Prevalence and Predictors of Insulin Resistance in Non-Obese Healthy Young Females in Qatar

Alterations in Choline Metabolism in Non-Obese Individuals with Insulin Resistance and Type 2 Diabetes Mellitus

The prevalence of non-obese individuals with insulin resistance (IR) and type 2 diabetes (T2D) is increasing worldwide. This study investigates the metabolic signature of phospholipid-associated metabolites in non-obese individuals with IR and T2D, aiming to identify potential biomarkers for these metabolic disorders. The study cohort included non-obese individuals from the Qatar Biobank categorized into three groups: insulin sensitive, insulin resistant, and patients with T2D. Each group comprised 236 participants, totaling 708 individuals. Metabolomic profiling was conducted using high-resolution mass spectrometry, and statistical analyses were performed to identify metabolites associated with the progression from IS to IR and T2D. The study observed significant alterations in specific phospholipid metabolites across the IS, IR, and T2D groups. Choline phosphate, glycerophosphoethanolamine, choline, glycerophosphorylcholine (GPC), and trimethylamine N-oxide showed significant changes correlated with disease progression. A distinct metabolic signature in non-obese individuals with IR and T2D was characterized by shifts in choline metabolism, including decreased levels of choline and trimethylamine N-oxide and increased levels of phosphatidylcholines, phosphatidylethanolamines, and their degradation products. These findings suggest that alterations in choline metabolism may play a critical role in the development of glucose intolerance and insulin resistance. Targeting choline metabolism could offer potential therapeutic strategies for treating T2D. Further research is needed to validate these biomarkers and understand their functional significance in the pathogenesis of IR and T2D in non-obese populations.

Triglyceride/high-density cholesterol ratio as a predictor of cardiometabolic risk in young population

Cardiovascular disease remains a leading cause of morbidity and mortality worldwide. Understanding and detecting risk factors are crucial for early diagnosis and prevention strategies. Obesity, dyslipidemia, hypertension, and insulin resistance, among others, have been described as modifiable risk factors. Among these, the triglycerides-to-HDL cholesterol (TG/HDL) ratio has been described as a marker of insulin resistance and a predictor of cardiovascular disease. Our objective was to investigate the association between the TG/HDL ratio and various cardiometabolic risk factors. A total of 239 young adults aged 18-24 years were recruited. We assessed anthropometric measurements, lipid profiles, glucose levels, insulin, the HOMA index, and the TG/HDL ratio. Participants were stratified based on their BMI and TG/HDL ratio. Our findings revealed that individuals with an elevated TG/HDL ratio had higher blood pressure, BMI, waist circumference, cholesterol, and triglyceride levels compared to those with a normal ratio. Specifically, the TG/HDL ratio was associated with an odds ratio (OR) of 9.3 for overweight, 27.5 for obesity, and 4.41 for abdominal obesity. Additionally, the HOMA index, which measures insulin resistance, was higher in those with an elevated TG/HDL ratio, with a prevalence of 45.6%. In conclusion, the TG/HDL ratio is a predictive marker of insulin resistance in young individuals and is associated with modifiable risk factors for cardiometabolic disease.

Predictability of Insulin Resistance Based on the Clinical Manifestations Among Male Medical Students of a Private College in Saudi Arabia

Background Numerous clinical signs and symptoms are thought to be associated with insulin resistance. The purpose of this study was to examine the prevalence of insulin resistance among male medical students attending a private Saudi Arabian institution, based on clinical indications. Methods A convenient non-probability sample consisting of 241 male medical students was used to conduct cross-sectional research. Each participant had an in-person interview as well as anthropometric measurements. The interview consisted of a questionnaire that was used to assess demographic data and clinical manifestations related to insulin resistance. Results The study demonstrated the connection between a few dermatological symptoms and waist circumference as an indicator of insulin resistance. In both the high and normal waist circumference groups, acne was the most common symptom. There was no correlation found between waist circumference and psoriasis, hidradenitis suppurativa, androgenic alopecia, alopecia areata, or vitiligo. Nevertheless, as an indicator of insulin resistance, waist circumference was statistically significantly correlated with both skin tags and acanthosis nigricans. Most students had excessive day sleep, foggy brains, struggled with planning and solving problems, and had a memory that became worse in the past few years. In addition, many students feel hungry even after eating some sweets and usually have extreme thirst. Conclusion Among medical students, skin tags, acanthosis nigricans, and acne were the most prevalent dermatological manifestations. Clinicians need to be aware that skin conditions, sleep difficulties throughout the day, changes in cognition, and food cravings might all be indicators of internal changes and/or illnesses such as diabetes and prediabetes.

Molecular regulators of exercise-mediated insulin sensitivity in non-obese individuals

Insulin resistance is a significant contributor to the development of type 2 diabetes (T2D) and is associated with obesity, physical inactivity, and low maximal oxygen uptake. While intense and prolonged exercise may have negative effects, physical activity can have a positive influence on cellular metabolism and the immune system. Moderate exercise has been shown to reduce oxidative stress and improve antioxidant status, whereas intense exercise can increase oxidative stress in the short term. The impact of exercise on pro-inflammatory cytokine production is complex and varies depending on intensity and duration. Exercise can also counteract the harmful effects of ageing and inflamm-ageing. This review aims to examine the molecular pathways altered by exercise in non-obese individuals at higher risk of developing T2D, including glucose utilization, lipid metabolism, mitochondrial function, inflammation and oxidative stress, with the potential to improve insulin sensitivity. The focus is on understanding the potential benefits of exercise for improving insulin sensitivity and providing insights for future targeted interventions before onset of disease.

Prevalence of Contributing Factors Leading to the Development of Insulin Resistance Among Male Medical Students at a Private College in Saudi Arabia

Background Insulin resistance can result from various genetic and lifestyle factors. Initially, symptoms of insulin resistance may not be readily noticeable, but as the condition progresses, individuals may start experiencing symptoms. This study aimed to investigate the factors contributing to the development of insulin resistance among medical students at a private college in Saudi Arabia. Methodology We conducted a cross-sectional study using a convenient non-probability sampling technique, with a sample size of 241 participants. We employed validated questionnaires to gather information on physical activity, sleep, dietary habits, and stress. Specifically, we used the International Physical Activity Questionnaire (IPAQ)-Short Form for assessing physical activity, the Single-Item Sleep Quality Scale (SQS) for evaluating sleep quality, the Healthy Eating Quiz (HEQ) to gauge dietary patterns, and the stress questionnaire designed by the International Stress Management Association (ISMA) to measure stress levels. Additionally, we collected anthropometric measurements, as well as systolic and diastolic blood pressure readings. We calculated prevalence using percentages and employed the chi-square test to analyze variables, with a significance level set at p-values <0.05. Results This study investigated risk factors associated with lifestyle, focusing on waist circumference as an indicator of insulin resistance. Our findings revealed that a majority of individuals with high waist circumference were physically inactive and more susceptible to stress, and this difference was statistically significant when compared to those with normal waist circumference. Additionally, we observed that sleep deprivation and poor nutrition were more prevalent among individuals with high waist circumference, although these differences were not statistically significant. Conclusions This study highlights a high prevalence of elevated waist circumference, indicating insulin resistance, among medical students. Furthermore, it underscores the significant presence of well-known risk factors associated with insulin resistance within this population of medical students.

Periodontitis is associated with insulin resistance in adults living with diabetes mellitus in Uganda: a cross- sectional study

INTRODUCTION

Evidence suggests that majority of patients with diabetes mellitus in Uganda have poor glycaemic control as well as periodontal disease. This study set out to determine the association between periodontitis and insulin resistance in adult patients with diabetes mellitus in Uganda using the triglyceride glucose index.

METHODS

Two hundred and twenty-three adult study participants with confirmed diabetes mellitus were enrolled in a cross-sectional study. Oral examination was carried with the aid of a periodontal probe to determine the periodontal status and findings recorded using the WHO Oral Health Assessment Tool for Adults, 2013. We recorded clinical details for body mass index (BMI in kg/m2) and laboratory parameters including fasting blood sugar (mmol/L), glycated hemoglobin levels (HbA1c, %) and serum triglycerides (mmol/L) using a study questionnaire. Data were analyzed using R version 4.10. The glucose triglyceride index was used as a measure of insulin resistance. Logistic regression analysis carried out to determine the factors associated insulin resistance.

RESULTS

The majority of the study participants was female (70%) with an average age of 48.5 years (SD+/- 11.1). The mean body mass index was 29.6 kg/m2 (SD+/- 5.82). The mean serum triglyceride index was 9.48 (SD+/- 0.675). Eighty-six-point 1% of the participants had periodontal disease. Bivariate analysis revealed high odds for male sex (OR = 1.31, 95% C.I = 0.44-4.84, p = 0.65) and periodontitis (OR = 3.65, 95% C.I = 0.79-26.15, p = 0.13) but low odds for a high BMI (OR = 0.45. 95% C.I = 0.07-1.67, p = 0.30). Multivariate regression revealed a significant association between insulin resistance and periodontitis. (AOR = 3.52, 95% C.I = 1.19-1.83, p = 0.03).

CONCLUSION

Insulin resistance is highly prevalent in patients with diabetes mellitus in Uganda and is associated with periodontitis and low body weight.

Anthropometric Indices With Insulin Resistance in Obese Patients: A Literature Review

The hormone insulin is responsible for regulating the metabolism of proteins, carbs, and lipids by promoting the absorption of molecules such as glucose from the bloodstream into fat, the liver, and skeletal muscle cells. Insulin resistance (IR) is considered to be a physiological response to obesity that inhibits fat from accumulating and supports weight stabilization. People with IR gain less weight than those with insulin sensitivity, and therefore IR individuals have a three-fold increased likelihood of losing more weight when compared with insulin-sensitive individuals. A person's health is jeopardized by obesity, which is defined as excessive or unusual storage of fat in adipose tissue. Early identification using different anthropometric measuring parameters and proper and suitable therapy is essential as the incidence of obesity cases is increasing as a result of sedentary lifestyles, bad eating habits, a lack of physical exercise, and a lack of knowledge among young adults. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, following which based on inclusion and exclusion criteria, eight articles were considered for the review. The analysis showed that all the parameters are easily accessible and hence can be used in daily practices. Due to being readily available, body mass index (BMI) and waist circumference (WC) constituted the most often employed anthropometric measures in everyday practices. In addition, variances in the values of the variables were seen due to differences in gender.

Predictability of the Development of Insulin Resistance Based on the Risk Factors Among Female Medical Students at a Private College in Saudi Arabia

BACKGROUND

Insulin resistance (IR) is currently an underlying phenomenon in the etiology of most non-communicable diseases. IR has been proposed as the key linking factor for the metabolic syndrome disease cluster of glucose intolerance.

OBJECTIVES

This study's target was to assess the predictability of risk factors for IR among female medical students Methods: A cross-sectional study involving female medical students was carried out. The sample size was 272, and a suitable non-probability sampling method was employed. A correlation test was done, and a P value less than 0.05 is considered statistically significant. Each participant underwent assessment of anthropometric measurements and biochemical testing. For assessing lifestyle, validated questionnaires on physical activity, sleep pattern, dietary pattern, and stress were adopted. The anthropometric data such as height, weight, and waist circumference were collected. Biochemical testing involved estimation of the postprandial capillary blood glucose level on campus. Additionally, systolic blood pressure and diastolic blood pressure were measured.

RESULTS

The association of lifestyle risk factors with waist circumference as an indicator of IR was done where the majority of those with high waist circumference were physically inactive and more prone to stress which was statistically significant when compared to those with normal waist circumference. However, poor sleep and unhealthy diet were high among those with high waist circumference, but they were not statistically significant.

CONCLUSION

The correlation of waist circumference as an indicator of IR was highly significant with body mass index, postprandial blood sugar, systolic blood pressure, and diastolic blood pressure. A series of unhealthy lifestyle habits was contributable to developing obesity and therefore IR among medical students in Saudi Arabia.

Triglyceride/high-density lipoprotein ratio as a predictor for insulin resistance in a sample of healthy Iraqi adults

Insulin resistance (IR) is a common pathophysiological condition associated with many metabolic diseases, including obesity, prediabetes, type 2 diabetes mellitus (T2DM), and cardiovascular disease. The widely used homeostasis model assessment for IR (HOMA-IR) is usually used to estimate IR. However, this model cannot be used for screening IR due to several logistic difficulties, such as costs and insulin instability, which are essential for measurement. Thus, finding feasible alternatives is of paramount importance. This study aimed to evaluate the value of triglyceride/high-density lipoprotein-cholesterol (TG/HDL-c) ratio in predicting IR in healthy adult individuals. The study involved 83 euglycemic non-diabetic adults (≥45 years old). Lipid profile, fasting insulin, fasting blood sugar (FBS), and glycated hemoglobin were measured for all participants. The TG/HDL-c ratio was calculated by dividing TG by HDL. Insulin resistance was calculated using the HOMA-IR formula. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the TG/HDL-c ratio. The prevalence of IR among healthy adult Iraqis was 28.92%. Subjects in the IR group showed a higher TG/HDL ratio than the insulin-sensitive group (3.69±0.68 versus 2.71±1.0) with a significant difference. The area under the curve (AUC) for this ratio was 0.849, 95% CI= 0.763-0.935, p<0.002. The sensitivity and specificity of the test were 83% and 81%, respectively, at a best cut-off value of 3.1 (TG/HDL ratio). The prevalence of IR among healthy adult Iraqis was 28.92%. Triglyceride/HDL-c ratio had a very good predictive value for IR.

Age-Related Sex Differences in Glucose Tolerance by 75 g Oral Glucose Tolerance Test in Japanese

To elucidate the age-related sex difference in glucose tolerance, we conducted 75 g oral glucose tolerance tests in 1156 participants. Participants were divided into four groups, namely, young (22−29) males, young females, middle-aged (>50) males, and middle-aged females. According to the Japanese Clinical Practice Guideline for Diabetes 2019, the prevalence of normal glucose tolerance (NGT) was significantly lower in middle-aged than in young participants. The prevalence of high-normal fasting plasma glucose (FPG) was higher, and NGT was lower in young males (high-normal FPG 15.2%, NGT 82.0%) than young females (high-FPG 3.9%, NGT 94.3%). Combined glucose intolerance (CGI) was higher and NGT was lower in middle-aged males (CGI 10.2%, NGT 25.2%) than in middle-aged females (CGI 3.3%, NGT 39.8%). FPG and body mass index (BMI) were the lowest and Homeostatic model assessment beta cell function (HOMA-β) was the highest in young females, followed by young males, middle-aged females, and middle-aged males. Multiple linear regression analysis revealed that BMI weakly correlated with HOMA-β and Matsuda index in all subjects except young females. The superior glucose tolerance in females was apparent in young, but attenuated in middle-aged females. The differences are due to the higher insulin secretion potential and lower BMI in young females.

Comparing the Metabolic Profiles Associated with Fitness Status between Insulin-Sensitive and Insulin-Resistant Non-Obese Individuals

(1) Background: Young non-obese insulin-resistant (IR) individuals could be at risk of developing metabolic diseases including type 2 diabetes mellitus. The protective effect of physical activity in this apparently healthy group is expected but not well characterized. In this study, clinically relevant metabolic profiles were determined and compared among active and sedentary insulin-sensitive (IS) and IR young non-obese individuals. (2) Methods: Data obtained from Qatar Biobank for 2110 young (20-30 years old) non-obese (BMI ≤ 30) healthy participants were divided into four groups, insulin-sensitive active (ISA, 30.7%), insulin-sensitive sedentary (ISS, 21.4%), insulin-resistant active (IRA, 20%), and insulin-resistant sedentary (IRS, 23.3%), using the homeostatic model assessment of insulin resistance (HOMA-IR) and physical activity questionnaires. The effect of physical activity on 66 clinically relevant biochemical tests was compared among the four groups using linear models. (3) Results: Overall, non-obese IR participants had significantly (p ≤ 0.001) worse vital signs, blood sugar profiles, inflammatory markers, liver function, lipid profiles, and vitamin D levels than their IS counterparts. Physical activity was positively associated with left handgrip (p ≤ 0.01) and levels of creatine kinase (p ≤ 0.001) and creatine kinase-2 (p ≤ 0.001) in both IS and IR subjects. Furthermore, physical activity was positively associated with levels of creatinine (p ≤ 0.01) and total vitamin D (p = 0.006) in the IR group and AST (p = 0.001), folate (p = 0.001), and hematocrit (p = 0.007) in the IS group. Conversely, physical inactivity was negatively associated with the white blood cell count (p = 0.001) and an absolute number of lymphocytes (p = 0.003) in the IR subjects and with triglycerides (p = 0.005) and GGT-2 (p ≤ 0.001) in the IS counterparts. (4) Conclusions: An independent effect of moderate physical activity was observed in non-obese apparently healthy individuals a with different HOMA-IR index. The effect was marked by an improved health profile including higher vitamin D and lower inflammatory markers in IRA compared to IRS, and a higher oxygen carrying capacity and lipid profile in ISA compared to the ISS counterparts.

Insulin resistance and related factors in patients with moderate and severe traumatic brain injury

BACKGROUND

Traumatic brain injury (TBI) is associated with atherosclerosis and cardiovascular mortality. However, the causal relationship between TBI and atherosclerosis is unclear.

AIMS

This study aimed to evaluate insulin resistance in patients with TBI and its relationship with clinical and demographic characteristics of the patients.

METHODS

The case-controlled study included 60 patients with moderate and severe TBI in the chronic phase and 60 healthy controls matched for sex, age, and body mass index (BMI). Demographic characteristics, serum insulin, and fasting blood glucose levels of both groups were assessed. Insulin resistance was determined by the Homeostasis Model Assessment insulin resistance. The clinical features of the TBI group were also recorded.

RESULTS

Insulin resistance was observed to be higher in the TBI group than in the control group (46.7% vs. 18.33%, P = 0.002). However, no significant difference was determined between TBI patients with and without insulin resistance in terms of all demographic and clinical parameters examined (all P > 0.05). Age, sex, BMI, and trauma severity were not significant predictors of insulin resistance in TBI patients.

CONCLUSION

Moderate-to-severe TBI patients have more prevalent insulin resistance than healthy controls. Evaluation of insulin resistance in these patients, who currently have limited participation in life activities and healthy lifestyles, may be useful to prevent cardiovascular diseases caused by insulin resistance.

Metabolomics of Lean/Overweight Insulin-Resistant Females Reveals Alterations in Steroids and Fatty Acids

BACKGROUND

The global diabetes epidemic is largely attributed to obesity-triggered metabolic syndrome. However, the impact of insulin resistance (IR) prior to obesity on the high prevalence of diabetes and the molecular mediators remain largely unknown. This study aims to compare the metabolic profiling of apparently healthy lean/overweight participants with IR and insulin sensitivity (IS), and identify the metabolic pathways underlying IR.

METHODS

In this cross-sectional study, clinical and metabolic data for 200 seemingly healthy young female participants (100 IR and 100 IS) was collected from Qatar Biobank. Orthogonal partial least square analysis was performed to assess the extent of separation between individuals from the 2 groups based on measured metabolites. Classical linear models were used to identify the metabolic signature of IR, followed by elastic-net-regularized generalized linear model (GLMNET) and receiver operating characteristic (ROC) analysis to determine top metabolites associated with IR.

RESULTS

Compared to lean/overweight participants with IS, those with IR showed increased androgenic steroids, including androsterone glucuronide, in addition to various microbiota byproducts, such as the phenylalanine derivative carboxyethylphenylalanine. On the other hand, participants with IS had elevated levels of long-chain fatty acids. A ROC analysis suggested better discriminatory performance using 20 metabolites selected by GLMNET in comparison to the classical clinical traits (area under curve: 0.93 vs 0.73, respectively).

CONCLUSION

Our data confirm the multifactorial mechanism of IR with a diverse spectrum of emerging potential biomarkers, including steroids, long-chain fatty acids, and microbiota metabolites. Further studies are warranted to validate these markers for diagnostic and therapeutic applications.