1
|
Çelik Kavaklılar B, Aybı Özdemir Ö, Yıldırım T, Dikmetaş Ö, Toprak H, Hekimsoy V, İşler AO, Yılmaz R, Kadayıfçılar S, Erdem Y, Erbas T, Ünlütürk U. Evaluation of Microvascular Complications in Kidney Recipients With Posttransplant Diabetes Mellitus. J Clin Endocrinol Metab 2024; 109:e1623-e1633. [PMID: 38101939 PMCID: PMC11244200 DOI: 10.1210/clinem/dgad738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 11/27/2023] [Accepted: 12/13/2023] [Indexed: 12/17/2023]
Abstract
CONTEXT The paucity of data on microvascular complications in patients with posttransplant diabetes (PTDM) is an obstacle to developing follow-up algorithms. OBJECTIVE To evaluate diabetic microvascular complications in patients with long-standing PTDM. METHODS In patients with ≥5-year history of PTDM and age-matched renal transplant recipients without PTDM (NDM), diabetic peripheral neuropathy was evaluated using the Michigan Neuropathy Screening Instrument, the CASE IV device, and in vivo corneal confocal microscopy (CCM). Cardiac autonomic neuropathy tests were performed using heart rate variability. Nephropathy screening was assessed using spot urine albumin/creatinine ratio and eGFR calculation. Diabetic retinopathy was evaluated by fundus examination and photography, and optical coherence tomography. RESULTS This study included 41 patients with PTDM and 45 NDM patients. The median follow-up was 107.5 months in the PTDM group. Peripheral neuropathy was significantly higher in the PTDM group than in the NDM group (P = .02). In the PTDM patients with peripheral neuropathy, corneal nerve fiber density examined by CCM was significantly lower than in PTDM patients without neuropathy (P = .001). Parasympathetic involvement was observed in 58.5% of the PTDM group and 22% of the NDM group (P = .001). Sympathetic involvement was present in 65.9% of the PTDM group and 29.3% of the NDM group (P = .001). Retinopathy was observed in 19.5% of patients in the PTDM group and in none of the NDM patients (P < .001). Renal functions were similar between the study groups. CONCLUSION Cardiac autonomic neuropathy and diabetic retinopathy can affect patients with PTDM at a high rate. Diabetic retinopathy is a threat to the vision of PTDM patients. Diabetic peripheral neuropathy can be detected early in PTDM patients by CCM.
Collapse
Affiliation(s)
- Başak Çelik Kavaklılar
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara 06100, Turkey
| | - Özge Aybı Özdemir
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara 06100, Turkey
| | - Tolga Yıldırım
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara 06100, Turkey
- Department of Nephrology, Hacettepe University School of Medicine, Ankara 06100, Turkey
| | - Özlem Dikmetaş
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara 06100, Turkey
| | - Hilal Toprak
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara 06100, Turkey
| | - Vedat Hekimsoy
- Department of Cardiology, Hacettepe University School of Medicine, Ankara 06100, Turkey
| | - Alperen Onur İşler
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara 06100, Turkey
- Department of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara 06100, Turkey
| | - Rahmi Yılmaz
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara 06100, Turkey
- Department of Nephrology, Hacettepe University School of Medicine, Ankara 06100, Turkey
| | - Sibel Kadayıfçılar
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara 06100, Turkey
| | - Yunus Erdem
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara 06100, Turkey
- Department of Nephrology, Hacettepe University School of Medicine, Ankara 06100, Turkey
| | - Tomris Erbas
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara 06100, Turkey
- Department of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara 06100, Turkey
| | - Uğur Ünlütürk
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara 06100, Turkey
- Department of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara 06100, Turkey
| |
Collapse
|
2
|
Zhang D, Zhu J, Wewer Albrechtsen NJ, Rayner CK, Saffery R, Zhang H, Chen C, Wu T. Impairments of insulin and glucagon sensitivity in Chinese women with gestational diabetes mellitus. Diabetes Obes Metab 2024. [PMID: 38957925 DOI: 10.1111/dom.15740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 06/06/2024] [Accepted: 06/08/2024] [Indexed: 07/04/2024]
Abstract
AIM To evaluate insulin and glucagon sensitivity in Han Chinese women with and without gestational diabetes mellitus (GDM). METHODS In total, 81 women with GDM and 81 age-matched healthy controls were evaluated with a 75 g oral glucose tolerance test (OGTT) at gestational weeks 24-28. Plasma glucose concentrations were measured at fasting and 1 h and 2 h post-OGTT. Fasting plasma insulin, glucagon and amino acids were also measured. Insulin and glucagon sensitivity were assessed by the homeostatic model assessment of insulin resistance (HOMA-IR) and glucagon-alanine index, respectively. RESULTS As expected, plasma glucose concentrations were higher at fasting and 1 h and 2 h post-OGTT in GDM participants (p < .001 each). Both the HOMA-IR and the glucagon-alanine index were higher in GDM participants. There was a weak positive correlation between HOMA-IR and glucagon-alanine index (r = 0.24, p = .0024). Combining the HOMA-IR and the glucagon-alanine index yielded better capacity (area under the curve = 0.878) than either alone (area under the curve = 0.828 for HOMA-IR and 0.751 for glucagon-alanine index, respectively) in differentiating GDM from healthy participants. While the majority of GDM participants (64%) exhibited both reduced insulin and glucagon sensitivity, a third of them presented either reduced insulin (20%) or glucagon (14%) sensitivity alone. HOMA-IR and glucagon-alanine index correlated differentially with fasting glucose, triglycerides, low-density lipoprotein cholesterol, sum of amino acids and hepatic steatosis index. CONCLUSIONS Impairments of both insulin and glucagon sensitivity occur frequently in Chinese women with GDM, which may, individually or together, drive metabolic derangements in GDM. These observations provide new insights into the pathophysiology of GDM and support the need to target insulin or glucagon resistance, or both, in the management of GDM.
Collapse
Affiliation(s)
- Dan Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jianan Zhu
- Laboratory Medicine Centre, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, China
| | | | - Christopher K Rayner
- Centre for Research Excellence in Translating Nutritional Sciences to Good Health, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Richard Saffery
- Molecular Immunity, Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Hua Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chang Chen
- Institute of Life Sciences, College of Pharmacy, Chongqing Medical University, Chongqing, China
| | - Tongzhi Wu
- Centre for Research Excellence in Translating Nutritional Sciences to Good Health, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| |
Collapse
|
3
|
Deng S, Hu X, Zhang X. Association of single-point insulin sensitivity estimator index (SPISE) with future cardiovascular outcomes in patients with type 2 diabetes. Diabetes Obes Metab 2024; 26:2820-2829. [PMID: 38618968 DOI: 10.1111/dom.15600] [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: 01/20/2024] [Revised: 03/29/2024] [Accepted: 03/29/2024] [Indexed: 04/16/2024]
Abstract
AIMS To investigate the association of single-point insulin sensitivity estimator (SPISE) index with future cardiovascular outcomes in patients with type 2 diabetes. MATERIALS AND METHODS SPISE index (= 600 × high-density lipoprotein cholesterol [mg/dL]0.185/triglycerides [mg/dL]0.2 × body mass index [kg/m2]1.338) was calculated in 10 190 participants. Cox proportional hazard regression models were applied to evaluate the association between SPISE index and future cardiovascular outcomes. Restricted cubic spline analyses and two-piecewise linear regression models were employed to explore the nonlinear association and to determine the threshold value. Subgroup and interaction analyses were conducted to test the robustness of the results. RESULTS After fully adjusting for well-established metabolic confounders, higher SPISE index was significantly associated with lower risk of future cardiovascular outcomes in patients with type 2 diabetes (major adverse cardiovascular event [MACE]): hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.90-0.98, p = 0.0026; overall mortality: HR 0.90, 95% CI 0.86-0.93, p < 0.0001; cardiovascular disease [CVD] mortality: HR 0.85, 95% CI 0.79-0.92, p < 0.0001; congestive heart failure (CHF): HR 0.72, 95% CI 0.67-0.78, p < 0.0001; major coronary events: HR 0.91, 95% CI 0.87-0.95, p < 0.0001. There was a nonlinear association between SPISE index and future cardiovascular outcomes (the threshold value was 5.68 for MACE, 5.71 for overall mortality, 4.64 for CVD mortality, 4.48 for CHF, and 6.09 for major coronary events, respectively). CONCLUSIONS Higher SPISE index was independently associated with lower risk of future cardiovascular outcomes in type 2 diabetes patients after full adjustment for well-established metabolic confounders.
Collapse
Affiliation(s)
- Simin Deng
- Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xinqun Hu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiangyu Zhang
- Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
4
|
Park H, Choi JE, Jun S, Lee H, Kim HS, Lee HA, Park H. Metabolic complications of obesity in children and adolescents. Clin Exp Pediatr 2024; 67:347-355. [PMID: 37986568 PMCID: PMC11222907 DOI: 10.3345/cep.2023.00892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/18/2023] [Accepted: 08/18/2023] [Indexed: 11/22/2023] Open
Abstract
The global prevalence of childhood and adolescent obesity, exacerbated by the coronavirus disease 2019 pandemic, affects school-aged children and preschoolers. Early-onset obesity, which carries a high risk of metabolic complications, may contribute to a lower age at the onset of cardiovascular disease. As metabolic diseases such as diabetes, dyslipidemia, and nonalcoholic fatty liver disease observed in adulthood are increasingly recognized in the pediatric population, there is an emphasis on moving disease susceptibility assessments from adulthood to childhood to enable early detection. However, consensus is lacking regarding the definition of metabolic diseases in children. In response, various indicators such as the pediatric simple metabolic syndrome score, continuous metabolic syndrome score, single-point insulin sensitivity estimator, and fatty liver index have been proposed in several studies. These indicators may aid the early detection of metabolic complications associated with pediatric obesity, although further validation studies are needed. Obesity assessments are shifting in perspective from visual obesity to metabolic health and body composition considerations to fill the gap in health impact assessments. Sarcopenic obesity, defined as the muscle- to-fat ratio, has been proposed in pediatric populations and is associated with metabolic health in children and adolescents. The National Health Screening Program for Children in Korea has expanded but still faces limitations in laboratory testing. These tests facilitate timely intervention by identifying groups at a high risk of metabolic complications. Early detection and intervention through comprehensive health screening are critical for mitigating long-term complications of childhood obesity.
Collapse
Affiliation(s)
- Hyunjin Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Jung Eun Choi
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Seunghee Jun
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Hyelim Lee
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Hae Soon Kim
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Hye Ah Lee
- Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| |
Collapse
|
5
|
Al-Daghri NM, Wani K, Khattak MNK, Alnaami AM, Al-Saleh Y, Sabico S. The single point insulin sensitivity estimator (SPISE) is associated with bone health in Arab adults. Aging Clin Exp Res 2024; 36:136. [PMID: 38904881 PMCID: PMC11192813 DOI: 10.1007/s40520-024-02789-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 06/05/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND The Single Point Insulin Sensitivity Estimator (SPISE) index is a surrogate marker for insulin sensitivity. Given the emerging role of bone as an active endocrine organ, its associations with non-invasive measures of extra-skeletal functions such as insulin sensitivity warrant investigation. AIMS This study aimed to explore the relationship between the SPISE index and Bone Mineral Density (BMD) in an adult population. METHODS Data from a total of 1270 Arab adults (84% females, mean age 56.7 ± 8.1 years) from the Osteoporosis Registry Database of the Chair for Biomarkers of Chronic Diseases in King Saud University, Riyadh, Saudi Arabia was used in this study. T-scores and SPISE were calculated. Regression models were used to determine associations between SPISE and bone health indices. RESULTS The low BMD group (N = 853; T-score <-1.0) had significantly higher SPISE values than those with normal BMD (N = 417; T-score - 1.0 and above) (4.6 ± 1.3 vs. 4.3 ± 1.2, p < 0.001). Multivariate linear regression, adjusted for covariates, confirmed a significant inverse association between SPISE and BMD for all participants (β=-0.22, p < 0.001), as well as both groups [normal BMD (β = -0.10, p = 0.02) and low BMD groups (β = -0.15, p < 0.001)]. SPISE, family history of T2DM, and history of fractures collectively account for 17% of the variances perceived in T-score for all participants (p < 0.001). CONCLUSIONS A significant inverse association between the SPISE index and BMD was observed in adults, suggesting a link between BMD and extra-skeletal health. Underlying mechanisms need to be investigated prospectively using BMD as secondary outcomes in lifestyle modification programs.
Collapse
Affiliation(s)
- Nasser M Al-Daghri
- Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia.
| | - Kaiser Wani
- Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Malak N K Khattak
- Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Abdullah M Alnaami
- Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Yousef Al-Saleh
- Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
- Department of Medicine, Health Oasis Hospital, Riyadh, Saudi Arabia
| | - Shaun Sabico
- Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| |
Collapse
|
6
|
Wang B, Zuo L, Fan J, Ji Y, Xu L, Xu M, An Y, Zhang Y, Ji G, Yu D. Association between higher intermuscular adipose tissue and decreased renal function in patients with systemic lupus erythematosus mediated by insulin resistance. Insights Imaging 2024; 15:144. [PMID: 38886276 PMCID: PMC11182995 DOI: 10.1186/s13244-024-01722-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 05/26/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVES To quantify the relationship between abdominal computed tomography (CT)-based body composition parameters and renal function in systemic lupus erythematosus (SLE) patients and evaluate the potential effect of insulin resistance on this relationship. METHODS SLE patients from institutions A and B between January 2017 and August 2023 were enrolled. Areas and attenuation values of subcutaneous adipose tissue, visceral adipose tissue, intermuscular adipose tissue (IMAT), and skeletal muscle index on CT images were measured at the L3 vertebral level. Logistic regression analysis was used to identify risk factors associated with decreased renal function. Linear regression models were used to describe the relationships between body composition parameters and estimated glomerular filtration rate (eGFR). Finally, we used a single-point insulin sensitivity estimator to indirectly reflect the degree of insulin resistance and assess its mediating effect on the association between IMAT area and decreased renal function. RESULTS Three-hundred thirty-nine SLE patients from institution A (internal dataset) and 114 SLE patients from institution B (external validation dataset) were included. Multivariate logistic regression revealed that IMAT area (odds ratio (OR)institution A: 1.05 (95% confidence intervals (95% CI): 1.01, 1.10), and ORinstitution B: 1.19 (95% CI: 1.03, 1.39)) was an independent risk factor for decreased renal function in SLE patients. In the adjusted linear regression model, high IMAT area was significantly associated with reduced eGFR (βinstitution A = -1.15, Pinstitution A = 0.005; βinstitution B = -0.98, Pinstitution B = 0.049). Additionally, insulin resistance contributed a mediating role of 22.8% to the association. CONCLUSION High IMAT area was associated with decreased renal function in SLE patients and insulin resistance mediated this relationship. CRITICAL RELEVANCE STATEMENT High intermuscular adipose tissue area is associated with decreased renal function in systemic lupus erythematosus patients mediated by insulin resistance and is correlated with chronicity index in lupus nephritis patients. KEY POINTS High intramuscular adipose tissue (IMAT) area was associated with decreased renal function in systemic lupus erythematosus (SLE) patients. Insulin resistance mediated the association between IMAT area and eGFR. IMAT area was associated with chronicity index in lupus nephritis patients.
Collapse
Affiliation(s)
- Bowen Wang
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China
| | - Liping Zuo
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China
| | - Jinlei Fan
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China
| | - Yu Ji
- Department of Radiology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250033, China
| | - Lei Xu
- Medical Imaging Department, Shengli Oilfield Central Hospital, Dongying, Shandong, 257100, China
| | - Min Xu
- Department of Radiology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, 264200, China
| | - Yueming An
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China
| | - Yuting Zhang
- Department of Arrhythmia, Weifang People's Hospital, Weifang, Shandong, 261000, China
| | - Guanming Ji
- Medical Imaging Department, Shengli Oilfield Central Hospital, Dongying, Shandong, 257100, China
| | - Deixin Yu
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China.
| |
Collapse
|
7
|
Stinson SE, Fernández de Retana Alzola I, Brünner Hovendal ED, Lund MAV, Fonvig CE, Holm LA, Jonsson AE, Frithioff-Bøjsøe C, Christiansen M, Pedersen O, Ängquist L, Sørensen TIA, Holst JJ, Hartmann B, Holm JC, Hansen T. Altered Glucagon and GLP-1 Responses to Oral Glucose in Children and Adolescents With Obesity and Insulin Resistance. J Clin Endocrinol Metab 2024; 109:1590-1600. [PMID: 38087928 PMCID: PMC11099488 DOI: 10.1210/clinem/dgad728] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Indexed: 05/18/2024]
Abstract
CONTEXT Pediatric obesity is characterized by insulin resistance, yet it remains unclear whether insulin resistance contributes to abnormalities in glucagon and incretin secretion. OBJECTIVE To examine whether fasting and stimulated glucagon, glucagon-like peptide-1 (GLP-1), and glucose-dependent insulinotropic polypeptide (GIP) concentrations differ between children and adolescents with obesity and insulin resistance (OIR), obesity and normal insulin sensitivity (OIS), and controls with normal weight (NW). METHODS 80 (34 boys) children and adolescents, aged 7-17 years with OIR (n = 22), OIS (n = 22), and NW (n = 36) underwent an oral glucose tolerance test with measurements of serum insulin, plasma glucose, glucagon, total GLP-1, and total GIP. Homeostatic model assessment of insulin resistance (HOMA-IR), single point insulin sensitivity estimator (SPISE), Matsuda index, insulinogenic index (IGI), and oral disposition index (ODI) were calculated. RESULTS Fasting concentrations of glucagon and GLP-1 were higher in the OIR group, with no significant differences for GIP. The OIR group had higher glucagon total area under the curve (tAUC0-120) and lower GLP-1 incremental AUC (iAUC0-120), with no significant differences in GIP iAUC0-120. Higher fasting glucagon was associated with higher HOMA-IR, lower Matsuda index, lower SPISE, higher IGI, and higher plasma alanine transaminase, whereas higher fasting GLP-1 was associated with higher HOMA-IR, lower Matsuda index, and lower ODI. Higher glucagon tAUC0-120 was associated lower SPISE and lower Matsuda index, whereas lower GLP-1 iAUC0-120 was associated with a higher HOMA-IR, lower Matsuda index, and lower ODI. CONCLUSION Children and adolescents with OIR have elevated fasting concentrations of glucagon and GLP-1, higher glucagon and lower GLP-1 responses during an OGTT compared to those with OIS and NW. In contrast, individuals with OIS have similar hormone responses to those with NW.
Collapse
Affiliation(s)
- Sara Elizabeth Stinson
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Ierai Fernández de Retana Alzola
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Emilie Damgaard Brünner Hovendal
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
- The Children's Obesity Clinic, accredited European Centre for Obesity Management, Department of Pediatrics, Holbæk Hospital, 4300 Holbæk, Denmark
| | - Morten Asp Vonsild Lund
- The Children's Obesity Clinic, accredited European Centre for Obesity Management, Department of Pediatrics, Holbæk Hospital, 4300 Holbæk, Denmark
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Cilius Esmann Fonvig
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
- The Children's Obesity Clinic, accredited European Centre for Obesity Management, Department of Pediatrics, Holbæk Hospital, 4300 Holbæk, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Louise Aas Holm
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
- The Children's Obesity Clinic, accredited European Centre for Obesity Management, Department of Pediatrics, Holbæk Hospital, 4300 Holbæk, Denmark
| | - Anna Elisabet Jonsson
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Christine Frithioff-Bøjsøe
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
- The Children's Obesity Clinic, accredited European Centre for Obesity Management, Department of Pediatrics, Holbæk Hospital, 4300 Holbæk, Denmark
| | - Michael Christiansen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
- Department for Congenital Disorders, Statens Serum Institute, 2300 Copenhagen, Denmark
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
- Center for Clinical Metabolic Research, Herlev-Gentofte University Hospital, 2900 Copenhagen, Denmark
| | - Lars Ängquist
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 1353 Copenhagen, Denmark
| | - Jens Juul Holst
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Bolette Hartmann
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Jens-Christian Holm
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
- The Children's Obesity Clinic, accredited European Centre for Obesity Management, Department of Pediatrics, Holbæk Hospital, 4300 Holbæk, Denmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| |
Collapse
|
8
|
Dutil C, Podinic I, Featherstone RB, Eaton A, Sadler CM, Goldfield GS, Hadjiyannakis S, Gruber R, Tremblay MS, Prud’homme D, Chaput JP. Sleep and insulin sensitivity in adolescents at risk of type 2 diabetes: the Sleep Manipulation in Adolescents at Risk of Type 2 Diabetes randomized crossover study. Sleep 2024; 47:zsad313. [PMID: 38070132 PMCID: PMC11082473 DOI: 10.1093/sleep/zsad313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 11/01/2023] [Indexed: 01/21/2024] Open
Abstract
STUDY OBJECTIVES To investigate the effect of increasing sleep duration for 1 week, compared to a week of habitual and decreased sleep, on insulin sensitivity (IS) in adolescents at risk for type 2 diabetes (T2D). METHODS Adolescents, 13-18 years old, at risk for T2D, with obesity and other risk factors, were recruited for a randomized (1:1), open-label, sex-stratified crossover study, that manipulated time-in-bed to modify sleep duration (measured by actigraphy). Following a week of habitual (HB) sleep, time-in-bed was increased (IN) and decreased (DE) by 1 hour 30 min/night for 1 week, counterbalanced across participants (HBINDE or HBDEIN), and separated by a week of washout sleep. The main outcome measure was IS, obtained via 2-hour oral-glucose-tolerance-test conducted after each sleep week. RESULTS Of the 43 participants recruited, 36 (84%) completed all sleep interventions (52.8% female, age = 15.1 years, body mass index = 99.9th percentile, order: HBINDE = 18 and HBDEIN = 18). On average, during the HB week, participants slept 7 hours 31 min/night; sleep duration was 1 hour 02 min/night higher during the IN week and 1 hour 19 min/night lower during the DE week. We found a significant effect of sleep week on IS with a large effect size. Following the IN sleep week, IS was 20% higher compared to after the HB and DE sleep weeks, but there was no significant difference in IS following HB versus DE sleep weeks. CONCLUSIONS Whenever possible, clinicians should empower youth at risk of T2D to improve their sleep duration, since even a modest increase in sleep duration of 1 h/night for 1 week can have a positive impact on IS in this population. CLINICAL TRIALS Sleep Extension and IS in Adolescents, https://clinicaltrials.gov/study/NCT03754036, November 23rd, 2018. TRIAL REGISTRATION ClinicalTrials.gov (ID:NCT03754036).
Collapse
Affiliation(s)
- Caroline Dutil
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Irina Podinic
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Ryan B Featherstone
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Centre for Healthy Active Living (CHAL), Children’s Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - Amelia Eaton
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Christin M Sadler
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Gary S Goldfield
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | - Stasia Hadjiyannakis
- Centre for Healthy Active Living (CHAL), Children’s Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | - Reut Gruber
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Attention, Behaviour and Sleep Lab, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | - Denis Prud’homme
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Université de Moncton, Moncton, NB, Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
9
|
Lee J, Baek HS, Jo K, Kim MH, Lee JM, Chang SA, Lim DJ. The Impact of Physical Activity on Thyroid Health: Insights From Representative Data in Korea. J Clin Endocrinol Metab 2024:dgae178. [PMID: 38620035 DOI: 10.1210/clinem/dgae178] [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: 05/12/2023] [Indexed: 04/17/2024]
Abstract
CONTEXT Thyroid hormones are essential for energy metabolism related to thermogenesis and oxygen consumption. OBJECTIVE This study evaluated the potential association of thyroid function including thyroid peroxidase antibodies (TPOAb) with physical activity in nationally representative data. DESIGN/SETTING/PARTICIPANTS This retrospective cohort study used data from the Korean National Health and Nutrition Examination Survey between 2013 and 2015. Physical activity (PA) was assessed using metabolic equivalents based on the validated Korean version of the International Physical Activity Questionnaire Short Form. PA level was categorized into 3 groups of high, moderate, and low. Participants with abnormal thyroid function test, restricted activity, or previous history of thyroid disease were excluded in the study. RESULTS A total of 5372 participants was finally selected. The free T4 level was lowest in the low PA group, while TSH was not significantly different among the groups. TPOAb titers increased in the following order: moderate PA, low PA, and high PA. After adjustment for confounding factors, moderate PA was associated with a high T4 level and a decrease in TSH and TPOAb with significance. However, there were no significant changes in free T4, TSH, or TPOAb titer in the high PA group. In a subanalysis, females with moderate PA showed a significant decrease in TSH and TPOAb. In both males and females, insulin sensitivity was increased with moderate PA. In obese participants, TSH negatively correlated with PA, and free T4 levels decreased in the low PA. The sensitivity to thyroid hormone did not differ in our study. CONCLUSION The present study found an association between thyroid function and moderate PA. Therefore, moderate-intensity PA should be recommended to improve thyroid function.
Collapse
Affiliation(s)
- Jeongmin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 03312, Republic of Korea
| | - Han-Sang Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Kwanhoon Jo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, 21431, Republic of Korea
| | - Min-Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 03312, Republic of Korea
| | - Jung Min Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 03312, Republic of Korea
| | - Sang Ah Chang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 03312, Republic of Korea
| | - Dong-Jun Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| |
Collapse
|
10
|
Khamseh ME, Malek M, Jahangiri S, Nobarani S, Hekmatdoost A, Salavatizadeh M, Soltanieh S, Chehrehgosha H, Taheri H, Montazeri Z, Attaran F, Ismail-Beigi F, Alaei-Shahmiri F. Insulin Resistance/Sensitivity Measures as Screening Indicators of Metabolic-Associated Fatty Liver Disease and Liver Fibrosis. Dig Dis Sci 2024; 69:1430-1443. [PMID: 38438774 DOI: 10.1007/s10620-024-08309-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/19/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Measures of insulin resistance (IR)/sensitivity (IS) are emerging tools to identify metabolic-associated fatty liver disease (MAFLD). However, the comprehensive assessment of the performance of various indicators is limited. Moreover, the utility of measures of IR/IS in detecting liver fibrosis remains unclear. AIMS To evaluate the predictive ability of seventeen IR/IS and two beta cell function indices to identify MAFLD and liver fibrosis. METHODS A cross-sectional study was conducted on individuals aged 25-75 years. Transient elastography was used to estimate liver stiffness and controlled attenuation parameter. The following measures were computed: homeostatic model assessment (HOMA/HOMA2) for IR, IS, and beta cell function; QUICKI; Bennett index; glucose/insulin; FIRI; McAuley index; Reynaud index; SPISE index; TyG; TyG-BMI; TyG-WC; TyG-WHtR; TG/HDL; and METS-IR. Subgroup analyses were performed according to age, gender, diabetes status, and body weight. RESULTS A total of 644 individuals were included in our analysis. MAFLD and significant liver fibrosis were detected in 320 (49.7%) and 80 (12.4%) of the participants, respectively. All measures of IR/IS identified MAFLD and liver fibrosis. However, TyG-WC, TyG-BMI, and TyG-WHtR were the top three indicators that identified MAFLD. Measures that include insulin level in their mathematical calculation, namely, Raynaud index, HOMA-IR, HOMA 2-IR, FIRI, and QUICKI had the best performance in identifying liver fibrosis in the entire population, as well as among the study subgroups. CONCLUSIONS TyG-WC, TyG-BMI, and TyG-WHtR were the best predictors of MAFLD. Insulin-based measures had better performances in the detection of advanced fibrosis. This was independent of age, gender, obesity, or diabetes status.
Collapse
Affiliation(s)
- Mohammad E Khamseh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mojtaba Malek
- Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Soodeh Jahangiri
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Sohrab Nobarani
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Azita Hekmatdoost
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marieh Salavatizadeh
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samira Soltanieh
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Haleh Chehrehgosha
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Hoda Taheri
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Zeinab Montazeri
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Fereshteh Attaran
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Faramarz Ismail-Beigi
- Department of Medicine, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, OH, 44106, USA
| | - Fariba Alaei-Shahmiri
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| |
Collapse
|
11
|
Li R, Wang J, Wang Y, Lin X, Sun C, Xu L. Telomere length as a modifier in the relationship between phthalate metabolites exposure and glucose homeostasis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 344:123309. [PMID: 38190874 DOI: 10.1016/j.envpol.2024.123309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/20/2023] [Accepted: 01/04/2024] [Indexed: 01/10/2024]
Abstract
Given the rising concern over the potential impact of environmental factors on metabolic heath, we conducted a cross-sectional analysis among 645 adults aged 20 and older in the National Health and Nutrition Examination Survey (NHANES), examining the association between nine phthalate metabolites (Mono-n-butyl phthalate (MBP), Mono-ethyl phthalate (MEP), Mono-(2-ethyl)-hexyl phthalate (MEHP), Mono-benzyl phthalate (MBzP), Mono-n-methyl phthalate (MnMP), Mono-(3-carboxy propyl) phthalate (MCPP), Mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), Mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), Mono-isobutyl phthalate (MiBP)) and six glucose homeostasis indices (fasting glucose, fasting insulin, hemoglobin A1C (HbA1C), homeostatic model assessment of insulin resistance (HOMA-IR), single Point Insulin Sensitivity Estimator (SPISE), and HOMA-β). Latent Class Analysis identified three phthalate metabolites exposure patterns: high MEP-low MEOHP (n = 282), high MBzP-low MEHHP (n = 214), and high MEHHP, MEOHP (n = 149). The high MBzP-low MEHHP and high MEHHP, MEOHP, versus the high MEP-low MEOHP, exposure groups showed significantly higher levels of fasting insulin (β = 0.126, 95% CI: 0.023-0.228), SPISE (β = 0.091, 95% CI: 0.018-0.164), and HOMA-IR (β = 0.091, 95% CI: 0.018-0.164). In the shorter telomere length group, high MEHHP, MEOHP exposure showed an increase in SPISE levels (β = 0.153, 95% CI: 0.037-0.269), while in the overweight/obese subgroup, high MEHHP, MEOHP exposure was significantly positively associated with HOMA-IR (β = 0.392, 95% CI: 0.150-0.735). Bayesian kernel machine regression analyses showed positive associations between higher combined phthalate exposure and increased glucose homeostasis indices (fasting glucose, HbA1C, fasting insulin, SPISE, and HOMA-IR). The quantile of g-calculation analysis also supported the positive associations with HbA1C, HOMA-IR, and fasting insulin. Our findings indicate that phthalate exposure was positively associated with glucose homeostasis indices, which strengthen the call for proactive measures to reduce phthalate exposure and mitigate potential risks to glucose metabolism.
Collapse
Affiliation(s)
- Ruiqiang Li
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jiao Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ying Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaoyi Lin
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ce Sun
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, China; School of Public Health, The University of Hong Kong, Hong Kong, China; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| |
Collapse
|
12
|
Tatsumi Y, Miyamoto Y, Asayama K, Satoh M, Miyamatsu N, Ohno Y, Ikei H, Ohkubo T. Characteristics and Risk of Diabetes in People With Rare Glucose Response Curve During an Oral Glucose Tolerance Test. J Clin Endocrinol Metab 2024; 109:e975-e982. [PMID: 38038623 PMCID: PMC10876410 DOI: 10.1210/clinem/dgad698] [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: 11/19/2023] [Accepted: 11/28/2023] [Indexed: 12/02/2023]
Abstract
CONTEXT Existing differences in persons with lower 30- or 60-minute plasma glucose (PG) levels during 75-g oral glucose tolerance test (OGTT) than fasting PG remain unclear. OBJECTIVE To clarify the characteristics of persons whose PG levels decrease after glucose administration during OGTT and their risk of incidence of diabetes in a Japanese general population. METHODS In this cohort study, a total of 3995 men and 3500 women (mean age 56.7 years) without diabetes were classified into 3 groups: (1) PG at both 30 and 60 minutes ≥ fasting PG; (2) PG at 30 minutes ≥ fasting PG and PG at 60 minutes < fasting PG; (3) PG at 30 minutes < fasting PG. The characteristics and the risk of diabetes onset were analyzed using ordered logistic regression and Cox proportional hazard regression, respectively. RESULTS Among 7495 participants, the numbers of individuals in the group 1, 2, and 3 were 6552, 769, and 174, respectively. The glucose response curve of the group 3 was boat shaped. Group 3 had the youngest age, lowest percentage of men, and best health condition, followed by groups 2 and 1. Among 3897 participants analyzed prospectively, 434 developed diabetes during the mean follow-up period of 5.8 years. The hazard ratio for diabetes onset in the group 2 was 0.30 with reference to the group 1. No-one in group 3 developed diabetes. CONCLUSION People with lower 30-minute PG than fasting PG tended to be women, young, healthy, and at low risk of diabetes onset.
Collapse
Affiliation(s)
- Yukako Tatsumi
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo 173-8605, Japan
- Open Innovation Center, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan
- Department of Clinical Nursing, Shiga University of Medical Science, Otsu 520-2192, Japan
| | - Yoshihiro Miyamoto
- Open Innovation Center, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan
| | - Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo 173-8605, Japan
| | - Michihiro Satoh
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai 983-8536, Japan
| | - Naomi Miyamatsu
- Department of Clinical Nursing, Shiga University of Medical Science, Otsu 520-2192, Japan
| | - Yuko Ohno
- Division of Health Sciences, Osaka University Graduate School of Medicine, Suita 565-0871, Japan
| | - Hajime Ikei
- Department of Health Checkup, Saku Central Hospital, Saku 384-0301, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo 173-8605, Japan
| |
Collapse
|
13
|
Kwon H, Han KD, Moon SJ, Park SE, Rhee EJ, Lee WY. Nonalcoholic Fatty Liver Disease and the Risk of Thyroid Cancer Among Young Adults in South Korea. J Clin Endocrinol Metab 2024; 109:e1095-e1104. [PMID: 37921093 DOI: 10.1210/clinem/dgad575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Indexed: 11/04/2023]
Abstract
CONTEXT Nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of metabolic syndrome. Obesity and metabolic syndrome are known risk factors for thyroid cancer. OBJECTIVE We investigated the association between NAFLD and thyroid cancer risk in young adults. METHODS This nationwide cohort study included 1 135 967 participants aged 20 to 39 years who underwent 4 consecutive health screenings in South Korea. NAFLD was categorized using the fatty liver index (FLI), as follows: ≥60, 30 to 60, and <30. The cumulative FLI points were defined as the number of times participants had a FLI of ≥30 (0-4). RESULTS During a median follow-up of 5.2 years, 4126 participants (0.36%) were newly diagnosed with thyroid cancer. Compared with the participants with an FLI of <30, those with an FLI of 30 to 60 (men: hazard ratio [HR] 1.36 [95% CI, 1.22-1.51] and women: HR 1.44 [1.21-1.70]) and those with an FLI of ≥60 (men: HR 1.71 [1.53-1.92] and women: HR 1.81 [1.46-2.25]) had a significantly higher risk of thyroid cancer. Participants with higher cumulative FLI points had a higher risk of thyroid cancer compared to those with a cumulative FLI point of 0 (P < .001). During the follow-up period, the participants with an increased FLI exhibited an increased risk of thyroid cancer. CONCLUSION NAFLD was associated with an increased risk of thyroid cancer in young adults. Repeatedly elevated FLI and progression of NAFLD were associated with an increased risk of thyroid cancer in this study.
Collapse
Affiliation(s)
- Hyemi Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Republic of Korea
| | - Sun Joon Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
| | - Se Eun Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
| | - Eun-Jung Rhee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
| | - Won-Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
| |
Collapse
|
14
|
Agbaje AO, Saner C, Zhang J, Henderson M, Tuomainen TP. DEXA-based Fat Mass with the Risk of Worsening Insulin Resistance in Adolescents: A 9-Year Temporal and Mediation Study. J Clin Endocrinol Metab 2024:dgae004. [PMID: 38173399 DOI: 10.1210/clinem/dgae004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 01/05/2024]
Abstract
CONTEXT Surrogate measures of childhood and adolescent obesity have impaired the understanding of body composition's relationship with insulin resistance in the young population. OBJECTIVES We aim to examine the longitudinal associations of directly measured total fat mass, trunk fat mass, and lean mass with the risk of hyperglycaemia, hyperinsulinemia, and insulin resistance from ages 15-24 years, the mediation path through which lipids and inflammation influence insulin resistance and whether increased fat mass temporally precede insulin resistance. METHODS We studied 3160 adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC), UK birth cohort, who had complete dual-energy Xray absorptiometry measure and fasting blood samples at age 15 years and repeated measures at ages 17- and 24-years clinic visit. Fasting glucose >6.1 mmol/L, insulin >11.78 mU/L, and homeostatic model assessment for insulin resistance (HOMA-IR) ≥75th percentile were categorized as hyperglycaemia, hyperinsulinemia, and high insulin resistance, respectively. Longitudinal associations were examined with generalized logit-mixed effect models, whilst mediation and temporal path analyses were examined using structural equation models, adjusting for cardiometabolic and other lifestyle factors. RESULTS Among 3160 participants (51% female), fat mass and lean mass increased linearly in both males and females while glucose, insulin, and HOMA-IR had a U-shaped course from age 15 through 24 years. After full adjustment, each 1 kg cumulative increase in total fat mass [odds ratio 1.12 (95% confidence interval 1.11-1.13)] and trunk fat mass [1.21 (1.19-1.23)] from ages 15 through 24 years were associated with a progressively worsening risk of high insulin resistance as well as hyperglycaemia and hyperinsulinemia. The association of increased total fat mass with increased insulin resistance was partly mediated by triglycerides (9% mediation). In the temporal path analysis, higher total fat mass at age 15 years was associated with higher insulin resistance at 17 years, but not vice versa. Higher total fat mass at 17 years was bi-directionally associated with higher insulin resistance at 24 years. CONCLUSION Mid-adolescence may be an optimal time for interrupting the worsening fat mass-insulin resistance pathologic cycle and attenuating the risk of progressively worsening metabolic dysfunction before young adulthood.
Collapse
Affiliation(s)
- Andrew O Agbaje
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Children's Health and Exercise Research Centre, Department of Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Christoph Saner
- Division of Pediatric Endocrinology, Diabetology and Metabolism, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Biomedical Research, University of Bern, Bern, Switzerland
| | - Jie Zhang
- Department of Public Health, Aarhus University, DK-8000 Aarhus, Denmark
| | - Mélanie Henderson
- School of Public Health, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Research Center of Centre Hospitalier Universitaire Sainte-Justine, Montréal, QC, Canada
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| |
Collapse
|
15
|
Stein R, Göpel E, Weghuber D, Hammel MC, Vogel M, Kiess W, Körner A. Are there relevant thresholds of insulin-independent indices across the lifespan to predict alterations in glycemic control?-Authors' reply. THE LANCET REGIONAL HEALTH. EUROPE 2023; 33:100734. [PMID: 37701043 PMCID: PMC10493605 DOI: 10.1016/j.lanepe.2023.100734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/24/2023] [Accepted: 08/24/2023] [Indexed: 09/14/2023]
Affiliation(s)
- Robert Stein
- Medical Faculty, University Hospital for Children and Adolescents, Center for Pediatric Research, University of Leipzig, Leipzig, Germany
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Germany
| | - Eric Göpel
- Medical Faculty, University Hospital for Children and Adolescents, Center for Pediatric Research, University of Leipzig, Leipzig, Germany
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Private Medical University, Salzburg, Austria
| | - Maximiliane Chiara Hammel
- Medical Faculty, University Hospital for Children and Adolescents, Center for Pediatric Research, University of Leipzig, Leipzig, Germany
| | - Mandy Vogel
- LIFE Child Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Wieland Kiess
- Medical Faculty, University Hospital for Children and Adolescents, Center for Pediatric Research, University of Leipzig, Leipzig, Germany
- LIFE Child Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Antje Körner
- Medical Faculty, University Hospital for Children and Adolescents, Center for Pediatric Research, University of Leipzig, Leipzig, Germany
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Germany
- LIFE Child Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| |
Collapse
|
16
|
Pereyra González I, Lopez-Arana S. Usefulness of SPISE Index for Screening and Detection of Early Stages of Insulin Resistance among Chilean Young Adults. ANNALS OF NUTRITION & METABOLISM 2023; 79:372-378. [PMID: 37552962 DOI: 10.1159/000533222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 07/22/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND As the gold standard test to quantify insulin resistance (IR) involves intravenous insulin loading and repeated blood glucose monitoring, many indexes have been developed for IR assessment for convenience. OBJECTIVE The objective of this study was to evaluate the agreement of the Single-Point Insulin Sensitivity Estimator (SPISE) by comparing it with the homeostasis model assessment of insulin resistance (HOMA-IR) in identifying IR. METHOD Data came from the ongoing LIMACHE BIRTH COHORT. 1,948 individuals (aged 22-28 years) were studied. We performed an agreement plot called a Bangdiwala's Observer Agreement to evaluate patterns in departures from agreement in ordinal categorical variables. RESULTS According to the Bangdiwala-Weighted statistics, we found that the agreement between both indexes was 0.14; this value would be considered a slight agreement. Thus, we found bias in the marginal distributions, and we noticed that the SPISE has a bias toward the central quintiles of the index. CONCLUSIONS The identification of IR in young adult individuals by the SPISE index has slight agreement with HOMA-IR. Therefore, caution would be taken when considering SPISE index among young Chilean adults.
Collapse
Affiliation(s)
| | - Sandra Lopez-Arana
- Department of Nutrition, Faculty of Medicine, Universidad de Santiago, Santiago, Chile
| |
Collapse
|
17
|
Antoniotti V, Amore M, Caputo M, Fania C, Mancioppi V, Casoli G, Tini S, Antonioli A, Aimaretti G, Rabbone I, Bellone S, Prodam F. Glucose Alterations, Insulin Resistance, Arterial Hypertension, and Renin are Strictly Associated in Pediatric Obesity. J Endocr Soc 2023; 7:bvad088. [PMID: 37424701 PMCID: PMC10326241 DOI: 10.1210/jendso/bvad088] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Indexed: 07/11/2023] Open
Abstract
Context Insulin resistance, glucose alterations, arterial hypertension (HTN), and the renin-angiotensin-aldosterone system (RAAS) are related in adult obesity. This crosstalk is still unexplored in childhood. Objective Characterize the relationships of fasting and postload glucose and insulin levels with new American Academy of Pediatrics classification of HTN and RAAS in pediatric obesity. Methods This was a retrospective observational study; 799 pediatric outpatients (11.4 ± 3.1 years) at a tertiary center who were overweight or obese and not yet on diet were included. The main outcome measures were mean and correlations among parameters of a complete clinical and metabolic screening (body mass index, blood pressure, and glucose and insulin levels during an oral glucose tolerance test, and renin and aldosterone levels and their ratio). Results 774 subjects had all the parameters, of whom 87.6% had HTN (5% elevated blood pressure, 29.2% stage I HTN, and 53.4% stage II HTN). Eighty subjects had 1 or more glucose alterations, and more frequently presented HTN. Blood pressure levels were higher in subjects with glucose alterations than in those with normal glucose levels. Fasting and stimulated glucose and insulin levels were directly related to the HTN stages, and insulin sensitivity was lower in HTN than in normal blood pressure. Aldosterone, renin, and aldosterone-renin ratio (ARR) were similar in sexes, whereas aldosterone was higher in prepubertal individuals. Subjects with impaired glucose tolerance (IGT) had higher renin and lower ARR. Renin was positively correlated with postload glucose, and ARR was negatively correlated with the Homeostatic Model Assessment for Insulin Resistance index. Conclusion A close relationship exists among insulin resistance, glucose alterations, HTN, and renin in childhood obesity. Specific categories of risk could provide indicators for strict clinical surveillance.
Collapse
Affiliation(s)
- Valentina Antoniotti
- SCDU of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
| | - Martina Amore
- SCDU of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
| | - Marina Caputo
- Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy
- Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
| | - Chiara Fania
- SCDU Clinical Chemistry Laboratory, Maggiore della Carità University Hospital, 28100 Novara, Italy
| | - Valentina Mancioppi
- SCDU of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
| | - Gloria Casoli
- SCDU Clinical Chemistry Laboratory, Maggiore della Carità University Hospital, 28100 Novara, Italy
| | - Sabrina Tini
- Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
| | - Alessandro Antonioli
- Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
| | - Gianluca Aimaretti
- Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy
- Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
| | - Ivana Rabbone
- SCDU of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
| | - Simonetta Bellone
- SCDU of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
| | - Flavia Prodam
- Correspondence: Flavia Prodam, MD, PhD, Department of Health Sciences, SCDU Endocrinology, University of Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy.
| |
Collapse
|
18
|
Seo MW, Cho W, Kim JY. The single point insulin sensitivity estimator (SPISE) index as a predictor of metabolic syndrome in Korean adults. Obes Res Clin Pract 2023:S1871-403X(23)00040-6. [PMID: 37246046 DOI: 10.1016/j.orcp.2023.05.001] [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: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/30/2023]
Abstract
PURPOSE Recently, the single-point insulin sensitivity estimator (SPISE) has been developed as a simple surrogate of insulin resistance based on BMI, triglycerides (TG), and HDL-C. However, no studies have focused on the predictive power of the SPISE index for identifying metabolic syndrome (MetSyn) in Korean adults. Here, this study aimed to estimate the predictive power of the SPISE index for determining MetSyn and to compare its predictive power with other insulin sensitivity/resistance indices in South Korean adults. METHODS A total of 7837 participants from the 2019 and 2020 Korean National Health and Nutrition Examination Surveys were analyzed in the present study. MetSyn was defined by the AHA/NCEP criteria. In addition, HOMA-IR, inverse insulin, TG/HDL, TyG index (triglyceride-glucose index), and SPISE index were calculated based on the previous literature. RESULTS Predictive power of the SPISE index for determining MetSyn (ROC-AUC [95 % CI] = 0.90 [0.90-0.91], sensitivity = 83.4 %, specificity = 82.2 %, cut-off point = 6.14, p < .001) was higher than that of HOMA-IR (ROC-AUC: 0.81), inverse insulin (ROC-AUC: 0.76), TG/HDL-C (ROC-AUC: 0.87), and TyG index (ROC-AUC: 0.88), the P value for ROC-AUC comparison < .001. CONCLUSION SPISE index has demonstrated superior predictive value for diagnosing MetSyn regardless of sex and is strongly correlated with blood pressure compared with other surrogate indices of insulin resistance, attesting to its utility as a reliable indicator of insulin resistance and MetSyn in Korean adults.
Collapse
Affiliation(s)
- Myong-Won Seo
- Departments of Exercise Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | - Wonhee Cho
- Departments of Exercise Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | - Joon Young Kim
- Departments of Exercise Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA.
| |
Collapse
|
19
|
Wang N, Guo H, Jing Y, Zhang Y, Sun B, Pan X, Chen H, Xu J, Wang M, Chen X, Song L, Cui W. Development and validation of risk prediction models for large for gestational age infants using logistic regression and two machine learning algorithms. J Diabetes 2023; 15:338-348. [PMID: 36890429 PMCID: PMC10101839 DOI: 10.1111/1753-0407.13375] [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: 11/07/2022] [Revised: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Large for gestational age (LGA) is one of the adverse outcomes during pregnancy that endangers the life and health of mothers and offspring. We aimed to establish prediction models for LGA at late pregnancy. METHODS Data were obtained from an established Chinese pregnant women cohort of 1285 pregnant women. LGA was diagnosed as >90th percentile of birth weight distribution of Chinese corresponding to gestational age of the same-sex newborns. Women with gestational diabetes mellitus (GDM) were classified into three subtypes according to the indexes of insulin sensitivity and insulin secretion. Models were established by logistic regression and decision tree/random forest algorithms, and validated by the data. RESULTS A total of 139 newborns were diagnosed as LGA after birth. The area under the curve (AUC) for the training set is 0.760 (95% confidence interval [CI] 0.706-0.815), and 0.748 (95% CI 0.659-0.837) for the internal validation set of the logistic regression model, which consisted of eight commonly used clinical indicators (including lipid profile) and GDM subtypes. For the prediction models established by the two machine learning algorithms, which included all the variables, the training set and the internal validation set had AUCs of 0.813 (95% CI 0.786-0.839) and 0.779 (95% CI 0.735-0.824) for the decision tree model, and 0.854 (95% CI 0.831-0.877) and 0.808 (95% CI 0.766-0.850) for the random forest model. CONCLUSION We established and validated three LGA risk prediction models to screen out the pregnant women with high risk of LGA at the early stage of the third trimester, which showed good prediction power and could guide early prevention strategies.
Collapse
Affiliation(s)
- Ning Wang
- Department of EndocrinologyThe Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Haonan Guo
- Department of Endocrinology and Second Department of GeriatricsThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Yingyu Jing
- Department of Endocrinology and Second Department of GeriatricsThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Yifan Zhang
- Department of Endocrinology and Second Department of GeriatricsThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Bo Sun
- Department of Physiology and Pathophysiology, School of Basic Medical SciencesXi'an Jiaotong University Health Science CenterXi'anChina
| | | | - Huan Chen
- Department of Endocrinology and Second Department of GeriatricsThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Jing Xu
- Department of EndocrinologyThe Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | | | - Xi Chen
- Department of Epidemiology and Statistics, School of Public Health, Medical CollegeZhejiang UniversityHangzhouChina
| | - Lin Song
- Department of Physiology and Pathophysiology, School of Basic Medical SciencesXi'an Jiaotong University Health Science CenterXi'anChina
| | - Wei Cui
- Department of Endocrinology and Second Department of GeriatricsThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| |
Collapse
|
20
|
Park H, Jun S, Lee HA, Kim HS, Hong YS, Park H. The Effect of Childhood Obesity or Sarcopenic Obesity on Metabolic Syndrome Risk in Adolescence: The Ewha Birth and Growth Study. Metabolites 2023; 13:metabo13010133. [PMID: 36677058 PMCID: PMC9865823 DOI: 10.3390/metabo13010133] [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: 12/29/2022] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 01/17/2023] Open
Abstract
The prevalence of obesity and metabolic syndrome (MetS) in the pediatric population has increased globally. We evaluated the impact of childhood obesity and sarcopenic obesity on the risk of MetS in adolescence using the Ewha Birth and Growth Cohort study data. In this study, we analyzed data from 227 participants who were followed up at the ages of 7-9 and 13-15 years. Overweight and obesity were defined as a body mass index of the 85th percentile or higher based on national growth charts, and sarcopenic obesity was defined using body composition data. Metabolic diseases in adolescence were identified by calculating the pediatric simple metabolic syndrome score (PsiMS), continuous metabolic syndrome score (cMetS), and single-point insulin sensitivity estimator (SPISE) as MetS indices. The prevalence of overweight was approximately 15% at both 7-9 and 13-15 years old, and that of sarcopenic obesity (7-9 years old) was 19.5%. Boys aged 13-15 years had a significantly larger waist circumference (WC) and higher systolic blood pressure (SBP) than girls. The MetS indices (PsiMS, cMetS, and SPISE) showed no significant differences by gender. Overweight and sarcopenic obese people have a higher overall risk of MetS components than normal people. The overweight group had a significantly higher prevalence of PsiMS and cMetS than the normal group, while the SPISE was significantly lower and the MetS indicator was worse in the overweight group than in the normal group. Similar results were obtained in the group with sarcopenic obesity. Both overweight and sarcopenic obesity remained significantly associated with MetS indicators, even after adjusting for covariates. Furthermore, metabolic health assessed by the cMetS in adolescence was affected not only by childhood overweight but also by adolescence, which showed an interaction effect. The results of this study emphasize the importance and need for early detection of childhood obesity and effective public health interventions.
Collapse
Affiliation(s)
- Hyunjin Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Seunghee Jun
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Hye-Ah Lee
- Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul 07985, Republic of Korea
- Correspondence: (H.-A.L.); (H.P.); Tel.: +82-2-2650-2836 (H.-A.L.); +82-2-6986-6241 (H.P.); Fax: +82-2-6986-7019 (H.P.)
| | - Hae Soon Kim
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
| | - Young Sun Hong
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
| | - Hyesook Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Republic of Korea
- Correspondence: (H.-A.L.); (H.P.); Tel.: +82-2-2650-2836 (H.-A.L.); +82-2-6986-6241 (H.P.); Fax: +82-2-6986-7019 (H.P.)
| |
Collapse
|
21
|
Wani K, Khattak MNK, Saadawy GM, Al-Attas OS, Alokail MS, Al-Daghri NM. Sex-Specific Cut-Offs of Single Point Insulin Sensitivity Estimator (SPISE) in Predicting Metabolic Syndrome in the Arab Adolescents. Diagnostics (Basel) 2023; 13:diagnostics13020324. [PMID: 36673133 PMCID: PMC9858553 DOI: 10.3390/diagnostics13020324] [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: 12/12/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
The Single Point Insulin Sensitivity Estimator (SPISE) is a novel surrogate marker for insulin sensitivity and was found comparable to the gold standard clamp test as well as for predicting the Metabolic Syndrome (MetS) in several populations. The present study aimed to assess for the first time, the validity of SPISE in predicting MetS among Arab adolescents. In this cross-sectional study, 951 Saudi adolescents aged 10−17 years were randomly recruited from different schools across Riyadh, Saudi Arabia. Anthropometrics were measured and fasting blood samples were collected for the assessment of glucose, lipid profile, adipokines, C-reactive protein and 25 hydroxyvitamin (OH) D. MetS was defined using the National Cholesterol Education Program’s (NCEP) criteria with age-specific thresholds for adolescents. The SPISE as well as insulin resistance (HOMA-IR) indices were calculated. The over-all prevalence of MetS was 8.6% (82 out of 951). SPISE index was significantly lower in MetS than non-MetS participants in both sexes (5.5 ± 2.5 vs. 9.4 ± 3.2, p < 0.001 in boys and 4.4 ± 1.4 vs. 8.6 ± 3.2, p < 0.001 in girls). The SPISE index showed a significant inverse correlation with resistin, leptin, and C-reactive protein, and a significant positive correlation with adiponectin and 25(OH) D. Areas under the curve (AUC) revealed fair and good accuracy for predicting MetS 84.1% and 90.3% in boys and girls, respectively. The sex-specific cut-off proposed was SPISE index ≤6.1 (sensitivity 72.2% and specificity 83.9%) for boys and ≤6.46 (sensitivity 96.3% and specificity 73.4%), for girls. This study suggests that the SPISE index is a simple and promising diagnostic marker of insulin sensitivity and MetS in Arab adolescents.
Collapse
|
22
|
Stein R, Koutny F, Riedel J, Dörr N, Meyer K, Colombo M, Vogel M, Anderwald CH, Blüher M, Kiess W, Körner A, Weghuber D. Single Point Insulin Sensitivity Estimator (SPISE) As a Prognostic Marker for Emerging Dysglycemia in Children with Overweight or Obesity. Metabolites 2023; 13:metabo13010100. [PMID: 36677025 PMCID: PMC9867183 DOI: 10.3390/metabo13010100] [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: 12/12/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
The single point insulin sensitivity estimator (SPISE) is a recently developed fasting index for insulin sensitivity based on triglycerides, high density lipoprotein cholesterol, and body mass index. SPISE has been validated in juveniles and adults; still, its role during childhood remains unclear. To evaluate the age- and sex-specific distribution of SPISE, its correlation with established fasting indexes and its application as a prognostic marker for future dysglycemia during childhood and adolescence were assessed. We performed linear modeling and correlation analyses on a cross-sectional cohort of 2107 children and adolescents (age 5 to 18.4 years) with overweight or obesity. Furthermore, survival analyses were conducted upon a longitudinal cohort of 591 children with overweight/obesity (1712 observations) with a maximum follow-up time of nearly 20 years, targeting prediabetes/dysglycemia as the end point. The SPISE index decreased significantly with age (−0.34 units per year, p < 0.001) among children and adolescents with overweight and obesity. Sex did not have an influence on SPISE. There was a modest correlation between SPISE and established fasting markers of insulin resistance (R = −0.49 for HOMA-IR, R = −0.55 for QUICKI-IR). SPISE is a better prognostic marker for future dysglycemia (hazard ratio (HR) 3.47, 95% confidence interval (CI) 1.60−7.51, p < 0.01) than HOMA-IR and QUICKI-IR (HR 2.44, 95% CI 1.24−4.81, p < 0.05). The SPISE index is a surrogate marker for insulin resistance predicting emerging dysglycemia in children with overweight or obesity, and could, therefore, be applied to pediatric cohorts that lack direct insulin assessment.
Collapse
Affiliation(s)
- Robert Stein
- Center for Pediatric Research, University Hospital for Children and Adolescents, Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG), University Hospital Leipzig, 04103 Leipzig, Germany
| | - Florian Koutny
- Department of Pediatrics, Paracelsus Private Medical University, Muellner Hauptstrasse 48, 5020 Salzburg, Austria
- Department of Gastroenterology, Hepatology and Rheumatology, University Hospital St. Pölten, 3100 St. Pölten, Austria
| | - Johannes Riedel
- Center for Pediatric Research, University Hospital for Children and Adolescents, Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
| | - Natascha Dörr
- Center for Pediatric Research, University Hospital for Children and Adolescents, Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
| | - Klara Meyer
- Center for Pediatric Research, University Hospital for Children and Adolescents, Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG), University Hospital Leipzig, 04103 Leipzig, Germany
| | - Marco Colombo
- Center for Pediatric Research, University Hospital for Children and Adolescents, Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
| | - Mandy Vogel
- Leipzig Research Center for Civilization Diseases (LIFE Child), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
| | - Christian Heinz Anderwald
- Department of Pediatrics, Paracelsus Private Medical University, Muellner Hauptstrasse 48, 5020 Salzburg, Austria
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, 1090 Vienna, Austria
- Health Care Center Arnoldstein, 9601 Arnoldstein, Austria
| | - Matthias Blüher
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG), University Hospital Leipzig, 04103 Leipzig, Germany
| | - Wieland Kiess
- Center for Pediatric Research, University Hospital for Children and Adolescents, Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
- Leipzig Research Center for Civilization Diseases (LIFE Child), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
| | - Antje Körner
- Center for Pediatric Research, University Hospital for Children and Adolescents, Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG), University Hospital Leipzig, 04103 Leipzig, Germany
- Leipzig Research Center for Civilization Diseases (LIFE Child), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Private Medical University, Muellner Hauptstrasse 48, 5020 Salzburg, Austria
- Correspondence:
| |
Collapse
|
23
|
Correa-Burrows P, Matamoros M, de Toro V, Zepeda D, Arriaza M, Burrows R. A Single-Point Insulin Sensitivity Estimator (SPISE) of 5.4 is a good predictor of both metabolic syndrome and insulin resistance in adolescents with obesity. Front Endocrinol (Lausanne) 2023; 14:1078949. [PMID: 36843603 PMCID: PMC9945119 DOI: 10.3389/fendo.2023.1078949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND The Single-Point Insulin Sensitivity Estimator (SPISE) is a biomarker of insulin sensitivity estimated using BMI and triglycerides and high-density lipoprotein cholesterol. We assessed the accuracy of SPISE to screen obesity-related cardiometabolic risk in children and adolescents. METHOD Cross-sectional validation study for a screening test in a sample of n=725 children and adolescents from an obesity clinic. Weight, height, waist circumference, blood arterial pressure, lipid profile, glucose, insulin and Tanner stage were measured. BMI, BMI for-age-and sex (BAZ), and HOMA-IR were estimated. HOMA-IR values ≥2.1 and ≥3.3 were considered IR in Tanner I-II, ≥3.3 for Tanner III-IV and ≥2.6 for Tanner V, respectively. Metabolic Syndrome (MetS) was diagnosed with the Cook phenotype. SPISE was estimated according to the following algorithm: [600* HDL^0.185/(TG^0.2* BMI^1.338)]. The optimal SPISE cut points for IR and MetS prediction were determined by ROC curve analysis. RESULTS In prepubertal obese patients (9.2 ± 2.1y; 18.4% males), the prevalence of IR and MetS was 28.2% y 46.9%, respectively; 58% had severe obesity (BAZ ≥4 SD). In pubertal obese patients (12.6 ± 1.8y; 57% males), the prevalence of IR and MetS was 34.1% and 55.3%, respectively; 34% had severe obesity. In prepubertal children, a SPISE of 6.3 showed the highest sensitivity (73.2%) and specificity (80%) to screen individuals with IR (AUC: 0.80; LR +: 3.3). Likewise, a SPISE of 5.7 got the highest sensitivity (82.6%) and specificity (86.1%) to screen patients with MetS (AUC: 0.87; LR +: 5.4). In pubertal patients, a SPISE of 5.4 showed the highest sensitivity and specificity to screen children and adolescents with both IR (Sn: 76.1%; Sp: 77.5%; AUC: 0.8; LR +: 3.1) and MetS (Sn: 90.4%; Sp: 76.1%; AUC: 0.90; LR +: 3.5). CONCLUSION In children and adolescents with obesity, SPISE has good or very good performance in predicting IR and MetS. SPISE may be considered a relatively simple and low-cost diagnosis tool that can be helpful to identify patients with greater biological risk. In adolescents with obesity, the same cut point allows identification of those at higher risk of both IR and MetS.
Collapse
Affiliation(s)
- Paulina Correa-Burrows
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
| | - Mariela Matamoros
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
| | - Valeria de Toro
- Departamento de Gastroenterología y Nutrición Pediátrica, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Diego Zepeda
- Instituto de Investigación Materno Infantil, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Marta Arriaza
- Servicio de Pediatría, Hospital Gustavo Fricke, Viña del Mar, Chile
| | - Raquel Burrows
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
- Programa Clínico de Obesidad Infantil (POI), Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
- *Correspondence: Raquel Burrows,
| |
Collapse
|
24
|
Pan L, Gao Y, Han J, Li L, Wang M, Peng H, Liao J, Wan H, Xiang G, Han Y. Comparison of longitudinal changes in four surrogate insulin resistance indexes for incident T2DM in middle-aged and elderly Chinese. Front Public Health 2022; 10:1046223. [PMID: 36530691 PMCID: PMC9748338 DOI: 10.3389/fpubh.2022.1046223] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/14/2022] [Indexed: 12/02/2022] Open
Abstract
Aims Previous studies suggested a significant relationship between four surrogate indexes of insulin resistance and subsequent type 2 diabetes mellitus (T2DM). But the association of longitudinal changes (denoted as -D) in CVAI (Chinese visceral adiposity index), LAP (lipid accumulation product), TyG (triglyceride-glucose), and TG/HDL-C (triglyceride/ high-density lipoprotein cholesterol) indexes with the risk of T2DM remained uncertain. We aimed to compare the changes in those four surrogate indexes for predicting T2DM in middle-aged and elderly Chinese. Methods We extracted data from the China Health and Retirement Longitudinal Study (CHARLS). Multivariate logistic regression models were used to estimate odds ratio (OR) with 95% confidence interval (CI) of incident T2DM with four surrogate indexes. The restricted cubic spline analysis was used to examine potential non-linear correlation and visualize the dose-response relationship between four indexes and T2DM. The receiver operator characteristic curve was used to compare the performance of the four indexes to predict T2DM. Results We enrolled 4,596 participants in total, including 504 (10.97%) with T2DM. Analysis results showed that four surrogate indexes were associated with T2DM, and the multivariate-adjusted ORs (95% CIs) of T2DM were 1.08 (1.00-1.16), 1.47 (1.32-1.63), 1.12 (1.00-1.25), and 2.45 (2.12-2.83) for each IQR (interquartile range) increment in CVAI-D, LAP-D, TG/HDLC-D, and TyG-D, respectively. Restricted cubic spline regression showed a non-linear correlation between four surrogate indexes and the risk of T2DM (p for non-linear < 0.001). From the ROC (receiver operating characteristic) curve, TyG-D had the highest AUC (area under curve), and its AUC values were significantly different from other three indexes both in male and female (all P < 0.001). Conclusion Compared with other indexes, TyG-D was a better predictor in the clinical setting for identifying middle-aged and elderly Chinese with T2DM. Monitoring long-term changes in TyG might help in the early identification of individuals at high risk of T2DM.
Collapse
Affiliation(s)
- Liang Pan
- Phase 1 Clinical Trial Center, Deyang People's Hospital, Sichuan, China
| | - Yu Gao
- College of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Jing Han
- The First College of Clinical Medical Science, China Three Gorges University, Yichang, China
| | - Ling Li
- Division of Central Archives, Deyang People's Hospital, Sichuan, China
| | - Miyuan Wang
- School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Hongye Peng
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Juan Liao
- Department of Science and Education, Deyang People's Hospital, Sichuan, China
| | - Hua Wan
- Deyang Maternal and Child Health Service Center, Sichuan, China
| | - Guohua Xiang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Yangyun Han
- Deyang People's Hospital, Sichuan, China,*Correspondence: Yangyun Han
| |
Collapse
|
25
|
Salvatori B, Linder T, Eppel D, Morettini M, Burattini L, Göbl C, Tura A. TyGIS: improved triglyceride-glucose index for the assessment of insulin sensitivity during pregnancy. Cardiovasc Diabetol 2022; 21:215. [PMID: 36258194 PMCID: PMC9580191 DOI: 10.1186/s12933-022-01649-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 09/28/2022] [Indexed: 11/21/2022] Open
Abstract
Background The triglyceride-glucose index (TyG) has been proposed as a surrogate marker of insulin resistance, which is a typical trait of pregnancy. However, very few studies analyzed TyG performance as marker of insulin resistance in pregnancy, and they were limited to insulin resistance assessment at fasting rather than in dynamic conditions, i.e., during an oral glucose tolerance test (OGTT), which allows more reliable assessment of the actual insulin sensitivity impairment. Thus, first aim of the study was exploring in pregnancy the relationships between TyG and OGTT-derived insulin sensitivity. In addition, we developed a new version of TyG, for improved performance as marker of insulin resistance in pregnancy. Methods At early pregnancy, a cohort of 109 women underwent assessment of maternal biometry and blood tests at fasting, for measurements of several variables (visit 1). Subsequently (26 weeks of gestation) all visit 1 analyses were repeated (visit 2), and a subgroup of women (84 selected) received a 2 h-75 g OGTT (30, 60, 90, and 120 min sampling) with measurement of blood glucose, insulin and C-peptide for reliable assessment of insulin sensitivity (PREDIM index) and insulin secretion/beta-cell function. The dataset was randomly split into 70% training set and 30% test set, and by machine learning approach we identified the optimal model, with TyG included, showing the best relationship with PREDIM. For inclusion in the model, we considered only fasting variables, in agreement with TyG definition. Results The relationship of TyG with PREDIM was weak. Conversely, the improved TyG, called TyGIS, (linear function of TyG, body weight, lean body mass percentage and fasting insulin) resulted much strongly related to PREDIM, in both training and test sets (R2 > 0.64, p < 0.0001). Bland–Altman analysis and equivalence test confirmed the good performance of TyGIS in terms of association with PREDIM. Different further analyses confirmed TyGIS superiority over TyG. Conclusions We developed an improved version of TyG, as new surrogate marker of insulin sensitivity in pregnancy (TyGIS). Similarly to TyG, TyGIS relies only on fasting variables, but its performances are remarkably improved than those of TyG. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-022-01649-8.
Collapse
Affiliation(s)
| | - Tina Linder
- Department of Obstetrics and Gynaecology, Medical University of Vienna, 1090, Vienna, Austria
| | - Daniel Eppel
- Department of Obstetrics and Gynaecology, Medical University of Vienna, 1090, Vienna, Austria
| | - Micaela Morettini
- Department of Information Engineering, Università Politecnica Delle Marche, 60131, Ancona, Italy
| | - Laura Burattini
- Department of Information Engineering, Università Politecnica Delle Marche, 60131, Ancona, Italy
| | - Christian Göbl
- Department of Obstetrics and Gynaecology, Medical University of Vienna, 1090, Vienna, Austria
| | - Andrea Tura
- CNR Institute of Neuroscience, Corso Stati Uniti 4, 35127, Padua, Italy.
| |
Collapse
|
26
|
Ha J, Oh YR, Kang E, Nam HK, Rhie YJ, Lee KH. Single Point Insulin Sensitivity Estimator for predicting type 2 diabetes mellitus in obese adolescents. Ann Pediatr Endocrinol Metab 2022; 27:201-206. [PMID: 35073668 PMCID: PMC9537672 DOI: 10.6065/apem.2142178.089] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/15/2021] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The prevalence of adolescents with type 2 diabetes mellitus (T2DM) has rapidly increased in Korea over the past few decades with the increase in the number of obese adolescents. The single point insulin sensitivity estimator (SPISE) was recently introduced as a surrogate marker for insulin sensitivity to predict T2DM in adults. We aimed to determine risk factors for T2DM in obese adolescents, including SPISE. METHODS This retrospective study included 104 adolescents diagnosed with T2DM at Korea University Hospital between January 2010 and December 2020. We compared clinical and biochemical parameters and the SPISE of normoglycemic overweight and obese individuals with those of prediabetic and diabetic adolescents to determine risk factors for T2DM. Receiver operating characteristic analysis was performed with the Youden index to determine the cutoff point of SPISE. RESULTS Frequency of fatty liver and family history of T2DM were significantly higher and SPISE level was significantly lower in patients with T2DM than in normoglycemic overweight/obese and prediabetic adolescents (p<0.01). A family history of T2DM, fatty liver, and SPISE value below the cutoff point (4.49) were identified as significant risk factors for T2DM in multiple logistic regression analysis after controlling for age, sex, and body mass index standard deviation score (p<0.01). CONCLUSION Family history of T2DM, fatty liver, and low SPISE (<4.49) are risk factors that can independently affect the occurrence of T2DM in obese adolescents. Among these risk factors, SPISE is a promising marker for predicting adolescent T2DM; careful monitoring of these individuals is needed to prevent progression to T2DM.
Collapse
Affiliation(s)
- Jaewook Ha
- Department of Pediatrics, Veterans Health Service, Seoul, Korea
| | - Ye-Rim Oh
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Eungu Kang
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Hyo-Kyoung Nam
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Young-Jun Rhie
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Kee-Hyoung Lee
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| |
Collapse
|
27
|
Singh PK, Naithani M, Pathania M, Mirza AA, Saha S. An Insight Into the Association of Sclerostin With Insulin Sensitivity and Glycemic Parameters in Male Indian Prediabetic and Diabetic Population. Cureus 2022; 14:e27123. [PMID: 36004027 PMCID: PMC9392653 DOI: 10.7759/cureus.27123] [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] [Accepted: 07/12/2022] [Indexed: 11/07/2022] Open
Abstract
Background Type 2 diabetes (T2D) is increasing day by day and creating a huge financial and social burden on the Indian population. Insulin resistance results in hyperglycemia, a condition that eventually causes prediabetes and Type 2 diabetes. The etiopathogenesis of T2D is still not clearly defined. Wnt signaling pathway is involved in pancreas development, islet function, insulin production, and secretion. Recent studies show that sclerostin, a Wnt signaling inhibitor, is associated with diabetes. The sclerostin level is altered as a function of race and ethnicity. However, no study has been conducted to observe the sclerostin level in prediabetic and diabetic individuals in the Indian population. Objectives The main objectives of the study are: to determine whether sclerostin is associated with glycemic parameters, serum insulin levels, insulin resistance/ sensitivity, beta-cell function, and adipose tissue insulin resistance (Adipo-IR). Methods This observational study was carried out at a tertiary care hospital, in Rishikesh, Uttarakhand, India. Individuals with T2D and prediabetes and healthy references were included in this study. Sclerostin and free fatty acids (FFA) were measured with the enzyme-linked immunosorbent assay (ELISA), and blood sugar, insulin, and glycated haemoglobin (HbA1c) were measured by the hexokinase, chemiluminescent, and chromatography methods, respectively. Messenger RNA (mRNA) was quantified by real-time polymerase chain reaction (PCR) using the SYBR Green protocol. Adipo-IR, homeostasis model assessment-estimated insulin resistance (HOMA-IR), homeostasis model assessment of β-cell function (HOMA-B), quantitative insulin sensitivity check index (QUICKI), and single point insulin sensitivity estimator (SPISE) indices were calculated. Results A total of 171 study participants were enrolled in type 2 diabetes, prediabetes, and controls groups, having 57 each in the group. There was a gradual increase in sclerostin levels from healthy [242.12(158.44)] to prediabetes [256.06(299.65)] and diabetes [465.76 (735.71)] with a significant (<0.001) difference from healthy reference. Sclerostin showed a significant positive correlation with fasting blood sugar (r=0.200; p=0.009), HbA1c (r=0.394; p<0.001) and free fatty acids (r=0.205; p=0.007) in total study participants. The SPISE index showed a significant positive correlation (r=0.269, p=0.043) in the prediabetic group. SOST, GLUT4, and insulin receptor (IR) mRNA expression all corroborate with the glycemic status. Conclusion Significantly higher expression of sclerostin (both protein and gene) in newly diagnosed T2D and prediabetes male patients, as well as significant association with SPISE index, suggest that sclerostin might be an indicator of pathophysiology related to insulin resistance, which is a characteristic feature of diabetes mellitus. However, the identification of causal relationships would warrant a large-scale prospective cohort study.
Collapse
|
28
|
Pérez-Castro E, Godínez-Jaimes F, Vázquez-Medina MU, Ocharan-Hernández ME, Vargas-De-León C. Derivation and validation of sex-specific continuous metabolic syndrome scores for the Mexican adult population. Sci Rep 2022; 12:9659. [PMID: 35688913 PMCID: PMC9187334 DOI: 10.1038/s41598-022-10963-w] [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: 09/14/2021] [Accepted: 03/31/2022] [Indexed: 11/09/2022] Open
Abstract
Traditionally the diagnosis of Metabolic syndrome (MetS) is binary (present/absent). The goal of this work is to propose a sex-specific continuous score to measure the severity of MetS in Mexican adults using waist circumference and body mass index as adiposity measures. MetSx-WC and MetSx-BMI indexes by sex were derived by confirmatory factor analysis (CFA) using data for 6567 adult participants of the National Health and Nutrition Survey 2018. The overall fit of the two proposed CFA models was excellent. We then validated these scores using a community-based health study of 862 university participants and determined that the reliability and strength of agreement between the MetSx-WC and MetSx-BMI scores were excellent. The ROC analysis of the resulting indexes indicates that they have excellent ability to discriminate a MetS classification according to the different criteria. The correlations of MetSx scores and surrogate markers of insulin resistance and obesity ranged from weak to strong. Subsequently, a retrospective study of 310 hospitalized patients with COVID-19 was used to determined that MetSx-BMI score was associated with the mortality of patients with COVID-19. The proposed indices provide a continuous measure in the identification of MetS risk in Mexican adults.
Collapse
Affiliation(s)
- Eduardo Pérez-Castro
- Maestría en Matemáticas Aplicadas, Facultad de Matemáticas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, Mexico
| | - Flaviano Godínez-Jaimes
- Maestría en Matemáticas Aplicadas, Facultad de Matemáticas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, Mexico
| | - Martín Uriel Vázquez-Medina
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico.,Departamento de Investigación, Hospital Central Militar, Secretaria de la Defensa Nacional, Mexico City, Mexico
| | - María Esther Ocharan-Hernández
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Cruz Vargas-De-León
- Maestría en Matemáticas Aplicadas, Facultad de Matemáticas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, Mexico. .,Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico. .,Divisón de Investigación, Hospital Juárez de México, Mexico City, Mexico.
| |
Collapse
|
29
|
Wang X, Chen C, Xie C, Huang W, Young RL, Jones KL, Horowitz M, Rayner CK, Sun Z, Wu T. Serum bile acid response to oral glucose is attenuated in patients with early type 2 diabetes and correlates with 2-hour plasma glucose in individuals without diabetes. Diabetes Obes Metab 2022; 24:1132-1142. [PMID: 35238131 PMCID: PMC9540586 DOI: 10.1111/dom.14683] [Citation(s) in RCA: 4] [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: 01/19/2022] [Revised: 02/21/2022] [Accepted: 03/01/2022] [Indexed: 12/13/2022]
Abstract
AIM To determine the serum bile acid (BA) response to 75-g oral glucose in individuals without diabetes, and whether this is attenuated in patients with 'early' type 2 diabetes (T2D) and related to the glycaemic response at 2 hours in either group. METHODS Forty newly diagnosed, treatment-naïve Han Chinese T2D subjects and 40 age-, gender-, and body mass index-matched controls without T2D ingested a 75-g glucose drink after an overnight fast. Plasma glucose and serum concentrations of total and individual BAs, fibroblast growth factor-19 (FGF-19), total glucagon-like peptide-1 (GLP-1), and insulin, were measured before and 2 hours after oral glucose. RESULTS Fasting total BA levels were higher in T2D than control subjects (P < .05). At 2 hours, the BA profile exhibited a shift from baseline in both groups, with increases in conjugated BAs and/or decreases in unconjugated BAs. There were increases in total BA and FGF-19 levels in control (both P < .05), but not T2D, subjects. Plasma glucose concentrations at 2 hours related inversely to serum total BA levels in control subjects (r = -0.42, P = .006). Total GLP-1 and the insulin/glucose ratio were increased at 2 hours in both groups, and the magnitude of the increase was greater in control subjects. CONCLUSIONS The serum BA response to a 75-g oral glucose load is attenuated in patients with 'early' T2D, as is the secretion of FGF-19 and GLP-1, while in individuals without T2D it correlates with 2-hour plasma glucose levels. These observations support a role for BAs in the regulation of postprandial glucose metabolism.
Collapse
Affiliation(s)
- Xuyi Wang
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good HealthThe University of AdelaideAdelaide
- Department of Clinical NutritionSoutheast UniversityNanjingChina
| | - Chang Chen
- Institute of Life SciencesChongqing Medical UniversityChongqingChina
| | - Cong Xie
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good HealthThe University of AdelaideAdelaide
| | - Weikun Huang
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good HealthThe University of AdelaideAdelaide
| | - Richard L. Young
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good HealthThe University of AdelaideAdelaide
- Nutrition, Diabetes & Gut Health, Lifelong Health ThemeSouth Australian Health & Medical Research InstituteAdelaideAustralia
| | - Karen L. Jones
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good HealthThe University of AdelaideAdelaide
- Endocrine and Metabolic UnitRoyal Adelaide HospitalAdelaide
| | - Michael Horowitz
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good HealthThe University of AdelaideAdelaide
- Endocrine and Metabolic UnitRoyal Adelaide HospitalAdelaide
| | - Christopher K. Rayner
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good HealthThe University of AdelaideAdelaide
- Department of Gastroenterology and HepatologyRoyal Adelaide HospitalAdelaideAustralia
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of MedicineSoutheast UniversityNanjing
| | - Tongzhi Wu
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good HealthThe University of AdelaideAdelaide
- Endocrine and Metabolic UnitRoyal Adelaide HospitalAdelaide
| |
Collapse
|
30
|
Chevli PA, Mehta A, Allison M, Ding J, Nasir K, Blaha MJ, Blankstein R, Talegawkar SA, Kanaya AM, Shapiro MD, Mongraw-Chaffin M. Relationship of American Heart Association's Life Simple 7, Ectopic Fat, and Insulin Resistance in 5 Racial/Ethnic Groups. J Clin Endocrinol Metab 2022; 107:e2394-e2404. [PMID: 35188972 PMCID: PMC9113808 DOI: 10.1210/clinem/dgac102] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND The inverse association between ideal cardiovascular health (CVH) as measured by the American Heart Association's Life Simple 7 (LS7) and cardiovascular disease (CVD) incidence is well documented. However, research exploring the association between CVH and specific risk factors for cardiometabolic disease is sparse in diverse cohorts. METHODS This study included 7717 participants from the Mediators of Atherosclerosis in South Asians Living in America and the Multi-Ethnic Study of Atherosclerosis cohorts. We assigned each LS7 component a 0, 1, and 2 and summed these scores to derive an overall CVH score. Visceral, subcutaneous, and intermuscular fat area, pericardial fat volume, and hepatic fat attenuation were measured using noncontrast computed tomography. Multivariable linear regression was used to examine associations between CVH categories and each log-transformed ectopic fat depot, as well as the homeostatic assessment for insulin resistance (HOMA-IR). RESULTS In adjusted analysis, compared to those with ideal CVH, participants with poor CVH demonstrated 63.4% (95% CI, 54.3-73.0) higher visceral fat area, 84.0% (95% CI, 76.5-92.1) higher pericardial fat volume, 61.6% (95% CI, 50.7-73.2) higher subcutaneous fat area, and 40.6% (95% CI, 30.2-52.0) higher intermuscular fat area, and 15.1% (95% CI, 13.1-17.2) higher hepatic fat (all Ps < 0.001). Also, poor CVH was associated with 148.2% (95% CI, 131.1-166.7) higher HOMA-IR. We also found significant heterogeneity in the strengths of association by race/ethnicity for each ectopic fat depot. CONCLUSION Poor and intermediate CVH, as defined by LS7 metrics, were associated with significantly higher measures of ectopic fat and insulin resistance among individuals from 5 racial/ethnic groups.
Collapse
Affiliation(s)
- Parag Anilkumar Chevli
- Section on Hospital Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Anurag Mehta
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Atlanta, GA, USA
| | - Matthew Allison
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA, USA
| | - Jingzhong Ding
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Khurram Nasir
- Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA
| | - Ron Blankstein
- Department of Medicine (Cardiovascular Division) and Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Sameera A Talegawkar
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Alka M Kanaya
- Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Michael D Shapiro
- Center for the Prevention of Cardiovascular Disease Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Morgana Mongraw-Chaffin
- Department of Epidemiology & Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| |
Collapse
|
31
|
Yu L, Li Y, Ma R, Guo H, Zhang X, Yan Y, He J, Wang X, Niu Q, Guo S. Construction of a Personalized Insulin Resistance Risk Assessment Tool in Xinjiang Kazakhs Based on Lipid- and Obesity-Related Indices. Risk Manag Healthc Policy 2022; 15:631-641. [PMID: 35444477 PMCID: PMC9013923 DOI: 10.2147/rmhp.s352401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/22/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to explore the relationship between obesity- and lipid-related indices and insulin resistance (IR) and construct a personalized IR risk model for Xinjiang Kazakhs based on representative indices. Methods This cross-sectional study was performed from 2010 to 2012. A total of 2170 Kazakhs from Xinyuan County were selected as research subjects. IR was estimated using the homeostasis model assessment of insulin resistance. Multivariable logistic regression analysis, least absolute shrinkage and selection operator penalized regression analysis, and restricted cubic spline were applied to evaluate the association between lipid- and obesity-related indices and IR. The risk model was developed based on selected representative variables and presented using a nomogram. The model performance was assessed using the area under the ROC curve (AUC), the Hosmer–Lemeshow goodness-of-fit test, and decision curve analysis (DCA). Results After screening out 25 of the variables, the final risk model included four independent risk factors: smoking, sex, triglyceride-glucose (TyG) index, and body mass index (BMI). A linear dose–response relationship was observed for the BMI and TyG indices against IR risk. The AUC of the risk model was 0.720 based on an independent test and 0.716 based on a 10-fold cross-validation. Calibration curves showed good consistency between actual and predicted IR risks. The DCA demonstrated that the risk model was clinically effective. Conclusion The TyG index and BMI had the strongest association with IR among all obesity- and lipid-related indices, and the developed model was useful for predicting IR risk among Kazakh individuals.
Collapse
Affiliation(s)
- Linzhi Yu
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
| | - Yu Li
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
| | - Rulin Ma
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
| | - Heng Guo
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
| | - Xianghui Zhang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
| | - Yizhong Yan
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
| | - Jia He
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
| | - Xinping Wang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
| | - Qiang Niu
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
| | - Shuxia Guo
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People’s Republic of China
- Department of NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, The First Affiliated Hospital of Shihezi University Medical College, Shihezi, Xinjiang, People’s Republic of China
- Correspondence: Shuxia Guo; Qiang Niu, Tel +86-1800-9932-625; 86-993-2057153, Fax +86-993-2057-153, Email ;
| |
Collapse
|
32
|
Zhao Y, Guo L, Jiang Y, Wu H, Dai J, Cui Y, Mao H, Ju S, Wei Q, Peng XG. Assessment of Calf Skeletal Muscle in Male Type 2 Diabetes Mellitus Patients With Different Courses Using T1ρ Mapping. J Clin Endocrinol Metab 2022; 107:e1699-e1709. [PMID: 34747996 DOI: 10.1210/clinem/dgab817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT The current clinical methods for detecting skeletal muscle complications of type 2 diabetes mellitus (T2DM) are invasive and insensitive. There is an urgent need for noninvasive assessment of skeletal muscle microstructure changes during the disease progression and treatment to assist the clinical management. OBJECTIVE This work aimed to investigate the T2DM caused changes in the fast-twitch tibialis anterior (TA) and slow-twitch soleus (SOL) skeletal muscles using T1ρ magnetic resonance imaging (MRI). METHODS This cross-sectional study took place from December 2014 to December 2020 at Zhongda Hospital Southeast University. A total of 26 new-onset and 15 long-term T2DM patients were enrolled, with the addition of 20 young and 13 older healthy volunteers as age-matched controls. T1ρ relaxation times of SOL and TA muscles in different groups were measured. Parametric and nonparametric tests were used to analyze the relationship between the T1ρ values in SOL and TA muscles and the length of illness, level of fasting blood glucose, and status of homeostasis model assessment of insulin resistance (HOMA-IR). RESULTS T1ρ relaxation times of SOL and TA muscles both of new-onset and long-term T2DM patients were significantly higher than those of the young (P < .01, P < .05) and older healthy controls (P < .05, P < .01). Positive correlations were observed between the T1ρ relaxation times of the TA or SOL and the duration of T2DM (R2 = 0.420, R2 = 0.326), the level of fasting blood glucose (R2 = 0.253, R2 = 0.071) and HOMA-IR (R2 = 0.232, R2 = 0.414). CONCLUSION Quantitative MRI measurement of T1ρ provides a noninvasive tool to assess T2DM-induced changes in the skeletal muscles of T2DM patients.
Collapse
Affiliation(s)
- Yufei Zhao
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing 210009, China
| | - Li Guo
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, Nanjing 210009, China
| | - Yang Jiang
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing 210009, China
| | - Honghong Wu
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing 210009, China
| | - Jingyue Dai
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing 210009, China
| | - Ying Cui
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing 210009, China
| | - Hui Mao
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia 30329, USA
| | - Shenghong Ju
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing 210009, China
| | - Qiong Wei
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, Nanjing 210009, China
| | - Xin-Gui Peng
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing 210009, China
| |
Collapse
|
33
|
Maruszczak K, Radzikowski K, Schütz S, Mangge H, Bergsten P, Forslund A, Manell H, Pixner T, Ahlström H, Kullberg J, Mörwald K, Weghuber D. Determinants of hyperglucagonemia in pediatric non-alcoholic fatty liver disease. Front Endocrinol (Lausanne) 2022; 13:1004128. [PMID: 36133310 PMCID: PMC9483010 DOI: 10.3389/fendo.2022.1004128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Over the years, non-alcoholic fatty liver (NAFLD) disease has progressed to become the most frequent chronic liver disease in children and adolescents. The full pathology is not yet known, but disease progression leads to cirrhosis and hepatocellular carcinoma. Risk factors included hypercaloric diet, obesity, insulin resistance and genetics. Hyperglucagonemia appears to be a pathophysiological consequence of hepatic steatosis, thus, the hypothesis of the study is that hepatic fat accumulation leads to increased insulin resistance and impaired glucagon metabolism leading to hyperglucagonemia in pediatric NAFLD. METHODS 132 children and adolescents between 10 and 18 years, with varying degrees of obesity, were included in the study. Using Magnetic Resonance Imaging (MRI) average liver fat was determined, and patients were stratified as NAFLD (>5% liver fat content) and non-NAFLD (<5%). All patients underwent a standardized oral glucose tolerance test (OGTT). Additionally, anthropometric parameters (height, weight, BMI, waist circumference, hip circumference) such as lab data including lipid profile (triglycerides, HDL, LDL), liver function parameters (ALT, AST), uric acid, glucose metabolism (fasting insulin and glucagon, HbA1c, glucose 120 min) and indices evaluating insulin resistance (HIRI, SPISE, HOMA-IR, WBISI) were measured. RESULTS Children and adolescents with NAFLD had significantly higher fasting glucagon values compared to the non-NAFLD cohort (p=0.0079). In the NAFLD cohort univariate analysis of fasting glucagon was associated with BMI-SDS (p<0.01), visceral adipose tissue volume (VAT) (p<0.001), average liver fat content (p<0.001), fasting insulin concentration (p<0.001), triglycerides (p<0.001) and HDL (p=0.034). This correlation equally applied to all insulin indices HOMA-IR, WBISI, HIRI (all p<0.001) and SPISE (p<0.002). Multivariate analysis (R² adjusted 0.509) for the same subgroup identified HIRI (p=0.003) and VAT volume (p=0.017) as the best predictors for hyperglucagonemia. Average liver fat content is predictive in pediatric overweight and obesity but not NAFLD. CONCLUSIONS Children and adolescents with NAFLD have significantly higher fasting plasma glucagon values, which were best predicted by hepatic insulin resistance and visceral adipose tissue, but not average liver fat content.
Collapse
Affiliation(s)
- Katharina Maruszczak
- Department of Pediatrics, Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Konrad Radzikowski
- Department of Pediatrics, Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Sebastian Schütz
- Department of Mathematics, Paris Lodron University, Salzburg, Austria
| | - Harald Mangge
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Peter Bergsten
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Anders Forslund
- 5Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Hannes Manell
- 5Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Thomas Pixner
- Department of Pediatric and Adolescent Medicine, Salzkammergutklinikum Voecklabruck, Voecklabruck, Austria
| | - Håkan Ahlström
- Department of Radiology, Uppsala University, Uppsala, Sweden & Antaros Medical, BioVenture Hub, Mölndal, Sweden
| | - Joel Kullberg
- Department of Radiology, Uppsala University, Uppsala, Sweden & Antaros Medical, BioVenture Hub, Mölndal, Sweden
| | - Katharina Mörwald
- Department of Pediatrics, Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Daniel Weghuber
- Department of Pediatrics, Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- *Correspondence: Daniel Weghuber,
| |
Collapse
|
34
|
Barchetta I, Dule S, Bertoccini L, Cimini FA, Sentinelli F, Bailetti D, Marini G, Barbonetti A, Loche S, Cossu E, Cavallo MG, Baroni MG. The single-point insulin sensitivity estimator (SPISE) index is a strong predictor of abnormal glucose metabolism in overweight/obese children: a long-term follow-up study. J Endocrinol Invest 2022; 45:43-51. [PMID: 34142364 PMCID: PMC8741725 DOI: 10.1007/s40618-021-01612-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 06/07/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE To investigate the relationship between the single-point insulin sensitivity estimator (SPISE) index, an insulin sensitivity indicator validated in adolescents and adults, and metabolic profile in overweight/obese children, and to evaluate whether basal SPISE is predictive of impaired glucose regulation (IGR) development later in life. METHODS The SPISE index (= 600 × HDL0.185/Triglycerides0.2 × BMI1.338) was calculated in 909 overweight/obese children undergoing metabolic evaluations at University of Cagliari, Italy, and in 99 normal-weight, age-, sex-comparable children, selected as a reference group, together with other insulin-derived indicators of insulin sensitivity/resistance. 200 overweight/obese children were followed-up for 6.5 [3.5-10] years, data were used for longitudinal retrospective investigations. RESULTS At baseline, 96/909 (11%) overweight/obese children had IGR; in this subgroup, SPISE was significantly lower than in normo-glycaemic youths (6.3 ± 1.7 vs. 7 ± 1.6, p < 0.001). The SPISE index correlated positively with the insulin sensitivity index (ISI) and the disposition index (DI), negatively with age, blood pressure, HOMA-IR, basal and 120 min blood glucose and insulin (all p values < 0.001). A correlation between SPISE, HOMA-IR and ISI was also reported in normal-weight children. At the 6.5-year follow-up, lower basal SPISE-but not ISI or HOMA-IR-was an independent predictor of IGR development (OR = 3.89(1.65-9.13), p = 0.002; AUROC: 0.82(0.72-0.92), p < 0.001). CONCLUSION In children, low SPISE index is significantly associated with metabolic abnormalities and predicts the development of IGR in life.
Collapse
Affiliation(s)
- I Barchetta
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - S Dule
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - L Bertoccini
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - F A Cimini
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - F Sentinelli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - D Bailetti
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences (MeSVA), University of L'Aquila, L'Aquila, Italy
| | - G Marini
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - A Barbonetti
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences (MeSVA), University of L'Aquila, L'Aquila, Italy
| | - S Loche
- Pediatric Endocrine Unit, Ospedale Pediatrico Microcitemico "A. Cao", Cagliari, Italy
| | - E Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - M G Cavallo
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - M G Baroni
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences (MeSVA), University of L'Aquila, L'Aquila, Italy.
- Neuroendocrinology and Metabolic Diseases, IRCCS Neuromed, Pozzilli, IS, Italy.
| |
Collapse
|
35
|
Ting YW, Jalaludin MY, Zaini AA, Mohamed R. Triglyceride to high-density lipoprotein cholesterol ratio is an independent predictor of liver fibrosis among pediatrics non-alcoholic fatty liver disease. Front Endocrinol (Lausanne) 2022; 13:1071350. [PMID: 36589844 PMCID: PMC9800858 DOI: 10.3389/fendo.2022.1071350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Insulin resistance (IR), one of the key components of the metabolic syndrome, is recognized as the pathophysiological hallmark of non-alcoholic fatty liver disease (NAFLD). This study aims to investigate the relationship between surrogate markers of IR and the severity of NAFLD among overweight or obese children. METHODOLOGY A total of 56 consecutive children aged 6 to 18 years old were recruited from the pediatric obesity and type 2 diabetes mellitus (T2DM) clinic in University Malaya Medical Centre (UMMC) from 2016 to 2019. Data on anthropometric measurements, clinical components of metabolic syndrome and fasting serum insulin were collected. Triglyceride to high-density lipoprotein cholesterol ratio (TG: HDL-C), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and Single Point Insulin Sensitivity Estimator (SPISE) were calculated. Transient elastography was performed with hepatic steatosis and liver fibrosis assessed by controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), respectively. RESULTS A total of 44 children (78.6%) had liver steatosis and 35.7% had presence of significant liver fibrosis (stage F≥2). Majority (89.3%) are obese and 24 children (42.9%) were diagnosed with metabolic syndrome. Higher number of children with T2DM and significant liver fibrosis were associated with higher tertiles of TG: HDL-C ratio (p<0.05). Top tertile of TG: HDL-C ratio was an independent predictor of liver fibrosis (OR=8.14, 95%CI: 1.24-53.36, p=0.029). ROC analysis showed that the area under the curve (AUC) of HOMA-IR (0.77) and TG: HDL-C ratio (0.71) were greater than that of metabolic syndrome (0.70), T2DM (0.62) and SPISE (0.22). The optimal cut-off values of HOMA-IR and TG: HDL-C ratio for detecting liver fibrosis among children with NAFLD are 5.20 and 1.58, respectively. CONCLUSION Children with NAFLD and higher TG: HDL-C ratio are more likely to have liver fibrosis. TG: HDL-C ratio is a promising tool to risk stratify those with NAFLD who are at risk of developing advanced liver disease.
Collapse
Affiliation(s)
- Yi-Wen Ting
- Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Muhammad Yazid Jalaludin
- Endocrinology Unit, Department of Pediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
- *Correspondence: Muhammad Yazid Jalaludin,
| | - Azriyanti Anuar Zaini
- Endocrinology Unit, Department of Pediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Rosmawati Mohamed
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
36
|
Furthner D, Anderwald CH, Bergsten P, Forslund A, Kullberg J, Ahlström H, Manell H, Ciba I, Mangge H, Maruszczak K, Koren P, Schütz S, Brunner SM, Schneider AM, Weghuber D, Mörwald K. Single Point Insulin Sensitivity Estimator in Pediatric Non-Alcoholic Fatty Liver Disease. Front Endocrinol (Lausanne) 2022; 13:830012. [PMID: 35185803 PMCID: PMC8848352 DOI: 10.3389/fendo.2022.830012] [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: 12/06/2021] [Accepted: 01/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Attenuated insulin-sensitivity (IS) is a central feature of pediatric non-alcoholic fatty liver disease (NAFLD). We recently developed a new index, single point insulin sensitivity estimator (SPISE), based on triglycerides, high-density-lipoprotein and body-mass-index (BMI), and validated by euglycemic-hyperinsulinemic clamp-test (EHCT) in adolescents. This study aims to assess the performance of SPISE as an estimation of hepatic insulin (in-)sensitivity. Our results introduce SPISE as a novel and inexpensive index of hepatic insulin resistance, superior to established indices in children and adolescents with obesity. MATERIALS AND METHODS Ninety-nine pubertal subjects with obesity (13.5 ± 2.0 years, 59.6% males, overall mean BMI-SDS + 2.8 ± 0.6) were stratified by MRI (magnetic resonance imaging) into a NAFLD (>5% liver-fat-content; male n=41, female n=16) and non-NAFLD (≤5%; male n=18, female n=24) group. Obesity was defined according to WHO criteria (> 2 BMI-SDS). EHCT were used to determine IS in a subgroup (n=17). Receiver-operating-characteristic (ROC)-curve was performed for diagnostic ability of SPISE, HOMA-IR (homeostatic model assessment for insulin resistance), and HIRI (hepatic insulin resistance index), assuming null hypothesis of no difference in area-under-the-curve (AUC) at 0.5. RESULTS SPISE was lower in NAFLD (male: 4.8 ± 1.2, female: 4.5 ± 1.1) than in non-NAFLD group (male 6.0 ± 1.6, female 5.6 ± 1.5; P< 0.05 {95% confidence interval [CI]: male NAFLD 4.5, 5.2; male non-NAFLD 5.2, 6.8; female NAFLD 4.0, 5.1, female non-NAFLD 5.0, 6.2}). In males, ROC-AUC was 0.71 for SPISE (P=0.006, 95% CI: 0.54, 0.87), 0.68 for HOMA-IR (P=0.038, 95% CI: 0.48, 0.88), and 0.50 for HIRI (P=0.543, 95% CI: 0.27, 0.74). In females, ROC-AUC was 0.74 for SPISE (P=0.006), 0.59 for HOMA-IR (P=0.214), and 0.68 for HIRI (P=0.072). The optimal cutoff-level for SPISE between NAFLD and non-NAFLD patients was 5.18 overall (Youden-index: 0.35; sensitivity 0.68%, specificity 0.67%). CONCLUSION SPISE is significantly lower in juvenile patients with obesity-associated NAFLD. Our results suggest that SPISE indicates hepatic IR in pediatric NAFLD patients with sensitivity and specificity superior to established indices of hepatic IR.
Collapse
Affiliation(s)
- Dieter Furthner
- Department of Pediatrics, Salzkammergutklinikum Voecklabruck, Voecklabruck, Austria
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Christian-Heinz Anderwald
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
- Direction, Arnoldstein Healthcare Centre, Arnoldstein, Austria
| | - Peter Bergsten
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Anders Forslund
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Joel Kullberg
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - Håkan Ahlström
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - Hannes Manell
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Iris Ciba
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Harald Mangge
- Clinical Institute of Medical and Chemical Laboratory Diagnosis, Medical University of Graz, Graz, Austria
| | - Katharina Maruszczak
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Pia Koren
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Sebastian Schütz
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Susanne Maria Brunner
- Research Program for Receptor Biochemistry and Tumor Metabolism, Department of Pediatrics, University Hospital of the Paracelsus Medical University, Salzburg, Austria
| | - Anna Maria Schneider
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Daniel Weghuber
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- *Correspondence: Daniel Weghuber,
| | - Katharina Mörwald
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| |
Collapse
|
37
|
Karczewska-Kupczewska M, Nikołajuk A, Stefanowicz M, Matulewicz N, Arnoriaga-Rodriguez M, Fernandez-Real JM, Strączkowski M. Novel Laboratory Index, Based on Fasting Blood Parameters, Accurately Reflects Insulin Sensitivity. J Clin Endocrinol Metab 2021; 106:e5208-e5221. [PMID: 34228124 DOI: 10.1210/clinem/dgab489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Indexed: 01/02/2023]
Abstract
CONTEXT Simple and reliable measurement of insulin sensitivity may be important for the prevention of insulin-resistance-related diseases. Surrogate indices of insulin sensitivity are of limited utility in population without signs of metabolic syndrome. OBJECTIVE The aim of our study was to provide simple and accurate index of insulin sensitivity. DESIGN The study group comprised 150 young healthy participants. Hyperinsulinemic-euglycemic clamp was performed. Regression models with different laboratory parameters were constructed. Validation cohort 1 comprised independent group of 110 subjects, including individuals with prediabetes and newly diagnosed type 2 diabetes. Validation cohort 2 comprised 38 obese subjects before and after diet-induced weight loss. Validation cohort 3 comprised 60 nondiabetic subjects from an independent center. RESULTS The supervised principal component model established optimal set of variables correlated with insulin sensitivity. This model (Fasting Laboratory Assessment of Insulin Sensitivity [FLAIS]) used red blood cell count, alanine aminotransferase activity, serum C-peptide, SHBG, IGF-binding protein 1, and adiponectin concentrations. FLAIS exhibited strong correlation with clamp-derived insulin sensitivity. The sensitivity of the model was 90% and the specificity was 68%. In validation cohort 1, differences in FLAIS among the groups paralleled those observed with the clamp, with the lowest values in prediabetes and diabetes. In validation cohort 2, FLAIS reflected the change in insulin sensitivity after weight loss. The main findings were confirmed in validation cohort 3. CONCLUSION We provide simple and accurate method of assessing insulin sensitivity, which allows to identify insulin resistance even in the population without overt metabolic disturbances.
Collapse
Affiliation(s)
- Monika Karczewska-Kupczewska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, 15-276 Białystok, Poland
| | - Agnieszka Nikołajuk
- Department of Prophylaxis of Metabolic Diseases, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| | - Magdalena Stefanowicz
- Department of Metabolic Diseases, Medical University of Białystok, Białystok, Poland
| | - Natalia Matulewicz
- Department of Metabolic Diseases, Medical University of Białystok, Białystok, Poland
| | - Maria Arnoriaga-Rodriguez
- Department of Diabetes, Endocrinology and Nutrition, Dr. Josep Trueta University Hospital; Department of Medical Sciences, Faculty of Medicine, University of Girona; and CIBERobn Pathophysiology of Obesity and Nutrition, Girona, Spain
| | - Jose Manuel Fernandez-Real
- Department of Diabetes, Endocrinology and Nutrition, Dr. Josep Trueta University Hospital; Department of Medical Sciences, Faculty of Medicine, University of Girona; and CIBERobn Pathophysiology of Obesity and Nutrition, Girona, Spain
| | - Marek Strączkowski
- Department of Prophylaxis of Metabolic Diseases, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| |
Collapse
|
38
|
Yu D, Wang Z, Zhang X, Qu B, Cai Y, Ma S, Zhao Z, Simmons D. Remnant Cholesterol and Cardiovascular Mortality in Patients With Type 2 Diabetes and Incident Diabetic Nephropathy. J Clin Endocrinol Metab 2021; 106:3546-3554. [PMID: 34291804 DOI: 10.1210/clinem/dgab533] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT The association between remnant cholesterol (remnant-C) and cardiovascular mortality in patients with type 2 diabetes (T2D) and incident diabetic nephropathy remains unclear. OBJECTIVE To examinie the association between remnant-C and cardiovascular mortality in patients with T2D, chronic kidney disease (CKD) stages 3 to 5, and newly diagnosed DN. METHODS This study determined the baseline lipid profile and searched for deaths with cardiovascular disease (CVD) within 2 years of baseline among 2282 adults enrolled between January 1, 2015 and December 31, 2016, who had T2D, CKD stages 3 to 5, and newly diagnosed DN. Adjusted logistic regression models were used to assess the associations between lipid, especially remnant-C concentration (either as continuous or categorical variables), and risk of cardiovascular mortality. RESULTS In multivariable-adjusted analyses, low-density lipoprotein cholesterol (LDL-C) (odds ratio [OR], 1.022; 95% CI, 1.017-1.026, per 10 mg/dL), high-density lipoprotein cholesterol (HDL-C) (OR, 0.929; 95% CI, 0.922-0.936, per 5 mg/dL), non-HDL-C (OR, 1.024; 95% CI, 1.021-1.028, per 10 mg/dL), and remnant-C (OR, 1.115; 95% CI, 1.103-1.127, per 10 mg/dL), but not triglycerides were associated with cardiovascular mortality. Atherogenic dyslipidemia (triglycerides > 150 mg/dL [1.69 mmol/L] and HDL-C < 40 mg/dL in men or < 50 mg/dL in women) was also associated with cardiovascular mortality (OR, 1.073; 95% CI, 1.031-1.116). Remnant-C greater than or equal to 30 mg/dL differentiated patients at a higher risk of cardiovascular mortality from those with lower concentrations, especially with interaction with LDL-C level greater than 100 mg/dL: The highest risk was found in patients with higher levels both of remnant-C and LDL-C (OR, 1.696; 95% CI, 1.613-1.783). CONCLUSION In patients with T2D, CKD stages 3 to 5, and incident DN, remnant-C was associated with a higher risk of death with CVD. Different from the general population, the interaction of remnant-C and LDL-C was associated with the highest risk of cardiovascular mortality.
Collapse
Affiliation(s)
- Dahai Yu
- Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele ST5 5BG, UK
| | - Zheng Wang
- Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Xiaoxue Zhang
- Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Bingjie Qu
- Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Yamei Cai
- Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Shuang Ma
- Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Zhanzheng Zhao
- Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - David Simmons
- Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
- Macarthur Clinical School, Western Sydney University, Campbelltown, Sydney NSW 2751, Australia
| |
Collapse
|
39
|
Fu J, Malale K, Luo X, Chen M, Liu Q, Cheng W, Liu D. The relationship of mesencephalic astrocyte-derived neurotrophic factor with hyperlipidemia in patients with or without type 2 diabetes mellitus. Hormones (Athens) 2021; 20:537-543. [PMID: 33559083 DOI: 10.1007/s42000-021-00272-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/17/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE This study was conducted to determine the relationship between mesencephalic astrocyte-derived neurotrophic factor (MANF) and lipid metabolism with or without type 2 diabetes mellitus (T2DM). METHODS Human serum samples were collected from 58 normal controls (NC), 40 subjects with hyperlipidemia (HLD) without T2DM, and 42 subjects with HLD and T2DM. Their MANF levels were detected using an enzyme-linked immunosorbent assay (ELISA). Subgroup analysis was performed in the group with HLD and T2DM based on fasting blood glucose (FBG) > 8.22 vs. FBG ≤ 8.22. Furthermore, the relationship between MANF levels and lipid indices was analyzed. RESULTS Serum MANF levels were found to be significantly higher in the HLD group, both with and without T2DM (5.62 (3.59-7.11) and 4.21 (2.87-6.11)), both P < 0.001, than in the NC (2.81(1.81-4.01). MANF levels were higher in those with FBG > 8.22 than that in those with FBG ≤ 8.22. In addition, in the HLD without T2DM group, MANF levels were negatively correlated with total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and age, while LDL-C and age were independently related to MANF levels. The area under the curve (AUC) in the ROC analysis of MANF for the diagnosis of HLD without T2DM and HLD with T2DM was 0.709 and 0.841, respectively (P < 0.001). CONCLUSION Serum MANF levels increased in the HLD with or without T2DM groups and was associated with lipid and glucose metabolism. MANF may be a useful marker for predicting the development of dyslipidemia in T2DM.
Collapse
Affiliation(s)
- Jili Fu
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Chongqing Medical University, 76, Linjiang Road, Yuzhong District, 400010, Chongqing, China
- Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Kija Malale
- Department of Gastroenterology, The Second Affiliated Hospital of Chongqing Medical University, 76, Linjiang Road, Yuzhong District, 400010, Chongqing, China
- Archbishop Anthony Mayala School of Nursing, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Xie Luo
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Chongqing Medical University, 76, Linjiang Road, Yuzhong District, 400010, Chongqing, China
| | - Min Chen
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Chongqing Medical University, 76, Linjiang Road, Yuzhong District, 400010, Chongqing, China
| | - Qicong Liu
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Chongqing Medical University, 76, Linjiang Road, Yuzhong District, 400010, Chongqing, China
| | - Wei Cheng
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Chongqing Medical University, 76, Linjiang Road, Yuzhong District, 400010, Chongqing, China.
| | - Dongfang Liu
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Chongqing Medical University, 76, Linjiang Road, Yuzhong District, 400010, Chongqing, China
| |
Collapse
|
40
|
Shi Q, Wang R, Zhang H, Shan Y, Ye M, Jia B. Association between serum uric acid and cardiovascular disease risk factors in adolescents in America: 2001-2018. PLoS One 2021; 16:e0254590. [PMID: 34424900 PMCID: PMC8382197 DOI: 10.1371/journal.pone.0254590] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 06/29/2021] [Indexed: 11/19/2022] Open
Abstract
SUA is associated with cardiovascular disease and cardiovascular disease risk factors in adults, including chronic kidney disease, coronary artery disease, stroke, diabetes mellitus, preeclampsia, and hypertension. A cross-sectional study was carried out among 11219 adolescents 12 to 18 years of age examined in the 2001-2018 National health and Nutrition Examination Survey. We examined the association between SUA and CVD risk factors. The overall mean SUA level was 5.00±1.24mg/dl. Restricted cubic spline analysis results revealed SUA was inversely associated with HDL-C and SPISE and positively associated with TC, TG, LDL-C, nonHDL-C, insulin, SBP and DBP after full adjustment. Multiple logistic analyses showed SUA level was independently associated with high TC, high TG, high nonHDL-C and low HDL-C (all p<0.05). Furthermore, females in the highest quartile of SUA had significantly higher odds for elevated BP (OR = 2.38, 95%CI:1.02-5.54, P<0.05) and high TC (OR = 2.22, 95%CI: 1.49-3.30, P<0.001), which not observed in males. Increased levels of SUA were associated with increased odds of various cardiovascular risk factors in American adolescents, especially females.
Collapse
Affiliation(s)
- Qiqi Shi
- Department of Pediatric Cardiothoracic Surgery, Children’s Hospital of Fudan University, Shanghai, China
| | - Ran Wang
- Department of Neonatology, Children’s Hospital of Fudan University, Shanghai, China
| | - Huifeng Zhang
- Department of Pediatric Cardiothoracic Surgery, Children’s Hospital of Fudan University, Shanghai, China
| | - Yaping Shan
- Department of Pediatric Cardiothoracic Surgery, Children’s Hospital of Fudan University, Shanghai, China
| | - Ming Ye
- Department of Pediatric Cardiothoracic Surgery, Children’s Hospital of Fudan University, Shanghai, China
| | - Bing Jia
- Department of Pediatric Cardiothoracic Surgery, Children’s Hospital of Fudan University, Shanghai, China
- * E-mail:
| |
Collapse
|
41
|
Rao C, Ping F. Second-trimester maternal lipid profiles rather than glucose levels predict the occurrence of neonatal macrosomia regardless of glucose tolerance status: A matched cohort study in Beijing. J Diabetes Complications 2021; 35:107948. [PMID: 34024685 DOI: 10.1016/j.jdiacomp.2021.107948] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/18/2021] [Accepted: 05/08/2021] [Indexed: 01/15/2023]
Abstract
AIMS The mechanism underlying fetal overgrowth during pregnancy remains elusive. We aimed to establish a predictive model to identify the high-risk individuals with macrosomia in the second trimester of pregnancy. DESIGN A total of 2577 pregnant women with a routine 75-g oral glucose tolerance test during 24-28 gestational weeks were screened in a prospective cohort. Gestational diabetes mellitus (GDM) cases were 1:1 matching with age (±2 years) in normal glucose tolerance (NGT) ones from the same region. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve were performed to determine the index and its inflection point for predicting macrosomia occurrence. RESULTS The data of perinatal outcomes of 565 GDM and 549 NGT who had given birth to single live babies at term were analyzed. Notably, we found serum apolipoprotein B (ApoB) level higher than 4.04 g/L combined with triglycerides (TG)/high-density lipoprotein cholesterol (HDLC) ratio above 1.36 formed the predictive model in both groups. The area under the ROC curve of this predictive model included ApoB and TG/HDL-C reached 0.807 (95% CI: 0.771-0.873) with a sensitivity of 71.9% and a specificity of 78.6%. Mediation analysis revealed that ApoB and TG/HDL-C ratio mediated the harmful effect of FBG on the risk of macrosomia. CONCLUSION Maternal ApoB levels and TG/HDL-C ratio could predict macrosomia occurrence in pregnancy, which might be a new target for early intervention to prevent excess fetal growth.
Collapse
Affiliation(s)
- Chong Rao
- Department of Endocrinology, Beijing ChuiYangLiu Hospital, Beijing 100022, China
| | - Fan Ping
- Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Key Laboratory of Endocrinology Assigned by Ministry of Health, Beijing 100730, China.
| |
Collapse
|
42
|
Pereyra I, López-Arana S, Horta BL. Undernutrition and suboptimal growth during the first year are associated with glycemia but not with insulin resistance in adulthood. CAD SAUDE PUBLICA 2021; 37:e00120320. [PMID: 34346980 DOI: 10.1590/0102-311x00120320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 11/26/2020] [Indexed: 11/22/2022] Open
Abstract
This study aimed to assess whether weight, length, and conditional growth during the first year are associated with glycemia and insulin resistance among young adults. A non-concurrent longitudinal design was used in the study. This is a population-based cohort study, composed of people aged from 22 to 28 years. We estimated z-scores from birth to the first year and the infants were classified as stunted, underweight, overweight, obese, wasted, and at risk of wasting, using cut-offs proposed by the World Health Organization (Child Growth Standards, 2006). Conditional weight and length gain variables were estimated. Glycemia, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), and single point insulin sensitivity estimator (SPISE) were evaluated in adulthood. Multiple linear regressions that includes the variables associated with glycemia and insulin resistance were used. In total, 1,070 subjects were evaluated and glycemia in adulthood was higher among subjects who were wasted or at risk of wasting at 12 months (β coefficient = 2.77; 95%CI: 0.37; 5.21). In relation to normal weight, those subjects who were overweight at 12 months showed the lowest glycemia (β coefficient = -2.39; 95%CI: -4.32; -0.36). Conditional weight gain in the first year was negatively associated with glycemia in adulthood (β coefficient = -0.65; 95%CI: -1.23; -0.08). SPISE was higher among underweight subjects, and negatively associated with conditional relative weight gain and conditional linear growth in the first year. In conclusion, we found that undernutrition and suboptimal growth were associated with higher glycemia.
Collapse
Affiliation(s)
- Isabel Pereyra
- Universidad Católica del Uruguay, Canelones, Paraguay.,Universidad de Chile, Santiago, Chile
| | | | | |
Collapse
|
43
|
Rabari K, Naithani M, Patra P, Sonagara N, Dudi P, Goyal B, Saha S, Mirza AA, Darbari A. Single-Point Insulin Sensitivity Estimator (SPISE) as a Feasible Marker of Insulin Resistance in Adult Metabolic Syndrome: Evaluated in a Hospital Based Cross-Sectional Pilot Study at Tertiary Care Centre of Uttarakhand. Indian J Clin Biochem 2021; 37:356-360. [DOI: 10.1007/s12291-021-00992-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 06/15/2021] [Indexed: 12/01/2022]
|
44
|
Zhang Y, Ding X, Hua B, Liu Q, Gao H, Chen H, Zhao XQ, Li W, Li H. Predictive effect of triglyceride‑glucose index on clinical events in patients with type 2 diabetes mellitus and acute myocardial infarction: results from an observational cohort study in China. Cardiovasc Diabetol 2021; 20:43. [PMID: 33573649 PMCID: PMC7879620 DOI: 10.1186/s12933-021-01236-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 02/01/2021] [Indexed: 02/06/2023] Open
Abstract
Background Triglyceride glucose (TyG) index is considered a reliable alternative marker of insulin resistance and an independent predictor of cardiovascular (CV) outcomes. However, the prognostic value of TyG index in patients with type 2 diabetes mellitus (T2DM) and acute myocardial infarction (AMI) remains unclear. Methods A total of 1932 consecutive patients with T2DM and AMI were enrolled in this study. Patients were divided into tertiles according to their TyG index levels. The incidence of major adverse cardiac and cerebral events (MACCEs) was recorded. The TyG index was calculated as the ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. Results Competing risk regression revealed that the TyG index was positively associated with CV death [2.71(1.92 to 3.83), p < 0.001], non-fatal MI [2.02(1.32 to 3.11), p = 0.001], cardiac rehospitalization [2.42(1.81 to 3.24), p < 0.001], revascularization [2.41(1.63 to 3.55), p < 0.001] and composite MACCEs [2.32(1.92 to 2.80), p < 0.001]. The area under ROC curve of the TyG index for predicting the occurrence of MACCEs was 0.604 [(0.578 to 0.630), p < 0.001], with the cut-off value of 9.30. The addition of TyG index to a baseline risk model had an incremental effect on the predictive value for MACCEs [net reclassification improvement (NRI): 0.190 (0.094 to 0.337); integrated discrimination improvement (IDI): 0.027 (0.013 to 0.041); C-index: 0.685 (0.663 to 0.707), all p < 0.001]. Conclusions The TyG index was significantly associated with MACCEs, suggesting that the TyG index may be a valid marker for risk stratification and prognosis in patients with T2DM and AMI. Trial registration Retrospectively registered.
Collapse
Affiliation(s)
- Yue Zhang
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Beijing, 100050, China
| | - Xiaosong Ding
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Beijing, 100050, China
| | - Bing Hua
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Beijing, 100050, China
| | - Qingbo Liu
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Beijing, 100050, China
| | - Hui Gao
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Beijing, 100050, China
| | - Hui Chen
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Beijing, 100050, China
| | - Xue-Qiao Zhao
- Clinical Atherosclerosis Research Lab, Division of Cardiology, University of Washington, Seattle, WA, USA
| | - Weiping Li
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Beijing, 100050, China.,Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease, Beijing, China
| | - Hongwei Li
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Beijing, 100050, China. .,Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease, Beijing, China. .,Department of Geriatrics, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| |
Collapse
|
45
|
Endukuru CK, Gaur GS, Yerrabelli D, Sahoo J, Vairappan B. Cut-off Values and Clinical Utility of Surrogate Markers for Insulin Resistance and Beta-Cell Function to Identify Metabolic Syndrome and Its Components among Southern Indian Adults. J Obes Metab Syndr 2020; 29:281-291. [PMID: 33229629 PMCID: PMC7789024 DOI: 10.7570/jomes20071] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/27/2020] [Accepted: 09/16/2020] [Indexed: 12/31/2022] Open
Abstract
Background Insulin resistance (IR) is a collective clinical entity that exacerbates metabolic syndrome (MetS). As the gold-standard test to quantify IR involves intravenous insulin loading and repeated blood glucose monitoring, many indices have been developed for IR assessment for convenience. This study tested the ideal cut-off values and clinical utility of IR indices in identifying MetS. Methods We recruited 150 subjects, 75 MetS patients and 75 healthy controls, then obtained written informed consent to participate in this study. We collected fasting blood samples for glucose and lipid profiles and calculated nineteen indices of IR and insulin secretion using validated formulae. We determined the precision of these IR indices using the area under the curve (AUC) in a receiver operating characteristic analysis. Results Subjects with MetS have significantly higher IR coupled with lower insulin sensitivity and beta-cell function than controls. Among the surrogate markers of IR tested, the homeostatic model assessment of insulin resistance (HOMA-IR), HOMA-adiponectin (HOMA-AD), triglyceride-glucose (TyG) index, HOMA-1%S (insulin sensitivity), quantitative insulin sensitivity check index (QUICKI), McAuley index, single-point insulin sensitivity estimator (SPISE), and HOMA-2%B (beta-cell function) showed the highest AUC values for detecting MetS. Conclusion Our study results suggest that the ideal cut-off and AUC values identified for HOMA-IR, HOMA-AD, the TyG index, HOMA-1%S, QUICKI, the McAuley index, SPISE, and HOMA-2%B offer a clinical approach to the early detection and risk stratification for MetS among people in southern India.
Collapse
Affiliation(s)
- Chiranjeevi Kumar Endukuru
- Department of 1Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Girwar Singh Gaur
- Department of 1Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Dhanalakshmi Yerrabelli
- Department of 1Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Jayaprakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Balasubramaniyan Vairappan
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
46
|
Beiglböck H, Wolf P, Pfleger L, Caliskan B, Fellinger P, Zettinig G, Anderwald CH, Kenner L, Trattnig S, Kautzky-Willer A, Krššák M, Krebs M. Effects of Thyroid Function on Phosphodiester Concentrations in Skeletal Muscle and Liver: An In Vivo NMRS Study. J Clin Endocrinol Metab 2020; 105:5908058. [PMID: 32944774 DOI: 10.1210/clinem/dgaa663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/15/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Thyroid function is clinically evaluated by determination of circulating concentrations of thyrotropin (thyroid-stimulating hormone; TSH) and free thyroxine (fT4). However, a tissue-specific effector substrate of thyroid function is lacking. Energy-rich phosphorus-containing metabolites (PM) and phospholipids (PL) might be affected by thyroid hormone action and can be noninvasively measured by 31P nuclear magnetic resonance spectroscopy (NMRS). OBJECTIVES To measure the actions of peripheral thyroid hormones on PM and PL tissue concentrations. DESIGN AND SETTING A longitudinal, prospective pilot study was performed. PARTICIPANTS Nine patients with hyperthyroidism (HYPER) and 4 patients with hypothyroidism (HYPO) were studied at baseline and 3 months after treatment. MAIN OUTCOME MEASURES High-field 1H/31P NMRS was used to assess profiles of PM, PL, and flux through oxidative phosphorylase in liver and skeletal muscle, as well as ectopic tissue lipid content. RESULTS The concentrations of total skeletal muscle (m-) and hepatic (h-) phosphodiesters (PDE) and one of the PDE constituents, glycerophosphocholine (GPC), were lower in HYPER compared with HYPO (m-PDE: 1.4 ± 0.4 mM vs 7.4 ± 3.5 mM, P = 0.003; m-GPC: 0.9 ± 0.3 mM vs 6.7 ± 3.5 mM, P = 0.003; h-PDE: 4.4 ± 1.4 mM vs 9.9 ± 3.9 mM, P = 0.012; h-GPC: 2.2 ± 1.0 mM vs 5.1 ± 2.4 mM, P = 0.024). Both h-GPC (rho = -0.692, P = 0.018) and h-GPE (rho = -0.633, P = 0.036) correlated negatively with fT4. In muscle tissue, a strong negative association between m-GPC and fT4 (rho = -0.754, P = 0.003) was observed. CONCLUSIONS Thyroxine is closely negatively associated with the PDE concentrations in liver and skeletal muscle. Normalization of thyroid dysfunction resulted in a decline of PDE in hypothyroidism and an increase in hyperthyroidism. Thus, PDE might be a sensitive tool to estimate tissue-specific peripheral thyroid hormone action.
Collapse
Affiliation(s)
- Hannes Beiglböck
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Peter Wolf
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Lorenz Pfleger
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Burak Caliskan
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Paul Fellinger
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Georg Zettinig
- Schilddruesenpraxis Josefstadt, Laudongasse, Vienna, Austria
| | - Christian Heinz Anderwald
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Lukas Kenner
- Department of Pathology, Medical University Vienna, Vienna, Austria
- Center for Biomarker Research in Medicine (CBmed), Graz, Austria
- Unit for Laboratory Animal Pathology, University of Veterinary Medicine Vienna, Vienna, Austria
- Ludwig Boltzmann Platform for Comparative Laboratory Animal Pathology, Vienna, Austria
- Christian Doppler Laboratory for Applied Metabolomics (CDL-AM), Medical University of Vienna, Vienna, Austria
| | - Siegfried Trattnig
- Centre of Excellence-High Field MR, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- Christian Doppler Laboratory for Clinical Molecular Imaging, MOLIMA, Medical University of Vienna, Vienna, Austria
| | - Alexandra Kautzky-Willer
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Martin Krššák
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
- Christian Doppler Laboratory for Clinical Molecular Imaging, MOLIMA, Medical University of Vienna, Vienna, Austria
| | - Michael Krebs
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
47
|
Luo K, Aimuzi R, Wang Y, Nian M, Zhang J. Urinary organophosphate esters metabolites, glucose homeostasis and prediabetes in adolescents. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 267:115607. [PMID: 33254666 DOI: 10.1016/j.envpol.2020.115607] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 07/17/2020] [Accepted: 09/03/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Emerging experimental evidence indicates that organophosphate esters (OPEs) can trigger glucose metabolic disorders. However, human evidence, especially in adolescents, is unavailable. OBJECTIVES We utilized data from the National Health and Nutrition Examination Survey 2011-2014 to evaluate whether urinary OPEs metabolites were associated with prediabetes and glucose homeostasis. METHODS A total of 349 adolescents (12-19-year old) who provided at least 8 h fasting blood samples, had urinary OPEs metabolites detected were included. Prediabetes was defined according to the levels of fasting plasma glucose (FPG), 2-h post oral plasma glucose (2 h-OGTT) and glycated hemoglobin A1c (HbA1c). The homeostatic model assessment (HOMA-IR) and the Single Point Insulin Sensitivity Estimator (SPISE) were used to assess insulin resistance and sensitivity, respectively. Multiple binary logistic and linear regressions were used to evaluate the associations with prediabetes and indices of glucose homeostasis. The least absolute shrinkage and selection operator (LASSO) regression was used to assess the associations in a multi-pollutant context. RESULTS After adjusting for covariates, certain urinary OPEs metabolites were associated with prediabetes and indices of glucose homeostasis in all adolescents. Stratified analyses by sex revealed that such associations were largely sex-dependent. In females, the multiple pollutant models showed that bis(1,3-32 dichloro-2-propyl) phosphate (BDCIPP) was positively associated with prediabetes [odds ratio (OR) = 2.51, 95%CI:1.29, 4.89, for one scaled unit increase in exposure] and 2 h-OGTT (β = 0.07, 95%CI:0.01,0.12); bis(2-chloroethyl) phosphate (BCEP) was negatively associated with fasting insulin (β = -0.10, 95%CI: 0.19,-0.01) and HOMA-IR (β = -0.10, 95%CI: 0.19,-0.003); and detectable bis(1-choloro-2-propyl) phosphate (BCIPP) (>LOD vs < LOD) was inversely associated with 2 h-OGTT (β = -0.11, 95%CI: 0.21,-0.02). In males, consistent inverse associations were found for detectable di-n-butyl phosphate (DNBP) with prediabetes, FPG, 2 h-OGTT, fasting insulin and HOMA-IR. CONCLUSION Urinary OPEs metabolites were associated with prediabetes and indices of glucose homeostasis in adolescents. But such associations varied by sex. Future studies with multiple measurements of OPEs exposure are needed to confirm our findings.
Collapse
Affiliation(s)
- Kai Luo
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China; School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Ruxianguli Aimuzi
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China; School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Yuqing Wang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Min Nian
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China; School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China; School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China.
| |
Collapse
|
48
|
Shimada Y, Nakasone Y, Hirabayashi K, Sakuma T, Koike H, Oguchi T, Yamashita K, Uchimido R, Moriya T, Komatsu M, Aizawa T. Development of glomerular hyperfiltration, a multiphasic phenomenon. Am J Physiol Renal Physiol 2020; 319:F1037-F1041. [PMID: 33135477 DOI: 10.1152/ajprenal.00305.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The trajectory of glomerular filtration rate (GFR) in relation to glomerular hyperfiltration (GHF) has been unknown. It was evaluated retrospectively in 23,982 GHF-free health examinees who were followed for 2-10 yr (mean: 5.1 yr). GFR was estimated by the serum creatinine concentration, and GHF was defined as age- and sex-specific estimated GFR (eGFR) ≥ 95% of the Japanese general population. The temporal profile of eGFR was plotted in a GHF-centered way, which was fitted to a random coefficient linear mixed model. Of the 23,982 subjects, 797 and 23,185 subjects developed or did not develop GHF, respectively, so that they were termed as the GHF(+) and GHF(-) groups. At baseline, median eGFR was significantly elevated in the GHF(+) group compared with in the GHF(-) group: 94.1 versus 77.3 mL/min/1.73 m2 (P < 0.001). Elevation of basal eGFR lasted for a mean (SD) of 3.3 (1.9) yr in the GHF(+) group; mean eGFR then rose to the GHF range, which was 108.5 mL/min/1.73 m2. The eGFR decline after the peak was steeper in the GHF(+) group than in the GHF(-) group: -0.984 versus -0.497 mL/min/1.73 m2/yr (P < 0.001). Baseline eGFR, but no other variable, well predicted incident GHF, with an area under the receiver operating characteristic curve of 0.87 (95% confidence interval: 0.86-0.88). In conclusion, GHF occurs as a chronic, multiphasic phenomenon: initially with a sustained GFR elevation for years, followed by a GFR surge to the GHF range, which was accompanied by accelerated GFR declining.
Collapse
Affiliation(s)
| | | | | | | | - Hideo Koike
- Health Center, Aizawa Hospital, Matsumoto, Japan
| | - Tomomasa Oguchi
- Kidney Disease and Dialysis Center, Aizawa Hospital, Matsumoto, Japan
| | | | - Ryo Uchimido
- Department of Intensive Care Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tatsumi Moriya
- Health Care Center, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Mitsuhisa Komatsu
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Toru Aizawa
- Diabetes Center, Aizawa Hospital, Matsumoto, Japan
| |
Collapse
|
49
|
Optimal reference values for insulin sensitivity indices in Iranian healthy females: a population-based study. Int J Diabetes Dev Ctries 2020. [DOI: 10.1007/s13410-020-00814-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
50
|
Validity assessment of the single-point insulin sensitivity estimator (spise) for diagnosis of cardiometabolic risk in post-pubertal hispanic adolescents. Sci Rep 2020; 10:14399. [PMID: 32873820 PMCID: PMC7462984 DOI: 10.1038/s41598-020-71074-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 08/10/2020] [Indexed: 11/29/2022] Open
Abstract
Insulin measurements are not advised for cardiometabolic risk screening in large groups. Here we assessed the accuracy of the single-point insulin sensitivity estimator (SPISE) to diagnose cardiometabolic risk in Chilean adolescents. In 678 post-pubertal adolescents (52% males, M(SD) age = 16.8 (0.2) years), height, weight, waist circumference, blood lipids, glucose, insulin, and blood pressure were measured. BMI, HOMA-IR, and SPISE were estimated; HOMA-IR values ≥ 2.6 were considered insulin resistance (IR). Metabolic syndrome (MetS) was defined with the joint IDF/AHA/NHBLI standard. Using receiver operating characteristic curves, we obtained optimal SPISE cutpoints for IR and MetS diagnosis. The prevalence of MetS and IR was 8.2% and 17.1%, respectively. In males, the optimal cutoff for MetS diagnosis was 5.0 (sensitivity: 97%; specificity: 82%), and the optimal cutoff for IR diagnosis was 5.9 (sensitivity: 71%; specificity: 83%). In females, a SPISE of 6.0 had the highest sensitivity (90%) and specificity (74%) for MetS diagnosis. A SPISE of 6.4 was the optimal cutoff for IR diagnosis; however, sensitivity and specificity were 61% and 75%. In males and female post-pubertal adolescents, SPISE had a very good and good diagnostic performance, respectively, in predicting MetS. It was an accurate diagnostic tool for IR prediction in males, but not necessarily in females.
Collapse
|