Higher Homeostasis Model Assessment Of Insulin Resistance Research Articles

High triglyceride-glucose index and HOMA-IR are associated with different cardiometabolic profile in adults from the ELSA-Brasil study

Background and aimsInsulin resistance (IR) is a risk factor for several cardiometabolic disorders; however, there is conflicting evidence about the reliability of certain IR markers. In this context, the triglyceride-glucose index (TyG) has been proposed as a surrogate marker for IR. This study aimed to compare the TyG index and homeostasis model assessment of insulin resistance (HOMA-IR). Methods and resultsA cross-sectional analysis was conducted using baseline data from 11,314 adults (aged 35–74 years) from the ELSA-Brasil study. The correlation between TyG and HOMA-IR, their interrater reliability, and their predictive value in identifying metabolic syndrome (MetS) were assessed. The mean TyG and HOMA-IR in our sample were 8.81 ± 0.52 and 2.78 ± 1.58 for men, and 8.53 ± 0.48 and 2.49 ± 1.38 for women, respectively. TyG and HOMA-IR showed a weak to moderate correlation with each other (Pearson’s r for men: 0.395 and 0.409 for women, p-value <0.05) and other markers of glycemic metabolism. Additionally, the area under the curve for the prediction of MetS was greater for TyG than HOMA-IR, regardless of sex (TyG: 0.836 for men and 0.826 for women; HOMA-IR: 0.775 for men and 0.787 for women). The concordance between these markers was low (Coheńs kappa coefficient: 0.307 for men and 0.306 for women). Individuals with increased TyG exhibited mainly anthropometrical and glycemic metabolic alterations, whereas those with elevated HOMA-IR displayed mostly lipid-associated metabolic alterations. ConclusionTyG and HOMA-IR might indicate different profiles of cardiometabolic disorders, showing poor agreement in classifying individuals (normal vs. altered) and a weak correlation. Therefore, further studies are needed to investigate the role of TyG as a surrogate marker of IR.

Associations of Serum Insulin and Related Measures With Neuropathology and Cognition in Older Persons With and Without Diabetes.

To examine associations of serum insulin and related measures with neuropathology and cognition in older persons. We studied 192 older persons (96 with diabetes and 96 without, matched by sex and balanced by age-at-death, education, and postmortem interval) from a community-based, clinical-pathologic study of aging, with annual evaluations including neuropsychological testing (summarized into global cognition and 5 cognitive domains) and postmortem autopsy. We assessed serum insulin, glucose, leptin, adiponectin, hemoglobin A1C, advanced glycation-end products (AGEs), and receptors for advanced glycation-end products, and calculated the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and adiponectin-to-leptin ratio. Using adjusted regression analyses, we examined the associations of serum measures with neuropathology of cerebrovascular disease and Alzheimer's disease, and with the level of cognition proximate-to-death. Higher HOMA-IR was associated with the presence of brain infarcts and specifically microinfarcts, and higher HOMA-IR and leptin were each associated with subcortical infarcts. Further, higher leptin levels and lower adiponectin-to-leptin ratios were associated with the presence of moderate-to-severe atherosclerosis. Serum insulin and related measures were not associated with the level of Alzheimer's disease pathology, as assessed by global, as well as amyloid burden or tau tangle density scores. Regarding cognitive outcomes, higher insulin and leptin levels, and lower adiponectin and receptors for advanced glycation-end products levels, respectively, were each associated with lower levels of global cognition. Peripheral insulin resistance indicated by HOMA-IR and related serum measures was associated with a greater burden of cerebrovascular neuropathology and lower cognition. ANN NEUROL 2024;95:665-676.

Diabetes Status, c-Reactive Protein, and Insulin Resistance in Community-Acquired Pneumonia-A Prospective Cohort Study.

C-reactive protein (CRP) is commonly used to guide community-acquired pneumonia (CAP) treatment. A positive association between admission glucose and CRP levels has been observed in patients with CAP. The associations between prediabetes, unknown diabetes, acute-on-chronic hyperglycaemia, and CRP levels, and between admission CRP levels and insulin resistance (IR) in CAP, remain unexplored. This study investigated the associations firstly between chronic, acute, and acute-on-chronic hyperglycaemia and CRP levels, and secondly between admission CRP levels and IR in CAP. In a prospective cohort study of adults with CAP, the associations between chronic, acute, and acute-on-chronic hyperglycaemia (admission glucose minus HbA1c-derived average glucose) and CRP levels until admission day 3 were modelled with repeated-measures linear mixed models. IR was estimated with the homeostasis model assessment of IR (HOMA-IR). The association between admission CRP levels and HOMA-IR was modelled with linear regression. In 540 patients, no association between chronic, acute, or acute-on-chronic hyperglycaemia and CRP levels was found. In 266 patients, every 50 mg/L increase in admission CRP was associated with a 7% (95% CI 1-14%) higher HOMA-IR. In conclusion, our findings imply that hyperglycaemia does not influence CRP levels in patients with CAP, although admission CRP levels were positively associated with IR.

Insulin resistance is associated with incident chronic kidney disease in population with normal renal function.

Insulin resistance is prevalent in chronic kidney disease and may accelerate the progression of chronic kidney disease. This study aimed to investigate whether insulin resistance is associated with the development of incident chronic kidney disease in a population with normal renal function. A total of 3,331 participants from a community-based cohort with normal renal function were prospectively analyzed. We determined the relationship of insulin resistance indices with the incident chronic kidney disease using the Cox proportional hazard model and Kaplan-Meier survival analysis. During a mean follow-up of 11.03 ± 4.22 years, incident chronic kidney disease occurred in 414 participants (12.4%). The high homeostasis model assessment-insulin resistance level group had an increased risk of incident chronic kidney disease (hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.13-1.74; p = 0.002) compared to the normal group after adjustment for age, sex, history of hypertension, body mass index, total cholesterol, alcohol drinking status, smoking status, and baseline estimated glomerular filtration rate. The risk of incident chronic kidney disease also increased with the lower quantitative insulin sensitivity check index level (HR, 0.62; 95% CI, 0.41-0.92; p = 0.02) and higher leptin-adiponectin ratio level (HR, 1.23; 95% CI, 1.06-1.42; p = 0.006). Higher insulin resistance indices are associated with the incidence of chronic kidney disease. Our data suggest that increased insulin resistance may be involved in the development of incident chronic kidney disease in a population with normal renal function.

Correlation of body mass index and waist to height ratio with cardiovascular risk factors in Colombian preschool and school children.

To analyze the agreement between body mass index (BMI) and waist-to-height Ratio (WHtR) to identify preschool and school children with cardiovascular risk factors (CRFs). Three-hundred-twenty-one kids were divided into preschool (3-5 years) and school children (6-10 years). BMI was used to classify children as overweight or obese. Abdominal obesity was defined with a WHtR ≥0.50. Fasting blood lipids, glucose and insulin were measured, and the homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. The presence of CRFs and multiple non-waist circumference (non-WC) metabolic syndrome factors (MetS-Factors) [high HOMA-IR, high triglycerides and low high-density lipoprotein cholesterol (HDL-C)] were analyzed. One-hundred-twelve preschool and 209 school children were evaluated. WHtR ≥0.50 classified abdominal obesity in more than half of the preschool children, exceeding those classified with overweight+obesity by BMI (59.5% vs. 9.8%; p<0.001). There was no agreement between WHtR and BMI to identify preschool kids with CRFs and multiple non-WC MetS-Factors (kappa: 0.0 to 0.23, p>0.05). There were similar proportions of school children classified with abdominal obesity by the WHtR and overweight+obesity by the BMI (18.7% vs. 24.9%; p>0.05). There was substantial agreement between WHtR and BMI to identify school children with high total cholesterol values, low-density lipoprotein cholesterol (LDL-C), triglycerides, non-HDL-C, insulin, HOMA-IR, low HDL-C values, and the presence of multiple non-WC MetS-Factors (kappa: 0.616 to 0.857, p<0.001). In preschool children WHtR ≥0.5 disagree with BMI results, but in school kids, it has good agreement with the BMI to classify the children´s nutritional status and to identify those with CRFs.

#3781 INSULIN RESISTANCE IS ASSOCIATED WITH INCIDENT CHRONIC KIDNEY DISEASE IN POPULATION WITH NORMAL RENAL FUNCTION

Abstract Background and Aims Insulin resistance is prevalent in chronic kidney disease (CKD) and may accelerate its progression. This study aimed to investigate whether insulin resistance was associated with the development of incident CKD in a population with normal renal function. Method A total of 3,331 individuals with normal renal function from a community-based cohort formed the study population. We determined the relationship between insulin resistance indices and incident CKD using Cox proportional hazard model and Kaplan-Meier survival analysis. Results During a mean follow-up of 11.03 ± 4.22 years, incident CKD occurred in 414 (12.4%) participants. The high homeostasis model assessment-insulin resistance (HOMA-IR) level group had an increased risk of incident CKD (HR, 1.40; 95% CI, 1.13-1.74; p = 0.002) compared to the normal group after adjusting for confounding factors The risk of incident CKD also increased with lower quantitative insulin sensitivity check index (QUICKI) levels (HR, 0.62; 95% CI, 0.41-0.92; p = 0.018) and higher leptin-adiponectin ratio (LAR) levels (HR, 1.23; 95% CI, 1.06-1.42; p = 0.006). Conclusion Higher insulin resistance indices were associated with the incidence of CKD. Our data suggests that increased insulin resistance may be involved in the development of incident CKD in individuals with normal renal function.

Combining HbA1c and insulin resistance to assess the risk of gestational diabetes mellitus: A prospective cohort study

ObjectiveTo investigate the association of glycated hemoglobin (HbA1c) and homeostasis model assessment insulin resistance (HOMA-IR) with gestational diabetes mellitus (GDM) risk. MethodsData for this study were from a prospective cohort in Hangzhou, China. We included pregnant women with HbA1c, fasting insulin, and fasting glucose (FG) measured at 15–20 weeks of gestation and underwent oral glucose tolerance test (OGTT) at 24–28 weeks. Based on HbA1c and HOMA-IR, participants were divided into four groups. We estimated the odds ratios (OR) with 95% confidence intervals (CI) to assess the associations of HbA1c and HOMA-IR with GDM occurrence. Finally, we the potential additive interaction between HbA1c and HOMA-IR by calculating relative excess risk due to interaction (RERI) and the attributable proportion due to interaction (AP). Result462 pregnant women were included, of whom 136 (29.44%) developed GDM. Based on HbA1c and HOMA-IR, the study population was divided into four groups, with the percentages of each group being 51.30%, 15.58%, 20.56%, and 12.55%, respectively. The incidence of GDM increased with the increase of HOMA-IR and HbA1c, respectively, and the risk of GDM was significantly increased when both HOMA-IR and HbA1c were elevated. However, no such risk was observed in pregnant women < 35 years. Finally, we found significantly higher FG at 24–28 weeks in the high HOMA-IR and HbA1c group among GDM-positive pregnant women. ConclusionsThe incidence of GDM increased with increasing HbA1c and HOMA-IR, and the risk of GDM was significantly increased when both HbA1c and HOMA-IR were elevated. This finding may help to identify high-risk women for GDM early in pregnancy and provide timely interventions.

PS-P11-4: ASSOCIATION OF HOME AND OFFICE SYSTOLIC AND DIASTOLIC HYPERTENSION WITH GLUCOSE METABOLISM IN A GENERAL POPULATION

Objective: The aim of this study was to investigate the association of hypertension subtypes with glucose metabolism among the general population. Methods: The study involved 646 residents (mean age: 62.4 years) without treatment for hypertension or a history of diabetes from a rural community, who underwent an oral glucose tolerance test from 1997 to 2019. Hypertension subtypes [normotension (NT), isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic and diastolic hypertension (SDH)] were defined based on home and office systolic and diastolic blood pressure (HBP and OBP, respectively). The estimated means of blood glucose levels during OGTT, homeostasis model assessment (HOMA)-insulin resistance (IR), Matsuda-DeFronzo index, HOMA-beta and insulinogenic index among the groups were compared by analysis of covariance adjusted for possible confounding factors. Results: BG-related indices were not different among the morning HBP-defined hypertension subtypes. Participants with evening HBP-defined ISH had a significantly higher estimated mean BG at 120 min, higher homeostasis model assessment-insulin resistance (HOMA-IR), and lower Matsuda-DeFronzo index than participants with NT (the adjusted mean: 146 vs 127 mg/dl, 1.3 vs 1.0, and 6.6 vs 8.1, respectively) (all p &lt; 0.021). Participants with OBP-defined SDH had a significantly higher estimated mean fasting BG; BG at 30, 60, and 120 min; and HOMA-IR and a lower Matsuda-DeFronzo index than participants with NT (the adjusted mean: 101 vs 94 mg/dl, 177 vs 158 mg/dl, 182 vs 157 mg/dl, 145 vs 125 mg/dl, 1.3 vs 1.0, and 6.3 vs 8.3, respectively) (all p &lt; 0.0025). Conclusion: The BG-related indices were different among hypertension subtypes. Participants with evening HBP-defined ISH and OBP-defined SDH had higher BG levels and insulin resistance than participants with correspondingly defined NT, while those with morning HBP did not. These findings suggest the importance of measuring evening HBP and OBP for early detection of coexisting hypertension and diabetes.

Evaluation of First Trimester Fasting Blood Glucose, HOMA-IR and HbA1c in Prediction of Gestational Diabetes Mellitus in Non-Obese Pregnant Women: A Retrospective Study

Aim: Gestational Diabetes Mellitus (GDM) is the most common endocrine complication in pregnancy with fetomaternal comorbidities. It is aimed to evaluate fasting blood glucose (FBG), homeostasis model assessment of insulin resistance (HOMA-IR), and hemoglobin A1c (HbA1c) values in the first trimester in non-obese pregnant women for early detection of GDM.&#x0D; Material and Methods: Pregnant women with first-trimester FBG, HOMA-IR, HbA1c values, and second-trimester OGTT results were scanned from the hospital database. First-trimester height, weight, age and gestational weeks were also recorded. The presence of Body Mass Index (BMI) over 30 kg/m2, chronic and systemic disease and history of G(DM) were not included in the study. ROC analysis was performed on FBG, HOMA-IR, and HbA1c.&#x0D; Results: This retrospective study was conducted between 01/01/2021, and 01/01/2022 in Tuzla State Hospital Gynecology and Obstetrics Clinic. 131 pregnant women who met the inclusion criteria were reached. Twenty of pregnant women were evaluated as GDM positive(+). Age, height, weight, BMI, gestational week, and nulliparity were observed to be similar between the groups. FBG, insulin, HOMA-IR, and HbA1c values were higher in the group with GDM. As a result of ROC analysis, those with an FBG value of 88,5 mg/dl (sensitivity 68.2%, specificity 68.2%), a HOMA-IR value of 2.24 (sensitivity 63.6%, specificity 64.5%), and a HbA1c (sensitivity 68.2%, specificity 66.7%) value of over 5.25% were observed to be at risk for GDM.&#x0D; Conclusion: It has shown that pregnant women with high first trimester FBG, HOMA-IR and HbA1c have a high risk for GDM and can be used as a predictor of GDM.

Body Mass Index is The Most Associated Anthropometry Indicators of Obesity with Insulin Resistance in Female College Students

Background: Dysfunction of body tissues due to excessive food consumption is often referred to obesity. Excess storage of visceral fat can develop insulin resistance. Insulin resistance is associated with cardiovascular diseases. Anthropometric measurements can illustrate the early risk of insulin resistance. The aim of this study is to identify the association between anthropometric indicators and insulin resistance.Materials and Methods: The participants in this study were 163 female students aged 19-24 years who live in Semarang. This is a cross sectional study with a purposive sampling method using the "google form". Anthropometric data that were collected in this study include weight, height, waist cirrcumference, hip, sagittal abdominal diameter. Biochemical data that were collected include blood sugar and insulin levels. The data were analyzed using Pearson Correlation test and Multiple Linear Regression test.Results: Anthropometric indicators with high risk were 72.4% for Waist to Height Ratio (WHtR); 22.1% for Waist Hip Ratio (WHR); 35.6% for Body Mass Index (BMI); 12.2% for Sagittal Abdominal Diameter (SAD) and 55.2% for waist cirrcumference. Meanwhile, subjects with high Fasting Blood Glucose levels was 16.6%, subjects had the Conicity Index (C-Index) at risk was 74.8% and based on the Relative Fat Mass (RFM) it was 23.9% of the participants were at risk of obesity and high Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) levels were 74.2%. Anthropometric indicators of obesity, including Conicity Index, Relative Fat Mass, WHtR, WHR, BMI, SAD, and waist and hip ratio were all positively associated with insulin resistance. Therefore, multivariate analysis showed that an increase in body mass index is an indicator that is most associated with the insulin resistance (p&lt;0,001).Conclusion: Body Mass Index is the anthropometric indicator that is most associated with insulin resistance.

Association of home hypertension subtypes with glucose metabolism.

Objective: This study was performed to investigate the association of home and office hypertension with glucose metabolism among the Japanese general population. Methods: The study involved 646 residents without treatment for hypertension or a history of diabetes from Ohasama, a rural Japanese community, who underwent an oral glucose tolerance test measuring blood glucose (BG) and insulin levels at fasting and 30, 60 and 120 min. Hypertension subtypes [normotension (NT), isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic and diastolic hypertension (SDH)] were defined based on home and office systolic and diastolic blood pressure (HBP and OBP, respectively). The estimated means of blood glucose (BG)-related indices among the groups were compared by analysis of covariance adjusted for possible confounding factors. In addition, the association between continuous HBP and OBP (as independent variables) and BG-related indices (as dependent variables) were assessed by multiple linear regression analysis. Results: Mean age was 62.4 years. Of participants, 29% were men. No estimated mean BG-related indices were different among the morning HBP-defined hypertension subtypes, although morning systolic BP and BG at 120 min were significantly positively associated. Participants with evening HBP-defined ISH had a significantly higher estimated mean BG at 120 min (146 vs 127 mg/dl), higher homeostasis model assessment-insulin resistance (HOMA-IR) (1.29 vs 1.02), and lower Matsuda–DeFronzo index (6.55 vs 8.06) than participants with NT. In addition, evening systolic BP levels with BG at 60 and 120 min and HOMA-IR and diastolic BP levels with fasting BG were significantly positively associated. Participants with OBP-defined SDH had significantly higher estimated means of fasting BG (101 vs 94 mg/dl), BG at 30 min (177 vs 158 mg/dl), 60 min (181 vs 157 mg/dl), and 120 min (145 vs 125 mg/dl); and HOMA-IR (1.30 vs 0.98) and a lower Matsuda–DeFronzo index (6.26 vs 8.30) than participants with NT. Both office systolic and diastolic BP levels were associated with BG levels at all time points, HOMA-IR and Matsuda–DeFronzo index. Conclusion: Evening HBP and OBP were clearly associated with BG-related indices. Participants with evening HBP-defined ISH and OBP-defined SDH had higher BG levels and insulin resistance than participants with correspondingly defined NT. However, morning HBP were not obviously associated, compared with evening HBP and OBP. These findings suggest the importance of measuring evening HBP and OBP for early detection of coexisting hypertension and diabetes.

Association between maternal shift work during pregnancy child overweight and metabolic outcomes in early childhood.

BackgroundPrevious studies found that maternal shift work during pregnancy was associated with many reproductive hazards, including small for gestational age, preterm birth, stillbirth, and neurodevelopmental impairment. Some studies also showed that these children are more likely to become overweight in early childhood. However, the association with metabolic factors, such as insulin resistance and dyslipidemia, was less studied. Hence, we aimed to understand better the relationship between maternal shift work during pregnancy and the risk of childhood overweight and metabolic outcomes. Confounding factors were also discussed, including diet, exercise, and demographical factors.MethodsWe enrolled pregnant women before delivery in the Taiwan Birth Panel Study (TBPS) II conducted between 2010 and 2012, and followed the children of these participants in 2018. The objective of this study is to investigate the influence of prenatal and postnatal factors on infant and early childhood health. During the follow-up in 2018, we checked children's demographic data, obtained blood specimens, and checked their blood sugar, blood insulin, and lipid profiles. Structured questionnaires were used to evaluate demographic data. Multiple linear and logistic regressions were used to examine the associations between maternal shift work during pregnancy and child overweight, metabolic disorders, such as HOMA-IR, and lipid profiles.ResultsIn this study, we included 407 mother-children pairs with different work shifts (350 day workers and 57 shift workers), and a sub-population without underweight children was also created (290 day workers and 47 shift workers). Shift work during pregnancy was associated with a higher Homeostasis Model Assessment-Insulin Resistance index (HOMA-IR) and a higher odds ratio for overweight in children born from mothers doing shift work during pregnancy after adjustment. The findings were attenuated when we investigated the effect of shift work before pregnancy.ConclusionOur study suggested that maternal shift work during pregnancy was associated with child overweight and insulin resistance in early childhood.

Relationship between Leptin and Insulin Resistance among Community-Dwelling Middle-Aged and Elderly Populations in Taiwan.

The relationship between leptin and insulin resistance among middle-aged and elderly populations in Asia is seldom reported. Our research included 398 middle-aged and elderly Taiwanese individuals. First, we divided participants into three groups according to the tertiles of the homeostasis model assessment of insulin resistance (HOMA-IR) to analyze the parameters between each group. Pearson’s correlation was then applied to calculate the correlation between HOMA-IR and cardiometabolic risk factors after adjusting for age. A scatter plot indicated a relationship between serum leptin levels and the HOMA-IR index. Finally, the coefficients of the serum leptin level and HOMA-IR were assessed by multivariate linear regression. The participants in the high HOMA-IR index group were more likely to have higher serum leptin levels. Meanwhile, the HOMA-IR index was positively correlated with serum leptin levels, even after adjusting for age. Serum leptin levels were positively correlated with the HOMA-IR index (β = 0.226, p < 0.01) in the multivariate linear regression after adjusting for age, sex, smoking, drinking, BMI, triglycerides, systolic blood pressure, fasting plasma glucose, uric acid, ALT, and creatinine. Furthermore, the leptin–creatinine ratio also showed a significantly positive relationship with HOMA-IR in the same multivariate linear regression model. In conclusion, serum leptin levels showed a positive relationship with insulin resistance in middle-aged and elderly people in Taiwan. Furthermore, serum leptin levels may be an independent risk factor for insulin resistance according to our study.

Adipose tissue insulin resistance predicts the incidence of hypertension: The Hiroshima Study on Glucose Metabolism and Cardiovascular Diseases

We investigated the association of adipose tissue insulin resistance with blood pressure and hypertension incidence, comparing it with hepatic and skeletal muscle insulin resistance. The cross-sectional analysis included 6892 general health checkup examinees (mean age: 69.3 years; 51.3% women and 48.7% men) who had no cardiovascular disease. Of those, 3948 normotensive participants (mean age: 68.4 years; 54.8% women and 45.2% men) were enrolled in the retrospective cohort analysis. The adipose insulin resistance index (Adipo-IR) was calculated as the product of fasting serum insulin and free fatty acid levels. A high adipo-IR, high homeostasis model assessment of insulin resistance (HOMA-IR), and low Matsuda index were indicated based on the optimal cutoff values in a receiver operating characteristic curve analysis. Adipo-IR (β = 0.096, P < 0.001), HOMA-IR (β = 0.052, P < 0.001), and Matsuda index (β = -0.055, P < 0.001) were associated with systolic blood pressure in the cross-sectional analysis. Over a mean 5.3-year follow-up period, 1310 participants developed hypertension. A high adipo-IR (adjusted OR, 1.29; 95% CI, 1.11-1.51), but not HOMA-IR or Matsuda index, was significantly associated with the incidence of hypertension. Moreover, the combination of high adipo-IR with high HOMA-IR or low Matsuda index showed no higher odds of hypertension than a high adipo-IR alone. These results suggest that insulin resistance is associated with blood pressure control regardless of the tissue in which it occurs; however, the risk of hypertension is determined by insulin resistance in adipose tissue rather than in liver or muscle tissue.

Association of home and office systolic and diastolic hypertension with glucose metabolism in a general population: the Ohasama study.

This study was performed to investigate the association of hypertension subtypes with glucose metabolism among the Japanese general population. The study involved 646 residents (mean age: 62.4 years) without treatment for hypertension or a history of diabetes from Ohasama, a rural Japanese community, who underwent an oral glucose tolerance test. Hypertension subtypes [normotension, isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic and diastolic hypertension (SDH)] were defined on the basis of home and office SBP and DBP (HBP and OBP, respectively). The estimated means of blood glucose related indices among the groups were compared by analysis of covariance adjusted for possible confounding factors. Blood glucose related indices were not different among the morning HBP-defined hypertension subtypes. Participants with evening HBP-defined ISH had a significantly higher estimated mean BG at 120 min, higher homeostasis model assessment-insulin resistance (HOMA-IR) and lower Matsuda-DeFronzo index than participants with NT (all P < 0.021). Participants with OBP-defined SDH had a significantly higher estimated mean fasting blood glucose; blood glucose at 30, 60 and 120 min; and HOMA-IR and a lower Matsuda-DeFronzo index than participants with NT (all P < 0.0025). The blood glucose related indices were different among hypertension subtypes. Participants with evening HBP-defined ISH and OBP-defined SDH had higher blood glucose levels and insulin resistance than participants with correspondingly defined normotension, while those with morning HBP did not. These findings suggest the importance of measuring evening HBP and office blood pressure for early detection of coexisting hypertension and diabetes.

Insulin resistance in people living with HIV is associated with exposure to thymidine analogues and/or didanosine and prior immunodeficiency

BackgroundAs people living with HIV (PLWH) are growing older, there is increased incidence of metabolic diseases, including type 2 diabetes mellitus, for which insulin resistance is a key determinant. In this study, we aimed to investigate risk factors associated with insulin resistance in PLWH.MethodsWe included well-treated PLWH without hepatitis co-infection, and with available fasting serum insulin and plasma glucose (n = 643) from the Copenhagen Comorbidity in HIV Infection Study. Insulin resistance was calculated using the homeostasis model assessment of insulin resistance (HOMA-IR). We investigated the association between risk factors and high HOMA-IR in a logistic regression model adjusted for age, sex, abdominal obesity, smoking status, and origin. When including use of thymidine analogues and/or didanosine in the model, we also adjusted for time with HIV.ResultsMedian (IQR) age of PLWH was 52 years (46–61), and 87% (n = 557) were male. Median (IQR) HOMA-IR was 1.86 (1.23–3.14) mmol/L × mU/L. Risk factors significantly associated with high HOMA-IR included older age, BMI ≥ 25, abdominal obesity, waist circumference, use of thymidine analogues and/or didanosine, time with HIV, and CD4+ nadir < 200 cells/µL.ConclusionsInsulin resistance in PLWH is associated with both use of thymidine analogues and/or didanosine and prior immunodeficiency suggesting that increased attention on blood glucose in these patients could be beneficial.

Evaluation of Risk Factors for Malignancy in Patients With Thyroid Nodules

Background: Despite thyroid nodules mostly have benign nature, there are always malignancy risks. Therefore, understanding the mechanisms influencing this potential malignant transformation is highly important in thyroid cancer prevention strategies. We aimed in this case-control study to investigate the relationship of anthropometric parameters, and insulin resistance with thyroid nodules and the malignancy risk in nodular thyroid patients. Methods: This single-center case-control study included 81 patients with thyroid nodules who were divided into two groups according to post-thyroidectomy pathology: the malignant group included 36 differentiated thyroid carcinoma patients and the benign group included 45 patients. We compared the anthropometric and radiological parameters, homeostasis model assessment of insulin resistance (HOMA-IR), and insulin levels between both groups. Results: We observed significant differences as regard HOMA-IR, insulin levels and waist circumference between both groups. Benign thyroid nodules volume correlated with weight, waist, body mass index (BMI), fat percentage, age, HOMA-IR, and insulin levels. Malignant thyroid nodules volume did not correlate with any parameters apart from weight. We found that the final significant risk factor was HOMA-IR in stepwise logistic regression analysis. Conclusions: Malignant thyroid nodules are associated with higher insulin resistance, visceral obesity, and hyperinsulinemia. Furthermore, higher HOMA-IR is a significant risk factor for differentiated thyroid carcinoma. J Endocrinol Metab. 2022;12(2):66-72 doi: https://doi.org/10.14740/jem770

Free Triiodothyronine Levels are Related to Executive Function and Scene Memory in Type 2 Diabetes Mellitus Patients Without Diagnosed Thyroid Diseases.

PurposeWe aim to determine the role of free triiodothyronine (FT3), the main active ingredient of thyroid hormones (THs), in type 2 diabetes mellitus (T2DM) patients with mild cognitive impairment (MCI).Patients and MethodsA total of 255 T2DM patients without diagnosed thyroid diseases were recruited and divided into MCI group and healthy cognition group. Neuropsychological functions were observed by multidimensional cognitive function scales in including MoCA, Digit Span Test (DST), Verbal Fluency Test (VFT), Clock drawing test (CDT), Trail Making Test (TMT) A and B, Instantaneously Recalled Auditory Verbal Learning Test (AVLT-IR), Delayed Recalled Auditory Verbal Learning Test (AVLT-DR) and Logical Memory Test (LMT). Correlation and logistic regression analyses were performed to explore the association between FT3 and diabetic cognitive dysfunction.ResultsCompared with 147 normal cognition patients, 108 MCI patients exhibited lower FT3 and higher HOMA-IR. FT3 level was not only positively correlated with MoCA scores, but DST, VFT and LMT, while negatively associated with TMTB. Furthermore, there is a negative association between FT3 and HOMA-IR. Logistic regression showed that decreased FT3 is a risk factor of MCI in T2DM patients. Although FT3 is not the risk factor of MCI after homeostasis model assessment of insulin resistance (HOMA-IR) was entered as an independent variable, lower FT3 is associated with VFT and LMT adjusted by age, education, BMI, DM duration, HBP duration, smoking, HbA1c and HOMA-IR.ConclusionLower FT3 levels may involve in MCI, especially for executive function and scene memory in T2DM patients without diagnosed thyroid diseases.

Epicardial and Perihepatic Fat as Cardiometabolic Risk Predictors in Girls with Turner Syndrome: A Cardiac Magnetic Resonance Study

Objective:Turner syndrome (TS) patients are at high risk of cardiometabolic disorders. Cardiometabolic risk factors are more commonly related to visceral rather than total body adiposity. Adipocytokines have been explored as a potential link between obesity and obesity-related cardiometabolic dysfunction. This study explored the validity of epicardial fat-thickness (EFT) and perihepatic fat-thickness (PHFT) measurement as cardiometabolic-risk predictors in TS-girls in relation to standard obesity-indices and metabolic syndrome (MetS) components.Methods:Forty-six TS girls and twenty-five controls (10-16 years) were subdivided into two age-groups (10 to less than 13 and 13-16). Participants were assessed for body mass index (BMI) Z-scores, waist circumference (WC), total-fat mass (FM) and trunk-FM by bioimpedance-technique, EFT and PHFT by cardiovascular magnetic resonance, lipid-profile, homeostasis model assessment of insulin resistance (HOMA-IR), and serum chemerin. MetS was defined according to International Diabetes Federation criteria.Results:Overweight/obesity and MetS were detected in 45.7% and 37% of TS-girls respectively. BMI Z-score, WC, total-FM, trunk-FM, EFT and PHFT values were significantly higher in TS-age groups compared to age-matched control groups, being more pronounced in the older group when TS-girls had been exposed to estrogen. Dyslipidemia, higher HOMA-IR, chemerin, EFT and PHFT values were observed in lean-Turner compared to BMI-Z-matched controls. EFT and PHFT were significantly correlated with chemerin and several components of MetS. EFT at a cut-off-value of 6.20 mm (area under the curve=0.814) can predict MetS in TS-girls.Conclusion:TS-girls displayed an adverse cardiometabolic profile during late childhood and adolescence. EFT and PHFT are emerging cardiometabolic risk predictors in TS-patients. Excess EFT rather than total body adiposity may contribute to altered metabolic profile among lean-Turner patients.

Association between baseline insulin resistance and psoriasis incidence: the Women's Health Initiative.

Small-scale studies offer conflicting evidence regarding the relationship/association between psoriasis and insulin resistance by HOMA-IR (homeostasis model assessment of insulin resistance). The purpose of this study was to assess the association between baseline HOMA-IR and psoriasis incidence in a large-scale longitudinal cohort of postmenopausal women. The analysis included 21,789 postmenopausal women from the Women’s Health Initiative. Psoriasis diagnosis was defined by fee-for-service Medicare ICD-9-CM codes assigned by dermatologists or rheumatologists, and a 2-year lookback period to exclude prevalent cases. Baseline HOMA-IR was calculated using the updated HOMA2 model. Hazard rates from the Cox regression models were stratified by age (10-year intervals), on WHI component (Clinical Trial or Observational Study), and on randomization status within each of the WHI clinical trials. The complete model also adjusted for ethnicity, waist–hip-ratio, and smoking and alcohol habits. Among participants free of psoriasis at entry, those with high baseline HOMA-IR (≥ 2) compared to low (< 1.4) had significantly higher risk for psoriasis over 21-year cumulative follow-up (HR: 1.39, 95% CI 1.08–1.79, P-trend: 0.011). In postmenopausal women, higher baseline HOMA-IR levels were significantly associated with higher incidence of psoriasis over 21-year cumulative follow-up. Results from this time-to-event analysis indicate that insulin resistance can precede and is associated with an increased risk of psoriasis. Study is limited by Medicare diagnostic code accuracy and cohort age. Supplementary InformationThe online version contains supplementary material available at 10.1007/s00403-021-02298-9.