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Ermetici F, Briganti S, Delnevo A, Cannaò P, Leo GD, Benedini S, Terruzzi I, Sardanelli F, Luzi L. Bone marrow fat contributes to insulin sensitivity and adiponectin secretion in premenopausal women. Endocrine 2018. [PMID: 28624865 DOI: 10.1007/s12020-017-1349-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE Bone marrow fat is a functionally distinct adipose tissue that may contribute to systemic metabolism. This study aimed at evaluating a possible association between bone marrow fat and insulin sensitivity indices. METHODS Fifty obese (n = 23) and non-obese (n = 27) premenopausal women underwent proton magnetic resonance spectroscopy to measure vertebral bone marrow fat content and unsaturation index at L4 level. Abdominal visceral, subcutaneous fat, and epicardial fat were also measured using magnetic resonance imaging. Bone mineral density was measured by dual-energy X-ray absorptiometry. Body composition was assessed by bioelectrical impedance analysis. Fasting serum glucose, insulin, lipids, adiponectin were measured; the insulin resistance index HOMA (HOMA-IR) was calculated. RESULTS Bone marrow fat content and unsaturation index were similar in obese and non-obese women (38.5 ± 0.1 vs. 38.6 ± 0.1%, p = 0.994; 0.162 ± 0.065 vs. 0.175 ± 0.048, p = 0.473, respectively). Bone marrow fat content negatively correlated with insulin and HOMA-IR (r = -0.342, r = -0.352, respectively, p = 0.01) and positively with high density lipoprotein cholesterol (r = 0.270, p = 0.043). From a multivariate regression model including lnHOMA-IR as a dependent variable and visceral, subcutaneous, epicardial fat, and bone marrow fat as independent variables, lnHOMA-IR was significantly associated with bone marrow fat (β = -0.008 ± 0.004, p = 0.04) and subcutaneous fat (β = 0.003 ± 0.001, p = 0.04). Bone marrow fat, among the other adipose depots, was a significant predictor of circulating adiponectin (β = 0.147 ± 0.060, p = 0.021). Bone marrow fat unsaturation index negatively correlated with visceral fat (r = -0.316, p = 0.026). CONCLUSIONS There is a relationship between bone marrow fat content and insulin sensitivity in obese and non-obese premenopausal women, possibly mediated by adiponectin secretion. Visceral fat does not seem to regulate bone marrow fat content while it may affect bone marrow fat composition.
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Affiliation(s)
- Federica Ermetici
- Endocrinology and Metabolism, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
| | - Silvia Briganti
- Endocrinology and Metabolism, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Alessandra Delnevo
- Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Paola Cannaò
- Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Giovanni Di Leo
- Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Stefano Benedini
- Endocrinology and Metabolism, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | - Ileana Terruzzi
- Diabetes Research Institute, Metabolism, Nutrigenomics and Cellular Differentiation Unit, San Raffaele Scientific Institute, Milano, Italy
| | - Francesco Sardanelli
- Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | - Livio Luzi
- Endocrinology and Metabolism, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
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Dock-Nascimento DB, Aguilar-Nascimento JED, Linetzky Waitzberg D. Ingestion of glutamine and maltodextrin two hours preoperatively improves insulin sensitivity after surgery: a randomized, double blind, controlled trial. Rev Col Bras Cir 2014; 39:449-55. [PMID: 23348639 DOI: 10.1590/s0100-69912012000600002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 07/18/2012] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To investigate whether the abbreviation of preoperative fasting with a drink containing glutamine and dextrinomaltose improves organic response to surgical trauma. METHODS Thirty-six female patients adult (18-62 years) candidates for elective laparoscopic cholecystectomy were randomly divided into three groups: conventional fasting (fasting group), and two groups receiving two different diets, eight hours (400ml) and two hours before induction of anesthesia (200ml): carbohydrate (CHO) group (12.5% dextrinomaltose) and the glutamine (GLN) group (12.5% dextrinomaltose and 40 and 10g of glutamine, respectively). Blood samples were collected pre and postoperatively. RESULTS Twenty-eight patients completed the study. No pulmonary complication occurred. Gastric residual volume was similar between groups (p = 0.95). Postoperatively, all patients from the fasting group had abnormal glucose (> 110mg/dl), this abnormality being of 50% when compared to the CHO group (p = 0.14), and of 22.2% when compared to the GLN group (p = 0.01). All patients who had the fasting period shortened (CHO + GLN) had normal postoperative insulin, contrasting with 66.7% in the fasted group (p = 0.02). The abnormal sensitivity to insulin postoperatively rose from 32.1% to 46.4% of cases (p = 0.24), and it occurred in only 11.1% of patients in GLN group when compared to 55.5% in the fasting group (p = 0.02). CONCLUSION the abbreviation of preoperative fasting for two hours with dextrinomaltose and glutamine improves insulin sensitivity in patients undergoing elective laparoscopic cholecystectomy.
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Maahs DM, Nadeau K, Snell-Bergeon JK, Schauer I, Bergman B, West NA, Rewers M, Daniels SR, Ogden LG, Hamman RF, Dabelea D. Association of insulin sensitivity to lipids across the lifespan in people with Type 1 diabetes. Diabet Med 2011; 28:148-55. [PMID: 21219421 PMCID: PMC3395467 DOI: 10.1111/j.1464-5491.2010.03143.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS Insulin resistance and dyslipidaemia both increase cardiovascular risk in Type 1 diabetes. However, little data exist on the associations of insulin resistance to lipids in Type 1 diabetes. Our objective was to explore the associations between insulin resistance (assessed by glucose infusion rate) and lipids in people with Type 1 diabetes and determine whether adiposity and/or average glycaemia influence these associations. METHODS Hyperinsulinaemic-euglycaemic clamp studies were performed in 60 subjects with Type 1 diabetes aged 12-19 years (age 15±2 years, 57% female, duration of diabetes 6.3±3.8 years, HbA(1c) 8.6±1.5%, IFCC=70 mmol/mol) and 40 subjects with Type 1 diabetes aged 27-61 years (age 45±9 years, 53% female, duration of diabetes 23±8 years, HbA(1c) 7.5±0.9%, IFCC=58 mmol/mol). Multiple linear regression models were fit to examine the association between glucose infusion rate and fasting lipid levels with adjustment for possible confounders. RESULTS Lower glucose infusion rate was significantly associated with lower levels of HDL cholesterol in youths with Type 1 diabetes and with higher levels of triglycerides and higher triglyceride/HDL ratio in both youths and adults. The magnitude of the associations between glucose infusion rate and lipid levels translate into interquartile differences of 0.098 mmol/l for HDL cholesterol, 0.17 mmol/l for triglycerides and 1.06 for triglycerides/HDL in the adolescents and 0.20 mmol/l for triglycerides and 1.01 for triglycerides/HDL in the adults. The associations were attenuated and no longer statistically significant by adjustment for adiposity among adults, while adjustment for HbA(1c) had a small effect in youths and adults. CONCLUSIONS Lower insulin sensitivity is associated with a more atherogenic lipid profile in both youths and adults with Type 1 diabetes.
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Affiliation(s)
- D M Maahs
- Barbara Davis Center for Childhood Diabetes, University of Colorado, Denver, CO, USA
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Stadler M, Anderwald C, Pacini G, Zbýň Š, Promintzer-Schifferl M, Mandl M, Bischof M, Gruber S, Nowotny P, Luger A, Prager R, Krebs M. Chronic peripheral hyperinsulinemia in type 1 diabetic patients after successful combined pancreas-kidney transplantation does not affect ectopic lipid accumulation in skeletal muscle and liver. Diabetes 2010; 59:215-8. [PMID: 19833878 PMCID: PMC2797924 DOI: 10.2337/db09-0354] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE So far it is unclear whether chronic peripheral hyperinsulinemia per se might contribute to ectopic lipid accumulation and consequently insulin resistance. We investigated the effects of systemic instead of portal insulin release in type 1 diabetic patients after successful pancreas-kidney transplantation (PKT) with systemic venous drainage on the intracellular lipid content in liver and soleus muscle, endogenous glucose production (EGP), and insulin sensitivity. RESEARCH DESIGN AND METHODS In nine PKT patients and nine matching nondiabetic control subjects, intrahepatocellular lipids (IHCLs) and intramyocellular lipids (IMCLs) were measured using (1)H nuclear magnetic resonance spectroscopy. Fasting EGP was measured using d-[6,6-(2)H(2)]glucose tracer dilution. A 3-h 75-g oral glucose tolerance test (OGTT) allowed us to assess kinetics of glucose, free fatty acids, insulin, and C-peptide concentrations in plasma and to calculate the clamp-like index (CLIX) for insulin sensitivity and the hepatic insulin resistance (HIR) index. RESULTS The PKT patients displayed approximately twofold increased fasting insulin (20 +/- 6 vs. 9 +/- 3 microU/ml; P < 0.0002) compared with that in nondiabetic control subjects and approximately 10% increased fasting glucose (P < 0.02) concentrations, but during the OGTT areas under the concentration curves of C-peptide and insulin were similar. IHCL (PKT, 2.9 +/- 2.5%; nondiabetic control subjects, 4.4 +/- 6.6%), IMCL (PKT, 1.0 +/- 0.4%; nondiabetic control subjects, 1.0 +/- 0.5%), CLIX (PKT, 8 +/- 2; nondiabetic control subjects, 7 +/- 3), HIR (PKT, 25.6 +/- 13.2; nondiabetic control subjects, 35.6 +/- 20 [mg * min(-1) * kg(-1)] x [microU/ml]), and EGP (PKT, 1.6 +/- 0.2; nondiabetic control subjects, 1.7 +/- 0.2 mg * min(-1) * kg(-1)) were comparable between PKT patients and nondiabetic control subjects. IHCL was negatively correlated with CLIX in all participants (r = -0.55; P < 0.04). CONCLUSIONS Despite fasting peripheral hyperinsulinemia because of systemic venous drainage, type 1 diabetic patients after PKT show similar IHCL, IMCL, insulin sensitivity, and fasting EGP in comparison with nondiabetic control subjects. These results suggest that systemic hyperinsulinemia per se does not cause ectopic lipid accumulation in liver and skeletal muscle.
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Affiliation(s)
- Marietta Stadler
- Hietzing Hospital, 3rd Medical Department of Metabolic Diseases and Nephrology, Vienna, Austria
- Karl Landsteiner Institute of Metabolic Diseases and Nephrology, Vienna, Austria
| | - Christian Anderwald
- Medical University of Vienna, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Vienna, Austria
- Corresponding author: Christian Anderwald,
| | - Giovanni Pacini
- Metabolic Unit, Institute of Biomedical Engineering, National Research Council, Padova, Italy
| | - Štefan Zbýň
- Medical University of Vienna, Department of Radiology, MR Center–High Field MR, Vienna, Austria
| | - Miriam Promintzer-Schifferl
- Medical University of Vienna, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Vienna, Austria
| | - Martina Mandl
- Medical University of Vienna, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Vienna, Austria
| | - Martin Bischof
- Medical University of Vienna, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Vienna, Austria
| | - Stephan Gruber
- Medical University of Vienna, Department of Radiology, MR Center–High Field MR, Vienna, Austria
| | - Peter Nowotny
- Medical University of Vienna, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Vienna, Austria
| | - Anton Luger
- Medical University of Vienna, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Vienna, Austria
| | - Rudolf Prager
- Hietzing Hospital, 3rd Medical Department of Metabolic Diseases and Nephrology, Vienna, Austria
- Karl Landsteiner Institute of Metabolic Diseases and Nephrology, Vienna, Austria
| | - Michael Krebs
- Medical University of Vienna, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Vienna, Austria
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Ijzerman RG, Stehouwer CDA, Serné EH, Voordouw JJ, Smulders YM, Delemarre-van de Waal HA, van Weissenbruch MM. Incorporation of the fasting free fatty acid concentration into quantitative insulin sensitivity check index improves its association with insulin sensitivity in adults, but not in children. Eur J Endocrinol 2009; 160:59-64. [PMID: 18835976 DOI: 10.1530/eje-08-0699] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Based on fasting insulin and glucose, several indices of insulin sensitivity have been developed in adults. Recently, it has been demonstrated that incorporation of the fasting free fatty acid (FFA) concentration improves the association with insulin sensitivity in adults. We investigated the association of clamp-derived insulin sensitivity with indices of insulin sensitivity derived from fasting blood in prepubertal children and adults, with and without incorporation of FFAs. DESIGN AND METHODS We studied 59 healthy adults and 29 of them are prepubertal children. We measured insulin sensitivity with the euglycemic-hyperinsulinemic clamp. Based on fasting insulin and glucose, we estimated insulin sensitivity with the homeostasis model assessment (HOMA), the quantitative insulin sensitivity check index (QUICKI), and the revised QUICKI after the incorporation of FFAs. RESULTS The associations of HOMA and QUICKI with clamp-derived insulin sensitivity in children (r=-0.55 and 0.54 respectively; P<0.01) were similar to those in adults (r=-0.54 and 0.53 respectively; P<0.01). However, incorporation of FFAs into the QUICKI model resulted in an increase in the association in adults, but not in children (r=0.68 and 0.48 respectively; P<0.01). Adding FFA levels to a regression model with glucose and insulin as independent variables resulted in an increase in the explained variance in clamp-derived insulin sensitivity in adults, but not in children (P value 0.004 in adults and 0.3 in children). CONCLUSIONS HOMA and QUICKI are associated with clamp-derived insulin sensitivity in both children and adults. Incorporating fasting levels of FFAs into the QUICKI model improves the association with clamp-derived insulin sensitivity in adults, but not in children.
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Affiliation(s)
- Richard G Ijzerman
- Department of Internal Medicine, Institute for Cardiovascular Research-Vrije Universiteit, VU University Medical Center, Amsterdam, The Netherlands.
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Mohler ML, He Y, Wu Z, Hwang DJ, Miller DD. Recent and emerging anti-diabetes targets. Med Res Rev 2009; 29:125-95. [DOI: 10.1002/med.20142] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Abstract
Simultaneous pancreas-kidney (SPK) transplantation is a promising treatment option for patients with type 1 diabetes and end-stage renal disease. Most of these patients can achieve normalization of glucose and hemoglobin A(1c) levels. Patient and graft survival continues to improve; however, defects in beta-cell function and insulin resistance can be seen over time after transplant. Various methods can be used to assess the SPK recipient for the development of hyperglycemia and graft dysfunction, with treatment aimed at minimizing diabetogenic immunosuppression, using agents that may preserve beta-cell function, and improving insulin resistance.
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Affiliation(s)
- Elizabeth Diakoff
- The Ohio State University, Division of Endocrinology, Diabetes, and Metabolism, 1581 Dodd Drive, 491C McCampbell Hall, Columbus, OH 43210, USA.
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Fiorina P, Vergani A, Petrelli A, D'Addio F, Monti L, Abdi R, Bosi E, Maffi P, Secchi A. Metabolic and immunological features of the failing islet-transplanted patient. Diabetes Care 2008; 31:436-8. [PMID: 18071001 DOI: 10.2337/dc07-1831] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This retrospective study was designed to identify metabolic and immune predictors of early islet allograft failure. RESEARCH DESIGN AND METHODS We measured several metabolic and immunological markers at the time of pretransplant and several time points posttransplantation in 17 patients with long-term functioning graft (long fx) and 20 patients with short-term functioning graft (short fx). RESULTS The short fx group showed higher insulin resistance, altered proinsulin processing, lower soluble interleukin-2 receptor (sIL-2r) (marker of T-cell activation), and higher soluble FasL (marker of apoptosis) during the entire follow-up, particularly at time of failure. CONCLUSIONS Patients who experienced an early failure of islet allograft showed specific metabolic and immunological signs long before islet failure.
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Affiliation(s)
- Paolo Fiorina
- Department of Medicine, San Raffaele Scientific Institute, Milan, Italy
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Petruzzo P, Badet L, Lefrançois N, Berthillot C, Dorel SB, Martin X, Laville M. Metabolic consequences of pancreatic systemic or portal venous drainage in simultaneous pancreas-kidney transplant recipients. Diabet Med 2006; 23:654-9. [PMID: 16759308 DOI: 10.1111/j.1464-5491.2006.01891.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIMS The aim was to investigate pancreatic B-cell function and insulin sensitivity in simultaneous pancreas-kidney (SPK) recipients with systemic or portal venous drained pancreas allograft using simple and easy tests. METHODS The study included 44 patients with Type 1 diabetes and end-stage renal disease who had undergone SPK transplantation: 20 recipients received a pancreas allograft with systemic venous drainage (S-SPK) and 24 with portal venous drainage (P-SPK). We studied only recipients with functioning grafts, with normal serum glucose, HbA(1c) and serum creatinine values, on a stable drug regimen. The subjects were studied at 6, 12, 24, 36, 48 and 60 months after transplantation. Insulin sensitivity and B-cell function indices were derived from blood samples and oral glucose tolerance tests. RESULTS All patients from both groups had normal fasting glucose, body mass index and HbA(1c) values by selection. The homeostatic model (HOMA) beta-cell index was significantly lower in P-SPK recipients at several points of the follow-up. HOMA-IR was significantly higher in S-SPK recipients at 6 and 24 months after transplantation and was positively correlated with fasting insulin values, but never exceeded 3.2. There was no significant difference in QUICKI index values between the two groups. Although all patients from both groups always had normal glucose tolerance, the area under the insulin curve was higher in the S-SPK group. Cholesterol, low-density lipoprotein-cholesterol and triglycerides were higher in the P-SPK group. CONCLUSIONS The results suggest sustained long-term endocrine function in both groups and show that portal venous drainage does not offer major metabolic advantages.
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Affiliation(s)
- P Petruzzo
- Department of Surgery, University of Cagliari, Cagliari, Italy.
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Havrdova T, Saudek F, Boucek P, Adamec M, Koznarova R, Jedinakova T, Karasova L, Skibova J. Metabolic effect of sirolimus versus mycophenolate mofetil on pancreatic graft function in the early posttransplant period. Transplant Proc 2006; 37:3544-5. [PMID: 16298655 DOI: 10.1016/j.transproceed.2005.09.056] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Metabolic effects of immunosuppressive agents are of great importance in pancreas or islet transplantation. The aim of our study was to compare effects of tacrolimus-based immunosuppression in conjunction with sirolimus (RAPA) versus mycophenolate mofetil (MMF) on glucose metabolism in type 1 diabetic recipients following a simultaneous pancreas and kidney transplantation (SPK). We examined 30 insulin-independent patients after SPK with venous systemic drainage of the pancreatic graft. All recipients had good kidney graft function. Fasting glycemia, insulin levels, glycosylated hemoglobin (HbA(lc)), standard intravenous glucose tolerance test (IVGTT), and trough RAPA levels were assessed in pancreas recipients before elective steroid withdrawal. Insulin sensitivity was evaluated using the homeostasis model assessment (HOMA-IR). The groups did not differ in age, BMI, posttransplant period, steroid daily dose, HbA(lc), and fasting glycemia. We did not find any significant difference in the IVGTT response. Area under the curve of insulin levels during IVGTT and HOMA-IR were significantly lower in the RAPA group. Trough levels of RAPA had no significant impact on any of the examined parameters. Glucose tolerance measured with the use of IVGTT was similar in patients treated with RAPA and MMF. However, recipients on sirolimus treatment had significantly lower insulinemia during the test and consequently more favorable indices of insulin action as assessed by HOMA-IR.
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Affiliation(s)
- T Havrdova
- Diabetes Center, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140-21 Prague 4, Czech Republic.
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Perseghin G, Caumo A, Mazzaferro V, Pulvirenti A, Piceni Sereni L, Romito R, Lattuada G, Coppa J, Costantino F, Regalia E, Luzi L. Assessment of insulin sensitivity based on a fasting blood sample in men with liver cirrhosis before and after liver transplantation. Transplantation 2003; 76:697-702. [PMID: 12973112 DOI: 10.1097/01.tp.0000079252.94857.8d] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Insulin resistance is a key factor in the pathogenesis of hepatogenous diabetes and influences the prognosis of chronic liver diseases. In vivo assessment of insulin resistance in humans is expensive; therefore, surrogate indices based on a fasting plasma glucose and insulin concentrations (HOMA-IS, QUICKI) were proposed. This study aimed to test whether these simple indices are reliable measures of insulin sensitivity in patients with liver cirrhosis before and after liver transplantation (LTx). METHODS HOMA-IS and QUICKI were compared with insulin sensitivity as assessed with the gold standard technique (insulin clamp) in 20 patients with liver cirrhosis, in 36 patients after LTx, and in 25 matched healthy subjects (predominantly men). To test whether these indices may be applied also in prospective studies, 10 patients with liver cirrhosis were studied longitudinally before and 2 years after LTx. RESULTS Both HOMA-IS and QUICKI were associated with insulin sensitivity in patients with liver cirrhosis (r=0.63, P=0.005 and r=0.60, P=0.009) and in LTx patients (r=0.41, P=0.02 and r=0.46, P=0.05). Both were able to detect the improvement of insulin sensitivity after LTx in the patients studied prospectively. CONCLUSIONS HOMA-IS and QUICKI are simple reliable tools to assess insulin sensitivity in clinical and epidemiologic investigations of chronic liver disease before and after LTx.
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Affiliation(s)
- Gianluca Perseghin
- Nutrition/Metabolism, Istituto Scientifico H San Raffaele, Milan, Italy.
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