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Ozturk D, Sivaslioglu A, Bulus H, Ozturk B. TyG index is positively associated with HOMA-IR in cholelithiasis patients with insulin resistance: Based on a retrospective observational study. Asian J Surg 2024; 47:2579-2583. [PMID: 38508891 DOI: 10.1016/j.asjsur.2024.03.004] [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: 10/14/2023] [Revised: 12/24/2023] [Accepted: 03/01/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND/OBJECTIVE Cholelithiasis is a common disease but pose significant global health and financial burdens. Mechanisms of the disease are associated with insulin resistance (IR), obesity, metabolic syndrome, and type 2 diabetes. Insulin resistance is commonly observed in cholelithiasis patients. More recently, the triglyceride-glucose (TyG) index has been proposed as an alternative marker of insulin resistance. In our study we aimed to understand whether the TyG index is correlated with HOMA-IR in cholelithiasis patients. And also we aimed the predict a cutoff value for determining insulin resistance in cholelithiasis patients. METHODS A total of 184 cholelithiasis patients were matched in terms of age, gender, and BMI. They were divided into two groups based on their Homa IR levels (IR and Non-IR group). This study was a retrospective, observational study and clinical data was obtained from electronic medical records. Cutoff value for Tyg index was established through ROC Analysis. Binary Logistic Regression was used to identify factors affecting insulin resistance. RESULTS A significant cutoff value was found for the TyG index in determining the presence of insulin resistance. Having a TyG index of ≥8.71 indicates the presence of insulin resistance. The sensitivity was 68.48%, the specificity was 58.70%. Binary Logistic Regression analyses showed that an increase in Tyg Index, waist circumference and waist-to-height ratio values increases the risk of insulin resistance by 2.705 (p = 0.001), 1.032 (p = 0.029), and 334.057 (p = 0.012) times respectively. CONCLUSION Our study indicated that TyG index is positively correlated with HOMA-IR. TyG index was found as a risk factor for insulin resistance.
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Affiliation(s)
- Dogan Ozturk
- University of Health Sciences, Ankara Ataturk Sanatoryum Training and Research Hospital, Department of General Surgery, Ankara, Turkiye
| | - Aysegul Sivaslioglu
- Hacettepe University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Ankara, Turkiye.
| | - Hakan Bulus
- University of Health Sciences, Ankara Ataturk Sanatoryum Training and Research Hospital, Department of General Surgery, Ankara, Turkiye
| | - Bulent Ozturk
- University of Health Sciences, Ankara Ataturk Sanatoryum Training and Research Hospital, Department of General Surgery, Ankara, Turkiye
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Lee JH, Lee HS, Jeon S, Lee YJ, Park B, Lee JH, Kwon YJ. Association between experience of insulin resistance and long-term cardiovascular disease risk: findings from the Korean Genome and Epidemiology Study (KOGES). Endocrine 2024; 84:481-489. [PMID: 38006539 DOI: 10.1007/s12020-023-03615-0] [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: 06/01/2023] [Accepted: 11/14/2023] [Indexed: 11/27/2023]
Abstract
PURPOSE Although the correlation between insulin resistance (IR) and cardiovascular disease (CVD) risk is well-established, the impact of changes in IR status over time has received little attention. This study aimed to investigate the effect of IR on CVD risk in a large prospective cohort of middle-aged Korean adults. METHODS We assessed 3597 participants from the Korean Genome and Epidemiology Study (KoGES). Participants were categorized as having IR if their HOMA-IR was ≥2.5 at least once during the exposure period. Multivariate Cox proportional hazards regression analysis was performed to assess hazard ratios (HRs) with 95% CIs for incident CVD after adjusting for confounders. RESULTS Among a total of 3597 participants, 2259 did not have IR and 1138 had IR. The cumulative incidence rate of CVD in the IR group was significantly higher than that in the non-IR group (log-rank test, p = 0.015). Compared to the non-IR group, the HR and 95% CI for incident CVD in the IR group was 1.40 (1.07-1.83) in the unadjusted model. The presence of IR during the exposure period was significantly associated with a higher risk of incident CVD after adjusting for age, sex, body mass index, diabetes, hypertension, dyslipidemia, C-reactive protein, physical activity, alcohol intake, and smoking status (HR = 1.37; 95% CI: 1.01-1.84). CONCLUSION Individuals who have experienced IR have a consistently higher likelihood of developing CVD than those who have never had IR. More intensive efforts should be made to prevent IR in middle-aged and older adults.
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Affiliation(s)
- Jong Hee Lee
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, 16995, Republic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, 03277, Republic of Korea
| | - Soyoung Jeon
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, 03277, Republic of Korea
| | - Yong-Jae Lee
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 03277, Republic of Korea
| | - Byoungjin Park
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, 16995, Republic of Korea
| | - Jun-Hyuk Lee
- Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, 01830, Republic of Korea.
- Department of Medicine, Hanyang University Graduate School of Medicine, Seoul, 04763, Republic of Korea.
| | - Yu-Jin Kwon
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, 16995, Republic of Korea.
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Ruple BA, Mattingly ML, Godwin JS, McIntosh MC, Kontos NJ, Agyin-Birikorang A, Michel JM, Plotkin DL, Chen SY, Ziegenfuss TN, Fruge AD, Gladden LB, Robinson AT, Mobley CB, Mackey AL, Roberts MD. The effects of resistance training on denervated myofibers, senescent cells, and associated protein markers in middle-aged adults. FASEB J 2024; 38:e23621. [PMID: 38651653 PMCID: PMC11047210 DOI: 10.1096/fj.202302103rrr] [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: 10/16/2023] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 04/25/2024]
Abstract
Denervated myofibers and senescent cells are hallmarks of skeletal muscle aging. However, sparse research has examined how resistance training affects these outcomes. We investigated the effects of unilateral leg extensor resistance training (2 days/week for 8 weeks) on denervated myofibers, senescent cells, and associated protein markers in apparently healthy middle-aged participants (MA, 55 ± 8 years old, 17 females, 9 males). We obtained dual-leg vastus lateralis (VL) muscle cross-sectional area (mCSA), VL biopsies, and strength assessments before and after training. Fiber cross-sectional area (fCSA), satellite cells (Pax7+), denervated myofibers (NCAM+), senescent cells (p16+ or p21+), proteins associated with denervation and senescence, and senescence-associated secretory phenotype (SASP) proteins were analyzed from biopsy specimens. Leg extensor peak torque increased after training (p < .001), while VL mCSA trended upward (interaction p = .082). No significant changes were observed for Type I/II fCSAs, NCAM+ myofibers, or senescent (p16+ or p21+) cells, albeit satellite cells increased after training (p = .037). While >90% satellite cells were not p16+ or p21+, most p16+ and p21+ cells were Pax7+ (>90% on average). Training altered 13 out of 46 proteins related to muscle-nerve communication (all upregulated, p < .05) and 10 out of 19 proteins related to cellular senescence (9 upregulated, p < .05). Only 1 out of 17 SASP protein increased with training (IGFBP-3, p = .031). In conclusion, resistance training upregulates proteins associated with muscle-nerve communication in MA participants but does not alter NCAM+ myofibers. Moreover, while training increased senescence-related proteins, this coincided with an increase in satellite cells but not alterations in senescent cell content or SASP proteins. These latter findings suggest shorter term resistance training is an unlikely inducer of cellular senescence in apparently healthy middle-aged participants. However, similar study designs are needed in older and diseased populations before definitive conclusions can be drawn.
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Affiliation(s)
| | | | | | | | | | | | - J. Max Michel
- School of Kinesiology, Auburn University, Auburn, AL, USA
| | | | | | | | | | | | | | | | - Abigail L. Mackey
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DK
- Institute of Sports Medicine Copenhagen, Department of Orthopaedic Surgery, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
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Asma Sakalli A, Küçükerdem HS, Aygün O. What is the relationship between serum uric acid level and insulin resistance?: A case-control study. Medicine (Baltimore) 2023; 102:e36732. [PMID: 38206747 PMCID: PMC10754590 DOI: 10.1097/md.0000000000036732] [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: 09/04/2023] [Accepted: 11/29/2023] [Indexed: 01/13/2024] Open
Abstract
Diabetes, arises from either an absolute or relative insufficiency of insulin or insulin resistance of peripheral tissues. For assessing long-term blood glucose concentration and insulin resistance, the utilization of glycosylated hemoglobin (HbA1c) and the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) is widespread. Insulin resistance can lead to hyperuricemia by reducing the kidney ability to excrete urate, thus increasing sodium reabsorption. The aim of this study was to investigate the possible relationship between serum uric acid levels and insulin resistance. This was a retrospective case-control study. A total of 2530 applications in 2-year time were included in the study. Patient, known hypertension status, fasting plasma glucose, insulin, uric acid, HDL, low-density lipoprotein (LDL), triglyceride/Tg, HbA1c laboratory values and Tg/HDL ratio were examined. A statistically significant difference existed in the median uric acid values between the insulin-resistant and insulin-sensitive groups (P < .001). Additionally, a weak positive statistical correlation was identified between uric acid and HOMA-IR values (R = 0.299; P < .001) and uric acid and Tg/HDL values (R = 0.357; P < .001). This study concludes that there is a positive correlation between serum uric acid levels and insulin resistance.
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Affiliation(s)
- Ayça Asma Sakalli
- Department of Family Medicine, Balikesir Atatürk City Hospital, Gaziosmanpaşa, Turkey
| | - H. Seda Küçükerdem
- Department of Family Medicine, Health Science University, Izmir Bozyaka Training and Education Hospital, Izmir, Turkey
| | - Olgu Aygün
- Department of Family Medicine, Health Science University, Izmir Bozyaka Training and Education Hospital, Izmir, Turkey
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Son DH, Han JH, Lee JH. Neck Circumference as a Predictor of Insulin Resistance in People with Non-alcoholic Fatty Liver Disease. J Obes Metab Syndr 2023; 32:214-223. [PMID: 37649143 PMCID: PMC10583771 DOI: 10.7570/jomes22066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/17/2023] [Accepted: 05/21/2023] [Indexed: 09/01/2023] Open
Abstract
Background Insulin resistance is common in individuals with non-alcoholic fatty liver disease (NAFLD). Because insulin resistance is a predictive factor for advanced liver diseases in people with NAFLD, efforts have been made to predict it through anthropometric variables. Recently, neck circumference (NC) has been regarded as a reliable alternative marker for metabolic disorders. This study verified the association between NC and insulin resistance in patients with NAFLD. Methods We analyzed data from 847 people with NAFLD who participated in the 2019 Korean National Health and Nutrition Examination Survey. NAFLD was defined by a hepatic steatosis index score of ≥36 points, and insulin resistance was defined by a homeostatic model assessment of insulin resistance score of ≥2.5 points. Participants were divided according to sex-specific NC tertiles (T1, lowest; T2, middle; T3, highest). Results In the analysis of the area under the receiver operating characteristic curve (AUC), NC displayed a greater predictive power than body mass index (BMI) for insulin resistance in women (AUC of NC=0.625 vs. AUC of BMI=0.573, P=0.035). NC and the odds ratio (OR) for insulin resistance showed a cubic relationship in both men and women. In the weighted multiple logistic regression analysis, the ORs with 95% confidence intervals for insulin resistance in people with NAFLD in T2 and T3 compared to the reference tertile (T1) were 1.06 (0.47-2.41) and 1.13 (0.41-3.11), respectively, in men and 1.12 (0.64-1.97) and 2.54 (1.19-5.39), respectively, in women, after adjusting for confounding factors. Conclusion NC was positively correlated with insulin resistance in women with NAFLD.
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Affiliation(s)
- Da-Hye Son
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jee Hye Han
- Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Jun-Hyuk Lee
- Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
- Department of Medicine, Graduate School of Hanyang University, Seoul, Korea
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Takeuchi T, Kubota T, Nakanishi Y, Tsugawa H, Suda W, Kwon ATJ, Yazaki J, Ikeda K, Nemoto S, Mochizuki Y, Kitami T, Yugi K, Mizuno Y, Yamamichi N, Yamazaki T, Takamoto I, Kubota N, Kadowaki T, Arner E, Carninci P, Ohara O, Arita M, Hattori M, Koyasu S, Ohno H. Gut microbial carbohydrate metabolism contributes to insulin resistance. Nature 2023; 621:389-395. [PMID: 37648852 PMCID: PMC10499599 DOI: 10.1038/s41586-023-06466-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/20/2023] [Indexed: 09/01/2023]
Abstract
Insulin resistance is the primary pathophysiology underlying metabolic syndrome and type 2 diabetes1,2. Previous metagenomic studies have described the characteristics of gut microbiota and their roles in metabolizing major nutrients in insulin resistance3-9. In particular, carbohydrate metabolism of commensals has been proposed to contribute up to 10% of the host's overall energy extraction10, thereby playing a role in the pathogenesis of obesity and prediabetes3,4,6. Nevertheless, the underlying mechanism remains unclear. Here we investigate this relationship using a comprehensive multi-omics strategy in humans. We combine unbiased faecal metabolomics with metagenomics, host metabolomics and transcriptomics data to profile the involvement of the microbiome in insulin resistance. These data reveal that faecal carbohydrates, particularly host-accessible monosaccharides, are increased in individuals with insulin resistance and are associated with microbial carbohydrate metabolisms and host inflammatory cytokines. We identify gut bacteria associated with insulin resistance and insulin sensitivity that show a distinct pattern of carbohydrate metabolism, and demonstrate that insulin-sensitivity-associated bacteria ameliorate host phenotypes of insulin resistance in a mouse model. Our study, which provides a comprehensive view of the host-microorganism relationships in insulin resistance, reveals the impact of carbohydrate metabolism by microbiota, suggesting a potential therapeutic target for ameliorating insulin resistance.
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Affiliation(s)
- Tadashi Takeuchi
- Laboratory for Intestinal Ecosystem, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan
| | - Tetsuya Kubota
- Laboratory for Intestinal Ecosystem, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan.
- Intestinal Microbiota Project, Kanagawa Institute of Industrial Science and Technology, Kawasaki, Japan.
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
- Division of Diabetes and Metabolism, The Institute for Medical Science Asahi Life Foundation, Tokyo, Japan.
- Department of Clinical Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), Tokyo, Japan.
| | - Yumiko Nakanishi
- Laboratory for Intestinal Ecosystem, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan
- Intestinal Microbiota Project, Kanagawa Institute of Industrial Science and Technology, Kawasaki, Japan
| | - Hiroshi Tsugawa
- Metabolome Informatics Research Team, RIKEN Center for Sustainable Resource Science (CSRS), Yokohama, Japan
- Laboratory for Metabolomics, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan
- Graduate School of Medical Life Science, Yokohama City University, Yokohama, Japan
- Department of Biotechnology and Life Science, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Wataru Suda
- Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan
| | - Andrew Tae-Jun Kwon
- Laboratory for Applied Regulatory Genomics Network Analysis, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan
| | - Junshi Yazaki
- Laboratory for Integrative Genomics, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan
| | - Kazutaka Ikeda
- Laboratory for Metabolomics, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan
- Department of Applied Genomics, Kazusa DNA Research Institute, Kisarazu, Japan
| | - Shino Nemoto
- Laboratory for Intestinal Ecosystem, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan
| | - Yoshiki Mochizuki
- Laboratory for Integrative Genomics, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan
| | - Toshimori Kitami
- Laboratory for Developmental Genetics, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan
| | - Katsuyuki Yugi
- Laboratory for Integrated Cellular Systems, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan
- Institute for Advanced Biosciences, Keio University, Fujisawa, Japan
- Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo, Japan
| | - Yoshiko Mizuno
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
- Development Bank of Japan, Tokyo, Japan
| | - Nobutake Yamamichi
- Center for Epidemiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | | | - Iseki Takamoto
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Metabolism and Endocrinology, Tokyo Medical University Ibaraki Medical Center, Ami Town, Japan
| | - Naoto Kubota
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takashi Kadowaki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Toranomon Hospital, Tokyo, Japan
| | - Erik Arner
- Laboratory for Applied Regulatory Genomics Network Analysis, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan
| | - Piero Carninci
- Laboratory for Transcriptome Technology, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan
- Fondazione Human Technopole, Milan, Italy
| | - Osamu Ohara
- Laboratory for Integrative Genomics, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan
- Department of Applied Genomics, Kazusa DNA Research Institute, Kisarazu, Japan
| | - Makoto Arita
- Laboratory for Metabolomics, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan
- Graduate School of Medical Life Science, Yokohama City University, Yokohama, Japan
- Division of Physiological Chemistry and Metabolism, Graduate School of Pharmaceutical Sciences, Keio University, Tokyo, Japan
- Human Biology-Microbiome-Quantum Research Center (WPI-Bio2Q), Keio University, Tokyo, Japan
| | - Masahira Hattori
- Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan
| | - Shigeo Koyasu
- Laboratory for Immune Cell Systems, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan
| | - Hiroshi Ohno
- Laboratory for Intestinal Ecosystem, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan.
- Intestinal Microbiota Project, Kanagawa Institute of Industrial Science and Technology, Kawasaki, Japan.
- Graduate School of Medical Life Science, Yokohama City University, Yokohama, Japan.
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Lee H, Kim H, Provido SMP, Kang M, Chung GH, Lee JW, Hong S, Yu SH, Lee CB, Lee JE. Associations of Dietary Intakes of Total and Specific Types of Fat with Blood Lipid Levels in the Filipino Women's Diet and Health Study (FiLWHEL). Glob Heart 2023; 18:29. [PMID: 37334397 PMCID: PMC10275172 DOI: 10.5334/gh.1209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/11/2023] [Indexed: 06/20/2023] Open
Abstract
Background Limited evidence exists on the association between dietary fat intake and lipid profiles in Southeast Asian populations. Objectives We aimed to examine the cross-sectional associations of dietary intake of total and specific types of fat with dyslipidemia in Filipino immigrant women in Korea. Methods We included 406 Filipino women married to Korean in the Filipino Women's Diet and Health Study (FiLWHEL). Dietary fat intake was assessed using 24-hour recalls. Impaired blood lipid profiles were defined as high total cholesterol (TC) (≥200 mg/dL), high triglyceride (TG) (≥150 mg/dL), high LDL Cholesterol (LDL-C) (≥ 130 mg/dL), or low HDL cholesterol (HDL-C) (<50 mg/dL). The genomic DNA samples were genotyped using DNA chip. The odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariate logistic regression. Results Substituting carbohydrates with dietary saturated fat (SFA) intake was associated with increased prevalence of dyslipidemia; ORs (95% CIs) for subsequent tertiles compared to the first tertile were 2.28 (1.19-4.35), and 2.88 (1.29-6.39) (P for trend = 0.02). When we examined individual markers, ORs (95% CIs, P for trend) comparing the third to the first tertile were 3.62 (1.53-8.55, 0.01) for high TC, 1.46 (0.42-5.10, 0.72) for high TG, 4.00 (1.48-10.79, 0.02) for high LDL-C, and 0.69 (0.30-1.59, 0.36) for low HDL-C. When we examined the interaction by LDL-C-related polymorphisms, the association with dyslipidemia was more pronounced among participants with CC alleles than among those with T alleles of rs6102059 (P for interaction = 0.01). Conclusions High dietary SFA intake was significantly associated with a high prevalence of dyslipidemia in Filipino women in Korea. Further prospective cohort studies are warranted to determine risk factors for CVD in Southeast Asian populations.
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Affiliation(s)
- Heejin Lee
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Republic of Korea
| | - Hyojin Kim
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Republic of Korea
| | - Sherlyn Mae P. Provido
- Research Institute of Human Ecology, Seoul National University, Seoul, Republic of Korea
| | - Minji Kang
- Department of Food and Nutrition, Duksung Women’s University, Seoul, Republic of Korea
| | - Grace H. Chung
- Child Development and Family Studies, College of Human Ecology, Seoul National University, Seoul, Republic of Korea
| | - Jae W. Lee
- Department of Computer Science and Engineering, Seoul National University, Seoul, Republic of Korea
| | - Sangmo Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
| | - Sung Hoon Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
| | - Chang Beom Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
| | - Jung Eun Lee
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Republic of Korea
- Research Institute of Human Ecology, Seoul National University, Seoul, Republic of Korea
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Masoodian SM, Omidifar A, Moradkhani S, Asiabanha M, Khoshmirsafa M. HOMA-IR mean values in healthy individuals: a population-based study in iranian subjects. J Diabetes Metab Disord 2023; 22:219-224. [PMID: 37255829 PMCID: PMC10225417 DOI: 10.1007/s40200-022-01099-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 06/07/2022] [Accepted: 07/16/2022] [Indexed: 06/01/2023]
Abstract
Purpose Homeostasis Model Assessment-estimated Insulin Resistance (HOMA-IR) is an important indicator of insulin resistance. In this population-based investigation, we sought to report the mean value of HOMA-IR in different subgroups of a large population-based database of Iranian healthy subjects. Methods This study recruited adult healthy individuals between the ages of 18 to 70 years old to Massoud Medical Laboratory, Tehran, Iran. Fasting insulin was measured by using the Electro Chemiluminescence method using Roche Cobas 6000 e601/602 instrument. Results The mean ± SD value of the HOMA-IR index in the studied population was 2.11 ± 0.99 (2.5-97.5% percentiles: 0.66-4.50). In addition, the mean ± SD of HOMA-IR index in male and female groups were 2.35 1.0 (2.5-97.5 percentile: 0.57-4.37) and 2.05 ± 1.0 (2.5-97.5 percentiles: 0.53-4.35), respectively. Interestingly, it was observed a significant increment for the HOMA-IR index in the male group compared with the female group in all age subgroups (P < 0.01). Conclusions Our findings showed the mean value of 2.11 ± 0.99 HOMA-IR in the Iranian healthy population. Considering the large sample size in our study, more clinical investigations in terms of ethnicity should be done to provide a precise standardized HOMA-IR index in the Iranian population. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-022-01099-9.
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Affiliation(s)
| | - Abolfazl Omidifar
- Department of Biochemistry and Immunochemistry, Massoud Laboratory, Tehran, Iran
| | - Sepideh Moradkhani
- Department of Biochemistry and Immunochemistry, Massoud Laboratory, Tehran, Iran
| | - Majid Asiabanha
- Department of Biochemistry and Immunochemistry, Massoud Laboratory, Tehran, Iran
| | - Majid Khoshmirsafa
- Immunology Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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9
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Aktas H, Gul M, Inci S, Yildirim O, Turgut M. The effect of insulin resistance on the heart rate recovery in healthy individuals with a low-to-moderate cardiovascular disease risk profile. J Investig Med 2023; 71:482-488. [PMID: 36825620 DOI: 10.1177/10815589231158040] [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: 02/25/2023]
Abstract
The association between insulin resistance (IR) and heart rate recovery index (HRRI) has been reported previously, but the cardiovascular disease (CVD) risk profile of the subjects was unclear in these studies. Therefore, we evaluated the association between IR and HRRI in apparently healthy individuals without metabolic syndrome who had a low-to-moderate CVD risk profile. A total of 182 eligible subjects were retrospectively included in the study. The subjects were divided into two groups according to the homeostasis model assessment of IR (HOMA-IR) value. HOMA-IR ≥2.5 was defined as IR (+) group (92 subjects), and <2.5 as IR (-) group (88 subjects). HRRI-2 was found by subtracting the heart rate at the second minute in the post-exercise recovery period from the maximum heart rate. Abnormal HRRI was defined as HRRI-2 that is ≤42 beats. The mean age of the patients was 41.91 ± 8.64 and 49.4% of them were female. Abnormal HRRI rates were significantly higher in the IR (+) group (37.2% vs 18.2%; p = 0.004). A negative correlation was detected between HRRI-2 and HOMA-IR (r = -0.416; p < 0.001). HOMA-IR (Odds Ratio (OR) = 1.57; confidence interval (CI) = 1.10-2.23; p = 0.013) and maximum heart rate during exercise (OR = 0.95; CI = 0.91-0.99; p = 0.013) as independent variables of abnormal HRRI. The HOMA-IR value of 2.82 was identified as an effective cutoff point for the prediction of abnormal HRRI (area under the curve: 0.658; CI: 0.570-0.746; p = 0.001). In this study, it was shown that IR without metabolic syndrome reduces HRRI in healthy individuals with a low-to-moderate CVD risk profile.
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Affiliation(s)
- Halil Aktas
- Department of Cardiology, Faculty of Medicine, Aksaray University, Aksaray, Turkey
| | - Murat Gul
- Department of Cardiology, Faculty of Medicine, Aksaray University, Aksaray, Turkey
| | - Sinan Inci
- Department of Cardiology, Faculty of Medicine, Aksaray University, Aksaray, Turkey
| | - Oguz Yildirim
- Department of Cardiology, Aksaray Education and Research Hospital, Aksaray, Turkey
| | - Mustafa Turgut
- Department of Internal Medicine, Aksaray Education and Research Hospital, Aksaray, Turkey
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Sinatra VJ, Lin B, Parikh M, Berger JS, Fisher EA, Heffron SP. Bariatric surgery normalizes diabetes risk index by one month post-operation. Acta Diabetol 2023; 60:265-271. [PMID: 36350383 PMCID: PMC10868715 DOI: 10.1007/s00592-022-02002-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/30/2022] [Indexed: 11/11/2022]
Abstract
AIM The Diabetes risk index (DRI) is a composite of NMR-measured lipoproteins and branched chain amino acids predictive of diabetes mellitus development. Bariatric surgery is indicated in patients with severe obesity, many of whom are at high-risk for developing diabetes. Substantial weight loss occurs following bariatric surgery and sustained weight loss likely contributes to reductions in the development of diabetes and cardiovascular disease. However, some evidence suggests that bariatric surgical procedures themselves may contribute to reducing risk of these conditions independent of weight loss. We aimed to investigate DRI and its association with reductions in body weight and adiposity over one year following bariatric surgery. METHODS We examined 51 severely obese premenopausal women without diabetes. DRI, BMI, body weight and waist measurements were made before and at 1, 6 and 12 months after Roux-en-Y Gastric Bypass (RYGB) or Sleeve Gastrectomy. Values were compared to healthy women with normal BMI (18.5-24.9 kg/m2; n = 15). RESULTS Non-diabetic women with severe obesity (BMI 44.7 ± 6.2 kg/m2) exhibited significantly elevated DRI scores prior to surgery versus controls (35 [26, 39] vs 12 [1, 20]; p < 0.0001). At 1 month after surgery, BMI decreased 5.1 ± 1.1 kg/m2, but DRI decreased so that it no longer differed from that of normal BMI controls (1.9 [1, 17] vs control 12 [1, 20]; p = 0.35). Subjects continued to lose weight, whereas DRI remained similar, throughout follow-up with DRI 1.0 [1, 7] at 12 months. Changes in DRI did not correlate with changes in BMI, body weight or waist circumference at any time during follow-up. There was no difference in change in DRI between surgical procedures or pre-operative metabolic syndrome status. CONCLUSIONS Our analysis of DRI scores supports the capacity of bariatric surgery to reduce risk of developing diabetes in severely obese individuals. Our findings suggest that bariatric surgical techniques may have inherent effects that improve cardiometabolic risk independent of reductions in body weight or adiposity.
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Affiliation(s)
- Vincent J Sinatra
- Leon H Charney Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, 435 East 30Th St. #515, New York, NY, 10016, USA
| | - BingXue Lin
- Leon H Charney Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, 435 East 30Th St. #515, New York, NY, 10016, USA
| | - Manish Parikh
- Department of Surgery, NYU Grossman School of Medicine, New York, NY, USA
| | - Jeffrey S Berger
- Leon H Charney Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, 435 East 30Th St. #515, New York, NY, 10016, USA
- NYU Center for the Prevention of Cardiovascular Disease, NYU Grossman School of Medicine, New York, NY, USA
- Division of Vascular Surgery, Department of Surgery, NYU Grossman School of Medicine, New York, NY, USA
| | - Edward A Fisher
- Leon H Charney Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, 435 East 30Th St. #515, New York, NY, 10016, USA
- NYU Center for the Prevention of Cardiovascular Disease, NYU Grossman School of Medicine, New York, NY, USA
| | - Sean P Heffron
- Leon H Charney Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, 435 East 30Th St. #515, New York, NY, 10016, USA.
- NYU Center for the Prevention of Cardiovascular Disease, NYU Grossman School of Medicine, New York, NY, USA.
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11
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Zhang Y, Dilimulati D, Chen D, Cai M, You H, Sun H, Gao X, Shao X, Zhang M, Qu S. Serum fibrinogen-like protein 1 as a novel biomarker in polycystic ovary syndrome: a case-control study. J Endocrinol Invest 2022; 45:2123-2130. [PMID: 35790683 DOI: 10.1007/s40618-022-01844-0] [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: 04/20/2022] [Accepted: 06/17/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the relationship between fibrinogen-like protein 1 (FGL-1) concentrations and various metabolic characteristics in patients with polycystic ovary syndrome (PCOS) and explore whether FGL-1 could be a predictive biomarker for PCOS. METHODS This case-control study included 136 patients with PCOS and 34 normal controls recruited in the Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital between May 2017 and June 2021. Anthropometric characteristics, metabolic parameters, and reproductive hormones were collected. Serum FGL-1 measurement was conducted using enzyme-linked immunosorbent assay (ELISA) kits. RESULTS Serum FGL-1 concentrations were higher in patients with PCOS than in control subjects in body mass index (BMI) subgroups, insulin resistance (IR) subgroups, and hepatic function subgroups, respectively. Serum FGL-1 concentrations were significantly associated with BMI, glycosylated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), homeostasis model assessment of insulin resistance (HOMA-IR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), high-density lipoprotein cholesterol (HDL-c), and serum uric acid (SUA) in all individuals. The receiver operating characteristic (ROC) curve analysis revealed that the best cutoff value for FGL-1 levels to predict PCOS was 21.02 ng/ml with a sensitivity of 74.3% and a specificity of 70.6%. Both univariate and multiple logistic regressions indicated that the odds ratio (OR) for PCOS significantly increased in the subjects with high levels of FGL-1. CONCLUSION In our study, FGL-1 was associated with serum aminotransferase and various metabolic indexes. Moreover, the high risk of PCOS was independently associated with the increased FGL-1 levels, which suggested that FGL-1 could be a predictive biomarker for PCOS.
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Affiliation(s)
- Y Zhang
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072, China
| | - D Dilimulati
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072, China
| | - D Chen
- Department of Pediatrics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072, China
| | - M Cai
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072, China
| | - H You
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072, China
| | - H Sun
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072, China
| | - X Gao
- Department of Obstetrics and Gynecology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072, China
| | - X Shao
- Department of Obstetrics and Gynecology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072, China.
| | - M Zhang
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072, China.
| | - S Qu
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072, China
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12
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Primo D, Izaola O, de Luis DA. Triglyceride-Glucose Index Cutoff Point Is an Accurate Marker for Predicting the Prevalence of Metabolic Syndrome in Obese Caucasian Subjects. ANNALS OF NUTRITION & METABOLISM 2022; 79:238-245. [PMID: 36209727 DOI: 10.1159/000526988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/28/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Recently, the triglyceride-glucose (TyG) index has been suggested as a surrogate insulin resistance marker. This index could act as an early screening marker in individuals with a high risk of metabolic syndrome (MS) such as obese subjects. AIMS The objective of this work was to detect the cutoff point of the TyG index for the diagnosis of MS according to ATPIII criteria on obese subjects and to compare with HOMA-IR. METHODS We conducted a cross-sectional study in 1,494 obese subjects. Measurements of adiposity parameters, blood pressure, fasting blood glucose, insulin concentration, insulin resistance (HOMA-IR), lipid profile, C-reactive protein, adipokines, and the prevalence of MS were determined. The TyG index was calculated from the next equation: Ln (fasting triglycerides (mg/dL) × fasting glucose (mg/dL))/2. RESULTS A total of 1,494 subjects were recruited, 421 males (28.1%) and 1,073 females (71.8%), with an average age of 45.8 ± 15.3 years (range: 29-62). A total of 677 subjects had MS (45.5%) and 817 did not show MS (54.6%). The averages of HOMA-IR and TyG index values increased as the components of MS were aggregated, and both indexes were higher in subjects with MS. The area under the curve (AUC) of the TyG index according to ATPIII criteria showed values of 0.746 (0.721-0.771; p = 0.001). The cutoff point according to the Youden index was 4.72, with sensitivity and specificity of 87% and 88.2%, respectively. For the HOMA-IR, AUC showed values of 0.682 (0.654-0.710; p = 0.01). The cutoff point was 3.23, with sensitivity and specificity of 78% and 70.1%, respectively. CONCLUSIONS The TyG index is more powerful for predicting MS than HOMA-IR in Caucasian obese subjects.
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Affiliation(s)
- David Primo
- Endocrinology and Nutrition Department, Hospital Clínico Universitario de Valladolid, Investigation Centre on Endocrinology and Nutrition (IEN), University of Valladolid, Valladolid, Spain
| | - Olatz Izaola
- Endocrinology and Nutrition Department, Hospital Clínico Universitario de Valladolid, Investigation Centre on Endocrinology and Nutrition (IEN), University of Valladolid, Valladolid, Spain
| | - Daniel A de Luis
- Endocrinology and Nutrition Department, Hospital Clínico Universitario de Valladolid, Investigation Centre on Endocrinology and Nutrition (IEN), University of Valladolid, Valladolid, Spain
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13
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A patient with ketosis-prone type 2 diabetes showing nearly normalized glucose tolerance after recovery from severe diabetic ketoacidosis. Diabetol Int 2022; 14:109-113. [PMID: 36636160 PMCID: PMC9829925 DOI: 10.1007/s13340-022-00599-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/20/2022] [Indexed: 01/16/2023]
Abstract
Unprovoked A-β+ ketosis-prone type 2 diabetes (KPD) is characterized by the sudden onset of diabetic ketosis/ketoacidosis (DK/DKA) without precipitating factors, negative anti-islet autoantibodies ("A- "), and preservation of β-cell function ("β+ ") after recovery from DKA using insulin therapy. However, there have been few reports on glucose tolerance after recovery. We present a case of KPD with nearly normalized glucose tolerance after recovery from severe DKA. A 41-year-old obese woman first presented with unprovoked severe DKA, i.e., ketonuria, plasma glucose 570 mg/dL, pH 7.18, and HCO3 - 5.2 mmol/L, without anti-islet autoantibodies. She achieved insulin-free glycemic remission after recovery from DKA, leading to the diagnosis of KPD. Thereafter, 75 g oral glucose tolerance test showed impaired fasting glucose and time-in-range using intermittently scanned continuous glucose monitoring was 97% without medication. These findings suggest that, despite the initial severe DKA, some patients with KPD might achieve normalized glucose tolerance after recovery. The similar onset patterns of DKA necessitates appropriately distinguishing KPD from acute-onset type 1B (idiopathic) diabetes. Supplementary Information The online version contains supplementary material available at 10.1007/s13340-022-00599-6.
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14
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Possible role of insulin resistance in activation of plasma xanthine oxidoreductase in health check-up examinees. Sci Rep 2022; 12:10281. [PMID: 35717455 PMCID: PMC9206666 DOI: 10.1038/s41598-022-11094-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 04/18/2022] [Indexed: 11/23/2022] Open
Abstract
We previously found an association of insulin resistance (IR) with plasma xanthine oxidoreductase (XOR) activity in a cross-sectional study. However, whether IR induces increased XOR activity has not been elucidated. This retrospective longitudinal observational study included 347 participants (173 males, 174 females) who underwent annual health examinations and were medication naïve. Homeostasis model assessment of IR (HOMA-IR) index, and physical and laboratory measurements were determined at the baseline. At baseline and 12-month follow-up examinations, plasma XOR activity was determined using our novel assay based on [13C2,15N2] xanthine and liquid chromatography/triple quadrupole mass spectrometry. Subjects with IR, defined as HOMA-IR index ≥ 1.7 (n = 92), exhibited significantly (p < 0.001) higher plasma XOR activity levels than those without IR (n = 255), with an increase in that activity seen in 180 (51.9%) after 12 months. Multivariable linear and logistic regression analyses showed that IR, but not BMI or waist circumference, at baseline was significantly associated with plasma XOR activity (β = 0.094, p = 0.033) and increased plasma XOR activity over the 12-month period (odds ratio, 1.986; 95% confidence interval, 1.048–3.761; p = 0.035), after adjustments for various clinical parameters, including plasma XOR activity at baseline. These results suggest that IR induces increased plasma XOR activity in a manner independent of adiposity.
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15
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Association of Low Skeletal Muscle Mass with the Phenotype of Lean Non-Alcoholic Fatty Liver Disease. Healthcare (Basel) 2022; 10:healthcare10050850. [PMID: 35627987 PMCID: PMC9141446 DOI: 10.3390/healthcare10050850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 12/04/2022] Open
Abstract
Low skeletal muscle mass (LSMM) has emerged as a potential risk factor for non-alcoholic fatty liver disease (NAFLD). However, its clinical implications in patients with lean NAFLD have not yet been elucidated. We investigated the role of LSMM in patients with lean NAFLD. Lean NAFLD was defined as a body mass index of ≤23 kg/m2. Using bioelectrical impedance analysis, the appendicular skeletal muscle mass (ASM) was adjusted by height squared. The LSMM was based on 1 SD below the sex-specific mean for young, healthy Asian adults. Of the 8905 ultrasound-confirmed NAFLD patients, 3670 (41.2%) were diagnosed with lean NAFLD. The lean NAFLD group was younger (45.0 vs. 49.0 years, p < 0.001), and had a lower waist circumference (74.0 vs. 85.0 cm, p < 0.001), lower prevalence of diabetes (3.1 vs. 7.4%, p < 0.001) and hypertension (4.2 vs. 15.2%, p < 0.001), and a higher proportion of LSMM (28.0 vs. 2.2%, p < 0.001) than the non-lean NAFLD group. Stepwise adjusted models suggested that LSMM was associated with lean individuals with NAFLD (odds ratio = 7.02, p < 0.001). LSMM may be a novel risk factor for lean NAFLD patients more than non-lean NAFLD patients, independent of classic metabolic factors.
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Li W, Jiao Y, Wang L, Wang S, Hao L, Wang Z, Wang H, Zhang B, Ding G, Jiang H. Association of Serum Magnesium with Insulin Resistance and Type 2 Diabetes among Adults in China. Nutrients 2022; 14:nu14091799. [PMID: 35565766 PMCID: PMC9104014 DOI: 10.3390/nu14091799] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/21/2022] [Accepted: 04/23/2022] [Indexed: 11/28/2022] Open
Abstract
Magnesium is an essential mineral for the human body and a cofactor or activator for more than 300 enzymatic reactions, including blood glucose control and insulin release. Diabetes is a well-known global burden of disease with increasing global prevalence. In China, the prevalence of diabetes in adults is higher than the global average. Evidence shows that magnesium is a predictor of insulin resistance and diabetes. However, the majority of studies focus on dietary magnesium instead of serum magnesium concentration. We study the correlation of serum magnesium levels with insulin resistance and Type 2 diabetes. In this prospective cohort study, we included 5044 participants aged 18 years and older without insulin resistance (IR) and diabetes at the baseline from China Health and Nutrition Survey (CHNS). A fasting blood sample was taken for the measurement of both types of magnesium, fasting blood glucose, hemoglobin A1c (HbA1c), and fasting insulin. The homeostatic model (HOMA-IR) was calculated. Demographic characteristics of participants, and risk factors such as intensity of physical activities, smoking status, drinking habit, and anthropometric information were recorded. IR was defined as HOMA-IR ≥ 2.5, and Type 2 diabetes mellitus was defined as fasting plasma glucose ≥ 7.0 mmol/L or HbA1c ≥ 6.5%, or a self-reported diagnosis or treatment of diabetes. A total of 1331 incident insulin resistance events and 429 incident diabetic events were recorded during an average follow-up of 5.8 years. The serum magnesium concentration was categorized into quintiles. After adjusting for relevant covariates, the third quintile of serum magnesium (0.89−0.93 mmol/L) was correlated with 29% lower risk of incident insulin resistance (hazard ratio = 0.71, 95% CI 0.58, 0.86) and with a lower risk of Type 2 diabetes. Multivariable-adjusted hazard ratios (95% confidence intervals) for insulin resistance were compared with the lowest quintile of serum magnesium (<0.85). We found similar results when evaluating serum magnesium as a continuous measure. Restricted cubic spline (RCS) curves showed a nonlinear dose−response correlation in both serum magnesium levels and insulin resistance, and in serum magnesium levels and Type 2 diabetes. Lower serum magnesium concentration was associated with a higher risk of insulin resistance and diabetes.
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Affiliation(s)
- Weiyi Li
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Yingying Jiao
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
| | - Liusen Wang
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Shaoshunzi Wang
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Lixin Hao
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Zhihong Wang
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Huijun Wang
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Bing Zhang
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Gangqiang Ding
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Hongru Jiang
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
- Correspondence: ; Tel.: +86-10-6623-7057
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Moon S, Chung GE, Joo SK, Park JH, Chang MS, Yoon JW, Koo BK, Kim W. A PNPLA3 Polymorphism Confers Lower Susceptibility to Incident Diabetes Mellitus in Subjects With Nonalcoholic Fatty Liver Disease. Clin Gastroenterol Hepatol 2022; 20:682-691.e8. [PMID: 33905771 DOI: 10.1016/j.cgh.2021.04.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS We investigated the association between the patatin-like phospholipase domain-containing-3 (PNPLA3) rs738409 genotype and the risk of diabetes mellitus (DM) using a biopsy-confirmed nonalcoholic fatty liver disease (NAFLD) cohort and a longitudinal observational cohort. METHODS Associations between genotypes and the prevalence of DM were evaluated with stratification according to the histological severity of NAFLD in the Boramae cohort (n = 706). A longitudinal cohort consisting of nondiabetic individuals with ≥2 health checkups was then selected to investigate the risk of incident DM according to the genotype (the GENIE cohort; n = 4998). RESULTS Among subjects with NAFLD in the Boramae cohort, the G allele was independently associated with a lower prevalence of DM in both NAFL (odds ratio [OR] per 1 allele, 0.66; 95% confidence interval [CI], 0.46-0.97) and nonalcoholic steatohepatitis (OR per 1 allele, 0.59; 95% CI, 0.38-0.92). This result was replicated in the longitudinal GENIE cohort. The G allele was associated with a lower risk of incident DM during the median follow-up of 60 months in subjects with NAFLD (hazard ratio, 0.65; 95% CI, 0.45-0.93). In contrast, G allele carriers without NAFLD showed higher odds for DM in the context of the Boramae cohort (OR, 2.44; 95% CI, 1.00-5.95). CONCLUSIONS These findings clarify conflicting results regarding the association between the PNPLA3 rs738409 genotype and the risk of DM, demonstrating a clear difference between subjects with and without NAFLD; this difference might be explained by the low metabolic risk in genetic NAFLD.
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Affiliation(s)
- Seoil Moon
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea; On behalf of the Innovative Target Exploration of NAFLD (ITEN) consortium
| | - Goh Eun Chung
- Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea; On behalf of the Innovative Target Exploration of NAFLD (ITEN) consortium
| | - Sae Kyung Joo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea; On behalf of the Innovative Target Exploration of NAFLD (ITEN) consortium
| | - Jeong Hwan Park
- Department of Pathology, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea; On behalf of the Innovative Target Exploration of NAFLD (ITEN) consortium
| | - Mee Soo Chang
- Department of Pathology, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea; On behalf of the Innovative Target Exploration of NAFLD (ITEN) consortium
| | - Ji Won Yoon
- Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea; On behalf of the Innovative Target Exploration of NAFLD (ITEN) consortium
| | - Bo Kyung Koo
- Division of Endocrinology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea; On behalf of the Innovative Target Exploration of NAFLD (ITEN) consortium.
| | - Won Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea; On behalf of the Innovative Target Exploration of NAFLD (ITEN) consortium.
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Cai M, Shao X, Xing F, Zhang Y, Gao X, Zeng Q, Dilimulati D, Qu S, Zhang M. Efficacy of canagliflozin versus metformin in women with polycystic ovary syndrome: A randomized, open-label, noninferiority trial. Diabetes Obes Metab 2022; 24:312-320. [PMID: 34726324 DOI: 10.1111/dom.14583] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/07/2021] [Accepted: 10/20/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To determine the safety and efficacy of canagliflozin in comparison to metformin in polycystic ovary syndrome (PCOS) patients with insulin resistance (IR). METHODS A single-centre, prospective, randomized open-label (ratio 1:1) noninferiority trial was conducted at the Department of Endocrinology, Shanghai Tenth People's Hospital, between July 2019 and April 2021. Women aged 18 to 45 years with PCOS and IR were enrolled and randomly assigned to either 100 mg (n = 33) canagliflozin daily or 1500 to 2000 mg metformin daily (n = 35) for 12 weeks. The primary outcome was changes in homeostatic model assessment (HOMA)-IR after 12 weeks of treatment. The secondary outcomes included changes in anthropometric measurements, menstrual frequency, sex hormone levels, metabolic variables and body fat distribution. RESULTS For lowering of HOMA-IR after 12 weeks of treatment, canagliflozin was found to be noninferior to metformin (least-squares mean difference -0.81% [95% confidence interval -2.13 to 0.51]). Both canagliflozin and metformin significantly improved menstrual pattern, reduced body weight and total fat mass, and decreased triglyceride levels. Compared with metformin, canagliflozin had significant advantages in reducing uric acid and dehydroepiandrosterone sulphate levels. Pruritus vulvae (9.09%) and gastrointestinal reaction (55.55%) were the main adverse events in the metformin group and canagliflozin group, respectively. CONCLUSION This study demonstrates that canagliflozin was not inferior to metformin in PCOS patients with IR, which suggests that sodium-glucose cotransporter-2 inhibitors should be considered as effective drugs in the treatment of PCOS patients with IR.
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Affiliation(s)
- Meili Cai
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaowen Shao
- Department of Obstetrics and Gynecology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Feng Xing
- Department of Obstetrics and Gynecology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yuqin Zhang
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xinyu Gao
- Department of Obstetrics and Gynecology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qiongjing Zeng
- Department of Obstetrics and Gynecology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Diliqingna Dilimulati
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Shen Qu
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- National Metabolic Management Center, Shanghai Tenth People's Hospital, Shanghai, China
| | - Manna Zhang
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- National Metabolic Management Center, Shanghai Tenth People's Hospital, Shanghai, China
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Development and Validation of an Insulin Resistance Predicting Model Using a Machine-Learning Approach in a Population-Based Cohort in Korea. Diagnostics (Basel) 2022; 12:diagnostics12010212. [PMID: 35054379 PMCID: PMC8774355 DOI: 10.3390/diagnostics12010212] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 12/19/2022] Open
Abstract
Background: Insulin resistance is a common etiology of metabolic syndrome, but receiver operating characteristic (ROC) curve analysis shows a weak association in Koreans. Using a machine learning (ML) approach, we aimed to generate the best model for predicting insulin resistance in Korean adults aged > 40 of the Ansan/Ansung cohort using a machine learning (ML) approach. Methods: The demographic, anthropometric, biochemical, genetic, nutrient, and lifestyle variables of 8842 participants were included. The polygenetic risk scores (PRS) generated by a genome-wide association study were added to represent the genetic impact of insulin resistance. They were divided randomly into the training (n = 7037) and test (n = 1769) sets. Potentially important features were selected in the highest area under the curve (AUC) of the ROC curve from 99 features using seven different ML algorithms. The AUC target was ≥0.85 for the best prediction of insulin resistance with the lowest number of features. Results: The cutoff of insulin resistance defined with HOMA-IR was 2.31 using logistic regression before conducting ML. XGBoost and logistic regression algorithms generated the highest AUC (0.86) of the prediction models using 99 features, while the random forest algorithm generated a model with 0.82 AUC. These models showed high accuracy and k-fold values (>0.85). The prediction model containing 15 features had the highest AUC of the ROC curve in XGBoost and random forest algorithms. PRS was one of 15 features. The final prediction models for insulin resistance were generated with the same nine features in the XGBoost (AUC = 0.86), random forest (AUC = 0.84), and artificial neural network (AUC = 0.86) algorithms. The model included the fasting serum glucose, ALT, total bilirubin, HDL concentrations, waist circumference, body fat, pulse, season to enroll in the study, and gender. Conclusion: The liver function, regular pulse checking, and seasonal variation in addition to metabolic syndrome components should be considered to predict insulin resistance in Koreans aged over 40 years.
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Zeytinli Aksit M, Demet Arslan F, Karakoyun I, Aydin C, Turgut E, Parildar H, Gokbalci U, Isbilen Basok B, Duman C, Emiroglu M. Galectin-3 levels and inflammatory response in patients undergoing bariatric surgery. Cytokine 2022; 151:155793. [PMID: 35032862 DOI: 10.1016/j.cyto.2022.155793] [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: 09/27/2021] [Revised: 12/03/2021] [Accepted: 12/29/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE Obesity, a low-grade systemic inflammatory disease, causes inflammation in metabolic tissues. Galectin-3(Gal-3) is one of the lectin molecules involved in inflammatory processes. We evaluated the possible relationship between Gal-3 level and the metabolic inflammatory process before and after obesity surgery. METHODS One hundred participants were included in the study and classified as normal weight, overweight, Class I, II, and III obese. Class III obese group underwent bariatric surgery and evaluated in the 3rd and 6th months after surgery. Glucose, insulin, glycated hemoglobin A1c (HbA1c), homeostatic model assessment of insulin resistance (HOMA-IR), high sensitivity C-reactive protein (hsCRP), Gal-3, interleukin (IL)-6, IL-10, adiponectin, and leptin levels were determined. RESULTS Gal-3 levels were higher in Class III obese compared to the normal weight group. Postoperative leptin and hsCRP levels were decreased significantly, but the decrease in IL-6 and Gal-3 levels were not significant. Postoperative increased adiponectin and IL-10 levels were significant. Gal-3 was found significantly higher in insulin resistant group. The correlation between Gal-3 with BMI, adiponectin, leptin, hsCRP levels, and HOMA-IR was found weak. CONCLUSION These findings might support the fact that Gal-3 is one of the molecules involved in the linkage between insulin resistance and meta-inflammation in morbid obese.
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Affiliation(s)
- Merve Zeytinli Aksit
- Department of Medical Biochemistry, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey.
| | - Fatma Demet Arslan
- Department of Medical Biochemistry, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Inanc Karakoyun
- Department of Medical Biochemistry, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Cengiz Aydin
- Department of General Surgery, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Emre Turgut
- Department of General Surgery, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Hulya Parildar
- Department of Family Medicine, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Umut Gokbalci
- Department of Family Medicine, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Banu Isbilen Basok
- Department of Medical Biochemistry, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Can Duman
- Department of Medical Biochemistry, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Mustafa Emiroglu
- Department of General Surgery, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
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21
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Al-Naemi A. Establishing a Reference Interval for an Estimate of Peripheral Insulin Resistance in a Group of Iraqi People. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background and aims: Insulin resistance (IR) is the cornerstone in pathophysiology of T2DM. Identifying people with IR can slow the progress to diabetes. Triglyceride and glucose index (TyG index) is a simple tool to assess IR without insulin measurement. This study aims at establishing the reference interval for TyG index in apparently healthy Iraqis. Material and method: This study involved (77) apparently healthy adults (41 men and 36 women) in Mosul, Iraq. Fasting Serum lipids, glucose and insulin were measured and BMI was calculated. The modified TyG index was calculated and compared to other surrogate measures of IR and its reference interval was calculated. Results: TyG index values were normally distributed and significantly correlated with HOMA-IR, Mc-Auley index, QUICKI, and triglycerides/ HDL-c index (r= 0.322, p= 0.004; r=-0.68, p<0001; r= -0.29, p=0.01; r=0.84, p<0.0001respectively). ANOVA and PostHoc Duncan’s analyses revealed significant differences in mean TyG between (lean people) and (overweight and obese subjects), (p=0.02). BMI- based TyG reference intervals were calculated as (4.11- 4.91) and (4.25- 5.05) respectively. This is the first study in Iraq to set a reference interval for TyG index. Values should be interpreted according to BMI.
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22
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Ikeda H. The Effect of Mild Renal Dysfunction on the Assessment of Plasma Amino Acid Concentration and Insulin Resistance in Patients with Type 2 Diabetes Mellitus. J Diabetes Res 2022; 2022:2048300. [PMID: 35734236 PMCID: PMC9208954 DOI: 10.1155/2022/2048300] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND An increase in the levels of branched-chain amino acids (BCAAs) and certain aromatic amino acids, such as alanine, in plasma is correlated with insulin resistance (IR) in type 2 diabetes mellitus (T2DM). T2DM is a leading risk factor for chronic kidney disease. Meanwhile, renal dysfunction causes changes in plasma amino acid levels. To date, no study has examined how mild renal dysfunction and IR interact with plasma amino acid levels. This study examines the effects of IR and renal dysfunction on plasma amino acid concentrations in T2DM. METHODS Data were collected from healthy male participants (controls) and male patients with T2DM between May 2018 and February 2022. Blood samples were collected after overnight fasting. IR and renal function were evaluated using the homeostasis model assessment of IR (HOMA-IR) and serum cystatin C (CysC), respectively. RESULTS A total of 49 and 93 participants were included in the control and T2DM groups, respectively. In the T2DM group, eight amino acids (alanine, glutamic acid, glutamine, glycine, isoleucine, leucine, tyrosine, and valine) and total BCAA showed a significant correlation with HOMA-IR (p < 0.01), whereas six amino acids (γ-aminobutyric acid, citrulline, cysteine, glycine, methionine, and valine) and total BCAA showed a significant correlation with 1/CysC (p < 0.02). However, only alanine, glutamic acid, and each BCAA showed significant differences between the control group and the IR T2DM subgroup. Increases in the BCAA levels with T2DM were canceled by renal dysfunction (CysC ≥ 0.93) in patients with intermediate IR. CONCLUSION To use plasma BCAA concentration as a marker of IR, renal function must be considered, even in mild renal dysfunction. Increased alanine and glutamic acid levels indicate IR, regardless of mild renal dysfunction.
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Affiliation(s)
- Hideki Ikeda
- Department of Internal Medicine, Sanyudo Hospital, Chuo 6 Chome-1-219, Yonezawa, Yamagata 992-0045, Japan
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Park HM, Lee HS, Lee YJ, Lee JH. The triglyceride-glucose index is a more powerful surrogate marker for predicting the prevalence and incidence of type 2 diabetes mellitus than the homeostatic model assessment of insulin resistance. Diabetes Res Clin Pract 2021; 180:109042. [PMID: 34506839 DOI: 10.1016/j.diabres.2021.109042] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/28/2021] [Accepted: 09/02/2021] [Indexed: 01/22/2023]
Abstract
AIMS Insulin resistance is an independent risk factor for developing type 2 diabetes. Therefore, this study compared the predictability of the triglyceride-glucose (TyG) index and the homeostatic model assessment of insulin resistance (HOMA-IR) for the prevalence and incidence of type 2 diabetes. METHODS We analyzed data from 9730 adults aged 40-69 years at baseline and 7783 participants without diabetes who were followed up in the Korean Genome and Epidemiology Study survey. From 2001 to 2002 (baseline survey) to 2013-2014, this survey was conducted biennially (six follow-ups). The average follow-up period was 9.0 years. RESULTS The TyG index showed better predictability for the prevalence of type 2 diabetes than HOMA-IR (TyG index: 0.784, HOMA-IR: 0.728, p < 0.001). The area under the time-dependent receiver operating characteristic curve of the TyG index for incident type 2 diabetes was 0.640 (0.628-0.652), which was significantly higher than that of HOMA-IR [0.531 (0.521-0.541)] (p < 0.001). CONCLUSIONS The TyG index is superior to HOMA-IR for predicting type 2 diabetes. The TyG index could, therefore, be more useful for the early detection and prevention of type 2 diabetes.
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Affiliation(s)
- Hye Min Park
- Department of Family Medicine, Chaum Medical Checkup Center Samseongdong Branch, Cha University, Seoul 06125, Republic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Yong-Jae Lee
- Department of Family Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 06273, Republic of Korea
| | - Jun-Hyuk Lee
- Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul 01830, Republic of Korea.
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Fasting and Exercise in Oncology: Potential Synergism of Combined Interventions. Nutrients 2021; 13:nu13103421. [PMID: 34684421 PMCID: PMC8537603 DOI: 10.3390/nu13103421] [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] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 12/28/2022] Open
Abstract
Nutrition and exercise interventions are strongly recommended for most cancer patients; however, much debate exists about the best prescription. Combining fasting with exercise is relatively untouched within the oncology setting. Separately, fasting has demonstrated reductions in chemotherapy-related side effects and improved treatment tolerability and effectiveness. Emerging evidence suggests fasting may have a protective effect on healthy cells allowing chemotherapy to exclusively target cancer cells. Exercise is commonly recommended and attenuates treatment- and cancer-related adverse changes to body composition, quality of life, and physical function. Given their independent benefits, in combination, fasting and exercise may induce synergistic effects and further improve cancer-related outcomes. In this narrative review, we provide a critical appraisal of the current evidence of fasting and exercise as independent interventions in the cancer population and discuss the potential benefits and mechanisms of combined fasting and exercise on cardiometabolic, body composition, patient-reported outcomes, and cancer-related outcomes. Our findings suggest that within the non-cancer population combined fasting and exercise is a viable strategy to improve health-related outcomes, however, its safety and efficacy in the oncology setting remain unknown. Therefore, we also provide a discussion on potential safety issues and considerations for future research in the growing cancer population.
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25
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Wang Y. Definition, Prevalence, and Risk Factors of Low Sex Hormone-Binding Globulin in US Adults. J Clin Endocrinol Metab 2021; 106:e3946-e3956. [PMID: 34125885 PMCID: PMC8571812 DOI: 10.1210/clinem/dgab416] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Indexed: 11/25/2022]
Abstract
CONTEXT Lower sex hormone-binding globulin (SHBG) is associated with many diseases including cardiovascular disease, cancer, polycystic ovarian syndrome, arthritis, and liver disease. However, the definition of low SHBG and its prevalence in US adults are unknown. OBJECTIVE To define low SHBG and to determine its prevalence and risk factors in US adults. DESIGN, SETTING, AND PARTICIPANTS This cohort study included adults ≥20 years from the US National Health and Nutrition Examination Survey (NHANES) from 2013 to 2016 who had fasting serum SHBG. EXPOSURES NHANES coverage during 2013-2016. MAIN OUTCOMES MEASURES Definition, prevalence, and risk factors of low SHBG. RESULTS This study included 4093 adults (weighted sample size of 204 789 616) with a mean (SD) age of 47.5 (17.0) years. In a "healthy" reference sub-cohort of 1477 adults, low SHBG was defined as SHBG < 12.3 nmol/L in men < 50 years, <23.5 nmol/L in men ≥ 50 years, <14.5 nmol/L in women < 30 years, and <21.9 nmol/L in women ≥ 30 years. The estimated US national prevalence of low SHBG was 3.3% in men, 2.7% in women, and 3.0% overall. Risk factors for this condition in both men and women included higher body mass index, diabetes, ethnicity (being other than Hispanic, non-Hispanic black, or non-Hispanic white), chronic obstructive pulmonary disease, coronary heart disease, and smoking. CONCLUSIONS This study established the criteria for low SHBG among US adults. The estimated US national prevalence of low SHBG was 3.3% in men and 2.7% in women.
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Affiliation(s)
- Yutang Wang
- School of Science, Psychology and Sport, Federation University Australia, Ballarat, VIC, Australia
- Correspondence: Yutang Wang, PhD, Discipline of Life Sciences, School of Science, Psychology and Sport, Federation University Australia, Ballarat, VIC, 3350, Australia.
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26
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HOMA indices as screening tests for cystic fibrosis-related diabetes. J Cyst Fibros 2021; 21:123-128. [PMID: 34090803 DOI: 10.1016/j.jcf.2021.05.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 04/19/2021] [Accepted: 05/17/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND We assessed the diagnostic performances of homeostasis model assessment indices (HOMA) of β-cell function (HOMA-%β) and of insulin resistance (HOMA-IR) for cystic fibrosis related diabetes (CFRD) screening. METHODS Data were collected from a prospective cohort of 228 patients with CF (117 adults and 111 children). Fasting insulin and glucose levels were measured to calculate HOMA-%β and HOMA-IR. HOMA-%β <100 indicated insulin secretion deficiency and HOMA-IR >1 insulin resistance. Both were used to calculate sensitivity, specificity, and positive and negative predictive values (PPV and NPV). Two-hour oral glucose tolerance tests (2h-OGTT) defined CFRD. Analyses were conducted separately for children and adults. Performances of HOMA-%β and HOMA-IR were calculated at inclusion, for each year of follow-up and for pooled data over the follow-up period. RESULTS Sensitivity, specificity, NPV and PPV were respectively: 88%, 45%, 98% and 11% for HOMA-%β and 42%, 48%, 91% and 6% for HOMA-IR in the pooled data of children; and 83%, 18%, 90% and 10% for HOMA-%β, and 39%, 80%, 92% and 18% for HOMA-IR in the pooled data of adults. Combining HOMA-%β and HOMA-IR did not improve performances. CONCLUSION Within both age groups, HOMA-%β <100 provided good sensitivity and NPV. HOMA-IR >1 had low sensitivity. Calculation of the HOMA-%β could be an interesting first-line screening approach to exclude CFRD and thus avoid unnecessary OGTT in patients for whom value is ≥100. However, HOMA-%β<100 does not support the diagnosis of CFRD and should be complemented by OGTT.
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Lee EK, Koo B, Hwangbo Y, Lee YJ, Baek JY, Cha YJ, Kim SY, Sim SH, Lee KS, Park IH, Lee H, Joo J, Go S, Heo SC, Moon MK. Incidence and disease course of new-onset diabetes mellitus in breast and colorectal cancer patients undergoing chemotherapy: A prospective multicenter cohort study. Diabetes Res Clin Pract 2021; 174:108751. [PMID: 33722701 DOI: 10.1016/j.diabres.2021.108751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/24/2021] [Accepted: 03/05/2021] [Indexed: 10/21/2022]
Abstract
AIMS To investigate the incidence of and risk factors for new-onset type 2 diabetes mellitus (DM) developed during chemotherapy that included steroids in cancer patients without DM. METHODS This multicenter, prospective, and observational cohort study enrolled 299 cancer patients without DM (aged > 18 years), planning 4-8 cycles of adjuvant chemotherapy. The endpoints were the incidence, remission rate, and independent determinants of new-onset DM during chemotherapy. RESULTS Between April 2015 and March 2018, 270 subjects with colorectal cancer or breast cancer (mean age, 51.0 years) completed the follow up (mean 39 months). Of whom, 17 subjects (6.3%) developed DM within a median time of 90 days (range, 17-359 days). Male sex (hazard ratio [HR], 15.839; 95% confidence interval [CI], 2.004-125.20) and impaired fasting glucose (IFG) at baseline (HR, 8.307; CI, 1.826-37.786) were independent risk factors. Six months after chemotherapy completion, 11/17 subjects (64.7%) experienced DM remission, associated with a significantly higher C-peptide level at baseline (C-peptide levels, 1.3 ng/mL in subjects with remission and 0.9 ng/mL in subjects without remission, age- and sex-adjusted P = 0.007). CONCLUSIONS DM incidence was 6.3% in patients who received chemotherapy with dexamethasone. Close monitoring for hyperglycemia is recommended, especially for men with IFG. TRIAL REGISTRATION ClinicalTrials.gov (NCT03062072).
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Affiliation(s)
- Eun Kyung Lee
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea; Center for Thyroid Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Bokyung Koo
- Division of Endocrinology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yul Hwangbo
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea; Center for Thyroid Cancer, National Cancer Center, Goyang, Republic of Korea
| | - You Jin Lee
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea; Center for Thyroid Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Ji Yeon Baek
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea; Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Yong Jun Cha
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea; Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Sun Young Kim
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea; Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Sung Hoon Sim
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Keun Seok Lee
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea
| | - In Hae Park
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Hyewon Lee
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea
| | - Jungnam Joo
- Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, USA
| | - Sujeong Go
- Center for Thyroid Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Seung Chul Heo
- Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Min Kyong Moon
- Division of Endocrinology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Kianu Phanzu B, Nkodila Natuhoyila A, Kintoki Vita E, M'Buyamba Kabangu JR, Longo-Mbenza B. Association between insulin resistance and left ventricular hypertrophy in asymptomatic, Black, sub-Saharan African, hypertensive patients: a case-control study. BMC Cardiovasc Disord 2021; 21:1. [PMID: 33388039 PMCID: PMC7777396 DOI: 10.1186/s12872-020-01829-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 12/15/2020] [Indexed: 01/19/2023] Open
Abstract
Background Conflicting information exists regarding the association between insulin resistance (IR) and left ventricular hypertrophy (LVH). We described the associations between obesity, fasting insulinemia, homeostasis model assessment of insulin resistance (HOMA-IR), and LVH in Black patients with essential hypertension. Methods A case–control study was conducted at the Centre Médical de Kinshasa (CMK), the Democratic Republic of the Congo, between January and December 2019. Cases and controls were hypertensive patients with and without LVH, respectively. The relationships between obesity indices, physical inactivity, glucose metabolism and lipid disorder parameters, and LVH were assessed using linear and logistic regression analyses in simple and univariate exploratory analyses, respectively. When differences were observed between LVH and independent variables, the effects of potential confounders were studied through the use of multiple linear regression and in conditional logistic regression in multivariate analyses. The coefficients of determination (R2), adjusted odds ratios (aORs), and their 95% confidence intervals (95% CIs) were calculated to determine associations between LVH and the independent variables.
Results Eighty-eight LVH cases (52 men) were compared against 132 controls (81 men). Variation in left ventricular mass (LVM) could be predicted by the following variables: age (19%), duration of hypertension (31.3%), body mass index (BMI, 44.4%), waist circumference (WC, 42.5%), glycemia (20%), insulinemia (44.8%), and HOMA-IR (43.7%). Hypertension duration, BMI, insulinemia, and HOMA-IR explained 68.3% of LVM variability in the multiple linear regression analysis. In the logistic regression model, obesity increased the risk of LVH by threefold [aOR 2.8; 95% CI (1.06–7.4); p = 0.038], and IR increased the risk of LVH by eightfold [aOR 8.4; 95 (3.7–15.7); p < 0.001]. Conclusion Obesity and IR appear to be the primary predictors of LVH in Black sub-Saharan African hypertensive patients. The comprehensive management of cardiovascular risk factors should be emphasized, with particular attention paid to obesity and IR. A prospective population-based study of Black sub-Saharan individuals that includes the use of serial imaging remains essential to better understand subclinical LV deterioration over time and to confirm the role played by IR in Black sub-Saharan individuals with hypertension.
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Affiliation(s)
- Bernard Kianu Phanzu
- Cardiology Unit, University Hospital of Kinshasa, PO Box 1038, Kinshasa, Democratic Republic of Congo. .,Centre Médical de Kinshasa (CMK), Kinshasa, Democratic Republic of Congo.
| | | | - Eleuthère Kintoki Vita
- Cardiology Unit, University Hospital of Kinshasa, PO Box 1038, Kinshasa, Democratic Republic of Congo
| | | | - Benjamin Longo-Mbenza
- Cardiology Unit, University Hospital of Kinshasa, PO Box 1038, Kinshasa, Democratic Republic of Congo
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Development and Validation of a Scoring System, Based on Genetic and Clinical Factors, to Determine Risk of Steatohepatitis in Asian Patients with Nonalcoholic Fatty Liver Disease. Clin Gastroenterol Hepatol 2020; 18:2592-2599.e10. [PMID: 32062042 DOI: 10.1016/j.cgh.2020.02.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 01/28/2020] [Accepted: 02/07/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS There are no biomarkers of nonalcoholic steatohepatitis (NASH) that are ready for routine clinical use. We investigated whether an analysis of PNPLA3 and TM6SF2 genotypes (rs738409 and rs58542926) can be used to identify patients with nonalcoholic fatty liver disease (NAFLD), with and without diabetes, who also have NASH. METHODS We collected data from the Boramae registry in Korea on 453 patients with biopsy-proven NAFLD with sufficient clinical data for calculating scores. Patients enrolled from February 2014 through March 2016 were assigned to cohort 1 (n = 302; discovery cohort) and patients enrolled thereafter were assigned to cohort 2 (n = 151; validation cohort). DNA samples were obtained from all participants and analyzed for the PNPLA3 rs738409 C>G, TM6SF2 rs58542926 C>T, SREBF2 rs133291 C>T, MBOAT7-TMC4 rs641738 C>T, and HSD17B13 rs72613567 adenine insertion (A-INS) polymorphisms. We used multivariable logistic regression analyses with stepwise backward selection to build a model to determine patients' risk for NASH (NASH PT) using the genotype and clinical data from cohort 1 and tested its accuracy in cohort 2. We used the receiver operating characteristic (ROC) curve to compare the diagnostic performances of the NASH PT and the NASH scoring systems. RESULTS We developed a NASH PT scoring system based on PNPLA3 and TM6SF2 genotypes, diabetes status, insulin resistance, and levels of aspartate aminotransferase and high-sensitivity C-reactive protein. NASH PT scores identified patients with NASH with an area under the ROC (AUROC) of 0.859 (95% CI, 0.817-0.901) in cohort 1. In cohort 2, NASH PT scores identified patients with NASH with an AUROC of 0.787 (95% CI, 0.715-0.860), which was significantly higher than the AUROC of the NASH score (AUROC, 0.729; 95% CI, 0.647-0.812; P = .007). The AUROC of the NASH PT score for detecting NASH in patients with NAFLD with diabetes was 0.835 (95% CI, 0.776-0.895) and in patients without diabetes was 0.809 (95% CI, 0.757-0.861). The negative predictive value of the NASH PT score <-0.785 for NASH in patients with NAFLD with diabetes reached 0.905. CONCLUSIONS We developed a scoring system, based on polymorphisms in PNPLA3 and TM6SF2 and clinical factors that identifies patients with NAFLD, with or without diabetes, who have NASH, with an AUROC value of 0.787. This system might help clinicians better identify NAFLD patients at risk for NASH.
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Hotta N, Hori A, Okamura Y, Baba R, Watanabe H, Sugawara J, Vongpatanasin W, Wang J, Kim HK, Ishizawa R, Iwamoto GA, Mitchell JH, Smith SA, Mizuno M. Insulin resistance is associated with an exaggerated blood pressure response to ischemic rhythmic handgrip exercise in nondiabetic older adults. J Appl Physiol (1985) 2020; 129:144-151. [PMID: 32584663 DOI: 10.1152/japplphysiol.00247.2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Patients with type 2 diabetes display an exaggerated pressor response to exercise. However, evidence supporting the association between the magnitude of the pressor response to exercise and insulin resistance-related factors including hemoglobin A1c (HbA1c) or homeostatic model assessment of insulin resistance (HOMA-IR) in nondiabetic subjects has remained sparse and inconclusive. Thus we investigated the relationship between cardiovascular responses to exercise and insulin resistance-related factors in nondiabetic healthy men (n = 23) and women (n = 22) above 60 yr old. We measured heart rate (HR) and blood pressure (BP) responses during: isometric handgrip (IHG) exercise of 30% maximal voluntary contraction, a period of skeletal muscle ischemia (SMI) induced by tourniqueting the arm after IHG, and rhythmic dynamic handgrip (DHG) exercise during SMI. Greater diastolic BP (DBP) responses to DHG with SMI was associated with male sex (r = 0.44, P = 0.02) and higher HbA1c (r = 0.33, P = 0.03), heart-ankle pulse wave velocity (haPWV) (r = 0.45, P < 0.01), and resting systolic BP (SBP) (r = 0.36, P = 0.02). HbA1c persisted as a significant determinant explaining the variance in the DBP response to DHG with SMI in multivariate models despite adjustment for sex, haPWV, and resting SBP. It was also determined that the DBP response to DHG with SMI in a group in which HOMA-IR was abnormal (Δ33 ± 3 mmHg) was significantly higher than that of groups in which HOMA-IR was at intermediate (Δ20 ± 4 mmHg) and normal (Δ23 ± 2 mmHg) levels. These data suggest that even in nondiabetic older adults, insulin resistance is related to an exaggerated pressor response to exercise especially when performed under ischemic conditions.NEW & NOTEWORTHY The diastolic blood pressure response to rhythmic dynamic handgrip exercise under ischemic conditions was demonstrated to be correlated with insulin resistance-related factors in nondiabetic older adults. This finding provides important insight to the prescription of exercise in this particular patient population as the blood pressure response to exercise, especially under ischemic conditions, could be exaggerated to nonsafe levels.
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Affiliation(s)
- Norio Hotta
- College of Life and Health Sciences, Chubu University, Kasugai, Japan
| | - Amane Hori
- Graduate School of Life and Health Sciences, Chubu University, Kasugai, Japan
| | - Yukiko Okamura
- College of Life and Health Sciences, Chubu University, Kasugai, Japan
| | - Reizo Baba
- College of Life and Health Sciences, Chubu University, Kasugai, Japan
| | - Hidehiro Watanabe
- Department of Rehabilitation, Tokai Memorial Hospital, Kasugai, Japan
| | - Jun Sugawara
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
| | - Wanpen Vongpatanasin
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jijia Wang
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Han-Kyul Kim
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Rie Ishizawa
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Gary A Iwamoto
- Department of Cell Biology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jere H Mitchell
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Scott A Smith
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Masaki Mizuno
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
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Metabolic profiles among COPD and controls in the CanCOLD population-based cohort. PLoS One 2020; 15:e0231072. [PMID: 32275684 PMCID: PMC7147771 DOI: 10.1371/journal.pone.0231072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 03/15/2020] [Indexed: 12/28/2022] Open
Abstract
A high prevalence of intermediate cardiometabolic risk factors and obesity in chronic obstructive pulmonary disease (COPD) has suggested the existence of pathophysiological links between hypertriglyceridemia, insulin resistance, visceral adiposity, and hypoxia or impaired pulmonary function. However, whether COPD contributes independently to the development of these cardiometabolic risk factors remains unclear. Our objective was to compare ectopic fat and metabolic profiles among representative individuals with COPD and control subjects and to evaluate whether the presence of COPD alters the metabolic risk profile. Study participants were randomly selected from the general population and prospectively classified as non-COPD controls and COPD, according to the Global Initiative for Chronic Obstructive Lung Disease classification. The metabolic phenotype, which consisted of visceral adipose tissue area, metabolic markers including homeostasis model assessment of insulin resistance (HOMA-IR), and blood lipid profile, was obtained in 144 subjects with COPD and 119 non-COPD controls. The metabolic phenotype was similar in COPD and controls. The odds ratios for having pathologic values for HOMA-IR, lipids and visceral adipose tissue area were similar in individuals with COPD and control subjects in multivariate analyses that took into account age, sex, body mass index, tobacco status and current medications. In a population-based cohort, no difference was found in the metabolic phenotype, including visceral adipose tissue accumulation, between COPD and controls. Discrepancies between the present and previous studies as to whether or not COPD is a risk factor for metabolic abnormalities could be related to differences in COPD phenotype or disease severity of the study populations.
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Lee SG, Lee YH, Choi E, Cho Y, Kim JH. Fasting serum bile acids concentration is associated with insulin resistance independently of diabetes status. Clin Chem Lab Med 2020; 57:1218-1228. [PMID: 30964746 DOI: 10.1515/cclm-2018-0741] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 12/20/2018] [Indexed: 12/19/2022]
Abstract
Background Bile acids (BAs) have been demonstrated to exert a variety of metabolic effects and alterations in BAs have been reported in patients with obesity, insulin resistance (IR) and type 2 diabetes mellitus (T2DM). However, it is unclear which metabolic condition is the main contributor to alterations in BAs. In this study, we investigate the associations between different BA profiles with glycemia, obesity or IR status. Methods Fasting serum concentrations of 15 BA species were determined in a total of 241 individuals (71 drug-naïve patients with T2DM, 95 patients with impaired fasting glucose [IFG], and 75 healthy controls. Results A comparison of the mean values of the BAs revealed no significant differences between normoglycemic controls and patients with IFG or T2DM. However, when the entire cohort was divided according to the presence of IR as determined by a homeostasis model assessment of insulin resistance (HOMA-IR) value >2.5, the levels of total BA and most species of BAs were significantly higher in patients with IR than in patients without. In the correlation analysis, most species of BAs, as well as total BA, were significantly associated with HOMA-IR levels. Furthermore, when the subjects were divided into four groups according to IR and diabetic status, subjects with IR had significantly higher total BAs than participants without IR both in diabetic and non-diabetic groups. Ultimately, multiple linear regression analysis identified HOMA-IR as the only significant contributor to most serum BA species. Conclusions Our findings support the essential role of IR in regulating BA metabolism and that this effect is independent of diabetic status.
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Affiliation(s)
- Sang-Guk Lee
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Yong-Ho Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Eunhye Choi
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Yonggeun Cho
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Jeong-Ho Kim
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
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Ojeda-Granados C, Panduro A, Rivera-Iñiguez I, Sepúlveda-Villegas M, Roman S. A Regionalized Genome-Based Mexican Diet Improves Anthropometric and Metabolic Parameters in Subjects at Risk for Obesity-Related Chronic Diseases. Nutrients 2020; 12:nu12030645. [PMID: 32121184 PMCID: PMC7146143 DOI: 10.3390/nu12030645] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/21/2020] [Accepted: 02/26/2020] [Indexed: 12/13/2022] Open
Abstract
Obesity-related chronic diseases (CD) are highly prevalent in Mexicans who show moderate to high frequencies of diet-related adaptive gene (DRAG) polymorphisms and recent shifts in traditional dietary habits and lifestyles. This study first evaluated the effects of a regionalized genome-based Mexican (GENOMEX) diet on anthropometric and biochemical parameters and, subsequently their relationship with the genetic profile of DRAG polymorphisms in subjects with metabolic risk factors for obesity-related CD. Thirty-seven eligible subjects underwent a 24-week dietary intervention with a GENOMEX diet. The DRAG polymorphisms were determined by an allelic discrimination real-time assay to evaluate their association with the clinical response to diet. The GENOMEX diet significantly improved anthropometric parameters such as total weight, body mass index, waist circumference, and body fat percentage, with an average weight loss of 6.6% (5.3 ± 5.3 kg). The frequency of subjects with insulin resistance, hypertriglyceridemia and elevated VLDL-c (48.5% vs. 24.2%, p = 0.041; 45.5% vs. 12.1%, p = 0.003; and 39.4% vs. 15.2%, p = 0.027, baseline vs. 24-weeks, respectively) was reduced. A more significant favorable effect in HOMA-IR and insulin was observed in MTHFR 677T adaptive allele carriers, but no other DRAG polymorphism was associated with clinical changes. The GENOMEX diet improved the metabolic risk factors for obesity-related CD. The recommendation and habitual consumption of a traditional Mexican diet based on knowledge of the population’s genetic and cultural history may be effective in preventing current obesity-related CD.
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Affiliation(s)
- Claudia Ojeda-Granados
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara “Fray Antonio Alcalde,” Hospital #278, Col. El Retiro, Guadalajara 44280, Mexico; (C.O.-G.); (A.P.); (I.R.-I.); (M.S.-V.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Mexico
| | - Arturo Panduro
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara “Fray Antonio Alcalde,” Hospital #278, Col. El Retiro, Guadalajara 44280, Mexico; (C.O.-G.); (A.P.); (I.R.-I.); (M.S.-V.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Mexico
| | - Ingrid Rivera-Iñiguez
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara “Fray Antonio Alcalde,” Hospital #278, Col. El Retiro, Guadalajara 44280, Mexico; (C.O.-G.); (A.P.); (I.R.-I.); (M.S.-V.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Mexico
| | - Maricruz Sepúlveda-Villegas
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara “Fray Antonio Alcalde,” Hospital #278, Col. El Retiro, Guadalajara 44280, Mexico; (C.O.-G.); (A.P.); (I.R.-I.); (M.S.-V.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Mexico
| | - Sonia Roman
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara “Fray Antonio Alcalde,” Hospital #278, Col. El Retiro, Guadalajara 44280, Mexico; (C.O.-G.); (A.P.); (I.R.-I.); (M.S.-V.)
- Health Sciences Center, University of Guadalajara, Guadalajara 44340, Mexico
- Correspondence: ; Tel.: +52-33-3614-7743
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Li WC, Chen JY, Liu YP, Lee YY, Yeh WC, Yu W, Tsao YC. Association between metabolic body composition status and risk for impaired renal function: A cross-sectional study. PLoS One 2019; 14:e0223664. [PMID: 31770376 PMCID: PMC6879116 DOI: 10.1371/journal.pone.0223664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 09/25/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The risk for obesity-related disorders is proportional to the visceral region and had been observed to be highly related with impaired renal function. In the current study, we aimed to evaluate renal function impairment, according to sex, age, and different status of metabolic body composition. METHODS We retrospectively collected from the medical records the basic information and metabolic titers of Chinese adults (13,373 men and 10,175 women) who underwent health checkup from 2013 to 2016. The population was divided into four groups, according to metabolic body composition, including metabolic healthy norms-weight (MHNW), metabolic healthy obesity (MHO), metabolic unhealthy norms-weight (MUNW), and metabolic unhealthy obesity (MUO). The categorical data were compared among the groups and logistic regression analyses were conducted to investigate the association between metabolic body composition status and risk for renal function impairment. RESULTS Across all ages in both sexes, the odds ratios (OR) for renal function impairment were higher in the MHO, MUNW, and MUO groups than in the MHNW group, except for women <45 years old in the MUNW group. However, after adjustment, the trend was no longer significant in all groups under 45 years old. For individuals >45 years old, the relatively high risk for renal function impairment remained significantly associated with the MUNW group (OR 2.95, 95% CI 2.02-4.30 in men and OR 1.95, 95% CI 1.35-2.82 in women) and MUO group (OR 2.33, 95% CI 1.82-3.00 in men and OR 2.67, 95% CI 2.04-3.48 in women). CONCLUSION Impaired renal function was independently associated with the status of metabolic obesity. However, the trend was only observed in individuals >45 years old, with significant sex difference.
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Affiliation(s)
- Wen-Cheng Li
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Health Management, Xiamen Chang-Gung Hospital, Xiamen, China
| | - Jau-Yuan Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Ping Liu
- Department of Endocrinology and Metabolism, Xiamen Chang-Gung Hospital, Xiamen, China
| | - Yi-Yen Lee
- Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Chung Yeh
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei Yu
- Department of Health Management, Xiamen Chang-Gung Hospital, Xiamen, China
| | - Yu-Chung Tsao
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Health Management, Xiamen Chang-Gung Hospital, Xiamen, China
- Department of Occupational Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- * E-mail:
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Wu X, Du R, Hu C, Cheng D, Ma L, Li M, Xu Y, Xu M, Chen Y, Li D, Bi Y, Wang W, Ning G, Lu J. Resting heart rate is associated with metabolic syndrome and predicted 10-year risk of cardiovascular disease: a cross-sectional study. J Diabetes 2019; 11:884-894. [PMID: 30941862 DOI: 10.1111/1753-0407.12927] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 02/19/2019] [Accepted: 03/27/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study examined whether resting heart rate (RHR) was associated with metabolic syndrome (MetS) and the 10-year predicted risk of cardiovascular disease in a Chinese population. METHODS The associations of RHR with MetS and 10-year risk of atherosclerotic cardiovascular diseases (ASCVD) was examined in a cross-sectional study conducted in Shanghai, China (n = 9486). RESULTS Compared with individuals in the lowest RHR quintile (≤71 b.p.m.), those in the highest quintile (≥91 b.p.m.) had a higher prevalence of MetS (21.2% vs 32.6%, respectively; P < 0.001). Logistic regression analyses showed that the multivariate-adjusted odds ratio (OR) and 95% confidence interval (CI) for MetS was 1.13 (1.08-1.18) for each 10-b.p.m. increment of RHR (P < 0.0001). Furthermore, RHR was strongly associated with the prevalence of hypertension, high blood glucose, and dyslipidemia, but not with central obesity. A stronger association of RHR with MetS was observed among individuals aged <65 years, male, with a body mass index <24 kg/m2 , without diabetes, hypertension, abnormal lipids, and insulin resistance than among their counterparts (P < 0.05 for all). A significantly higher 10-year risk for ASCVD was observed with each 10-b.p.m. increment in RHR in both men and women (ORs [95% CIs] 1.20 [1.07-1.33] and 1.28 [1.17-1.39], respectively; Ptrend = 0.002 and < 0.0001, respectively). CONCLUSIONS In this study, RHR was associated with a higher prevalence of MetS and elevated 10-year predicted risk of ASCVD in both Chinese men and women. Whether RHR may serve as an indicator for MetS among relatively healthy individuals requires further investigation.
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Affiliation(s)
- Xueyan Wu
- National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Rui Du
- National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Chunyan Hu
- National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Di Cheng
- National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Lina Ma
- National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Mian Li
- National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Yu Xu
- National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Min Xu
- National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Yuhong Chen
- National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Donghui Li
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yufang Bi
- National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Weiqing Wang
- National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Guang Ning
- National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Jieli Lu
- National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
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HOMA-estimated insulin resistance as an independent prognostic factor in patients with acute pancreatitis. Sci Rep 2019; 9:14894. [PMID: 31624312 PMCID: PMC6797758 DOI: 10.1038/s41598-019-51466-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 10/01/2019] [Indexed: 12/17/2022] Open
Abstract
This prospective study investigated the relationship between insulin resistance assessed using the homeostatic model assessment of insulin resistance (HOMA-IR) and the prognosis of acute pancreatitis (AP). A total of 269 patients with AP were recruited in this study. HOMA-IR scores were calculated using fasting insulin and plasma glucose levels. Patients were then categorized into the non-insulin-resistant group (HOMA-IR <2.5) and the insulin-resistant group (HOMA-IR ≥2.5). We performed multivariable logistic regression analysis to investigate the independent association between IR assessed using HOMA-IR and the severity of AP. We also conducted receiver operating characteristic analysis to investigate the predictive ability of HOMA-IR for severe AP. The proportion of patients with severe AP (according to the Atlanta classification) and the percentage of ICU admissions and mortality were higher in patients with insulin resistance than in those without insulin resistance. The area under the curve (AUC) of HOMA-IR for predicting severe AP was 0.719 (95% CI 0.59–0.85, P = 0.003). This value was not significantly different from the AUCs of other AP scoring systems such as CTSI, Ranson, and BISAP. Insulin resistance was the only independent factor for either ICU admission (OR 5.95, 95% CI 1.95–18.15, P = 0.002) or severe AP (OR 6.72, 95% CI 1.34–33.62, P = 0.020). Our findings suggest that the HOMA-IR score is an independent prognostic factor in patients with acute pancreatitis. This finding indicates that insulin resistance is potentially involved in the mechanism for severe AP.
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Late-Evening Snack with Branched-Chain Amino Acid-Enriched Nutrients Does Not Always Inhibit Overt Diabetes in Patients with Cirrhosis: A Pilot Study. Nutrients 2019; 11:nu11092140. [PMID: 31500257 PMCID: PMC6770337 DOI: 10.3390/nu11092140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 09/02/2019] [Accepted: 09/02/2019] [Indexed: 01/02/2023] Open
Abstract
Cirrhosis patients often have abnormal glucose metabolism. We investigated the effects of a late-evening snack (LES) with branched-chain amino acid-enriched nutrients (BCAA-EN) on glucose metabolism in cirrhosis patients. LES with BCAA-EN was administered for 1 week in 13 patients with cirrhosis and hypoalbuminemia. Blood glucose (BG) levels were measured every 15 min. The patients were divided into two groups based on BG levels: group 1 (G1, n = 11): nocturnal BG levels <200 mg/dL and group 2 (G2, n = 2): nocturnal BG levels ≥200 mg/dL. G1 had nocturnal BG levels <200 mg/dL, whereas G2 had nocturnal BG levels ≥200 mg/dL. The average BG levels did not significantly change after BCAA-EN administration in G1 (before 91.9 ± 29.0 mg/dL; after 89.0 ± 24.3 mg/dl). However, the average BG levels significantly increased after BCAA-EN administration in G2 (before 153.6 ± 43.3 mg/dL; after 200.9 ± 59.7 mg/dL) (p < 0.01). The glycated albumin level (16.6 ± 0.9% vs. 16.2 ± 2.1%), fasting immunoreactive insulin (F-IRI) level (53.9 ± 34.0 μU/mL vs. 16.5 ± 11.0 μU/mL), and homeostasis model assessment of insulin resistance (HOMA-IR) score (17.85 ± 10.58 vs. 4.02 ± 2.59) were significantly higher in G2 than in G1 (p < 0.05, p < 0.05, and p < 0.01, respectively). The quantitative insulin sensitivity check indices (0.32 ± 0.03 vs. 0.27 ± 0.02) were significantly higher in G1 than in G2 (p < 0.01). One patient in G2 was obese and had type 2 diabetes. The other patient was obese and had a high HOMA-IR score and F-IRI level. A LES with BCAA-EN does not inhibit overt diabetes in most cirrhosis patients. However, close attention should be paid to fluctuations in BG levels in cirrhosis patients who present with obesity and severe insulin resistance.
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Association between the Frequency of Dining Out and the Risk of Obesity, Diabetes Mellitus, and Dyslipidemia among Korean Adults. Ecol Food Nutr 2019; 58:560-574. [PMID: 31327256 DOI: 10.1080/03670244.2019.1644327] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study aimed to clarify the association between the frequency of dining out and the risk of obesity, diabetes mellitus, and dyslipidemia among Korean adults. This cross-sectional study surveyed 640 participants aged 20-69 years in Korea. Daily intake of energy, fat, protein, and cholesterol significantly increased as the frequency of dining out increased (P < .001). Energy derived from carbohydrates significantly decreased with the frequency of dining out, while that derived from fat and protein increased (P < .001). Among participants who rarely dined out, the fully adjusted odds ratios (ORs) for hyperglycemia were significantly lower at 0.35 (95% CI, 0.16-0.76). Decreased risk of being hyperglycemia among participants who rarely dined out suggests that the frequency of dining out can be related to diabetes risk.
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Placzkowska S, Pawlik-Sobecka L, Kokot I, Piwowar A. Indirect insulin resistance detection: Current clinical trends and laboratory limitations. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2019; 163:187-199. [PMID: 31165793 DOI: 10.5507/bp.2019.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 05/07/2019] [Indexed: 11/23/2022] Open
Abstract
There is a steady increase in the number of overweight and obese people worldwide and increasingly, younger people. Excess adipose tissue impairs the action of insulin, leading to insulin resistance (IR). Tissue IR is a major factor in relation to cardiovascular disease, metabolic syndrome and diabetes. Thus, it is important to recognize at the pre-disease stage with the possibility of therapeutic intervention. IR is assessed using indicators of epidemiological significance, most often calculated from fasting and postprandial glucose and insulin values, so-called indirect indicators of insulin resistance. The most commonly used parameter is the Homeostatic Model Assessment (HOMA). Although the Quantitative Insulin Sensitivity Check Index (QUICKI), Matsuda Index and the Insulin Secretion-Sensitivity Index-2 (ISSI-2) are also used, the values of these indices established for IR vary for different age, sex, populations and ethnic groups. Thus, appropriate reference values of indirect indices should be determined for such groups, and when this is precluded, data from published studies carried out on the most ethnically, socio-economically and age-matched populations should be applied.
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Affiliation(s)
- Sylwia Placzkowska
- Diagnostics Laboratory for Teaching and Research, Faculty of Pharmacy with the Division of Laboratory Diagnostics, Wroclaw Medical University, Wroclaw, Poland
| | - Lilla Pawlik-Sobecka
- Department of Laboratory Diagnostics, Faculty of Pharmacy with the Division of Laboratory Diagnostics, Wroclaw Medical University, Wroclaw, Poland
| | - Izabela Kokot
- Department of Laboratory Diagnostics, Faculty of Pharmacy with the Division of Laboratory Diagnostics, Wroclaw Medical University, Wroclaw, Poland
| | - Agnieszka Piwowar
- Department of Toxicology, Faculty of Pharmacy with the Division of Laboratory Diagnostics, Wroclaw Medical University, Wroclaw, Poland
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Horáková D, Štěpánek L, Janout V, Janoutová J, Pastucha D, Kollárová H, Petráková A, Štěpánek L, Husár R, Martiník K. Optimal Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) Cut-Offs: A Cross-Sectional Study in the Czech Population. ACTA ACUST UNITED AC 2019; 55:medicina55050158. [PMID: 31108989 PMCID: PMC6571793 DOI: 10.3390/medicina55050158] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 02/13/2019] [Accepted: 05/14/2019] [Indexed: 11/16/2022]
Abstract
Background and Objectives: The key pathogenetic mechanism of glucose metabolism disorders, insulin resistance (IR), can be assessed using the Homeostasis Model Assessment of IR (HOMA-IR). However, its application in clinical practice is limited due to the absence of cut-offs. In this study, we aimed to define the cut-offs for the Czech population. Methods: After undergoing anthropometric and biochemical studies, the sample of 3539 individuals was divided into either nondiabetics, including both subjects with normal glucose tolerance (NGT, n = 1947) and prediabetics (n = 1459), or diabetics (n = 133). The optimal HOMA-IR cut-offs between subgroups were determined to maximize the sum of the sensitivity and specificity for diagnosing type 2 diabetes mellitus (T2DM) or prediabetes. The predictive accuracy was illustrated using receiver operating characteristic (ROC) curves. Logistic regression was performed to assess the association between a target variable (presence/absence of T2DM) depending on the HOMA-IR score as well as on the age and sex. Results: The HOMA-IR cut-off between nondiabetics and diabetics for both sexes together was 3.63, with a sensitivity of 0.56 and a specificity of 0.86. The area under the ROC curve was 0.73 for T2DM diagnosing in both sexes. The HOMA-IR cut-off between the NGT subjects and prediabetics was 1.82, with a sensitivity of 0.60 and a specificity of 0.66. Logistic regression showed that increased HOMA-IR is a risk factor for the presence of T2DM (odds ratio (OR) 1.2, 95% confidence interval (CI) 1.14–1.28, p < 0.0001). The predictive ability of HOMA-IR in diagnosing T2DM is statistically significantly lower in females (OR 0.66, 95% CI 0.44–0.98). The results are valid for middle-aged European adults. Conclusions: The results suggest the existence of HOMA-IR cut-offs signaling established IR. Introduction of the instrument into common clinical practice, together with the known cut-offs, may contribute to preventing T2DM.
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Affiliation(s)
- Dagmar Horáková
- Department of Public Health, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hněvotínská 3, 77515 Olomouc, Czech Republic.
| | - Ladislav Štěpánek
- Department of Public Health, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hněvotínská 3, 77515 Olomouc, Czech Republic.
| | - Vladimír Janout
- Department of Public Health, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hněvotínská 3, 77515 Olomouc, Czech Republic.
| | - Jana Janoutová
- Department of Healthcare Management, Faculty of Health Sciences, Palacký University Olomouc, Hněvotínská 3, 77515 Olomouc, Czech Republic.
| | | | - Helena Kollárová
- Department of Public Health, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hněvotínská 3, 77515 Olomouc, Czech Republic.
| | - Alena Petráková
- Department of Public Health, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hněvotínská 3, 77515 Olomouc, Czech Republic.
| | - Lubomír Štěpánek
- Institute of Biophysics and Informatics, First Faculty of Medicine, Charles University, Salmovská 1, 12000 Prague, Czech Republic.
| | - Roman Husár
- Department of Public Health, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hněvotínská 3, 77515 Olomouc, Czech Republic.
| | - Karel Martiník
- Ambulance Prof. MUDr. Karla Martiníka DrSc. s.r.o, Bratří Štefanů 895, 50003 Hradec Králové, Czech Republic.
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Hirasawa Y, Matsuki R, Ebisu T, Kurose T, Hamamoto Y, Seino Y. Evaluation of skeletal muscle mass indices, assessed by bioelectrical impedance, as indicators of insulin resistance in patients with type 2 diabetes. J Phys Ther Sci 2019; 31:190-194. [PMID: 30858661 PMCID: PMC6382481 DOI: 10.1589/jpts.31.190] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 11/19/2018] [Indexed: 12/25/2022] Open
Abstract
[Purpose] This study aimed to investigate the association between two skeletal muscle
mass indices and insulin resistance, and to determine the skeletal muscle mass index that
is beneficial in evaluating insulin resistance in patients with type 2 diabetes mellitus.
[Participants and Methods] This study evaluated 136 male and 100 female patients with type
2 diabetes mellitus. The skeletal muscle mass was evaluated by bioelectrical impedance
analysis. Two skeletal muscle mass indices were investigated as the appendicular skeletal
muscle mass index (appendicular skeletal muscle mass divided by the square of height) and
relative total skeletal muscle mass (total skeletal muscle mass as a percent of body
weight). The homeostasis model assessment of insulin resistance was used as a marker of
insulin resistance. Associations were investigated by grouping the participants according
to gender and age (<60 or ≥60 years). [Results] The appendicular skeletal muscle mass
index was positively associated with the homeostasis model assessment of insulin
resistance, except in male patients aged ≥60 years, whereas the relative total skeletal
muscle mass was significantly inversely associated with the homeostasis model assessment
of insulin resistance, in all patient groups. The cutoff values of the relative total
skeletal muscle mass for the presence of insulin resistance were 37.9% and 32.5% in male
and female patients, respectively. [Conclusion] This finding suggests that relative total
skeletal muscle mass may be a better indicator of insulin resistance than appendicular
skeletal muscle mass index is, in patients with type 2 diabetes mellitus.
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Affiliation(s)
- Yoshikazu Hirasawa
- Department of Rehabilitation, Kansai Electric Power Hospital: 2-1-7 Fukushima, Fukushima-ku, Osaka-shi, Osaka 553-0003, Japan.,Kansai Electric Power Medical Research Institute, Japan
| | - Ryosuke Matsuki
- Department of Rehabilitation, Kansai Electric Power Hospital: 2-1-7 Fukushima, Fukushima-ku, Osaka-shi, Osaka 553-0003, Japan.,Kansai Electric Power Medical Research Institute, Japan
| | - Toshihiko Ebisu
- Department of Rehabilitation, Kansai Electric Power Hospital: 2-1-7 Fukushima, Fukushima-ku, Osaka-shi, Osaka 553-0003, Japan.,Kansai Electric Power Medical Research Institute, Japan
| | | | - Yoshiyuki Hamamoto
- Kansai Electric Power Medical Research Institute, Japan.,Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital, Japan
| | - Yutaka Seino
- Kansai Electric Power Medical Research Institute, Japan.,Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital, Japan
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Hijioka N, Kamioka M, Matsumoto Y, Nodera M, Yamada S, Kaneshiro T, Yoshihisa A, Ishida T, Takeishi Y. Clinical impact of insulin resistance on pulmonary vein isolation outcome in patients with paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol 2019; 30:479-486. [PMID: 30575179 DOI: 10.1111/jce.13827] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/10/2018] [Accepted: 12/18/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The relationship between insulin resistance and atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) remains unclear. METHODS Drug-refractory 114 paroxysmal AF patients (89 males, 62 ± 8 years) who underwent successful PVI were enrolled. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated and a value of ≥2.5 was defined as insulin resistant. The left atrial volume index (LAVI) was measured using echocardiography before and 1 year after PVI. Tumor necrosis factor-α (TNF-α) and TGF-β1 serum levels were measured before PVI, and the left atrium (LA) conduction velocity was calculated. The patients were divided into two groups (group 1: HOMA-IR < 2.5, n = 81; group 2: HOMA-IR ≥ 2.5, n = 33). RESULTS The LAVI between the two groups before PVI did not significantly differ (P > 0.05), nor did TNF-α (7.7 ± 2.0 vs 7.5 ± 1.0 pg/mL; P = 0.149) or TGF-β1 (28.4 ± 12.0 vs 27.6 ± 10.3 ng/mL; P = 0.757). LAVI before and 1 year after PVI in each group did not change. The conduction velocity of group 2 was slower than that of group 1 (0.7 ± 0.1 vs 1.1 ± 0.3 m/s, P < 0.001). Kaplan-Meier analysis showed significantly higher AF recurrence in group 2 than that in group 1 ( P = 0.019). Cox multivariable analysis revealed that insulin resistance was an independent predictor of recurrence (hazard ratio 1.287, P = 0.004). CONCLUSION Our results suggest that insulin resistance promotes LA electrical remodeling and might be related to AF recurrence after PVI.
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Affiliation(s)
- Naoko Hijioka
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Masashi Kamioka
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yoshiyuki Matsumoto
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Minoru Nodera
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Shinya Yamada
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Takashi Kaneshiro
- Department of Arrhythmia and Cardiac Pacing, Fukushima Medical University, Fukushima, Japan
| | - Akiomi Yoshihisa
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Takafumi Ishida
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yasuchika Takeishi
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
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Moon HU, Ha KH, Han SJ, Kim HJ, Kim DJ. The Association of Adiponectin and Visceral Fat with Insulin Resistance and β-Cell Dysfunction. J Korean Med Sci 2019; 34:e7. [PMID: 30618514 PMCID: PMC6318440 DOI: 10.3346/jkms.2019.34.e7] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 11/08/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Obesity is a risk factor for metabolic abnormalities. We investigated the relationship of adiponectin levels and visceral adiposity with insulin resistance and β-cell dysfunction. METHODS This cross-sectional study enrolled 1,347 participants (501 men and 846 women aged 30-64 years) at the Cardiovascular and Metabolic Diseases Etiology Research Center. Serum adiponectin levels and visceral fat were measured using enzyme-linked immunosorbent assay kits and dual-energy X-ray absorptiometry, respectively. Insulin resistance was evaluated using the homeostatic model assessment of insulin resistance (HOMA-IR) and Matsuda insulin sensitivity index. β-cell dysfunction was evaluated using the homeostatic model assessment of β-cell function (HOMA-β), insulinogenic index, and disposition index. RESULTS Regarding insulin resistance, compared with individuals with the highest adiponectin levels and visceral fat mass < 75th percentile, the fully adjusted odds ratios (ORs) for HOMA-IR ≥ 2.5 and Matsuda index < 25th percentile were 13.79 (95% confidence interval, 7.65-24.83) and 8.34 (4.66-14.93), respectively, for individuals with the lowest adiponectin levels and visceral fat ≥ 75th percentile. Regarding β-cell dysfunction, the corresponding ORs for HOMA-β < 25th percentile, insulinogenic index < 25th percentile, and disposition index < 25th percentile were 1.20 (0.71-2.02), 1.01 (0.61-1.66), and 1.87 (1.15-3.04), respectively. CONCLUSION Low adiponectin levels and high visceral adiposity might affect insulin resistance and β-cell dysfunction.
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Affiliation(s)
- Hyun Uk Moon
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Kyoung Hwa Ha
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
- Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea
| | - Seung Jin Han
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
- Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea
| | - Hae Jin Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
- Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
- Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea
- Institute on Aging, Ajou University Medical Center, Suwon, Korea
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Kim KS, Kim SJ, Kim S, Choi DW, Ju YJ, Park EC. Association of self-reported sedentary time with insulin resistance among Korean adults without diabetes mellitus: a cross-sectional study. BMC Public Health 2018; 18:1335. [PMID: 30509229 PMCID: PMC6278102 DOI: 10.1186/s12889-018-6237-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 11/20/2018] [Indexed: 01/07/2023] Open
Abstract
Background A more sedentary lifestyle can result in insulin resistance. However, few research studies have assessed the association between insulin resistance and sedentary lifestyle in Asian populations. Therefore, this study aimed to investigate the association of sedentary time with insulin resistance. In addition, we also investigate the moderate effect of employment status, moderate-to-vigorous physical activity (MVPA), and body mass index (BMI) in this association. Methods Data from 2573 individuals who participated in the 2015 Korean National Health and Nutrition Examination Survey were analyzed. Sedentary time was measured using self-administered questionnaires, and IR data were estimated using the homeostasis model assessment–insulin resistance index (HOMA-IR). Adjusted odds ratio (OR) and 95% confidence intervals (CIs) from a multivariable logistic regression model were generated for all participants. Subgroup analysis was only performed between sedentary time and HOMA-IR stratified by employment status, because moderate effects were not significant in the tests for interaction for MVPA and BMI. For all analyses, the individuals were categorized as having high or normal HOMA-IR values (> 1.6 and ≤ 1.6, respectively). Results A HOMA-IR > 1.6 was observed in 40.3% of the sedentary time Q1 (low) group (< 5.0 h/day), 41.4% of the sedentary time Q2 (middle-low) group, 44.2% of the sedentary time Q3 (middle-high) group, and 48.4% of the sedentary time Q4 (high) group (≥10.0 h/day). When the low level sedentary time group was used as the reference group, the high level sedentary time group was significantly associated with high IR value (HOMA-IR > 1.6) (OR = 1.40, 95% CI: 1.060–1.838). However, this association was not significant across the other sedentary time groups. Moreover, participants reporting a high sedentary time and were employed had 1.67 times the odds of having a high IR value (HOMA-IR > 1.6) compared to those who reported having a low sedentary time and were employed (OR = 1.67, 95% CI: 1.184–2.344). In the unemployed participants, sedentary time was not associated with IR. Conclusions High sedentary time (≥10.0 h/day) was associated with elevated HOMA-IR among Korean adults without diabetes mellitus. Furthermore, the association between high sedentary time and HOMA-IR values was more pronounced in the employed population.
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Affiliation(s)
- Kyeong Seok Kim
- Premedical Courses, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Seong Jun Kim
- Premedical Courses, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Seonggwan Kim
- Premedical Courses, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Dong-Woo Choi
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Yeong Jun Ju
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea. .,Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. .,Present address: Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea.
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. .,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. .,Department of Preventive Medicine & Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
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Baek JH, Kim H, Kim KY, Jung J. Insulin Resistance and the Risk of Diabetes and Dysglycemia in Korean General Adult Population. Diabetes Metab J 2018; 42:296-307. [PMID: 29885105 PMCID: PMC6107354 DOI: 10.4093/dmj.2017.0106] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 03/02/2018] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Insulin resistance is a major pathogenic hallmark of impaired glucose metabolism. We assessed the accuracy of insulin resistance and cut-off values using homeostasis model assessment of insulin resistance (HOMA-IR) to classify type 2 diabetes mellitus (T2DM) and dysglycemia according to age and sex. METHODS In this cross-sectional study, we analyzed 4,291 anti-diabetic drug-naïve adults (≥20 years) from the 6th Korea National Health and Nutrition Examination Survey in 2015. Metabolic syndrome (MetS) was defined by the modified National Cholesterol Education Program III guideline. Diagnosis of dysglycemia and T2DM were based on fasting glucose and glycosylated hemoglobin levels. The receiver operating characteristic curve and optimal cut-off values of HOMA-IR were assessed to identify T2DM/dysglycemia according to sex and were further analyzed by age. RESULTS Sex differences were found in the association of MetS and the different MetS components with T2DM/dysglycemia. The overall optimal cut-off value of HOMA-IR for identifying dysglycemia was 1.6 in both sex. The cut-off values for T2DM were 2.87 in men and 2.36 in women. However, there are differences in diagnostic range of HOMA-IR to distinguish T2DM according to sex and age, and the accuracy of HOMA-IR in identifying T2DM gradually decreased with age especially in women. CONCLUSION Insulin resistance is closely associated with the risk for T2DM/dysglycemia. The accuracy of HOMA-IR levels is characterized by sex- and age-specific differences in identifying T2DM. In addition to insulin resistance index, insulin secretory function, and different MetS components should be considered in the detection of early T2DM, especially in elderly.
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Affiliation(s)
- Jong Ha Baek
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Hosu Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Kyong Young Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Jaehoon Jung
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
- Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.
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Koo BK, Joo SK, Kim D, Bae JM, Park JH, Kim JH, Kim W. Additive effects of PNPLA3 and TM6SF2 on the histological severity of non-alcoholic fatty liver disease. J Gastroenterol Hepatol 2018; 33:1277-1285. [PMID: 29193269 DOI: 10.1111/jgh.14056] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/08/2017] [Accepted: 11/20/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM We investigated the effects of PNPLA3 rs738409, TM6SF2 rs58542926, and MBOAT7-TMC4 rs641738 variants on metabolic phenotypes and their combined effects on the histological severity of non-alcoholic fatty liver disease (NAFLD). METHODS We genotyped rs738409, rs58542926, and rs641738 in biopsy-proven NAFLD patients (n = 416) and healthy controls (n = 109). Homeostasis model assessment of insulin resistance and adipose tissue insulin resistance were calculated. RESULTS The rs738409 and rs58542926 variants, but not rs641738, were associated not only with non-alcoholic steatohepatitis (NASH) (odds ratio [OR], 2.00; 95% confidence interval [CI], 1.46-2.73 and OR, 1.91; 95% CI, 1.04-3.51) but also with significant fibrosis (≥ F2) (OR, 1.53; 95% CI, 1.11-2.11 and OR, 1.88; 95% CI, 1.02-3.46) in NAFLD, even after adjustment for metabolic risk factors. Of both variants, only rs738409 was associated with homeostasis model assessment of insulin resistance and adipose tissue insulin resistance even in healthy controls (P = 0.046 and 0.002, respectively) as well as in the entire study cohort (P = 0.016 and 0.048, respectively). PNPLA3 and TM6SF2 risk variants additively increased the risk of NASH and significant fibrosis (OR per risk allele, 2.03; 95% CI, 1.50-2.73 and 1.61; 95% CI, 1.19-2.17). Even in subjects with low insulin resistance, the risk of NASH or significant fibrosis increased as the number of risk alleles increased (P = 0.008 and 0.020, respectively). CONCLUSIONS PNPLA3 and TM6SF2 determine the risk of NASH and significant fibrosis, even after adjustment for insulin resistance, and exert an additive effect on NASH and significant fibrosis.
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Affiliation(s)
- Bo Kyung Koo
- Division of Endocrinology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
| | - Sae Kyung Joo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
| | - Donghee Kim
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA
| | - Jeong Mo Bae
- Department of Pathology, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
| | - Jeong Hwan Park
- Department of Pathology, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
| | - Jung Ho Kim
- Department of Pathology, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
| | - Won Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
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Ha KH, Park CY, Jeong IK, Kim HJ, Kim SY, Kim WJ, Yoon JS, Kim IJ, Kim DJ, Kim S. Clinical Characteristics of People with Newly Diagnosed Type 2 Diabetes between 2015 and 2016: Difference by Age and Body Mass Index. Diabetes Metab J 2018; 42:137-146. [PMID: 29676543 PMCID: PMC5911517 DOI: 10.4093/dmj.2018.42.2.137] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 10/31/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND We evaluated the clinical characteristics of insulin resistance and β-cell dysfunction in newly diagnosed, drug-naive people with type 2 diabetes by analyzing nationwide cross-sectional data. METHODS We collected the clinical data of 912 participants with newly diagnosed diabetes from 83 primary care clinics and hospitals nationwide from 2015 to 2016. The presence of insulin resistance and β-cell dysfunction was defined as a homeostatic model assessment of insulin resistance (HOMA-IR) value ≥2.5 and fasting C-peptide levels <1.70 ng/mL, respectively. RESULTS A total of 75.1% and 22.6% of participants had insulin resistance and β-cell dysfunction, respectively. The proportion of participants with insulin resistance but no β-cell dysfunction increased, and the proportion of participants with β-cell dysfunction but no insulin resistance decreased as body mass index (BMI) increased. People diagnosed with diabetes before 40 years of age had significantly higher HOMA-IR and BMI than those diagnosed over 65 years of age (HOMA-IR, 5.0 vs. 3.0; BMI, 28.7 kg/m² vs. 25.1 kg/m²). However, the β-cell function indices were lower in people diagnosed before 40 years of age than in those diagnosed after 65 years of age (homeostatic model assessment of β-cell function, 39.3 vs. 64.9; insulinogenic index, 10.3 vs. 18.7; disposition index, 0.15 vs. 0.25). CONCLUSION We observed that the main pathogenic mechanism of type 2 diabetes is insulin resistance in participants with newly diagnosed type 2 diabetes. In addition, young adults with diabetes are more likely to have higher insulin resistance with obesity and have higher insulin secretory defect with severe hyperglycemia in the early period of diabetes than older populations.
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Affiliation(s)
- Kyoung Hwa Ha
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
- Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea
| | - Cheol Young Park
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - In Kyung Jeong
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Hyun Jin Kim
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Sang Yong Kim
- Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University College of Medicine, Gwangju, Korea
| | - Won Jun Kim
- Department of Endocrinology and Metabolism, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Ji Sung Yoon
- Department of Endocrinology and Metabolism, Yeungnam University College of Medicine, Daegu, Korea
| | - In Joo Kim
- Department of Endocrinology and Metabolism, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
- Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea.
| | - Sungrae Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.
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Du R, Cheng D, Lin L, Sun J, Peng K, Xu Y, Xu M, Chen Y, Bi Y, Wang W, Lu J, Ning G. Association between serum CA 19-9 and metabolic syndrome: A cross-sectional study. J Diabetes 2017; 9:1040-1047. [PMID: 28067474 DOI: 10.1111/1753-0407.12523] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 01/01/2017] [Accepted: 01/03/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Increasing evidence suggests that serum CA 19-9 is associated with abnormal glucose metabolism. However, data on the association between CA 19-9 and metabolic syndrome is limited. The aim of the present study was to investigate the association between serum CA 19-9 and metabolic syndrome. METHODS A cross-sectional study was conducted on 3641 participants aged ≥40 years from the Songnan Community, Baoshan District in Shanghai, China. Logistic regression analysis was used to evaluate the association between serum CA 19-9 and metabolic syndrome. RESULTS Multivariate logistic regression analysis showed that compared with participants in the first tertile of serum CA 19-9, those in the second and third tertiles had increased odds ratios (OR) for prevalent metabolic syndrome (multivariate adjusted OR 1.46 [95% confidence interval {CI} 1.11-1.92] and 1.51 [95% CI 1.14-1.98]; P trend = 0.005). In addition, participants with elevated serum CA 19-9 (≥37 U/mL) had an increased risk of prevalent metabolic syndrome compared with those with serum CA 19-9 < 37 U/mL (multivariate adjusted OR 2.10; 95% CI 1.21-3.65). CONCLUSION Serum CA 19-9 is associated with an increased risk of prevalent metabolic syndrome. In order to confirm this association and identify potential mechanisms, prospective cohort and mechanic studies should be performed.
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Affiliation(s)
- Rui Du
- National Clinical Research Center for Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Di Cheng
- National Clinical Research Center for Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Lin
- National Clinical Research Center for Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jichao Sun
- National Clinical Research Center for Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kui Peng
- National Clinical Research Center for Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Xu
- National Clinical Research Center for Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Xu
- National Clinical Research Center for Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhong Chen
- National Clinical Research Center for Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yufang Bi
- National Clinical Research Center for Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiqing Wang
- National Clinical Research Center for Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jieli Lu
- National Clinical Research Center for Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guang Ning
- National Clinical Research Center for Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Yang A, Kim J, Cho SY, Jin DK. Prevalence and risk factors for type 2 diabetes mellitus with Prader-Willi syndrome: a single center experience. Orphanet J Rare Dis 2017; 12:146. [PMID: 28854950 PMCID: PMC5577752 DOI: 10.1186/s13023-017-0702-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 08/23/2017] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Prader-Willi syndrome (PWS) is often related to severe obesity and type-2 diabetes mellitus (T2DM). However, few studies, and none in Korea, have examined prevalence of T2DM and other variables in PWS. The aim of this study was to identify the prevalence and associated risk factors for T2DM in Korean patients with PWS. METHODS We performed a retrospective cohort study of the 84 PWS patients aged 10 or over (10.3-35.8 years of age) diagnosed with PWS at Samsung Medical Center from 1994 to 2016. We estimated occurrence of T2DM according to age (10-18 years versus >18 years), body mass index (BMI), genotype, history of growth hormone therapy, homeostasis model of assessment-insulin resistance (HOMA-IR), and the presence of dyslipidemia, hypogonadism, or central precocious puberty. Additionally, we investigated cutoff values of risk factors for development of T2DM. RESULTS Twenty-nine of a total 211 patients, diagnosed with PWS over the study period, were diagnosed as having T2DM (13.7%, mean age 15.9 ± 3.6 years). In the >18 years group, obesity, HOMA-IR, and presence of dyslipidemia, hypogonadism, or central precocious puberty were associated with the occurrence of T2DM in univariate analysis. In multivariate logistic regression analysis, only obesity (p = 0.001) and HOMA-IR (p < 0.001) were significant predictive factors for T2DM. Based on the receiver operating a characteristic curve analysis, the cutoff values of HOMA-IR and BMI for predicting T2DM were >2.7 and >28.49 kg/m2, respectively. Of the 29 patients, seven had ≥1 microvascular complication, with non-proliferative diabetic retinopathy in 6 of 7 cases. Advanced age and HOMA-IR were positively correlated with diabetic microvascular complications (p < 0.05, Spearman correlation coefficient 0.393 and 0.434, respectively). CONCLUSIONS The prevalence of diabetes in Korean PWS was similar to that in previous results. BMI and HOMA-IR were strong predictive factors for the development of T2DM in PWS. We specifically suggest the regular monitoring of glucose homeostasis parameters through a detailed settlement of ethnically specific cutoff values for BMI and HOMA-IR in PWS to prevent progression of T2DM and diabetic microvascular complications.
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Affiliation(s)
- Aram Yang
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Jinsup Kim
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Sung Yoon Cho
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
| | - Dong-Kyu Jin
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
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50
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Kwon SS, Lee SG, Lee YH, Lim JB, Kim JH. Homeostasis model assessment of insulin resistance in a general adult population in Korea: additive association of sarcopenia and obesity with insulin resistance. Clin Endocrinol (Oxf) 2017; 86:44-51. [PMID: 27623436 DOI: 10.1111/cen.13233] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 08/31/2016] [Accepted: 09/09/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Insulin resistance (IR) is a major factor associated with type 2 diabetes. Using homeostasis model assessment of insulin resistance (HOMA-IR), we aimed to elucidate the factors associated with IR risk, especially the cumulative effect of obesity and sarcopenia on IR. METHODS A total of 8,707 adults from the fourth and fifth Korean National Health and Examination Surveys were studied. Laboratory, anthropometric and lifestyle factors were analysed to reveal their association with HOMA-IR and IR risk. Subjects were divided into four groups according to the presence of obesity and sarcopenia to identify their effect on IR risk. RESULTS We found that high triglycerides and alanine aminotransferase, low high-density lipoprotein cholesterol, obesity and sarcopenia were independent risk factors for IR in both sexes. Obese men with sarcopenia had a significantly higher risk of IR than men who were obese or sarcopenic (but not both). The additive effect of sarcopenia with obesity on IR risk was not observed in women. Cut-offs of HOMA-IR for determining IR were calculated as 75 percentile value of young healthy subpopulation, 2·19 in men and 2·18 in women. These cut-offs could distinguish individuals with impaired fasting glucose from normal ones, with a sensitivity of 65·4% (men) and 73·3% (women), and a specificity of 68·8% (men) and 69·4% (women). CONCLUSION These data showed that obese men with sarcopenia exhibited a significantly higher IR risk than obese, nonsarcopenic men. In women, body composition did not affect IR if they were already obese.
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Affiliation(s)
- Soon Sung Kwon
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Medicine, The graduate school, Yonsei University, Seoul, Korea
| | - Sang-Guk Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Yong-Ho Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jong-Beack Lim
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong-Ho Kim
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
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