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Chen Y, Ni H, Zhang H. Exploring the relationship between live microbe intake and obesity prevalence in adults. Sci Rep 2024; 14:21724. [PMID: 39289456 PMCID: PMC11408724 DOI: 10.1038/s41598-024-72961-4] [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: 04/19/2024] [Accepted: 09/12/2024] [Indexed: 09/19/2024] Open
Abstract
Obesity has become a global health problem. In recent years, the influence of dietary microbes in the obese population has attracted the attention of scholars. Our study aimed to investigate the link between live microbe intake and obesity in adults. Participants (aged over 20 years) for this study were from the 1999-2018 National Health and Nutrition Examination Survey (NHANES). Participants were categorised into low, medium and high dietary live microbe intake groups. Linear regression was used to analyse the link between live microbe intake and body mass index (BMI) and waist circumference (WC). Logistic regression was used to analyse the link between live microbe intake and obesity and abdominal obesity prevalence. Restricted cubic spline curves (RCS) were used to check whether there was a non-linear relationship between live microbe intake and obesity. A total of 42,749 participants were included in this study and the number of obese reached 15,463. We found that live microbe intake was negatively linked to BMI and WC. In models adjusted for all confounders, the high live microbe intake group had lower obesity (OR = 0.812, 95%CI: 0.754-0.873) and abdominal obesity prevalence (OR = 0.851, 95%CI: 0.785-0.923) than the lowest intake group. Upon further quantification of live microbe intake, we found similar results. RCS analyses showed that live microbe intake was nonlinearly negatively correlated with BMI, WC, obesity, and abdominal obesity prevalence (P for non-linearity < 0.05). This study preliminarily reveals a negative link between live microbe intake and obesity in adults.
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Affiliation(s)
- Yuting Chen
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhejiang Chinese Medical University, No.54, Youdian Road, Shangcheng District, Hangzhou, 310009, Zhejiang, China
| | - Haixiang Ni
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhejiang Chinese Medical University, No.54, Youdian Road, Shangcheng District, Hangzhou, 310009, Zhejiang, China
| | - Hong Zhang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhejiang Chinese Medical University, No.54, Youdian Road, Shangcheng District, Hangzhou, 310009, Zhejiang, China.
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Dagogo-Jack S, Asuzu P, Wan J, Grambergs R, Stentz F, Mandal N. Plasma Ceramides and Other Sphingolipids in Relation to Incident Prediabetes in a Longitudinal Biracial Cohort. J Clin Endocrinol Metab 2024; 109:2530-2540. [PMID: 38501230 PMCID: PMC11403313 DOI: 10.1210/clinem/dgae179] [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: 10/12/2023] [Revised: 02/23/2024] [Accepted: 03/15/2024] [Indexed: 03/20/2024]
Abstract
CONTEXT Sphingolipids are linked to the pathogenesis of type 2 diabetes. OBJECTIVE To test the hypothesis that plasma sphingolipid profiles predict incident prediabetes. DESIGN A case-control study nested in the Pathobiology of Prediabetes in a Biracial Cohort study, a 5-year follow-up study. SETTING Academic health center. PARTICIPANTS Normoglycemic adults enrolled in the Pathobiology of Prediabetes in a Biracial Cohort study. Assessments included oral glucose tolerance test, insulin sensitivity, and insulin secretion. Participants with incident prediabetes were matched in age, sex, and ethnicity with nonprogressors. INTERVENTIONS We assayed 58 sphingolipid species (ceramides, monohexosyl ceramides, sphingomyelins, and sphingosine) using liquid chromatography/tandem mass spectrometry in baseline plasma levels from participants and determined association with prediabetes risk. MAIN OUTCOME MEASURE The primary outcome was progression from normoglycemia to prediabetes, defined as impaired fasting glucose or impaired glucose tolerance. RESULTS The mean age of participants (N = 140; 50% Black, 50% female) was 48.1 ± 8.69 years, body mass index 30.1 ± 5.78 kg/m2, fasting plasma glucose 92.7 ± 5.84 mg/dL, and 2-hour plasma glucose 121 ± 23.3 mg/dL. Of the 58 sphingolipid species assayed, higher ratios of sphingomyelin C26:0/C26:1 (OR, 2.73 [95% CI, 1.172-4.408], P = .015) and ceramide C18:0/C18:1 (OR, 1.236 [95% CI, 1.042-1.466], P = .015) in baseline plasma specimens were significantly associated with progression to prediabetes during the 5-year follow-up period, after adjustments for age, race, sex, body mass index, fasting plasma glucose, 2-hour plasma glucose, insulin sensitivity, and insulin secretion. CONCLUSION We conclude that the saturated-to-monounsaturated ratios of long-chain ceramide C18:0/C18:1 and very-long-chain sphingomyelin C26:0/C26:1 are potential biomarkers of prediabetes risk among individuals with parental history of type 2 diabetes.
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Affiliation(s)
- Samuel Dagogo-Jack
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- General Clinical Research Center, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Peace Asuzu
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Jim Wan
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Richard Grambergs
- Department of Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Frankie Stentz
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Nawajes Mandal
- Departments of Ophthalmology, Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Memphis VA Medical Center, Memphis, TN 38104, USA
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Bosello F, Vanzo A, Zaffalon C, Polinelli L, Saggin F, Bonacci E, Pedrotti E, Marchini G, Bosello O. Obesity, body fat distribution and eye diseases. Eat Weight Disord 2024; 29:33. [PMID: 38710948 PMCID: PMC11074037 DOI: 10.1007/s40519-024-01662-8] [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: 03/20/2024] [Accepted: 04/22/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND The prevalence of obesity, a chronic disease, is increasing, and obesity is now considered a global epidemic. Eye diseases are also increasing worldwide and have serious repercussions on quality of life as well as increasingly high costs for the community. The relationships between obesity and ocular pathologies are not yet well clarified and are not pathologically homogeneous: they seem to be somehow linked to excess body fat, especially to the distribution of adipose tissue and its ectopic deposits. PURPOSE Our objective was to examine the associations between obesity and anthropometric indices, including body mass index (BMI), waist circumference (WC), and the waist/hip ratio (WHR), and the risk of most widespread eye diseases, with particular attention given to the most significant metabolic mechanisms. METHODS This article provides a narrative overview of the effect of obesity and anthropometric measurements of body fat on prevalent eye diseases. We used the MEDLINE/PubMed, CINAHL, EMBASE, and Cochrane Library databases from 1984 to 2024. In addition, we hand-searched references from the retrieved articles and explored a number of related websites. A total of 153 publications were considered. RESULTS There is significant evidence that obesity is associated with several eye diseases. Waist circumference (WC) and the waist/hip ratio (WHR) have been observed to have stronger positive associations with eye diseases than BMI. CONCLUSIONS Obesity must be considered a significant risk factor for eye diseases; hence, a multidisciplinary and multidimensional approach to treating obesity, which also affects ocular health, is important. In the prevention and treatment of eye diseases related to obesity, lifestyle factors, especially diet and physical activity, as well as weight changes, both weight loss and weight gain, should not be overlooked. LEVEL OF EVIDENCE Level V narrative review.
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Affiliation(s)
- Francesca Bosello
- Department of Surgery, Dentistry, Maternity and Infant, Ophthalmology Clinic, University of Verona, Verona, Italy.
| | - Angiola Vanzo
- Food Hygiene and Nutrition Unit, Azienda ULSS 8, Berica, Veneto, Italy
| | - Chiara Zaffalon
- Department of Surgery, Dentistry, Maternity and Infant, Ophthalmology Clinic, University of Verona, Verona, Italy
| | - Luca Polinelli
- Department of Surgery, Dentistry, Maternity and Infant, Ophthalmology Clinic, University of Verona, Verona, Italy
| | - Filippo Saggin
- Department of Surgery, Dentistry, Maternity and Infant, Ophthalmology Clinic, University of Verona, Verona, Italy
| | - Erika Bonacci
- Department of Engineering for Innovation Medicine, Ophthalmology Clinic, University of Verona, Verona, Italy
| | - Emilio Pedrotti
- Department of Surgery, Dentistry, Maternity and Infant, Ophthalmology Clinic, University of Verona, Verona, Italy
| | - Giorgio Marchini
- Department of Surgery, Dentistry, Maternity and Infant, Ophthalmology Clinic, University of Verona, Verona, Italy
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Dagogo-Jack S. Leptin and Insulin Sensitivity: Endogenous Signals of Metabolic Homeostasis. J Clin Endocrinol Metab 2024; 109:e1402-e1403. [PMID: 37943695 DOI: 10.1210/clinem/dgad653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023]
Affiliation(s)
- Sam Dagogo-Jack
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- General Clinical Research Center, University of Tennessee Health Science Center, Memphis, TN 38163, USA
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Deng X, Liu D, Li M, He J, Fu Y. Association between systemic immune-inflammation index and insulin resistance and mortality. Sci Rep 2024; 14:2013. [PMID: 38263234 PMCID: PMC10806274 DOI: 10.1038/s41598-024-51878-y] [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: 10/19/2023] [Accepted: 01/10/2024] [Indexed: 01/25/2024] Open
Abstract
The role of inflammation in disease promotion is significant, yet the precise association between a newly identified inflammatory biomarker and insulin resistance (IR) and mortality remains uncertain. We aim to explore the potential correlation between systemic immune-inflammation index (SII) and these factors. We used data from 2011 to 2016 of National Health and Nutrition Examination Survey, and multivariate logistic regression and restricted cubic spline were employed. Subgroup and interaction analysis were conducted to recognize the consistency of the results. The association between SII and mortality was described by survival analysis. 6734 participants were enrolled, of whom 49.3% (3318) exhibited IR and 7.02% experienced mortality. Multivariate logistic regression revealed that individuals in the highest quartile (Q4) of SII had a significantly increased risk of IR compared to those in the lowest quartile (Q1). We then identified a linear association between SII and IR with an inflection point of 407, but may be influenced by gender. Similarly, compared to Q1, people whose SII at Q4 showed a higher all-cause and cardiovascular mortality. It showed a significant association between SII and both all-cause and cardiovascular mortality, but the results need to be interpreted with caution.
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Affiliation(s)
- Xiaoqi Deng
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Dichuan Liu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
| | - Miao Li
- Nursing Department, Beijing Tiantan Hospital, Beijing, 100070, China
| | - Jie He
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Yufan Fu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
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Zhang L, Vella A, Nair KS, Jensen MD. Characteristics of Normal Weight Insulin-Resistant Adults with Unfavorable Health Outcomes. Metab Syndr Relat Disord 2024. [PMID: 38227797 DOI: 10.1089/met.2023.0154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024] Open
Abstract
Background: Insulin resistance can be present in otherwise healthy, normal weight adults. Whether there are phenotype/sex-differences between normal weight insulin-resistant (NWIR) and normal weight insulin-sensitive (NWIS) Caucasians and whether there are differences in adverse health outcomes are unknown. Our goal was to define phenotypes and intermediate-term health outcomes of NWIR versus NWIS Caucasian adults. Methods: We analyzed data from 227 healthy volunteers body mass index 18 to <25.0 kg/m2 who underwent insulin clamp studies between January 1987 and January 2017 at Mayo Clinic to identify those in the top (NWIS, n = 56) and bottom (NWIR, n = 56) quartiles of insulin action. We compared the phenotypical characteristics and were able to collect medical records data for 80% of NWIS and 88% of NWIR to identify time to onset of hypertension, hyperglycemia, coronary heart disease, cerebrovascular disease, peripheral vascular disease, and all cause death; the follow-up averaged 11 (4, 20) years. Results: Body fat was significantly greater and peak VO2 was significantly less in both NWIS than NWIR males and females. Only in females was abdominal subcutaneous fat by computed tomography significantly greater in NWIR than NWIS. In NWIR males high-density lipoprotein-cholesterol and fat free mass were significantly less, and fasting insulin was greater than NWIS males. For the entire NWIS population, Kaplan-Meier disease-free survival analysis showed longer times free of hypertension, hyperglycemia, and some cardiovascular diseases than for NWIR. Conclusions: There are sex-specific phenotypes of NWIR in Caucasian adults. NWIR may be associated with accelerated onset of some adverse medical outcomes.
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Affiliation(s)
- Lili Zhang
- Division of Endocrinology, Department of Medicine, Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota, USA
| | - Adrian Vella
- Division of Endocrinology, Department of Medicine, Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota, USA
| | - K Sreekumaran Nair
- Division of Endocrinology, Department of Medicine, Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael D Jensen
- Division of Endocrinology, Department of Medicine, Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota, USA
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Wu L, Meng XJ, Xu TB, Zhang XC, Zhou Y, Tong ZF, Jiang JH. Berberine attenuates cognitive dysfunction and hippocampal apoptosis in rats with prediabetes. Chem Biol Drug Des 2024; 103:e14420. [PMID: 38230770 DOI: 10.1111/cbdd.14420] [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: 09/15/2023] [Revised: 11/16/2023] [Accepted: 11/30/2023] [Indexed: 01/18/2024]
Abstract
The cognitive dysfunction caused by prediabetes causes great difficulties in human life, and the terrible thing is that the means to prevent the occurrence of this disease are very limited at present, Berberine has shown the potential to treat diabetes and cognitive dysfunction, but it still needs to be further explored to clarify the mechanism of its therapeutic effect. Therefore, the aim of this study was to investigate the effects and mechanisms of Berberine on prediabetes-induced cognitive dysfunction. Prediabetes rat model was induced by a high-fat diet and a normal diet was used as a control. They were fed for 20 weeks. At week 13, the model rats were given 100 mg/kg Berberine by gavage for 7 weeks. The cognitive function of rats was observed. At the same time, OGTT, fasting blood glucose, blood lipids, insulin and other metabolic parameters, oxidative stress, and apoptosis levels were measured. The results showed that the model rats showed obvious glucose intolerance, elevated blood lipids, and insulin resistance, and the levels of oxidative stress and apoptosis were significantly increased. However, after the administration of Berberine, the blood glucose and lipid metabolism of prediabetic rats were significantly improved, and the oxidative stress level and apoptosis level of hippocampal tissue were significantly reduced. In conclusion, Berberine can alleviate the further development of diabetes in prediabetic rats, reduce oxidative stress and apoptosis in hippocampal tissue, and improve cognitive impairment in prediabetic rats.
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Affiliation(s)
- Lan Wu
- Health Management Center, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, China
| | - Xiang-Jian Meng
- Department of Endocrinology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, China
| | - Tian-Bao Xu
- Mathematics Teaching and Research Group, The High School Affiliated to Anhui Normal University, Wuhu, Anhui Province, China
| | - Xian-Cui Zhang
- Health Management Center, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, China
| | - Yong Zhou
- Health Management Center, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, China
| | - Zhu-Feng Tong
- Department of General Practice, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, China
| | - Jing-Han Jiang
- Department of General Practice, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, China
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Almuraikhy S, Doudin A, Domling A, Althani AAJF, Elrayess MA. Molecular regulators of exercise-mediated insulin sensitivity in non-obese individuals. J Cell Mol Med 2024; 28:e18015. [PMID: 37938877 PMCID: PMC10805515 DOI: 10.1111/jcmm.18015] [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: 03/08/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023] Open
Abstract
Insulin resistance is a significant contributor to the development of type 2 diabetes (T2D) and is associated with obesity, physical inactivity, and low maximal oxygen uptake. While intense and prolonged exercise may have negative effects, physical activity can have a positive influence on cellular metabolism and the immune system. Moderate exercise has been shown to reduce oxidative stress and improve antioxidant status, whereas intense exercise can increase oxidative stress in the short term. The impact of exercise on pro-inflammatory cytokine production is complex and varies depending on intensity and duration. Exercise can also counteract the harmful effects of ageing and inflamm-ageing. This review aims to examine the molecular pathways altered by exercise in non-obese individuals at higher risk of developing T2D, including glucose utilization, lipid metabolism, mitochondrial function, inflammation and oxidative stress, with the potential to improve insulin sensitivity. The focus is on understanding the potential benefits of exercise for improving insulin sensitivity and providing insights for future targeted interventions before onset of disease.
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Affiliation(s)
- Shamma Almuraikhy
- Biomedical Research CenterQatar UniversityDohaQatar
- Groningen Research Institute of Pharmacy, Drug DesignGroningen UniversityGroningenThe Netherlands
| | - Asmaa Doudin
- Biomedical Research CenterQatar UniversityDohaQatar
| | - Alexander Domling
- Groningen Research Institute of Pharmacy, Drug DesignGroningen UniversityGroningenThe Netherlands
| | - Asmaa Ali J. F. Althani
- Biomedical Research CenterQatar UniversityDohaQatar
- Department of Biomedical Sciences, College of Health Science, QU HealthQatar UniversityDohaQatar
| | - Mohamed A. Elrayess
- Biomedical Research CenterQatar UniversityDohaQatar
- College of Pharmacy, QU HealthQatar UniversityDohaQatar
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Yildirim V, Sheraton VM, Brands R, Crielaard L, Quax R, van Riel NA, Stronks K, Nicolaou M, Sloot PM. A data-driven computational model for obesity-driven diabetes onset and remission through weight loss. iScience 2023; 26:108324. [PMID: 38026205 PMCID: PMC10665812 DOI: 10.1016/j.isci.2023.108324] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/22/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Obesity is a major risk factor for the development of type 2 diabetes (T2D), where a sustained weight loss may result in T2D remission in individuals with obesity. To design effective and feasible intervention strategies to prevent or reverse T2D, it is imperative to study the progression of T2D and remission together. Unfortunately, this is not possible through experimental and observational studies. To address this issue, we introduce a data-driven computational model and use human data to investigate the progression of T2D with obesity and remission through weight loss on the same timeline. We identify thresholds for the emergence of T2D and necessary conditions for remission. We explain why remission is only possible within a window of opportunity and the way that window depends on the progression history of T2D, individual's metabolic state, and calorie restrictions. These findings can help to optimize therapeutic intervention strategies for T2D prevention or treatment.
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Affiliation(s)
- Vehpi Yildirim
- Department of Public and Occupational Health, Amsterdam University Medical Centers, University of Amsterdam, 1081 BT Amsterdam, the Netherlands
- Institute for Advanced Study, University of Amsterdam, 1012 GC Amsterdam, the Netherlands
| | - Vivek M. Sheraton
- Institute for Advanced Study, University of Amsterdam, 1012 GC Amsterdam, the Netherlands
- Computational Science Lab, University of Amsterdam, 1098 XH Amsterdam, the Netherlands
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers, 1100 DD Amsterdam, the Netherlands
| | - Ruud Brands
- AMRIF B.V., Agro Business Park, 6708 PW Wageningen, the Netherlands
- Institute for Risk Assessment Sciences, Utrecht University, 3584 CL Utrecht, the Netherlands
| | - Loes Crielaard
- Department of Public and Occupational Health, Amsterdam University Medical Centers, University of Amsterdam, 1081 BT Amsterdam, the Netherlands
- Institute for Advanced Study, University of Amsterdam, 1012 GC Amsterdam, the Netherlands
| | - Rick Quax
- Institute for Advanced Study, University of Amsterdam, 1012 GC Amsterdam, the Netherlands
- Computational Science Lab, University of Amsterdam, 1098 XH Amsterdam, the Netherlands
| | - Natal A.W. van Riel
- Department of Biomedical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, the Netherlands
- Department of Experimental and Vascular Medicine, Amsterdam University Medical Centers, 1100 DD Amsterdam, the Netherlands
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam University Medical Centers, University of Amsterdam, 1081 BT Amsterdam, the Netherlands
- Institute for Advanced Study, University of Amsterdam, 1012 GC Amsterdam, the Netherlands
| | - Mary Nicolaou
- Department of Public and Occupational Health, Amsterdam University Medical Centers, University of Amsterdam, 1081 BT Amsterdam, the Netherlands
- Institute for Advanced Study, University of Amsterdam, 1012 GC Amsterdam, the Netherlands
| | - Peter M.A. Sloot
- Institute for Advanced Study, University of Amsterdam, 1012 GC Amsterdam, the Netherlands
- Computational Science Lab, University of Amsterdam, 1098 XH Amsterdam, the Netherlands
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Ghani ZA, Qaddori H, Al-Mayah Q. Triglyceride/high-density lipoprotein ratio as a predictor for insulin resistance in a sample of healthy Iraqi adults. J Med Life 2023; 16:668-674. [PMID: 37520476 PMCID: PMC10375356 DOI: 10.25122/jml-2022-0239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/28/2022] [Indexed: 08/01/2023] Open
Abstract
Insulin resistance (IR) is a common pathophysiological condition associated with many metabolic diseases, including obesity, prediabetes, type 2 diabetes mellitus (T2DM), and cardiovascular disease. The widely used homeostasis model assessment for IR (HOMA-IR) is usually used to estimate IR. However, this model cannot be used for screening IR due to several logistic difficulties, such as costs and insulin instability, which are essential for measurement. Thus, finding feasible alternatives is of paramount importance. This study aimed to evaluate the value of triglyceride/high-density lipoprotein-cholesterol (TG/HDL-c) ratio in predicting IR in healthy adult individuals. The study involved 83 euglycemic non-diabetic adults (≥45 years old). Lipid profile, fasting insulin, fasting blood sugar (FBS), and glycated hemoglobin were measured for all participants. The TG/HDL-c ratio was calculated by dividing TG by HDL. Insulin resistance was calculated using the HOMA-IR formula. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the TG/HDL-c ratio. The prevalence of IR among healthy adult Iraqis was 28.92%. Subjects in the IR group showed a higher TG/HDL ratio than the insulin-sensitive group (3.69±0.68 versus 2.71±1.0) with a significant difference. The area under the curve (AUC) for this ratio was 0.849, 95% CI= 0.763-0.935, p<0.002. The sensitivity and specificity of the test were 83% and 81%, respectively, at a best cut-off value of 3.1 (TG/HDL ratio). The prevalence of IR among healthy adult Iraqis was 28.92%. Triglyceride/HDL-c ratio had a very good predictive value for IR.
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Affiliation(s)
| | - Hussein Qaddori
- Department of Physiology, College of Medicine, Al Nahrain University, Baghdad, Iraq
| | - Qasim Al-Mayah
- Department of Physiology, College of Medicine, Al Nahrain University, Baghdad, Iraq
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Almuraikhy S, Anwardeen N, Doudin A, Sellami M, Domling A, Agouni A, Al Thani AA, Elrayess MA. The Metabolic Switch of Physical Activity in Non-Obese Insulin Resistant Individuals. Int J Mol Sci 2023; 24:ijms24097816. [PMID: 37175541 PMCID: PMC10178125 DOI: 10.3390/ijms24097816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
Healthy non-obese insulin resistant (IR) individuals are at higher risk of metabolic syndrome. The metabolic signature of the increased risk was previously determined. Physical activity can lower the risk of insulin resistance, but the underlying metabolic pathways remain to be determined. In this study, the common and unique metabolic signatures of insulin sensitive (IS) and IR individuals in active and sedentary individuals were determined. Data from 305 young, aged 20-30, non-obese participants from Qatar biobank, were analyzed. The homeostatic model assessment of insulin resistance (HOMA-IR) and physical activity questionnaires were utilized to classify participants into four groups: Active Insulin Sensitive (ISA, n = 30), Active Insulin Resistant (IRA, n = 20), Sedentary Insulin Sensitive (ISS, n = 21) and Sedentary Insulin Resistant (SIR, n = 23). Differences in the levels of 1000 metabolites between insulin sensitive and insulin resistant individuals in both active and sedentary groups were compared using orthogonal partial least square discriminate analysis (OPLS-DA) and linear models. The study indicated significant differences in fatty acids between individuals with insulin sensitivity and insulin resistance who engaged in physical activity, including monohydroxy, dicarboxylate, medium and long chain, mono and polyunsaturated fatty acids. On the other hand, the sedentary group showed changes in carbohydrates, specifically glucose and pyruvate. Both groups exhibited alterations in 1-carboxyethylphenylalanine. The study revealed different metabolic signature in insulin resistant individuals depending on their physical activity status. Specifically, the active group showed changes in lipid metabolism, while the sedentary group showed alterations in glucose metabolism. These metabolic discrepancies demonstrate the beneficial impact of moderate physical activity on high risk insulin resistant healthy non-obese individuals by flipping their metabolic pathways from glucose based to fat based, ultimately leading to improved health outcomes. The results of this study carry significant implications for the prevention and treatment of metabolic syndrome in non-obese individuals.
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Affiliation(s)
- Shamma Almuraikhy
- Biomedical Research Center, Qatar University, Doha P.O. Box 2713, Qatar
- Groningen Research Institute of Pharmacy, Drug Design, Groningen University, 9713 AV Groningen, The Netherlands
| | - Najeha Anwardeen
- Biomedical Research Center, Qatar University, Doha P.O. Box 2713, Qatar
| | - Asmma Doudin
- Biomedical Research Center, Qatar University, Doha P.O. Box 2713, Qatar
| | - Maha Sellami
- Physical Education Department (PE), College of Education, Qatar University, Doha P.O. Box 2713, Qatar
| | - Alexander Domling
- Groningen Research Institute of Pharmacy, Drug Design, Groningen University, 9713 AV Groningen, The Netherlands
| | - Abdelali Agouni
- College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Asmaa A Al Thani
- Biomedical Research Center, Qatar University, Doha P.O. Box 2713, Qatar
- Department of Biomedical Sciences, College of Health Science, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Mohamed A Elrayess
- Biomedical Research Center, Qatar University, Doha P.O. Box 2713, Qatar
- College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
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Abstract
Importance Prediabetes, an intermediate stage between normal glucose regulation and diabetes, affects 1 in 3 adults in the US and approximately 720 million individuals worldwide. Observations Prediabetes is defined by a fasting glucose level of 100 to 125 mg/dL, a glucose level of 140 to 199 mg/dL measured 2 hours after a 75-g oral glucose load, or glycated hemoglobin level (HbA1C) of 5.7% to 6.4% or 6.0% to 6.4%. In the US, approximately 10% of people with prediabetes progress to having diabetes each year. A meta-analysis found that prediabetes at baseline was associated with increased mortality and increased cardiovascular event rates (excess absolute risk, 7.36 per 10 000 person-years for mortality and 8.75 per 10 000 person-years for cardiovascular disease during 6.6 years). Intensive lifestyle modification, consisting of calorie restriction, increased physical activity (≥150 min/wk), self-monitoring, and motivational support, decreased the incidence of diabetes by 6.2 cases per 100 person-years during a 3-year period. Metformin decreased the risk of diabetes among individuals with prediabetes by 3.2 cases per 100 person-years during 3 years. Metformin is most effective for women with prior gestational diabetes and for individuals younger than 60 years with body mass index of 35 or greater, fasting plasma glucose level of 110 mg/dL or higher, or HbA1c level of 6.0% or higher. Conclusions and Relevance Prediabetes is associated with increased risk of diabetes, cardiovascular events, and mortality. First-line therapy for prediabetes is lifestyle modification that includes weight loss and exercise or metformin. Lifestyle modification is associated with a larger benefit than metformin.
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Affiliation(s)
- Justin B Echouffo-Tcheugui
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Leigh Perreault
- Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora
| | - Linong Ji
- Department of Endocrinology, Peking University People's Hospital, Xicheng District, Beijing, China
| | - Sam Dagogo-Jack
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis
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13
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The potential impact of insulin resistance and metabolic syndrome on migraine headache characteristics. BMC Neurol 2022; 22:422. [DOI: 10.1186/s12883-022-02966-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 11/04/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background & objectives
Studying comorbidities with migraine aids in a better understanding of its pathophysiology and potential therapeutic targets. This case-control study aimed to study the impact of insulin resistance and metabolic syndrome on the characteristics of migraine headache attacks.
Methods
A case-control study was conducted on 30 migraine patients and 30 healthy controls. The following data were assessed in migraine patients: type of migraine, duration of attacks, Migraine Severity Scale (MIGSEV), and Headache Impact Test-6 (HIT-6). Both groups were assessed for waist circumference and underwent the following tests: fasting blood glucose, fasting insulin, high-density lipoprotein cholesterol level, and triglycerides, and homeostasis model assessment–insulin resistance (HOMA-IR) was applied.
Results
This study included age and sex-matched patients and controls. Migraine patients had significantly higher waist circumference, higher mean values of serum insulin, HOMA-IR and higher frequency of insulin resistance and metabolic syndrome than the control group (P-value = 0.005, 0.049, 0.01, 0.012, 0.024, respectively). Migraine patients with insulin resistance had significantly higher intensity and tolerability scores, MIGSEV total score, and HIT-6 total score compared to those without (P-value = 0.005, 0.005, 0.002, 0.018, respectively). There was a significantly positive correlation between the MIGSEV and HIT-6 scores and fasting insulin levels, and HOMA-IR value (P-value = 0.006, ≤ 0.001, 0.017, ≤ 0.001, respectively).
Conclusion
Insulin resistance and metabolic syndrome are more common in migraine patients than in healthy controls. The severity and impact of migraine attacks are higher in patients with insulin resistance than in those without.
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14
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AlMuraikhy S, Anwardeen N, Naeem A, Sellami M, Domling A, Agouni A, Elrayess MA. Comparing the Metabolic Profiles Associated with Fitness Status between Insulin-Sensitive and Insulin-Resistant Non-Obese Individuals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912169. [PMID: 36231474 PMCID: PMC9564877 DOI: 10.3390/ijerph191912169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 05/27/2023]
Abstract
(1) Background: Young non-obese insulin-resistant (IR) individuals could be at risk of developing metabolic diseases including type 2 diabetes mellitus. The protective effect of physical activity in this apparently healthy group is expected but not well characterized. In this study, clinically relevant metabolic profiles were determined and compared among active and sedentary insulin-sensitive (IS) and IR young non-obese individuals. (2) Methods: Data obtained from Qatar Biobank for 2110 young (20-30 years old) non-obese (BMI ≤ 30) healthy participants were divided into four groups, insulin-sensitive active (ISA, 30.7%), insulin-sensitive sedentary (ISS, 21.4%), insulin-resistant active (IRA, 20%), and insulin-resistant sedentary (IRS, 23.3%), using the homeostatic model assessment of insulin resistance (HOMA-IR) and physical activity questionnaires. The effect of physical activity on 66 clinically relevant biochemical tests was compared among the four groups using linear models. (3) Results: Overall, non-obese IR participants had significantly (p ≤ 0.001) worse vital signs, blood sugar profiles, inflammatory markers, liver function, lipid profiles, and vitamin D levels than their IS counterparts. Physical activity was positively associated with left handgrip (p ≤ 0.01) and levels of creatine kinase (p ≤ 0.001) and creatine kinase-2 (p ≤ 0.001) in both IS and IR subjects. Furthermore, physical activity was positively associated with levels of creatinine (p ≤ 0.01) and total vitamin D (p = 0.006) in the IR group and AST (p = 0.001), folate (p = 0.001), and hematocrit (p = 0.007) in the IS group. Conversely, physical inactivity was negatively associated with the white blood cell count (p = 0.001) and an absolute number of lymphocytes (p = 0.003) in the IR subjects and with triglycerides (p = 0.005) and GGT-2 (p ≤ 0.001) in the IS counterparts. (4) Conclusions: An independent effect of moderate physical activity was observed in non-obese apparently healthy individuals a with different HOMA-IR index. The effect was marked by an improved health profile including higher vitamin D and lower inflammatory markers in IRA compared to IRS, and a higher oxygen carrying capacity and lipid profile in ISA compared to the ISS counterparts.
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Affiliation(s)
- Shamma AlMuraikhy
- Biomedical Research Center, Qatar University, Doha P.O. Box 2713, Qatar
- Groningen Research Institute of Pharmacy, Drug Design, Groningen University, 9712 CP Groningen, The Netherlands
| | - Najeha Anwardeen
- Biomedical Research Center, Qatar University, Doha P.O. Box 2713, Qatar
| | - Aisha Naeem
- Ministry of Public Health, Doha P.O. Box 42, Qatar
- Department of Oncology and Pathology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3800 Reservoir Rd., NW, Washington, DC 20007, USA
| | - Maha Sellami
- Physical Education Department (PE), College of Education, Qatar University, Doha P.O. Box 2713, Qatar
| | - Alexander Domling
- Groningen Research Institute of Pharmacy, Drug Design, Groningen University, 9712 CP Groningen, The Netherlands
| | - Abdelali Agouni
- College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Mohamed A. Elrayess
- Biomedical Research Center, Qatar University, Doha P.O. Box 2713, Qatar
- College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
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15
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Ali M, Hussein M, Magdy R, Khamis A, Othman AM, Abdelkareem SA, Osama W. The potential role of insulin resistance in predicting outcome from intravenous thrombolytic therapy. Acta Neurol Belg 2022:10.1007/s13760-022-02060-6. [DOI: 10.1007/s13760-022-02060-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/08/2022] [Indexed: 11/30/2022]
Abstract
Abstract
Background
The potential impact of insulin resistance on stroke prognosis after IV thrombolysis is poorly understood. This study aimed to assess the effect of insulin resistance and metabolic syndrome on the outcome of IV thrombolysis in non-diabetic patients with acute ischaemic stroke.
Methods
This prospective observational study was conducted on 70 non-diabetic acute ischaemic stroke patients who received rt-PA within 3 h of stroke onset. Patients were subjected to baseline and follow-up NIHSS measurements at 24 h and 3 months post-treatment. Stroke outcome was assessed after 3 months using the Modified Rankin Scale (mRS). The homeostasis model assessment–insulin resistance (HOMA-IR) was calculated for the included patients at stroke onset.
Results
The mean age of included patients was 57.04 ± 14.39 years. Patients with unfavourable outcome had a significantly higher frequency of insulin resistance and metabolic syndrome, higher values of baseline NIHSS, insulin, HOMA-IR, uric acid and lower levels of HDL than those with favourable outcome (P value = 0.035, 0.007, ≤ 0.001, 0.001, ≤ 0.001, 0.002, 0.033, respectively). Each point increase in NIHSS before rt-PA increased the odds of an unfavourable outcome by 2.06 times (95% CI 1.22 − 3.478). Also, insulin resistance increased the odds of the unfavourable outcome by 11.046 times (95% CI 1.394–87.518). There was a statistically significant improvement in NIHSS 3 months after receiving rt-PA in all patients, significantly higher in patients who did not have insulin resistance or metabolic syndrome.
Conclusion
Insulin resistance and metabolic syndrome were associated with worse functional outcomes in non-diabetic stroke patients after receiving rt-PA.
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16
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Derella CC, Blanks AM, Nguyen A, Looney J, Tucker MA, Jeong J, Rodriguez-Miguelez P, Thomas J, Lyon M, Pollock DM, Harris RA. Dual endothelin receptor antagonism increases resting energy expenditure in people with increased adiposity. Am J Physiol Endocrinol Metab 2022; 322:E508-E516. [PMID: 35373585 PMCID: PMC9126219 DOI: 10.1152/ajpendo.00349.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 03/22/2022] [Accepted: 03/29/2022] [Indexed: 01/18/2023]
Abstract
Increased adiposity is associated with dysregulation of the endothelin system, both of which increase the risk of cardiovascular disease (CVD). Preclinical data indicate that endothelin dysregulation also reduces resting energy expenditure (REE). The objective was to test the hypothesis that endothelin receptor antagonism will increase REE in people with obesity compared with healthy weight individuals. Using a double blind, placebo-controlled, crossover design, 32 participants [healthy weight (HW): n = 16, BMI: 21.3 ± 2.8 kg/m2, age: 26 ± 7 yr and overweight/obese (OB): n = 16, BMI: 33.5 ± 9.5 kg/m2, age: 31 ± 6 yr] were randomized to receive either 125 mg of bosentan (ETA/B antagonism) or placebo twice per day for 3 days. Breath-by-breath gas exchange data were collected and REE was assessed by indirect calorimetry. Venous blood samples were analyzed for concentrations of endothelin-1 (ET-1). Treatment with bosentan increased plasma ET-1 in both OB and HW groups. Within the OB group, the changes in absolute REE (PLA: -77.6 ± 127.6 vs. BOS: 72.2 ± 146.6 kcal/day; P = 0.046). The change in REE was not different following either treatment in the HW group. Overall, absolute plasma concentrations of ET-1 following treatment with bosentan were significantly associated with kcal/day of fat (r = 0.488, P = 0.005), percentage of fat utilization (r = 0.415, P = 0.020), and inversely associated with the percentage of carbohydrates (r = -0.419, P = 0.019), and respiratory exchange ratio (r = -0.407, P = 0.023). Taken together, these results suggest that modulation of the endothelin system may represent a novel therapeutic approach to increase both resting metabolism and caloric expenditure, and reduce CVD risk in people with increased adiposity.NEW & NOTEWORTHY Findings from our current translational investigation demonstrate that dual endothelin A/B receptor antagonism increases total REE in overweight/obese individuals. These results suggest that modulation of the endothelin system may represent a novel therapeutic target to increase both resting metabolism and caloric expenditure, enhance weight loss, and reduce CVD risk in seemingly healthy individuals with elevated adiposity.
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Affiliation(s)
- Cassandra C Derella
- Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Anson M Blanks
- Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Andy Nguyen
- Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Jacob Looney
- Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Matthew A Tucker
- Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Jinhee Jeong
- Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Paula Rodriguez-Miguelez
- Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
| | - Jeffrey Thomas
- Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Matthew Lyon
- Medical College of Georgia, Augusta University, Augusta, Georgia
| | - David M Pollock
- Cardio-Renal Physiology and Medicine Section, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Ryan A Harris
- Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
- Sport and Exercise Science Research Institute, Ulster University, Jordanstown, United Kingdom
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17
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Angiotensin II Inhibits Insulin Receptor Signaling in Adipose Cells. Int J Mol Sci 2022; 23:ijms23116048. [PMID: 35682723 PMCID: PMC9181642 DOI: 10.3390/ijms23116048] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/20/2022] [Accepted: 05/20/2022] [Indexed: 11/17/2022] Open
Abstract
Angiotensin II (Ang II) is a critical regulator of insulin signaling in the cardiovascular system and metabolic tissues. However, in adipose cells, the regulatory role of Ang II on insulin actions remains to be elucidated. The effect of Ang II on insulin-induced insulin receptor (IR) phosphorylation, Akt activation, and glucose uptake was examined in 3T3-L1 adipocytes. In these cells, Ang II specifically inhibited insulin-stimulated IR and insulin receptor substrate-1 (IRS-1) tyrosine-phosphorylation, Akt activation, and glucose uptake in a time-dependent manner. These inhibitory actions were associated with increased phosphorylation of the IR at serine residues. Interestingly, Ang II-induced serine-phosphorylation of IRS was not detected, suggesting that Ang II-induced desensitization begins from IR regulation itself. PKC inhibition by BIM I restored the inhibitory effect of Ang II on insulin actions. We also found that Ang II promoted activation of several PKC isoforms, including PKCα/βI/βII/δ, and its association with the IR, particularly PKCβII, showed the highest interaction. Finally, we also found a similar regulatory effect of Ang II in isolated adipocytes, where insulin-induced Akt phosphorylation was inhibited by Ang II, an effect that was prevented by PKC inhibitors. These results suggest that Ang II may lead to insulin resistance through PKC activation in adipocytes.
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18
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Giha HA, Joatar FE, AlDehaini DMB, Malalla ZHA, Ali ME, Al Qarni AA. Association of obesity in T2DM with differential polymorphism of ghrelin, growth hormone secretagogue receptor-1 and telomeres maintenance genes. Horm Mol Biol Clin Investig 2022; 43:297-306. [PMID: 35446515 DOI: 10.1515/hmbci-2021-0063] [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: 07/23/2021] [Accepted: 03/12/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although obesity and T2DM comorbidity is too frequent, the molecular basis of diabetic obesity is largely unexplained and barely investigated. MATERIALS Cross-sectional studies were conducted in Kingdom of Saudi Arabia (KSA) in 2013 and Kuwait in 2019. Fasting blood samples were obtained from a total of 216 T2DM patients (104 from KSA) and 193 nondiabetic subjects (93 from KSA) after their consents. Eight SNPs in 5 genes known to be associated with both obesity and T2DM, ghrelin (GHRL) and growth hormone secretagogue receptor -GHSR (KSA) and telomeres maintenance genes (Kuwait) were genotyped by rtPCR. Both patients and controls were grouped into obese and non-obese and sub-grouped into 4-BMI- grades: normal, overweight (OW), obese (OBS) and severely obese (SOBS). RESULTS Showed that the only SNP which was distinguished between all groups/subgroups in all study subjects was the ACYP2 rs6713088G/C, where the common CC genotype was under-expressed in the obese compared to non-obese diabetics (17.8% vs. 40.4%, p 0.01) and between the 4-BMI-grade (p 0.025). Interestingly the same genotype was over-expressed in obese compared to non-obese non-diabetics (50% vs. 27.6%, p 0.04). Furthermore, the GHRL (rs27647C/T), GHSR (rs509030G/C) and TERC (rs12696304G/C) MAFs were significantly low in normal BMI patients; p= 0.034, 0.008 and 0.011, respectively. CONCLUSIONS This is the first report about the molecular distinction between the obese and non-obese diabetics, it showed the association of rs6713088G/C mutant allele with diabetic obesity, while the GHRL, GHSR and TERC SNPs were differentially expressed based on the BMI-grades.
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Affiliation(s)
- Hayder A Giha
- Medical Biochemistry and Molecular Biology, Khartoum, Sudan
| | - Faris E Joatar
- Clinical Biochemistry Laboratory, King Abdulaziz Hospital, Ministry of National Guard Health affairs, Al Ahsa, Saudi Arabia
| | | | - Zainab H A Malalla
- Medical Department of Biochemistry, College of Medicine and Medical Sciences (CMMS), Arabian Gulf University (AGU), Manama, Kingdom of Bahrain
| | - Muhalab E Ali
- Medical Department of Biochemistry, College of Medicine and Medical Sciences (CMMS), Arabian Gulf University (AGU), Manama, Kingdom of Bahrain
| | - Ali A Al Qarni
- Endocrinology and Metabolism Section, King Abdulaziz Hospital, Ministry of National Guard Health Affairs, King Abdullah Medical Research Center-Estern Region, Al Ahsa, Saudi Arabia
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19
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Alqunai MS, Alrashid FF. Bariatric surgery for the management of type 2 diabetes mellitus-current trends and challenges: a review article. Am J Transl Res 2022; 14:1160-1171. [PMID: 35273720 PMCID: PMC8902546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
Obesity has become an epidemic and has emerged as a serious ailment of global concern. Longstanding obesity may lead to several complications, including type 2 diabetes mellitus (T2DM). Considering the role of the gastrointestinal tract (GIT) in glycemic control, altering it would be relevant to the T2DM management algorithm. Bariatric surgery is a well-known surgical procedure that alters the GIT for managing T2DM among moderate to severely obese patients. T2DM remissions (adequate glycemic control without any other antidiabetic drugs) among the post-bariatric patients are due to weight loss related and weight loss unrelated pathophysiological mechanisms, including caloric intake restriction, increased insulin secretion, sensitivity, and malabsorption. Evidence suggests that bariatric surgeries among T2DM patients improved micro and macrovascular complications. Bariatric surgical procedures have more advantages of post-operative weight loss and glycemic control in biliopancreatic diversions than other available bariatric surgical procedures. Several concerns raised on the short and long-term risks associated with the bariatric surgery were nutritional deficiencies, psychological issues, GIT ulcers, and survival rates. Data related to follow-up of complications related to the above-stated risk are still elusive. According to some of the recently published studies, relapse of T2DM after remission is a worrying phenomenon among post-bariatric surgery patients, requiring more clinical trials and long-term follow-up on the relapsed patients. The effectiveness of reoperation among the relapsed patients also needs to be evaluated. Other unresolved issues related to bariatric surgery are patient compliance, cost-effectiveness, quality of life among post-bariatric patients, and the effectiveness of the post-operative holistic approach to avoid relapse. Future studies, especially randomized controlled trials, are recommended to resolve the existing controversies associated with bariatric surgery.
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Affiliation(s)
- Mansur Suliman Alqunai
- Department of Surgery, College of Medicine, Jouf UniversitySakaka, Aljouf, Saudi Arabia
- Department of Surgery, King Fahad Specialist Hospital, Ministry of HealthBuraidah, Qassim, Saudi Arabia
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20
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Parcha V, Heindl B, Kalra R, Li P, Gower B, Arora G, Arora P. Insulin Resistance and Cardiometabolic Risk Profile Among Nondiabetic American Young Adults: Insights From NHANES. J Clin Endocrinol Metab 2022; 107:e25-e37. [PMID: 34473288 PMCID: PMC8684535 DOI: 10.1210/clinem/dgab645] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND The burden of insulin resistance (IR) among young American adults has not been previously assessed. We evaluated (1) the prevalence and trends of IR and cardiometabolic risk factors and (2) the association between measures of adiposity and IR among adults 18 to 44 years of age without diabetes and preexisting cardiovascular disease. METHODS Cross-sectional survey data from six consecutive National Health and Nutrition Examination Survey (2007-2008 to 2017-2018) cycles were analyzed. IR was defined by the homeostatic model assessment for IR (HOMA-IR) of ≥2.5. The temporal trends of IR, cardiometabolic risk factors, and the relationship between IR and measures of adiposity were assessed using multivariable-adjusted regression models. RESULTS Among 6247 young adults 18 to 44 years of age, the prevalence of IR was 44.8% (95% CI: 42.0%-47.6%) in 2007-2010 and 40.3% (95% CI: 36.4%-44.2%) in 2015-2018 (P for trend = 0.07). There was a modest association of HOMA-IR with higher body mass index (BMI), waist circumference, total lean fat mass, and total and localized fat mass (all Ps < 0.001). Participants with IR had a higher prevalence of hypertension [31.3% (95% CI: 29.2%-33.5%) vs 14.7% (95% CI: 13.2%-16.2%)], hypercholesterolemia [16.0% (95% CI: 12.4%-19.5%) vs 7.0% (95% CI: 5.8%-8.5%)], obesity [56.6% (95% CI: 53.9%-59.3%) vs 14.7% (95% CI: 13.0%-16.5%)], and poor physical activity levels [18.3% (95% CI: 16.4%-20.2%) vs 11.7% (95%CI: 10.3-13.1%)] compared to participants without IR (all Ps < 0.05). CONCLUSIONS Four-in-10 young American adults have IR, which occurs in a cluster with cardiometabolic risk factors. Nearly half of young adults with IR are nonobese. Screening efforts for IR irrespective of BMI may be required.
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Affiliation(s)
- Vibhu Parcha
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brittain Heindl
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rajat Kalra
- Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA
| | - Peng Li
- School of Nursing, University of Alabama at Birmingham, AL, USA
| | - Barbara Gower
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Garima Arora
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Pankaj Arora
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
- Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA
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21
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Hoddy KK, Axelrod CL, Mey JT, Hari A, Beyl RA, Blair JB, Dantas WS, Kirwan JP. Insulin resistance persists despite a metabolically healthy obesity phenotype. Obesity (Silver Spring) 2022; 30:39-44. [PMID: 34816598 PMCID: PMC9136885 DOI: 10.1002/oby.23312] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 08/06/2021] [Accepted: 09/07/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Metabolically healthy obesity (MHO) is often defined as the absence of metabolic syndrome in the presence of obesity. However, phenotypic features of MHO are unclear. Insulin sensitivity in MHO was cross-sectionally compared with metabolically unhealthy obesity (MUO) and a reference group of young healthy participants without obesity. METHODS Sedentary adults (n = 96) undergoing anthropometric, blood chemistries, maximal aerobic capacity, and euglycemic-hyperinsulinemic clamp measurements were classified by BMI (<25 and ≥30 kg/m2 ). MUO was defined as having obesity with metabolic syndrome (≥2 additional risk factors). Data were analyzed using a linear mixed models approach. RESULTS Body weight was similar between MHO and MUO. Body fat (percentage) and high-density lipoprotein cholesterol were higher (p < 0.001), and systolic blood pressure, triglycerides, glucose, and insulin were lower in MHO versus MUO (p < 0.03, all). The MHO group also had lower high-density lipoprotein cholesterol and higher low-density lipoprotein cholesterol, diastolic blood pressure, and insulin compared with the reference. Both the MHO and MUO groups displayed impaired insulin sensitivity compared with the reference control (p < 0.001). CONCLUSIONS Participants with MHO had distinct clinical measures related to hypertension, lipid metabolism, and glycemic control compared with a healthy reference group. Peripheral insulin resistance in obesity independent of metabolic status portends increased risk for type 2 diabetes in the MHO patient population.
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Affiliation(s)
- Kristin K. Hoddy
- Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Christopher L. Axelrod
- Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Jacob T. Mey
- Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Adithya Hari
- Department of Nuclear Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Robbie A. Beyl
- Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Jourdan B. Blair
- Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Wagner S. Dantas
- Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - John P. Kirwan
- Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
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22
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Hempe JM, Yang S, Liu S, Hsia DS. Standardizing the haemoglobin glycation index. ENDOCRINOLOGY DIABETES & METABOLISM 2021; 4:e00299. [PMID: 34558807 PMCID: PMC8502217 DOI: 10.1002/edm2.299] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/11/2021] [Accepted: 09/08/2021] [Indexed: 02/02/2023]
Abstract
Aims A high haemoglobin glycation index (HGI) is associated with greater risk for hypoglycaemia and chronic vascular disease. Standardizing how the HGI is calculated would normalize results between research studies and hospital laboratories and facilitate the clinical use of HGI for assessing risk. Methods The HGI is the difference between an observed HbA1c and a predicted HbA1c obtained by inserting fasting plasma glucose (FPG) into a regression equation describing the linear relationship between FPG and HbA1c in a reference population. We used data from the 2005–2016 U.S. National Health and Nutrition Examination Survey (NHANES) to identify a reference population of 18,675 diabetes treatment–naïve adults without self‐reported diabetes. The reference population regression equation (predicted HbA1c = 0.024 FPG + 3.1) was then used to calculate the HGI and divide participants into low (<−0.150), moderate (−0.150 to <0.150) and high (≥0.150) HGI subgroups. Diabetes status was classified by OGTTs. Results As previously reported in multiple studies, a high HGI was associated with black race independent of diabetes status, and with older age, higher BMI and higher CRP in normal and prediabetic but not diabetic participants. The mean HGI was 0.6% higher in self‐reported diabetic adults. The HGI was not associated with plasma insulin, HOMA‐IR or 2 h OGTT in participants classified as normal, prediabetic or diabetic. Conclusions The regression equation derived from this demographically diverse diabetes treatment–naïve adult NHANES reference population is suitable for standardizing how the HGI is calculated for both clinical use and in research to mechanistically explain population variation in the HGI and why a high HGI is associated with greater risk for chronic vascular disease.
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Affiliation(s)
- James M Hempe
- Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Shengping Yang
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Shuqian Liu
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Daniel S Hsia
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
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23
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Ishimwe MCS, Wentzel A, Shoup EM, Osei-Tutu NH, Hormenu T, Patterson AC, Bagheri H, DuBose CW, Mabundo LS, Ha J, Sherman A, Sumner AE. Beta-cell failure rather than insulin resistance is the major cause of abnormal glucose tolerance in Africans: insight from the Africans in America study. BMJ Open Diabetes Res Care 2021; 9:9/1/e002447. [PMID: 34531244 PMCID: PMC8449936 DOI: 10.1136/bmjdrc-2021-002447] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/26/2021] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Uncertainties exist on whether the main determinant of abnormal glucose tolerance (Abnl-GT) in Africans is β-cell failure or insulin resistance (IR). Therefore, we determined the prevalence, phenotype and characteristics of Abnl-GT due to β-cell failure versus IR in 486 African-born blacks (male: 64%, age: 38±10 years (mean±SD)) living in America. RESEARCH DESIGN AND METHODS Oral glucose tolerance test were performed. Abnl-GT is a term which includes both diabetes and prediabetes and was defined as fasting plasma glucose (FPG) ≥5.6 mmol/L and/or 2-hour glucose ≥7.8 mmol/L. IR was defined by the lowest quartile of the Matsuda Index (≤2.98) and retested using the upper quartile of homeostatic model assessment of insulin resistance (HOMA-IR) (≥2.07). Abnl-GT-IR required both Abnl-GT and IR. Abnl-GT-β-cell failure was defined as Abnl-GT without IR. Beta-cell compensation was assessed by the Disposition Index (DI). Fasting lipids were measured. Visceral adipose tissue (VAT) volume was obtained with abdominal CT scan. RESULTS The prevalence of Abnl-GT was 37% (182/486). For participants with Abnl-GT, IR occurred in 38% (69/182) and β-cell failure in 62% (113/182). Compared with Africans with Abnl-GT-IR, Africans with Abnl-GT-β-cell failure had lower body mass index (BMI) (30.8±4.3 vs 27.4±4.0 kg/m2), a lower prevalence of obesity (52% vs 19%), less VAT (163±72 vs 107±63 cm2), lower triglyceride (1.21±0.60 vs 0.85±0.42 mmol/L) and lower FPG (5.9±1.4 vs 5.3±0.6 mmol/L) and 2-hour glucose concentrations (10.0±3.1 vs 9.0±1.9 mmol/L) (all p<0.001) and higher DI, high-density lipoprotein (HDL), low-density lipoprotein particle size and HDL particle size (all p<0.01). Analyses with Matsuda Index and HOMA-IR yielded similar results. Potential confounders such as income, education, alcohol and fiber intake did not differ by group. CONCLUSIONS Beta-cell failure occurred in two-thirds of participants with Abnl-GT and may be a more frequent determinant of Abnl-GT in Africans than IR. As BMI category, degree of glycemia and lipid profile appeared more favorable when Abnl-GT was due to β-cell failure rather than IR, the clinical course and optimal interventions may differ. TRIAL REGISTRATION NUMBER NCT00001853.
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Affiliation(s)
| | | | - Elyssa M Shoup
- NIDDK, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Thomas Hormenu
- NIDDK, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Hadi Bagheri
- Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | | | | | - Joon Ha
- NIDDK, National Institutes of Health, Bethesda, Maryland, USA
| | - Arthur Sherman
- NIDDK, National Institutes of Health, Bethesda, Maryland, USA
| | - Anne E Sumner
- NIDDK, National Institutes of Health, Bethesda, Maryland, USA
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24
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Zouiouich S, Loftfield E, Huybrechts I, Viallon V, Louca P, Vogtmann E, Wells PM, Steves CJ, Herzig KH, Menni C, Jarvelin MR, Sinha R, Gunter MJ. Markers of metabolic health and gut microbiome diversity: findings from two population-based cohort studies. Diabetologia 2021; 64:1749-1759. [PMID: 34110438 PMCID: PMC8245388 DOI: 10.1007/s00125-021-05464-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 03/08/2021] [Indexed: 12/17/2022]
Abstract
AIMS/HYPOTHESIS The gut microbiome is hypothesised to be related to insulin resistance and other metabolic variables. However, data from population-based studies are limited. We investigated associations between serologic measures of metabolic health and the gut microbiome in the Northern Finland Birth Cohort 1966 (NFBC1966) and the TwinsUK cohort. METHODS Among 506 individuals from the NFBC1966 with available faecal microbiome (16S rRNA gene sequence) data, we estimated associations between gut microbiome diversity metrics and serologic levels of HOMA for insulin resistance (HOMA-IR), HbA1c and C-reactive protein (CRP) using multivariable linear regression models adjusted for sex, smoking status and BMI. Associations between gut microbiome diversity measures and HOMA-IR and CRP were replicated in 1140 adult participants from TwinsUK, with available faecal microbiome (16S rRNA gene sequence) data. For both cohorts, we used general linear models with a quasi-Poisson distribution and Microbiome Regression-based Kernel Association Test (MiRKAT) to estimate associations of metabolic variables with alpha- and beta diversity metrics, respectively, and generalised additive models for location scale and shape (GAMLSS) fitted with the zero-inflated beta distribution to identify taxa associated with the metabolic markers. RESULTS In NFBC1966, alpha diversity was lower in individuals with higher HOMA-IR with a mean of 74.4 (95% CI 70.7, 78.3) amplicon sequence variants (ASVs) for the first quartile of HOMA-IR and 66.6 (95% CI 62.9, 70.4) for the fourth quartile of HOMA-IR. Alpha diversity was also lower with higher HbA1c (number of ASVs and Shannon's diversity, p < 0.001 and p = 0.003, respectively) and higher CRP (number of ASVs, p = 0.025), even after adjustment for BMI and other potential confounders. In TwinsUK, alpha diversity measures were also lower among participants with higher measures of HOMA-IR and CRP. When considering beta diversity measures, we found that microbial community profiles were associated with HOMA-IR in NFBC1966 and TwinsUK, using multivariate MiRKAT models, with binomial deviance dissimilarity p values of <0.001. In GAMLSS models, the relative abundances of individual genera Prevotella and Blautia were associated with HOMA-IR in both cohorts. CONCLUSIONS/INTERPRETATION Overall, higher levels of HOMA-IR, CRP and HbA1c were associated with lower microbiome diversity in both the NFBC1966 and TwinsUK cohorts, even after adjustment for BMI and other variables. These results from two distinct population-based cohorts provide evidence for an association between metabolic variables and gut microbial diversity. Further experimental and mechanistic insights are now needed to provide understanding of the potential causal mechanisms that may link the gut microbiota with metabolic health.
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Affiliation(s)
- Semi Zouiouich
- Section of Nutrition and Metabolism, International Agency for Research on Cancer-WHO, Lyon, France.
| | - Erikka Loftfield
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Inge Huybrechts
- Section of Nutrition and Metabolism, International Agency for Research on Cancer-WHO, Lyon, France
| | - Vivian Viallon
- Section of Nutrition and Metabolism, International Agency for Research on Cancer-WHO, Lyon, France
| | | | - Emily Vogtmann
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | | | - Claire J Steves
- Department of Twin Research, King's College London, London, UK
| | - Karl-Heinz Herzig
- Research Unit of Biomedicine, Medical Research Center (MRC), University of Oulu, University Hospital, Oulu, Finland
- Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland
| | - Cristina Menni
- Department of Twin Research, King's College London, London, UK
| | - Marjo-Riitta Jarvelin
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Unit of Primary Health Care, Oulu University Hospital, OYS, Oulu, Finland
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, UK
| | - Rashmi Sinha
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer-WHO, Lyon, France
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25
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Rohner M, Heiz R, Feldhaus S, Bornstein SR. Hepatic-Metabolite-Based Intermittent Fasting Enables a Sustained Reduction in Insulin Resistance in Type 2 Diabetes and Metabolic Syndrome. Horm Metab Res 2021; 53:529-540. [PMID: 34192792 PMCID: PMC8360708 DOI: 10.1055/a-1510-8896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/12/2021] [Indexed: 11/03/2022]
Abstract
Insulin resistance is the hallmark of Type 2 Diabetes and is still an unmet medical need. Insulin resistance lies at the crossroads of non-alcoholic fatty liver disease, obesity, weight loss and exercise resistance, heart disease, stroke, depression, and brain health. Insulin resistance is purely nutrition related, with a typical molecular disease food intake pattern. The insulin resistant state is accessible by TyG as the appropriate surrogate marker, which is found to lead the personalized molecular hepatic nutrition system for highly efficient insulin resistance remission. Treating insulin resistance with a molecular nutrition-centered approach shifts the treatment paradigm of Type 2 Diabetes from management to cure. This allows remission within five months, with a high efficiency rate of 85%. With molecular intermittent fasting a very efficient treatment for prediabetes and metabolic syndrome is possible, improving the non-alcoholic fatty liver disease (NAFL) state and enabling the body to lose weight in a sustainable manner.
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Affiliation(s)
| | - Robert Heiz
- Zentrum für Komplementärmedizin AG, Uster,
Switzerland
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26
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Spires DR, Palygin O, Levchenko V, Isaeva E, Klemens CA, Khedr S, Nikolaienko O, Kriegel A, Cheng X, Yeo JY, Joe B, Staruschenko A. Sexual dimorphism in the progression of type 2 diabetic kidney disease in T2DN rats. Physiol Genomics 2021; 53:223-234. [PMID: 33870721 PMCID: PMC8285576 DOI: 10.1152/physiolgenomics.00009.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/05/2021] [Accepted: 04/14/2021] [Indexed: 12/14/2022] Open
Abstract
Diabetic kidney disease (DKD) is a common complication of diabetes, which frequently leads to end-stage renal failure and increases cardiovascular disease risk. Hyperglycemia promotes renal pathologies such as glomerulosclerosis, tubular hypertrophy, microalbuminuria, and a decline in glomerular filtration rate. Importantly, recent clinical data have demonstrated distinct sexual dimorphism in the pathogenesis of DKD in people with diabetes, which impacts both severity- and age-related risk factors. This study aimed to define sexual dimorphism and renal function in a nonobese type 2 diabetes model with the spontaneous development of advanced diabetic nephropathy (T2DN rats). T2DN rats at 12- and over 48-wk old were used to define disease progression and kidney injury development. We found impaired glucose tolerance and glomerular hyperfiltration in T2DN rats to compare with nondiabetic Wistar control. The T2DN rat displays a significant sexual dimorphism in insulin resistance, plasma cholesterol, renal and glomerular injury, urinary nephrin shedding, and albumin handling. Our results indicate that both male and female T2DN rats developed nonobese type 2 DKD phenotype, where the females had significant protection from the development of severe forms of DKD. Our findings provide further evidence for the T2DN rat strain's effectiveness for studying the multiple facets of DKD.
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Affiliation(s)
- Denisha R Spires
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Oleg Palygin
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Vladislav Levchenko
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Elena Isaeva
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Christine A Klemens
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Sherif Khedr
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Physiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Oksana Nikolaienko
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Alison Kriegel
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Xi Cheng
- Department of Physiology and Pharmacology, University of Toledo, Ohio
| | - Ji-Youn Yeo
- Department of Physiology and Pharmacology, University of Toledo, Ohio
| | - Bina Joe
- Department of Physiology and Pharmacology, University of Toledo, Ohio
| | - Alexander Staruschenko
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin
- Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin
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27
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Galaviz KI, Schneider MF, Tien PC, Althoff KN, Ali MK, Ofotokun I, Brown TT. Expanding the Finnish Diabetes Risk Score for Predicting Diabetes Incidence in People Living with HIV. AIDS Res Hum Retroviruses 2021; 37:373-379. [PMID: 33683149 DOI: 10.1089/aid.2020.0247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study investigated whether the predictive ability of the Finnish Diabetes Risk Score (FINDRISC) can be improved among people with HIV by adding a marker of insulin resistance. In this longitudinal analysis of the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study, HIV-positive and HIV-negative participants without prevalent diabetes were included. FINDRISC score and the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) were calculated at baseline. Cox proportional hazards models were used to examine associations between baseline risk scores and time to incident diabetes (first self-report of diabetes medication use). Model discrimination (Uno's c-statistic) and calibration (observed vs. cumulative probability of diabetes) were assessed for FINDRISC, HOMA-IR, and combined FINDRISC and HOMA-IR. Overall, 2,527 men (1,299 HIV-positive and 1,228 HIV-negative, median age = 44) and 2,446 women (1,841 HIV-positive and 605 HIV-negative, median age = 41) were included. Over 47,040 person-years of follow-up, diabetes incidence rates per 1,000 person-years were 9.5 in HIV-positive men, 7.1 in HIV-negative men, 14.5 in HIV-positive women, and 15.1 in HIV-negative women. FINDRISC discrimination (HIV-positive men c = 0.64 [0.55, 0.74], HIV-negative men c = 0.74 [0.68, 0.79], HIV-positive women c = 0.68 [0.64, 0.71], and HIV-negative women c = 0.73 [0.66, 0.79]) was significantly better than that of HOMA-IR. FINDRISC was better calibrated than HOMA-IR in each of the four groups. Adding HOMA-IR did not improve FINDRISC discrimination/calibration. Diabetes risk prediction with FINDRISC was suboptimal in men and women with HIV, and its performance was not improved with addition of HOMA-IR. The optimal method for identifying people living with HIV at-risk for diabetes is yet to be identified.
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Affiliation(s)
| | - Michael F. Schneider
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Phyllis C. Tien
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Keri N. Althoff
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Mohammed K. Ali
- Department of Family and Precentive Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Igho Ofotokun
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Todd T. Brown
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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28
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Owei I, Umekwe N, Stentz F, Wan J, Dagogo-Jack S. Association of plasma acylcarnitines with insulin sensitivity, insulin secretion, and prediabetes in a biracial cohort. Exp Biol Med (Maywood) 2021; 246:1698-1705. [PMID: 33926260 DOI: 10.1177/15353702211009493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The ability to predict prediabetes, which affects ∼90 million adults in the US and ∼400 million adults worldwide, would be valuable to public health. Acylcarnitines, fatty acid metabolites, have been associated with type 2 diabetes risk in cross-sectional studies of mostly Caucasian subjects, but prospective studies on their link to prediabetes in diverse populations are lacking. Here, we determined the association of plasma acylcarnitines with incident prediabetes in African Americans and European Americans enrolled in a prospective study. We analyzed 45 acylcarnitines in baseline plasma samples from 70 adults (35 African-American, 35 European-American) with incident prediabetes (progressors) and 70 matched controls (non-progressors) during 5.5-year (mean 2.6 years) follow-up in the Pathobiology of Prediabetes in a Biracial Cohort (POP-ABC) study. Incident prediabetes (impaired fasting glucose/impaired glucose tolerance) was confirmed with OGTT. We measured acylcarnitines using tandem mass spectrometry, insulin sensitivity by hyperinsulinemic euglycemic clamp, and insulin secretion using intravenous glucose tolerance test. The results showed that progressors and non-progressors during POP-ABC study follow-up were concordant for 36 acylcarnitines and discordant for nine others. In logistic regression models, beta-hydroxy butyryl carnitine (C4-OH), 3-hydroxy-isovaleryl carnitine/malonyl carnitine (C5-OH/C3-DC), and octenoyl carnitine (C8:1) were the only significant predictors of incident prediabetes. The combined cut-off plasma levels of <0.03 micromol/L for C4-OH, <0.03 micromol/L for C5-OH/C3-DC, and >0.25 micromol/L for C8:1 acylcarnitines predicted incident prediabetes with 81.9% sensitivity and 65.2% specificity. Thus, circulating levels of one medium-chain and two short-chain acylcarnitines may be sensitive biomarkers for the risk of incident prediabetes among initially normoglycemic individuals with parental history of type 2 diabetes.
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Affiliation(s)
- Ibiye Owei
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Nkiru Umekwe
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Frankie Stentz
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Jim Wan
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Sam Dagogo-Jack
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, USA
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29
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Gubbi S, Muniyappa R, Sharma ST, Grewal S, McGlotten R, Nieman LK. Mifepristone Improves Adipose Tissue Insulin Sensitivity in Insulin Resistant Individuals. J Clin Endocrinol Metab 2021; 106:1501-1515. [PMID: 33507248 PMCID: PMC8063260 DOI: 10.1210/clinem/dgab046] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Increased tissue cortisol availability has been implicated in abnormal glucose and fat metabolism in patients with obesity, metabolic syndrome, and type 2 diabetes (T2DM). Our objective was to evaluate whether blockade of glucocorticoid receptor (GR) with mifepristone ameliorates insulin resistance (IR) in overweight/obese subjects with glucose intolerance. METHODS We conducted a randomized, double-blinded, placebo-controlled, crossover study in overweight/obese individuals (n = 16, 44% female) with prediabetes or mild T2DM but not clinical hypercortisolism. Mifepristone (50 mg every 6 h) or placebo was administered for 9 days, followed by crossover to the other treatment arm after a washout period of 6 to 8weeks. At baseline and following each treatment, oral glucose tolerance test (OGTT) and frequently sampled intravenous glucose tolerance test (FSIVGTT) were performed. Insulin sensitivity was measured using FSIVGTT [primary outcome: insulin sensitivity index (SI)] and OGTT [Matsuda index (MI) and oral glucose insulin sensitivity index (OGIS)]. Hepatic and adipose insulin resistance were assessed using hepatic insulin resistance index (HIRI), and adipose tissue insulin sensitivity index (Adipo-SI) and adipo-IR, derived from the FSIVGTT. RESULTS Mifepristone administration did not alter whole-body glucose disposal indices of insulin sensitivity (SI, MI, and OGIS). GR blockade significantly improved Adipo-SI (61.7 ± 32.9 vs 42.8 ± 23.9; P = 0.002) and reduced adipo-IR (49.9 ± 45.9 vs 65.5 ± 43.8; P = 0.004), and HIRI (50.2 ± 38.7 vs 70.0 ± 44.3; P = 0.08). Mifepristone increased insulin clearance but did not affect insulin secretion or β-cell glucose sensitivity. CONCLUSION Short-term mifepristone administration improves adipose and hepatic insulin sensitivity among obese individuals with hyperglycemia without hypercortisolism.
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Affiliation(s)
- Sriram Gubbi
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Ranganath Muniyappa
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Susmeeta T Sharma
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
- MedStar Washington Hospital Center, Washington, DC, USA
| | - Shivraj Grewal
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Raven McGlotten
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Lynnette K Nieman
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
- Correspondence: Lynnette K. Nieman, M.D., 10 Center Drive, Building 10, CRC, Rm 1-3140, Bethesda, MD 20892-1613.
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30
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Won YB, Seo SK, Yun BH, Cho S, Choi YS, Lee BS. Non-alcoholic fatty liver disease in polycystic ovary syndrome women. Sci Rep 2021; 11:7085. [PMID: 33782517 PMCID: PMC8007604 DOI: 10.1038/s41598-021-86697-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/18/2021] [Indexed: 02/01/2023] Open
Abstract
To evaluate risk factors leading to non-alcoholic fatty liver disease (NAFLD) occurrence in polycystic ovarian syndrome (PCOS) women. A retrospective cohort study of a total of 586 women diagnosed with PCOS aged 13-35 years at the gynecology department at a university hospital was done to evaluate PCOS phenotype, metabolic syndrome (MetS) diagnosis, body composition, insulin sensitivity, sex hormones, lipid profile, liver function, and transient elastography (TE). In PCOS women with NAFLD compared to those without, MetS diagnosis (Hazard ratio [HR] 5.6, 95% Confidence interval [CI] 2.2-14.4, p < 0.01) and hyperandrogenism (HA) (HR 4.4, 95% CI 1.4-13.4, p = 0.01) were risk factors significantly associated with subsequent NAFLD occurrence, whereas 2-h insulin level in 75 g glucose tolerance test (GTT) (HR 1.2, 95% CI 0.5-2.5, p = 0.70) and body mass index (BMI) > 25 kg/m2 (HR 2.2, 95% CI 0.6-8.0, p = 0.24) was not. Among NAFLD patients who underwent TE, a higher number of MetS components indicated a worse degree of fibrosis and steatosis. MetS diagnosis and HA at PCOS diagnosis were risk factors associated with NAFLD, while 2-h insulin level in 75 g GTT and obesity were not. Although elevated aspartate aminotransferase levels were significant for NAFLD risk, liver enzyme elevations may not be present until late liver damage. Further prospective studies of PCOS women with MetS or HA are warranted to determine whether patients without liver enzyme elevations should undergo preemptive liver examinations.
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Affiliation(s)
- Young Bin Won
- grid.15444.300000 0004 0470 5454Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea ,grid.15444.300000 0004 0470 5454Institute of Women’s Life Science, Yonsei University College of Medicine, Seoul, Korea
| | - Seok Kyo Seo
- grid.15444.300000 0004 0470 5454Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea ,grid.15444.300000 0004 0470 5454Institute of Women’s Life Science, Yonsei University College of Medicine, Seoul, Korea
| | - Bo Hyon Yun
- grid.15444.300000 0004 0470 5454Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea ,grid.15444.300000 0004 0470 5454Institute of Women’s Life Science, Yonsei University College of Medicine, Seoul, Korea
| | - SiHyun Cho
- grid.15444.300000 0004 0470 5454Institute of Women’s Life Science, Yonsei University College of Medicine, Seoul, Korea ,grid.15444.300000 0004 0470 5454Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Sik Choi
- grid.15444.300000 0004 0470 5454Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea ,grid.15444.300000 0004 0470 5454Institute of Women’s Life Science, Yonsei University College of Medicine, Seoul, Korea
| | - Byung Seok Lee
- grid.15444.300000 0004 0470 5454Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
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Tranæs K, Ding C, Chooi YC, Chan Z, Choo J, Leow MKS, Magkos F. Dissociation Between Insulin Resistance and Abnormalities in Lipoprotein Particle Concentrations and Sizes in Normal-Weight Chinese Adults. Front Nutr 2021; 8:651199. [PMID: 33718425 PMCID: PMC7952320 DOI: 10.3389/fnut.2021.651199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 02/09/2021] [Indexed: 11/25/2022] Open
Abstract
Insulin resistance in obesity coincides with abnormalities in lipid profile and lipoprotein subclass distribution and size even before abnormalities in glucose homeostasis manifest. We aimed to assess this relationship in the absence of obesity. Insulin sensitivity (3-h intravenous glucose tolerance test and minimal modeling) and lipoprotein particle concentrations and sizes (proton nuclear magnetic resonance spectroscopy) were evaluated in 15 insulin-resistant and 15 insulin-sensitive lean Asians of Chinese descent with normal glucose tolerance, matched on age, sex, and body mass index. Despite a ~50% lower insulin sensitivity index (Si) in insulin-resistant than in insulin-sensitive subjects, which was accompanied by significantly greater acute insulin response to glucose (AIRg) and fasting insulin concentration but not different fasting glucose concentration, there were no significant differences between groups in the blood lipid profile (p ≥ 0.44) or the lipoprotein subclass concentrations (p ≥ 0.30) and particle sizes (p ≥ 0.43). We conclude that, contrary to observations in subjects with obesity, insulin resistance is not accompanied by unfavorable changes in the plasma lipid profile and lipoprotein particle concentrations and sizes in lean Asians with normal glucose tolerance. Therefore, insulin resistance at the level of glucose metabolism is mechanistically or temporally dissociated from lipid and lipoprotein metabolism. Trial Registration:clinicaltrials.gov, NCT03264001.
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Affiliation(s)
- Kaare Tranæs
- Section for Obesity Research, Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Cherlyn Ding
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR) and National University Health System, Singapore, Singapore
| | - Yu Chung Chooi
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR) and National University Health System, Singapore, Singapore
| | - Zhiling Chan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR) and National University Health System, Singapore, Singapore
| | - John Choo
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR) and National University Health System, Singapore, Singapore
| | - Melvin K-S Leow
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR) and National University Health System, Singapore, Singapore.,Department of Endocrinology, Tan Tock Seng Hospital, Singapore, Singapore.,Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Faidon Magkos
- Section for Obesity Research, Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR) and National University Health System, Singapore, Singapore
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Al Hommos NA, Ebenibo S, Edeoga C, Dagogo-Jack S. Trajectories of Body Weight and Fat Mass in Relation to Incident Prediabetes in a Biracial Cohort of Free-Living Adults. J Endocr Soc 2021; 5:bvaa164. [PMID: 33381668 PMCID: PMC7750996 DOI: 10.1210/jendso/bvaa164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Indexed: 11/19/2022] Open
Abstract
Objectives Obesity is a risk factor for type 2 diabetes (T2D), but prospective data relating adiposity measures to incident prediabetes are scant. Methods The Pathobiology of Prediabetes in A Biracial Cohort study followed normoglycemic African Americans (AA) and European Americans (EA) with parental history of T2D for the primary outcome of incident prediabetes (impaired fasting glucose and/or impaired glucose tolerance) for 5.5 years. Serial assessments included anthropometry and body fat composition. We analyzed weight, body mass index (BMI), waist, total, and abdominal fat mass in relation to incident prediabetes risk. Results Of the 376 subjects enrolled (217 AA, 159 EA; mean age 44.2 years, BMI 31.4 kg/m2), 343 (192 AA, 151 EA) had evaluable follow-up data. A total of 101 (52 AA, 49 EA) developed prediabetes during follow-up. Progressors to prediabetes had a mean baseline weight of 90.0 ± 20.4 kg versus 82.9 ± 21.7 kg among nonprogressors (P = 0.0036). During 5.5 (mean 2.62) years of follow-up, the weight change among nonprogressors was 0.63 ± 6.11 kg compared with 2.54 ± 6.91 kg among progressors (ANOVA P = 0.0072). Progressors also showed greater increases in total fat (P = 0.0015) and trunk fat (P = 0.0005) mass than nonprogressors. Adjusted for age and sex, the significant predictors of incident prediabetes were BMI (P = 0.0013), waist (P < 0.0001), total fat (P = 0.0025), and trunk fat (P < 0.0001) mass. Conclusions Among obese free-living offspring of parents with T2D, long-term normoglycemic status was associated with a weight gain of ~0.2 kg/y, whereas progression to prediabetes was associated with a weight gain of ~1 kg/y.
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Affiliation(s)
- Nisreen Abu Al Hommos
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Sotonte Ebenibo
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Chimaroke Edeoga
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Sam Dagogo-Jack
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN, USA.,General Clinical Research Center, University of Tennessee Health Science Center, Memphis, TN, USA
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Diboun I, Al-Mansoori L, Al-Jaber H, Albagha O, Elrayess MA. Metabolomics of Lean/Overweight Insulin-Resistant Females Reveals Alterations in Steroids and Fatty Acids. J Clin Endocrinol Metab 2021; 106:e638-e649. [PMID: 33053159 DOI: 10.1210/clinem/dgaa732] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/08/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND The global diabetes epidemic is largely attributed to obesity-triggered metabolic syndrome. However, the impact of insulin resistance (IR) prior to obesity on the high prevalence of diabetes and the molecular mediators remain largely unknown. This study aims to compare the metabolic profiling of apparently healthy lean/overweight participants with IR and insulin sensitivity (IS), and identify the metabolic pathways underlying IR. METHODS In this cross-sectional study, clinical and metabolic data for 200 seemingly healthy young female participants (100 IR and 100 IS) was collected from Qatar Biobank. Orthogonal partial least square analysis was performed to assess the extent of separation between individuals from the 2 groups based on measured metabolites. Classical linear models were used to identify the metabolic signature of IR, followed by elastic-net-regularized generalized linear model (GLMNET) and receiver operating characteristic (ROC) analysis to determine top metabolites associated with IR. RESULTS Compared to lean/overweight participants with IS, those with IR showed increased androgenic steroids, including androsterone glucuronide, in addition to various microbiota byproducts, such as the phenylalanine derivative carboxyethylphenylalanine. On the other hand, participants with IS had elevated levels of long-chain fatty acids. A ROC analysis suggested better discriminatory performance using 20 metabolites selected by GLMNET in comparison to the classical clinical traits (area under curve: 0.93 vs 0.73, respectively). CONCLUSION Our data confirm the multifactorial mechanism of IR with a diverse spectrum of emerging potential biomarkers, including steroids, long-chain fatty acids, and microbiota metabolites. Further studies are warranted to validate these markers for diagnostic and therapeutic applications.
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Affiliation(s)
- Ilhame Diboun
- College of Health and Life Sciences, Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | | | - Hend Al-Jaber
- Biomedical Research Center (BRC), Qatar University, Doha, Qatar
| | - Omar Albagha
- College of Health and Life Sciences, Hamad Bin Khalifa University (HBKU), Doha, Qatar
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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: 46] [Impact Index Per Article: 15.3] [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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Hashemipour S, Ghorbani A, Khashayar A, Olfati H. Association of sleep quality with insulin resistance in obese or overweight subjects. Sleep Sci 2021; 14:75-78. [PMID: 34917277 PMCID: PMC8663725 DOI: 10.5935/1984-0063.20200084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 11/13/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction Obesity or overweight are two factors associated with insulin resistance (IR). There are limited studies with regard to the role of some non-traditional factors such as sleep quality in level of IR in obese individuals. The current study aimed at investigating the association of sleep quality with IR in overweight or obese people. Material and Methods In this cross-sectional study, 612 obese or overweight participants of the Qazvin metabolic disease study (QMDS) were evaluated. Sleep quality was measured using the Pittsburgh sleep quality index (PSQI) and compared between two groups of participants with and without IR. Results Our findings showed that the total score of sleep quality in the IR group was significantly lower than that in the non-insulin resistant group (8.78±2.78 vs. 8.13±2.70, p=0.008). After adjustment, each unit increase of the sleep latency and subjective sleep quality scores was associated with a 1.23 and 1.33 times increased risk of IR, respectively (p<0.05). Conclusion In the obese or overweight people, sleep quality is associated with IR.
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Affiliation(s)
- Sima Hashemipour
- Associate Professor of Endocrinology. Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Azam Ghorbani
- Instructor of Nursing, Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Atoosa Khashayar
- General Practitioner, Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Hamideh Olfati
- Internist, Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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The NLRP3 inflammasome regulates adipose tissue metabolism. Biochem J 2020; 477:1089-1107. [PMID: 32202638 DOI: 10.1042/bcj20190472] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 12/27/2022]
Abstract
Adipose tissue regulates metabolic homeostasis by participating in endocrine and immune responses in addition to storing and releasing lipids from adipocytes. Obesity skews adipose tissue adipokine responses and degrades the coordination of adipocyte lipogenesis and lipolysis. These defects in adipose tissue metabolism can promote ectopic lipid deposition and inflammation in insulin-sensitive tissues such as skeletal muscle and liver. Sustained caloric excess can expand white adipose tissue to a point of maladaptation exacerbating both local and systemic inflammation. Multiple sources, instigators and propagators of adipose tissue inflammation occur during obesity. Cross-talk between professional immune cells (i.e. macrophages) and metabolic cells (i.e. adipocytes) promote adipose tissue inflammation during metabolic stress (i.e. metaflammation). Metabolic stress and endogenous danger signals can engage pathogen recognition receptors (PRRs) of the innate immune system thereby activating pro-inflammatory and stress pathways in adipose tissue. The Nod-like receptor protein 3 (NLRP3) inflammasome can act as a metabolic danger sensor to a wide range of pathogen- and damage-associated molecular patterns (PAMPs and DAMPs). Activation of the NLRP3 inflammasome facilitates caspase-1 dependent production of the pro-inflammatory cytokines IL-1β and IL-18. Activation of the NLRP3 inflammasome can promote inflammation and pyroptotic cell death, but caspase-1 is also involved in adipogenesis. This review discusses the role of the NLRP3 inflammasome in adipose tissue immunometabolism responses relevant to metabolic disease. Understanding the potential sources of NLRP3 activation and consequences of NLRP3 effectors may reveal therapeutic opportunities to break or fine-tune the connection between metabolism and inflammation in adipose tissue during obesity.
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James D, Umekwe N, Edeoga C, Nyenwe E, Dagogo-Jack S. Multi-year reproducibility of hyperinsulinemic euglycemic clamp-derived insulin sensitivity in free-living adults: Association with incident prediabetes in the POP-ABC study. Metabolism 2020; 109:154263. [PMID: 32445642 PMCID: PMC7387175 DOI: 10.1016/j.metabol.2020.154263] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/15/2020] [Accepted: 05/16/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The hyperinsulinemic euglycemic clamp (HEC) is the "gold standard" for measuring insulin sensitivity (Si-clamp). Here, we determined the reproducibility of serial HEC data in healthy subjects. RESEARCH DESIGN AND METHODS The Pathobiology of Prediabetes in A Biracial Cohort study assessed incident prediabetes in healthy African Americans (AA) and European Americans (EA) with parental type 2 diabetes mellitus during 5.5 years of follow-up. Assessments included anthropometry, OGTT, and HEC. Ninety subjects (44 AA, 46 EA) who underwent Year-1HEC consented to Year-3 HEC. We calculated coefficients of variation (CVs), 95% limits of agreement, and repeatability coefficients for Year-1 and Year-3 data, and assessed the association of change in Si-clamp with incident prediabetes. RESULTS The mean (SD) baseline age was 47.5 ± 8.13y, body mass index was 30.4 ± 9.16 kg/m2, fasting plasma glucose was 93.7 ± 7.82 mg/dL and 2-hrPG was 126 ± 26.8 mg/dL. Si-clamp (umol/kg/min·pmol/L-1) was 0.071 ± 0.04 in Year 1 and 0.067 ± 0.04 in Year 3 (P = 0.22). Year 1 and Year 3 values were strongly correlated (r = 0.81, P < 0.0001); the CV was 13.6% and repeatability coefficient was ±0.025. Intrasubject differences in serial Si-clamp were less than the repeatability coefficients and within the 95% limits of agreement. After 5.5 years of follow-up, 40 subjects progressed to prediabetes and 50 were nonprogressors. The change in Si-clamp was greater in progressors than nonprogressors (-10% vs. -2.5%, P = 0.02). CONCLUSIONS The HEC is reproducible over ~2 years in free-living individuals, with a temporal decline in Si-clamp that predicts prediabetes risk.
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Affiliation(s)
- Deirdre James
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Nkiru Umekwe
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Chimaroke Edeoga
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Ebenezer Nyenwe
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Sam Dagogo-Jack
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
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Elrayess MA, Rizk NM, Fadel AS, Kerkadi A. Prevalence and Predictors of Insulin Resistance in Non-Obese Healthy Young Females in Qatar. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145088. [PMID: 32679640 PMCID: PMC7399794 DOI: 10.3390/ijerph17145088] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 02/23/2020] [Accepted: 02/24/2020] [Indexed: 12/18/2022]
Abstract
The state of Qatar suffers from diabetes epidemic due to obesity-associated metabolic syndrome. However, the prevalence of insulin resistance prior to obesity, which could play an important role in the high prevalence of diabetes, has not yet been described. This study aims to compare the prevalence of insulin resistance in apparently healthy non-obese and obese participants from Qatar and identify the predictors of insulin resistance in different body mass index (BMI)-groups. In this cross-sectional study, 150 young healthy females from Qatar were dichotomized into four groups (underweight, normal weight, overweight and obese) based on their BMI. Anthropometric measures as well as fasting plasma levels of lipids, adipokines, blood glucose and insulin were recorded. The prevalence of insulin resistance as per homeostatic model assessment of insulin resistance (HOMA-IR) was estimated and differences between insulin sensitive and insulin resistant were compared. Linear models were used to identify predictors of insulin resistance in every BMI group. Prevalence of insulin resistance in non-obese healthy females from Qatar ranges between 7% and 37% and increases with BMI. Overall, predictors of insulin resistance in the Qatari population are triglycerides/high-density lipoprotein (HDL) ratio and free fat mass but vary according to the BMI group. The main predictors were triglycerides in normal weight, triglycerides/HDL in overweight and triglycerides/HDL and interleukin-6 (IL-6) in obese individuals. The high prevalence of insulin resistance in non-obese Qataris may partially explain diabetes epidemic. Larger studies are warranted to confirm these findings and identify underlying causes for insulin resistance in non-obese individuals in Qatar, aiming at targeted intervention before diabetes onset.
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Affiliation(s)
- Mohamed A. Elrayess
- Biomedical Research Center, Qatar University, Doha 2713, Qatar
- Correspondence: (M.A.E.); (A.K.)
| | - Nasser M. Rizk
- Department of Biomedical Science, College of Health Sciences, QU-Health, Qatar University, Doha 2713, Qatar; (N.M.R.); (A.S.F.)
- Physiology Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Amina S. Fadel
- Department of Biomedical Science, College of Health Sciences, QU-Health, Qatar University, Doha 2713, Qatar; (N.M.R.); (A.S.F.)
| | - Abdelhamid Kerkadi
- Human Nutrition Department, College of Health Science, QU-Health, Qatar University, Doha 2713, Qatar
- Correspondence: (M.A.E.); (A.K.)
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Silveira EA, de Souza Rosa LP, de Carvalho Santos ASEA, de Souza Cardoso CK, Noll M. Type 2 Diabetes Mellitus in Class II and III Obesity: Prevalence, Associated Factors, and Correlation between Glycemic Parameters and Body Mass Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3930. [PMID: 32498226 PMCID: PMC7312992 DOI: 10.3390/ijerph17113930] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/24/2020] [Accepted: 05/27/2020] [Indexed: 12/20/2022]
Abstract
Despite the worldwide growth of class II and III obesity, the factors associated with type 2 diabetes mellitus (T2DM) in these obese individuals are not widely understood. Moreover, no study has investigated these associations in South America. Our study aimed to investigate the prevalence of T2DM and its associated factors, with an emphasis on biochemical parameters and eating habits, in class II and III obese individuals. We also aimed to analyze the correlation between glycemic parameters and body mass index (BMI). Baseline data from a randomized clinical trial (DieTBra Trial) of 150 class II and III obese individuals (BMI > 35 kg/m2) was used. An accelerometer, Food Frequency Questionnaire, and bioimpedance analysis were used to assess physical activity levels, eating habits, and body composition, respectively. Blood was collected after 12 h of fasting. Hierarchical multivariate Poisson regression was performed, and prevalence ratios (PRs) were calculated. Correlations between glycemic parameters (fasting blood glucose, glycosylated hemoglobin, homeostasis model assessment of insulin resistance (HOMA-IR), and insulin) and BMI were also analyzed. The prevalence of T2DM was 40.0% (95% CI, 32.1-48.3), high fasting blood glucose level was 19.33% (95% CI, 13.3-26.6), and high glycosylated hemoglobin was 32.67% (95% CI, 25.2-40.8). Age ≥ 50 years (PR = 3.17, 95% CI, 1.26-7.98) was significantly associated with T2DM; there was a positive linear trend between age and T2DM (p = 0.011). Multivariate analysis showed an association with educational level (PR = 1.49, 1.07-2.09, p = 0.018), nonconsumption of whole grains daily (PR = 1.67, 1.00-2.80, p = 0.049), and high HOMA-IR (PR = 1.54, 1.08-2.18, p = 0.016). We found a high prevalence of T2DM and no significant correlations between BMI and glycemic parameters.
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Affiliation(s)
- Erika Aparecida Silveira
- Post-Graduate Program in Health Sciences, School of Medicine, Federal University of Goiás, Goiás 74605-050, Brazil; (L.P.d.S.R.); (A.S.e.A.d.C.S.); (C.K.d.S.C.); (M.N.)
| | - Lorena Pereira de Souza Rosa
- Post-Graduate Program in Health Sciences, School of Medicine, Federal University of Goiás, Goiás 74605-050, Brazil; (L.P.d.S.R.); (A.S.e.A.d.C.S.); (C.K.d.S.C.); (M.N.)
- Federal Institute of Goiás, Goiânia Oeste Campus, Goiás 74270-040, Brazil
| | - Annelisa Silva e Alves de Carvalho Santos
- Post-Graduate Program in Health Sciences, School of Medicine, Federal University of Goiás, Goiás 74605-050, Brazil; (L.P.d.S.R.); (A.S.e.A.d.C.S.); (C.K.d.S.C.); (M.N.)
- United College of Campinas, Goiás 74535-040, Brazil
| | - Camila Kellen de Souza Cardoso
- Post-Graduate Program in Health Sciences, School of Medicine, Federal University of Goiás, Goiás 74605-050, Brazil; (L.P.d.S.R.); (A.S.e.A.d.C.S.); (C.K.d.S.C.); (M.N.)
- Nutrition Course, School of Social and Health Sciences, Pontifical Catholic University of Goiás, Goiás 74605-010, Brazil
| | - Matias Noll
- Post-Graduate Program in Health Sciences, School of Medicine, Federal University of Goiás, Goiás 74605-050, Brazil; (L.P.d.S.R.); (A.S.e.A.d.C.S.); (C.K.d.S.C.); (M.N.)
- Instituto Federal Goiano, Ceres Campus, Goiás 76310-000, Brazil
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Hjelmgren O, Gummesson A, Bergström G, Schmidt C. Beta-Cell Function, Self-rated Health, and Lifestyle Habits in 64-Year-Old Swedish Women with Metabolically Healthy Obesity Phenotype. J Obes Metab Syndr 2020; 29:39-46. [PMID: 32200605 PMCID: PMC7117998 DOI: 10.7570/jomes19078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/08/2020] [Accepted: 02/29/2020] [Indexed: 01/11/2023] Open
Abstract
Background A subset of obese individuals do not present metabolic abnormalities that commonly define the metabolic syndrome (MetS). This is referred to as a metabolically healthy obese (MHO) phenotype. The aim of the present study was to evaluate the prevalence of the MHO phenotype and its relationship with beta cell dysfunction by measuring C-peptide and proinsulin, anthropometric-, metabolic- and lipid appearance, as well as lifestyle behaviors and self-rated health in a cohort of 64-year-old Swedish women. Methods The National Cholesterol Education Program definition was used to assess MetS. We defined normal weight as body mass index (BMI) 18.5–24.9 kg/m2 and obesity as BMI ≥30 kg/m2 to categorize participants as metabolically healthy normal weight, MHO, and metabolically unhealthy obese. Results The MHO phenotype represented 36.3% of obese participants and 16.3% of total participants. The MHO group were at greater risk of having proinsulin levels >11 pmol/L, indicating impaired beta cell function. Further, homeostatic model assessment for insulin resistance, fasting plasma levels of insulin, and C-peptide showed significant trends, with the MHO phenotype group having intermediate levels among three groups. Health behaviors such as leisure time physical activity and alcohol intake were also intermediate in individuals with the MHO phenotype. Conclusion In this study, we demonstrate that over a third of the obese women in our sample were MHO. Further, women with the MHO phenotype showed intermediate profiles considering beta cell function and insulin resistance, as well as metabolic variables, and tended to rate their general health as worse than otherwise similar individuals of normal weight.
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Affiliation(s)
- Ola Hjelmgren
- Department of Clinical Physiology, Institution of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, Göteborg, Sweden
| | - Anders Gummesson
- Department of Molecular and Clinical Medicine, Institution of Medicine, Sahlgrenska Academy at Gothenburg University, Göteborg, Sweden
| | - Göran Bergström
- Department of Clinical Physiology, Institution of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, Göteborg, Sweden.,Department of Molecular and Clinical Medicine, Institution of Medicine, Sahlgrenska Academy at Gothenburg University, Göteborg, Sweden
| | - Caroline Schmidt
- Department of Molecular and Clinical Medicine, Institution of Medicine, Sahlgrenska Academy at Gothenburg University, Göteborg, Sweden
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The Metabolic Syndrome: Emerging Novel Insights Regarding the Relationship between the Homeostasis Model Assessment of Insulin Resistance and other Key Predictive Markers in Young Adults of Western Algeria. Nutrients 2020; 12:nu12030727. [PMID: 32164195 PMCID: PMC7146633 DOI: 10.3390/nu12030727] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/07/2020] [Accepted: 03/08/2020] [Indexed: 12/16/2022] Open
Abstract
Several biological markers have been identified as risk factors for cardiovascular disease and are associated with increased risk of metabolic syndrome (MetS). This study provides a factual information on promising biomarkers that are associated with MetS and can aid in early detection and management of MetS in young adults of Western Algeria. We studied a total of one hundred subjects aged between thirty and forty years with MetS, in which anthropometric measurements, insulin resistance, C peptide and HbA1c, lipid profile, circulating adipokines and glucagon-like peptide-1 were measured by suitable methods, in comparison to two groups of control. MetS is closely linked to altered glucose homeostasis, the plasma insulin/glucose ratio; i.e., the insulinogenic index helps to estimate the level of insulin secretion and also for assessing β-cell function. The correlation between homeostasis model assessment insulin resistance index (HOMA-IR) and HbA1c, body mass index or plasma triglycerides yielded positive and significant values. Biomarkers with a known and predictable association with MetS can provide a means to detect those at risk and intervene as needed. This could significantly decrease the burden complications impose on patients and the healthcare system.
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Lee S, Lacy ME, Jankowich M, Correa A, Wu WC. Association between obesity phenotypes of insulin resistance and risk of type 2 diabetes in African Americans: The Jackson Heart Study. J Clin Transl Endocrinol 2020; 19:100210. [PMID: 31871895 PMCID: PMC6909037 DOI: 10.1016/j.jcte.2019.100210] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 11/05/2019] [Accepted: 11/18/2019] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To determine whether insulin resistance (IR) measured by homeostasis model of insulin resistance (HOMA-IR) can further stratify diabetes risk in African Americans (AAs) beyond obesity and identify obese, low risk and non-obese, high risk individuals. METHODS Using the Jackson Heart Study cohort, we categorized participants without diabetes into four phenotypes: non-obese/insulin-sensitive, non-obese/IR, obese/insulin-sensitive and obese/IR. Obesity was defined as BMI ≥ 30 or BMI 25-30 plus an increased waist circumference. IR was defined as HOMA-IR ≥ 2. We used modified Poisson regression models to estimate the incident risk-ratios (IRR) of diabetes across these phenotypes adjusting for potential confounders and HbA1c. RESULTS Among 3219 AAs without diabetes, 14.0% were non-obese/insulin-sensitive, 24.6% non-obese/IR, 6.2% obese/insulin-sensitive, and 55.3% obese/IR. The overall crude incidence rate of diabetes was 29.91 cases/1000 person-years. In fully-adjusted models, compared to the non-obese/insulin-sensitive group, the relative risk of diabetes was highest in obese/IR (IRR = 2.35; 95% CI: 1.53, 3.60), followed by non-obese/IR (IRR = 1.59; 95% CI: 1.02, 2.46), and non-significant for the obese/insulin-sensitive (IRR = 1.70; 95% CI: 0.97, 2.99) group. CONCLUSIONS HOMA-IR can further stratify diabetes risk in AA adults beyond obesity, identifying non-obese high-risk and lower-risk obese individuals. However, diabetes risk should still be carefully monitored in obese populations despite insulin sensitivity.
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Affiliation(s)
- Sean Lee
- Providence VA Medical Center, Alpert Medical School & School of Public Health at Brown University, United States
| | - Mary E. Lacy
- Department of Epidemiology and Biostatistics, University of California, San Francisco, United States
- Department of Epidemiology, University of Kentucky, United States
| | - Mathew Jankowich
- Providence VA Medical Center, Alpert Medical School & School of Public Health at Brown University, United States
| | - Adolfo Correa
- Departments of Medicine and Population Health Science, University of Mississippi Medical Center, United States
| | - Wen-Chih Wu
- Providence VA Medical Center, Alpert Medical School & School of Public Health at Brown University, United States
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Teh JL, Leong WQ, Tan YZ, So JBY, Kim G, Shabbir A. Effect of bariatric surgery on glycemic profiles in multiethnic obese nondiabetic Asians. Surg Obes Relat Dis 2020; 16:422-430. [PMID: 31954632 DOI: 10.1016/j.soard.2019.11.017] [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: 09/01/2019] [Revised: 10/29/2019] [Accepted: 11/24/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND The effect of bariatric surgery on improvement and remission of type 2 diabetes (T2D) is well studied. The effect of surgery on glycemic profiles of obese, but nondiabetic individuals is unknown. OBJECTIVES We aimed to study changes in glycemic indices in obese nondiabetics undergoing bariatric surgery and correlate fat mass loss with changes in glycemic profiles. SETTING University Hospital, Singapore. METHODS A prospective database of nonT2D patients who underwent bariatric surgery between April 2009 and December 2014 was analyzed. Changes in weight, fat mass, and glycemic profiles, including glycated hemoglobin, C-peptide levels, and the homeostasis model assessment of insulin resistance were studied at 1- and 3-year follow-up. RESULTS One hundred thirty-three nondiabetics underwent bariatric surgery in the study period. Twenty-nine (21.8%) patients were found to have impaired fasting glycemia. We observed reductions in mean fat mass from 47.4 ± 12.2 kg preoperatively to 27.8 ± 11.6 kg at 1 year. Despite mean fat mass regain to 33.9 ± 19.6 kg at 3 years, homeostasis model assessment of insulin resistance improved from severe insulin resistant state of >5.00 (7.13 ± 11.5) preoperatively to normal ranges of <3.00 (1.55 ± .91) at 3 years. CONCLUSION Bariatric surgery results in significant sustained weight loss in obese nondiabetics and normalizes glycated hemoglobin and homeostasis model assessment of insulin resistance after surgery. It is a promising modality to prevent or delay the onset of T2D in obese nondiabetic patients. Further studies should be conducted in nondiabetics to assess the efficacy of bariatric surgery in prevention of T2D onset in the longer term.
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Affiliation(s)
- Jun Liang Teh
- Department of Surgery, Jurong Health Campus, National University Health System, Singapore; Department of Surgery, National University Hospital, National University Health System, Singapore
| | - Wei Qi Leong
- Department of Surgery, National University Hospital, National University Health System, Singapore
| | - Ying Zhi Tan
- Department of Surgery, National University Hospital, National University Health System, Singapore
| | - Jimmy Bok-Yan So
- Department of Surgery, National University Hospital, National University Health System, Singapore; Department of Surgery, National University of Singapore, Singapore
| | - Guowei Kim
- Department of Surgery, National University Hospital, National University Health System, Singapore
| | - Asim Shabbir
- Department of Surgery, National University Hospital, National University Health System, Singapore.
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Al-Sulaiti H, Diboun I, Agha MV, Mohamed FFS, Atkin S, Dömling AS, Elrayess MA, Mazloum NA. Metabolic signature of obesity-associated insulin resistance and type 2 diabetes. J Transl Med 2019; 17:348. [PMID: 31640727 PMCID: PMC6805293 DOI: 10.1186/s12967-019-2096-8] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 10/11/2019] [Indexed: 12/17/2022] Open
Abstract
Background Obesity is associated with an increased risk of insulin resistance and type 2 diabetes mellitus (T2DM). However, some obese individuals maintain their insulin sensitivity and exhibit a lower risk of associated comorbidities. The underlying metabolic pathways differentiating obese insulin sensitive (OIS) and obese insulin resistant (OIR) individuals remain unclear. Methods In this study, 107 subjects underwent untargeted metabolomics of serum samples using the Metabolon platform. Thirty-two subjects were lean controls whilst 75 subjects were obese including 20 OIS, 41 OIR, and 14 T2DM individuals. Results Our results showed that phospholipid metabolites including choline, glycerophosphoethanolamine and glycerophosphorylcholine were significantly altered from OIS when compared with OIR and T2DM individuals. Furthermore, our data confirmed changes in metabolic markers of liver disease, vascular disease and T2DM, such as 3-hydroxymyristate, dimethylarginine and 1,5-anhydroglucitol, respectively. Conclusion This pilot data has identified phospholipid metabolites as potential novel biomarkers of obesity-associated insulin sensitivity and confirmed the association of known metabolites with increased risk of obesity-associated insulin resistance, with possible diagnostic and therapeutic applications. Further studies are warranted to confirm these associations in prospective cohorts and to investigate their functionality.
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Affiliation(s)
- Haya Al-Sulaiti
- Department of Drug Design, University of Groningen, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - Ilhame Diboun
- Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | | | | | - Stephen Atkin
- Weill Cornell Medicine-Qatar, Doha, Qatar.,Royal College of Surgeons, Ireland, Bahrain
| | - Alex S Dömling
- Department of Drug Design, University of Groningen, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands
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Owei I, Umekwe N, Stentz F, Wan J, Dagogo-Jack S. Amino acid signature predictive of incident prediabetes: A case-control study nested within the longitudinal pathobiology of prediabetes in a biracial cohort. Metabolism 2019; 98:76-83. [PMID: 31228482 PMCID: PMC6690793 DOI: 10.1016/j.metabol.2019.06.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Circulating branched-chain amino acids (BCAAs, isoleucine, leucine, valine) and aromatic amino acids (AAAs, tyrosine and phenylalanine) predicted type 2 diabetes mellitus (T2DM) risk in a Caucasian population. Here, we assessed amino acid levels in relation to incident prediabetes among initially normoglycemic African Americans (AA) and European Americans (EA). RESEARCH DESIGN AND METHODS Using a nested case-control design, we studied 70 adults (35 AA, 35 EA) who developed prediabetes (progressors) and 70 matched participants who maintained normoglycemia (nonprogressors) during 5.5 years of follow-up in the Pathobiology of Prediabetes in a Biracial Cohort study. Assessments included plasma amino acid levels, insulin sensitivity, and beta-cell function. RESULTS The total level of all 18 amino acid assayed was significantly associated with lean mass (r = 0.36, P < 0.0001), waist circumference (r = 0.27, P = 0.001), fasting plasma glucose (r = 0.24, P = 0.005), HOMA-IR (r = 0.22, P = 0.01) and HDL cholesterol (r = -0.18, P = 0.03). Individual amino acid levels were significantly associated with insulin sensitivity and insulin secretion. Compared with nonprogressors, progressors had higher baseline levels of asparagine and aspartic acid (P <0.0001), glutamine/glutamic acid (P = 0.005) and phenylalanine (P = 0.02), and lower histidine (P = 0.02) levels. In fully-adjusted logistic regression models, aspartic acid/asparagine (OR 2.72 [95% CI 1.91-3.87]) and histidine (OR 0.90 [95% CI 0.85-0.96]) were the only amino acids that significantly predicted incident prediabetes. CONCLUSIONS Baseline plasma aspartic acid and asparagine levels predicted progression to prediabetes, whereas histidine levels were protective of prediabetes risk. Thus, the amino acid signature associated with prediabetes in a diverse population may be distinct from that previously linked to T2DM in Caucasians.
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Affiliation(s)
- Ibiye Owei
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, United States of America
| | - Nkiru Umekwe
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, United States of America
| | - Frankie Stentz
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, United States of America
| | - Jim Wan
- Department of Preventive Medicine University of Tennessee Health Science Center, Memphis, TN 38163, United States of America
| | - Samuel Dagogo-Jack
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, United States of America.
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Agbim U, Carr RM, Pickett-Blakely O, Dagogo-Jack S. Ethnic Disparities in Adiposity: Focus on Non-alcoholic Fatty Liver Disease, Visceral, and Generalized Obesity. Curr Obes Rep 2019; 8:243-254. [PMID: 31144261 PMCID: PMC6662200 DOI: 10.1007/s13679-019-00349-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Excessive adiposity has become a public health problem worldwide, contributing to the rise in obesity-related diseases and associated morbidity and mortality. This review details the relative significance of race/ethnicity as it pertains to adiposity and non-alcoholic fatty liver disease (NAFLD). RECENT FINDINGS Fat distribution remains a more reliable measure of adiposity than anthropometric measures, with visceral adipose tissue (VAT) associated with increased risk of cardiometabolic disease. While obesity is the most common risk factor for NAFLD, the racial/ethnic prevalence of obesity does not completely parallel NAFLD risk. Combating racial/ethnic disparities in obesity requires understanding differential risk among various groups. Hispanics are disproportionally impacted by NAFLD and have high rates of obesity, VAT, and insulin resistance (IR). This contrasts with Blacks, who have high prevalence of obesity and IR, accompanied by a paradoxically favorable lipid profile and low prevalence of VAT and NAFLD. Many features of adiposity and NAFLD are mediated by genetic and environmental factors, the latter being modifiable and the focus of interventions.
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Affiliation(s)
- Uchenna Agbim
- Division of Transplant Surgery, Department of Surgery, Methodist University Hospital Transplant Institute, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Rotonya M Carr
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Octavia Pickett-Blakely
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sam Dagogo-Jack
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, University of Tennessee Health Science Center, 920 Madison Avenue, Suite 300A, Memphis, TN, 38163, USA.
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Edwin Thanarajah S, Hoffstall V, Rigoux L, Hanssen R, Brüning JC, Tittgemeyer M. The role of insulin sensitivity and intranasally applied insulin on olfactory perception. Sci Rep 2019; 9:7222. [PMID: 31076634 PMCID: PMC6510903 DOI: 10.1038/s41598-019-43693-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 04/30/2019] [Indexed: 01/24/2023] Open
Abstract
Olfactory perception determines food selection behavior depending on energy homeostasis and nutritional status. The mechanisms, however, by which metabolic signals in turn regulate olfactory perception remain largely unclear. Given the evidence for direct insulin action on olfactory neurons, we tested olfactory performance (olfactory threshold, olfactory discrimination) in 36 subjects of normal- and overweight after administration of three different insulin doses (40 I.U., 100 I.U., 160 I.U.) or corresponding placebo volume in a within-subject design. Poor peripheral insulin sensitivity as quantified by HOMA-IR in baseline condition and increases in systemic insulin levels reactive to intranasal administration predicted poor olfactory performance. In contrast, intranasal insulin enhanced odor perception with a dose-dependent improvement of olfactory threshold. These findings indicate a new diametric impact of insulin on olfactory perception depending on peripheral or central availability.
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Affiliation(s)
- Sharmili Edwin Thanarajah
- Max-Planck-Institute for Metabolism Research, Cologne, Germany.
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany.
| | - Vera Hoffstall
- Max-Planck-Institute for Metabolism Research, Cologne, Germany
| | - Lionel Rigoux
- Max-Planck-Institute for Metabolism Research, Cologne, Germany
| | - Ruth Hanssen
- Max-Planck-Institute for Metabolism Research, Cologne, Germany
- Center for Endocrinology, Diabetes and Preventive Medicine (CEPD), University Hospital of Cologne, Cologne, Germany
| | - Jens C Brüning
- Max-Planck-Institute for Metabolism Research, Cologne, Germany
- Cologne Cluster of Excellence in Cellular Stress and Aging associated Disease (CECAD), Cologne, Germany
- Center for Endocrinology, Diabetes and Preventive Medicine (CEPD), University Hospital of Cologne, Cologne, Germany
| | - Marc Tittgemeyer
- Max-Planck-Institute for Metabolism Research, Cologne, Germany
- Cologne Cluster of Excellence in Cellular Stress and Aging associated Disease (CECAD), Cologne, Germany
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Canbay A, Kälsch J, Neumann U, Rau M, Hohenester S, Baba HA, Rust C, Geier A, Heider D, Sowa JP. Non-invasive assessment of NAFLD as systemic disease-A machine learning perspective. PLoS One 2019; 14:e0214436. [PMID: 30913263 PMCID: PMC6435145 DOI: 10.1371/journal.pone.0214436] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 03/13/2019] [Indexed: 12/19/2022] Open
Abstract
Background & aims Current non-invasive scores for the assessment of severity of non-alcoholic fatty liver disease (NAFLD) and identification of patients with non-alcoholic steatohepatitis (NASH) have insufficient performance to be included in clinical routine. In the current study, we developed a novel machine learning approach to overcome the caveats of existing approaches. Methods Non-invasive parameters were selected by an ensemble feature selection (EFS) from a retrospectively collected training cohort of 164 obese individuals (age: 43.5±10.3y; BMI: 54.1±10.1kg/m2) to develop a model able to predict the histological assessed NAFLD activity score (NAS). The model was evaluated in an independent validation cohort (122 patients, age: 45.2±11.75y, BMI: 50.8±8.61kg/m2). Results EFS identified age, γGT, HbA1c, adiponectin, and M30 as being highly associated with NAFLD. The model reached a Spearman correlation coefficient with the NAS of 0.46 in the training cohort and was able to differentiate between NAFL (NAS≤4) and NASH (NAS>4) with an AUC of 0.73. In the independent validation cohort, an AUC of 0.7 was achieved for this separation. We further analyzed the potential of the new model for disease monitoring in an obese cohort of 38 patients under lifestyle intervention for one year. While all patients lost weight under intervention, increasing scores were observed in 15 patients. Increasing scores were associated with significantly lower absolute weight loss, lower reduction of waist circumference and basal metabolic rate. Conclusions A newly developed model (http://CHek.heiderlab.de) can predict presence or absence of NASH with reasonable performance. The new score could be used to detect NASH and monitor disease progression or therapy response to weight loss interventions.
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Affiliation(s)
- Ali Canbay
- Department of Gastroenterology, Hepatology, and Infectious Diseases, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- * E-mail:
| | - Julia Kälsch
- Department of Gastroenterology and Hepatology, University Hospital, University Duisburg-Essen, Essen, Germany
- Institute for Pathology, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Ursula Neumann
- Department of Mathematics and Computer Science, University of Marburg, Marburg, Germany
| | - Monika Rau
- Division of Hepatology, Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - Simon Hohenester
- Department of Medicine II, University Hospital, LMU Munich, Munich, Germany
| | - Hideo A. Baba
- Institute for Pathology, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Christian Rust
- Center for Nutritional Medicine and Prevention, Department of Medicine I, Hospital Barmherzige Brüder, Munich, Germany
| | - Andreas Geier
- Division of Hepatology, Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - Dominik Heider
- Department of Mathematics and Computer Science, University of Marburg, Marburg, Germany
| | - Jan-Peter Sowa
- Department of Gastroenterology, Hepatology, and Infectious Diseases, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- Department of Gastroenterology and Hepatology, University Hospital, University Duisburg-Essen, Essen, Germany
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Affiliation(s)
- Zachary Bloomgarden
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert Chilton
- Department of Medicine, University of Texas Health Science Center, San Antonio, Texas
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Choi YS, Klaric JS, Beltran TH. Prediction of Insulin Resistance with Anthropometric and Clinical Laboratory Measures in Nondiabetic Teenagers. Metab Syndr Relat Disord 2019; 17:37-45. [DOI: 10.1089/met.2018.0072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Young Sammy Choi
- Department of Medicine, Womack Army Medical Center, Fort Bragg, North Carolina
- Department of Pediatrics, Womack Army Medical Center, Fort Bragg, North Carolina
- Department of Research, Womack Army Medical Center, Fort Bragg, North Carolina
| | - John S. Klaric
- Department of Research, Womack Army Medical Center, Fort Bragg, North Carolina
| | - Thomas H. Beltran
- Department of Research, Womack Army Medical Center, Fort Bragg, North Carolina
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