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Łupińska A, Aszkiełowicz S, Kowalik D, Jeziorny K, Kolasa-Kicińska M, Smalczewska P, Zygmunt A, Lewiński A, Stawerska R. Comparison of the Clinical Utility of Two Insulin Resistance Indices: IRI-HOMA and IRI-Belfiore in Diagnosing Insulin Resistance and Metabolic Complications in Children Based on the Results Obtained for the Polish Population. J Clin Med 2024; 13:2865. [PMID: 38792408 PMCID: PMC11122103 DOI: 10.3390/jcm13102865] [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: 04/08/2024] [Revised: 05/06/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Recognizing insulin resistance (IR) in children remains challenging due to uncertain IRI-HOMA cut-offs and unclear recommendations for evaluating IR based on OGTT. In our study, we compare the effectiveness of IRI-HOMA and IRI-Belfiore (OGTT-based) in detecting IR and its metabolic complications in children. Methods: The analysis included 553 children who were hospitalized at the Department of Endocrinology and Metabolic Diseases of the Polish Mother's Memorial Hospital Research Institute (PMMH-RI) in Lodz, Poland, between 2002 and 2018 due to various reasons-of these, 67.5% were girls. All underwent OGTT for glucose and insulin assessment. IR diagnosis relied on IRI-HOMA and IRI-Belfiore. IR based on IRI-HOMA was evaluated using three criteria: (A) >2.5; (B) >2.67 in boys and >2.22 in girls before puberty and >5.22 and >3.82 during puberty, respectively; (C) >95th percentile according to charts for IRI-HOMA in children. Results: Prepubertal children exhibited significantly lower IRI-HOMA and IRI-Belfiore than their pubertal counterparts (p < 0.00005). IRI-HOMA and IRI-Belfiore values positively correlated with age and BMI SDS value (p < 0.000001 for all calculations). As many as 26% to 46.9% of children with normal IRI-HOMA showed elevated IRI-Belfiore, with notably higher levels of triglycerides, a lower HDL cholesterol fraction, and a lower HDL/total cholesterol ratio in this subgroup. Conclusions: A notable proportion of children exhibited elevated IRI-Belfiore levels despite having normal IRI-HOMA values. This suggests the possibility of peripheral IR preceding hepatic IR in children-omitting an OGTT may therefore lead to overlooking cases of IR. Children diagnosed with IR via OGTT displayed significantly poorer lipid profiles compared to those without IR (characterized by normal values in both IRI-HOMA and IRI-Belfiore). This underscores the ability of OGTT-derived IR indices to identify individuals at risk of developing complications associated with obesity and IR before the onset of metabolic syndrome (MS) symptoms. If IR is already detected in children based on fasting glucose and insulin levels (IRI-HOMA), further evaluation may not be warranted, as OGTT results often simply confirm the diagnosis.
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Affiliation(s)
- Anna Łupińska
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
- Department of Pediatric Endocrinology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Sara Aszkiełowicz
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
| | - Dorota Kowalik
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
| | - Krzysztof Jeziorny
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
- Department of Pediatric Endocrinology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Marzena Kolasa-Kicińska
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
| | - Paula Smalczewska
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
| | - Arkadiusz Zygmunt
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, 90-419 Lodz, Poland
| | - Andrzej Lewiński
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
- Department of Pediatric Endocrinology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Renata Stawerska
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
- Department of Pediatric Endocrinology, Medical University of Lodz, 90-419 Lodz, Poland
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Pajuelo-Vasquez R, Benites-Meza JK, Durango-Chavez HV, Salinas-Sedo G, Toro-Huamanchumo CJ. Diagnostic performance of the GGT/HDL-C ratio for NAFLD in adults with obesity undergoing bariatric surgery. Diabetes Res Clin Pract 2024; 211:111649. [PMID: 38574896 DOI: 10.1016/j.diabres.2024.111649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 04/01/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) has become the most frequent liver disease, closely related with metabolic risk factors such as obesity, insulin resistance, dyslipidemia, diabetes mellitus, and metabolic syndrome. In this context, γ-Glutamyl transpeptidase (GGT) and high-density lipoprotein cholesterol (HDL-C) have shown correlations with steatosis severity and metabolic syndrome, respectively. This positions the GGT/HDL-C ratio as a potential diagnostic indicator for NAFLD. OBJECTIVE To assess the diagnostic performance of the GGT/HDL-C ratio for NAFLD in adults with obesity undergoing bariatric surgery. METHODS We conducted an analytical cross-sectional study, designed as a diagnostic test evaluation. A secondary database of 249 adults with obesity was analyzed. The optimal cut-off point was ascertained using three methodologies, and five adjustment models were constructed for the total population, further stratified by sex. RESULTS The optimal cut-off point was 20.5 U/mmol and the AUC of the ratio was 0.81 (95% CI: 0.64-0.98), with sensitivity and specificity being 82.5% and 77.8%, respectively. In the overall group with an elevated GGT/HDL-C ratio, the prevalence of NAFLD increased by 14% (PR: 1.14; 95% CI: 1.04-1.33). Specifically, women displaying this altered ratio showed a 19% increased prevalence (PR: 1.19; 95% CI: 1.07-1.42) compared to those with normal values. CONCLUSIONS The GGT/HDL-C ratio is a promising biomarker for the diagnosis of NAFLD in an adult population living with obesity.
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Affiliation(s)
- Renzo Pajuelo-Vasquez
- CHANGE Research Working Group, Facultad de Ciencias de la Salud, Carrera de Medicina Humana, Universidad Científica del Sur, Lima, Peru
| | - Jerry K Benites-Meza
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Trujillo, Peru; Grupo Peruano de Investigación Epidemiológica, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | | | | | - Carlos J Toro-Huamanchumo
- OBEMET Center for Obesity and Metabolic Health, Lima, Peru; Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru; Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
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Silva ACD, Mapa V, Ferreira-Júnior JB, Oliveira ECD, Becker LK, Rosse I, Coelho DB. Progressive strength training can reverse sarcopenia stage in middle-aged and older adults regardless of their genetic profile. Arch Gerontol Geriatr 2024; 117:105182. [PMID: 37688919 DOI: 10.1016/j.archger.2023.105182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/04/2023] [Accepted: 09/04/2023] [Indexed: 09/11/2023]
Abstract
The aim of this study was to verify the association of the ACTN3-R577X polymorphism with sarcopenia stage, according to the Revised European Consensus on the Definition and Diagnosis of Sarcopenia, in middle-aged and older adults, pre- and post- ST. In the 12-week longitudinal study, 71 middle-aged and older adults were evaluated; the participants were assigned to either control or intervention group. The intervention group underwent progressive ST three times a week. All participants underwent blood collection, DNA extraction, genotyping of the ACTN3-R577X polymorphism, anthropometric evaluations, and diagnostic tests for sarcopenia. The last two tests were repeated after 12 weeks. No association of the ACTN3-R577X polymorphism with sarcopenia stage was observed before and after 12 weeks. However, the intervention group remained non-sarcopenic (n = 25, p <0.05) or achieved changes in sarcopenia stage (from sarcopenic to non-sarcopenic) (n = 13, p <0.05). Our study demonstrates that progressive ST performed regularly can reverse or prevent sarcopenia regardless of genotype for the ACTN3-R577X polymorphism.
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Affiliation(s)
- Ana C da Silva
- Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Vinícius Mapa
- Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - João B Ferreira-Júnior
- Department of Physical Education, Federal Institute of Southeast Minas Gerais - Campus Rio Pomba, Rio Pomba, Minas Gerais, Brazil
| | - Emerson C de Oliveira
- Federal University of Ouro Preto, School of Physical Education and Postgraduate Program in Health and Nutrition, Ouro Preto, Minas Gerais, Brazil
| | - Lenice K Becker
- Federal University of Ouro Preto, School of Physical Education and Postgraduate Program in Health and Nutrition, Ouro Preto, Minas Gerais, Brazil
| | - Izinara Rosse
- Federal University of Ouro Preto, School of Pharmacy, Ouro Preto, Minas Gerais, Brazil
| | - Daniel B Coelho
- Federal University of Ouro Preto, School of Physical Education and Postgraduate Program in Health and Nutrition, Ouro Preto, Minas Gerais, Brazil.
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Puerto-Carranza E, Nuevo-Casals S, Roca-Portella B, Mas-Parés B, Gómez-Vilarrubla A, Carreras-Badosa G, Niubó M, Prats-Puig A, de Zegher F, Ibáñez L, Bassols J, López-Bermejo A. Total bilirubin and bilirubin-to-triglycerides ratio predict changes in glycated hemoglobin in healthy children. Front Endocrinol (Lausanne) 2023; 14:1303597. [PMID: 38107514 PMCID: PMC10722262 DOI: 10.3389/fendo.2023.1303597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/16/2023] [Indexed: 12/19/2023] Open
Abstract
Objective Bilirubin and triglycerides can regulate insulin secretion and glucose uptake. The aim of our study is to analyze associations between total bilirubin (TB) and the bilirubin-to-triglycerides ratio (BTR) with metabolic markers in healthy prepubertal children. Methods Subjects were 246 healthy children (mean age 8), of whom 142 (58%) were reevaluated 4 years later (mean age 12). The subjects were stratified according to age into three groups (<7.8 years; 7.8-9.6 years; and >9.6 years; n=82 each) at baseline and into two groups (<12.9 years and ≥12.9 years; n=71 each) at follow-up. Anthropometrics and laboratory parameters [TB and its fractions (direct and indirect bilirubin), triglycerides, HDL-cholesterol, glucose, insulin, HOMA-IR, HOMA-B and glycated hemoglobin (HbA1c)] were assessed at both baseline and follow-up. Results TB and BTR showed independent and negative association with baseline and follow-up HbA1c. These associations were stronger for BTR and in the highest age group. No independent associations were observed with HOMA-IR or HOMA-B. Conclusion TB and BTR are independently associated with HbA1c and predict its changes over time in healthy children. Our results indicate that TB and BTR may be useful parameters in studies of glucose tolerance in healthy children.
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Affiliation(s)
- Elsa Puerto-Carranza
- Pediatric Endocrinology Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
- Pediatrics, Dr. Trueta University Hospital, Girona, Spain
| | | | | | - Berta Mas-Parés
- Pediatric Endocrinology Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
| | | | - Gemma Carreras-Badosa
- Pediatric Endocrinology Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
| | - Maria Niubó
- Maternal-Fetal Metabolic Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
| | - Anna Prats-Puig
- University School of Health and Sport (EUSES), University of Girona, Girona, Spain
| | - Francis de Zegher
- Department of Development & Regeneration, University of Leuven, Leuven, Belgium
| | - Lourdes Ibáñez
- Endocrinology, Pediatric Research Institute, Sant Joan de Déu Children’s Hospital, Esplugues, Barcelona, Spain
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), ISCIII, Madrid, Spain
| | - Judit Bassols
- Maternal-Fetal Metabolic Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
| | - Abel López-Bermejo
- Pediatric Endocrinology Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
- Pediatrics, Dr. Trueta University Hospital, Girona, Spain
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Gong S, Gan S, Zhang Y, Zhou H, Zhou Q. Gamma-glutamyl transferase to high-density lipoprotein cholesterol ratio is a more powerful marker than TyG index for predicting metabolic syndrome in patients with type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2023; 14:1248614. [PMID: 37854188 PMCID: PMC10579940 DOI: 10.3389/fendo.2023.1248614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/13/2023] [Indexed: 10/20/2023] Open
Abstract
Purpose The prevalence of metabolic syndrome (MetS) is increasing globally and has become a global and national public health problem that cannot be ignored as an independent predictor of cardiovascular events, cancer and all-cause mortality. γ-glutamyl transferase (GGT) and high-density lipoprotein cholesterol (HDL-C) are associated with insulin resistance, dyslipidemia and oxidative stress. This study was designed to explore the relationship and predictive performance between γ-glutamyl transferase high-density lipoprotein cholesterol ratio (GGT/HDL-C) and MetS. Methods This was a cross-sectional study. MetS was diagnosed from biochemical and anthropometric data in subjects with T2DM. Multivariate logistic regression was used to analyses the relationship between GGT/HDL-C ratio, TyG index and HOMA-IR and MetS in subjects with T2DM. Receiver operating characteristic (ROC) curve was drawn and the areas under the curve (AUC) were used to assess the ability of these indexes in screening MetS in subjects with T2DM. Statistical differences between the AUC values of these indexes were compared. In addition, we performed subgroup analyses and interactions. Results 769 (70.55%) patients with T2DM were defined as having MetS. patients with MetS had higher anthropometric values and biochemical indicators compared to those without MetS. Multivariate logistic regression analysis of GGT/HDL-C ratio was an independent risk factor for MetS (Per 1 SD increase, OR = 2.49, 95% CI: 1.51, 4.10). According to ROC curve analysis, the value of GGT/HDL-C ratio in predicting MetS in subjects with T2DM was superior to that of TyG index and HOMA-IR. The best cut-off value for GGT/HDL-C prediction was 19.94. Conclusions GGT/HDL-C ratio may be an important predictor of MetS in subjects with T2DM, and its predictive power is stronger than that of TyG index and HOMA-IR. The risk of MetS in subjects with T2DM is increased in the presence of a higher GGT/HDL-C ratio.
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Affiliation(s)
- Shijun Gong
- Department of Medicine, Jishou University, Jishou, China
| | - Shenglian Gan
- Department of Endocrinology, The First People’s Hospital of Changde City, Changde, China
| | - YuHua Zhang
- Department of Medicine, Jishou University, Jishou, China
| | - HaiFeng Zhou
- Department of Endocrinology, The First People’s Hospital of Changde City, Changde, China
| | - Quan Zhou
- Department of Science and Education, The First People’s Hospital of Changde City, Changde, China
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Cao C, Hu H, Han Y, Yuan S, Zheng X, Zhang X, Zan Y, Wang Y, He Y. The nonlinear correlation between alanine aminotransferase to high-density lipoprotein cholesterol ratio and the risk of diabetes: a historical Japanese cohort study. BMC Endocr Disord 2023; 23:124. [PMID: 37248447 DOI: 10.1186/s12902-023-01382-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/25/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Low levels of high-density lipoprotein cholesterol (HDL-C) and high levels of alanine aminotransferase (ALT) are related to insulin resistance, metabolic syndrome, and diabetes mellitus (DM). However, evidence on the connection between the alanine aminotransferase to high-density lipoprotein cholesterol (ALT/HDL-C) ratio and diabetes mellitus (DM) risk was limited. The study aimed to investigate the relationship between baseline ALT/HDL-C ratio and DM among Japanese individuals. METHODS This second analysis was based on a cohort study using open-source data. Data from 15,342 individuals who participated in the medical examination program were recorded at Murakami Memorial Hospital in Japan between 2004 and 2015. Smooth curve fitting, subgroup analysis, Cox proportional-hazards regression, and a series of sensitivity analyses were conducted to examine the relationship between ALT/HDL-C ratio and incident diabetes. The ability of the ALT/HDL-C ratio to predict diabetes was evaluated using a receiver operating characteristic curve analysis. RESULTS After controlling for confounding covariates, the ALT/HDL-C ratio was found to be positively correlated to the DM risk in Japanese adults (HR: 1.01, 95%CI: 1.00-1.02, P = 0.049). This study also found a stable relationship between ALT/HDL-C ratio and diabetes after employing a series of sensitivity analyses. Additionally, there was a non-linear association between the ALT/HDL-C ratio and incident diabetes, and the ALT/HDL-C ratio inflection point was 30.12. When the ALT/HDL-C ratio was below 30.12, the present study discovered a significant positive association between the ALT/HDL-C ratio and incident diabetes (HR: 1.04, 95%CI: 1.02-1.06, P = 0.001). Furthermore, among liver enzymes, blood lipids, and anthropometric indicators, the ALT/HDL-C ratio best predicts DM (AUC = 0.75, 95%CI: 0.73-0.78). CONCLUSION Increased ALT/HDL-C ratio levels at baseline correlated to incident DM. The relationship between ALT/HDL-C ratio and incident DM was also non-linear. When the ALT/HDL-C ratio is below 30.12, there is a statistically significant positive correlation between the ALT/HDL-C ratio and incident DM.
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Affiliation(s)
- Changchun Cao
- Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, No. 6, Renmin Road, Dapeng New District, Shenzhen, 518000, Guangdong Province, China
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong Province, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong Province, China
| | - Shuting Yuan
- Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, No. 6, Renmin Road, Dapeng New District, Shenzhen, 518000, Guangdong Province, China
| | - Xiaodan Zheng
- Department of Neurology, Shenzhen Samii International Medical Center (The Fourth People's Hospital of Shenzhen), Shenzhen, 518000, Guangdong Province, China
| | - Xiaohua Zhang
- Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, No. 6, Renmin Road, Dapeng New District, Shenzhen, 518000, Guangdong Province, China
| | - Yibing Zan
- Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, No. 6, Renmin Road, Dapeng New District, Shenzhen, 518000, Guangdong Province, China
| | - Yulong Wang
- Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, No. 6, Renmin Road, Dapeng New District, Shenzhen, 518000, Guangdong Province, China.
- Department of Nephrology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong Province, China.
| | - Yongcheng He
- Department of Nephrology, Shenzhen Hengsheng Hospital, Shenzhen, 518000, Guangdong Province, China.
- Department of Nephrology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan Province, China.
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Solorzano M, Granfeldt G, Ulloa N, Molina-Recio G, Molina-Luque R, Aguayo C, Petermann-Rocha F, Martorell M. Comparison of Diagnostic Models to Estimate the Risk of Metabolic Syndrome in a Chilean Pediatric Population: A Cross-Sectional Study. Metabolites 2023; 13:metabo13020293. [PMID: 36837911 PMCID: PMC9958789 DOI: 10.3390/metabo13020293] [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: 12/22/2022] [Revised: 02/09/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023] Open
Abstract
The pediatric population has various criteria for measuring metabolic syndrome (MetS). The diversity of consensus for diagnosis has led to different non-comparable reported prevalence. Given the increase in its prevalence in pediatric ages, it is necessary to develop efficient methods to encourage early detection. Consequently, early screening for the risk of MetS could favor timely action in preventing associated comorbidities in adulthood. This study aimed to establish the diagnostic capacity of models that use non-invasive (anthropometric) and invasive (serum biomarkers) variables for the early detection of MetS in Chilean children. A cross-sectional study was carried out on 220 children aged 6 to 11. Multivariate logistic regressions and discriminant analyses were applied to determine the diagnostic capacity of invasive and non-invasive variables. Based on these results, four diagnostic models were created and compared: (i) anthropometric, (ii) hormonal (insulin, leptin, and adiponectin), (iii) Lipid A (high-density cholesterol lipoprotein [HDL-c] and triglycerides [TG]) and (iv) Lipid B (TG/HDL-c). The prevalence of MetS was 26.8%. Lipid biomarkers (HDL-c and TG) and their ratio (TG/HDL-c) presented higher diagnostic capacity, above 80%, followed by body mass index (BMI, 0.71-0.88) and waist-to-height ratio (WHtR, 0.70-0.87). The lipid model A was the most accurate (sensitivity [S] = 62.7%, specificity [E] = 96.9%, validity index 87.7%), followed by the anthropometric model (S = 69.5%, E = 88.8% and validity index = 83.6%). In conclusion, detecting MetS was possible through invasive and non-invasive methods tested in overweight and obese children. The proposed models based on anthropometric variables, or serum biomarkers of the lipid model A, presented acceptable validity indices. Moreover, they were higher than those that measured adipokines, leptin, and adiponectin. The anthropometric model was the most cost-effective and easy to apply in different environments.
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Affiliation(s)
- Marlín Solorzano
- Programa de Magíster en Nutrición Humana, Departamento de Nutrición y Dietética, Universidad de Concepción, Concepción 4070386, Chile
- Residente del Programa de Endocrinología Adultos, Departamento de Endocrinología, Escuela de Medicina, Universidad Católica de Chile, Santiago 8330077, Chile
| | - Gislaine Granfeldt
- Departamento de Nutrición y Dietética, Facultad de Farmacia, Universidad de Concepción, Concepción 4070386, Chile
| | - Natalia Ulloa
- Departamento de Bioquímica Clínica e Inmunología, Facultad de Farmacia, Universidad de Concepción, Concepción 4070386, Chile
- Centro de Vida Saludable, Universidad de Concepción, Concepción 4070386, Chile
| | - Guillermo Molina-Recio
- Lifestyles, Innovation and Health (GA-16), Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
- Department of Nursing, Pharmacology and Physiotherapy, University of Córdoba, 14004 Córdoba, Spain
| | - Rafael Molina-Luque
- Lifestyles, Innovation and Health (GA-16), Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
- Department of Nursing, Pharmacology and Physiotherapy, University of Córdoba, 14004 Córdoba, Spain
| | - Claudio Aguayo
- Centro de Vida Saludable, Universidad de Concepción, Concepción 4070386, Chile
| | - Fanny Petermann-Rocha
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago 8370068, Chile
- Correspondence: (F.P.-R.); (M.M.)
| | - Miquel Martorell
- Departamento de Nutrición y Dietética, Facultad de Farmacia, Universidad de Concepción, Concepción 4070386, Chile
- Centro de Vida Saludable, Universidad de Concepción, Concepción 4070386, Chile
- Correspondence: (F.P.-R.); (M.M.)
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Nuwaylati D, Eldakhakhny B, Bima A, Sakr H, Elsamanoudy A. Low-Carbohydrate High-Fat Diet: A SWOC Analysis. Metabolites 2022; 12:1126. [PMID: 36422267 PMCID: PMC9695571 DOI: 10.3390/metabo12111126] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 08/27/2023] Open
Abstract
Insulin resistance (IR) plays a role in the pathogenesis of many diseases, such as type 2 diabetes mellitus, cardiovascular disease, non-alcoholic fatty liver disease, obesity, and neurodegenerative diseases, including Alzheimer's disease. The ketogenic diet (KD) is a low-carbohydrate/high-fat diet that arose in the 1920s as an effective treatment for seizure control. Since then, the KD has been studied as a therapeutic approach for various IR-related disorders with successful results. To date, the use of the KD is still debatable regarding its safety. Some studies have acknowledged its usefulness, while others do not recommend its long-term implementation. In this review, we applied a SWOC (Strengths, Weaknesses, Opportunities, and Challenges) analysis that revealed the positive, constructive strengths of the KD, its potential complications, different conditions that can make used for it, and the challenges faced by both physicians and subjects throughout a KD. This SWOC analysis showed that the KD works on the pathophysiological mechanism of IR-related disorders such as chronic inflammation, oxidative stress and mitochondrial stress. Furthermore, the implementation of the KD as a potential adjuvant therapy for many diseases, including cancer, neurodegenerative disorders, polycystic ovary syndrome, and pain management was proven. On the other hand, the short and long-term possible undesirable KD-related effects, including nutritional deficiencies, growth retardation and nephrolithiasis, should be considered and strictly monitored. Conclusively, this review provides a context for decision-makers, physicians, researchers, and the general population to focus on this dietary intervention in preventing and treating diseases. Moreover, it draws the attention of scientists and physicians towards the opportunities and challenges associated with the KD that requires attention before KD initiation.
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Affiliation(s)
- Dena Nuwaylati
- Clinical Biochemistry Department, Faculty of Medicine, University of Jeddah, Jeddah 21959, Saudi Arabia
| | - Basmah Eldakhakhny
- Clinical Biochemistry Department, Faculty of Medicine, King Abdulaziz University, Jeddah 21465, Saudi Arabia
| | - Abdulhadi Bima
- Clinical Biochemistry Department, Faculty of Medicine, King Abdulaziz University, Jeddah 21465, Saudi Arabia
| | - Hussein Sakr
- Physiology Department, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman
- Medical Physiology Department, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Ayman Elsamanoudy
- Clinical Biochemistry Department, Faculty of Medicine, King Abdulaziz University, Jeddah 21465, Saudi Arabia
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
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Al-Beltagi M, Bediwy AS, Saeed NK. Insulin-resistance in paediatric age: Its magnitude and implications. World J Diabetes 2022; 13:282-307. [PMID: 35582667 PMCID: PMC9052009 DOI: 10.4239/wjd.v13.i4.282] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/12/2022] [Accepted: 03/27/2022] [Indexed: 02/06/2023] Open
Abstract
Insulin resistance (IR) is insulin failure in normal plasma levels to adequately stimulate glucose uptake by the peripheral tissues. IR is becoming more common in children and adolescents than before. There is a strong association between obesity in children and adolescents, IR, and the metabolic syndrome components. IR shows marked variation among different races, crucial to understanding the possible cardiovascular risk, specifically in high-risk races or ethnic groups. Genetic causes of IR include insulin receptor mutations, mutations that stimulate autoantibody production against insulin receptors, or mutations that induce the formation of abnormal glucose transporter 4 molecules or plasma cell membrane glycoprotein-1 molecules; all induce abnormal energy pathways and end with the development of IR. The parallel increase of IR syndrome with the dramatic increase in the rate of obesity among children in the last few decades indicates the importance of environmental factors in increasing the rate of IR. Most patients with IR do not develop diabetes mellitus (DM) type-II. However, IR is a crucial risk factor to develop DM type-II in children. Diagnostic standards for IR in children are not yet established due to various causes. Direct measures of insulin sensitivity include the hyperinsulinemia euglycemic glucose clamp and the insulin-suppression test. Minimal model analysis of frequently sampled intravenous glucose tolerance test and oral glucose tolerance test provide an indirect estimate of metabolic insulin sensitivity/resistance. The main aim of the treatment of IR in children is to prevent the progression of compensated IR to decompensated IR, enhance insulin sensitivity, and treat possible complications. There are three main lines for treatment: Lifestyle and behavior modification, pharmacotherapy, and surgery. This review will discuss the magnitude, implications, diagnosis, and treatment of IR in children.
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Affiliation(s)
- Mohammed Al-Beltagi
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31511, Egypt
- Department of Pediatrics, University Medical Center, Arabian Gulf University, Dr. Sulaiman Al Habib Medical Group, Manama 26671, Bahrain
| | - Adel Salah Bediwy
- Department of Chest Disease, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
- Department of Pulmonology, University Medical Center, Arabian Gulf University, Dr. Sulaiman Al Habib Medical Group, Manama 26671, Bahrain
| | - Nermin Kamal Saeed
- Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, Ministry of Health, Manama 12, Bahrain
- Microbiology Section, Department of Pathology, Irish Royal College of Surgeon, Busaiteen 15503, Bahrain
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Xing Y, Chen J, Liu J, Ma H. Associations Between GGT/HDL and MAFLD: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2022; 15:383-394. [PMID: 35177915 PMCID: PMC8843704 DOI: 10.2147/dmso.s342505] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To explore the association between γ-glutamyl transpeptidase to high-density lipoprotein ratio (GGT/HDL), triglyceride glucose-body mass index (TYG-BMI), and metabolic associated fatty liver disease (MAFLD) in a Chinese population with type 2 diabetes (T2DM) by cross-sectional analysis. To investigate the role of GGT/HDL played in MAFLD by TYG-BMI. PATIENTS AND METHODS A total of 1434 adult patients hospitalized with T2DM at Hebei General Hospital (Shijiazhuang, China) were included in the study. Patients' demographic and clinical data were collected. Spearman correlation was used to test for an association between GGT/HDL or TYG-BMI and related risk factors of MAFLD among T2DM patients. Multiple logistic regression analyses were performed to investigate the association between GGT/HDL or TYG-BMI and MAFLD. Mediation analysis was used to explore whether TYG-BMI mediated the association between GGT/HDL and MAFLD. RESULTS A total of 1434 T2DM patients were enrolled, the MAFLD group showed a higher level of GGT/HDL compared to the non-MAFLD group. There was a progressive increase in the prevalence of MAFLD with increasing tertiles of GGT/HDL. After adjusting for confounding factors, multivariate logistic regression analysis revealed that high levels of GGT/HDL were independent risk factors for MAFLD in T2DM patients. BMI further grouped the patients: ≤ 23kg/m2,>23kg/m2. GGT/HDL was found to be an independent risk factor for MAFLD but only in T2DM patients with a BMI greater than 23 kg/m2. Mediation analysis indicated that GGT/HDL had a significant direct effect on MAFLD. CONCLUSION GGT/HDL was positively associated with MAFLD incidence in T2DM patients with a BMI greater than 23 Kg/m2, and TYG-BMI partly mediated the association.
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Affiliation(s)
- Yuling Xing
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, 050017, People’s Republic of China
- Graduate School of Hebei Medical University, Shijiazhuang, 050017, People’s Republic of China
| | - Jinhu Chen
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, 050017, People’s Republic of China
- Graduate School of Hebei Medical University, Shijiazhuang, 050017, People’s Republic of China
| | - Jing Liu
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, 050017, People’s Republic of China
- Graduate School of Hebei Medical University, Shijiazhuang, 050017, People’s Republic of China
| | - Huijuan Ma
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, 050017, People’s Republic of China
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, 050017, People’s Republic of China
- Correspondence: Huijuan Ma, Department of Endocrinology, Hebei General Hospital, Shijiazhuang, 050017, People’s Republic of China, Tel +86 18032838686, Email
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Lang X, Liu Q, Fang H, Zhou Y, Forster MT, Li Z, Zhang X. The prevalence and clinical correlates of metabolic syndrome and cardiometabolic alterations in 430 drug-naive patients in their first episode of schizophrenia. Psychopharmacology (Berl) 2021; 238:3643-3652. [PMID: 34586464 DOI: 10.1007/s00213-021-05983-9] [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: 01/25/2021] [Accepted: 09/15/2021] [Indexed: 11/26/2022]
Abstract
RATIONALE Although metabolic abnormalities and metabolic syndrome (MetS) have been extensively investigated in schizophrenia, few studies have examined them in first-episode drug-naive (FEDN) patients. OBJECTIVES This study aimed to investigate the prevalence and clinical correlates of metabolic abnormalities in FEDN schizophrenia patients. METHODS A total of 430 FEDN schizophrenia patients and 453 controls were recruited. Various parameters were measured including BMI, waist circumference, blood pressure, lipid profiles, blood glucose, glycosylated hemoglobin (HbA1c), insulin, and homeostatic model assessment for insulin resistance (HOMA-IR). RESULTS Patients had a higher prevalence of MetS, hypertension, hypertriglyceridemia, hypo-HDL-C, elevated HAb1c, and elevated insulin than controls (19.1% vs. 6.6%, OR = 2.52; 33.3% vs. 12.1%, OR = 3.05; 30.5% vs. 16.1%, OR = 2.25; 43.1% vs. 24.0%, OR = 2.21; 25.6% vs. 10.8%, OR = 2.62; 9.1% vs. 0.9%, OR = 10.29; all pBonferroni < 0.001). Waist circumference was associated with PANSS general psychopathology and total score (correlation coefficient r = 0.17, pBonferroni < 0.001; correlation coefficient r = 0.16, pBonferroni = 0.004). Fasting glucose was associated with PANSS negative, general psychopathology, and total score (correlation coefficient r = 0.13, pBonferroni = 0.03; correlation coefficient r = 0.19, pBonferroni < 0.001; correlation coefficient r = 0.20, pBonferroni < 0.001). BMI (OR = 1.37), smoking (OR = 3.39), and HOMA-IR (OR = 5.60) were associated with MetS in FEDN schizophrenia (all p < 0.001). CONCLUSIONS Our results demonstrate that MetS and metabolic abnormalities co-existed in the early stages of schizophrenia without antipsychotics. Waist circumference and glucose were associated with psychopathological symptoms, while BMI, smoking, and HOMA-IR were associated with MetS in FEDN schizophrenia.
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Affiliation(s)
- Xiaoe Lang
- Department of Psychiatry, The First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Qinqin Liu
- Qingdao Mental Health Center, Qingdao University, Qingdao, China
| | - Hanliu Fang
- Qingdao Mental Health Center, Qingdao University, Qingdao, China
| | - Yongjie Zhou
- Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
| | - Mattew T Forster
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Zezhi Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Guangzhou, 510370, China.
| | - Xiangyang Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Guangzhou, 510370, China.
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, 100101, Beijing, China.
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12
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Lee H, Chien RN, Pao LH, Kuo CJ, Huang PH, Chang ML. Decoupled Glucose and Lipid Metabolic Recovery after Viral Clearance in Direct-Acting Antiviral-Treated HCV Patients: A 3-Year Prospective Cohort Study. Cells 2021; 10:2934. [PMID: 34831156 PMCID: PMC8616092 DOI: 10.3390/cells10112934] [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] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND/AIM The recovery pattern of hepatitis C virus (HCV)-associated metabolic alteration after sustained virological response (SVR) following direct-acting antivirals (DAAs) remains elusive. METHODS A prospective cohort study of chronic HCV-infected (CHC) patients (n = 415) receiving DAAs (n = 365) was conducted. Metabolic profiles were examined in SVR patients (n = 360) every 3-6 months after therapy and compared with those of sex- and age-matched controls (n = 470). RESULTS At baseline, of 415, 168 (40.5%) had insulin resistance (IR). The following were associated: levels of high-density lipoprotein cholesterol (HDL-C), triglycerides (TGs), HCV RNA, fibrosis-4 score, and interferon-λ3-rs12979860 genotype with total cholesterol (TC) levels; and TG levels and BMI with HOMA-IR. Over a 3-year follow-up, in SVR patients, BMI and TC levels and TG/HDL-C ratios increased from baseline, while HOMA-IR trended downward by 72 weeks after therapy and then increased. The increased HDL-C levels began to decrease after 72 weeks after therapy. TC and HOMA-IR were negatively associated with each other until 24 weeks after therapy. Earlier increases in BMI and decreases in HOMA-IR were noted in SVR patients with than in those without baseline IR. Compared with controls, in the subgroup without baseline IR, SVR patients had increased BMI and HOMA-IR levels. Metabolic profiles were similar between SVR patients and controls in the subgroup with baseline IR. CONCLUSIONS In SVR patients treated with DAAs, the recovery of altered lipid and glucose metabolism was not coupled until 72-week post-therapy, when HOMA-IR reached its nadir. SVR patients with baseline IR recovered from HCV-associated metabolic alterations earlier than those without baseline IR.
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Affiliation(s)
- Heng Lee
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan; (H.L.); (R.-N.C.); (C.-J.K.); (P.-H.H.)
- Department of Medicine, Taipei Veterans General Hospital, Taipei 112201, Taiwan
| | - Rong-Nan Chien
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan; (H.L.); (R.-N.C.); (C.-J.K.); (P.-H.H.)
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
| | - Li-Heng Pao
- Graduate Institute of Health Industry Technology, Chang Gung University of Science and Technology, Taoyuan 33303, Taiwan;
- Research Center for Food and Cosmetic Safety and Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan 33303, Taiwan
| | - Chia-Jung Kuo
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan; (H.L.); (R.-N.C.); (C.-J.K.); (P.-H.H.)
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
| | - Po-Han Huang
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan; (H.L.); (R.-N.C.); (C.-J.K.); (P.-H.H.)
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
| | - Ming-Ling Chang
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan; (H.L.); (R.-N.C.); (C.-J.K.); (P.-H.H.)
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
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Kiuchi Y, Makizako H, Nakai Y, Taniguchi Y, Tomioka K, Sato N, Wada A, Doi T, Kiyama R, Takenaka T. Associations of alpha-actinin-3 genotype with thigh muscle volume and physical performance in older adults with sarcopenia or pre-sarcopenia. Exp Gerontol 2021; 154:111525. [PMID: 34425205 DOI: 10.1016/j.exger.2021.111525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 08/10/2021] [Accepted: 08/17/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND This cross-sectional study aimed to investigate the relationship of the ACTN3 genotype with thigh muscle volume and physical performance in older adults with sarcopenia or pre-sarcopenia. METHODS Data from 64 older Japanese adults (mean age 74.4 ± 6.9 years, women 71.9%) with sarcopenia or pre-sarcopenia were analyzed. Sarcopenia and pre-sarcopenia were defined using the Asian Working Group for Sarcopenia. We collected oral mucosa samples to determine the ACTN3 genotype. Thigh muscle volumes were measured using magnetic resonance imaging. Physical performance was assessed using the usual and maximum gait speed, timed up and go test, and five-repetition sit-to-stand test. Muscle strength was assessed using grip strength. RESULT The ACTN3 genotype proportions were 20.3% for RR, 51.6% for RX, and 28.1% for XX. Participants with the RR genotype showed greater thigh muscle volume/ht2 compared to those with the RX and XX ACTN3 genotypes (p < 0.05). The multiple linear regression analysis revealed that RX (p < 0.01) and XX (p < 0.01) ACTN3 genotypes, compared to RR, were associated with lower thigh muscle volume/ht2 and with age, sex (reference; men), weight and maximum walking speed. There was no significant difference between physical performance and muscle strength between the ACTN3 genotypes. CONCLUSION The ACTN3 genotype of the X allele was associated with decreased thigh muscle volume compared to the ACTN3 genotype of RR in older adults with sarcopenia or pre-sarcopenia.
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Affiliation(s)
- Yuto Kiuchi
- Graduate School of Health Sciences, Kagoshima University, Kagoshima 890-8544, Japan; Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan.
| | - Hyuma Makizako
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan.
| | - Yuki Nakai
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan.
| | - Yoshiaki Taniguchi
- Graduate School of Health Sciences, Kagoshima University, Kagoshima 890-8544, Japan; Department of Physical Therapy, Kagoshima Medical Professional College, Kagoshima 891-0133, Japan.
| | - Kazutoshi Tomioka
- Graduate School of Health Sciences, Kagoshima University, Kagoshima 890-8544, Japan; Tarumizu Municipal Medical Center, Tarumizu Chuo Hospital, Kagoshima 891-2124, Japan.
| | - Nana Sato
- Graduate School of Health Sciences, Kagoshima University, Kagoshima 890-8544, Japan.
| | - Ayumi Wada
- Graduate School of Health Sciences, Kagoshima University, Kagoshima 890-8544, Japan.
| | - Takehiko Doi
- Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan.
| | - Ryoji Kiyama
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan.
| | - Toshihiro Takenaka
- Tarumizu Municipal Medical Center, Tarumizu Chuo Hospital, Kagoshima 891-2124, Japan.
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Pavliuk B, Stechyshyn I, Chubka M, Hroshovyi T. Preclinical safety evaluation of drone brood homogenate and justification of pharmacological action. PHARMACIA 2021. [DOI: 10.3897/pharmacia.68.e70678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The problem of studying the metabolic syndrome, as well as its integration into other pathological processes, despite large-scale research, remains relevant. The complexity of the interaction of different links in pathogenesis requires scientists to find new tools and methods for both diagnosis and treatment. Drone brood homogenate, which is a multifactorial pharmacological agent in terms of chemical composition, seems to be promising to study for today. And the lack of contraindications and a wide age range makes it an excellent object of research. The current study evaluated the pharmacological aspects of safety: acute toxicity, effects on the functional and motor activity of the gastrointestinal tract, as well as local irritation of the gastric mucosa, the secretory function of the stomach. All experiments were performed according to the classical methods. The specific pharmacological activity of the drone brood homogenate was determined in comparison with metformin in the experimental fructose metabolic syndrome. Animals obtained from the Vivarium of I.Horbachevsky Ternopil National Medical University were used to implement the set goals. Working with animals was met all bioethical requirements. The study found that the lyophilized drone brood homogenate does not have a local irritant effect and does not cause ulcers on the surface of the gastric mucosa, does not affect the secretory function of the stomach and motor-evacuatory activity of the gastrointestinal tract and is a low-toxic substance, indicating the possibility of its long-term safe use. As expected, glucose, insulin, and HOMA index were significantly increased in animals that were simulated metabolic syndrome. The use of drone brood homogenate by animals contributed to a relatively positive effect on selected indicators of the metabolic syndrome. Accordingly, drone brood homogenate is a promising active pharmaceutical ingredient for the normalization of biochemical disorders in metabolic syndrome.
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Association between the FTO SNP rs9939609 and Metabolic Syndrome in Chilean Children. Nutrients 2021; 13:nu13062014. [PMID: 34208143 PMCID: PMC8230726 DOI: 10.3390/nu13062014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/05/2021] [Accepted: 06/08/2021] [Indexed: 11/05/2022] Open
Abstract
Background: The increasing prevalence of obesity in children has raised the incidence of Metabolic Syndrome (MetS) in this age group. Given the short- and long-term health impact of MetS, it is essential to prevent its onset by detecting its main triggers. Besides, genetic factors play an essential role in influencing which individuals within a population are most likely to develop obesity in response to a particular environment. In this regard, a common variation in the FTO gene is reproducibly associated with BMI and obesity from childhood and the genetic load has been linked to several cardiovascular risk factors, highlighting the FTO single nucleotide polymorphism (SNP) rs9939609. Therefore, this study aimed to establish the relationship between the FTO SNP rs9939609 and MetS. Methods: A cross-sectional study was carried out on 220 children from the Biobío region (Chile). MetS diagnosis was established through the modified Cook criteria, using prevalence ratios, COR curves, and linear regressions to determine its association with MetS and its components. Results: The prevalence of MetS was significantly increased among carriers of the risk allele (A): TT, 20.2%; TA, 25.4%; AA, 44.7% (p = 0.006). Also, the presence of A was associated with altered MetS-related variables. Conclusions: The FTO SNP rs9939609 was associated with a raised prevalence of MetS among A allele carriers, and was higher in the homozygous genotype (AA).
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Prevalence of Metabolic Syndrome among Children and Adolescents in High-Income Countries: A Systematic Review and Meta-Analysis of Observational Studies. BIOMED RESEARCH INTERNATIONAL 2021. [DOI: 10.1155/2021/6661457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Introduction. Metabolic syndrome (MetS) is an assemblage of interconnected cardiovascular risk factors that are prevalent among children and adolescents in high-income countries (HICs). Despite the presence of several studies on the issue, the study findings are incongruent due to the absence of a gold standard diagnostic method of MetS in children. Thus, the findings of the original studies are inconclusive for policy makers and other stakeholders. This systematic review and meta-analysis is aimed at giving conclusive evidence about MetS among children and adolescents in HICs. Methods. We conducted searches using electronic databases (PubMed, Scopus, Web of Science, CINAHL (EBSCOhost), EMBASE (Elsevier), and Medline (EBSCOhost)) and other sources (Google Scholar and Google) up to September 2020. Observational studies reporting the prevalence of MetS were eligible in this study. The pooled estimates were computed in fixed and random effect models using six diagnostic methods (IDF, ATP III, de Ferranti et al., WHO, Weiss et al., and Cruz and Goran). Publication bias was verified using funnel plots and Egger’s regression tests. Subgroup and sensitivity analysis were performed in case of higher heterogeneities among the included studies. Result. In this study, 77 studies with a total population of 125,445 children and adolescents were used in the final analysis. Metabolic syndrome among the overweight and obese population was computed from 28 studies with the pooled prevalence of 25.25%, 24.47%, 39.41%, 29.52%, and 33.36% in IDF, ATP III, de Ferranti et al., WHO, and Weiss et al. criteria, respectively. Likewise, 49 studies were eligible to compute the pooled prevalence of MetS in the general population of children and adolescents. Hence, MetS was found in 3.70% (IDF), 5.40% (ATP III), 14.78% (de Ferranti et al.), 3.90% (WHO), and, 4.66% (Cruz and Goran) of study participants. Regarding the components of MetS, abdominal obesity in the overweight and obese population, and low HDL-C in the general population were the most common components. Besides, the prevalence of Mets among males was higher than females. Conclusion. This study demonstrates that MetS among children and adolescents is undoubtedly high in HICs. The prevalence of MetS is higher among males than females. Community-based social and behavioral change communications need to be designed to promote healthy eating behaviors and physical activities. Prospective cohort studies could also help to explore all possible risk factors of MetS and to design specific interventions accordingly.
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An Approach to Early Detection of Metabolic Syndrome through Non-Invasive Methods in Obese Children. CHILDREN-BASEL 2020; 7:children7120304. [PMID: 33348633 PMCID: PMC7767015 DOI: 10.3390/children7120304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/06/2020] [Accepted: 12/15/2020] [Indexed: 01/21/2023]
Abstract
Background: Metabolic Syndrome (MetS) has a high prevalence in children, and its presence increases in those with a high BMI. This fact confirms the need for early detection to avoid the development of other comorbidities. Non-invasive variables are presented as a cost-effective and easy to apply alternative in any clinical setting. Aim: To propose a non-invasive method for the early diagnosis of MetS in overweight and obese Chilean children. Methods: We conducted a cross-sectional study on 221 children aged 6 to 11 years. We carried out multivariate logistic regressions, receiver operating characteristic curves, and discriminant analysis to determine the predictive capacity of non-invasive variables. The proposed new method for early detection of MetS is based on clinical decision trees. Results: The prevalence of MetS was 26.7%. The area under the curve for the BMI and waist circumference was 0.827 and 0.808, respectively. Two decision trees were calculated: the first included blood pressure (≥104.5/69 mmHg), BMI (≥23.5 Kg/m2) and WHtR (≥0.55); the second used BMI (≥23.5 Kg/m2) and WHtR (≥0.55), with validity index of 74.7% and 80.5%, respectively. Conclusions: Early detection of MetS is possible through non-invasive methods in overweight and obese children. Two models (Clinical decision trees) based on anthropometric (non-invasive) variables with acceptable validity indexes have been presented. Clinical decision trees can be applied in different clinical and non-clinical settings, adapting to the tools available, being an economical and easy to measurement option. These methods reduce the use of blood tests to those patients who require confirmation.
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Ádány R, Pikó P, Fiatal S, Kósa Z, Sándor J, Bíró É, Kósa K, Paragh G, Bácsné Bába É, Veres-Balajti I, Bíró K, Varga O, Balázs M. Prevalence of Insulin Resistance in the Hungarian General and Roma Populations as Defined by Using Data Generated in a Complex Health (Interview and Examination) Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134833. [PMID: 32635565 PMCID: PMC7370128 DOI: 10.3390/ijerph17134833] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 12/17/2022]
Abstract
Data mainly from one-off surveys clearly show that the health of Roma, the largest ethnic minority of Europe, is much worse than that of the general population. However, results from comprehensive exploratory studies are missing. The aim of our study was to create a complex database for comparative and association studies to better understand the background of the very unfavourable health of Roma, especially the high burden of cardiometabolic diseases. A three-pillar (questionnaire-based, physical and laboratory examinations) health survey was carried out on randomly selected samples of the Hungarian general (HG, n = 417) and Roma (HR, n = 415) populations, and a database consisting of more than half a million datapoints was created. Using selected data, the prevalence rates of metabolic syndrome (MetS) and of its components were determined, and to estimate the risk of insulin resistance (IR), surrogate measures (the homeostasis model assessment of insulin resistance index, quantitative insulin sensitivity check index, McAuley and TyG indices and the TG/HDL-C ratio) were calculated. Receiver operating characteristic curve analysis and Youden’s method were used to define the optimal cut-off values of each IR index. The prevalence of MetS was very high in both study populations (HG: 39.8%, HR: 44.0%) with no statistically significant difference between the two groups in females or males. The prevalence of MetS showed a very marked increase in the HR 35–49 years age group. Among surrogate measures, the TyG index showed the greatest power for predicting IR/MetS at a cut-off value of 4.69 (77% sensitivity, 84% specificity) and indicated a 42.3% (HG) and 40.5% (HR) prevalence of IR. The prevalence of MetS and IR is almost equally very unfavourable in both groups; thus, the factors underlying the high premature mortality burden of Roma should be further clarified by investigating the full spectrum of risk factors available in the database, with a special focus on the access of Roma people to preventive and curative health services.
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Affiliation(s)
- Róza Ádány
- MTA-DE Public Health Research Group, Public Health Research Institute, University of Debrecen, 4032 Debrecen, Hungary
| | - Péter Pikó
- MTA-DE Public Health Research Group, Public Health Research Institute, University of Debrecen, 4032 Debrecen, Hungary
| | - Szilvia Fiatal
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary
| | - Zsigmond Kósa
- Department of Health Methodology and Public Health, Faculty of Health, University of Debrecen, 4400 Nyíregyháza, Hungary
| | - János Sándor
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary
| | - Éva Bíró
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary
| | - Karolina Kósa
- Institute of Behavioural Sciences, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary
| | - György Paragh
- Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Éva Bácsné Bába
- Institute of Sport Management, University of Debrecen, 4032 Debrecen, Hungary
| | - Ilona Veres-Balajti
- Department of Physiotherapy, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary
| | - Klára Bíró
- Department of Health Systems Management and Quality Management in Health Care, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary
| | - Orsolya Varga
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary
| | - Margit Balázs
- MTA-DE Public Health Research Group, Public Health Research Institute, University of Debrecen, 4032 Debrecen, Hungary
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Feng G, Feng L, Zhao Y. Association between ratio of γ-glutamyl transpeptidase to high-density lipoprotein cholesterol and prevalence of nonalcoholic fatty liver disease and metabolic syndrome: a cross-sectional study. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:634. [PMID: 32566571 PMCID: PMC7290624 DOI: 10.21037/atm-19-4516] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Metabolic risk factors including obesity, insulin resistance, dyslipidemia, metabolic syndrome (MS), and diabetes are associated with nonalcoholic fatty liver disease (NAFLD). γ-Glutamyl transpeptidase (GGT) and high-density lipoprotein cholesterol (HDL-C) are associated with insulin resistance, dyslipidemia, oxidative stress, and obesity. We investigated the associations between GGT/HDL-C ratio and prevalence of NAFLD in a Chinese population. Methods The study included 1,813 NAFLD (526 females, 1,287 males) and 4,513 non-NAFLD (3,077 females, 1,436 males) participants. The diagnosis of NAFLD was based on ultrasonography. Results Participants with NAFLD had higher GGT/HDL-C ratio, BMI, WC, TG, TC, and HOMA-IR, but lower HDL-C than participants without NAFLD. GGT/HDL-C ratio was significantly associated with prevalence of NAFLD. Specifically, for each 1 unit increase in GGT/HDL-C ratio, the prevalence of NAFLD will increase by 0.3%. As GGT/HDL-C ratio quartiles increased, prevalence of NAFLD/MS in Q4 (highest GGT/HDL-C ratio quartile) was 6.362/3.968 times higher than that in Q1 (lowest GGT/HDL-C ratio quartile). The AUC [0.799 (0.788-0.810)] for GGT/HDL-C ratio was significantly higher than those for GGT and HDL-C alone. Conclusions The present results suggest that GGT/HDL-C ratio can be used as a predictive factor for prevalence of NAFLD after adjustment for confounding variables.
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Affiliation(s)
- Guofang Feng
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Limin Feng
- Department of Clinical Laboratory, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.,Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou 310003, China
| | - Ying Zhao
- Department of Clinical Laboratory, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.,Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou 310003, China
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Taliyan R, Chandran SK, Kakoty V. Therapeutic Approaches to Alzheimer's Type of Dementia: A Focus on FGF21 Mediated Neuroprotection. Curr Pharm Des 2020; 25:2555-2568. [PMID: 31333086 DOI: 10.2174/1381612825666190716101411] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 07/08/2019] [Indexed: 12/31/2022]
Abstract
Neurodegenerative disorders are the most devastating disorder of the nervous system. The pathological basis of neurodegeneration is linked with dysfunctional protein trafficking, mitochondrial stress, environmental factors and aging. With the identification of insulin and insulin receptors in some parts of the brain, it has become evident that certain metabolic conditions associated with insulin dysfunction like Type 2 diabetes mellitus (T2DM), dyslipidemia, obesity etc., are also known to contribute to neurodegeneration mainly Alzheimer's Disease (AD). Recently, a member of the fibroblast growth factor (FGF) superfamily, FGF21 has proved tremendous efficacy in diseases like diabetes mellitus, obesity and insulin resistance (IR). Increased levels of FGF21 have been reported to exert multiple beneficial effects in metabolic syndrome. FGF21 receptors are present in certain areas of the brain involved in learning and memory. However, despite extensive research, its function as a neuroprotectant in AD remains elusive. FGF21 is a circulating endocrine hormone which is mainly secreted by the liver primarily in fasting conditions. FGF21 exerts its effects after binding to FGFR1 and co-receptor, β-klotho (KLB). It is involved in regulating energy via glucose and lipid metabolism. It is believed that aberrant FGF21 signalling might account for various anomalies like neurodegeneration, cancer, metabolic dysfunction etc. Hence, this review will majorly focus on FGF21 role as a neuroprotectant and potential metabolic regulator. Moreover, we will also review its potential as an emerging candidate for combating metabolic stress induced neurodegenerative abnormalities.
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Affiliation(s)
- Rajeev Taliyan
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani-333031, Rajasthan, India
| | - Sarathlal K Chandran
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani-333031, Rajasthan, India
| | - Violina Kakoty
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani-333031, Rajasthan, India
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Salivary markers of hepato-metabolic comorbidities in pediatric obesity. Dig Liver Dis 2019; 51:516-523. [PMID: 30528710 DOI: 10.1016/j.dld.2018.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 10/31/2018] [Accepted: 11/05/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND The pediatric obesity epidemic calls for the noninvasive detection of individuals at higher risk of complications. AIMS To investigate the diagnostic role of combined salivary uric acid (UA), glucose and insulin levels to screen noninvasively for metabolic syndrome (MetS) and nonalcoholic fatty liver disease. METHODS Medical history, clinical, anthropometric, and laboratory data including serum triglyceride, glucose, insulin, HOMA, HDL-cholesterol, and UA levels of 23 obese children (15 with [St+] and 8 without [St-] ultrasonographic hepatic steatosis) and 18 normal weight controls were considered. RESULTS Serum and salivary UA (p < 0.05; R2 = 0.51), insulin (p < 0.0001; R2 = 0.79), and HOMA (p < 0.0001; R2 = 0.79) levels were significantly correlated; however their values tended to be only slightly higher in the obese patients, predominately in [St+], than in the controls. Notably, UA and insulin levels in both fluids increased in parallel to the number of MetS components. After conversion of the z-logit function including salivary/anthropometric parameters in a stepwise logistic regression analysis, a factor of 0.5 allowed for predicting hepatic steatosis with high sensitivity, specificity, and total accuracy. CONCLUSIONS Salivary testing together with selected anthropometric parameters helps to identify noninvasively obese children with hepatic steatosis and/or having MetS components.
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