Correlation Of Insulin Resistance Research Articles

Correlation of Insulin Resistance and Anti-müllerian Hormone in Women with Polycystic Ovarian Syndrome

Correlation of Insulin Resistance and Anti-müllerian Hormone in Women with Polycystic Ovarian Syndrome

Maternal Tryptophan Catabolites and Insulin Resistance Parameters in Preeclampsia.

Preeclampsia (PE) is a pregnancy-related disorder characterized by high blood pressure and proteinuria in the third trimester. The disease is associated with many metabolic and biochemical changes. There is a need for new biomarkers for diagnosis and follow-up. The present study examined the diagnostic ability of tryptophan catabolites (TRYCATs) and insulin resistance (IR) parameters in women with PE. This case-control study recruited sixty women with preeclampsia and 60 healthy pregnant women as a control group. Serum levels of TRYCATs (tryptophan, kynurenic acid, kynurenine, and 3-hydroxykynurenine) and IR parameters (insulin and glucose) were measured by ELISA and spectrophotometric methods. The results showed that PE women have a significantly lower tryptophan level than healthy pregnant women. However, there was a significant increase in kynurenic acid, kynurenic acid/kynurenine, kynurenine/tryptophan, and 3-hydroxykynurenine levels. PE women also have a state of IR. The correlation study indicated various correlations of IR and TRYCATs with clinical data and between each other, reflecting the role of these parameters in the pathophysiology of PE. The ROC study showed that the presence of IR state, reduced tryptophan, and increased 3-HK predicted PE disease in a suspected woman with moderate sensitivities and specificities. In conclusion, the pathophysiology of PE involves a state of IR and an alteration of the TRYCAT system. These changes should be taken into consideration when PE is diagnosed or treated.

Role of Insulin Resistance in Patients of Acne Vulgaris and Hirsutism in the Western Part of India- A Cross-Sectional Study.

Despite being common and easy to treat conditions, acne and hirsutism may have a striking consequence on one's perception of self. Though understanding the pathogenesis of acne and hirsutism has undergone a major paradigm shift, one of them being insulin resistance (IR), extensive research is still underway. The purpose of the study is to establish causal relationship linking IR with acne vulgaris and hirsutism, as well as to assess severity of the two with increasing IR. A cross-sectional observational study was conducted in the dermatology department. Patient's detailed clinical history and necessary parameters like height, weight, body mass index (BMI), etc., were recorded in predefined proforma, noting signs and symptoms of underlying IR, along with acne severity calculated by global acne grading system (GAGS) and hirsutism severity by modified Ferriman Gallwey score (mFG), then analyzing using Pearson's correlation test to establish correlation between IR and acne with/without hirsutism and hirsutism alone. A total of 349 patients included in our study were divided into three groups, (i) Acne-only (N = 308) group showed statistically significant correlation of IR with acne severity (P < 0.0001) and recurrence (P < 0.0001). (ii) In hirsutism-only (N = 24) group, homeostatic model assessment for insulin resistance (HOMA-IR) was strongly associated with modified Ferriman-Gallwey score and recurrence suggesting raised insulin resistance with increased severity of hirsutism (P < 0.0001) and recurrence (P < 0.007). (iii) In acne + hirsutism (N = 17) group, raised BMI was found to be positively associated with IR but not with severity of both conditions. IR has emerged as an important contributory, if not, causative event in pathogenesis of severe, resistant acne, and hirsutism. These conditions have great deal of impact on the psychological health of those affected necessitating different approach to manage such cases.

Correlation of Insulin Resistance With Short-Term Outcome in Nondiabetic Patients With ST-Segment Elevation Myocardial Infarction.

Obviously, hyperglycemia and insulin resistance (IR) are common in patients with acute ST-segment elevation myocardial infarction (STEMI). Additionally, IR is a substantial risk factor for cardiovascular diseases. The study aims to evaluate the association between IR and short-term outcomes of acute STEMI patients without diabetes mellitus in the form of reperfusion success, the occurrence of heart failure, the development of arrhythmias, and mortality. A cross-sectional study was done from August 2021 to December 2021 in two cardiology centers in Al-Sadr Teaching hospital and Basrah Oil hospital in Basrah, Southern Iraq. Sixty-one nondiabetic hospitalized patients with acute STEMI were included in the study. Twenty-five (41%) of them received thrombolytics and 36 (59%) were managed with percutaneous transluminal coronary angioplasty. From each patient, a fasting blood sample was taken for calculation of the Homeostasis Model Assessment for IR (HOMA-IR) and triglyceride glucose index (TyG) index. The patients were evaluated within 1-week for (reperfusion success, echocardiography for calculation of the ejection fraction (EF), arrhythmias, and mortality), and within 4-weeks for mortality. Within the tertile 3 of the HOMA-IR and TyG index, significant higher 4-week mortality (35% and 30%, respectively). Pearson correlation also showed significant and negative correlations between both HOMA-IR and TyG index values and EF. While reperfusion success, arrhythmias, and 1-week mortality did not correlate significantly with both HOMA-IR and TyG index. IR as defined by HOMA-IR and TyG index was significantly associated with poor outcomes in patients with acute STEMI in the form of EF<55 and 4-weekmortality.

Hyperprolactinemia and insulin resistance.

Hyperprolactinaemia is the most common dysfunction of the hypothalamic-pituitary axis and occurs more commonly in women. The prevalence of hyperprolactinaemia ranges from 0.4% in the general adult population to as high as 9-17% in women with reproductive diseases. It is accompanied by the phenomenon of insulin resistance (IR), which is also a significant clinical problem nowadays. The prevalence of IR is increasing, particularly in developing countries and in younger populations, with estimates of prevalence ranging from 20 to 40% in different populations. The aim of our review is to summarize recent data on the possible association between IR and hyperprolactinaemia. This review is based on an electronic search of the literature in the PubMed database published from 2000 to 2022 using combinations of the following keywords: IR, hyperprolactinemia or IR and hyperprolactinemia. The references included in previously published review articles were also checked, and any relevant papers were also included. Numerous scientific studies have shown a relationship between IR and hyperprolactinaemia. Increased plasma prolactin (PRL) levels are often associated with an increase in tissue resistance to insulin. There are many scientific theories explaining the probable mechanisms of this phenomenon. One is the finding that glucose and PRL act synergistically in inducing the transcription of insulin genes. It is also suggested that PRL may act as a regulator of insulin sensitivity and metabolic homeostasis in adipose tissue. The topic of the mutual correlation of hyperprolactinaemia and IR is important, and it certainly requires further research and observation.

Insulin Resistance and Other Adipokines as Clinical Predictors of Gestational Diabetes Mellitus among Pregnant Women

BACKGROUND: Gestational diabetes mellitus (GDM) has a strong relationship with an increased risk of maternal and perinatal complications. However, in Basrah, Iraq, studies regarding GDM are still limited. In current study, we aimed to investigate the association between insulin resistance and some clinical predictors of GDM among pregnant women in 1st and 3rd trimesters of gestation.METHODS: This case-control study was conducted on 44 pregnant women with GDM and 45 without GDM aged 20 to 40 years who applied for GDM screening during the first (9-13 week) and third trimester (24-28 week) of pregnancy. Demographics, blood glucose, HbA1c, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), spexin, nesfatin-1, orexin-A, vaspin and lipid profile levels were compared between groups.RESULTS: Subjects with GDM showed a higher level of glucose, insulin HOMA-IR, HbA1c, spexin, vaspin in the first and third trimesters of pregnancy (p&lt;0.01) compared to the healthy subjects. Meanwhile in the first and third trimester, subjects with GDM showed significantly lower level of nesfatin-1 and orexin-A compare to the control. In third trimester, oral glucose tolerance test (OGTT) outcomes for fasting glucose at 1 hour, 2 hours, and 3 hours after glucose load were significantly higher (p&lt;0.01). According to the area under the receiver operating characteristics (ROC) curve (AUC) findings, HOMA-IR, spexin, and vaspin may be more effective predictors biomarkers for GDM in pregnant subjects, while orexin-A and nesfatin-1 were ineffective.CONCLUSION: The correlation of insulin resistance and adipokines in the first and thrid trimester was not significantly different, which may cast new light on the possible role as an etiological cause of GDM and might be a better monitoring parameter in women with GDM. KEYWORDS: gestational diabetes mellitus, insulin resistance, vaspin, spexin, orexin-A, nesfatin-1

Abstract P164: Most Non-invasive Diabetes Risk Scores Identify Type 2 Diabetes Due To Insulin Resistance But Not β-cell Failure: The Africans In America Study

Background: Five of the most important Type 2 Diabetes (T2D) prediction scores are: Cambridge, Finnish Diabetes Risk Score (FINDRISC), Rotterdam, Kuwaiti and Omani. These scores are based on the premise that Insulin Resistance (IR) is the primary cause of T2D. Yet, data in Africans suggest β-cell-failure without obesity is the most common cause of T2D. It is unknown whether these scores can identify undiagnosed T2D when the cause is β-cell-failure. Aims: Our aim was to compare in 514 African-born Blacks (age 38±10 (mean±SD); 68% male; BMI 28±5 kg/m 2 ) the ability of Cambridge, FINDRISC, Rotterdam, Kuwait and Omani scores to identify previously undiagnosed T2D due to either IR or β-cell-failure. Methods: Diabetes was diagnosed by OGTT. Insulin resistance was defined by the lowest quartile of the Matsuda index (≤2.97). Beta-cell failure was defined as T2D diagnosis in the absence of IR. Body mass index (BMI), waist circumference (WC) and visceral adipose tissue (VAT) was measured. Area under the Receiver Operator Characteristic curve (AROC) estimated sensitivity, specificity, and criteria for AROC were: 0.70-0.79=acceptable; 0.80-0.89=excellent; &gt;0.90=outstanding. Logistic regression determined odds of T2D at the optimal cut-point for each score. Results: The prevalence of T2D was 7% (38/514). Of the T2D cases, IR occurred in 61% (23/38) and β-cell failure in 39% (15/38). Age did not differ by group, but the IR group had higher BMI (31±5 vs 27±4 kg/m 2 P &lt;0.001) and WC (101±10 vs 91±10 cm P &lt;0.001). This is supported by the higher VAT in the IR group (161±73 vs 106±62 cm 2 P &lt;0.001), an important physiological correlate of insulin resistance. All scores showed acceptable to outstanding predictability for T2D due to IR, ranging from Cambridge at AROC=0.75, to the FINDRISC with AROC=0.92. Only weak to moderate predictability for all scores were shown in β-cell-failure (Cambridge at AROC=0.48 to FINDRISC with AROC=0.63). All models predicted significant odds of T2D due to IR, with FINDRISC≥10 OR=6.8 (95%CI, 2.6, 17.8) P&lt;0 .001; Rotterdam≥7 OR=8.5 (95%CI, 3.1, 23.2) P&lt;0 .001; Cambridge≥23 OR=11.4 (95%CI, 2.6, 50.0) P =0.001) proving most effective. Only the Cambridge score significantly predicted odds of T2D in β-cell-failure (OR=5.7 (95%CI 1.58, 20.54) P =0.001). Conclusions: All 5 diabetes risk scores effectively predicted undiagnosed T2D in Africans when the etiology was IR, but only the Cambridge score predicted T2D when the cause was β-cell failure. The Cambridge risk score rates overweight status, not just obesity status, which might explain why it was successful in predicting T2D in β-cell failure and the others were not. Existing scores which predict T2D might be modified, to effectively assess T2D risk when β-cell failure is the primary cause.

Correlation of Insulin Resistance in Pregnancy with Obstetric Outcome.

Pregnancy is characterized by a series of metabolic changes that promote insulin resistance. This could be due to increase in the plasma levels of one or more pregnancy-related hormones such as oestrogen, progesterone, prolactin, cortisol, and human placental lactogen (HPL). The increased insulin resistance in pregnancy is associated with development of diabetes which has implications for the future gestations also. To determine status of insulin resistance in pregnant women and correlate the presence of insulin resistance with obstetric outcome. A prospective cohort study was conducted in the Department of Obstetrics and Gynaecology, KGMU, Lucknow, over a period of one year. Total 150 pregnant women were enrolled from OPD, out of which 136 women were followed up till delivery. Insulin resistance was calculated by HOMA IR index, twice in whole antenatal period (first in early pregnancy and second in late pregnancy). All women were also tested for GDM by DIPSI test (plasma glucose value after 2h of 75gm glucose load irrespective of last meal) as per protocol. In our study, we found 71 women out of 136 (52.2%) were GDM. Total 30 women out of 136 (22.05%) were GGI (Gestational Glucose Intolerance), and total 38 out of 136 (27.9%) women were found to have insulin resistance using HOMA IR ≥ 2 as cut off. Significant correlation was found in between BMI and insulin resistance (p = 0.001) and between GDM and insulin resistance (p = 0.001). Relative risk of development of complications like Preeclampsia, neonatal hypoglycemia, and respiratory distress syndrome was higher in women having insulin resistance and GDM. Obstetric complications like preeclampsia, neonatal hypoglycemia, and respiratory distress syndrome are more likely to occur in women with insulin resistance, but larger studies are required to delineate whether insulin resistance alone without development of GDM will have the same implication.

Insulin Resistance Shows Stronger Correlation With Ectopic Liver Fat Instead of Visceral Fat in Asian Indians

Introduction: Insulin resistance (IR) is associated with abdominal obesity. Asian Indians have higher insulin resistance at lower abdominal obesity levels as compared to the western population. However, the relative association of various compartments of abdominal fat, i.e., Subcutaneous Fat (SCAT), Visceral fat (VAT), and ectopic Liver Fat, is not very clear. Our study’s objective was to look for the association of abdominal fat composition in Asian Indians with IR level and gender and diabetes status. Methodology: Our study is an analytical cross-sectional study conducted from 2018–2020 at SMS Hospital located in northwest India. 91 subjects were studied during the study period and underwent MRI for SCAT, VAT, and Liver fat estimation. We divided subjects into tertile groups, based on HOMA-IR levels, and statistical analysis for SCAT, VAT, and Lipid fat in each tertile and as a whole group carried out. Similarly, we analysed data in male and female and diabetic and non-diabetic groups, as tertiles and as a whole. Results: Of the recruited subjects 49 were diabetics (M: F=23:26) and 42 were non-diabetic (M: F=12:30). In the overall group, HOMA-IR has a weak positive association with VAT and Liver Fat and a weak negative association with SCAT (R=0.28,0.38 and -0.11, respectively). From tertile1 to tertile3, there was a consistent increase in VAT and Liver fat (119.3, 121.1, 156.6 cm2 and 8.18, 10.02, 10.89% respectively), so that R value increases from -0.24 to 0.21 for VAT and -0.195 to 0.58 for Liver Fat. On the other hand, the SCAT levels were not different and correlation with IR declined from -0.299 to -0.39. On Sex wise analysis negative correlation of SCAT with IR become substantial from tertile1 to tertile3 in both males and females but strong correlation was seen in females (-0.189 to -0.515) though amount of SCAT was not different among tertiles. Both VAT and Liver Fat increased with tertile1 to terrtile3; IR was very strongly correlated with Liver Fat in both the sexes at higher tertiles (0.91 for males and 0.71 for females). In the diabetic group, liver fat was significantly associated with IR at higher tertile (R=0.9). The SCAT was negatively associated with IR, and a further decline in correlation coefficient with each tertile, became significant at 3rd tertile (-0.41) with a weak correlation of IR with VAT. These relations have similar SCAT and Liver fat trends but a strong correlation not seen in the non-diabetic group. Conclusion: Insulin resistance strongly correlated with ectopic liver fat in Asian Indians including diabetics with no gender disparity which became significant at higher tertile. As compared to ectopic liver fat, VAT has only a minor role in development of IR. SCAT has a protective role against IR in both diabetics and non-diabetics.

Association of insulin resistance with polymorphic variants of Clock and Bmal1 genes: A case–control study

ABSTRACTBackground: Little information is available in the literature for the correlation of insulin resistance (IR) and CLOCK gene polymorphism in Chinese population. This study aimed to investigate the relationship of HOMA-IR (homeostasis model assessment of insulin resistance) to polymorphic variants of Clock and Bmal1 genes in Chinese patients with essential hypertension.Methods: A total of 334 outpatients with essential hypertension (103 patients of HOMA-IR positive and 231 patients of HOMA-IR negative) were recruited to analyze Clock T3111C and Bmal1 A1420G genotypes with DNA sequencing approach.Results: Waist circumference, body mass index, glycated hemoglobin, total cholesterol, triglyceride, and plasminogen activator inhibitor-1 were significantly increased, while high-density lipoprotein cholesterol was significantly decreased in patients with HOMA-IR positive (P < .05–0.001 vs. patients with HOMA-IR negative). Twenty-four-hour ambulatory blood pressure monitoring showed that 24-h mean systolic blood pressure (SBP), especially nightime SBP, was higher in patients with HOMA-IR positive (P < .05 vs. patients with HOMA-IR negative). Notably, compared with the negative group, the distribution frequency of C allele of Clock T3111C and GG genotype of Bmal1 A1420G were significantly higher in the HOMA-IR positive group (29.1 vs. 10.8% P < .000 and 43.7 vs. 27.7% P = .007, respectively). Logistic regression analysis showed that C allele of Clock T3111C (OR = 4.128, CI 95% 2.313–7.368, p = .000) and GG genotype of Bmal1 A1420G (OR = 1.983, CI 95% 1.117–3.521, p = .019) were independent risk factors for potential HOMA-IR in Chinese patients with essential hypertension.Conclusion: Our results indicated that Chinese hypertensive patients with C allele of Clock T3111C or GG genotype of Bmal1 A1420G might be susceptible to IR and are more likely to develop high nighttime SBP.

226-OR: The Lipoprotein Insulin Resistance Index Is a Measure of Hepatic and Total Insulin Resistance: The Federal Women's Study

The lipoprotein insulin resistance index (LPIR) is an emerging biomarker that correlates with peripheral insulin resistance (IR) derived from a composite score of 6 nuclear magnetic resonance (NMR) lipoprotein (LP) parameters. However, its ability to reflect hepatic and total body IR in women of African descent, who have low-normal triglyceride-rich LP particles, is unclear. Our objectives were to compare LPIR in black (BW) and white (WW) women and determine the association with insulin sensitivity index (SI), hepatic insulin sensitivity index (HISI), and hepatic and visceral fat content. In 127 federally employed women without diabetes (78 BW and 49 WW; age 44±10 (24-62y); BMI 30.2±5.7 (20.3-45.2 kg/m2); mean±SD (range)), LPIR was derived, SI was calculated by the minimal model, basal HISI using stable isotopes and hepatic and visceral fat measured by proton NMR. LPIR was lower in BW (18 (8-37) vs. 26 (14-41), median (IQR), P=0.04) but there was no difference by race in the correlation coefficients of LPIR with SI (r=-0.5), HISI (r=-0.6), hepatic fat (r=0.5), visceral fat (r=0.6), all P&amp;lt;0.01. Compared to the 1st quartile, the 4th quartile of LPIR was associated with lower hepatic and total IR, and higher hepatic and visceral fat (Table). Overall, the LPIR index was a strong correlate of hepatic and total IR and may be a useful index for identifying individuals who are at risk for diabetes. Disclosure C.K. Cravalho: None. A.G. Meyers: None. L. Mabundo: None. A.E. Sumner: None. S.T. Chung: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases

Correlation of body mass index (BMI), anti-mullerian hormone (AMH), and insulin resistance among different polycystic ovary syndrome (PCOS) phenotypes – a cross-sectional study

One hundred and fifty infertile polycystic ovary syndrome (PCOS) women were classified into four phenotypes on the basis of Rotterdam criteria. Homeostatic model assessment of insulin resistance (HOMA-IR) with a cutoff ≥2.5 was considered as a measure of insulin resistance (IR). Maximum number of patients, 57 (38%) in our cohort belonged to phenotype A or the classical phenotype with all 3 features of Rotterdam criteria. Mean body mass index (BMI) in all phenotypes was more than 25 kg/m2 and the highest was seen in phenotype B. According to BMI categories in the four phenotypes, more number of women was in the obese category in phenotype A (24.5%) and B (56.5%) in comparison to phenotype C (18.2%) and D (10.8%) (p<.001). There was no difference in median HOMA-IR among different phenotype categories (p=.718). The median value of anti-mullerian hormone (AMH) was highest in phenotype A (11.68 ng/ml [7.94–16.46]) and significantly more in comparison to B phenotype (Kruskal–Wallis, p=.018). Thus there is heterogeneity in AMH levels and BMI in different PCOS phenotypes with higher levels in the most severe phenotypes. There is, however, no correlation of IR among the different phenotype groups and further investigation is needed to characterize its role in phenotypic classification.

Pulmonary arterial remodelling by deficiency of peroxisome proliferator-activated receptor-\u03b3 in murine vascular smooth muscle cells occurs independently of obesity-related pulmonary hypertension

BackgroundObesity is associated with cardiovascular complications, including pulmonary hypertension (PH). Reports suggest that peroxisome proliferator-activated receptor-γ (PPARγ) has direct action in preventing vascular remodelling in PH. Here we dissected the specific role of high-fat-diet (HFD)-induced obesity and vascular smooth muscle cell (VSMC)-PPARγ for remodelling of small pulmonary arteries.MethodsWild-type (WT) and VSMC-specific PPARγ-knockout (SmPparγ−/−) mice were fed a low-fat-diet (LFD, 10% kcal from fat) or HFD (60% kcal from fat) for 24 weeks. Mice were metabolically phenotyped (e.g. weight development, insulin/glucose tolerance) at the beginning, and after 12 and 24 weeks, respectively. At 24 weeks additionally pulmonary pressure, heart structure, pulmonary vascular muscularization together with gene and protein expression in heart and lung tissues were determined.ResultsHFD increased right ventricular systolic pressure (RVSP) to a similar extent in WT and SmPparγ−/− mice. HFD decreased glucose tolerance and insulin sensitivity in both WT and SmPparγ−/− mice. Importantly, the increase in RVSP correlated with the degree of insulin resistance. However, VSMC-PPARγ deficiency increased pulmonary vascular muscularization independently of the diet-induced rise in RVSP. This increase was associated with elevated expression of early growth response protein 1 in heart and osteopontin in lung tissue.ConclusionsHere we demonstrate a correlation of insulin resistance and pulmonary pressure. Further, deficiency of PPARγ in VSMCs diet-independently leads to increased pulmonary vascular muscularization.

Correlations of C-Reactive Protein (CRP), Interleukin-6 (IL-6), and Insulin Resistance with Cerebral Infarction in Hypertensive Patients

BackgroundThe aim of this study was to investigate the correlations of C-reactive protein (CRP), interleukin-6 (IL-6), and insulin resistance (IR) with cerebral infarction in hypertensive patients.Material/MethodsA total of 80 patients with cerebral infarction admitted to our hospital from March 2016 to November 2017 were selected and divided into 2 groups according to the diameter of cerebral infarction, namely, lacunar cerebral infarction group (n=40) and cerebral infarction group (n=40). The levels of high-sensitivity CRP (hs-CRP) and IL-6, homeostasis model assessment of IR (HOMA-IR) index and blood pressure level were compared between the 2 groups. The correlations of hs-CRP level, IL-6 level, and IR with the diameter of cerebral infarction, as well as the relationships of hs-CRP level and IR with the neurological function score after cerebral infarction were analyzed.ResultsThe levels of hs-CRP and IL-6 in the cerebral infarction group were significantly higher than those in the lacunar cerebral infarction group (P<0.05). The cerebral infarction group had a markedly higher HOMA-IR index than the lacunar cerebral infarction group (P<0.05), but it had remarkably decreased systolic blood pressure and diastolic blood pressure compared with those in the lacunar cerebral infarction group (P<0.05). There were positive correlations of hs-CRP level, IL-6 level, and IR with the diameter of cerebral infarction (P<0.05). The hs-CRP level and IR had positive correlations with the neurological function score after cerebral infarction (P<0.05).ConclusionsIn hypertensive patients complicated with cerebral infarction, the body’s inflammatory factors, and IR are positively correlated with the diameter of cerebral infarction, as well as the neurological prognosis of the patients.

Correlation of insulin-resistance with blood fat and glucose in elder patients after surgery for hepatic carcinoma.

The present study was designed to analyze variations in blood fat, blood glucose and insulin-resistance in elder patients following surgery for hepatic carcinoma. It also investigated the correlation of insulin with the level of serum leptin and blood fat. A total of 80 patients with primary hepatic cancer who were admitted to The First Hospital of Lanzhou University for treatment between October 2014 and June 2016 were enrolled in the study. At the 1-year follow-up, the patients were divided into two groups based on their recurrence of hepatic cancer after surgery. The levels of serum leptin were detected prior to, one month and one year after surgery; the changes in blood fat, body mass index (BMI), waistline and hipline were measured at one year after surgery; alterations in the fasting blood glucose and blood glucose were measured at 2 h after meal. The fasting insulin (FINS) level and homeostasis model assessment-insulin resistance (HOMA-IR) index were also measured. Correlations between serum leptin and total cholesterol, FINS and fasting blood glucose were analyzed. In the recurrence group, the levels of serum leptin and FINS level were significantly reduced, while waistline and hipline were increased, compared with the non-recurrence group (P<0.05). The BMI and fasting blood glucose in the recurrence group was significantly elevated in comparison with the non-recurrence group (P<0.05). The HOMA-IR index was significantly increased in the recurrence group compared with the non-recurrence group (P<0.05). These results indicated that following surgery for hepatic cancer, the level of serum leptin in patients with recurrence was decreased with an increase in susceptibility to abnormal metabolism of blood fat and glucose. In addition, the serum leptin was negatively correlated with the total cholesterol level and fasting blood glucose and positively correlated with the FINS level in patients. It was concluded that leptin levels decreased in patients with postoperative recurrence, as well as the accumulation of visceral adipose tissue and the development of abnormal blood glucose metabolism was observed.

Factors Associated With Insulin Resistance in Adults With HIV Receiving Contemporary Antiretroviral Therapy: a Brief Update.

This narrative review summarizes recent data on factors associated with insulin resistance (IR) in adults with HIV, including contemporary antiretroviral therapy (ART). IR remains common in persons with HIV, even those receiving contemporary ART. Generalized and abdominal obesity and ectopic fat are correlates of IR, and emerging data have identified associations with biomarkers of inflammation and immune activation. Small studies suggest associations between mitochondria and IR. In ART-naïve individuals, IR increased within 4weeks of starting ART in persons receiving contemporary boosted protease inhibitors or an integrase inhibitor. The importance of IR in non-diabetic persons with HIV will continue to grow as the population ages and obesity increases. Non-invasive estimates of IR appear to perform well in persons with HIV, but clinically relevant cutoffs are uncertain. Unexpected metabolic effects of newer HIV integrase inhibitors have been reported; thus, careful observation for and studies of IR are still warranted.

Trunk muscle quality assessed by computed tomography: Association with adiposity indices and glucose tolerance in men

Background/objectivesThigh muscle attenuation measured by computed tomography (CT) has been shown to be a reliable and useful index of skeletal muscle fat infiltration. Thigh muscle fat content assessed by CT has been linked to obesity and type 2 diabetes and is a correlate of insulin resistance in sedentary individuals. However, as measurement of mid-thigh fat content requires the assessment of another region of interest beyond the usual abdominal scan required to measure levels of visceral and subcutaneous abdominal adipose tissue, this study aimed at testing the hypothesis that skeletal muscle fat measured from a single abdominal scan (L4-L5) would also provide information relevant to the estimation of muscle fat infiltration as it relates to cardiometabolic risk. MethodsAbdominal (L4-L5) and mid-thigh CT scans were performed in a sample of 221 sedentary men covering a wide range of adiposity values. Trunk muscles on the L4-L5 scan were classified into 2 groups: 1) psoas and 2) core muscles. The two scans were segmented to calculate muscle areas, mean attenuation values as well as low-attenuation muscle (LAM) areas, the latter being considered as an index of skeletal muscle fat infiltration. Body mass index (BMI), body composition and waist circumference were assessed and a 75 g oral glucose tolerance test (OGTT) was performed. ResultsMid-thigh, psoas and core LAM areas were all significantly associated with body composition indices (0.46 ≤ r ≤ 0.71, p < 0.0001) whereas trunk muscle indices were more strongly associated with visceral adiposity and waist circumference (0.54 ≤ r ≤ 0.79, p < 0.0001) than were mid-thigh muscle variables (0.44 ≤ r ≤ 0.62, p < 0.0001). Mid-thigh LAM area as well as psoas and core LAM areas were significantly associated with fasting glucose, 2-h plasma glucose levels, the glucose area under the curve and with the HOMA-IR index (mid-thigh LAM area: 0.18 ≤ r ≤ 0.25, p < 0.01; psoas LAM area: 0.27 ≤ r ≤ 0.33, p < 0.0001; core LAM area: 0.24 ≤ r ≤ 0.34, p < 0.01). Multivariable stepwise regression analyses revealed that the associations between trunk muscle indices and glucose tolerance/insulin resistance were no longer significant after controlling for visceral adiposity measured at L4-L5. ConclusionOur results suggest that CT-imaging derived indices of trunk muscle quality are related to glucose tolerance and visceral adiposity. However, the relationship between skeletal muscle fat and insulin resistance appears to be largely mediated by the concomitant variation in visceral adiposity. Finally, our results suggest that a single CT scan performed at L4-L5 is adequate to assess skeletal muscle fat content related to cardiometabolic risk.

Correlation of insulin resistance and motor function in spinal and bulbar muscular atrophy.

This study aimed to evaluate various metabolic parameters in patients with spinal and bulbar muscular atrophy (SBMA), to investigate the association between those indices and disease severity, and to explore the underlying molecular pathogenesis. We compared the degree of obesity, metabolic parameters, and blood pressure in 55 genetically confirmed SBMA patients against those in 483 age- and sex-matched healthy control. In SBMA patients, we investigated the correlation between these factors and motor functional indices. SBMA patients had lower body mass index, blood glucose, and Hemoglobin A1c, but higher blood pressure, homeostasis model assessment of insulin resistance (HOMA-IR, a marker of insulin resistance), total cholesterol, and adiponectin levels than the control subjects. There were no differences in visceral fat areas, high-density lipoprotein-cholesterol (HDL-C), or triglyceride levels in two groups. Revised amyotrophic lateral sclerosis functional rating scale (ALSFRS-R) correlated positively with HDL-C, but negatively with HOMA-IR. Through stepwise multiple regression analysis, we identified HOMA-IR as a significant metabolic determinant of ALSFRS-R. In biochemical analysis, we found that decreased expressions of insulin receptors, insulin receptor substrate-1 and insulin receptor-β, in autopsied muscles and fibroblasts of SBMA patients. This study demonstrates that SBMA patients have insulin resistance, which is associated with the disease severity. The expressions of insulin receptors are attenuated in the skeletal muscle of SBMA, providing a possible pathomechanism of metabolic alterations. These findings suggested that insulin resistance is a metabolic index reflecting disease severity and pathogenesis as well as a potential therapeutic target for SBMA.

THE PECULARITIES OF CORRELATION BETWEEN INSULIN RESISTANCE, CARBOHYDRATE AND LIPID METABOLISM INDICES IN PATIENTS WITH GRAVES’DISEASE

Aim. The number of patients with endocrine disorders in the world, in particular, Graves’ disease is continuously increasing. Recent studies have determined the fact of insulin resistance in thyroid disorders. On the one hand, numerous researches prove correlation of hypothyroidism with arterial hypertension, ischaemic heart disease and lipid metabolism disorder, on the other – carbohydrate metabolism disorder and hyper-sympathicotonia are closely associated with hyperthyroidism. The subject of the research was to study the correlation of insulin resistance, lipid and carbohydrate metabolism indices in patients with Graves’disease. Material and Methods. During the study 53 (37 female and 16 male) patients with Graves’ disease with noticed IR have been examined. At the beginning, after 3– and 6-months thyreostatic therapy with insulin sensitizers (metformin or pioglitazone) the following investigations have been performed: assessing thyroid-stimulating hormone levels, free thyroxine and triiodothyronine; assessing glycated haemoglobin, glucose, C-peptide and fasting insulin as primary IR markers; calculating НОМА-IR index for analysing tissue sensitivity to insulin; calculating НОМА-β index for evaluating the functional capacity of β-cells of islets of Langerhans; measuring Caro indices to monitor hyperinsulinemia, measuring total cholesterol level, low-density lipoproteins, very-low-density lipoproteins, high-density lipoproteins , triglycerides, for analysing IR in relation to lipid metabolism. Results. The research results found out that free thyroid hormones and thyroid-stimulating hormone are closely related to lipid metabolism. Thus, thyroid-stimulating hormone was characterized as having direct correlation with low-density lipoproteins, while the free thyroxine inversely correlated with total cholesterol, low-density lipoproteins, and high-density lipoproteins. The free triiodothyronine negatively correlated with high-density lipoproteins. The research has also determined the direct correlation between insulin and free thyroxine, as well as free triiodothyronine in patients with diffuse toxic goitre. Conclusions. The study proves the presence of insulin resistance in patients with Graves’ disease that generates interest to further study of the changes in insulin sensitivity, relation of insulin resistance to thyroid-stimulating hormone, thyroid hormones and looking for the ways to correct these disorders.

Correlation of Insulin Resistance with Liver Histology in Obese Patients with NASH and in Lean NASH

Correlation of Insulin Resistance with Liver Histology in Obese Patients with NASH and in Lean NASH