squeglia V, Assante LR, Valerio G, Merone R, Guarino A. Relationship between severe obesity and gut inflammation in children: what's next? Ital J Pediatr 2010; 36:66. [PMID: 20920305 PMCID: PMC2964531 DOI: 10.1186/1824-7288-36-66] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Accepted: 10/01/2010] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Preliminary evidence suggests an association between obesity and gut inflammation. AIMS To evaluate the frequency of glucose abnormalities and their correlation with systemic and intestinal inflammation in severely obese children. PATIENTS AND METHODS Thirty-four children (25 males; median age 10.8 ± 3.4 yrs) with severe obesity (BMI >95%) were screened for diabetes with oral glucose tolerance test (OGTT), systemic inflammation with C-reactive protein (CRP) and gut inflammation with rectal nitric oxide (NO) and faecal calprotectin. RESULTS BMI ranged from 23 to 44 kg/m2, and BMI z-score between 2.08 e 4.93 (median 2.69 ± 0.53). Glucose abnormalities were documented in 71% of patients: type 2 diabetes in 29%, impaired fasting glucose (IFG) in 58%, and impaired glucose tolerance (IGT) in 37.5%. Thirty-one patients (91%) were hyperinsulinemic. CRP was increased in 73.5% with a correlation between BMI z-score and CRP (p 0.03). Faecal calprotectin was increased in 47% patients (mean 77 ± 68), and in 50% of children with abnormal glucose metabolism (mean 76 ± 68 μg/g), with a correlation with increasing BMI z-score. NO was pathological in 88%, and in 87.5% of glucose impairment (mean 6.8 ± 5 μM). CONCLUSIONS In this study, the prevalence of glucose abnormalities in obese children is higher than in other series; furthermore, a correlation is present between markers of systemic and intestinal inflammation and glucose abnormalities.
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Affiliation(s)
| | | | | | | | | | | | - Giuliana Valerio
- School of Movement Sciences (DiSiST), Parthenope University, Naples, Italy
| | - Rossella Merone
- Department of Paediatrics University Federico II, Naples, Italy
| | - Alfredo Guarino
- Department of Paediatrics University Federico II, Naples, Italy
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Loebig M, Klement J, Schmoller A, Betz S, Heuck N, Schweiger U, Peters A, Schultes B, Oltmanns KM. Evidence for a relationship between VEGF and BMI independent of insulin sensitivity by glucose clamp procedure in a homogenous group healthy young men. PLoS One 2010; 5:e12610. [PMID: 20830305 PMCID: PMC2935379 DOI: 10.1371/journal.pone.0012610] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Accepted: 08/09/2010] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This is the first study to experimentally explore the direct relationship between circulating VEGF levels and body mass index (BMI) as well as to unravel the role of insulin sensitivity in this context under standardized glucose clamp conditions as the methodical gold-standard. In order to control for known influencing factors such as gender, medication, and arterial hypertension, we examined a highly homogeneous group of young male subjects. Moreover, to encompass also subjects beyond the normal BMI range, low weight and obese participants were additionally included and stress hormones as a main regulator of VEGF were assessed. METHODOLOGY/PRINCIPAL FINDINGS Under euglycemic clamp conditions, VEGF was measured in 15 normal weight (BMI 20-25 kg/m(2)), 15 low weight (BMI<20 kg/m(2)), and 15 obese (BMI>30 kg/m(2)) male subjects aged 18-30 years and the insulin sensitivity index (ISI) was calculated. Since stress axis activation promotes VEGF secretion, concentrations of ACTH, cortisol, and catecholamines were monitored. Despite of comparable ACTH (P = 0.145), cortisol (P = 0.840), and norepinephrine (P = 0.065) levels, VEGF concentrations differed significantly between BMI-groups (P = 0.008) with higher concentrations in obese subjects as compared to normal weight (P = 0.061) and low weight subjects (P = 0.002). Pearson's correlation analysis revealed a positive relationship between BMI and VEGF levels (r = 0.407; P = 0.010) but no correlation of VEGF with ISI (r = 0.224; P = 0.175). CONCLUSIONS/SIGNIFICANCE Our data demonstrate a positive correlation between concentrations of circulating VEGF levels and BMI in healthy male subjects under highly controlled conditions. This relationship which is apparently disconnected from insulin sensitivity may be part of some pathogenetic mechanisms underlying obesity and type 2 diabetes.
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Affiliation(s)
- Michaela Loebig
- Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
- * E-mail:
| | - Johanna Klement
- Department of Internal Medicine I, University of Luebeck, Luebeck, Germany
| | - André Schmoller
- Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
| | - Simone Betz
- Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
| | - Nicole Heuck
- Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
| | - Ulrich Schweiger
- Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
| | - Achim Peters
- Department of Internal Medicine I, University of Luebeck, Luebeck, Germany
| | - Bernd Schultes
- Department of Interdisciplinary Obesity Center, Kantonsspital St. Gallen, Rorschach, Switzerland
| | - Kerstin M. Oltmanns
- Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
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Magkos F, Fabbrini E, Mohammed BS, Patterson BW, Klein S. Increased whole-body adiposity without a concomitant increase in liver fat is not associated with augmented metabolic dysfunction. Obesity (Silver Spring) 2010; 18:1510-5. [PMID: 20395947 PMCID: PMC3319734 DOI: 10.1038/oby.2010.90] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Aim of this study was to determine whether an increase in adiposity, without a concomitant increase in intrahepatic triglyceride (IHTG) content, is associated with a deterioration in metabolic function. To this end, multiorgan insulin sensitivity, assessed by using a two-stage hyperinsulinemic-euglycemic clamp procedure in conjunction with stable isotopically labeled tracer infusion, and very low-density lipoprotein (VLDL) kinetics, assessed by using stable isotopically labeled tracer infusion and mathematical modeling, were determined in 10 subjects with class I obesity (BMI: 31.6 +/- 0.3 kg/m(2); 37 +/- 2% body fat; visceral adipose tissue (VAT): 1,225 +/- 144 cm(3)) and 10 subjects with class III obesity (BMI: 41.5 +/- 0.5 kg/m(2); 43 +/- 2% body fat; VAT: 2,121 +/- 378 cm(3)), matched on age, sex, and IHTG content (14 +/- 4 and 14 +/- 3%, respectively). No differences between class I and class III obese groups were detected in insulin-mediated suppression of palmitate (67 +/- 3 and 65 +/- 3%, respectively; P = 0.635) and glucose (67 +/- 3 and 73 +/- 5%, respectively; P = 0.348) rates of appearance in plasma, and the insulin-mediated increase in glucose disposal (218 +/- 18 and 193 +/- 30%, respectively; P = 0.489). In addition, no differences between class I and class III obese groups were detected in secretion rates of VLDL-triglyceride (6.5 +/- 1.0 and 6.0 +/- 1.4 micromol/l x min, respectively; P = 0.787) and VLDL-apolipoprotein B-100 (0.40 +/- 0.05 and 0.41 +/- 0.04 nmol/l x min, respectively; P = 0.866), and plasma clearance rates of VLDL-triglyceride (31 (16-59) and 29 (18-46) ml/min, respectively; P = 0.888) and VLDL-apolipoprotein B-100 (15 (11-19) and 17 (11-25) ml/min, respectively; P = 0.608). We conclude that increased adiposity without a concomitant increase in IHTG content does not cause additional abnormalities in adipose tissue, skeletal muscle, and hepatic insulin sensitivity, or VLDL metabolism.
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Affiliation(s)
- Faidon Magkos
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, MO, USA
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Elisa Fabbrini
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, MO, USA
- Center for Clinical and Basic Research, Department of Medical Sciences, IRCCS San Raffaele, Rome, Italy
| | - B. Selma Mohammed
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, MO, USA
| | - Bruce W. Patterson
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, MO, USA
| | - Samuel Klein
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, MO, USA
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Kars M, Yang L, Gregor MF, Mohammed BS, Pietka TA, Finck BN, Patterson BW, Horton JD, Mittendorfer B, Hotamisligil GS, Klein S. Tauroursodeoxycholic Acid may improve liver and muscle but not adipose tissue insulin sensitivity in obese men and women. Diabetes 2010; 59:1899-905. [PMID: 20522594 PMCID: PMC2911053 DOI: 10.2337/db10-0308] [Citation(s) in RCA: 304] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Insulin resistance is commonly associated with obesity. Studies conducted in obese mouse models found that endoplasmic reticulum (ER) stress contributes to insulin resistance, and treatment with tauroursodeoxycholic acid (TUDCA), a bile acid derivative that acts as a chemical chaperone to enhance protein folding and ameliorate ER stress, increases insulin sensitivity. The purpose of this study was to determine the effect of TUDCA therapy on multiorgan insulin action and metabolic factors associated with insulin resistance in obese men and women. RESEARCH DESIGN AND METHODS Twenty obese subjects ([means +/- SD] aged 48 +/- 11 years, BMI 37 +/- 4 kg/m2) were randomized to 4 weeks of treatment with TUDCA (1,750 mg/day) or placebo. A two-stage hyperinsulinemic-euglycemic clamp procedure in conjunction with stable isotopically labeled tracer infusions and muscle and adipose tissue biopsies were used to evaluate in vivo insulin sensitivity, cellular factors involved in insulin signaling, and cellular markers of ER stress. RESULTS Hepatic and muscle insulin sensitivity increased by approximately 30% (P < 0.05) after treatment with TUDCA but did not change after placebo therapy. In addition, therapy with TUDCA, but not placebo, increased muscle insulin signaling (phosphorylated insulin receptor substrate(Tyr) and Akt(Ser473) levels) (P < 0.05). Markers of ER stress in muscle or adipose tissue did not change after treatment with either TUDCA or placebo. CONCLUSIONS These data demonstrate that TUDCA might be an effective pharmacological approach for treating insulin resistance. Additional studies are needed to evaluate the target cells and mechanisms responsible for this effect.
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Affiliation(s)
- Marleen Kars
- Center for Human Nutrition and Atkins Center of Excellence in Obesity Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Ling Yang
- Department of Genetics and Complex Diseases, Harvard School of Public Health, Boston, Massachusetts
| | - Margaret F. Gregor
- Department of Genetics and Complex Diseases, Harvard School of Public Health, Boston, Massachusetts
| | - B. Selma Mohammed
- Center for Human Nutrition and Atkins Center of Excellence in Obesity Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Terri A. Pietka
- Center for Human Nutrition and Atkins Center of Excellence in Obesity Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Brian N. Finck
- Center for Human Nutrition and Atkins Center of Excellence in Obesity Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Bruce W. Patterson
- Center for Human Nutrition and Atkins Center of Excellence in Obesity Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Jay D. Horton
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Bettina Mittendorfer
- Center for Human Nutrition and Atkins Center of Excellence in Obesity Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Gökhan S. Hotamisligil
- Department of Genetics and Complex Diseases, Harvard School of Public Health, Boston, Massachusetts
| | - Samuel Klein
- Center for Human Nutrition and Atkins Center of Excellence in Obesity Medicine, Washington University School of Medicine, St. Louis, Missouri
- Corresponding author: Samuel Klein,
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A prospective observational study of the relationship of critical illness associated hyperglycaemia in medical ICU patients and subsequent development of type 2 diabetes. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2010; 14:R130. [PMID: 20615210 PMCID: PMC2945097 DOI: 10.1186/cc9101] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2010] [Revised: 04/30/2010] [Accepted: 07/08/2010] [Indexed: 12/16/2022]
Abstract
Introduction Critical illness is commonly complicated by hyperglycaemia caused by mediators of stress and inflammation. Severity of disease is the main risk factor for development of hyperglycaemia, but not all severely ill develop hyperglycemia and some do even in mild disease. We hypothesised that acute disease only exposes a latent disturbance of glucose metabolism which puts those patients at higher risk for developing diabetes. Methods Medical patients with no history of impaired glucose metabolism or other endocrine disorder admitted to an intensive care unit between July 1998 and June 2004 were considered for inclusion. Glucose was measured at least two times a day, and patients were divided into the hyperglycaemia group (glucose ≥7.8 mmol/l) and normoglycaemia group. An oral glucose tolerance test was performed within six weeks after discharge to disclose patients with unknown diabetes or pre-diabetes who were excluded. Patients treated with corticosteroids and those terminally ill were also excluded from the follow-up which lasted for a minimum of five years with annual oral glucose tolerance tests. Results A five-year follow-up was completed for 398 patients in the normoglycaemia group, of which 14 (3.5%) developed type 2 diabetes. In the hyperglycaemia group 193 patients finished follow-up and 33 (17.1%) developed type 2 diabetes. The relative risk for type 2 diabetes during five years after the acute illness was 5.6 (95% confidence interval (CI) 3.1 to 10.2). Conclusions Patients with hyperglycaemia during acute illness who are not diagnosed with diabetes before or during the hospitalization should be considered a population at increased risk for developing diabetes. They should, therefore, be followed-up, in order to be timely diagnosed and treated.
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Hyperglycemia in sepsis is a risk factor for development of type II diabetes. J Crit Care 2010; 25:263-9. [DOI: 10.1016/j.jcrc.2009.10.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Revised: 09/03/2009] [Accepted: 10/01/2009] [Indexed: 11/22/2022]
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Han JH, Lee YT, Kwak KW, Ahn SH, Chang IH, Myung SC, Oh SY, Lee YS, Kim W, Jin YW, Choi TI, Sung SH. Relationship between insulin resistance, obesity and serum prostate-specific antigen levels in healthy men. Asian J Androl 2010; 12:400-4. [PMID: 20305674 DOI: 10.1038/aja.2009.90] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The purpose of this study was to determine the relationship between insulin resistance, obesity and serum prostate-specific antigen (PSA) levels in healthy men with serum PSA level below 4 ng mL(-1). The men included in the study cohort were 11 827 healthy male employees of the Korea Hydro and Nuclear Power Co., LTD who had undergone medical checkups including fasting glucose, fasting insulin and serum PSA between January 2003 and December 2008. Insulin resistance was calculated by homeostasis model assessment (HOMA [fasting glucose x fasting insulin]/22.5) and quantitative insulin sensitivity check index (QUICKI; 1/[log (fasting insulin) + log (fasting glucose)]). Age-adjusted body mass index (BMI) was significantly increased according to increasing quartile of insulin resistance as determined by HOMA and QUICKI, respectively, in analysis of variance (ANOVA) test and Duncan's multiple comparison test (P < 0.001), but age-adjusted serum PSA concentration was significantly decreased according to increasing quartile of insulin resistance as determined by HOMA and QUICKI (P < 0.001). Age, BMI, insulin resistance by HOMA or QUICKI were significantly independent variables to serum PSA level in a multivariate linear regression analysis (P < 0.001). Insulin resistance was a significant independent variable to serum PSA level along with BMI. Insulin resistance and BMI were negatively correlated with serum PSA level in healthy men. Insulin resistance was positively correlated with BMI.
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Affiliation(s)
- June Hyun Han
- Department of Urology, KEPCO Medical Foundation Hanil General Hospital, Seoul 132-703, Korea
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Esteghamati A, Khalilzadeh O, Anvari M, Rashidi A, Mokhtari M, Nakhjavani M. Association of serum leptin levels with homeostasis model assessment-estimated insulin resistance and metabolic syndrome: the key role of central obesity. Metab Syndr Relat Disord 2009; 7:447-52. [PMID: 19419266 DOI: 10.1089/met.2008.0100] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Leptin is correlated with several features of metabolic syndrome; however, possible confounders (eg, obesity) of this association are not known. This study evaluated the relationship between leptin, metabolic syndrome, and insulin resistance in an Iranian population and further investigated whether this relationship is confounded by obesity or central obesity. METHODS A total of 387 participants (18-65 years old) who referred to a large university general hospital for routine health examinations were categorized into 2 groups with (n = 130) and without (n = 257) metabolic syndrome. Fasting plasma glucose, insulin, lipids, and leptin levels were measured and the homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. RESULTS Age- and sex-adjusted leptin levels were significantly higher in patients with than those without metabolic syndrome (29.62 +/- 1.67 vs. 18.50 +/- 1.21 ng/mL, P < 0.001). After adjustment for age, sex, and body mass index (BMI), leptin values were significantly correlated with HOMA-IR (P < 0.001), metabolic syndrome, and its components (P < 0.05). After adjustment for waist circumference, however, these associations were no longer statistically significant. CONCLUSIONS We demonstrated that high leptin levels are associated with insulin resistance and metabolic syndrome independent of BMI but these associations are significantly mediated through the effects of central obesity.
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Affiliation(s)
- Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Effect of overweight on gastrointestinal microbiology and immunology: correlation with blood biomarkers. Br J Nutr 2009; 103:1070-8. [DOI: 10.1017/s0007114509992807] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
A cross-sectional study was carried out in order to compare intestinal microbiological and immunological biomarkers with blood glucose and lipids, satiety-related hormones and inflammatory biomarkers characterising differences between obese and normal weight subjects. Faecal and blood samples were obtained from twenty obese subjects with an average BMI of 32·9 kg/m2and twenty normal weight subjects with an average BMI of 23·3 kg/m2. Blood insulin, TAG and leptin were significantly elevated, whereas concentrations of HDL and ghrelin were significantly decreased in the obese subjects. Inflammatory status in the obese subjects was characterised by a trend for elevated blood C-reactive protein (CRP;P = 0·06) and IL-6 (P = 0·02). The faecal microbial composition differed between the groups; less sulphate-reducing bacteria (P = 0·05) and a trend for lessBacteroides(P = 0·07) were measured for overweight subjects. Furthermore, an inverse correlation was demonstrated between faecalBacteroideslevels and waist circumference (P = 0·05). The faecal microbial metabolites differed between the groups; increased concentrations of branched-chain fatty acids, phenolics, valeric acid, di- and hydroxy acids were described in the obese subjects. No differences between the measured intestinal inflammatory biomarkers were detected. However, systemic inflammation (CRP and IL-6) was correlated with the faecal concentrations of phenolics and lactic acid (P < 0·05 and 0·05, andP < 0·01 and 0·05, respectively). In summary, weight-related differences were observed both in the intestinal microbial composition and its activity. The role of intestinal signals, such as phenolics and lactic acid in the development of weight-related problems, needs to be studied further.
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Esteghamati A, Khalilzadeh O, Rashidi A, Meysamie A, Haghazali M, Asgari F, Abbasi M, Rastad S, Gouya MM. Association between physical activity and insulin resistance in Iranian adults: National Surveillance of Risk Factors of Non-Communicable Diseases (SuRFNCD-2007). Prev Med 2009; 49:402-6. [PMID: 19744508 DOI: 10.1016/j.ypmed.2009.09.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2009] [Revised: 08/31/2009] [Accepted: 09/01/2009] [Indexed: 10/24/2022]
Abstract
BACKGROUND Insulin resistance is an underlying mechanism of metabolic syndrome. We attempted to determine the association between physical activity and insulin resistance in Iranian adults. METHODS The data of the third national Surveillance of Risk Factors of Non-Communicable Diseases (SuRFNCD-2007) in Iran were used. We ran the Global Physical Activity Questionnaire (GPAQ) over a nationally representative sample of 3101 adults. Total physical activity (TPA) was calculated using metabolic equivalents (MET) for intensity of physical activities. Insulin resistance was measured by the homeostasis model assessment of insulin resistance (HOMA-IR). RESULTS When physical activity was classified into high, moderate, and low categories, HOMA-IR values significantly increased from the high category to the moderate and low categories (p<0.01). After adjustment for age, area of residence, smoking, and body mass index (BMI), TPA (r=-0.26, p<0.01 in males and r=-0.21, p<0.01 in females), duration of vigorous-intensity activity (r=-0.28, p<0.01 in males and r=-0.18, p=0.01 in females), duration of moderate-intensity activity (r=-0.16, p=0.01 in males and r=-0.17, p<0.01 in females), and the time spent on sedentary behaviors (r=0.16, p=0.01 in males and r=-0.22, p<0.01 in females) were significantly correlated to HOMA-IR. The prevalence of physical inactivity increased linearly with increasing HOMA-IR quintiles. CONCLUSIONS Our findings indicate a significant relationship between physical inactivity and insulin resistance. For communities in a transition phase of lifestyle, encouraging physical activity may help prevent insulin resistance and its adverse consequences.
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Affiliation(s)
- Alireza Esteghamati
- Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences PO Box 13145-784, Tehran, Iran.
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Kawamoto R, Kohara K, Tabara Y, Miki T, Ohtsuka N, Kusunoki T, Abe M. Alcohol consumption is associated with decreased insulin resistance independent of body mass index in Japanese community-dwelling men. TOHOKU J EXP MED 2009; 218:331-7. [PMID: 19638738 DOI: 10.1620/tjem.218.331] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Alcohol consumption is associated with a decreased risk of type II diabetes and cardiovascular diseases. However, there is a great deal of controversy concerning the relationship between alcohol consumption and insulin resistance. This association may be further confounded by an increase in body weight levels. The aim of this study was to determine whether alcohol consumption promotes insulin resistance according to body weight levels in community-dwelling men. Study participants without a clinical history of stroke, transient ischemic attack, myocardial infarction, angina or diabetes were randomly recruited from a single community at the time of their annual health examination (678 men aged 59 +/- 14 years). They were classified into never drinkers, light drinkers [< 1 unit (22.9 g ethanol)/day], moderate drinkers (1-1.9 unit/day), and heavy drinkers (> or = 2 unit/day), and further divided into underweight [body mass index (BMI) < 23 kg/m(2)] or overweight (BMI > or = 23.0 kg/m(2)). Insulin resistance was estimated on the basis of the homeostasis model assessment of insulin resistance (HOMA-IR), and HOMA-IR and potential confounders were compared between the groups. The confounders included age, BMI, smoking status, serum gamma glutamyltransferase, and high molecular-weight adiponectin. In the overall, HOMA-IR is significantly correlated with age, BMI, serum gamma glutamyltransferase, and high molecular-weight adiponectin. After adjustment for potential confounders, mean log HOMA-IR is significantly lower in the heavy drinkers irrespective of BMI categories. In conclusion, alcohol consumption is associated with decreased insulin resistance independent of BMI in Japanese community-dwelling men.
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Affiliation(s)
- Ryuichi Kawamoto
- Department of Community Medicine, Ehime University Graduate School of Medicine, 9-53 Nomura, Seiyo-city, Ehime, Japan.
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