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Choucair I, Mallela DP, Hilser JR, Hartiala JA, Nemet I, Gogonea V, Li L, Lusis AJ, Fischbach MA, Tang WW, Allayee H, Hazen SL. Comprehensive Clinical and Genetic Analyses of Circulating Bile Acids and Their Associations With Diabetes and Its Indices. Diabetes 2024; 73:1215-1228. [PMID: 38701355 PMCID: PMC11262044 DOI: 10.2337/db23-0676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 04/24/2024] [Indexed: 05/05/2024]
Abstract
Bile acids (BAs) are cholesterol-derived compounds that regulate glucose, lipid, and energy metabolism. Despite their significance in glucose homeostasis, the association between specific BA molecular species and their synthetic pathways with diabetes is unclear. Here, we used a recently validated, stable-isotope dilution, high-performance liquid chromatography with tandem mass spectrometry method to quantify a panel of BAs in fasting plasma from 2,145 study participants and explored structural and genetic determinants of BAs linked to diabetes, insulin resistance, and obesity. Multiple 12α-hydroxylated BAs were associated with diabetes (adjusted odds ratio [aOR] range, 1.3-1.9; P < 0.05 for all) and insulin resistance (aOR range, 1.3-2.2; P < 0.05 for all). Conversely, multiple 6α-hydroxylated BAs and isolithocholic acid (iso-LCA) were inversely associated with diabetes and obesity (aOR range, 0.3-0.9; P < 0.05 for all). Genome-wide association studies revealed multiple genome-wide significant loci linked with 9 of the 14 diabetes-associated BAs, including a locus for iso-LCA (rs11866815). Mendelian randomization analyses showed genetically elevated deoxycholic acid levels were causally associated with higher BMI, and iso-LCA levels were causally associated with reduced BMI and diabetes risk. In conclusion, comprehensive, large-scale, quantitative mass spectrometry and genetics analyses show circulating levels of multiple structurally specific BAs, especially DCA and iso-LCA, are clinically associated with and genetically linked to obesity and diabetes. ARTICLE HIGHLIGHTS
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Affiliation(s)
- Ibrahim Choucair
- Department of Cardiovascular & Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Center for Microbiome and Human Health, Cleveland Clinic, Cleveland, OH
| | - Deepthi P. Mallela
- Department of Cardiovascular & Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Center for Microbiome and Human Health, Cleveland Clinic, Cleveland, OH
| | - James R. Hilser
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
- Department of Biochemistry and Molecular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Jaana A. Hartiala
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Ina Nemet
- Department of Cardiovascular & Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Center for Microbiome and Human Health, Cleveland Clinic, Cleveland, OH
| | - Valentin Gogonea
- Department of Cardiovascular & Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Center for Microbiome and Human Health, Cleveland Clinic, Cleveland, OH
- Department of Chemistry, Cleveland State University, Cleveland, OH
| | - Lin Li
- Department of Cardiovascular & Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Center for Microbiome and Human Health, Cleveland Clinic, Cleveland, OH
| | - Aldons J. Lusis
- Division of Cardiology, Department of Medicine, University of California, Los Angeles, Los Angeles, CA
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA
| | | | - W.H. Wilson Tang
- Department of Cardiovascular & Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Center for Microbiome and Human Health, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
| | - Hooman Allayee
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
- Department of Biochemistry and Molecular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Stanley L. Hazen
- Department of Cardiovascular & Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Center for Microbiome and Human Health, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
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Francis EC, Kechris K, Johnson RK, Rawal S, Pathmasiri W, Rushing BR, Du X, Jansson T, Dabelea D, Sumner SJ, Perng W. Maternal Serum Metabolomics in Mid-Pregnancy Identifies Lipid Pathways as a Key Link to Offspring Obesity in Early Childhood. Int J Mol Sci 2024; 25:7620. [PMID: 39062861 PMCID: PMC11276882 DOI: 10.3390/ijms25147620] [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: 05/31/2024] [Revised: 06/29/2024] [Accepted: 07/04/2024] [Indexed: 07/28/2024] Open
Abstract
Maternal metabolism during pregnancy shapes offspring health via in utero programming. In the Healthy Start study, we identified five subgroups of pregnant women based on conventional metabolic biomarkers: Reference (n = 360); High HDL-C (n = 289); Dyslipidemic-High TG (n = 149); Dyslipidemic-High FFA (n = 180); Insulin Resistant (IR)-Hyperglycemic (n = 87). These subgroups not only captured metabolic heterogeneity among pregnant participants but were also associated with offspring obesity in early childhood, even among women without obesity or diabetes. Here, we utilize metabolomics data to enrich characterization of the metabolic subgroups and identify key compounds driving between-group differences. We analyzed fasting blood samples from 1065 pregnant women at 18 gestational weeks using untargeted metabolomics. We used weighted gene correlation network analysis (WGCNA) to derive a global network based on the Reference subgroup and characterized distinct metabolite modules representative of the different metabolomic profiles. We used the mummichog algorithm for pathway enrichment and identified key compounds that differed across the subgroups. Eight metabolite modules representing pathways such as the carnitine-acylcarnitine translocase system, fatty acid biosynthesis and activation, and glycerophospholipid metabolism were identified. A module that included 189 compounds related to DHA peroxidation, oxidative stress, and sex hormone biosynthesis was elevated in the Insulin Resistant-Hyperglycemic vs. the Reference subgroup. This module was positively correlated with total cholesterol (R:0.10; p-value < 0.0001) and free fatty acids (R:0.07; p-value < 0.05). Oxidative stress and inflammatory pathways may underlie insulin resistance during pregnancy, even below clinical diabetes thresholds. These findings highlight potential therapeutic targets and strategies for pregnancy risk stratification and reveal mechanisms underlying the developmental origins of metabolic disease risk.
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Affiliation(s)
- Ellen C. Francis
- Department of Biostatistics & Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - Katerina Kechris
- Department of Biostatistics & Informatics, Colorado School of Public Health, Aurora, CO 80045, USA;
| | - Randi K. Johnson
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (D.D.); (W.P.)
| | - Shristi Rawal
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers University, Newark, NJ 07102, USA;
| | - Wimal Pathmasiri
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.P.); (B.R.R.)
- Nutrition Research Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Blake R. Rushing
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.P.); (B.R.R.)
- Nutrition Research Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Xiuxia Du
- Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, USA;
| | - Thomas Jansson
- Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (D.D.); (W.P.)
- The Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Susan J. Sumner
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.P.); (B.R.R.)
- Nutrition Research Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Wei Perng
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (D.D.); (W.P.)
- The Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
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Chiyanika C, Hui SCN, Sin DMC, Shumbayawonda E, Wong SKH, Ng EKW, Yip TCF, Wong VWS, Chu WCW. The effectiveness of magnetic resonance imaging (MRI) iron corrected T1 in monitoring metabolic dysfunction-associated steatohepatitis in obesity following bariatric surgery and lifestyle modification: a prospective cohort study. Quant Imaging Med Surg 2024; 14:4659-4674. [PMID: 39022255 PMCID: PMC11250305 DOI: 10.21037/qims-24-148] [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: 01/24/2024] [Accepted: 04/29/2024] [Indexed: 07/20/2024]
Abstract
Background Bariatric surgery and lifestyle modification are important treatments for obesity, a risk factor for metabolic dysfunction-associated steatohepatitis (MASH). Studies have related weight reduction with changes in MASH, however, few have used imaging to investigate effects on liver health. We evaluated differences in liver response to obesity treatment using disease activity iron corrected T1 (cT1) and proton density fat fraction (PDFF) in patients with both obesity and metabolic dysfunction-associated steatotic liver disease (MASLD). Methods Thirty-four patients with obesity and MASLD were recruited between March 2019 to February 2022 from a tertiary hospital in this longitudinal study; 13 underwent laparoscopic sleeve gastrectomy (LSG) alongside intraoperative liver biopsy, and 21 underwent a 4-month lifestyle modification program (LMP). All patients had multi-parametric magnetic resonance imaging (MRI) at baseline and 4-months. Diagnostic accuracy to identify MASH was assessed using the area under receiver operating characteristic (AUROC) curve. Results Four (31%) of patients in the LSG group had MASH [non-alcoholic steatohepatitis (NAS) activity score ≥4] on liver biopsy. PDFF and cT1 correlated with the NAS activity score [r=0.81, 95% confidence interval (CI): 0.453 to 0.943, P<0.001] and (r=0.70, 95% CI: 0.228 to 0.907, P=0.008, respectively). There was good AUROC curve for cT1 (0.89, 95% CI: 0.67 to 1.00, P=0.031) and PDFF (0.83, 95% CI: 0.57 to 1.00, P=0.064) to identify MASH. At follow-up, weight reduction -22.8% (P=0.013) vs. -1.3% (P=0.262) resulted in cT1 reduction of -8.04% (864 ms, P=0.025) vs. -3.87% (907 ms, P=0.083) in the LSG vs. LMP group, respectively. Significant differences between interventions were observed for percentage PDFF decrease (-64.52% vs. -29.16%, P=0.001). Both biomarkers were significantly reduced in the LSG group (cT1 by -8.04%, P=0.025, PDFF by -64.52%, P=0.012), while only PDFF (-29.16%, P=0.012) was significantly reduced in the LMP group. Conclusions MRI biomarkers may have some utility to monitor MASH following intervention in patients with obesity allowing objective comparison between intervention strategies. Compared to LMP, LSG was more effective in improving liver health.
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Affiliation(s)
- Chileka Chiyanika
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Steve Cheuk Ngai Hui
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
- Developing Brain Institute, Children’s National Hospital, Washington, DC, USA
- Department of Radiology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Daisy Man Ching Sin
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Simon Kin Hung Wong
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Enders Kwok Wai Ng
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Terry Cheuk-Fung Yip
- Medical Data Analytic Centre, The Chinese University of Hong Kong, Hong Kong, China
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Vincent Wai-Sun Wong
- Medical Data Analytic Centre, The Chinese University of Hong Kong, Hong Kong, China
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - Winnie Chiu Wing Chu
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
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Ren S, Wu D, Li P. Evaluation of insulin secretion and insulin sensitivity in pregnant women: Application value of simple indices. Clin Chim Acta 2024; 554:117753. [PMID: 38185282 DOI: 10.1016/j.cca.2023.117753] [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: 06/15/2023] [Revised: 12/29/2023] [Accepted: 12/29/2023] [Indexed: 01/09/2024]
Abstract
The prevalence of gestational diabetes mellitus (GDM) is increasing annually, which poses substantial harm to the health of both mothers and children. Therefore, selection of clinically applicable and easily detectable indicators in the assessment of maternal insulin secretory function and insulin sensitivity in pregnant women undoubtedly holds great importance in evaluating the risk of GDM, guiding the choice of GDM therapy modalities, and improving the ability to provide early warning of adverse pregnancy outcomes. Compared with the classic clamp technique, many simple indices are more suited for use among pregnant women due to the low frequency of blood sampling and simple administration involved. While indices derived from fasting blood glucose and fasting insulin levels are most readily available, they are unable to provide information on the ability of insulin to manage the glucose load during pregnancy. Although the indices derived from the insulin and glucose values at each time point of the oral glucose tolerance test can provide a more comprehensive picture of the insulin sensitivity and insulin secretory function of the body, their application is constrained by the complexity of the procedure and associated high costs. Concomitantly, the findings from different studies are influenced by a variety of confounding factors, such as the gestational age during testing, race, and detection method. Furthermore, insulin secretory function and insulin sensitivity in pregnant women differ from those in non-pregnant women in that they change significantly with prolonged pregnancy; hence, there is an urgent need to develop a pregnancy-specific reference range. This article reviews the progress in the application of simple indices to help clinicians better understand their potential application in detecting GDM.
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Affiliation(s)
- Shuying Ren
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China
| | - Dan Wu
- Department of Endocrinology, 242 Hospital Affilliated to Shenyang Medical College, Shenyang, Liaoning Province, People's Republic of China
| | - Ping Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China.
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Hong KF, Liu PY, Zhang W, Gui DK, Xu YH. The Efficacy and Safety of Astragalus as an Adjuvant Treatment for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:11-24. [PMID: 37433206 DOI: 10.1089/jicm.2022.0767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
Objective: This meta-analysis evaluated the beneficial and potential adverse effects of Astragalus in the treatment of patients with type 2 diabetes mellitus (T2DM). Methods: The authors searched for randomized controlled trials of Astragalus treatment for patients with T2DM in the following databases: PubMed, Embase, Cochrane Library, China Knowledge Resource Integrated Database (CNKI), Wanfang Data, China Science and Technology Journal Database (CQVIP), and SinoMed. Two reviewers conducted independent selection of studies, data extraction, and coding, as well as the assessment of risk of bias in the studies included. Standard meta-analysis and, if appropriate, meta-regression were performed using the STATA, v.15.1, software. Results: This meta-analysis encompasses 20 studies and a total of 953 participants. Compared to the control group (CG), the observation group (OG) decreased fasting plasma glucose (FPG) (WMD = -0.67, 95% CI: -1.13∼-0.20, P = 0.005), 2 hours postprandial plasma glucose (2hPG) (WMD = -0.67 (95% CI: -1.13∼-0.20, P=0.005), glycated hemoglobin A1C (HbA1c) (WMD = -0.93, 95% CI: -1.22∼-0.64, P = 0.000), homeostatic model assessment for insulin resistance (HOMA-IR) (WMD = -0.45, 95% CI: -0.99∼0.99, P = 0.104), insulin sensitive index (WMD = 0.42, 95% CI: 0.13-0.72, P = 0.004). The total effective ratio of the OG is more effective than CG (RR = 1.33, 95% CI: 1.26-1.40, P = 0.000), the significant effective ratio (RR = 1.69, 95% CI: 1.48-1.93, P = 0.000). Conclusions: Astragalus may provide specific benefits for T2DM patients as an adjuvant treatment. Nonetheless, the certainty of the evidence and risk of bias fell short of optimal performance, indicating the need for additional clinical research to ascertain potential effects. PROSPERO REGISTRATION NUMBER CRD42022338491.
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Affiliation(s)
- Kin-Fong Hong
- Faculty of Medicine, Macau University of Science and Technology, Taipa, China
| | - Pei-Yu Liu
- Faculty of Medicine, Macau University of Science and Technology, Taipa, China
| | - Wei Zhang
- Faculty of Medicine, Macau University of Science and Technology, Taipa, China
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Ding-Kun Gui
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - You-Hua Xu
- Faculty of Medicine, Macau University of Science and Technology, Taipa, China
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Amelia R, Harahap J, Zulham, Fujiati II, Wijaya H. Educational Model and Prevention on Prediabetes: A Systematic Review. Curr Diabetes Rev 2024; 20:e101023221945. [PMID: 37818560 PMCID: PMC10909827 DOI: 10.2174/0115733998275518231006074504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Prediabetes is a reversible condition before the onset of Type 2 Diabetes Mellitus. Untreated condition of prediabetes will develop into diabetes and its complications. The prevalence of prediabetes has been emerging worldwide and has a considerable socioeconomic impact. The current study reviews the roles of early detection, educational models, life modification, and prophylaxis of individuals with prediabetes in preventing the progression of prediabetes into Type 2 Diabetes Mellitus and complications in the future. METHODS This study included published articles from several electronic databases. The obtained articles were limited to March 2023. Articles that were not open access and not in Indonesian or English were excluded. The protocol for this study used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020. RESULTS Of 39627 articles, 39601 were excluded due to duplication and did not meet the eligibility criteria. At the final, there were 26 articles that were eligible for systematic review. CONCLUSION Prevention of the development of prediabetes into diabetes is essential. A comprehensive understanding and training on intensive lifestyle modification protocols from local and national experts in diabetes prevention through digital-based education models and linguistically and culturally approach can be considered. Intensive lifestyle modification and pharmacological approaches may improve the outcome. Regular monitoring of glycemic control is also important for early diagnosis of diabetes, especially in patients with special conditions.
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Affiliation(s)
- Rina Amelia
- Department of Community Medicine/Public Health Sumatera Utara, Faculty of Medicine, Universitas Sumatera Utara, Utara, Indonesia
| | - Juliandi Harahap
- Department of Community Medicine/Public Health Sumatera Utara, Faculty of Medicine, Universitas Sumatera Utara, Utara, Indonesia
| | - Zulham
- Department of Histology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Isti Ilmiati Fujiati
- Department of Community Medicine/Public Health Sumatera Utara, Faculty of Medicine, Universitas Sumatera Utara, Utara, Indonesia
| | - Hendri Wijaya
- Department of Paediatics, Faculty of Medicine, Universitas Sumatera Utara, H. Adam Malik General Hospital, Madan, Indonesia
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De Sanctis V, Soliman AT, Daar S, Tzoulis P, Karimi M, Saki F, Di Maio S, Kattamis C. A prospective guide for clinical implementation of selected OGTT- derived surrogate indices for the evaluation of β- cell function and insulin sensitivity in patients with transfusion-dependent β- thalassaemia. ACTA BIO-MEDICA : ATENEI PARMENSIS 2023; 94:e2023221. [PMID: 38054665 PMCID: PMC10734222 DOI: 10.23750/abm.v94i6.15329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/07/2023]
Abstract
The gold standard for the measurement of insulin secretion is the hyperglycemic clamp and for insulin sensitivity the hyperinsulinemic euglycemic clamp, respectively. A number of surrogate indices, derived from plasma glucose and insulin levels at a fasting state or after oral glucose load, have been proposed to estimate β-cell response, and the ability of β-cells to compensate for changes of insulin sensitivity by modulating insulin secretion (disposition index). Starting from the current recommendations for the annual screening of glucose dysregulation in patients with transfusion dependent β-thalassemia (β-TDT), this article summarizes the most frequently used indirect indices of insulin secretion and resistance derived from the oral glucose tolerance test (OGTT) and discusses the strengths and weaknesses of selected indices and the basic concepts underlying each method for the appropriate evaluation of glucose regulation. Basal indices for β-cell function and insulin sensitivity, albeit simple and cheap, have limited usefulness due to a high coefficient variation and the lack of data about response to glucose load. Therefore, measurement of indices during an OGTT, despite being costly and time-consuming, is suggested since it can detect, even subtle, dynamic changes in insulin secretion and glucose handling. In patients with β-TDT, the indices derived from OGTT may offer an additional factor to evaluate the efficiency of iron chelation therapy and detect patients who may need intensification of iron chelation therapy and/or pharmacological intervention.
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Affiliation(s)
| | - Ashraf T Soliman
- Department of Pediatrics, Division of Endocrinology, Hamad General Hospital, Doha, Qatar .
| | - Shahina Daar
- Department of Haematology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman.
| | - Ploutarchos Tzoulis
- Department of Diabetes and Endocrinology, Whittington Hospital, University College London, London, UK.
| | - Mehran Karimi
- Hematology- Oncology Department, American Hospital Dubai, Dubai, UAE .
| | - Forough Saki
- Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Salvatore Di Maio
- Emeritus Director in Pediatrics, Children's Hospital "Santobono-Pausilipon", Naples, Italy.
| | - Christos Kattamis
- Τhalassemia Unit, First Department of Paediatrics, National Kapodistrian University of Athens 11527, Greece.
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Lauw S, Kei N, Chan PL, Yau TK, Ma KL, Szeto CYY, Lin JSC, Wong SH, Cheung PCK, Kwan HS. Effects of Synbiotic Supplementation on Metabolic Syndrome Traits and Gut Microbial Profile among Overweight and Obese Hong Kong Chinese Individuals: A Randomized Trial. Nutrients 2023; 15:4248. [PMID: 37836532 PMCID: PMC10574554 DOI: 10.3390/nu15194248] [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: 08/15/2023] [Revised: 09/29/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
In view of the limited evidence showing anti-obesity effects of synbiotics via modulation of the gut microbiota in humans, a randomized clinical trial was performed. Assessment of the metabolic syndrome traits and profiling of the fecal gut microbiota using 16S rRNA gene sequencing in overweight and obese Hong Kong Chinese individuals before and after dietary intervention with an 8-week increased consumption of fruits and vegetables and/or synbiotic supplementation was conducted. The selected synbiotic contained two probiotics (Lactobacillus acidophilus NCFM and Bifidobacterium lactis HN019) and a prebiotic (polydextrose). Fifty-five overweight or obese individuals were randomized and divided into a synbiotic group (SG; n = 19), a dietary intervention group (DG; n = 18), and a group receiving combined interventions (DSG; n = 18). DSG showed the greatest weight loss effects and number of significant differences in clinical parameters compared to its baseline values-notably, decreases in fasting glucose, insulin, HOMA-IR, and triglycerides and an increase in HDL-cholesterol. DSG lowered Megamonas abundance, which was positively associated with BMI, body fat mass, and trunk fat mass. The results suggested that increasing dietary fiber consumption from fruits and vegetables combined with synbiotic supplementation is more effective than either approach alone in tackling obesity.
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Affiliation(s)
- Susana Lauw
- Food and Nutritional Sciences Program, School of Life Sciences, Faculty of Science, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.L.); (N.K.); (K.L.M.); (P.C.K.C.)
- Food Research Centre, The Chinese University of Hong Kong, Hong Kong SAR, China;
| | - Nelson Kei
- Food and Nutritional Sciences Program, School of Life Sciences, Faculty of Science, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.L.); (N.K.); (K.L.M.); (P.C.K.C.)
| | - Po Lam Chan
- Food Research Centre, The Chinese University of Hong Kong, Hong Kong SAR, China;
- HSK GeneTech Limited, Hong Kong SAR, China;
| | - Tsz Kwan Yau
- Cell and Molecular Biology Program, School of Life Sciences, Faculty of Science, The Chinese University of Hong Kong, Hong Kong SAR, China;
| | - Ka Lee Ma
- Food and Nutritional Sciences Program, School of Life Sciences, Faculty of Science, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.L.); (N.K.); (K.L.M.); (P.C.K.C.)
| | | | - Janice Su-Chuen Lin
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China;
| | - Sunny Hei Wong
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore;
| | - Peter Chi Keung Cheung
- Food and Nutritional Sciences Program, School of Life Sciences, Faculty of Science, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.L.); (N.K.); (K.L.M.); (P.C.K.C.)
- Food Research Centre, The Chinese University of Hong Kong, Hong Kong SAR, China;
| | - Hoi Shan Kwan
- Food Research Centre, The Chinese University of Hong Kong, Hong Kong SAR, China;
- HSK GeneTech Limited, Hong Kong SAR, China;
- ProBioLife Limited, Hong Kong SAR, China
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Megawati G, Syahruddin SS, Tjandra W, Kusumawati M, Herawati DMD, Gurnida DA, Musfiroh I. Effects of Indonesian Shortfin Eel ( Anguilla bicolor) By-Product Oil Supplementation on HOMA-IR and Lipid Profile in Obese Male Wistar Rats. Nutrients 2023; 15:3904. [PMID: 37764688 PMCID: PMC10534436 DOI: 10.3390/nu15183904] [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: 07/30/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
The prevalence of people being overweight and obese has increased globally over the past decades. The use of omega-3 fatty acids-a compound usually primarily found in fish oil-has been known to improve the metabolic profile of obese patients. As the demand for eels increases, the number of waste products from the eels increases and creates environmental problems. This study was conducted to investigate the effect of a newly discovered Indonesian Shortfin eel by-product oil supplementation on the Homeostasis Model Assessment-Estimated Insulin Resistance (HOMA-IR) and lipid profiles of obese male (Lee index ≥ 0.3) Wistar rats (Rattus norvegicus). The oil was extracted from waste products (heads). Fifteen obese rats were divided into three groups and were administered NaCl (C), commercial fish oil (CO), and Indonesian shortfin eel by-product oil (EO). All groups had statistically significant differences in total cholesterol, LDL, and triglyceride levels (p < 0.05). The CO and EO group showed a significant decrease in total cholesterol, LDL, and triglyceride after treatment. However, no significant difference was found in HDL levels and HOMA-IR. The supplementation of Indonesian shortfin eel by-product oil significantly improved lipid profile while effectively mitigating environmental challenges.
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Affiliation(s)
- Ginna Megawati
- Doctoral Study Program, Faculty of Medicine, Universitas Padjadjaran, Bandung 40161, Indonesia;
- Division of Medical Nutrition, Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Sumedang 45363, Indonesia
| | - Siti Shofiah Syahruddin
- Medical Undergraduate Program, Faculty of Medicine, Universitas Padjadjaran, Sumedang 45363, Indonesia
| | - Winona Tjandra
- Medical Undergraduate Program, Faculty of Medicine, Universitas Padjadjaran, Sumedang 45363, Indonesia
| | - Maya Kusumawati
- Department of Internal Medicine, Faculty of Medicine, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung 40161, Indonesia
| | - Dewi Marhaeni Diah Herawati
- Division of Medical Nutrition, Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Sumedang 45363, Indonesia
| | - Dida Achmad Gurnida
- Department of Child Health, Faculty of Medicine, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung 40161, Indonesia
| | - Ida Musfiroh
- Department of Pharmaceutical Analysis dan Medicinal Chemistry, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang 45363, Indonesia
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10
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Masoodian SM, Omidifar A, Moradkhani S, Asiabanha M, Khoshmirsafa M. HOMA-IR mean values in healthy individuals: a population-based study in iranian subjects. J Diabetes Metab Disord 2023; 22:219-224. [PMID: 37255829 PMCID: PMC10225417 DOI: 10.1007/s40200-022-01099-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 06/07/2022] [Accepted: 07/16/2022] [Indexed: 06/01/2023]
Abstract
Purpose Homeostasis Model Assessment-estimated Insulin Resistance (HOMA-IR) is an important indicator of insulin resistance. In this population-based investigation, we sought to report the mean value of HOMA-IR in different subgroups of a large population-based database of Iranian healthy subjects. Methods This study recruited adult healthy individuals between the ages of 18 to 70 years old to Massoud Medical Laboratory, Tehran, Iran. Fasting insulin was measured by using the Electro Chemiluminescence method using Roche Cobas 6000 e601/602 instrument. Results The mean ± SD value of the HOMA-IR index in the studied population was 2.11 ± 0.99 (2.5-97.5% percentiles: 0.66-4.50). In addition, the mean ± SD of HOMA-IR index in male and female groups were 2.35 1.0 (2.5-97.5 percentile: 0.57-4.37) and 2.05 ± 1.0 (2.5-97.5 percentiles: 0.53-4.35), respectively. Interestingly, it was observed a significant increment for the HOMA-IR index in the male group compared with the female group in all age subgroups (P < 0.01). Conclusions Our findings showed the mean value of 2.11 ± 0.99 HOMA-IR in the Iranian healthy population. Considering the large sample size in our study, more clinical investigations in terms of ethnicity should be done to provide a precise standardized HOMA-IR index in the Iranian population. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-022-01099-9.
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Affiliation(s)
| | - Abolfazl Omidifar
- Department of Biochemistry and Immunochemistry, Massoud Laboratory, Tehran, Iran
| | - Sepideh Moradkhani
- Department of Biochemistry and Immunochemistry, Massoud Laboratory, Tehran, Iran
| | - Majid Asiabanha
- Department of Biochemistry and Immunochemistry, Massoud Laboratory, Tehran, Iran
| | - Majid Khoshmirsafa
- Immunology Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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11
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Alidu H, Dapare PPM, Quaye L, Amidu N, Bani SB, Banyeh M. Insulin Resistance in relation to Hypertension and Dyslipidaemia among Men Clinically Diagnosed with Type 2 Diabetes. BIOMED RESEARCH INTERNATIONAL 2023; 2023:8873226. [PMID: 37274075 PMCID: PMC10238133 DOI: 10.1155/2023/8873226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/03/2023] [Accepted: 05/19/2023] [Indexed: 06/06/2023]
Abstract
Pathophysiologically, type 2 diabetes can result from insulin resistance or insulin insufficiency alone. It is unclear whether relative insulin shortage or pronounced insulin resistance is linked to poor cardiometabolic problems like obesity. Therefore, the objective of this study was to evaluate the relationship between insulin resistance (IR), hypertension, and dyslipidaemia, in men with type 2 diabetes mellitus. One hundred and twenty-one (121) type 2 diabetic men participated in this cross-sectional study, which was conducted between September 2018 and September 2019. Sociodemographic information was collected using a self-designed questionnaire. Anthropometric data were also taken and blood samples collected for estimation of insulin, glucose, and lipid concentrations. HOMA-IR was calculated from the fasting insulin and glucose values, and a HOMA - IR ≥ 2 was considered to indicate insulin resistance. Of the 121 participants, 39.7% were classified as insulin-resistant. Levels of total cholesterol (4.82 ± 1.2 mmol/L; p = 0.007 vs. 4.25 ± 1.1 mmol/L), LDL cholesterol (3.17 ± 0.9 mmol/L; p = 0.001 vs. 2.52 ± 0.8 mmol/L), and TC/HDL-C ratio (3.93 ± 0.9; p = 0.042 vs. 3.58 ± 0.9) and the prevalence of abnormal LDL-C (14.6%; p = 0.015 vs. 2.7%) and elevated BP (83.3%; p = 0.048 vs. 67.1%) were higher in the insulin-resistant group. LDL cholesterol (AUC = 0.670; p = 0.001) better classified subjects as being insulin-resistant compared to other lipid markers. The odds of insulin resistance in dyslipidaemia were not statistically significant after adjusting for obesity. The link between insulin resistance and dyslipidaemia and hypertension in male diabetics may thus be mediated by obesity.
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Affiliation(s)
- Huseini Alidu
- Department of Medical Laboratory Science, University of Health and Allied Sciences, Ho, Ghana
| | | | - Lawrence Quaye
- Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
| | - Nafiu Amidu
- Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
| | - Simon Bannison Bani
- Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
| | - Moses Banyeh
- Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana
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12
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Francis EC, Kechris K, Jansson T, Dabelea D, Perng W. Novel Metabolic Subtypes in Pregnant Women and Risk of Early Childhood Obesity in Offspring. JAMA Netw Open 2023; 6:e237030. [PMID: 37014638 PMCID: PMC10074224 DOI: 10.1001/jamanetworkopen.2023.7030] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/21/2023] [Indexed: 04/05/2023] Open
Abstract
Importance The in utero metabolic milieu is associated with offspring adiposity. Standard definitions of maternal obesity (according to prepregnancy body mass index [BMI]) and gestational diabetes (GDM) may not be adequate to capture subtle yet important differences in the intrauterine environment that could be involved in programming. Objectives To identify maternal metabolic subgroups during pregnancy and to examine associations of subgroup classification with adiposity traits in their children. Design, Setting, and Participants This cohort study included mother-offspring pairs in the Healthy Start prebirth cohort (enrollment: 2010-2014) recruited from University of Colorado Hospital obstetrics clinics in Aurora, Colorado. Follow-up of women and children is ongoing. Data were analyzed from March to December 2022. Exposures Metabolic subtypes of pregnant women ascertained by applying k-means clustering on 7 biomarkers and 2 biomarker indices measured at approximately 17 gestational weeks: glucose, insulin, Homeostatic Model Assessment for Insulin Resistance, total cholesterol, high-density lipoprotein cholesterol (HDL-C), triglycerides, free fatty acids (FFA), HDL-C:triglycerides ratio, and tumor necrosis factor α. Main Outcomes and Measures Offspring birthweight z score and neonatal fat mass percentage (FM%). In childhood at approximately 5 years of age, offspring BMI percentile, FM%, BMI in the 95th percentile or higher, and FM% in the 95th percentile or higher. Results A total of 1325 pregnant women (mean [SD] age, 27.8 [6.2 years]; 322 [24.3%] Hispanic, 207 non-Hispanic Black [15.6%], and 713 [53.8%] non-Hispanic White), and 727 offspring with anthropometric data measured in childhood (mean [SD] age 4.81 [0.72] years, 48% female) were included. We identified the following 5 maternal metabolic subgroups: reference (438 participants), high HDL-C (355 participants), dyslipidemic-high triglycerides (182 participants), dyslipidemic-high FFA (234 participants), and insulin resistant (IR)-hyperglycemic (116 participants). Compared with the reference subgroup, women in the IR-hyperglycemic and dyslipidemic-high FFA subgroups had offspring with 4.27% (95% CI, 1.94-6.59) and 1.96% (95% CI, 0.45-3.47) greater FM% during childhood, respectively. There was a higher risk of high FM% among offspring of the IR-hyperglycemic (relative risk, 8.7; 95% CI, 2.7-27.8) and dyslipidemic-high FFA (relative risk, 3.4; 95% CI, 1.0-11.3) subgroups; this risk was of greater magnitude compared with prepregnancy obesity alone, GDM alone, or both conditions. Conclusions and Relevance In this cohort study, an unsupervised clustering approach revealed distinct metabolic subgroups of pregnant women. These subgroups exhibited differences in risk of offspring adiposity in early childhood. Such approaches have the potential to refine understanding of the in utero metabolic milieu, with utility for capturing variation in sociocultural, anthropometric, and biochemical risk factors for offspring adiposity.
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Affiliation(s)
- Ellen C. Francis
- The Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Aurora, Colorado
| | - Katerina Kechris
- The Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Aurora, Colorado
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora
| | - Thomas Jansson
- Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora
| | - Dana Dabelea
- The Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Aurora, Colorado
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora
| | - Wei Perng
- The Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Aurora, Colorado
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora
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13
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Chou T, Lin C, Chen L, Hu C, Chang J, Yen C, Chen S, Liu C, Chien C. Waist-to-height ratio for the prediction of gallstone disease among different obesity indicators. Obes Sci Pract 2023; 9:30-41. [PMID: 36789027 PMCID: PMC9913192 DOI: 10.1002/osp4.650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 11/09/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022] Open
Abstract
Background Factors of metabolic syndrome such as obesity are well-known risk factors for gallstone disease (GSD). There are different indicators of obesity, including weight, body mass index, waist circumference, and waist-to-height ratio. The predictive ability of different obesity indicators for GSD remains unclear. Objective To explore the most efficient predictor of GSD among the different anthropometric indicators of obesity. Methods This population-based cross-sectional study included 2263 participants who completed a questionnaire detailing their demographics, medical history, and lifestyle between 2014 and 2017 in Taiwan. Blood samples were collected and physical examinations, including anthropometric measurements, were performed. Gallstone disease was ascertained using ultrasonography. Multivariate analyses were performed to identify independent risk factors for GSD. Results The overall prevalence of GSD was 8.8%. According to the multivariate analysis, individuals with a waist-to-height ratio ≥0.5 (odds ratio|odds ratios (OR) = 1.65, 95% confidence interval (CI) = 1.10-2.48, p = 0.017) had an increased risk of GSD. Diabetes was the main risk factor for GSD in men (OR = 2.06, 95% CI = 1.17-3.65, p = 0.013). Among women, waist-to-height ratio >0.5 (OR = 1.76, 95% CI = 1.03-3.02, p = 0.040) and current hormone drug use (OR = 2.73, 95% CI = 1.09-6.84, p = 0.033) were significant risk factors for gallstones. Conclusion GSD was independently associated with central obesity and exogenous hormone intake in women. Among the anthropometric indicators used to assess central obesity, waist-to-height ratio was the most accurate predictor of GSD.
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Affiliation(s)
- Tien‐Shin Chou
- Division of GastroenterologyDepartment of Internal MedicineKeelung Chang Gung Memorial HospitalKeelungTaiwan, ROC
| | - Chih‐Lang Lin
- Division of GastroenterologyDepartment of Internal MedicineKeelung Chang Gung Memorial HospitalKeelungTaiwan, ROC
- Liver Research UnitKeelung Chang Gung Memorial HospitalKeelungTaiwan, ROC
- Community Medicine Research CenterKeelung Chang Gung Memorial HospitalKeelungTaiwan, ROC
| | - Li‐Wei Chen
- Division of GastroenterologyDepartment of Internal MedicineKeelung Chang Gung Memorial HospitalKeelungTaiwan, ROC
- Liver Research UnitKeelung Chang Gung Memorial HospitalKeelungTaiwan, ROC
- Community Medicine Research CenterKeelung Chang Gung Memorial HospitalKeelungTaiwan, ROC
| | - Ching‐Chih Hu
- Division of GastroenterologyDepartment of Internal MedicineKeelung Chang Gung Memorial HospitalKeelungTaiwan, ROC
- Liver Research UnitKeelung Chang Gung Memorial HospitalKeelungTaiwan, ROC
- Community Medicine Research CenterKeelung Chang Gung Memorial HospitalKeelungTaiwan, ROC
| | - Jia‐Jang Chang
- Division of GastroenterologyDepartment of Internal MedicineKeelung Chang Gung Memorial HospitalKeelungTaiwan, ROC
| | - Cho‐Li Yen
- Division of GastroenterologyDepartment of Internal MedicineKeelung Chang Gung Memorial HospitalKeelungTaiwan, ROC
| | - Shuo‐Wei Chen
- Division of GastroenterologyDepartment of Internal MedicineKeelung Chang Gung Memorial HospitalKeelungTaiwan, ROC
| | - Ching‐Jung Liu
- Division of GastroenterologyDepartment of Internal MedicineKeelung Chang Gung Memorial HospitalKeelungTaiwan, ROC
| | - Cheng‐Hung Chien
- Division of GastroenterologyDepartment of Internal MedicineKeelung Chang Gung Memorial HospitalKeelungTaiwan, ROC
- Liver Research UnitKeelung Chang Gung Memorial HospitalKeelungTaiwan, ROC
- Community Medicine Research CenterKeelung Chang Gung Memorial HospitalKeelungTaiwan, ROC
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14
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Huang YC, Chen BH. A Comparative Study on Improving Streptozotocin-Induced Type 2 Diabetes in Rats by Hydrosol, Extract and Nanoemulsion Prepared from Cinnamon Leaves. Antioxidants (Basel) 2022; 12:29. [PMID: 36670891 PMCID: PMC9855112 DOI: 10.3390/antiox12010029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/12/2022] [Accepted: 12/17/2022] [Indexed: 12/28/2022] Open
Abstract
Cinnamomoum osmophloeum Kanehira (C. osmophloeum) contains various biologically active antioxidant compounds such as flavonoids, phenolic acids and cinnamaldehyde. Type 2 diabetes mellitus is a chronic disease of metabolic abnormality caused by insulin deficiency or resistance. The objectives of this study were to analyze various bioactive compounds in C. osmophloeum leaves by ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS), and compare the effects of hydrosol, extract and nanoemulsion prepared from C. osmophloeum leaves on improving type 2 diabetes in rats. Our results show that a total of 15 bioactive compounds in C. osmophloeum leaves, including quercetin, quercetin-3-O-galactoside, quercetin-3-O-glucoside, rutin, caffeic acid, benzoic acid, 5-O-caffeoylquinic acid, kaempferol 3-β-D-glucopyranoside, trans-cinnamic acid, coumarin, cinnamyl alcohol, p-coumaric acid, eugenol, kaempferol and cinnamaldehyde, were separated within 14 min for subsequent identification and quantitation by UPLC-MS/MS. The nanoemulsion was successfully prepared by mixing C. osmophloeum leaf extract, soybean oil, lecithin, Tween 80 and deionized water in an appropriate proportion with a mean particle size, polydispersity index, zeta potential and encapsulation efficiency of 36.58 nm, 0.222, -42.6 mV and 91.22%, respectively, while a high storage and heating stability was obtained. The animal experiment results reveal that the high-dose nanoemulsion was the most effective in reducing both fasting blood glucose and oral glucose tolerance test value, followed by low-dose nanoemulsion, high-dose extract, low-dose extract and leaf powder in hydrosol. A similar trend was shown in reducing serum insulin and the homeostatic model assessment of insulin resistance index. In addition, the contents of serum biochemical parameters, including total cholesterol, triglyceride, aspartate aminotransferase, alanine aminotransferase, uric acid, urea nitrogen and creatinine, were reduced, with the high-dose nanoemulsion showing the most pronounced effect. Collectively, the high-dose nanoemulsion may possess great potential to be developed into a hypoglycemic health food or botanic drug.
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Affiliation(s)
- Yu-Chi Huang
- Department of Food Science, Fu Jen Catholic University, New Taipei City 24205, Taiwan
| | - Bing-Huei Chen
- Department of Food Science, Fu Jen Catholic University, New Taipei City 24205, Taiwan
- Department of Nutrition, China Medical University, Taichung 40402, Taiwan
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15
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Gong R, Pu X, Cheng Z, Ding J, Chen Z, Wang Y. The association between serum cadmium and diabetes in the general population: A cross-sectional study from NHANES (1999-2020). Front Nutr 2022; 9:966500. [PMID: 36570173 PMCID: PMC9768494 DOI: 10.3389/fnut.2022.966500] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Background Associations between serum cadmium and diabetes had been reported in previous studies, however there was still considerable controversy regarding associations. Studies in general population that investigated the effects of serum cadmium on diabetes were currently lacking. We designed this cross-sectional study among U.S. adults under high and low cadmium exposure to assess associations between serum cadmium and diabetes. Methods This cross-sectional study analyzed 52,593 adults who aged more than 20 years and participated in the National Health and Nutrition Examination Survey (NHANES), 1999-2020. The missing values and extreme values in the covariables were filled by multiple interpolation. Univariate logistics regression, multivariate logistics regression and smooth fitting curves were used to analyze the association between serum cadmium and diabetes. Simultaneously, sensitivity analysis was carried out by converting the serum cadmium from continuous variable to categorical variable. The stratification logistics regression model was used to analyze whether there were special groups in each subgroup to test the stability of the results. Results In this cross-sectional study, serum cadmium levels were negatively correlated with the occurrence of diabetes in the low serum cadmium exposure group (OR = 0.811, 95% CI 0.698, 0.943; P = 0.007). There was no association between serum cadmium level and the occurrence of diabetes in the high serum cadmium exposure group (OR = 1.01, 95% CI 0.982, 1.037; P = 0.511). These results were consistent across all the subgroups (P for interaction >0.05). Conclusion Serum cadmium was negatively associated diabetes among the representative samples of the whole population in the United States under the normal level of serum cadmium exposure. However, there was no association between serum cadmium level and the occurrence of diabetes in the high serum cadmium exposure group. This study promoted an update of new preventative strategy targeting environment for the prevention and control of diabetes in the future.
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Affiliation(s)
| | - Xiaolu Pu
- Qinghai University, Xining, Qinghai, China
| | - Zhenqian Cheng
- Department of Clinical Nutrition, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Jie Ding
- Department of Clinical Nutrition, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Zhenghao Chen
- University of Electronic Science and Technology of China, Chengdu, Sichuan, China,*Correspondence: Zhenghao Chen
| | - Yongjun Wang
- Department of Clinical Nutrition, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China,National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Yongjun Wang
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16
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González-González JG, Violante-Cumpa JR, Zambrano-Lucio M, Burciaga-Jimenez E, Castillo-Morales PL, Garcia-Campa M, Solis RC, González-Colmenero AD, Rodríguez-Gutiérrez R. HOMA-IR as a predictor of Health Outcomes in Patients with Metabolic Risk Factors: A Systematic Review and Meta-analysis. High Blood Press Cardiovasc Prev 2022; 29:547-564. [PMID: 36181637 DOI: 10.1007/s40292-022-00542-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/14/2022] [Indexed: 10/07/2022] Open
Abstract
INTRODUCTION There exists clinical interest in the following question: Is there an association between HOMA-IR and the risk of developing metabolic diseases? AIMS Assessing the association between high values of HOMA-IR with the incidence of T2DM, MACE, essential hypertension, dyslipidemia, NASH, and cancer in healthy participants and participants with a component of metabolic syndrome. METHODS Databases were searched by an experienced librarian to find eligible studies. Observational cohort studies enrolling healthy adults and adults with metabolic syndrome components that evaluated HOMA as a marker of IR were considered for inclusion. Eligibility assessment, data extraction and risk of bias assessment were performed independently and in duplicate. Baseline characteristics of patients, cutoff values of HOMA-IR to predict metabolic events were extracted independently and in duplicate. RESULTS 38 studies (215,878 participants) proved eligible. A higher HOMA-IR value had a significant effect on the risk of developing T2DM (HR 1.87; CI 1.40-2.49), presenting non-fatal MACE (HR 1.46; CI 1.08-1.97) and hypertension (HR 1.35; CI 1.15-1.59). No association was found regarding cancer mortality and fatal MACE with higher HOMA-IR values, there was not enough information to carry out a meta-analysis to establish an association between higher values of HOMA with cancer incidence, dyslipidemia, and NASH. CONCLUSIONS High values of HOMA were associated with an increased risk of diabetes, hypertension, and non-fatal MACE; yet, not for cardiovascular or cancer mortality. More research is needed to determine the value of the HOMA index in metabolic and cardiovascular outcomes. PROSPERO REGISTRATION NUMBER CRD42020187645.
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Affiliation(s)
- José G González-González
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Knowledge and Evaluation Research Unit, Mayo Clinic, 201 W. Center St, Rochester, MN, 55902, USA.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Jorge R Violante-Cumpa
- Division of Endocrinology, Internal Medicine Department, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Ave. Gonzalitos y Madero s/n 64460, Monterrey, Nuevo León, México.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Miguel Zambrano-Lucio
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Erick Burciaga-Jimenez
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Patricia L Castillo-Morales
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Mariano Garcia-Campa
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Ricardo César Solis
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Alejandro D González-Colmenero
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - René Rodríguez-Gutiérrez
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico. .,Knowledge and Evaluation Research Unit, Mayo Clinic, 201 W. Center St, Rochester, MN, 55902, USA. .,Division of Endocrinology, Internal Medicine Department, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Ave. Gonzalitos y Madero s/n 64460, Monterrey, Nuevo León, México. .,Research Unit, School of Medicine and University Hospital "Dr. Jose E. Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.
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17
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The Roles of Probiotics in the Gut Microbiota Composition and Metabolic Outcomes in Asymptomatic Post-Gestational Diabetes Women: A Randomized Controlled Trial. Nutrients 2022; 14:nu14183878. [PMID: 36145254 PMCID: PMC9504400 DOI: 10.3390/nu14183878] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 12/04/2022] Open
Abstract
Probiotics are widely used as an adjuvant therapy in various diseases. Nonetheless, it is uncertain how they affect the gut microbiota composition and metabolic and inflammatory outcomes in women who have recently experienced gestational diabetes mellitus (post-GDM). A randomized, double-blind, placebo-controlled clinical trial involving 132 asymptomatic post-GDM women was conducted to close this gap (Clinical Trial Registration: NCT05273073). The intervention (probiotics) group received a cocktail of six probiotic strains from Bifidobacterium and Lactobacillus for 12 weeks, while the placebo group received an identical sachet devoid of living microorganisms. Anthropometric measurements, biochemical analyses, and 16S rRNA gene sequencing results were evaluated pre- and post-intervention. After the 12-week intervention, the probiotics group’s fasting blood glucose level significantly decreased (mean difference −0.20 mmol/L; p = 0.0021). The HbA1c, total cholesterol, triglycerides, and high-sensitivity C-reactive protein levels were significantly different between the two groups (p < 0.05). Sequencing data also demonstrated a large rise in the Bifidobacterium adolescentis following probiotic supplementation. Our findings suggest that multi-strain probiotics are beneficial for improved metabolic and inflammatory outcomes in post-GDM women by modulating gut dysbiosis. This study emphasizes the necessity for a comprehensive strategy for postpartum treatment that includes probiotics to protect post-GDM women from developing glucose intolerance.
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LIONTOS A, BIROS D, PAPAGIANNOPOULOS C, ANASTASIOU G, ADAMIDIS PS, BAKOGIANNIS K, MILIONIS H, LIBEROPOULOS E, ELISAF M, LIAMIS G. The Effect of Commonly Used Fixed-Dose Single Pill Combinations of Renin-Angiotensin-System Blockers and Calcium Channel Blockers on HOMA-IR Index in Hypertensive Patients with Impaired Fasting Glucose: a 12-Week Randomized Open-Label Prospective Study. MAEDICA 2022; 17:561-570. [PMID: 36540585 PMCID: PMC9720647 DOI: 10.26574/maedica.2022.17.3.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Backround: The effect of antihypertensive drugs on glucose homeostasis and insulin resistance remains an issue under investigation. There is evidence that renin-angiotensin system (RAS) blockers may favorably affect glucose metabolism, while treatment with calcium channel blockers (CCBs) is considered to have an overall neutral metabolic effect. However, the effects on glycemic indices may differ among agents within the same class of antihypertensive drugs. Objective: To evaluate the effects of different fixed-dose single pill combinations of RAS blockers with CCBs on homeostatic model assessment for insulin resistance (HOMA-IR). Methods:Drug-naive patients with arterial hypertension (AH) and impaired fasting glucose (IFG) were randomly allocated to open-label fixed, single pill combinations of valsartan 160 mg/day plus amlodipine 5 mg/day (VAL/AMLO group, n = 54), delapril 30 mg/day and manidipine 10 mg/day (DEL/MANI group, n = 53) or telmisartan 80 mg/day and amlodipine 5 mg/day (TEL/AMLO group, n = 51) for 12 weeks. Glycemic indices and HOMA-IR were determined at baseline and post-treatment. Results:A total of 158 patients were included. All treatment combinations effectively reduced blood pressure (systolic and diastolic) to similar levels (all p < 0.001). A decrease in the HOMA-IR index by 22.55% (p <0.01) was noted following treatment with TEL/AMLO, while an increase by 1.4% (p = 0.57) and 12.65% (p = 0.072) was observed in the VAL/AMLO group and the DEL/MANI group, respectively. These changes were significantly different between TEL/AMLO and DEL/MANI (p < 0.05) as well as between TEL/AMLO and VAL/AMLO (p < 0.001). Conclusion:Despite similar antihypertensive action, the effect of fixed, single pill combinations with TEL/AMLO, VAL/AMLO and DEL/MANI on insulin resistance is in favor of TEL/AMLO. Trial registration: The study protocol was published online in https://diavgeia.gov.gr/ (No: ÂÈ6Ó46906Ç-ÁÅÓ) via the Ministry of Digital Governance, after receiving approval from the Scientific Council and Administrative Council of University Hospital of Ioannina (No. of approval: 1/12-06-2014 (issue 150). https://diavgeia.gov.gr/decision/view/%CE%92%CE%986%CE%A346906%CE%97- %CE%91%CE%95%CE%A3 h t t p s : / / d i a v g e i a . g o v . g r / d o c / % C E % 9 2 % C E % 9 8 6 % C E % A 3 4 6 9 0 6 % C E % 9 7 - %CE%91%CE%95%CE%A3?inline=true.
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Affiliation(s)
- Angelos LIONTOS
- First Department of Internal Medicine, Faculty of Medicine, University Hospital of Ioannina, University of Ioannina, Ioannina, Greece
| | - Dimitrios BIROS
- First Department of Internal Medicine, Faculty of Medicine, University Hospital of Ioannina, University of Ioannina, Ioannina, Greece
| | - Christos PAPAGIANNOPOULOS
- Department of Hygiene Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia ANASTASIOU
- Second Department of Internal Medicine, Faculty of Medicine, University Hospital of Ioannina, University of Ioannina, Ioannina, Greece
| | - Petros-Spyridon ADAMIDIS
- Second Department of Internal Medicine, Faculty of Medicine, University Hospital of Ioannina, University of Ioannina, Ioannina, Greece
| | - Konstantinos BAKOGIANNIS
- Second Department of Internal Medicine, Faculty of Medicine, University Hospital of Ioannina, University of Ioannina, Ioannina, Greece
| | - Haralampos MILIONIS
- First Department of Internal Medicine, Faculty of Medicine, University Hospital of Ioannina, University of Ioannina, Ioannina, Greece
| | - Evangelos LIBEROPOULOS
- First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Moses ELISAF
- Department of Hygiene Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - George LIAMIS
- Department of Hygiene Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
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Associations of Serum Total 25OHD, 25OHD3, and epi-25OHD3 with Insulin Resistance: Cross-Sectional Analysis of the National Health and Nutrition Examination Survey, 2011–2016. Nutrients 2022; 14:nu14173526. [PMID: 36079784 PMCID: PMC9459885 DOI: 10.3390/nu14173526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Vitamin D may have a role in insulin sensitivity. However, the data on the association between various metabolites of Vitamin D and insulin-related parameters have been limited. Methods: We identified 6026 adults aged 20–80 years who participated in the 2011–2016 National Health and Nutrition Examination Survey (NHANES). Serum total 25OHD, 25OHD3, and epi-25OHD3, fasting glucose, insulin, and HOMA2-IR were obtained from the NHANES data. The association between serum Vitamin D-related values and insulin resistance was analyzed using a generalized linear model. For risk analysis, multifactorial logistic regression was used. Results: The median total 25-hydroxyvitamin D level, 25-hydroxyvitamin D3 level, and 3-epi-25-hydroxyvitamin D3 level were 62.5 nmol/L, 58.8 nmol/L, and 3.3 nmol/L, respectively. After adjustment for sex, age, race, ethnicity, and education status, the ORs for the insulin resistance of participants of total 25-hydroxyvitamin D, 25-hydroxyvitamin D3, and 3-epi-25-hydroxyvitamin D3 were 0.32 (95% CI 0.24, 0.43), 0.34 (95% CI 0.26, 0.44), and 0.64 (95% CI 0.53, 0.77), respectively. After an adjustment for body mass index, diabetes, and drinking and smoking, the ORs for the insulin resistance of the participants for total 25-hydroxyvitamin D, 25-hydroxyvitamin D3, and 3-epi-25-hydroxyvitamin D3 were 0.56 (95% CI 0.40, 0.78), 0.63 (95% CI 0.46, 0.85), and 0.99 (95% CI 0.80, 1.24), respectively. Conclusions: Our study provides suggestive evidence for the association between Vitamin D concentrations and a lower risk of insulin resistance. Evidence from larger and more adequately powered cohort studies is needed to confirm our results.
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Tahapary DL, Pratisthita LB, Fitri NA, Marcella C, Wafa S, Kurniawan F, Rizka A, Tarigan TJE, Harbuwono DS, Purnamasari D, Soewondo P. Challenges in the diagnosis of insulin resistance: Focusing on the role of HOMA-IR and Tryglyceride/glucose index. Diabetes Metab Syndr 2022; 16:102581. [PMID: 35939943 DOI: 10.1016/j.dsx.2022.102581] [Citation(s) in RCA: 104] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Metabolic Syndrome (MS) prevalence is increasing worldwide in line with the growing prevalence of obesity. The underlying mechanism of MS is insulin resistance which can be diagnosed by measuring Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and Triglyceride/Glucose (TyG) Index. This review will focus on comparing studies assessing the HOMA-IR and TyG index cut-off points. METHODS We carried out a comprehensive review of the literature using suitable keywords on the search engines of PubMed, Scopus, Research Gate, and Google Scholar in the month of October 2020. RESULTS There is a high degree of variability in determining threshold levels of HOMA-IR for defining insulin resistance. The distribution of the HOMA-IR varies according to the demographic characteristics of the subjects, such as age, sex, and race, making it difficult to estimate the optimal cut-off point. Another simpler method without requiring the use of insulin assays is TyG Index. Similar to HOMA-IR, the TyG Index cut-off point from existing data shows varying results. CONCLUSION The HOMA-IR and the TyG index are simple and widely used methods for determining insulin resistance. However, an issue that arises is determining the insulin resistance cut-off point for both methods. Further studies are needed to assess the cut-off point of insulin resistance for various ethnicities associated with the risk of developing MS later in life.
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Affiliation(s)
- Dicky Levenus Tahapary
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia; Metabolic Disorder, Cardiovascular and Aging Cluster, Indonesia Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Livy Bonita Pratisthita
- Metabolic Disorder, Cardiovascular and Aging Cluster, Indonesia Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia; Department of Internal Medicine, University of Indonesia Hospital, Depok, Indonesia
| | | | - Cicilia Marcella
- Metabolic Disorder, Cardiovascular and Aging Cluster, Indonesia Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Syahidatul Wafa
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia; Metabolic Disorder, Cardiovascular and Aging Cluster, Indonesia Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Farid Kurniawan
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia; Metabolic Disorder, Cardiovascular and Aging Cluster, Indonesia Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Aulia Rizka
- Division of Geriatrics, Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital, Indonesia
| | - Tri Juli Edi Tarigan
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia; Metabolic Disorder, Cardiovascular and Aging Cluster, Indonesia Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Dante Saksono Harbuwono
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia; Metabolic Disorder, Cardiovascular and Aging Cluster, Indonesia Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Dyah Purnamasari
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia; Metabolic Disorder, Cardiovascular and Aging Cluster, Indonesia Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Pradana Soewondo
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia; Metabolic Disorder, Cardiovascular and Aging Cluster, Indonesia Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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Pradhan J, Mishra I, Rattan R, Choudhury AK, Baliarsinha AK. Correlation of Markers of Inflammation with Hormonal, Metabolic Parameters, Insulin Resistance and Adiposity Indices in First-Degree Relatives of Patient with Polycystic Ovary Syndrome. J Hum Reprod Sci 2022; 15:250-258. [PMID: 36341014 PMCID: PMC9635376 DOI: 10.4103/jhrs.jhrs_104_22] [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: 07/29/2022] [Revised: 09/02/2022] [Accepted: 09/02/2022] [Indexed: 11/06/2022] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is a state of chronic low-grade inflammation. Low-grade inflammation has been linked to the development of cardiovascular disease (CVD). There is evidence of clustering for metabolic syndrome, hypertension, dyslipidaemia in type 2 diabetes mellitus and insulin resistance (IR) in mothers, fathers, sisters and brothers of women with PCOS. Aims The aim is to study the levels of inflammatory markers and IR in first-degree relatives of patients with PCOS and find any correlation with hormonal parameters, metabolic parameters and adiposity indices in them. Settings and Design A total of 66 first-degree relatives of a patient with PCOS were included in this cross-sectional study. Materials and Methods All participants underwent detailed clinical evaluation and biochemical investigations, including high-sensitivity C-reactive protein (hsCRP), interleukin 6 (IL-6), luteinising hormone (LH), follicle-stimulating hormone (FSH) and total testosterone (only in females). Homeostasis model assessment of IR (HOMA-IR), lipid accumulation product and visceral adiposity index were calculated using standard equations. Visceral adipose tissue thickness and subcutaneous adipose tissue thickness were assessed using ultrasonography. Statistical Analysis Used Spearman's and Pearson's correlation coefficients were used to analyse the correlation between different non-parametric and parametric data, respectively. Multiple linear regression was used to correlate multiple dependent factors. Results The mean hs-CRP level was 2.4 ± 1.1 mg/L, which is greater than the cut-off of 2 mg/L and hs-CRP >2 mg/L was found in 62% (n = 41) participants. The mean IL-6 (3.5 ± 1.1 pg/ml) and total white blood cell count (7244 ± 2190/mm3) were in the normal range. The mean HOMA-IR was 2.35 ± 0.76, which is elevated, considering HOMA IR >2 as a predictor of IR and metabolic syndrome. HOMA IR >2 was found in 64% (n = 42) of the participants. Inflammatory markers were significantly correlated with LH and HOMA IR, even after multiple linear regression was fitted for each marker individually. Conclusion Apparently, healthy first-degree relatives of PCOS patients had evidence of chronic low-grade inflammation. The chronic inflammation in them correlated well with HOMA-IR and LH but was independent of body mass index. This low-grade inflammation may predispose the first-degree relatives of PCOS to CVD.
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Affiliation(s)
- Jeeban Pradhan
- Department of Endocrinology, S.C.B Medical College, Cuttack, Odisha, India
| | - Ipsita Mishra
- Department of Endocrinology, S.C.B Medical College, Cuttack, Odisha, India
| | - Roma Rattan
- Department of Biochemistry, S.C.B Medical College, Cuttack, Odisha, India
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Chebrolu P, Sangle S, Nimkar S, Salvi S, Chavan A, Kulkarni V, Shere D, Deshpande P, Brown TT, Mathad JS, Marbaniang I, Mave V. Inflammatory profile associated with insulin resistance in non-overweight versus overweight people living with HIV in Pune, Western India. Diabetes Metab Syndr 2022; 16:102551. [PMID: 35777254 PMCID: PMC9912190 DOI: 10.1016/j.dsx.2022.102551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND People living with HIV have greater diabetes (T2DM) than the general population despite lower prevalence of overweight/obesity. Both insulin resistance (IR), a T2DM precursor, and HIV are independently associated with chronic inflammation. Inflammation may be a pathophysiological link explaining IR in people living with HIV who are not overweight but is not well understood. AIMS To study the association between inflammation and IR in non-overweight and overweight people living with HIV. METHODS In a cohort of adult people living with HIV with undetectable viral load in Pune, India, we measured fasting insulin, glucose, and 9 inflammatory markers. IR was defined as HOMA-IR ≥2, and non-overweight as BMI ≤23 kg/m2. We used modified Poisson regression to evaluate the association between inflammatory markers and IR in overweight and non-overweight. RESULTS Of 288 participants, 66% (n = 189) were non-overweight. Among non-overweight, prevalence of IR was 34% (n = 65). Each doubling of MCP-1 and leptin was associated with IR on univariate analysis (prevalence ratio (PR) 1.29, 95%CI 1.07-1.53, p < 0.01; PR 1.13 95%CI 1.01-1.26, p = 0.03). Leptin remained associated with IR after adjustment for age, MCP-1, gender, cholesterol, and waist circumference (adjusted PR 1.20 95%CI 1.06-1.36, p < 0.01). Among overweight, prevalence of IR was 69% and no markers were associated with IR. CONCLUSIONS One in 3 non-overweight people living with HIV in India with controlled viremia have IR. Leptin was associated with IR among non-overweight people living with HIV and may provide insight into the pathophysiology of metabolic disease in this population.
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Affiliation(s)
- Puja Chebrolu
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, NY, USA.
| | | | - Smita Nimkar
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site (BJGMC-JHU CRS), Pune, India
| | - Sonali Salvi
- Byramjee-Jeejeebhoy Government Medical College, Pune, India
| | - Amol Chavan
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site (BJGMC-JHU CRS), Pune, India
| | - Vandana Kulkarni
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site (BJGMC-JHU CRS), Pune, India
| | - Dhananjay Shere
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site (BJGMC-JHU CRS), Pune, India
| | - Prasad Deshpande
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site (BJGMC-JHU CRS), Pune, India
| | - Todd T Brown
- Division of Endocrinology, Diabetes and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jyoti S Mathad
- Department of Medicine and Obstetrics & Gynecology, Center for Global Health, Weill Cornell Medicine, New York, NY, USA
| | - Ivan Marbaniang
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site (BJGMC-JHU CRS), Pune, India; Department of Epidemiology, McGill University, Montreal, QC, Canada
| | - Vidya Mave
- Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site (BJGMC-JHU CRS), Pune, India
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Li W, Jiao Y, Wang L, Wang S, Hao L, Wang Z, Wang H, Zhang B, Ding G, Jiang H. Association of Serum Magnesium with Insulin Resistance and Type 2 Diabetes among Adults in China. Nutrients 2022; 14:nu14091799. [PMID: 35565766 PMCID: PMC9104014 DOI: 10.3390/nu14091799] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/21/2022] [Accepted: 04/23/2022] [Indexed: 11/28/2022] Open
Abstract
Magnesium is an essential mineral for the human body and a cofactor or activator for more than 300 enzymatic reactions, including blood glucose control and insulin release. Diabetes is a well-known global burden of disease with increasing global prevalence. In China, the prevalence of diabetes in adults is higher than the global average. Evidence shows that magnesium is a predictor of insulin resistance and diabetes. However, the majority of studies focus on dietary magnesium instead of serum magnesium concentration. We study the correlation of serum magnesium levels with insulin resistance and Type 2 diabetes. In this prospective cohort study, we included 5044 participants aged 18 years and older without insulin resistance (IR) and diabetes at the baseline from China Health and Nutrition Survey (CHNS). A fasting blood sample was taken for the measurement of both types of magnesium, fasting blood glucose, hemoglobin A1c (HbA1c), and fasting insulin. The homeostatic model (HOMA-IR) was calculated. Demographic characteristics of participants, and risk factors such as intensity of physical activities, smoking status, drinking habit, and anthropometric information were recorded. IR was defined as HOMA-IR ≥ 2.5, and Type 2 diabetes mellitus was defined as fasting plasma glucose ≥ 7.0 mmol/L or HbA1c ≥ 6.5%, or a self-reported diagnosis or treatment of diabetes. A total of 1331 incident insulin resistance events and 429 incident diabetic events were recorded during an average follow-up of 5.8 years. The serum magnesium concentration was categorized into quintiles. After adjusting for relevant covariates, the third quintile of serum magnesium (0.89−0.93 mmol/L) was correlated with 29% lower risk of incident insulin resistance (hazard ratio = 0.71, 95% CI 0.58, 0.86) and with a lower risk of Type 2 diabetes. Multivariable-adjusted hazard ratios (95% confidence intervals) for insulin resistance were compared with the lowest quintile of serum magnesium (<0.85). We found similar results when evaluating serum magnesium as a continuous measure. Restricted cubic spline (RCS) curves showed a nonlinear dose−response correlation in both serum magnesium levels and insulin resistance, and in serum magnesium levels and Type 2 diabetes. Lower serum magnesium concentration was associated with a higher risk of insulin resistance and diabetes.
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Affiliation(s)
- Weiyi Li
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Yingying Jiao
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
| | - Liusen Wang
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Shaoshunzi Wang
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Lixin Hao
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Zhihong Wang
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Huijun Wang
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Bing Zhang
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Gangqiang Ding
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Hongru Jiang
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
- Correspondence: ; Tel.: +86-10-6623-7057
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Sangma H, Singh A, Srivastava A, Misra V. Prevalence of Latent Autoimmune Diabetes in Adult Based on the Presence of GAD 65 Antibodies in North-Eastern Uttar Pradesh, India. ANNALS OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES (INDIA) 2022. [DOI: 10.1055/s-0041-1741063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Abstract
Objective The objective of this paper was (1) to study the prevalence of latent autoimmune diabetes in adult (LADA) in the region of north-eastern Uttar Pradesh, India, based on the positivity for glutamic acid decarboxylase 65 (GAD65) antibodies and (2) to compare the glycemic profile between GAD65-positive and GAD65-negative subjects.
Materials and Methods The subjects were of more than 30 years of age, with either recently diagnosed pre-diabetes/diabetes presenting with the hemoglobin A1c (HbA1c) level of ≥5.7% or already diagnosed cases of type 2 diabetes mellitus (T2DM) who had no requirement of insulin therapy for at least 6 months from the time of their diagnosis. All the patients were natives of north-eastern Uttar Pradesh. The GAD65 test was done by the enzyme-linked immunosorbent assay. Further, the glycemic status of GAD-positive and GAD-negative subjects were compared on the basis of fasting blood sugar (FBS), fasting insulin (FI), and homeostatic model assessment for insulin resistance (HOMA-IR).
Statistical Analysis The “unpaired t-test” was used to compare and assess the significance of differences between the glycemic profile of GAD65-positive and GAD65-negative subjects using the GraphPad Prism Scientific Software, San Diego, CA, United States. The p-value of <0.05 was considered to be significant.
Results A total of 77 patients were included in the study, with the age group ranging from 30 to 75 years (47.81 ± 12.9 years) with the male–female ratio of 1:2.6. The prevalence of LADA was found to be 51.95%. On comparing GAD65-positive and GAD65-negative groups, a higher value of HbA1c levels and FBS were found in the former, whereas FI and HOMA-IR were found to be higher in the latter. On testing for significance of difference, only FI and HbA1c values were significant (p-value <0.0001).
Conclusion LADA can no longer be considered a rare type of diabetes mellitus, with the present study showing a high prevalence of LADA in this north eastern region of Uttar Pradesh. Identification of adult-onset diabetics accurately as LADA or true T2DM is very crucial for the appropriate treatment, as LADA patients require insulin inevitably and much earlier than true T2DM patients, who can be managed mostly on oral hypoglycemic agents with seldom requirement of insulin.
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Affiliation(s)
- Himalina Sangma
- Department of Pathology, Motilal Nehru Medical College, Prayagraj, Uttar Pradesh, India
| | - Anshul Singh
- Department of Pathology, Motilal Nehru Medical College, Prayagraj, Uttar Pradesh, India
| | - Anubha Srivastava
- Department of Medicine, Motilal Nehru Medical College, Prayagraj, Uttar Pradesh, India
| | - Vatsala Misra
- Department of Pathology, Motilal Nehru Medical College, Prayagraj, Uttar Pradesh, India
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Xu L, Lu L, Tong A, Chen S, Li W, Zhang H, Ping F, Li Y. New insights on hyperglycemia in 17-hydroxylase/17,20-lyase deficiency. Front Endocrinol (Lausanne) 2022; 13:917420. [PMID: 35937831 PMCID: PMC9354396 DOI: 10.3389/fendo.2022.917420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The adrenal glands of patients with 17-hydroxylase/17,20-lyase deficiency (17OHD) synthesize excessive 11-deoxycorticosterone(DOC) and progesterone, and produce less amount of sex steroid production. Mineralocorticoids and sex hormones play an important role in regulating glucose homeostasis. This study aimed to describe the glucose metabolism in 17OHD patients diagnosed at Peking Union Medical College Hospital (PUMCH). DESIGN/METHODS A total of 69 patients diagnosed with 17OHD after adolescence in PUMCH from 1995 to June in 2021. Among them 23 patients underwent a 3-hours oral glucose tolerance test (3hOGTT) after being diagnosed with 17OHD. Insulin response in patients with normal glucose tolerance (NGT) were further compared between the study two groups with different kalemia status. Another 19 patients were followed up to 30 years and older. All clinical data were obtained from the hospital information system of PUMCH. RESULTS Baseline: (1) The average body mass index(BMI) of all patients at baseline was 20.3 ± 3.7kg/m2. Twenty-three patients underwent 3hOGTT, of whom three were diagnosed with diabetes mellitus, and one with impaired glucose tolerance (IGT). Positive correlation between the ratio of progesterone to upper limit of normal range (P times) and hyperglycaemia was exist(r=0.707, P=0.005). (2) In 19 NGT patients, the insulin concentrations at 0 minute, results of the homeostasis model assessment for β-cell function and insulin resistance were lower in the hypokalaemia group than in the normal kalemia group(7.0(5.8-13.2) vs 12.4(8.9-14.9) μIU/ml, P=0.017; 115.5(88.2-240.9) vs 253.1(177.2-305.8), P=0.048; 1.54(1.17-2.61) vs 2.47(1.91-2.98), P=0.022, respectively). Follow-up: Four patients had IGT, while seven patients had diabetes mellitus. Of the 19 patients,11 had hyperglycaemia. P times was significantly higher(7.6(5.0-11.0) vs 3.75(2.2-5.3), P=0.008) in hyperglycemia group than in the normal glucose group. CONCLUSIONS Abnormal glucose metabolism was common in 17OHD patients, which was possibly associated with hypokalaemia and high progesterone levels. Routine monitoring on glucose metabolism in 17OHD patient should be conducted.
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Affiliation(s)
- Lingling Xu
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Lin Lu
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Anli Tong
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Shi Chen
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Wei Li
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Huabing Zhang
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Fan Ping
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Yuxiu Li
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
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Mishra I, Pradhan J, Rattan R, Choudhury A, Baliarsinha A. Correlation of markers of inflammation with hormonal, metabolic parameters, insulin resistance and adiposity indices in first-degree relatives of patient with polycystic ovary syndrome. J Hum Reprod Sci 2022. [DOI: 10.4103/jhrs.jhrs_104_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Nori W, Harmoosh SK, Abd Al-Badri HJ. Can Red cell distribution width screen for metabolic abnormality in women with Polycystic Ovarian Syndrome? THE JOURNAL OF MEDICAL INVESTIGATION 2022; 69:191-195. [PMID: 36244769 DOI: 10.2152/jmi.69.191] [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: 01/22/2023]
Abstract
Polycystic ovarian syndrome (PCOS) is a prevalent endocrinopathy in reproductive-age females, accredited to a chronic low-grade inflammatory reaction. Red distribution width (RDW), a parameter of complete blood count, was tested as an inflammatory marker ; higher RDW was linked to metabolic syndrome. We aimed to examine RDW in distinguishing PCOS-related metabolic and hormonal abnormalities. Methods : A case-control study recruited 128 women, divided into PCOS cases (64 / 128) and controls (64 / 128) according to Rotterdam criteria. Body mass index (BMI), estimated complete blood count parameters, hormonal markers (serum follicle-stimulating hormone (FSH), luteinizing hormone, and serum testosterone), and metabolic markers (HOMA-IR, serum high and low-density lipoprotein) were measured. Results showed that RDW was significantly higher in PCOS. HOMA-IR, LDL, testosterone, and LH / FSH were higher in PCOS and strongly correlated with RDW with positive correlations. HDL was elevated and correlated negatively with RDW in PCOS. ROC calculated (13.55) as RDW cut-off value for insulin-resistant with an AUC of 0.95, P < 0.001. In conclusion, a strong and remarkable correlation of RDW with metabolic abnormalities in PCOS cases with 100% sensitivity and specificity, in addition to being quick and inexpensive, makes it a reliable marker for screening for insulin resistance. J. Med. Invest. 69 : 191-195, August, 2022.
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Affiliation(s)
- Wassan Nori
- Assistant professor. College of Medicine / Department of Obstetrics and Gynecology Mustansiriyah University, Baghdad, Iraq. . ORCID Number : 0000-0002-8749-2444
| | - Shaima K Harmoosh
- IVF specialist PhD. Al Yarmouk Teaching Hospital / infertility clinic / Baghdad, Iraq . ORCID Number : 0000-0001-5527-9422
| | - Hadeel J Abd Al-Badri
- lecturer. College of Medicine / Department of Obstetrics and Gynecology Mustansiriyah University, Baghdad, Iraq. . ORCID Number 0000-0001-5604-7367
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Abdesselam A, Zidoum H, Zadjali F, Hedjam R, Al-Ansari A, Bayoumi R, Al-Yahyaee S, Hassan M, Albarwani S. Estimate of the HOMA-IR Cut-off Value for Identifying Subjects at Risk of Insulin Resistance Using a Machine Learning Approach. Sultan Qaboos Univ Med J 2021; 21:604-612. [PMID: 34888081 PMCID: PMC8631209 DOI: 10.18295/squmj.4.2021.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 09/25/2020] [Accepted: 12/03/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives This study describes an unsupervised machine learning approach used to estimate the homeostatic model assessment-insulin resistance (HOMA-IR) cut-off for identifying subjects at risk of IR in a given ethnic group based on the clinical data of a representative sample. Methods The approach was applied to analyse the clinical data of individuals with Arab ancestors, which was obtained from a family study conducted in Nizwa, Oman, between January 2000 and December 2004. First, HOMA-IR-correlated variables were identified to which a clustering algorithm was applied. Two clusters having the smallest overlap in their HOMA-IR values were retrieved. These clusters represented the samples of two populations, which are insulin-sensitive subjects and individuals at risk of IR. The cut-off value was estimated from intersections of the Gaussian functions, thereby modelling the HOMA-IR distributions of these populations. Results A HOMA-IR cut-off value of 1.62 ± 0.06 was identified. The validity of this cut-off was demonstrated by showing the following: 1) that the clinical characteristics of the identified groups matched the published research findings regarding IR; 2) that a strong relationship exists between the segmentations resulting from the proposed cut-off and those resulting from the two-hour glucose cut-off recommended by the World Health Organization for detecting prediabetes. Finally, the method was also able to identify the cut-off values for similar problems (e.g. fasting sugar cut-off for prediabetes). Conclusion The proposed method defines a HOMA-IR cut-off value for detecting individuals at risk of IR. Such methods can identify high-risk individuals at an early stage, which may prevent or delay the onset of chronic diseases such as type 2 diabetes.
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Affiliation(s)
| | | | | | | | | | - Riad Bayoumi
- Mohammed Bin Rashid University for Medicine and Health Science, Dubai, United Arab Emirates
| | | | - Mohammed Hassan
- Department of Sleep Medicine and Physiological Measurements, Canadian Health Center, Muscat, Oman
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Association between baseline insulin resistance and psoriasis incidence: the Women's Health Initiative. Arch Dermatol Res 2021; 314:869-880. [PMID: 34816303 PMCID: PMC9512862 DOI: 10.1007/s00403-021-02298-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/26/2021] [Indexed: 11/02/2022]
Abstract
Small-scale studies offer conflicting evidence regarding the relationship/association between psoriasis and insulin resistance by HOMA-IR (homeostasis model assessment of insulin resistance). The purpose of this study was to assess the association between baseline HOMA-IR and psoriasis incidence in a large-scale longitudinal cohort of postmenopausal women. The analysis included 21,789 postmenopausal women from the Women's Health Initiative. Psoriasis diagnosis was defined by fee-for-service Medicare ICD-9-CM codes assigned by dermatologists or rheumatologists, and a 2-year lookback period to exclude prevalent cases. Baseline HOMA-IR was calculated using the updated HOMA2 model. Hazard rates from the Cox regression models were stratified by age (10-year intervals), on WHI component (Clinical Trial or Observational Study), and on randomization status within each of the WHI clinical trials. The complete model also adjusted for ethnicity, waist-hip-ratio, and smoking and alcohol habits. Among participants free of psoriasis at entry, those with high baseline HOMA-IR (≥ 2) compared to low (< 1.4) had significantly higher risk for psoriasis over 21-year cumulative follow-up (HR: 1.39, 95% CI 1.08-1.79, P-trend: 0.011). In postmenopausal women, higher baseline HOMA-IR levels were significantly associated with higher incidence of psoriasis over 21-year cumulative follow-up. Results from this time-to-event analysis indicate that insulin resistance can precede and is associated with an increased risk of psoriasis. Study is limited by Medicare diagnostic code accuracy and cohort age.
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Okamoto C, Tsukamoto O, Hasegawa T, Hitsumoto T, Matsuoka K, Takashima S, Amaki M, Kanzaki H, Izumi C, Ito S, Kitakaze M. Lower B-type natriuretic peptide levels predict left ventricular concentric remodelling and insulin resistance. ESC Heart Fail 2021; 9:636-647. [PMID: 34786876 PMCID: PMC8787986 DOI: 10.1002/ehf2.13700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/21/2021] [Accepted: 10/29/2021] [Indexed: 01/19/2023] Open
Abstract
Aims Natriuretic peptides have reportedly been associated with cardiac hypertrophy and insulin resistance; however, it has not been established if B‐type natriuretic peptide (BNP) is associated with either insulin resistance or cardiac remodelling in a population with normal plasma BNP levels. We investigated the relationship among plasma BNP levels, insulin resistance, and left ventricular (LV) remodelling in a population with normal physiological plasma BNP levels. Methods and results Among 1632 individuals who participated in annual health checks between 2005 and 2008 in Arita‐cho, Saga, Japan, 675 individuals [median (interquartile range) for age 62 (51–69) years; 227 men (34%)] with LV ejection fraction 50% and BNP level <35 pg/mL were enrolled in this study. Insulin resistance was assessed using homeostatic model assessment of insulin resistance (HOMA‐IR). LV geometry, including LV concentric remodelling, was classified based on relative wall thickness (RWT) and LV mass index values derived from echocardiographic findings. Factors associated with insulin resistance and LV geometry were investigated using multiple logistic regression analysis. Tertiles of BNP were inversely associated with HOMA‐IR [1st tertile, 1.33 (0.76–1.74); 2nd tertile, 1.05 (0.72–1.59); 3rd tertile, 0.95 (0.66–1.58), P = 0.005]. Lower BNP was associated with the prevalence of insulin resistance, defined as HOMA‐IR ≥1.37, even after full multivariate adjustment [1 SD increment in BNP = adjusted odds ratio (aOR) 0.740; 95% confidence interval (CI) 0.601–0.912; P = 0.005]. LV concentric remodelling (RWT >0.42; LV mass index ≤115 g/m2 in men and ≤95 g/m2 in women) was observed in 107 (16%) participants, while normal LV geometry (RWT ≤0.42; LV mass index ≤115 g/m2 in men and ≤95 g/m2 in women) was seen in 423 (63%), and LV hypertrophy (LV mass index >115 g/m2 in men and >95 g/m2 in women) in 145 (21%). Both low BNP level and higher insulin resistance were independently linked to LV concentric remodelling after multivariate adjustment (1 SD increment in BNP = aOR 0.714, 95% CI 0.544–0.938, P = 0.015; HOMA‐IR ≥ 1.37 vs. <1.37: aOR 1.694, 95% CI 1.004–2.857, P = 0.048, respectively). Conclusions Lower BNP levels are linked to either insulin resistance or LV concentric remodelling in a population with normal plasma BNP levels, suggesting that participants with lower natriuretic peptide level might be vulnerable to the development of metabolic disorders and LV morphological abnormalities.
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Affiliation(s)
- Chisato Okamoto
- Department of Medical Biochemistry, Osaka University Graduate School of Medicine/Frontier Biosciences, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.,Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Osamu Tsukamoto
- Department of Medical Biochemistry, Osaka University Graduate School of Medicine/Frontier Biosciences, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Takuya Hasegawa
- Department of Cardiovascular Medicine, Garacia Hospital, Mino, Osaka, Japan
| | - Tatsuro Hitsumoto
- Department of Medical Biochemistry, Osaka University Graduate School of Medicine/Frontier Biosciences, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Ken Matsuoka
- Department of Medical Biochemistry, Osaka University Graduate School of Medicine/Frontier Biosciences, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Seiji Takashima
- Department of Medical Biochemistry, Osaka University Graduate School of Medicine/Frontier Biosciences, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Makoto Amaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hideaki Kanzaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Shin Ito
- Department of Clinical Medicine and Development, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Masafumi Kitakaze
- Department of Medical Biochemistry, Osaka University Graduate School of Medicine/Frontier Biosciences, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.,Department of Clinical Medicine and Development, National Cerebral and Cardiovascular Center, Osaka, Japan.,Hanwa Daini Senboku Hospital, Sakai, Osaka, 599-8271, Japan
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He Y, Liu C, Han Y, Huang Y, Zhou J, Xie Q. The impact of oral carbohydrate-rich supplement taken two hours before caesarean delivery on maternal and neonatal perioperative outcomes -- a randomized clinical trial. BMC Pregnancy Childbirth 2021; 21:682. [PMID: 34620123 PMCID: PMC8495981 DOI: 10.1186/s12884-021-04155-z] [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] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 09/28/2021] [Indexed: 12/17/2022] Open
Abstract
Background To evaluate the impact of oral carbohydrate-rich (Ch-R) supplement taken 2 hours before an elective caesarean delivery (CD) on maternal and neonatal perioperative outcomes. Methods Ninety pregnant women undergoing elective CD were randomized into the Ch-R group, placebo group and fasting group equally. Participants’ blood was drawn at three time points, before intervention, immediately after and 1 day after the surgery to measure maternal and neonatal biochemical indices. Meanwhile women’s perioperative symptoms and signs were recorded. Results Eighty-eight pregnant women were finally included in the study. Women who had drunk Ch-R supplement had lower postoperative insulin level (β = − 3.50, 95% CI − 5.45 to − 1.56), as well as postoperative HOMA-IR index (β = − 0.74, 95% CI − 1.15 to − 0.34), compared with women who had fasted. Additionally, neonates of mothers who were allocated in the Ch-R group also had a higher glucose level, compared with neonates of mothers in the fasting group (β = 0.40, CI 0.17 to 0.62). Conclusion Oral Ch-R solution administered 2 hours before an elective CD may not only alleviate maternal postoperative insulin resistance, but also comfort women’s preoperative thirst and hunger, compared to fasting. Additionally, it may increase neonatal glucose level as well. Trial registration Chinese Clinical Trial Registry, ChiCTR2000033163. Data of Registration: 2020-5-22. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04155-z.
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Affiliation(s)
- Yuanying He
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Chunhong Liu
- Department of Gynecology and Obstetrics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Yanchangzhong Road, Shanghai, 200072, China
| | - Ying Han
- Department of Gynecology and Obstetrics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Yanchangzhong Road, Shanghai, 200072, China
| | - Yun Huang
- Department of Gynecology and Obstetrics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Yanchangzhong Road, Shanghai, 200072, China
| | - Jianhong Zhou
- Department of Gynecology and Obstetrics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Yanchangzhong Road, Shanghai, 200072, China
| | - Qigui Xie
- Department of Gynecology and Obstetrics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Yanchangzhong Road, Shanghai, 200072, China.
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Fasting and Exercise in Oncology: Potential Synergism of Combined Interventions. Nutrients 2021; 13:nu13103421. [PMID: 34684421 PMCID: PMC8537603 DOI: 10.3390/nu13103421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 12/28/2022] Open
Abstract
Nutrition and exercise interventions are strongly recommended for most cancer patients; however, much debate exists about the best prescription. Combining fasting with exercise is relatively untouched within the oncology setting. Separately, fasting has demonstrated reductions in chemotherapy-related side effects and improved treatment tolerability and effectiveness. Emerging evidence suggests fasting may have a protective effect on healthy cells allowing chemotherapy to exclusively target cancer cells. Exercise is commonly recommended and attenuates treatment- and cancer-related adverse changes to body composition, quality of life, and physical function. Given their independent benefits, in combination, fasting and exercise may induce synergistic effects and further improve cancer-related outcomes. In this narrative review, we provide a critical appraisal of the current evidence of fasting and exercise as independent interventions in the cancer population and discuss the potential benefits and mechanisms of combined fasting and exercise on cardiometabolic, body composition, patient-reported outcomes, and cancer-related outcomes. Our findings suggest that within the non-cancer population combined fasting and exercise is a viable strategy to improve health-related outcomes, however, its safety and efficacy in the oncology setting remain unknown. Therefore, we also provide a discussion on potential safety issues and considerations for future research in the growing cancer population.
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Effects of Caloric Restriction and Rope-Skipping Exercise on Cardiometabolic Health: A Pilot Randomized Controlled Trial in Young Adults. Nutrients 2021; 13:nu13093222. [PMID: 34579097 PMCID: PMC8467906 DOI: 10.3390/nu13093222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/05/2021] [Accepted: 09/13/2021] [Indexed: 12/20/2022] Open
Abstract
The aim of this study is to investigate the effects of calorie restriction (CR), rope-skipping (RS) exercise, and their joint effects on cardiometabolic health in young adults. An 8-week randomized trial was conducted on 46 undergraduates aged 19–21 y from South China. The participants were randomized into the following three groups: Calorie restriction (CR) group (n = 14), Rope-skipping (RS) group (n = 14), and CR plus RS (CR–RS) group (n = 12). At both allocation and the end of the intervention, data on anthropometry, serum metabolic, and inflammatory markers were collected. A total of 40 participants completed the intervention and were included in the analysis. After the 8-week intervention, the participants from the CR group and the CR–RS group reduced in body weight (−1.1 ± 1.7 kg, −1.3 ± 2.0 kg), body mass index (−0.4 ± 0.6 kg/m2, −0.5 ± 0.7 kg/m2), body fat percentage (−1.2 ± 1.6%, −1.7 ± 1.8%), and body fat mass (−1.1 kg (−2.2, −0.3), −1.1 kg (−2.5, −0.4)) compared to the baseline (p < 0.05 or p = 0.051). For metabolic and inflammatory factors, the participants in the CR–RS group showed significant decreases in low density lipoprotein cholesterol (−0.40 mmol/L) and interleukin-8 (−0.73 mmol/L). While all the above markers showed no significant difference among the groups after intervention, in the subgroup of overweight/obese participants (n = 23), the CR–RS group had significantly lower blood pressure, fasting insulin, homeostatic model assessment of insulin resistance, tumor necrosis factor-α, and interleukin-8 levels than the CR or RS groups (p < 0.05). In conclusion, both CR and CR–RS could reduce weight and improve body composition in young adults. More importantly, in those with overweight or obesity, CR–RS intervention might be superior to either CR or RS in improving cardiometabolic health.
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Association between the Serum Coenzyme Q10 Level and Seizure Control in Patients with Drug-Resistant Epilepsy. Healthcare (Basel) 2021; 9:healthcare9091118. [PMID: 34574891 PMCID: PMC8471960 DOI: 10.3390/healthcare9091118] [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: 07/23/2021] [Revised: 08/21/2021] [Accepted: 08/23/2021] [Indexed: 11/26/2022] Open
Abstract
Drug-resistant epilepsy (DRE) is a chronic neurological disorder with somatic impacts and increased risk of metabolic comorbidities. Oxidative stress might play an important role in metabolic effects and as a regulator of seizure control, while coenzyme Q10 (CoQ10) could improve insulin sensitivity through antioxidant effects. We aimed to investigate the association between CoQ10 level and clinical outcome, represented by the seizure frequency and quality of life, in DRE patients. DRE patients (N = 33) had significantly higher serum insulin levels and lower scores on the physical domain of the World Health Organization Quality of Life questionnaire (WHOQoL) than gender-age matched controls. The serum CoQ10 level (2910.4 ± 1163.7 ng/mL) was much higher in DRE patients than the normal range. Moreover, the serum CoQ10 level was significantly correlated with the seizure frequency (r = −0.412, p = 0.037) and insulin level (r = 0.409, p = 0.038). Based on stratification by insulin resistance (HOMA-IR > 2.4), the subgroup analysis showed that patients with a greater HOMA-IR had higher CoQ10 levels and lower seizure frequency, and had a significantly worse quality of life. In summary, CoQ10 could be a mediator involved in the mechanism of epilepsy and serve as a biomarker of the clinical outcome in DER patients.
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Vacelet L, Hupin D, Pichot V, Celle S, Court-Fortune I, Thomas T, Garcin A, Barthélémy JC, Gozal D, Roche F. Insulin Resistance and Type 2 Diabetes in Asymptomatic Obstructive Sleep Apnea: Results of the PROOF Cohort Study After 7 Years of Follow-Up. Front Physiol 2021; 12:650758. [PMID: 34393806 PMCID: PMC8355896 DOI: 10.3389/fphys.2021.650758] [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: 01/07/2021] [Accepted: 07/05/2021] [Indexed: 11/25/2022] Open
Abstract
The aim of the study was to assess potential associations between obstructive sleep apnea (OSA) and the occurrence of diabetes mellitus and insulin resistance in the elderly. Nondiabetic volunteers (n = 549) with undiagnosed or untreated asymptomatic OSA (66.2+/−1 years at the inclusion) were evaluated as an ancillary study of the PROOF cohort study (n = 1,011). After 7 years follow-up, 494 subjects underwent assessment of fasting insulin and glucose levels. OSA was defined by an apnea-hypopnea index (AHI) of ≥15/h using polygraphy. Diabetes mellitus was defined by a fasting glucose ≥ 1.26 g/L and/or when requiring pharmacological treatment, while insulin resistance corresponded to HOMA-IR ≥ 2. Asymptomatic OSA subjects (men or women) did not display increased risk of incident diabetes (2.8 vs. 3.9%, p = 0.51). However, there was a greater frequency of insulin resistance in subjects with severe OSA (AHI > 30) [OR 2.21; 95% CI (1.22–4.02); p = 0.009]. Furthermore, multiple logistic regression showed that triglycerides levels [OR 1.61; 95% CI (1.10–2.36); p = 0.01] and fasting glycaemia [OR 4.69; 95% CI (1.12–192.78); p = 0.04], but not AHI or oxyhemoglobin desaturation index were independently associated with higher rate of insulin resistance. The deleterious metabolic effect of asymptomatic OSA in the population may be indirectly mediated via perturbations in lipids, and is particularly likely to become manifest in severe apneic subjects with higher glycemic levels.
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Affiliation(s)
- Laurine Vacelet
- Service de Physiologie Clinique et de l'Exercice, CHU Saint Etienne, Saint Etienne Cedex, France.,Sainbiose DVH U1059 Inserm, Faculté de Médecine J Lisfranc, Université Jean Monnet, Saint Etienne Cedex, France
| | - David Hupin
- Service de Physiologie Clinique et de l'Exercice, CHU Saint Etienne, Saint Etienne Cedex, France.,Service de Pneumologie, CHU Saint Etienne, Saint Etienne Cedex, France
| | - Vincent Pichot
- Service de Physiologie Clinique et de l'Exercice, CHU Saint Etienne, Saint Etienne Cedex, France.,Service de Pneumologie, CHU Saint Etienne, Saint Etienne Cedex, France
| | - Sébastien Celle
- Service de Physiologie Clinique et de l'Exercice, CHU Saint Etienne, Saint Etienne Cedex, France.,Service de Pneumologie, CHU Saint Etienne, Saint Etienne Cedex, France
| | - Isabelle Court-Fortune
- Sainbiose DVH U1059 Inserm, Faculté de Médecine J Lisfranc, Université Jean Monnet, Saint Etienne Cedex, France
| | - Thierry Thomas
- Service de Pneumologie, CHU Saint Etienne, Saint Etienne Cedex, France.,Service de Rhumatologie, CHU Saint Etienne, Saint Etienne Cedex, France
| | - Arnauld Garcin
- Service de Pneumologie, CHU Saint Etienne, Saint Etienne Cedex, France.,URCIP, CHU Saint Etienne, Saint Etienne Cedex, France
| | - Jean-Claude Barthélémy
- Service de Physiologie Clinique et de l'Exercice, CHU Saint Etienne, Saint Etienne Cedex, France.,Service de Pneumologie, CHU Saint Etienne, Saint Etienne Cedex, France
| | - David Gozal
- Department of Child Health, MU Women's and Children's Hospital, Columbia, MO, United States
| | - Frédéric Roche
- Service de Physiologie Clinique et de l'Exercice, CHU Saint Etienne, Saint Etienne Cedex, France.,Service de Pneumologie, CHU Saint Etienne, Saint Etienne Cedex, France
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Associations between insulin resistance and adverse pregnancy outcomes in women with gestational diabetes mellitus: a retrospective study. BMC Pregnancy Childbirth 2021; 21:526. [PMID: 34301212 PMCID: PMC8306365 DOI: 10.1186/s12884-021-04006-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 07/02/2021] [Indexed: 11/28/2022] Open
Abstract
Background This study aimed to explore the relationship between insulin resistance (IR) and adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM), and to determine the risk factors for IR in women with GDM. Methods This study employed a retrospective survey of 710 women diagnosed with GDM. Serum lipids, fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), and serum protein were measured in the first trimester (6–12 weeks), and OGTT and fasting insulin tests were performed in the second trimester (24–28 weeks). These results were then used to evaluate IR by homeostasis model assessment (HOMA). When HOMA-IR ≥ 2.0, IR was diagnosed. The relationship between HOMA-IR and adverse pregnancy outcomes was analyzed by a logistic regression model, and multiple stepwise regression was used to analyze the risk factors of IR. Results IR significantly increasd the risk of the hypertensive disorders of pregnancy and large for gestational age (LGA) (OR = 5.31,95%CI:1.87,15.10; OR = 1.65,95%CI:1.10, 2.48, respectively) in women with GDM, but not for cesarean section, premature delivery, premature rupture of membranes, postpartum hemorrhage, macrosomia and SGA. Compared to normal groups, greater body mass index (BMI) before pregnancy category (overweight or obesity group) were associated with higher risk of IR in the second trimester, the OR (95% CI) were 4.09 (2.65, 6.30) and 6.52 (2.99, 14.20). And higher level of FPG (OR = 1.63, 95%CI: 1.11, 2.40), TG (OR = 1.32, 95%CI: 1.08, 1.63) and weight gain before diagnosis of GDM (OR = 1.08, 95%CI: 1.02, 1.15) were also associated with higher risk of IR in the second trimester in women with GDM, while age (OR = 0.94, 95%CI: 0.90, 0.98)was the weak protective factor for IR. Conclusion GDM with IR in the second trimester increased adverse pregnancy outcomes, especially the risk of hypertensive disorders of pregnancy and LGA. In addition, FPG, HbA1c, and TG in early pregnancy, pre-pregnant BMI and weight gain before diagnosis of GDM were all independent risk factors for IR.
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Barbu E, Popescu MR, Popescu AC, Balanescu SM. Phenotyping the Prediabetic Population-A Closer Look at Intermediate Glucose Status and Cardiovascular Disease. Int J Mol Sci 2021; 22:6864. [PMID: 34202289 PMCID: PMC8268766 DOI: 10.3390/ijms22136864] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 06/12/2021] [Accepted: 06/17/2021] [Indexed: 01/08/2023] Open
Abstract
Even though the new thresholds for defining prediabetes have been around for more than ten years, there is still controversy surrounding the precise characterization of this intermediate glucose metabolism status. The risk of developing diabetes and macro and microvascular disease linked to prediabetes is well known. Still, the prediabetic population is far from being homogenous, and phenotyping it into less heterogeneous groups might prove useful for long-term risk assessment, follow-up, and primary prevention. Unfortunately, the current definition of prediabetes is quite rigid and disregards the underlying pathophysiologic mechanisms and their potential metabolic progression towards overt disease. In addition, prediabetes is commonly associated with a cluster of risk factors that worsen the prognosis. These risk factors all revolve around a common denominator: inflammation. This review focuses on identifying the population that needs to be screened for prediabetes and the already declared prediabetic patients who are at a higher risk of cardiovascular disease and require closer monitoring.
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Affiliation(s)
| | - Mihaela-Roxana Popescu
- Department of Cardiology, Elias Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, 011461 Bucharest, Romania; (E.B.); (S.-M.B.)
| | - Andreea-Catarina Popescu
- Department of Cardiology, Elias Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, 011461 Bucharest, Romania; (E.B.); (S.-M.B.)
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Hasain Z, Raja Ali RA, Abdul Razak S, Azizan KA, El-Omar E, Razalli NH, Mokhtar NM. Gut Microbiota Signature Among Asian Post-gestational Diabetes Women Linked to Macronutrient Intakes and Metabolic Phenotypes. Front Microbiol 2021; 12:680622. [PMID: 34248897 PMCID: PMC8270638 DOI: 10.3389/fmicb.2021.680622] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/21/2021] [Indexed: 01/02/2023] Open
Abstract
Aberrant gut microbiota dysbiosis in women with a previous history of gestational diabetes mellitus (post-GDM) was comparable to that in adults with type 2 diabetes mellitus (T2DM). Nonetheless, potential relationships between diet, gut microbiota, and metabolic phenotypes in post-GDM women after delivery are yet to be discovered. In this research, we assessed the relationship of the macronutrient intakes, gut microbiota composition, and metabolic phenotypes (i.e., anthropometrics and glycemic control) in post-GDM women with and without postpartum glucose intolerance (GI). About 24 post-GDM women were included in this study, 14 women were grouped in the GI group and 10 women were grouped in the normal glucose tolerance (NGT) group according to oral glucose tolerance test. Macronutrient intake assessment using a 3-day dietary record, anthropometric measurements, biochemical analyses, and fecal sampling were done during 3–6 months postpartum. Gut microbiota profiling was determined using 16S rRNA genes sequencing targeting the V3–V4 regions. The relationships between macronutrient intakes, gut microbiota composition, and metabolic phenotypes were evaluated using Pearson’s correlation coefficient and stepwise regression analyses. In this study, most post-GDM women had significantly poor dietary fiber adherence than the nutritional recommendations. Women from the GI group have significantly higher fasting blood glucose (FBG), HbA1c, and homeostasis model assessment-estimated insulin resistance (HOMA-IR) levels compared to the NGT group. The group also showed significant elevation of high-sensitivity C-reactive protein (hs-CRP) level when compared to the normal value. Specific gut microbial taxa derived from Proteobacteria and Bacteroidetes such as Parasutterella, Aquicella, Haliscomenobacter, and Prevotellaceae_NK3B31_group were significantly abundant in the GI group compared to the NGT group. Prevotellaceae_NK3B31_group was significantly associated with high FBG, HOMA-IR, and HbA1c levels. Low fiber and monounsaturated fatty acids intakes were associated with Lactobacillus. Meanwhile, Lactobacillus was associated with high body mass index, waist circumference, 2-h postprandial blood glucose, and hs-CRP levels. Our study suggested that macronutrient intake is an important predictor of gut microbiota dysbiosis and is associated with obesity, low-grade inflammation, and poor glycemic control in post-GDM women. Hence, dietary intake modification to remodel gut microbiota composition is a promising T2DM preventive strategy in post-GDM women.
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Affiliation(s)
- Zubaidah Hasain
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Raja Affendi Raja Ali
- Gastroenterology Unit, Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,GUT Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Shairah Abdul Razak
- Department of Applied Physics, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Kamalrul Azlan Azizan
- Metabolomics Research Laboratory, Institute of Systems Biology, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Emad El-Omar
- Microbiome Research Centre, St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Nurul Huda Razalli
- Dietetic Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norfilza Mohd Mokhtar
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,GUT Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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van Wyk J, Ait-Khaled M, Santos J, Scholten S, Wohlfeiler M, Ajana F, Jones B, Nascimento MC, Tenorio AR, Smith DE, Wright J, Wynne B. Brief Report: Improvement in Metabolic Health Parameters at Week 48 After Switching From a Tenofovir Alafenamide-Based 3- or 4-Drug Regimen to the 2-Drug Regimen of Dolutegravir/Lamivudine: The TANGO Study. J Acquir Immune Defic Syndr 2021; 87:794-800. [PMID: 33587500 PMCID: PMC8126488 DOI: 10.1097/qai.0000000000002655] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/22/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND In TANGO, switching to dolutegravir/lamivudine was noninferior at 48 weeks to continuing 3-/4-drug tenofovir alafenamide-based regimens in virologically suppressed individuals with HIV-1. Antiretroviral agents have been associated with weight gain and metabolic complications. SETTING One hundred thirty-four centers; 10 countries. METHODS We assessed weight; fasting lipids, glucose, and insulin; and prevalence of insulin resistance and metabolic syndrome at baseline and week 48 in TANGO participant subgroups by boosting agent use in baseline regimens (boosted and unboosted). RESULTS In each treatment group, 74% of participants used boosted regimens at baseline. In boosted and unboosted subgroups, weight and fasting glucose changes at week 48 were small and similar between treatment groups. Overall and in the boosted subgroup, greater decreases from baseline were observed with dolutegravir/lamivudine in fasting total cholesterol (P < 0.001), low-density lipoprotein cholesterol (P < 0.001), triglycerides (P < 0.001), total cholesterol/high-density lipoprotein cholesterol ratio (overall, P = 0.017; boosted, P = 0.007), and insulin (boosted, P = 0.005). Prevalence of HOMA-IR ≥2 was significantly lower at week 48 with dolutegravir/lamivudine overall [adjusted odds ratio (aOR), 0.59; 95% confidence interval (CI), 0.40 to 0.87; P = 0.008] and in the boosted subgroup [aOR, 0.56; 95% CI, 0.36 to 0.88; P = 0.012] but not in the unboosted subgroup [aOR, 0.70; 95% CI, 0.31 to 1.58; P = 0.396]. Prevalence of metabolic syndrome at week 48 was low and consistent between treatment groups overall, with differences trending to favor dolutegravir/lamivudine in the unboosted subgroup [aOR, 0.41; 95% CI, 0.15 to 1.09; P = 0.075]. CONCLUSION Generally, switching from 3-/4-drug tenofovir alafenamide-based regimens to dolutegravir/lamivudine improved metabolic parameters, particularly when switching from boosted regimens. Because of smaller sample size in the unboosted subgroup, results warrant further investigation.
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Affiliation(s)
| | | | - Jesus Santos
- Infectious Diseases Unit, Hospital Virgen de la Victoria, Málaga, Spain
| | | | | | - Faïza Ajana
- Infectious Diseases, Centre Hospitalier de Tourcoing, Tourcoing, France
| | - Bryn Jones
- ViiV Healthcare, Brentford, United Kingdom
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Interaction of Adiponectin Genotypes and Insulin Resistance on the Occurrence of Taiwanese Metabolic Syndrome. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5570827. [PMID: 33997011 PMCID: PMC8110375 DOI: 10.1155/2021/5570827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/20/2021] [Accepted: 04/23/2021] [Indexed: 02/01/2023]
Abstract
Backgrounds Adiponectin (apM1) may affect insulin sensitivity, and tumor necrosis factor (TNF-α) can inhibit the binding of insulin and insulin receptors. However, whether apM1 and TNF-α genes influence the development of metabolic syndrome (MetS) preceded by insulin resistance is unclear. The current study examines the interactions between the apM1 +45 genotypes, TNF-α -308 genotypes, and insulin resistance on the occurrence of MetS. Methods A total of 329 community residents were recruited, and their personal characteristics were collected. Waist circumference and biochemical markers were examined for determining MetS. Genotypes were identified by the polymerase chain reaction. Results After adjusting for the confounding effects, compared to apM1 +45 GG and GT genotypes carriers with HOMR-IR less than 2.0, those carriers with HOMA-IR greater than 2.0 had an increased MetS risk (OR = 4.35, 95% CI 2.14-8.85). Further, apM1 +45 TT carriers with HOMA-IR greater than 2.0 experienced a higher MetS risk (OR = 5.91, 95% CI 2.78-12.54). A significant interaction of the apM1 +45 genotype and insulin resistance on the MetS development was observed (P = 0.04). Conclusion Our data suggested that apM1 +45 genotypes might modify the effect of insulin resistance on the development of Taiwanese MetS.
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Insulin Resistance in Association with Thyroid Function, Psychoemotional State, and Cardiovascular Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073388. [PMID: 33805872 PMCID: PMC8036436 DOI: 10.3390/ijerph18073388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/17/2021] [Accepted: 03/23/2021] [Indexed: 12/27/2022]
Abstract
Background: Individuals with insulin resistance (IR) have a high risk of diabetes or metabolic syndrome, and they are more likely to have depression. Furthermore, IR by itself is a major cardiovascular risk factor in healthy persons. Thus, we aimed to investigate IR in association with thyroid function, psychoemotional state, and cardiovascular risk factors among 45–84-year-old citizens of Palanga. Methods: A randomized epidemiological study was performed with 850 subjects. All participants were evaluated for sociodemographic, clinical, and cardiovascular risk factors and biochemical analysis. IR was evaluated by the homeostasis model assessment of IR (HOMA-IR). Results: All study participants were stratified into groups without IR (HOMA-IR ≤ 2.7) and with IR (HOMA-IR > 2.7). The analysis of parameters between the two study groups showed some statistically significant relationships between IR and cardiovascular risk factors. The predictable accuracy was presented using receiver performance characteristic curves for HOMA-IR scores in women and men separately. If the HOMA-IR score is higher than 3.45, individuals are significantly more likely to have type 2 diabetes mellitus (T2DM). Conclusions: An increase of fasting glucose and more frequent incidence of metabolic syndrome, diabetes, and cardiovascular diseases in subjects with IR are associated with the prevalence of cardiovascular risk factors. There was no significant association between thyroid function and HOMA-IR. HOMA-IR cut-offs could predict the presence of T2DM.
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Kron V, Verner M, Smetana P, Horáková D, Šlégr J, Studnička F, Bušovský D, Martiník K. The Changes of Cholesterol Profile at the Different Insulin Resistance Range in the Czech Republic. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:249. [PMID: 33800137 PMCID: PMC8035656 DOI: 10.3390/medicina57030249] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/26/2021] [Accepted: 03/03/2021] [Indexed: 12/22/2022]
Abstract
Background and Objectives: The mechanism of the relationship between glycemia and lipid metabolism has not been completely clarified, and slight differences may be found between authors and the kinds of evaluated parameters. Therefore, this study focused on possible changes of lipoprotein profile with regards to HOMA IR (Homeostatic Model Assessment for Insulin Resistance) cut-off 3.63, considered a signal of glucose metabolism alterations. Materials and Methods: The metabolic profiles of 3051 individuals were divided by HOMA IR values into two groups below cut-off 3.63, including (n = 2627) and above cut-off (n = 424). Patients taking medication or supplements to affect lipid, insulin, or glucose metabolism were excluded. Fasting glucose levels, insulin, and lipoproteins (total, HDL-high density and LDL-low density lipoprotein cholesterol) were compared between the groups with different HOMA IR. After analysis of data distribution, F-test and t-test were provided to compare variances and mean values. Results: The evaluation shows that the kind of cholesterol is crucial for a possible relationship with glucose metabolism and consequently confirms the changes of lipoproteins (HDL and LDL) by HOMA IR cut-off 3.63. Conclusions: The results of patients divided by HOMA IR cut-off 3.63 also suggest possible changes in the regulation of glucose metabolism and lipoprotein concentrations (HDL and LDL).
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Affiliation(s)
- Vladimír Kron
- Department of Food Biotechnologies and Agricultural Products Quality, Faculty of Agriculture, University of South Bohemia, Studentská 1668, 370 05 České Budějovice, Czech Republic; (V.K.); (P.S.)
- Ambulance for Metabolic Assessment of Prof. MUDr. Karel Martiník, DrSc., s.r.o., Bratří Štefanů 895, 500 03 Hradec Králové, Czech Republic;
| | - Miroslav Verner
- Department of Clinical Biochemistry, Hospital of České Budějovice, B. Němcové 585/54, 370 01 České Budějovice, Czech Republic;
- Faculty of Health and Social Sciences, Institute of Laboratory Diagnostics, University of South Bohemia, J. Boreckého 1167/27, 370 11 České Budějovice, Czech Republic
| | - Pavel Smetana
- Department of Food Biotechnologies and Agricultural Products Quality, Faculty of Agriculture, University of South Bohemia, Studentská 1668, 370 05 České Budějovice, Czech Republic; (V.K.); (P.S.)
| | - Dagmar Horáková
- Department of Public Health, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hněvotínská 3, 775 15 Olomouc, Czech Republic;
| | - Jan Šlégr
- Center of Advanced Technology, Faculty of Science, University of Hradec Králové, Roktianského 62, 500 03 Hradec Králové, Czech Republic; (F.S.); (D.B.)
| | - Filip Studnička
- Center of Advanced Technology, Faculty of Science, University of Hradec Králové, Roktianského 62, 500 03 Hradec Králové, Czech Republic; (F.S.); (D.B.)
| | - Damián Bušovský
- Center of Advanced Technology, Faculty of Science, University of Hradec Králové, Roktianského 62, 500 03 Hradec Králové, Czech Republic; (F.S.); (D.B.)
| | - Karel Martiník
- Ambulance for Metabolic Assessment of Prof. MUDr. Karel Martiník, DrSc., s.r.o., Bratří Štefanů 895, 500 03 Hradec Králové, Czech Republic;
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Borzan V, Lerchbaum E, Missbrenner C, Heijboer AC, Goschnik M, Trummer C, Theiler-Schwetz V, Haudum C, Gumpold R, Schweighofer N, Obermayer-Pietsch B. Risk of Insulin Resistance and Metabolic Syndrome in Women with Hyperandrogenemia: A Comparison between PCOS Phenotypes and Beyond. J Clin Med 2021; 10:829. [PMID: 33670546 PMCID: PMC7922675 DOI: 10.3390/jcm10040829] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 02/07/2021] [Accepted: 02/11/2021] [Indexed: 02/07/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in premenopausal women, with a wide spectrum of possible phenotypes, symptoms and sequelae according to the current clinical definition. However, there are women who do not fulfill at least two out of the three commonly used "Rotterdam criteria" and their risk of developing type 2 diabetes or obesity later in life is not defined. Therefore, we addressed this important gap by conducting a retrospective analysis based on 750 women with and without PCOS. We compared four different PCOS phenotypes according to the Rotterdam criteria with women who exhibit only one Rotterdam criterion and with healthy controls. Hormone and metabolic differences were assessed by analysis of variance (ANOVA) as well as logistic regression analysis. We found that hyperandrogenic women have per se a higher risk of developing insulin resistance compared to phenotypes without hyperandrogenism and healthy controls. In addition, hyperandrogenemia is associated with developing insulin resistance also in women with no other Rotterdam criterion. Our study encourages further diagnostic and therapeutic approaches for PCOS phenotypes in order to account for varying risks of developing metabolic diseases. Finally, women with hyperandrogenism as the only symptom should also be screened for insulin resistance to avoid later metabolic risks.
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Affiliation(s)
- Valentin Borzan
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Endocrinology Lab Platform, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; (V.B.); (E.L.); (C.M.); (M.G.); (C.T.); (V.T.-S.); (C.H.); (R.G.); (N.S.)
- Center for Biomarker Research in Medicine (CBmed), 8010 Graz, Austria
| | - Elisabeth Lerchbaum
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Endocrinology Lab Platform, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; (V.B.); (E.L.); (C.M.); (M.G.); (C.T.); (V.T.-S.); (C.H.); (R.G.); (N.S.)
| | - Cornelia Missbrenner
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Endocrinology Lab Platform, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; (V.B.); (E.L.); (C.M.); (M.G.); (C.T.); (V.T.-S.); (C.H.); (R.G.); (N.S.)
| | - Annemieke C. Heijboer
- Endocrine Laboratory, Department of Clinical Chemistry, University Medical Center, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands;
| | - Michaela Goschnik
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Endocrinology Lab Platform, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; (V.B.); (E.L.); (C.M.); (M.G.); (C.T.); (V.T.-S.); (C.H.); (R.G.); (N.S.)
- Center for Biomarker Research in Medicine (CBmed), 8010 Graz, Austria
| | - Christian Trummer
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Endocrinology Lab Platform, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; (V.B.); (E.L.); (C.M.); (M.G.); (C.T.); (V.T.-S.); (C.H.); (R.G.); (N.S.)
| | - Verena Theiler-Schwetz
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Endocrinology Lab Platform, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; (V.B.); (E.L.); (C.M.); (M.G.); (C.T.); (V.T.-S.); (C.H.); (R.G.); (N.S.)
| | - Christoph Haudum
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Endocrinology Lab Platform, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; (V.B.); (E.L.); (C.M.); (M.G.); (C.T.); (V.T.-S.); (C.H.); (R.G.); (N.S.)
- Center for Biomarker Research in Medicine (CBmed), 8010 Graz, Austria
| | - Roswitha Gumpold
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Endocrinology Lab Platform, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; (V.B.); (E.L.); (C.M.); (M.G.); (C.T.); (V.T.-S.); (C.H.); (R.G.); (N.S.)
| | - Natascha Schweighofer
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Endocrinology Lab Platform, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; (V.B.); (E.L.); (C.M.); (M.G.); (C.T.); (V.T.-S.); (C.H.); (R.G.); (N.S.)
- Center for Biomarker Research in Medicine (CBmed), 8010 Graz, Austria
| | - Barbara Obermayer-Pietsch
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Endocrinology Lab Platform, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; (V.B.); (E.L.); (C.M.); (M.G.); (C.T.); (V.T.-S.); (C.H.); (R.G.); (N.S.)
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Lin YF, Peng KY, Chang CH, Hu YH, Wu VC, Chung SD. Changes in Glucose Metabolism after Adrenalectomy or Treatment with a Mineralocorticoid Receptor Antagonist for Primary Aldosteronism. Endocrinol Metab (Seoul) 2020; 35:838-846. [PMID: 33261310 PMCID: PMC7803597 DOI: 10.3803/enm.2020.797] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 09/23/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Data on the effects of excess aldosterone on glucose metabolism are inconsistent. This study compared the changes in glucose metabolism in patients with primary aldosteronism (PA) after adrenalectomy or treatment with a mineralocorticoid receptor antagonist (MRA). METHODS Overall, 241 patients were enrolled; 153 underwent adrenalectomy and 88 received an MRA. Fasting glucose, homeostatic model assessment of insulin resistance (HOMA-IR), and homeostatic model assessment of β-cell function (HOMA-β) were compared between the treatment groups after 1 year. Plasma aldosterone concentration (PAC) and factors determining HOMA-IR and PAC were evaluated. RESULTS No baseline differences were observed between the groups. Fasting insulin, HOMA-IR, and HOMA-β increased in both groups and there were no significant differences in fasting glucose following treatment. Multiple regression analysis showed associations between PAC and HOMA-IR (β=0.172, P=0.017) after treatment. Treatment with spironolactone was the only risk factor associated with PAC >30 ng/dL (odds ratio, 5.2; 95% confidence interval [CI], 2.7 to 10; P<0.001) and conferred a 2.48-fold risk of insulin resistance after 1 year compared with surgery (95% CI, 1.3 to 4.8; P=0.007). CONCLUSION Spironolactone treatment might increase insulin resistance in patients with PA. This strengthened the current recommendation that adrenalectomy is the preferred strategy for patient with positive lateralization test. Achieving a post-treatment PAC of <30 ng/dL for improved insulin sensitivity may be appropriate.
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Affiliation(s)
- Yu-Fang Lin
- Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei,
Taiwan
| | - Kang-Yung Peng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei,
Taiwan
| | - Chia-Hui Chang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei,
Taiwan
| | - Ya-Hui Hu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei,
Taiwan
| | - Vin-Cent Wu
- Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei,
Taiwan
| | - Shiu-Dong Chung
- Division of Urology, Department of Surgery, Far-Eastern Memorial Hospital, New Taipei,
Taiwan
- Graduate Program in Biomedical Informatics, College of Informatics, Yuan-Ze University, Chung-Li,
Taiwan
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Wang X, Feng H, Fan D, Zou G, Han Y, Liu L. The influence of dehydroepiandrosterone (DHEA) on fasting plasma glucose, insulin levels and insulin resistance (HOMA-IR) index: A systematic review and dose response meta-analysis of randomized controlled trials. Complement Ther Med 2020; 55:102583. [DOI: 10.1016/j.ctim.2020.102583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/19/2020] [Accepted: 09/22/2020] [Indexed: 02/07/2023] Open
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Chen Y, Das S, Zhuo G, Cai H. Elevated serum levels of galectin-3 binding protein are associated with insulin resistance in non-diabetic women after menopause. Taiwan J Obstet Gynecol 2020; 59:877-881. [PMID: 33218405 DOI: 10.1016/j.tjog.2020.09.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Galectin-3 binding protein (Gal-3BP) is one of the major fucosylated glycoprotein family members and has recently been implicated in non-alcoholic fatty liver disease, hyperlipaemia and coronary artery disease. Here, we analysed the serum concentrations of Gal-3BP in menopausal women to evaluate the association of circulating Gal-3BP and insulin resistance in females after menopause. MATERIALS AND METHODS We evaluated serum levels of Gal-3BP in sixty-two non-diabetic women with menopausal status for at least one year. The clinical features, biochemical profiles and homeostasis model assessment of insulin resistance (HOMA-IR) indices were obtained routinely. RESULTS Gal-3BP levels increased in women with higher HOMA-IR indices and were positively correlated with HOMA-IR indices. The Gal-3BP level was also an independent risk factor for a high HOMA-IR index and showed the most influence on the HOMA-IR index compared to fasting plasma glucose, triglyceride, age and body mass index. The cut-off value of the serum Gal-3BP level was 2234.32 ng/ml, with areas under the ROC curve (AUCs) of 0.68 (HOMA-IR index 1.5), 0.81 (HOMA-IR index 2.0) and 0.93 (HOMA-IR index 2.5). CONCLUSION Serum levels of Gal-3BP are associated with impaired insulin sensitivity in non-diabetic menopausal women.
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Affiliation(s)
- Yun Chen
- Department of Gynaecology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Sayantana Das
- Department of Gynaecology, North Middlesex University Hospital NHS TRUST, London, UK
| | - Guangchao Zhuo
- Department of Laboratory Medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hong Cai
- Department of Gynaecology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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Insulin Resistance Is Associated with Reduced Food Odor Sensitivity across a Wide Range of Body Weights. Nutrients 2020; 12:nu12082201. [PMID: 32721994 PMCID: PMC7468861 DOI: 10.3390/nu12082201] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/18/2020] [Accepted: 07/20/2020] [Indexed: 02/06/2023] Open
Abstract
The worldwide obesity epidemic is a major health problem driven by the modern food environment. Recently, it has been shown that smell perception plays a key role in eating behavior and is altered in obesity. However, the underlying mechanisms of this phenomenon are not well understood yet. Since the olfactory system is closely linked to the endocrine system, we hypothesized that hormonal shifts in obesity might explain this relationship. In a within-subject, repeated-measures design, we investigated sensitivity to a food and a non-food odor in the hungry and sated state in 75 young healthy (26 normal weight, 25 overweight, and 24 obese) participants (37 women). To determine metabolic health status and hormonal reactivity in response to food intake, we assessed pre- and postprandial levels of insulin, leptin, glucose, and ghrelin. Odor sensitivity did not directly depend on body weight status/body mass index (BMI) or hunger state. However, we could establish a strong negative mediating effect of insulin resistance on the relationship between BMI/waist-hip ratio and olfactory sensitivity for the food odor. These findings indicate an impact of metabolic health status on sensitivity to food odors. Our results contribute to a better understanding of the mechanisms behind altered smell perception in obesity.
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Nath C, Longkumer C, Barman B, Ruram A, Visi V, Yasir MD, Sangma M. Idiopathic post prandial glucose lowering, a whistle blower for subclinical hypothyroidism and insulin resistance. A cross-sectional study in Tertiary Care Centre of northeast India. J Family Med Prim Care 2020; 9:4637-4640. [PMID: 33209776 PMCID: PMC7652208 DOI: 10.4103/jfmpc.jfmpc_867_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/14/2020] [Accepted: 07/07/2020] [Indexed: 11/30/2022] Open
Abstract
Background and Aims: There has been a lot of confusion in management of apparently healthy individuals whose post prandial plasma glucose levels were lower than fasting levels. It has been observed that many clinicians do send for repeat tests to rule out analytical error since there is common knowledge that post prandial glucose should be higher than fasting glucose level. Blood glucose level is regulated by a fully integrated mechanism with complex interplay of hormones and enzymes on metabolic pathways. Increase or decrease of thyroid hormones can break this equilibrium leading to alterations of carbohydrate metabolism. The objective for this study was to look for subclinical hypothyroidism (SCH) and insulin resistance (IR) in Idiopathic Post prandial glucose lowering and the correlation between thyroid stimulating hormone (TSH) with IR in them. Methods: A cross-sectional study with subgroup analysis, 34 cases and 34 controls. Cases comprises of otherwise healthy individuals whose post prandial glucose is lower than fasting glucose and controls as those healthy individual whose post prandial glucose is higher than fasting. Thyroid hormones and insulin were measured in fasting serum samples. Homeostasis model assessment for IR was calculated as per formula. Results: Among the 34 cases with idiopathic post prandial glucose lowering, 76% (n = 26) had subclinical hypothyroidism and 61% (n = 21) had insulin resistance. A positive correlation (r = 0.55) was observed between Thyroid-Stimulating hormone (TSH) and Index of insulin resistance and homeostatic model assessment (HOMA-IR) and was statistically significant with P < 0.1. Conclusions: The study highlights the importance of evaluating glycoregulatory hormones like thyroid hormones and insulin in cases with idiopathic post prandial glucose lowering for early diagnosis and prevention of overt clinical diseases like Hypothyroidism and Diabetes Mellitus.
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Transcriptome analysis revealed the mechanism of the metabolic toxicity and susceptibility of di-(2-ethylhexyl)phthalate on adolescent male ICR mice with type 2 diabetes mellitus. Arch Toxicol 2019; 93:3183-3206. [DOI: 10.1007/s00204-019-02590-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 10/01/2019] [Indexed: 12/14/2022]
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50
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Yeh WC, Tsao YC, Li WC, Tzeng IS, Chen LS, Chen JY. Elevated triglyceride-to-HDL cholesterol ratio is an indicator for insulin resistance in middle-aged and elderly Taiwanese population: a cross-sectional study. Lipids Health Dis 2019; 18:176. [PMID: 31604438 PMCID: PMC6790048 DOI: 10.1186/s12944-019-1123-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 09/30/2019] [Indexed: 11/22/2022] Open
Abstract
Background Previous studies have reported that the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio could be a simple clinical indicator of insulin resistance (IR), but the results indicated that there were heterogeneities between different ethnicities. We aimed to investigate the association between TG/HDL-C and IR (as measured by homeostasis model assessment of IR [HOMA-IR]), and establish a clinical prediction rule for IR in middle-aged and elderly Taiwanese. Methods A total of 398 subjects were recruited, and each subject completed a questionnaire that included personal and medical history data, and underwent anthropometric measurement and blood sampling. IR was defined as HOMA-IR index value ≥2.0. Chi-squared test, independent two-sample t-test, Pearson’s correlation coefficient, and multiple logistic regression were used to evaluate the association between IR and TG/HDL-C ratio. A receiver operating characteristic (ROC) analysis was conducted to evaluate the ability of the developed clinical prediction rule to correctly discriminate between subjects of IR positive and IR negative groups. Results A significant association between IR and TG/HDL-C ratio was identified with a Pearson’s correlation coefficient of 0.35 (p-value< 0.001). In multiple logistic regression, high BMI (OR = 1.23; 95% C.I. = 1.13–1.33), hypertension (OR = 1.90; 95% C.I. = 1.12–3.21), diabetes mellitus (OR = 5.44; 95% C.I. = 2.93–10.08) and high TG/HDL ratio (OR = 1.45; 95% C.I. = 1.23–1.72) were significantly associated with the risk of elevated HOMA-IR. The area under ROC curves for TG/HDL-C ratio was 0.729 and the optimal threshold value was 2.197 where the corresponding of sensitivity and specificity were 72.4 and 65.1%. Conclusions Our findings showed that the elevated TG/HDL-C ratio was significantly associated with IR and could be used as an indicator of IR among the middle-aged and elderly population in Taiwan. It is clinically available, thus eliminating any additional costs. Future research is warranted to investigate the use of TG/HDL-C ratio combined with other risk factors for predicting IR under diverse ethnic backgrounds.
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Affiliation(s)
- Wei-Chung Yeh
- Department of Family Medicine, Chang-Gung Memorial Hospital, Linkou Branch, Postal address: No. 5, Fuxing St., Guishan Dist, Taoyuan City, 33305, Taiwan, Republic of China
| | - Yu-Chung Tsao
- Department of Family Medicine, Chang-Gung Memorial Hospital, Linkou Branch, Postal address: No. 5, Fuxing St., Guishan Dist, Taoyuan City, 33305, Taiwan, Republic of China.,Chang Gung University College of Medicine, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 333, Taiwan, Republic of China.,Department of Occupational Medicine, Chang Gung Memorial Hospital, Linkou Branch, No.5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan, Republic of China
| | - Wen-Cheng Li
- Department of Family Medicine, Chang-Gung Memorial Hospital, Linkou Branch, Postal address: No. 5, Fuxing St., Guishan Dist, Taoyuan City, 33305, Taiwan, Republic of China.,Department of Health Management, Xiamen Chang-Gung Hospital, Xiamen, No.123, Xiafei Road, Haicang District, Xiamen, China
| | - I-Shiang Tzeng
- Department of Research, Taipei Tzu Chi General Hospital, Buddhist Tzu Chi Medical Foundation, No.289, Jianguo Rd., Xindian Dist, New Taipei City, 23142, Taiwan, Republic of China
| | - Liang-Sien Chen
- Department of Family Medicine, Chang-Gung Memorial Hospital, Linkou Branch, Postal address: No. 5, Fuxing St., Guishan Dist, Taoyuan City, 33305, Taiwan, Republic of China
| | - Jau-Yuan Chen
- Department of Family Medicine, Chang-Gung Memorial Hospital, Linkou Branch, Postal address: No. 5, Fuxing St., Guishan Dist, Taoyuan City, 33305, Taiwan, Republic of China. .,Chang Gung University College of Medicine, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 333, Taiwan, Republic of China.
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