Higher Risk Of Insulin Resistance Research Articles

Phenotypic Characterization of Patients with Polycystic Ovary Syndrome in a Population from the Ecuadorian Andes: A Cross-Sectional Study.

Background: Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine-metabolic disorder in women of reproductive age. Diagnosis is based on the evidence-based international guideline 2018 and the Rotterdam Consensus to classify PCOS phenotypes. This study aims to characterize the biodemographic, clinical, metabolic, and reproductive variables and their relationship with PCOS phenotypes in a population from the Ecuadorian Andes. Methodology: A cross-sectional study was conducted with a non-random consecutive sample of 92 women who attended the outpatient gynecology and endocrinology clinic at the Hospital of the Technical University of Loja (UTPL)-Santa Inés, Loja, Ecuador, between January 2022 and July 2023. Descriptive statistics, mean calculations, standard deviation, parametric and nonparametric tests, odds ratios (OR), confidence intervals (CI), and p-values were employed. Results: The average age was 22 ± 3.4 years, with a predominantly mestizo, urban, single, highly educated, and medium-high socioeconomic level population. It was identified that phenotypes A + B are at a higher risk of developing oligomenorrhea and hypertriglyceridemia compared to phenotypes C + D, with statistically significant differences (p < 0.05). Furthermore, in terms of reproductive variables, phenotypes A + B exhibit a significantly higher frequency of elevated anti-Müllerian hormone (AMH) compared to phenotypes C + D, also with statistical significance (p < 0.05). Conclusions: The classical phenotypes A and B of PCOS are the most common in Ecuadorian Andean women and carry a higher risk of insulin resistance, anovulation, metabolic disorders, and elevated triglyceride levels compared to phenotypes C and D. Ethnic diversity and sociocultural habits influence the prevalence and clinical manifestations of these phenotypes.

The effect of BsmI (rs1544410) single nucleotide polymorphism of vitamin D receptor (VDR) on insulin resistance in healthy children and adolescents: a cross-sectional study

The increasing prevalence of metabolic syndrome, type 2 diabetes, and insulin resistance are driven by complex interactions between genetic and environmental factors. One of the single nucleotide polymorphisms (SNPs) in the VDR gene associated with vitamin D levels is the rs1544410 SNP. This study examined the association of the rs1544410 polymorphism with insulin resistance to predict and screen for possible association with type 2 diabetes and target these individuals for appropriate treatment. This cross-sectional study examined 270 children and adolescents aged 9 to 18 years. Anthropometric and biochemical parameters were determined. Insulin resistance/sensitivity was determined using Quicki, HOMA-IR, MacAuley, Revised MacAuley, Bennetts, FIRI and insulin-to-glucose ratio. The BsmI single nucleotide polymorphism (rs1544410) was determined using the PCR-RFLP method after extracting DNA from peripheral blood collected from fasted subjects, and the resulting data were analyzed using SPSS software and statistical tests.According to linear regression analysis, a significant difference was found in Insulin to glucose ratio, FIRI and HOMA-IR indices between Bb / bb and BB genotypes and it was observed that individuals with BB genotype polymorphism of BsmI vitamin D receptor gene, after Adjustment of age, sex, BMI are at greater risk for insulin resistance and type 2 diabetes.This study demonstrated that those with the BB genotype of VDR BsmI polymorphism were at higher risk for insulin resistance and developing type 2 DM.

Association between birth weight and insulin resistance in US adolescents: A retrospective cohort study exploring the role of concurrent body mass index

Background and aimsThis study aimed to investigate the association between birth weight (BW) and abnormal HOMA-IR in US adolescents aged 12–15 years. The role of concurrent body mass index (BMI) in adolescence was also examined. Methods and resultsThis retrospective cohort study included 3429 participants from NHANES with data in 1999–2020. HOMA-IR ≥2.3 was considered abnormal. Participants were classified as low (LBW; <2.5 kg), normal (NBW; 2.5–4.0 kg), or high (HBW; >4.0 kg) BW. Logistic regression was used to explore the association between BW and HOMA-IR. Mediation analysis was used to examine whether BMI z-score in adolescence mediated the association between BW and HOMA-IR. Compared with those in NBW, the odds ratios (95 % CI) of abnormal HOMA-IR in LBW and HBW groups were 1.26 (0.99–1.60), and 0.62 (0.47–0.83) respectively. The association between BW and abnormal HOMA-IR was consistent in all subgroups with no significant interactions. Mediation analysis showed that BW is associated with lower risk of HOMA-IR directly, but with higher risk indirectly via BMI in adolescence. ConclusionThere was a negative linear relationship between BW and the prevalence of abnormal HOMA-IR in adolescents aged 12–15 independent of concurrent BMI. Children who were born with LBW but had high BMI in adolescence were of particularly higher risk of insulin resistance.

Abstract 11624: Body Fat and Cardiometabolic Disease Burden in Adults With Normal Body Mass Index

Background: The role of body adiposity on metabolic dysregulation in subjects with normal body mass index (BMI) is still under debate with limited population-based evidence. Hypothesis: Body adiposity measured by dual x-ray absorptiometry (DEXA) is associated with metabolic disorders in normal-weight individuals. Methods: We evaluated a sample of adults aged 20-65 who underwent DEXA in the US National Health and Nutrition Examination Surveys from 1999-2006 and 2011-2018. We excluded those with history of cardiovascular disease, cancer, and chronic obstructive pulmonary disease. Weighted logistic regression was performed to test the association between body fat percentage (BF%) and metabolic disorders [e.g., insulin resistance (IR), metabolic syndrome (MS), dyslipidemia, type 2 diabetes mellitus (DM), hypertension]. Models were adjusted for potential confounders while considering complex survey design and were further stratified by sex and BF% as tertiles in normal-weight individuals. IR was tested as a secondary analysis to evaluate the effect on the predicted risk. Results: We included 20,613 individuals (51.5% men, 65.4% non-Hispanic whites), mean age ± SE was 39.42±0.22 years, and 6,424 were normal weight by BMI and represented our study sample. The overall BF% in these subjects measured by DEXA was 28.41±0.19%. In our cohort, metabolic disorders were prevalent in 2.1% to 40.4% of patients (Table 1). Every 10-unit % increase in total BF% was associated with a higher risk for IR, MS, dyslipidemia in the normal weight BMI group (Table 1). Metabolic disorders were associated with BF% tertiles (Figure 1). IR was significantly associated with body fat across all BF% tertiles for men and highest tertiles for women (Figure 2). Conclusion(s): Less than 1/3 of subjects in a representative national sample had a normal BMI. Even in these “normal weight” subjects, increases in body adiposity are significantly associated with increased cardiometabolic disease burden.

Association between biomarkers of iron status and cardiometabolic risk in Spanish children aged 9–10 years. The ELOIN study

The relationship between iron metabolism and cardiometabolic risk factors has been scarcely studied in children, and the results are controversial. The objective of this study was to evaluate the association between iron parameters and lipid, glycemic and blood pressure alterations in the pediatric population. This was a cross-sectional study of 1954 children between 9 and 10 years of age in Madrid (Spain), participants in a longitudinal study of childhood obesity. Iron metabolism parameters, i.e., serum iron (Is), ferritin (Fs), transferrin (Tf) and transferrin saturation (STf) and lipid, glycemic and blood pressure profiles were evaluated. Odds ratios (ORs) were estimated using logistic regression models adjusted for sociodemographic characteristics, diet, physical activity, C-reactive protein and body mass index. Compared with the participants in the low Is and STf tertiles, those in the upper tertiles had a lower risk of low HDL-Chol (OR: 0.34; 95%CI: 0.17; 0.67) and OR: 0.44 (95%CI: 0.23; 0.84), respectively, and children in the upper Fs tertile had an OR of 2.07 (95%CI: 1.16; 3.68) for low HDL-Chol. Children in the highest Is and STf tertiles had a lower risk of prediabetes [OR: 0.63 (95%CI: 0.41; 0.97) and OR: 0.53 (95%CI: 0.34; 0.82)] and insulin resistance (IR) (OR: 0.37; 95%CI: 0.22; 0.64), and those in the upper Tf tertile had a higher risk of IR (OR: 1.90; 95%CI: 1.16; 3.12). An increased risk of hypertension was found only in children in the upper Fs tertile (OR: 1.46; 95%CI: 1.01; 2.13). Conclusions: Biomarkers of iron metabolism are associated with cardiometabolic alterations in the pediatric population, with a variable direction and magnitude depending on the indicators used.What is Known:• Iron metabolism is related to important cardiometabolic alterations such as metabolic syndrome and its components.• Association between biomarkers of iron status and cardiometabolic risk have been less explored in children.What is New:• Biomarkers of iron metabolism are associated with cardiometabolic alterations in the pediatric population.• Iron parameters in the pediatric population could be of great help to detect and prevent cardiometabolic abnormalities early.

Association of HDL Subfraction Profile with the Progression of Insulin Resistance.

Type 2 diabetes mellitus (T2DM) is a major global public health problem, as it is associated with increased morbidity, mortality, and healthcare costs. Insulin resistance (IR) is a condition characterized by disturbances in carbohydrate and lipid metabolism that precedes T2DM. The aim of the present study was to investigate the association between HDL and its subfraction profile and the progression of IR, as assessed by the Homeostatic Model Assessment for IR (HOMA-IR) index, and to define cut-off values to identify an increased risk of IR. Individuals with a HOMA-IR greater than 3.63 were considered to have IR. The HDL subfractions were separated using the Lipoprint system, which identifies ten subfractions (HDL-1-10) in three subclasses as large (HDL-L), intermediate (HDL-I) and small (HDL-S). Analyses were performed on samples from 240 individuals without IR and 137 with IR from the Hungarian general and Roma populations. The HDL-1 to -6 subfractions and the HDL-L and -I classes showed a significant negative association with the progression and existence of IR. Among them, HDL-2 (B = -40.37, p = 2.08 × 10-11) and HDL-L (B = -14.85, p = 9.52 × 10-10) showed the strongest correlation. The optimal threshold was found to be 0.264 mmol/L for HDL-L and 0.102 mmol/L and above for HDL-2. Individuals with HDL-L levels below the reference value had a 5.1-fold higher risk of IR (p = 2.2 × 10-7), while those with HDL-2 levels had a 4.2-fold higher risk (p = 3.0 × 10-6). This study demonstrates that the HDL subfraction profile (especially the decrease in HDL-2 and -L) may be a useful marker for the early detection and intervention of atherogenic dyslipidemia in subjects with impaired glucose and insulin metabolism.

Sociodemographic Variables Associated with the Prevalence of Insulin Resistance Using a Non-Invasive Score System Among Adults in the Makkah Region of Saudi Arabia

Insulin resistance is considered as one of the significant causes of morbidity and mortality as it might develop diabetes, heart, and renal diseases. To investigate the prevalence of Insulin resistance in the Makkah region in Saudi Arabia and the related risk sociodemographic Method: An online valid questionnaire was collected from a random sample of only Saudi 1514 adults; non-Arabic speakers and non-Saudi were excluded. The related sociodemographic data was gathered. The insulin resistance risk score was conducted using a non-invasive easy scoring system based on Lindstrom and Tuomilehto's study18. In total, 70% of the sample had a lower risk level, and only about 14% with higher risk compared to 16% with no risk. Individuals at a higher risk of insulin resistance were males, with high-income levels (≤10,000SR) and elementary education. The most common risk of insulin resistance was at a moderate risk level for males with high income and lower education levels.

Prevalence of insulin resistance in Chinese solar greenhouse and field workers: evidence from a solar greenhouse and field workers study.

Evidence suggests that agricultural workers are at higher risk of insulin resistance (IR), but few studies have investigated IR in solar greenhouse workers, who are exposed to higher concentrations of agricultural risk factors than traditional agricultural workers. A prevalence study was conducted in a greenhouse vegetable farm in China. In total, 948 participants were enrolled in this study. Among them, 721 participants were allocated to the greenhouse worker group (G group), and 227 participants were assigned to the field worker group (F group). The TyG index, which is an indicator to evaluate prediabetes (IR), was calculated by the formula: TyG index = ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. To evaluate the associations of TyG index alternation with solar greenhouse and field work, multiple linear regression (MLR) and logistic regression models were performed. The TyG index in the G group (8.53 ± 0.56) was higher than that in the F group (8.44 ± 0.59) (p < 0.05). Solar greenhouse work was positively associated with an increased TyG index in both the multiple linear regression model [β = 0.207, (0.006, 0.408)] and the logistic regression model [OR = 1.469, (1.070, 2.016)]. IR was associated with the solar greenhouse work. However, the determination of agricultural hazard factors needs to be further strengthened to improve exposure assessment. Graphical Abstract.

Association of Glycosylated Hemoglobin Levels with Insulin Resistance in Adolescent among Medical Students Ain Shams University

Abstract Background Insulin resistance is a common pathway for the development of glucose metabolism disorders and high blood pressure, all of which are components of the metabolic syndrome. The earlier onset of obesity may cause a longer period of insulin resistance, which may explain the concomitant earlier onset of impaired glucose tolerance in young obese people and adolescents so insulin resistance has been implicated as risk factor for metabolic disorders and it is of real importance to develop simple test that can be used in routine clinical setting for identifying insulin resistant individuals in advance so HOMA-IR(Homeostatic Model Assessment for Insulin Resistance) and HbA1c (glycated haemoglobin) screening to identify young at high risk for insulin resistance and diabetes at an early stage. The study aimed to evaluate the association of HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) and HbA1c levels in overweight and nonoverweight young medical students to assess insulin resistance, a condition that can cause diabetes mellitus and metabolic syndrome in earlier life. Subject and Methods The study was systematic random sample was conducted between 40 overweight and 40 non-overweight students (80 in total). All cases were subjected to history taking, clinical examination and laboratory investigations included HOMA-IR and HbA1c. Results Regarding HOMA-IR in present study they illustrated statistically significant difference between groups with higher levels in overweighed group than for normal weight group.HOMA-IR ≥2.5 was represent (17.5%)of normal weight group and (45.0%) of overweighed group with statistically significant difference. N statistically significant difference regarding Glucose (mg/dl) level for normal and overweighed group. The relation was statistically significant regarding Insulin (mIU/ml) level as it was higher in overweighed group than normal group. Regarding HbA1c% in present study; there is no statistically significant difference between normal group compared to obese group that range within normal values with higher result in obese group. Our study found statistically significant association between HOMA-IR&amp;lt;2.5 and (glucose and insulin), in both groups and for HbA1c in obese group. Also statistically significant positive correlation between HOMA-IR and HbA1c% in all patients. Conclusion Obesity is significantly associated with higher levels of fasting insulin, and HOMA-IR values in adolescents. There is a positive correlation between HbA1c and HOMA-IR

Perilaku Makan Pada Individu Obesitas Dengan DM Tipe 2 Selama Pandemi Covid-19 Di Wilayah Kerja Puskesmas Sidorejo Lor, Kota Salatiga

Obesity is one of the risk factors for diabetes mellitus. Obese people have a higher risk of insulin resistance. The emergence of the COVID-19 pandemic prompted the Indonesian government to enforce policies ranging from large-scale social restriction and transition to implementing emergency community activity restrictions at levels 1–4 that can have impacts that affect people’s lives, including affecting diets. The study aims to find out the dietary picture of adult obese individuals with type 2 diabetes mellitus in the work area of Puskesmas Sidorejo Lor, Salatiga City, during the COVID-19 pandemic. The study respondents were individuals aged 25–59 years of age, with a total of 22 people identified with type 2 diabetes mellitus and obesity. The research uses quantitative descriptive methods with instruments such as Semi-quantitative Food Frequency questionnaires and Food recalls. Data is analyzed using the Food Ingredient Composition List, Nutrisurvey, and Microsoft Excel. The results of the study showed that the respondents’ energy, protein, and fat consumption was excessive, while the average respondent’s carbohydrate intake had a severe deficit. The study concluded that there was an imbalance in respondent intake because respondents reduced their consumption of carbohydrates, especially white rice, but their protein and fat intake was not in line with their needs.

Association of leptin receptor gene Gln223Arg polymorphism with insulin resistance and hyperglycemia in patients with metabolic syndrome.

Worldwide, there has been an increase in the incidence of metabolic syndrome. The search for genetic markers of this syndrome is ongoing. The leptin receptor has recently received attention. One of the polymorphisms (Gln223Arg) is possibly associated with the development of obesity and insulin resistance. However, the results of studies on this polymorphism remain equivocal. Gln223Arg polymorphism has not been studied previously in the Kyrgyz population. Thus, we aimed to investigate the possible association of the Gln223Arg polymorphism of the leptin receptor gene with metabolic syndrome components in the Kyrgyz population. 237 Kyrgyz subjects, aged 35-70 years, were studied. For the analysis anthropometric data, glucose, insulin, lipid spectrum, leptin were obtained. The genotype of the Gln223Arg leptin polymorphism was evaluated using TaqMan real-time PCR. The distribution of genotypes was as follows: Gln223Gln 46.4%, Gln223Arg 40.1%, Arg223Arg 13.5%. In the study no association was found with abdominal obesity, arterial hypertension, hypertriglyceridemia or low-density cholesterol levels. Relationships of Gln223Arg and Arg223Arg genotypes with insulin resistance (p < 0.03) were found. Gln223Arg polymorphism was associated with a higher level of glycemia (5.54 vs. 5.39 mmol/l, p < 0.05) and insulinemia (8.3 vs. 7.1 µIU/ml, p < 0.05). Correlation analysis showed that carriers of the Arg223 allele demonstrated a higher risk of insulin resistance (odds ratio (OR) = 1.83, 95% CI: 1.03-3.24; p < 0.03) than carriers of the Gln223 allele. Gln223Arg polymorphism of the leptin receptor gene may be a marker of predisposition to insulin resistance in the Kyrgyz population. Further studies are necessary to confirm these results in populations from other regions.

Individualized lifestyle intervention in PCOS women (IPOS): a study protocol for a multicentric randomized controlled trial for evaluating the effectiveness of an individualized lifestyle intervention in PCOS women who wish to conceive

BackgroundPolycystic ovary syndrome (PCOS) is a common endocrine condition which affects women in the reproductive age group. South Asian women with PCOS have a higher risk of insulin resistance and metabolic disorder compared to women from other ethnic backgrounds. Lifestyle interventions such as dietary advice and physical exercise are recommended as a first-line management option for infertile women with PCOS. Most of the randomized controlled trials evaluating the role of lifestyle interventions in infertile PCOS women were characterized by methodological issues. The uptake of lifestyle modifications as a treatment strategy in the South Asian population is complicated by a difficult-to-change conventional high-carbohydrate diet and limited availability of space for physical activity in the region.MethodsThe study is designed as an open-label, multicentre, randomized controlled trial in South Asian women with PCOS. Women attending the fertility clinic will be screened for eligibility, and women aged between 19 and 37 years who have been diagnosed with PCOS and wishing to conceive will be invited to participate in the trial. We will include women with body mass index (BMI) between ≥ 23 and ≤ 35 kg/m2 and duration of infertility ≤ 3 years. We plan to randomize women with PCOS into two groups: group A will receive the intervention which will consist of individualized advice on diet and physical exercise along with a telephonic reminder system and follow-up visits, and group B (control) will receive one-time advice on diet and physical exercise. Both groups will receive up to three cycles of ovulation induction with letrozole after 3 months of randomization during the 6-month treatment period. The primary outcome of the trial will be the live birth following conception during the intervention period. The secondary outcomes include clinical pregnancy rate, ongoing pregnancy rate, miscarriage rate, ectopic pregnancy rate, stillbirth, time to pregnancy, mean weight loss, differences in anthropometric parameters, improvement in menstrual regularity and quality of life score.DiscussionThe IPOS trial results could help clarify and provide more robust evidence for advocating an individualized lifestyle intervention in PCOS women who wish to conceive.Trial registrationClinical Trial Registry of India CTRI/2023/04/051620. Registered on 13 April 2023.

Adherence to 24-h movement guidelines in Spanish schoolchildren and its association with insulin resistance: a cross-sectional study.

Being more active, being less sedentary, and sleeping enough are associated with adequate body weight and adiposity in children. However, few researchers have analyzed these different lifestyle behaviors and the adherence to 24 h movement guidelines with respect to insulin resistance (IR) at school age. Therefore, we aimed to analyse the association between the adherence to 24 h movement guidelines (physical activity, sedentary time, sleep) and IR in Spanish schoolchildren. A cross-sectional study of 839 children (8-13 years, 51.1% girls) were studied. Anthropometric, biochemical, and lifestyle behavioral data were collected. IR was defined as HOMA-IR>3.16. Compliance with the 24 h movement guidelines were defined as ≥60 min/day of moderate and/or vigorous physical activity, < 120 min/day of screen time, and 9-11 h/day of sleep time. Associations between adherence to the 24 h movement guidelines and IR were performed by multivariate logistic regression analyses. The IR in our sample was 5.0%, being higher in girls. Compliance with physical activity or screen time, but not with sleep recommendations, was associated with lower fasting glucose, fasting insulin, and HOMA-IR values. A low adherence to 24 h movement guidelines was associated with a higher risk of IR (odds ratio (95% CI): 2.150 [1.089-4.247]), especially in girls (odds ratio (95% CI): 2.800 [1.180-6.645]). Higher physical activity levels and lower screen times were associated with a lower risk of IR in schoolchildren, underlining the importance of adhering to as many healthy lifestyle recommendations as possible.

#3932 INSULIN RESISTANCE IN PEDIATRIC CKD PATIENTS

Abstract Background and Aims Pediatric chronic kidney disease (CKD) is associated with disturbance of glucose metabolism &amp; insulin receptor sensitivity leading to impaired glucose tolerance &amp; insulin resistance (IR), which are potential risk factors for cardiovascular disease (CVD). Hyperinsulinemia and IR are not extensively investigated in children with CKD, especially in different stages of CKD. The aim of our study was to detect hyperinsulinemia &amp; IR in pediatric CKD patients. Method A total of 87 children and adolescents; 58 with chronic kidney disease (CKD); (29 CKD stage 2-4, pre-dialysis group &amp; 29 CKD stage 5 on regular hemodialysis, CKD5d group) &amp; 29 age &amp; gender matched controls were enrolled in the current cross-sectional study. Homeostasis model assessment of insulin resistance (HOMA-IR) using fasting insulin &amp; glucose, where IR was considered if HOMA-IR was 4.39. Results Fasting insulin &amp; glucose hadn't significantly changed between CKD patients &amp; controls (p = 0.7, 0.3 respectively), while IR represented by HOMA-IR was found in a total of 11 (12.6%) CKD patients (6, 6.89% CKD5d &amp; 5, 5.74% CKD 2-4) with no significant difference between pre-dialysis &amp; dialysis groups (p&amp;gt;0.05), while it was significant with controls (p = 0.039), meanwhile, the total means of HOMA-IR between were no statistically significant between all CKD patients &amp; (p = 0.64). HOMA-IR correlated positively to dialysis durations (p = &amp;lt;0.001, &amp;lt;0.001 respectively), but hadn't changed with BMI. Conclusion Pre-dialysis &amp; dialysis CKD pediatric patients are at a high risk of IR &amp; hence CVD. CKD &amp; dialysis durations are independent risk factors for IR.

Association between breakfast frequency and insulin resistance in Korean adults with prediabetes: A nationwide population-based cross-sectional study

AimsThis study aimed to investigate the association between breakfast frequency and insulin resistance using the triglyceride and glucose (TyG) index in Korean adults with prediabetes. MethodsThis study used data from the 2016–2018 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 16,925 participants were included in this study. Breakfast frequency was classified as 0 times, 1−4 times, and 5−7 times per week. High insulin resistance was defined as a TyG index of ≥8.5. A multivariate logistic regression analysis was performed. ResultsCompared with the group whose breakfast frequency was 5–7 times per week, the odds ratio for high insulin resistance was 1.39 times (95% confidence interval (CI), 1.21−1.59) and 1.17 times (95% CI, 1.04–1.32) higher in the group whose breakfast frequency was 0 times and 1−4 times per week, respectively. ConclusionsThis study revealed that a lower frequency of breakfast consumption was significantly associated with a higher risk of insulin resistance in Korean adults with prediabetes. In the future, a large-scale prospective longitudinal study is required to establish the causal relationship between breakfast frequency and insulin resistance.

Developing a risk assessment tool for identifying individuals at high risk for developing insulin resistance in European adolescents: the HELENA-IR score.

To develop and validate an easy-to-use screening tool for identifying adolescents at high-risk for insulin resistance (IR). Α total of 1,053 adolescents (554 females), aged 12.5 to 17.5 years with complete data on glucose and insulin levels were included. Body mass index (BMI), fat mass index (FMI) and the homeostasis model assessment for insulin resistance (HOMA-IR) were calculated. VO2max was predicted using 20m multi-stage fitness test. The population was randomly separated into two cohorts for the development (n=702) andvalidation (n=351) of the index, respectively. Factors associated with high HOMA-IR were identified by Spearman correlation in the development cohort; multiple logistic regression was performed for all identified independent factors to develop a score index. Finally, receiver operating characteristic (ROC) analysis was performed in the validation cohort and was used to define the cut-off values that could identify adolescents above the 75th and the 95th percentile for HOMA-IR. BMI and VO2max significantly identified high HOMA-IR in males; and FMI, TV watching and VO2max in females. The HELENA-IR index scores range from 0 to 29 for males and 0 to 43 for females. The Area Under the Curve, sensitivity and specificity for identifying males above the 75th and 95th of HOMA-IR percentiles were 0.635 (95%CI: 0.542-0.725), 0.513 and 0.735, and 0.714 (95%CI: 0.499-0.728), 0.625 and 0.905, respectively. For females, the corresponding values were 0.632 (95%CI: 0.538-0.725), 0.568 and 0.652, and 0.708 (95%CI: 0.559-0.725), 0.667 and 0.617, respectively. Simple algorithms were created using the index cut-off scores. Paediatricians or physical education teachers can use easy-to-obtain and non-invasive measures to apply the HELENA-IR score and identify adolescents at high risk for IR, who should be referred for further tests.

Exploring the role of systemic immune-inflammation index and neutrophil-lymphocyte ratio in cardiovascular risk stratification for patients with hidradenitis suppurativa: A cross-sectional study.

Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the hair follicle that has previously been associated with a higher cardiovascular risk (CVR). Although different methods have been described for CVR stratification in HS, there is little evidence about the role of hemogram indexes in CVR in HS. Given its potential convenience, the aim of this study was to assess the role of the hemogram indexes systemic immune-inflammation index (SII) and neutrophil-lymphocyte ratio (NLR) in CVR stratification for patients with HS. A cross-sectional study was performed to assess the role of SII and NLR in CVR stratification in patients with moderate to severe HS who were candidates for biologic therapy. SII, NLR, carotid intima-media thickness, and other clinical and biochemical CVR factors were assessed before the start of the treatment. Fifty patients were included. The male:female ratio was 3:2, and the mean International Hidradenitis Suppurativa Severity Score System score was 21.6. After multivariate analysis, SII correlated with higher values of systolic blood pressure, metabolic syndrome, and higher risk of insulin resistance (p < 0.05). NLR was associated with insulin resistance (p < 0.05). These associations were independent of age, sex, body mass index, severity of the disease, and tobacco consumption. The implementation of SII and NLR in daily practice may be of benefit for identifying patients with HS at higher risk of high blood pressure, insulin resistance, or metabolic syndrome. Since these indexes are simple to calculate, they could be used as a screening tool in HS-specific units.

The Value of Insulin Resistance indices For detecting Insulin Resistance in Polycystic Ovarian Syndrome Patients

Polycystic Ovarian Syndrome (PCOS) is characterized by increased ovarian and androgen hormone secretion. Patients with PCOS are said to be at high risk for insulin resistance(IR). IR is a sign of PCOS that comprises impaired glucose tolerance and elevated insulin production. HOMA-IR is a test that assesses insulin resistance by measuring blood glucose and insulin levels. There are other indexes that are also available for determining IR such as the quantitative insulin sensitivity check index(QUICKI) and McAuley index. Hence, in this study HOMA-IR, QUICKI and McAuley index were used to determine the IR among PCOS individuals. This case-control cross sectional study included 62 participants between the age group of 20-40 years. They were divided into two groups such as Group B which includes 31 PCOS patients diagnosed based on Rotterdam criteria and Group A includes 31 healthy age-matched female participants. After obtaining informed consent, fasting blood sample was collected from all the participants. Based on the analyzed biochemical parameters IR was assessed using HOMA-IR, QUICKI and McAuley index. For statistical analysis student t-test, ROC curve and bivariate regression analysis were done. In this study, it is observed that an increase in BMI was at a higher risk of developing PCOS. It is seen that fasting glucose, insulin and lipid profile (except HDL-C) were significantly elevated in PCOS individuals. The HOMA-IR was significantly increased and QUICKI and McAuley’s index were significantly decreased in PCOS which shows that PCOS patients are at higher risk of developing IR. Crude odds were calculated which shows that increase in HOMA-IR levels has an 86.25% increase risk of developing IR in PCOS patients when compared with the other indexes.HOMA-IR has a higher predictor % of developing IR in PCOS individuals, but still QUICKI and McAuley index can also be used as a predictor of risk.

Modeling the risk of insulin resistance in borderline personality disorder with romantic pathological jealousy in females: A Lyfas empirical study

Borderline Personality Disorder (BPD) with Romantic pathological jealousy (rPAJ) influences the heart rate variability (HRV) and its cardiovascular optical biomarkers (COBs), which the Lyfas mobile application captures through smartphones. The COBs surrogate insulin resistance (IR), a marker of cardiometabolic risks. The paper aims to non-invasively study the IR risk in BPD-rPAJ affected females. Personality-based Questionnaire (PBQ) and the Multidimensional jealousy scale (MDJS) and Lyfas tests were taken by the participants under psychologists’ supervision. The VO2Max (COB of heart-lung coherence after stressful exercise), LF/HF (COB of IR), and Arterial stiffness index (ASI), a marker of early vascular aging, are chosen as the IR biomarkers. HRVScore, SD1/SD2, and pNN50 are chosen as the mood, anxiety, and sleep (MAS) biomarkers. Finally, each of the MAS-IR COBs is regressed to examine the causality. The R2 value &gt;= 25 is considered the significant causative. Furthermore, the relative risk (RR) is computed between significant MAS-IR COBs. The study observes that HRVScore and pNN50 possess high causal relationships with ASI (R2 = 47% and 25%, respectively). The RR shows an increased risk of premature arterial stiffness (PAS) with mood dysregulations (RR = 10.5, p 0.02) and sleep issues (RR = 135, p 0.19) when compared to the baseline population. The study concludes that mood dysregulations and poor sleep quality are associated with a high risk of IR in females suffering from BPD-rPAJ disorder. The onset of the deterioration of their arterial health starts as early as an average of five-and-a-half years.

Association of Serum Magnesium with Insulin Resistance and Type 2 Diabetes among Adults in China.

Magnesium is an essential mineral for the human body and a cofactor or activator for more than 300 enzymatic reactions, including blood glucose control and insulin release. Diabetes is a well-known global burden of disease with increasing global prevalence. In China, the prevalence of diabetes in adults is higher than the global average. Evidence shows that magnesium is a predictor of insulin resistance and diabetes. However, the majority of studies focus on dietary magnesium instead of serum magnesium concentration. We study the correlation of serum magnesium levels with insulin resistance and Type 2 diabetes. In this prospective cohort study, we included 5044 participants aged 18 years and older without insulin resistance (IR) and diabetes at the baseline from China Health and Nutrition Survey (CHNS). A fasting blood sample was taken for the measurement of both types of magnesium, fasting blood glucose, hemoglobin A1c (HbA1c), and fasting insulin. The homeostatic model (HOMA-IR) was calculated. Demographic characteristics of participants, and risk factors such as intensity of physical activities, smoking status, drinking habit, and anthropometric information were recorded. IR was defined as HOMA-IR ≥ 2.5, and Type 2 diabetes mellitus was defined as fasting plasma glucose ≥ 7.0 mmol/L or HbA1c ≥ 6.5%, or a self-reported diagnosis or treatment of diabetes. A total of 1331 incident insulin resistance events and 429 incident diabetic events were recorded during an average follow-up of 5.8 years. The serum magnesium concentration was categorized into quintiles. After adjusting for relevant covariates, the third quintile of serum magnesium (0.89–0.93 mmol/L) was correlated with 29% lower risk of incident insulin resistance (hazard ratio = 0.71, 95% CI 0.58, 0.86) and with a lower risk of Type 2 diabetes. Multivariable-adjusted hazard ratios (95% confidence intervals) for insulin resistance were compared with the lowest quintile of serum magnesium (<0.85). We found similar results when evaluating serum magnesium as a continuous measure. Restricted cubic spline (RCS) curves showed a nonlinear dose–response correlation in both serum magnesium levels and insulin resistance, and in serum magnesium levels and Type 2 diabetes. Lower serum magnesium concentration was associated with a higher risk of insulin resistance and diabetes.