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Kosovski IB, Ghiga D, Ciurea CN, Cucoranu DC, Demian L, Gliga FI, Bacârea A. Evaluation of Fasting Glucose-Insulin-C-Peptide-Derived Metabolic Indices for Identifying Metabolic Syndrome in Young, Healthy Adults. Nutrients 2024; 16:2135. [PMID: 38999882 PMCID: PMC11243600 DOI: 10.3390/nu16132135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 06/30/2024] [Accepted: 07/02/2024] [Indexed: 07/14/2024] Open
Abstract
Metabolic syndrome (MetS) is a condition defined by a cluster of symptoms, including excessive adipose tissue, impaired glucose homeostasis, dyslipidemia, and high blood pressure (BP). We aimed to evaluate the correlation between the MetS criteria (IDF) and fasting glucose-insulin-C-peptide-derived indices in a cohort of 128 healthy young adults who were 20-35 years old at the time of this study. We measured fasting serum glucose, insulin, C-peptide (CP), HDL-cholesterol, triglycerides, and hsCRP; HOMA-IR INS, HOMA-IR CP1, HOMA-IR CP2, HOMA-BETA, HOMA-BETA CP, QUICKI, disposition index (DI), CP index (CPI), and 20/C-peptide*glucose. Significant correlations were found between BMI and all HOMA indices, QUICKI, and CPI; waist circumferences and HOMA-IR INS, HOMA-BETA, and QUICKI (for both sexes); glucose and HOMA-IR INS/CP1/CP2, HOMA-BETA CP, DI, and QUICKI; HDL-cholesterol and HOMA-IR INS, HOMA-BETA, and QUICKI for males and females only with QUICKI; triglycerides and HOMA-IR INS, HOMA-BETA, and QUICKI; systolic BP and HOMA-IR INS, HOMA-BETA; diastolic BP and DI. The cut-off values for HOMA-IR INS, HOMA-BETA, and QUICKI in the combined group (females + males) were 1.855, 82.250, 0.355; 2.115, 106.370, 0.345 for males; 1.805, 71.305, 0.355 for females. A stronger correlation was found between males' indices and hsCRP. In conclusion, CP-derived indices do not add significant information, and the male sex is more predisposed to MetS.
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Affiliation(s)
- Irina Bianca Kosovski
- Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
- Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
| | - Dana Ghiga
- Department of Research Methodology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
| | - Cristina Nicoleta Ciurea
- Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
| | | | - Liliana Demian
- Center for Advanced Medical and Pharmaceutical Research, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology Târgu Mureș, 540139 Târgu Mureș, Romania
| | - Florina Ioana Gliga
- Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
| | - Anca Bacârea
- Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
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Murai N, Saito N, Kodama E, Iida T, Mikura K, Imai H, Kaji M, Hashizume M, Kigawa Y, Koizumi G, Tadokoro R, Sugisawa C, Endo K, Iizaka T, Saiki R, Otsuka F, Ishibashi S, Nagasaka S. Glucose Effectiveness Decreases in Relationship to a Subtle Worsening of Metabolic Parameters in Young Japanese with Normal Glucose Tolerance. Metab Syndr Relat Disord 2021; 19:409-415. [PMID: 34190620 DOI: 10.1089/met.2021.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: The aim of the study was to investigate the relationship between glucose effectiveness (Sg) and some metabolic parameters in male and female young Japanese. Methods: We measured plasma glucose and immunoreactive insulin levels in 1309 young Japanese persons (age <40 years) with normal glucose tolerance (NGT) before and at 30, 60, and 120 min during a 75 gram oral glucose tolerance test. We also measured serum adiponectin and high-sensitivity C-reactive protein (hsCRP) levels and oral glucose effectiveness (SgIO), and investigated factors related to SgIO. Results: The results of Spearman correlation analysis revealed that high-density lipoprotein cholesterol (HDL) and adiponectin were positively correlated with SgIO, whereas the proportion of males, body mass index, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure, triglycerides (TG), and hsCRP were inversely correlated with SgIO. The results of multiple regression analysis indicated negative correlations between SgIO and the proportion of males, WC, and SBP and a positive correlation with HDL. The results of multiple regression analysis excluding WC indicated negative correlations between SgIO and the proportion of males, SBP, and TG and positive correlations with HDL and adiponectin. Conclusions: Sg decreased with a subtle worsening of metabolic parameters, even in young persons with NGT. Decreased Sg may be involved in the development of glucose intolerance in individuals with worse metabolic parameters.
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Affiliation(s)
- Norimitsu Murai
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Naoko Saito
- Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Eriko Kodama
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Tatsuya Iida
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Kentaro Mikura
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Hideyuki Imai
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Mariko Kaji
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Mai Hashizume
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Yasuyoshi Kigawa
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Go Koizumi
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Rie Tadokoro
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Chiho Sugisawa
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Kei Endo
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Toru Iizaka
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Ryo Saiki
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Fumiko Otsuka
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Shun Ishibashi
- Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Shoichiro Nagasaka
- Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan.,Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University, Tochigi, Japan
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La Grasta Sabolić L, Šepec MP, Cigrovski Berković M, Stipančić G. Time to the Peak, Shape of the Curve and Combination of These Glucose Response Characteristics During Oral Glucose Tolerance Test as Indicators of Early Beta-cell Dysfunction in Obese Adolescents. J Clin Res Pediatr Endocrinol 2021; 13:160-169. [PMID: 33006553 PMCID: PMC8186335 DOI: 10.4274/jcrpe.galenos.2020.2020.0142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Characteristics of the glucose response during oral glucose tolerance test (OGTT) may reflect differences in insulin secretion and action. The aim was to examine whether timing of the glucose peak, shape of the glucose curve and their combination could be indicators of beta-cell dysfunction in obese/severely obese adolescents with normal glucose tolerance (NGT). METHODS Data from 246 obese/severely obese adolescents who completed OGTT were reviewed. Out of 184 adolescents with NGT, 174 could be further classified into groups based on timing of the glucose peak (early/30 minutes vs late/≥60 minutes) and shape of the glucose curve (monophasic vs biphasic). Groups were compared with respect to insulin sensitivity (whole body insulin sensitivity index - WBISI), early-phase insulin secretion (insulinogenic index - IGI) and beta-cell function relative to insulin sensitivity (oral disposition index - oDI). RESULTS Late glucose peak (p=0.004) and monophasic glucose curve (p=0.001) were both associated with lower oDI after adjustment for age, sex, puberty stage and body mass index z-score. Among obese/severely obese adolescents with NGT, those with coexistent late glucose peak and monophasic glucose curve had lower oDI than those with early glucose peak and biphasic glucose curve (p=0.002). Moreover, a combination of late glucose peak and monophasic glucose curve was the most powerful predictor of the lowest oDI quartile [odds ratio (OR): 11.68, 95% confidence interval: 3.048-44.755, p<0.001]. CONCLUSION Late timing of the glucose peak, monophasic shape of the glucose curve and, in particular, a combination of those characteristics during OGTT may indicate early beta-cell dysfunction in obese/severely obese adolescents with NGT.
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Affiliation(s)
- Lavinia La Grasta Sabolić
- University Hospital Center Sestre Milosrdnice, Department of Pediatric Endocrinology, Diabetes and Metabolism, Zagreb, Croatia,* Address for Correspondence: University Hospital Center Sestre Milosrdnice, Department of Pediatric Endocrinology, Diabetes and Metabolism, Zagreb, Croatia Phone: +385 1 37 87 551 E-mail:
| | - Marija Požgaj Šepec
- University Hospital Center Sestre Milosrdnice, Department of Pediatric Endocrinology, Diabetes and Metabolism, Zagreb, Croatia
| | - Maja Cigrovski Berković
- Clinical Hospital Dubrava, Department of Endocrinology, Diabetes, Metabolism and Clinical Pharmacology, Zagreb, Croatia,University Osijek, Faculty of Medicine, Department of Pharmacology, Osijek, Croatia
| | - Gordana Stipančić
- University Hospital Center Sestre Milosrdnice, Department of Pediatric Endocrinology, Diabetes and Metabolism, Zagreb, Croatia,University of Zagreb, School of Dental Medicine, Zagreb, Croatia
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Impaired insulin exocytosis in chronic hepatitis C infection: contributory role of p38δ MAPK-protein kinase D-golgi complex axis. Clin Sci (Lond) 2020; 134:1449-1456. [PMID: 32556178 DOI: 10.1042/cs20200686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 05/31/2020] [Accepted: 06/03/2020] [Indexed: 11/17/2022]
Abstract
Hepatitis C virus (HCV) infection and chronic hepatitis C (CHC) are associated with a measurable risk of insulin resistance (IR)/impaired glucose tolerance (IGT)/diabetes mellitus (DM). While loss of hepatic endocrine function contributes to liver cirrhosis in diabetic patients, onset and progression of IR/IGT to diabetes and exacerbation of incident hyperglycemia are ostensibly linked with chronic HCV infection. In this regard, the study by Chen J et al. appearing in Clinical Science (2020) (134(5) https://doi.org/10.1042/CS20190900) attempts to understand the mechanisms underlying the savaging effects of chronic HCV infection on insulin-producing pancreatic β-cells and hence diabetic onset. The study investigated the role of mitogen-activated protein kinase (MAPK) p38δ-protein kinase D (PKD)-golgi complex axis in impacting insulin exocytosis. It was inferred that an insulin secretory defect of pancreatic β-cells, owing to disrupted insulin exocytosis, to an extent explains β-cell dysfunction in HCV-infected or CHC milieu. HCV infection negatively regulates first-phase and second-phase insulin secretion by impinging on PKD-dependent insulin secretory granule fission at trans-golgi network and insulin secretory vesicle membrane fusion events. This commentary highlights the study in question, that deciphered the contribution of p38δ MAPK-PKD-golgi complex axis to β-cell dysfunction in CHC milieu. This pivotal axis proffers a formidable therapeutic opportunity for alleviation of double burden of glucose abnormalities/DM and CHC.
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Antonio-Villa NE, Bello-Chavolla OY, Vargas-Vázquez A, Mehta R, Aguilar-Salinas CA. The combination of insulin resistance and visceral adipose tissue estimation improves the performance of metabolic syndrome as a predictor of type 2 diabetes. Diabet Med 2020; 37:1192-1201. [PMID: 32061103 DOI: 10.1111/dme.14274] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/13/2020] [Indexed: 12/16/2022]
Abstract
AIMS To assess the performance of metabolic syndrome as a predictor of type 2 diabetes in a model that also includes both a measure of insulin resistance and a metabolic score for visceral fat, and to propose a novel metabolic syndrome definition. METHODS In a prospective Metabolic Syndrome Cohort (n=6143), we evaluated improvements in type 2 diabetes risk prediction using International Diabetes Federation-defined and Adult Treatment Panel III-defined metabolic syndrome, after inclusion in the model of updated homeostatic model assessment of insulin resistance and a metabolic score for visceral fat. We also developed a modified metabolic syndrome construct, 'MS-METS', which used the metabolic score for visceral fat instead of waist circumference to evaluate improved predictive performance for risk of developing type 2 diabetes. RESULTS Participants who had metabolic syndrome as defined by both the Adult Treatment Panel III and the International Diabetes Federation criteria had a higher risk of type 2 diabetes compared to participants who did not meet these criteria. Addition of updated homeostatic model assessment of insulin resistance and metabolic score for visceral fat to both metabolic syndrome definitions increased predictive performance for type 2 diabetes risk. Homeostatic model assessment of insulin resistance was the only additional predictor of type 2 diabetes in participants without metabolic syndrome. Conversely, in participants with metabolic syndrome, the use of the metabolic score for visceral fat was the stronger added predictor for type 2 diabetes. When evaluating participants using the MS-METS definition we observed the largest improvement in predictive ability for type 2 diabetes risk and a significant reduction in risk overestimation compared to evaluation using metabolic syndrome defined according to the International Diabetes Federation and Adult Treatment Panel III criteria alone. CONCLUSION Inclusion of updated homeostatic model assessment of insulin resistance and metabolic score for visceral fat increases performance of metabolic syndrome in prediction of type 2 diabetes. Assessment of insulin resistance could be more useful than conventional metabolic syndrome and assessment of visceral adipose tissue could be more useful in people with metabolic syndrome. Metabolic syndrome as defined using our modified MS-METS construct improved the accuracy of type 2 diabetes prediction.
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Affiliation(s)
- N E Antonio-Villa
- Unidad de Investigacion de Enfermedades Metabólicas, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Tlalpan, Mexico
- MD/PhD (PECEM) Program, Faculty of Medicine, Universidad Nacional Autonoma de México, Tlalpan, Mexico
| | - O Y Bello-Chavolla
- Unidad de Investigacion de Enfermedades Metabólicas, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Tlalpan, Mexico
- Department of Physiology, Faculty of Medicine, Universidad Nacional Autonoma de México, Tlalpan, Mexico
- Research Division, Instituto Nacional de Geriatría, Tlalpan, Mexico
| | - A Vargas-Vázquez
- Unidad de Investigacion de Enfermedades Metabólicas, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Tlalpan, Mexico
- MD/PhD (PECEM) Program, Faculty of Medicine, Universidad Nacional Autonoma de México, Tlalpan, Mexico
| | - R Mehta
- Unidad de Investigacion de Enfermedades Metabólicas, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Tlalpan, Mexico
- Department of Endocrinolgy and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Tlalpan, Mexico
| | - C A Aguilar-Salinas
- Unidad de Investigacion de Enfermedades Metabólicas, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Tlalpan, Mexico
- Department of Endocrinolgy and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán, Tlalpan, Mexico
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Tlalpan, Mexico
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Mey JT, Hari A, Axelrod CL, Fealy CE, Erickson ML, Kirwan JP, Dweik RA, Heresi GA. Lipids and ketones dominate metabolism at the expense of glucose control in pulmonary arterial hypertension: a hyperglycaemic clamp and metabolomics study. Eur Respir J 2020; 55:13993003.01700-2019. [PMID: 32108049 PMCID: PMC7263739 DOI: 10.1183/13993003.01700-2019] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 01/18/2020] [Indexed: 12/31/2022]
Abstract
Individuals with idiopathic pulmonary arterial hypertension (PAH) display reduced oral glucose tolerance. This may involve defects in pancreatic function or insulin sensitivity but this hypothesis has not been tested; moreover, fasting nutrient metabolism remains poorly described in PAH. Thus, we aimed to characterise fasting nutrient metabolism and investigated the metabolic response to hyperglycaemia in PAH.12 participants (six PAH, six controls) were administered a hyperglycaemic clamp, while 52 (21 PAH, 31 controls) underwent plasma metabolomic analysis. Glucose, insulin, C-peptide, free fatty acids and acylcarnitines were assessed from the clamp. Plasma metabolomics was conducted on fasting plasma samples.The clamp verified a reduced insulin response to hyperglycaemia in PAH (-53% versus control), but with similar pancreatic insulin secretion. Skeletal muscle insulin sensitivity was unexpectedly greater in PAH. Hepatic insulin extraction was elevated in PAH (+11% versus control). Plasma metabolomics identified 862 metabolites: 213 elevated, 145 reduced in PAH (p<0.05). In both clamp and metabolomic cohorts, lipid oxidation and ketones were elevated in PAH. Insulin sensitivity, fatty acids, acylcarnitines and ketones correlated with PAH severity, while hepatic extraction and fatty acid:ketone ratio correlated with longer six-min walk distance.Poor glucose control in PAH could not be explained by pancreatic β-cell function or skeletal muscle insulin sensitivity. Instead, elevated hepatic insulin extraction emerged as an underlying factor. In agreement, nutrient metabolism in PAH favours lipid and ketone metabolism at the expense of glucose control. Future research should investigate the therapeutic potential of reinforcing lipid and ketone metabolism on clinical outcomes in PAH.
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Affiliation(s)
- Jacob T. Mey
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA,Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland OH
| | - Adithya Hari
- Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland OH
| | - Christopher L. Axelrod
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA,Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland OH,Department of Translational Services, Pennington Biomedical Research Center, Baton Rouge, LA
| | - Ciarán E. Fealy
- Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland OH,Diabetes and Metabolism Research Group, Maastricht University, Maastricht, Netherlands,Metabolic Translational Research Center, Endocrinology & Metabolism Institute, Cleveland Clinic, Cleveland, OH
| | - Melissa L. Erickson
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA,Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland OH
| | - John P. Kirwan
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA,Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland OH,Metabolic Translational Research Center, Endocrinology & Metabolism Institute, Cleveland Clinic, Cleveland, OH
| | - Raed A. Dweik
- Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland OH,Department of Pulmonary Care and Critical Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Gustavo A. Heresi
- Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland OH,Department of Pulmonary Care and Critical Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
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Su H, Ma X, Shen Y, He X, Ying L, Zhu W, Wang Y, Bao Y, Zhou J. 1,5-Anhydroglucitol × glycated hemoglobin A 1c/100 as a potential biomarker for islet β-cell function among patients with type 2 diabetes. Acta Diabetol 2020; 57:439-446. [PMID: 31728736 DOI: 10.1007/s00592-019-01452-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 11/01/2019] [Indexed: 12/14/2022]
Abstract
AIMS This study aimed to explore the level of and changes in the 1,5-anhydroglucitol × glycated hemoglobin A1c/100 (AH index, AHI) associated with different glucose metabolism statuses and to evaluate the islet function and insulin sensitivity of patients with type 2 diabetes (T2DM) with different AHI levels. METHODS Of the 3562 subjects enrolled in this study, 1697 had T2DM. The disposition index (DI) was the product of islet secretion function and insulin sensitivity-related indexes. RESULTS The mean AHI level was 1.0 (0.7-1.3) in the general population, while the mean AHI level in the T2DM group was 0.8 (0.5-1.2), which was significantly lower than that in the impaired glucose regulation and normal glucose tolerance group (both 1.2 (0.9-1.5), both P < 0.01). We further divided patients with T2DM into four subgroups according to the quartile of AHI. The results showed that with the increase in AHI level, the homeostasis model assessment of insulin resistance (HOMA-IR) decreased, while HOMA-β, insulin generation index, insulin sensitivity index, and DI increased (all Pfor trend < 0.01). Multivariate logistic regression showed that the odds ratios for a low DI for increasing levels of AHI were 1.00, 0.22 (0.16-0.29), 0.16 (0.11-0.22), and 0.09 (0.06-0.13), showing a decreasing trend (Pfor trend < 0.05). CONCLUSION The AHI could reflect the variation in glycemic disorder and the function of islet β cells. The lower the AHI, the worse the glycemic disorder, as well as the islet β-cell function.
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Affiliation(s)
- Hang Su
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Yun Shen
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Xingxing He
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Lingwen Ying
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Wei Zhu
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Yufei Wang
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Jian Zhou
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
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Adler GK, Murray GR, Turcu AF, Nian H, Yu C, Solorzano CC, Manning R, Peng D, Luther JM. Primary Aldosteronism Decreases Insulin Secretion and Increases Insulin Clearance in Humans. Hypertension 2020; 75:1251-1259. [PMID: 32172621 DOI: 10.1161/hypertensionaha.119.13922] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Primary aldosteronism is a frequent cause of resistant hypertension and is associated with an increased risk of developing diabetes mellitus. Aldosterone impairs insulin secretion in isolated islets, and insulin secretion is increased in aldosterone synthase-deficient mice. We hypothesized that treatment for primary aldosteronism increases insulin secretion and insulin sensitivity in humans. We conducted a prospective cohort study in patients with primary aldosteronism, with assessment of glucose metabolism before and 3 to 12 months after treatment. Participants underwent treatment for primary aldosteronism with adrenalectomy or a mineralocorticoid receptor antagonist at the discretion of their treating physician. We assessed insulin secretion and insulin sensitivity by hyperglycemic and hyperinsulinemic-euglycemic clamps, respectively, on 2 study days after a 5-day standardized diet. After treatment, the C-peptide and insulin response during the hyperglycemic clamp increased compared with pretreatment (ΔC-peptide at 90-120 minutes +530.5±384.1 pmol/L, P=0.004; Δinsulin 90-120 minutes +183.0±122.6, P=0.004). During hyperinsulinemic-euglycemic clamps, insulin sensitivity decreased after treatment (insulin sensitivity index 30.7±6.2 versus 18.5±4.7 nmol·kg-1·min-1·pmol-1·L; P=0.02). Insulin clearance decreased after treatment (872.8±207.6 versus 632.3±178.6 mL/min; P=0.03), and disposition index was unchanged. We conclude that the insulin response to glucose increases and insulin clearance decreases after treatment for primary aldosteronism, and these effects were not due to alterations in creatinine clearance or plasma cortisol. These studies may provide further insight into the mechanism of increased diabetes mellitus risk in primary aldosteronism.
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Affiliation(s)
- Gail K Adler
- From the Division of Endocrinology and Hypertension, Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA (G.K.A., G.R.M.)
| | - Gillian R Murray
- From the Division of Endocrinology and Hypertension, Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA (G.K.A., G.R.M.)
| | - Adina F Turcu
- Division of Endocrinology, Department of Medicine, University of Michigan, Ann Arbor, MI (A.F.T.)
| | - Hui Nian
- Department of Biostatistics, Vanderbilt University (H.N., C.Y.)
| | - Chang Yu
- Department of Biostatistics, Vanderbilt University (H.N., C.Y.)
| | - Carmen C Solorzano
- Department of Surgery (C.C.S.), Vanderbilt University Medical Center, Nashville, TN
| | - Robert Manning
- Division of Clinical Pharmacology, Department of Medicine (R.M., D.P., J.M.L.), Vanderbilt University Medical Center, Nashville, TN
| | - Dungeng Peng
- Division of Clinical Pharmacology, Department of Medicine (R.M., D.P., J.M.L.), Vanderbilt University Medical Center, Nashville, TN
| | - James M Luther
- Division of Clinical Pharmacology, Department of Medicine (R.M., D.P., J.M.L.), Vanderbilt University Medical Center, Nashville, TN
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Ladwa M, Hakim O, Amiel SA, Goff LM. A Systematic Review of Beta Cell Function in Adults of Black African Ethnicity. J Diabetes Res 2019; 2019:7891359. [PMID: 31781667 PMCID: PMC6855028 DOI: 10.1155/2019/7891359] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/16/2019] [Accepted: 08/11/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Understanding ethnic differences in beta cell function has important implications for preventative and therapeutic strategies in populations at high risk of type 2 diabetes (T2D). The existing literature, largely drawn from work in children and adolescents, suggests that beta cell function in black African (BA) populations is upregulated when compared to white Europeans (WE). METHODS A systematic literature search was undertaken in June 2018 to identify comparative studies of beta cell function between adults (>age 18 years) of indigenous/diasporic BA and WE ethnicity. All categories of glucose tolerance and all methodologies of assessing beta cell function in vivo were included. RESULTS 41 studies were identified for inclusion into a qualitative synthesis. The majority were studies in African American populations (n = 30) with normal glucose tolerance (NGT)/nondiabetes (n = 25), using intravenous glucose stimulation techniques (n = 27). There were fewer studies in populations defined as only impaired fasting glucose/impaired glucose tolerance (IFG/IGT) (n = 3) or only T2D (n = 3). Although BA broadly exhibited greater peripheral insulin responses than WE, the relatively small number of studies which measured C-peptide to differentiate between beta cell insulin secretion and hepatic insulin extraction (n = 14) had highly variable findings. In exclusively IGT or T2D cohorts, beta cell insulin secretion was found to be lower in BA compared to WE. CONCLUSIONS There is inconsistent evidence for upregulated beta cell function in BA adults, and they may in fact exhibit greater deficits in insulin secretory function as glucose intolerance develops.
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Affiliation(s)
- M. Ladwa
- Diabetes Research Group, Department of Diabetes, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - O. Hakim
- Diabetes Research Group, Department of Diabetes, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - S. A. Amiel
- Diabetes Research Group, Department of Diabetes, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - L. M. Goff
- Diabetes Research Group, Department of Diabetes, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
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10
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Hemnes AR, Luther JM, Rhodes CJ, Burgess JP, Carlson J, Fan R, Fessel JP, Fortune N, Gerszten RE, Halliday SJ, Hekmat R, Howard L, Newman JH, Niswender KD, Pugh ME, Robbins IM, Sheng Q, Shibao CA, Shyr Y, Sumner S, Talati M, Wharton J, Wilkins MR, Ye F, Yu C, West J, Brittain EL. Human PAH is characterized by a pattern of lipid-related insulin resistance. JCI Insight 2019; 4:e123611. [PMID: 30626738 PMCID: PMC6485674 DOI: 10.1172/jci.insight.123611] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/27/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Pulmonary arterial hypertension (PAH) is a deadly disease of the small pulmonary vasculature with an increased prevalence of insulin resistance (IR). Insulin regulates both glucose and lipid homeostasis. We sought to quantify glucose- and lipid-related IR in human PAH, testing the hypothesis that lipoprotein indices are more sensitive indices of IR in PAH. METHODS Oral glucose tolerance testing in PAH patients and triglyceride-matched (TG-matched) controls and proteomic, metabolomics, and lipoprotein analyses were performed in PAH and controls. Results were validated in an external cohort and in explanted human PAH lungs. RESULTS PAH patients were similarly glucose intolerant or IR by glucose homeostasis metrics compared with control patients when matched for the metabolic syndrome. Using the insulin-sensitive lipoprotein index, TG/HDL ratio, PAH patients were more commonly IR than controls. Proteomic and metabolomic analysis demonstrated separation between PAH and controls, driven by differences in lipid species. We observed a significant increase in long-chain acylcarnitines, phosphatidylcholines, insulin metabolism-related proteins, and in oxidized LDL receptor 1 (OLR1) in PAH plasma in both a discovery and validation cohort. PAH patients had higher lipoprotein axis-related IR and lipoprotein-based inflammation scores compared with controls. PAH patient lung tissue showed enhanced OLR1 immunostaining within plexiform lesions and oxidized LDL accumulation within macrophages. CONCLUSIONS IR in PAH is characterized by alterations in lipid and lipoprotein homeostasis axes, manifest by elevated TG/HDL ratio, and elevated circulating medium- and long-chain acylcarnitines and lipoproteins. Oxidized LDL and its receptor OLR1 may play a role in a proinflammatory phenotype in PAH. FUNDING NIH DK096994, HL060906, UL1 RR024975-01, UL1 TR000445-06, DK020593, P01 HL108800-01A1, and UL1 TR002243; American Heart Association 13FTF16070002.
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Affiliation(s)
- Anna R. Hemnes
- Division of Allergy, Pulmonary and Critical Care Medicine and
| | - J. Matthew Luther
- Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Christopher J. Rhodes
- Centre for Pharmacology and Therapeutics, Department of Medicine, Hammersmith Campus, Imperial College, London, United Kingdom
| | | | - James Carlson
- RTI International, Research Triangle Park, North Carolina, USA
| | - Run Fan
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Niki Fortune
- Division of Allergy, Pulmonary and Critical Care Medicine and
| | - Robert E. Gerszten
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Rezzan Hekmat
- Cardiovascular Medicine Division, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Luke Howard
- National Heart and Lung Institute, Imperial College, London and National Pulmonary Hypertension Service, Hammersmith Hospital, London, United Kingdom
| | - John H. Newman
- Division of Allergy, Pulmonary and Critical Care Medicine and
| | | | | | - Ivan M. Robbins
- Division of Allergy, Pulmonary and Critical Care Medicine and
| | - Quanhu Sheng
- Division of Cancer Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Cyndya A. Shibao
- Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Yu Shyr
- Division of Cancer Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Susan Sumner
- NIH Common Fund Eastern Regional Comprehensive Metabolomics Resource Core, School of Public Health, University of North Carolina at Chapel Hill, Kannapolis, North Carolina, USA
| | - Megha Talati
- Division of Allergy, Pulmonary and Critical Care Medicine and
| | - John Wharton
- Centre for Pharmacology and Therapeutics, Department of Medicine, Hammersmith Campus, Imperial College, London, United Kingdom
| | - Martin R. Wilkins
- Centre for Pharmacology and Therapeutics, Department of Medicine, Hammersmith Campus, Imperial College, London, United Kingdom
| | - Fei Ye
- Division of Cancer Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Chang Yu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - James West
- Division of Allergy, Pulmonary and Critical Care Medicine and
| | - Evan L. Brittain
- Cardiovascular Medicine Division, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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11
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Stahlhut RW, Myers JP, Taylor JA, Nadal A, Dyer JA, Vom Saal FS. Experimental BPA Exposure and Glucose-Stimulated Insulin Response in Adult Men and Women. J Endocr Soc 2018; 2:1173-1187. [PMID: 30302422 PMCID: PMC6169468 DOI: 10.1210/js.2018-00151] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 08/07/2018] [Indexed: 12/14/2022] Open
Abstract
Context Human cross-sectional and animal studies have shown an association of the chemical bisphenol A (BPA) with insulin resistance, type 2 diabetes, and other metabolic diseases, but no human experimental study has investigated whether BPA alters insulin/C-peptide secretion. Design Men and postmenopausal women (without diabetes) were orally administered either the vehicle or a BPA dose of 50 µg/kg body weight, which has been predicted by US regulators (Food and Drug Administration, Environmental Protection Agency) to be the maximum, safe daily oral BPA dose over the lifetime. Insulin response was assessed in two cross-over experiments using an oral glucose tolerance test (OGTT; experiment 1) and a hyperglycemic (HG) clamp (experiment 2). Main outcomes were the percentage change of BPA session measures relative to those of the control session. Results Serum bioactive BPA after experimental exposure was at levels detected in human biomonitoring studies. In the OGTT, a strong positive correlation was found between hemoglobin A1c(HbA1c) and the percentage change in the insulinogenic index (Spearman = 0.92), an indicator of early-phase insulin response, and the equivalent C-peptide index (Pearson = 0.97). In the HG clamp study, focusing on the later-phase insulin response to a stable level of glucose, several measures of insulin and C-peptide appeared suppressed during the BPA session relative to the control session; the change in insulin maximum concentration (Cmax) was negatively correlated with HbA1c and the Cmax of bioactive serum BPA. Conclusions This exploratory study suggests that BPA exposure to a dose considered safe by US regulators may alter glucose-stimulated insulin response in humans.
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Affiliation(s)
- Richard W Stahlhut
- Division of Biological Sciences, University of Missouri-Columbia, Columbia, Missouri
| | - John Peterson Myers
- Environmental Health Sciences, Charlottesville, Virginia.,Department of Chemistry, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - Julia A Taylor
- Division of Biological Sciences, University of Missouri-Columbia, Columbia, Missouri
| | - Angel Nadal
- CIBERDEM and Institute of Bioengineering, Miguel Hernandez University of Elche, Elche (Alicante), Spain
| | - Jonathan A Dyer
- Departments of Dermatology and Child Health, University of Missouri, Columbia, Missouri
| | - Frederick S Vom Saal
- Division of Biological Sciences, University of Missouri-Columbia, Columbia, Missouri
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