HOMA-IR In Group Research Articles

Effects of preoperative oral enzyme-hydrolyzed rice flour solution on gastric emptying and insulin resistance in patients undergoing laparoscopic cholecystectomy: a prospective randomized controlled trial

BackgroundThe effect of preoperative oral carbohydrates (POC) on insulin resistance (IR) of laparoscopic cholecystectomy (LC) remains debatable. Enzyme-hydrolyzed rice flour (EHR) is a kind of water-soluble micromolecular carbohydrates. This study aimed to investigate the impact of preoperative oral EHR solution on gastric emptying and IR in patients undergoing LC.MethodsPatients (n = 100) undergoing LC were divided into oral-water group (group C) or oral-EHR solution (group E) randomly (n = 50 each), and the patients drank 300 ml water or EHR solution 2-3 h before surgery respectively. Gastric emptying which was quantized by gastric volume (GV) from antrum ultrasonography, IR indicators, subjective comfort indicators, handgrip strength, postoperative recovery indexes, and complications were recorded.ResultsThere were no differences in GV between the two groups before oral administration (V0), immediately after oral administration (V1) and before anesthesia induction(V2). The GV at V2 (GV2) reduced to the level of V0 (GV0) in the two groups. Fasting glucose (FG), fasting insulin (FINS) and Homa-IR in the two groups increased at postoperative day 1 (Pos 1d) compared with those at preoperative day 1(Pre 1d). Homa-IS and Homa-β in the two groups decreased at Pos 1d compared with those at Pre 1d. FG, FINS and Homa-IR in group E were lower than those in group C at Pos 1d, and Homa-IS and Homa-β were higher in group E than those in group C at Pos 1d. Subjective comfort indictors (hunger, fatigue and anxiety) in group E were lower than those in group C at preoperative 15 min (Pre 15 min) and postoperative 1 h (Pos 1 h). Handgrip strength in group E was raised compared with that in group C at Pre 15 min, Pos 1 h and Pos 1d. There was a lower incidence of nausea and earlier exhaust time in group E.ConclusionOral 300 ml EHR solution 2-3 h before LC surgery did not increase the occurrence of reflux and aspiration during anesthesia induction with a normal gastric emptying, ameliorated postoperative IR, improved subjective comfort, and promoted postoperative gastrointestinal function recovery.Trial registrationProspectively registered at the China Clinical Trial Registry, registration number: ChiCTR2000039939, date of registration:14/11/2020.

Hyperhomocysteinemia and pregnancy outcomes in women with polycystic ovary syndrome: A case-control study.

One of the reproductive medicine challenges is to determine the role of hyperhomocysteinemia in the pathogenesis of polycystic ovary syndrome (PCOS), especially in women with recurrent pregnancy loss (RPL). Determine the correlation between hyperhomocysteinemia and pregnancy outcome in women with PCOS. This case-control study involved 245 women (20-30 yr) and was conducted in Georgia, Tbilisi from 2019-2022. Of these, 175 were women with PCOS (study group) and 70 were healthy women (control group). Women with PCOS were divided into group I with RPL (n = 90), and group II with live births (n = 85). Group I was divided into subgroups A and B with and without insulin resistance. The investigation measured homocysteine (Hcy), follicle-stimulating, luteinizing, anti-Mullerian hormones, total and free testosterone were determined. To determine the ovarian volume and antral follicle count, participants also underwent an ultrasound examination. In women with PCOS, the average Hcy level was significantly higher than in the controls, p 0.05. In group I, the average Hcy level was significantly higher than in group II and controls, p 0.05. There was no significant difference in average Hcy level between group II and controls. The average Hcy level in group I, subgroup A was significantly higher than in subgroup B, p 0.05. The average total, free testosterone levels, and homeostatic model assessment-insulin resistance levels (HOMA-IR) in group I was significantly higher than in group II and controls. HOMA-IR in group II and controls did not differ significantly. The average anti-Mullerian hormone levels in women with PCOS were significantly higher than controls, p 0.05. No significant difference was observed in average anti-Mullerian hormone level, ovarian volume, antral follicle count, and body mass index between the comparison groups of PCOS. In group I, a positive correlation between Hcy with HOMA-IR was detected. Serum Hcy levels are elevated in women with PCOS and RPL, which correlates with their insulin resistance status.

Assessment of Hepatic Steatosis in Patients with Chronic Hepatitis B Using Fibroscan and its Relation to Insulin Resistance

Background & Aim: Simple hepatic steatosis is a benign condition, but it may cause serious liver damage as it may lead to steatohepatitis, fibrosis and cirrhosis. The Controlled Attenuation Parameter (CAP) of fibroscan assesses hepatic steatosis. The aim of this work was to assess hepatic steatosis in patients with chronic hepatitis B infection using FibroScan and to detect its relation to insulin resistance. Methods: Seventy-seven patients with chronic HBV were enrolled in this study. Body mass index, complete lipid profile, fasting insulin, HOMA-IR, pelviabdominal ultrasound and fibroscan were assessed in all patients. Results: According to the presence of significant steatosis, seventy-seven patients enrolled in this study were divided into different groups, such as group I 47 patients (61.04%) with CHB virus infection with non-significant steatosis and group II 30 patients (38.96%) with CHB infection with significant steatosis. There was a statistically significant increase in fasting insulin and HOMA-IR in group II (p-value <0.001). CAP results ranged from 100-396 db/m with no significant difference in liver stiffness measurements in two studied groups (P value= 0.886). There was a significant positive correlation between the degree of hepatic steatosis measured by fibroscan and fasting insulin blood level, HOMA-IR, serum cholesterol and LDL. At cutoff > 222 db/m steatosis measured by fibroscan had a sensitivity of 63.33% and specificity of 82.35% for the detection of insulin resistance. Conclusion: In CHB infected patients, steatosis measurement by fibroscan was a strong predictor of Insulin Resistance (IR) and vice versa.

Serum high-sensitivity C-reactive protein levels in comorbid patients with type-2 diabetes mellitus and periodontal disease

Purpose: To investigate the relationship between serum levels of high-sensitivity C-reactive protein (hs-CRP) and the severity of periodontal disease in diabetics with periodontitis. Methods: Ninety patients were recruited for this study. They were divided into three groups, namely, group 1 (30 patients with type 2 diabetes mellitus (T2DM) and periodontal disease), group II (30 patients with T2DM only) and control (30 healthy individuals). Serum levels of hs-CRP and glycosylated hemoglobin (HbAc) were determined. Moreover, blood glucose (BG) and insulin (FNS) levels were determined in the fasted state, and their values used to compute insulin resistance index (Homa-IR). Results: Serum levels of FNS, FPG, HbAc and Homa-IR in group I patients were significantly higher (p < 0.05) than those of control group. While the levels of BG and Homa-IR in the serum of patients in groups I and II were significantly higher (p < 0.05) than those of control, marked reductions were seen in their values in group II, relative to group I. The serum levels of hs-CRP in group I and II were significantly increased (p < 0.05) relative to control, but were lower in group II than in group I (p < 0.05). Homa-IR was positively correlated with serum hs-CRP, FNS, BG, HbAc, and Homa-IR in groups I and II. Results from multiple regression analysis revealed significant effects of hs-CRP and HbAc on Homa-IR. Conclusion: Serum levels of hs-CRP in patients with T2DM and periodontitis are closely related to disease severity, insulin resistance and blood glucose level. Keywords: Type-2 diabetes mellitus, Periodontal disease, High-sensitivity C-reactive protein, Blood glucose, Insulin resistance, Correlation

The role of ≿ytokines in patients with osteoarthritis and type 2 diabetes mellitus

Purpose: to investigate influence of concentration in plasma tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) on articular syndrome and parameters of carbohydrate metabolism in patients with osteoarthritis (OA) and type 2 diabetes mellitus (T2DM). Methods: The study was performed on 65 patients (29 males), aged 57.9 ± 3.2 with combination OA and T2DM in Regional Hospital of Kharkov. Baseline characteristics of patients included history of OA (7.1 ± 2.3 years), T2DM (8.1 ± 2.5 years). All patients were divided into 2 groups: group 1 (n = 30) – with combined course of OA and T2DM with normal body weight, group 2 (n = 35) – with combined course of OA and T2DM with obesity (BMI≥ 30 kg/m2). The survey plan included: anthropometric data, indices of carbohydrate exchange (insulin, glucose, HbA1C, HOMA-IR) and level of C-reactive protein (CRP). The level of HbA1C was <7.5% in all patients. The level of TNF-α and IL-1β was determined by ELISA. All patients were made X-ray examination of knees. Results: Significant correlation between TNF-α and CRP was determined in 1st group (r=0.59; ⤳<0.05) and 2nd group (r=0.72; ⤳<0.05), also correlation between IL-1β and CRP was determined in 1st group (r=0.61; ⤳<0.05) and 2nd group (r=0.78; ⤳<0.05). Among the 1st group of patients the level of insulin resistance was correlated with TNF-α (r=0.36; ⤳<0.05) and IL-1β (r=0.42; ⤳<0.05). More significant correlation between TNF-α and glucose (r=0.44; ⤳<0.05), HbA1C (r=0.54; ⤳<0.05), insulin resistance (r=0.74; ⤳<0.05), HOMAIR (r=0.63; ⤳<0.05) and between IL-1β and glucose (r=0.42; ⤳<0.05), HbA1C (r=0.40; ⤳<0.05), insulin resistance (r=0.52; ⤳<0.05), HOMAIR (r=0.50; ⤳<0.05) was determined in 2nd group with comorbid pathology and obesity. We noticed, the degree of X-ray changes (by Kellgren-Lawrence) were more in 2nd group in compare with the 1st group. Conclusions: Significant correlation between TNF-α, IL-1β and CRP, glucose, НbА1, insulin resistance, HOMA-IR in group of patients with comorbid pathology and obesity means, that obesity is important factor of pathogenesis relationship immune and metabolic processes in patients with OA and T2DM.

Effects of Metformin on Thyroid Function in Patients of Subclinical Hypothyroidism

Background : To study the effect of metformin on thyroid function test (TFT) in patients of subclinical hypothyroidism (SCH). Methods: A total of 30 patients of SCH with TSH between 5 - 10 mIU/L were given 2, 000 mg/day of metformin for12 weeks. Patients were divided into two groups based on presence or absence of thyroid peroxidase antibody (TPO). Baseline anthropometric characteristics, fT3, fT4, TSH, serum insulin, HOMA-IR and quality of life were assessed at baseline and at 12 weeks. Results: A total of 23 patients (76.7%) who were TPO antibody negative (group 1) showed statistically significant decrease in TSH concentration at 12 weeks with no significant change in fT3 and fT4 in contrast to 7 patients (23.3%) who were TPO antibody positive (group 2). Patients in group 1 were significantly more obese, had higher serum insulin and HOMA-IR as compared to group 2. Body weight, waist circumference, BMI and percentage body fat decreases significantly in both the groups at 12 weeks as compared to baseline but on intergroup comparison this decrease was not significant statistically (P = 0.46). The HOMA-IR of group 1 was significantly higher than that of group 2 at baseline (P ? 0.02). Serum insulin and HOMA-IR decreased significantly in both the groups but again on intergroup comparison, no significant difference was observed. A positive correlation between serum TSH and serum insulin level and HOMA-IR level (r = 0.608, P ? 0.01 and r = 0.592, P ? 0.01 respectively) was observed in group 1. Conclusion: Metformin suppresses serum TSH levels without affecting fT3 and fT4 levels in SCH without any evidence of autoimmune thyroiditis. doi: http://dx.doi.org/10.4021/j em188 w

Pathomechanism of Insulin Resistance in Men with Central Obesity: Correlation of GGT, GPx, hs-CRP and Plasma Total Cysteine

BACKGROUND: Gamma glutamyltransferase (GGT) was reported recently to be associated with inflammation, oxidative stress and increased amino acid. However, role of GGT in insulin resistance pathomechanism is not exactly known. Therefore correlation of GGT with inflammation, oxidative stress and elevated amino acid, in men with central obesity need to be confirmed.METHODS: A cross-sectional study was designed. Men with central obesity were recruited and selected. Anthropometric parameters, creatinine, hs-CRP, fasting glucose, fasting insulin, glutathione peroxidase (GPx) activity, GGT, plasma total cysteine (tCys) and fatty liver were measured. Subjects were then divided in 4 groups based on waist circumference (WC) and fatty liver: Group I: WC ≤100 cm, without fatty liver; Group II: WC ≤100 cm, with fatty liver; Group III: WC &gt;100 cm, without fatty liver; Group IV: WC &gt;100 cm, with fatty liver. All biochemical characteristics in each group were then statistically analyzed.RESULTS: Seventy-two men with central obesity were selected. Numbers of subjects in each group were: Group I: n=33; Group II: n=5; Group III: n=17; Group IV: n=17. We found significant difference of HOMA-IR between Group I and IV, significant correlation between GGT and HOMAIR, and significant negative correlation between tCys with HOMA-IR in Group IV.CONCLUSION: GGT was significantly correlated with HOMA-IR in men with WC &gt;100 cm and fatty liver. Further investigation with more subjects is necessary to determine clear GGT cut-off to distinguish subjects with fatty liver and insulin resistance.KEYWORDS: GGT, hs-CRP, GPx, tCys, HOMA-IR, insulin resistance

Assess The Effect of Resistance Training Compared To a Weight Loss Diet Program, on Body Composition, Insulin Sensitivity and Cardio-Vascular Risk Factors In Obese Adolescents.

Purpose: To evaluate the effect of a Resistance training program (BT) versus weight loss diet (DR) on body composition, insulin sensitivity and cardiovascular risk factors in obese adolescents. Methods: Thirty obese adolescents with a BMI above the 97th percentile participated in a training program and diet for 12 weeks. They were randomized into two groups: a diet group (DR, n = 16) with a caloric restriction of 500 kcal / day and Strength training group (BT, n = 14) for all major muscle groups, three sessions / week with an intensity of 50-80% (1.RM) for 3 months. Anthropometric and biochemical measurements were performed for all of our subjects before and after the intervention program of 12 weeks. Results: Significant variations of body composition parameters were observed in both groups. The decrease of BMI, body weight, fat mass and (WC) for the group (DR) was more important than the group (BT) (p <0.01 and p <0.05 respectively). Strength training significantly increases the sensitivity to insulin (HOMA-IR of group (BT), was 4.53 ± 1.2 before and 3.47 ± 1.4 after the training program (p <0.05)), while there was no significant change for the group (DR). 12 weeks of strength training, improves the plasma concentrations of TG and HDL-C the LDL-C/HDL-C reports, TC / HDL-C and HDL-C / TG (p <0.05). The diet of weight loss induced a significant decrease only for the TC and LDL-C. (4,46 ± 0.24 before to 4.15 ± 0.37 after and 2.68 ± 0.18 before to 2.42 ± 0.14 after (p <0.05) respectively). Conclusion: Strength training improves much more the sensitivity to insulin and cardiovascular risk factors than weight loss diet program. The latter is more effective for weight loss, BMI and body fat in obese adolescent boys.

Effects of Metformin on Thyroid Function in Patients of Subclinical Hypothyroidism

Background : To study the effect of metformin on thyroid function test (TFT) in patients of subclinical hypothyroidism (SCH). Methods: A total of 30 patients of SCH with TSH between 5 - 10 mIU/L were given 2, 000 mg/day of metformin for12 weeks. Patients were divided into two groups based on presence or absence of thyroid peroxidase antibody (TPO). Baseline anthropometric characteristics, fT3, fT4, TSH, serum insulin, HOMA-IR and quality of life were assessed at baseline and at 12 weeks. Results: A total of 23 patients (76.7%) who were TPO antibody negative (group 1) showed statistically significant decrease in TSH concentration at 12 weeks with no significant change in fT3 and fT4 in contrast to 7 patients (23.3%) who were TPO antibody positive (group 2). Patients in group 1 were significantly more obese, had higher serum insulin and HOMA-IR as compared to group 2. Body weight, waist circumference, BMI and percentage body fat decreases significantly in both the groups at 12 weeks as compared to baseline but on intergroup comparison this decrease was not significant statistically (P = 0.46). The HOMA-IR of group 1 was significantly higher than that of group 2 at baseline (P &lt;= 0.02). Serum insulin and HOMA-IR decreased significantly in both the groups but again on intergroup comparison, no significant difference was observed. A positive correlation between serum TSH and serum insulin level and HOMA-IR level (r = 0.608, P &lt;= 0.01 and r = 0.592, P &lt;= 0.01 respectively) was observed in group 1. Conclusion: Metformin suppresses serum TSH levels without affecting fT3 and fT4 levels in SCH without any evidence of autoimmune thyroiditis. J Endocrinol Metab. 2013;3(4-5):105-110 doi: https://doi.org/10.4021/jem188w

Clinical study of continuous subcutaneous Insulin infusion combined with mefformln hydrochloride in the in-teusive treating of type 2 diabetes mellitus

Objective To evaluate the efleet of continuous subcutaneous insulin infusion (CSII)combined with mefformin hydroehloride( Met H)on type 2 diabetic patients. Methods 240 patients with type 2 diabetes melli-tus (T2DM) were divided into 3 groups randomly: CSII combined with Met H ( A group: n=80) ; simple CSII ( B group:n=80) ; multiple deliver insulin (MDI) ( C group: n=80). The levels of blood glucose, HbA1 e, therapeutic time, a-mount of insulin, Fins ,C-P, HOMA-IR and IAI were compared among them before and after 10d of treatment. Results GroupA, B eornpared with group C, the levels of HbA1 e significantly deeroased in other two groups [ ( 8.0±3.2)%vs. (6.9±1.4)% and(7.0±1.2)% ] (aU P<0.05),so did the therapeutic time[(6.0±1.9)d vs. (3.0±1.4) and(3.5±1.5) d] and insulin dose[ (55.0±17.0) U/d vs. (38.0±15.0) U/d and(45.0±16) U/d] (all P<0.05). The insulin dose was much less in group A than in group B. Versus group B and C,the HOMA-IR of group A (0.8±0.3 vs. 1.5±0.4 and 1.6±0.4)decreased(P<0.05) ,and IAI(-2.0±4.3 vs. -3.6±4. 2 and -4.1±4.3) increased (all P<0.05), without the function impairments of heart, liver or kidney. Conclusion CSII in combi-nation with mefformin hydreehloride can significantly enhance the treatment effect of the patients with type 2 diabetes mellitns; reduce blood glucose and HbA1 e, improve insulin resistenee,lessen insulin need. Key words: Diabetes mellitus,type2; Insulin infusion systems; Insulin resistanee; Mefformin

Influence of alcohol on insulin sensitivity and insulin receptor substrate-1 mRNA expression in rat skeletal muscle

To investigate the molecular mechanism of the effect of alcohol on insulin sensitivity. Four groups of Wistar rats were used, i.e. control (C) group, and low (L), moderate (M) and high (H) alcohol group. Alcohol doses of each group were 0, 0.6, 1.8 and 3.0 ml.(kg.bw)(-1).day(-1). Each group was comprised of 10 male and 10 female rats. Alcohol was given to rats by gastric intubation. Thirteen weeks later, serum was collected for testing of fasting plasma glucose and insulin. HOMA-IR index of each group were calculated. Total muscle RNA was extracted using Trizol Reagent (Promega). The expression level of IRS-1 mRNA in muscle was detected by RT-PCR. In female rats, the fasting plasma glucose of group (8.36 +/- 0.57) mmol/L was higher and the fasting plasma insulin (15.25 +/- 3.32) was lower than those of group C (7.56 +/- 0.85, 20.80 +/- 3.25). The HOMA-IR of group L (1.775 3 +/- 0.138 1) was lower than that of group C (1.982 6 +/- 0.124 6) (P < 0.05), while IRS-1 mRNA (0.766 1 +/- 0.076 9) was up-regulated (P < 0.05); HOMA-IR of group M (2.202 2 +/- 0.271 0) was higher than that of group C (P < 0.01), while IRS-1 mRNA (0.501 8 +/- 0.049 2) was suppressed (P < 0.01); HOMA-IR of group H (1.850 1 +/- 0.162 8) was not significantly changed as compared with that of group C (1.982 6 +/- 0.124 6) (P > 0.05), while IRS-1 mRNA (0.418 1 +/- 0.049 1) was significantly suppressed (P < 0.01). In male rats, the fasting plasma glucose and insulin had the similar change as those of female rats. The HOMA-IR of group M (1.878 5 +/- 0.250 2) was lower than that of C group (2.147 3 +/- 0.330 8) (P < 0.05), IRS-1 mRNA was up-regulated (0.824 9 +/- 0.064 7) (P < 0.05). The present study showed that low-to-moderate dose of alcohol could increase insulin sensitivity; while alcohol abuse could decrease insulin sensitivity. Sex difference in this effect was found. Changes of IRS-1 mRNA expression may be involved in the molecular mechanism of the effects of alcohol on insulin sensitivity.