Homeostasis Model Assessment Research Articles

The Association of the HEPAKID Index with Insulin Sensitivity Index in Obese Adolescents with Metabolic Syndrome.

Objective: The HEPAKID index, a novel diagnostic tool with a sensitivity of 82% and specificity of 62% for detecting nonalcoholic fatty liver disease in obese adolescents. Our study aimed to explore the potential relationship between the HEPAKID index and risk factors contributing to the development of cardiovascular disease in obese adolescents with metabolic syndrome. Methods: This prospective cross-sectional study, conducted at two medical centers from December 2023 to March 2024, included 208 obese adolescents, with a median age of 14.5 years and an average body mass index (BMI) of 30.57 kg/m2. Results: Elevated HEPAKID index values were found in obese adolescents with metabolic syndrome, showing positive associations with BMI, waist and hip circumferences, alanine aminotransferase level, fasting insulin, and homeostasis model assessment for insulin resistance. In those with metabolic syndrome, waist circumference (WC) and homeostasis model assessment for insulin resistance were significant independent variables linked to the HEPAKID index, while WC was the sole influencer in the nonmetabolic syndrome group. Multivariate logistic regression highlighted systolic and diastolic blood pressures, triglycerides, high-density lipoprotein cholesterol, and the HEPAKID index as reliable predictors of metabolic syndrome. A predictive cutoff value of 60.84 for the HEPAKID index showed 61.7% sensitivity and 59.1% specificity in identifying metabolic syndrome. Conclusions: Our study highlighted the potential value of the HEPAKID index in combination with other clinical parameters for predicting metabolic syndrome in obese adolescents, underscoring its role as a valuable screening tool. Furthermore, our findings revealed a correlation between the HEPAKID index and insulin sensitivity in this high-risk population.

Thyroid functions and insulin resistance in pregnant Sudanese women

BackgroundThe thyroid function test (free triiodothyronine [FT3], free thyroxine [FT4], and thyroid-stimulating hormone [TSH]) is one of the key determinant of glucose homeostasis by regulating the balance of insulin. Thyroid dysfunction alters glucose metabolism, leading to insulin resistance (IR). This study aimed to assess the association between thyroid function and IR in pregnant Sudanese women.MethodA cross-sectional study was conducted in Saad Abuelela Hospital, Khartoum-Sudan, from January to April 2021. Obstetric/sociodemographic characteristics were gathered through questionnaires. Serum TSH, FT3, FT4, fasting plasma glucose (FPG), and fasting insulin levels were measured and evaluated, and IR was estimated using the homeostatic model assessment for insulin resistance (HOMA-IR) equation.ResultsIn total, the study included 127 pregnant women with a median age of 27.0 years (interquartile range [IQR] 23.0‒31.2) and a median gestational (IQR) age of 25.0 (IQR 25.0‒27.0) weeks. The medians (IQRs) of the TSH, FT3, and FT4 were 1.600 (1.162‒2.092) IU/ml, 2.020(1.772‒2.240) nmol/l, and 10.70 (9.60‒11.90) pmol/l, respectively. The median (IQR) of the FPG and fasting blood insulin level was [69.0 (62.00‒78.00) mg/dl] and [5.68(2.99‒11.66) IU/ml], respectively. The median (IQR) of the HOMA-IR level was 0.9407 (0.4356‒2.1410). There was a positive correlation between HOMA -IR and FT3 levels (r = 0.375; P < 0.001) and a negative correlation with FT4 levels (r= -0.312; P < 0.001). Also, a significant positive correlation was found between fasting insulin levels and FT3 levels (r = 0.438; P < 0.001) and a negative correlation with FT4 levels (r= -0.305; P < 0.001).ConclusionsThis study indicated that FT3 has positive correlation with HOMA-IR, while FT4 has negative correlation among healthy pregnant women without a history of thyroid dysfunction. This may indicate screening of euthyroid pregnant women for thyroid dysfunction and IR. Further studies are needed.

A comparison of principal component analysis, reduced-rank regression, and partial least–squares in the identification of dietary patterns associated with cardiometabolic risk factors in Iranian overweight and obese women

BackgroundAccording to epidemiological studies, unhealthy dietary patterns and lifestyle lead to rising obesity and cardiometabolic diseases in Iran. Hybrid techniques were used to identify a dietary pattern characterized by fiber, folic acid, and carotenoid intake due to their association with cardiometabolic risk factors such as anthropometric measurements, blood pressure, lipid profile, C-Reactive Protein (CRP), Plasminogen Activator Inhibitor (PAI), Homeostatic Model Assessment Index (HOMA Index), cardiometabolic index (CMI), and monocyte chemoattractant protein (MCP-1). So, the objective of the recent study is to compare the reduced-rank regression (RRR) and partial least–squares (PLS) approaches to principal component analysis (PCA) for estimating diet-cardiometabolic risk factor correlations in Iranian obese women.MethodsData on dietary intake was gathered from 376 healthy overweight and obese females aged 18 to 65 years using a 147-item food frequency questionnaire (FFQ). In this cross-sectional study, participants were referred to health centers of Tehran. Dietary patterns were developed using PCA, PLS, and RRR, and their outputs were assessed to identify reasonable patterns connected to cardiometabolic risk factors. The response variables for PLS and RRR were fiber, folic acid, and carotenoid intake.ResultsIn this study, 3 dietary patterns were identified by the PCA method, 2 dietary patterns by the PLS method, and one dietary pattern by the RRR method. High adherence to the plant-based dietary pattern identified by all methods were associated with higher fat free mass index (FFMI) (P < 0.05). Women in the highest tertile of the plant-based dietary pattern identified by PLS had 0.06 mmol/L (95% CI: 0.007,0.66, P = 0.02), 0.36 mmHg (95% CI: 0.14,0.88, P = 0.02), and 0.46 mg/l (95% CI: 0.25,0.82, P < 0.001), lower FBS, DBP, and CRP respectively than women in the first tertile. Also, PLS and RRR-derived patterns explained greater variance in the outcome (PCA: 1.05%; PLS: 11.62%; RRR: 25.28%), while the PCA dietary patterns explained greater variance in the food groups (PCA: 22.81%; PLS: 14.54%; RRR: 1.59%).ConclusionPLS was found to be more appropriate in determining dietary patterns associated with cardiometabolic-related risk factors. Nevertheless, the advantage of PLS over PCA and RRR must be confirmed in future longitudinal studies with extended follow-up in different settings, population groups, and response variables.

An internet-based platform with a low-calorie dietary intervention improves cardiometabolic risk factors in overweight and obese people in China: Half-year follow-up results of a randomized controlled trial.

To explore the effectiveness of the Metawell programme on cardiometabolic risk factors in China, which combines meal replacement biscuits, a wireless scale, and a mobile phone application. In this two-arm, parallel-design randomized study, 220 participants were randomly assigned to an intervention (n = 110) and a control (n = 110) group. Participants in the intervention group were instructed to use meal replacement products and scales for weight loss and monitoring, whereas participants in the control group received printed materials containing a sample diet and face-to-face weight loss education at enrolment. The trial lasted 6 months, including a weight loss period in Months 1-3 and a weight maintenance period in Months 3-6. Generalized estimating equations were used to compare differences between the two groups. The median (interquartile range) ages of the intervention and control groups were 32.00 (28.00, 39.00) years and 33.00 (28.25, 41.00) years, with body mass indices of 28.20 (26.30, 30.95) kg/m2 and 27.70 (26.02, 29.70) kg/m2, respectively. Participants in the intervention group experienced significantly greater decreases in waist circumference, hip circumference, triglycerides, total cholesterol: high-density lipoprotein cholesterol ratio, fasting blood glucose, fasting insulin, and homeostatic model assessment of insulin resistance index compared to the control group (p < 0.01). Among participants who did not regain weight during the maintenance period after weight loss, the reductions in systolic and diastolic blood pressure were significantly greater in the intervention group than in the control group (p < 0.05). The Metawell programme of caloric restriction and remote monitoring can be adapted to overweight and obese people in China to reduce their cardiometabolic risk factors. Furthermore, there was a better improvement in blood pressure in participants who maintained the effects of weight loss.

Impact of cortisol on liver fat and metabolic health in adrenal incidentalomas and Cushing's syndrome.

To evaluate liver fat content in patients with non-functional adrenal incidentalomas (NFAI), mild autonomous cortisol secretion (MACS), and Cushing's syndrome (CS), and assess its relationship with cortisol levels. This cross-sectional study used retrospective data from 103 NFAI patients, 100 MACS (serum cortisol after a 1-mg dexamethasone test >50 nmol/L), and 59 with CS. Abdominal CT scans measured hepatic and splenic CT values to calculate the liver-to-spleen (L/S) ratio. Metabolic indicators including fasting plasma glucose (FPG), LDL-c, HDL-c, HbA1c, etc were measured. Mediation analysis was used to explore the indirect effects of metabolic traits on the cortisol-liver fat relationship. Patients included 103 NFAI, 100 MACS, and 59 CS. MACS patients had higher NAFLD prevalence (57%) than NFAI (26.2%, p < 0.001) but lower than CS (66.1%, p < 0.001). MACS and CS were associated with NAFLD (OR 3.83 and OR 5.73, p < 0.01), adjusted for age, body mass index (BMI), and covariates. Midnight serum cortisol correlated with L/S ratio (p < 0.001). HbA1c and Triglyceride-glucose index (TyG) mediated 24.5% and 49.5% of the cortisol and L/S ratio association, respectively. FPG, HbA1c, HDL-c, and TyG mediated the association between MACS or CS and the L/S ratio. Homeostasis model assessment of insulin resistance (HOMA-IR), fructosamine, and triglycerides mediated for MACS, while alkaline phosphatase did so for CS. Total cholesterol, LDL-c, ALT, AST, γ-GT, insulin, and uric acid did not mediate the association. MACS and CS are linked to significant metabolic disturbances, including increased liver fat and impaired glucose and lipid metabolism, contributing to fatty liver.

Does Breast Feeding Protect Mothers From Obesity?

Hepatosteatosis, which we frequently observe today with change in lifestyle, is often unnoticed, but preventable and reversible; if not prevented, it can lead to serious comorbidities. There is contradicting evidence in the literature; we believe that breastfeeding has a protective effect on hepatosteatosis. In this cross-sectional study we conducted, we aimed to examine the relationship between breastfeeding duration, metabolic parameters and fatty liver. We examined the data of 135 patients aged 20-40 years who have had at least one pregnancy and were admitted to our polyclinic. Forty-five healthcare staff who never breastfed were included in the control group. Measurements of height and weight were taken, and number of children and total breastfeeding time were questioned. Blood values were measured to calculate insulin resistance, non-alcoholic fatty liver disease (NAFLD) fibrosis score and Fibrosis-4 (FIB-4) score. Consequently, there was no significant correlation between total breastfeeding time and body mass index (BMI), NAFLD fibrosis score, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) value and hemoglobin A1C (HbA1C). When two groups were formed as patients breastfeeding for less than six months and patients breastfeeding for more than six months, a significant difference in BMI was observed between these two groups (p: 0.02). There was a significant relationship between BMI and NAFLD (p: 0.00) and HOMA-IR (p: 0.00). It was observed that there was a significant difference between BMI FIB-4 and NAFLD fibrosis scores of the control group and breastfed group. Lactation should be maintained for at least six months for maternal health together with the baby's health, and more comprehensive studies should be conducted for long-term data.

Semaglutide treatment for children with obesity: an observational study

ObjectiveTo assess efficacy and tolerability of semaglutide as a weight loss treatment for children living with comorbid obesity.DesignRetrospective observational study of the first 50 children from a weight management service...

Association of triglyceride-glucose index with sarcopenia: NHANES 2011-2014.

A newly developed technique, the Triglyceride-glucose (TyG) index, supplies a more straightforward method to identify IR than the HOMA-IR (Homeostasis Model Assessment of Insulin Resistance). Yet no methodical analysis has looked into the link involving the TyG index and low muscle mass (LMM), low muscle strength (LMS), and sarcopenia within the US. Thus, this study intended to find any connection concerning the TyG index and LMM, LMS, and sarcopenia. Between 2011 to 2014, data from the NHANES were used to conduct a nationally representative study involving 2,504 participants. LMM, LMS, and sarcopenia were the outcome variables. Moreover, this positive correlation persists irrespective of age and gender. The TyG index revealed a significant correlation with the prevalence of developing LMM (OR = 1.63(1.26-2.11), p=0.001), LMS (OR = 1.61(1.36-1.91), p<0.001) and sarcopenia (OR = 1.59 (1.23-2.07), p<0.001), after correcting for all variables. Utilizing smooth curve fitting alongside two-piecewise linear regression models, an inverted U-shaped correlation between the TyG index and the prevalence of LMM, LMS, and sarcopenia. Finally, subgroup analysis revealed that the association between the TyG index and LMM, LMS, and sarcopenia was particularly evident in all gender, age subgroups, and individuals with a normal BMI of 25. Sarcopenia and the TyG index reveal an essential positive link. It highlights the potential utility of the TyG index as a screening tool for identifying individuals at risk of sarcopenia earlier.

Correlation between fetal subcutaneous fat thickness and insulin resistance through cord blood analysis immediately after delivery

ObjectivesThis study aimed to determine whether fetal subcutaneous tissue (SCT) thickness, measured using ultrasound immediately before and after delivery, can reflect changes in glucose metabolism immediately after delivery. We also evaluated the impact of insulin resistance changes during pregnancy by comparing pregnant women with well-controlled gestational diabetes mellitus (GDM) and those with normal glucose metabolism. Study designThe study participants were 117 pregnant women, including 97 controls and 20 patients with GDM who visited our obstetric clinic between February and December 2022. The participants were scheduled for cesarean delivery at a gestational age of ≥37 weeks. SCT thickness before delivery was measured using ultrasound and within 48 h after delivery using Holtain calipers. The glucose and insulin concentrations were quantified from cord blood collected immediately after delivery. Based on these results, a Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) was performed to assess insulin resistance. Independent t-test or Wilcoxon rank-sum test for continuous variables and Fisher’s exact test for categorical variables were used to compare the various parameters. Correlations among the variables in each group were assessed by calculating the correlation coefficient (Pearson’s correlation). ResultsSCT thickness measured using ultrasound and calipers demonstrated a strong correlation where pregnant women with GDM exhibited thicker fetal SCT and neonate skinfolds than in those without GDM. Glucose and insulin levels in the cord blood were significantly elevated (p < 0.05) in the gestational diabetic group, along with remarkable differences (p < 0.001) in HOMA-IR. These variables indicated a higher prevalence of glucose intolerance in the neonates of mothers with GDM. In pregnant women with GDM, there was a statistically significant correlation between fetal abdominal SCT thickness and glucose levels (r = 0.64, p < 0.01) and HOMA-IR (r = 0.48, p < 0.05). ConclusionsMeasuring the subcutaneous fat thickness of the fetus shortly before delivery is beneficial for predicting insulin resistance in neonates. This is considered particularly useful for women with effectively managed GDM, where the presence of conditions such as macrosomia may not be pronounced.

Image J as the quantification tool in endosonography strain elastography may be reflected in the disturbance of endocrine pancreatic dysfunction.

Pancreatic fibrosis is one of the main pathological features of chronic pancreatitis (CP), suggesting a strong relationship between CP and pancreatic ductal cancer. There was no available data about pancreatic fibrosis and pancreatic dysfunction in the early CP (ECP) using endosonography (EUS). Asymptomatic patients with pancreatic enzyme abnormalities (AP-P; n = 56) and patients with ECP (n = 21) were determined by the absence of abnormal findings on upper gastrointestinal endoscopy, abdominal ultrasonography, and abdominal computed tomography. An Olympus EUS (GF-UCT 260; Olympus) was used to perform EUS. Open software "Image J", developed by NIH, was used to measure the surface area fraction of the designated elastic blue region. The maximum value among the pancreatic head, pancreatic body, and pancreatic tail was defined as the ELST-blue score. The exocrine and endocrine pancreatic functions were evaluated using the N-benzoyl-l-tyrosyl-p-aminobenzoic acid (BT-PABA) test and homeostasis model assessment of β-cell function (HOMA-β) value, respectively. EUS score, lobularity, and hyperechoic foci/strands in patients with ECP were significantly (p < 0.001) higher than those in patients with AP-P. In addition, there were no significant differences in the BT-PABA test (73.1 ± 25.5, 68.5 ± 15.6) and HOMA-β (93.1 ± 67.4, 73.5 ± 139.7) between patients with ECP and AP-P. The ELST-blue score measured by image J as the quantification tool in EUS strain elastography in patients with ECP was significantly higher (p = 0.002) than that in patients with AP-P. Interestingly, the ELST-blue score was significantly associated with HOMA-β in patients with ECP. The ELST-blue score may be a useful tool for the evaluation of endocrine pancreatic dysfunction in the ECP.

The effect of Fenugreek seed dry extract supplement on glycemic indices, lipid profile, and prooxidant-antioxidant balance in patients with type 2 diabetes: A double-blind randomized clinical trial.

This study aims to determine the effects of fenugreek seed dry extract (FDE) on the glycemic indices, lipid profile, and prooxidant-antioxidant balance (PAB) in patients with type 2 diabetes (T2D). A double-blind randomized clinical trial was carried out on 54 individuals with T2D. Participants were randomly assigned to a FDE group (received 3 tablets containing 335 mg of FDE daily for 8 weeks) or a placebo group (received tablets containing microcrystalline cellulose). Anthropometric indices, physical activity, diet, fasting blood sugar (FBS), serum insulin, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), triglyceride (TG), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein (HDL-C), and PAB were assessed. An eight-week intake of 3 tablets containing 335 mg of FDE decreased serum insulin (P=0.016, P<0.001), HOMA-IR (P=0.009, P<0.001), TG (P<0.001, P=0.001), and PAB (P<0.001, P<0.001) compared to the baseline, in both placebo and intervention groups respectively. TC decreased significantly compared to the baseline in the placebo group (P=0.028), while HDL-C increased in the FDE group compared to the baseline (P<0.001) and placebo group (P=0.014). In the present study even though changes of parameters were more in intervention group compared to the control group, we did not observe any significant differences between studied groups except for HDL-C. However, the effects might become apparent with a higher dosage, longer study duration, or a larger sample size compared to the placebo group. Further clinical trials are needed in this regard.

Chronic stress induces insulin resistance and enhances cognitive impairment in AD

BackgroundChronic stress can induce the cognitive impairment, and even promote the occurrence and development of Alzheimer's disease (AD). Evidence has suggested that chronic stress impacts on glucose metabolism, and both of these have been implicated in AD. Here we focused on the effect of insulin resistance in glucose metabolism, and further evaluated the changes in cognition and pathology. MethodsMale 9-month-old wild-type and APP/PS1 mice were randomly divided into 4 groups. Mice in the chronic unpredictable mild stress (CUMS) groups were exposed for 4 weeks. Homeostatic Model Assessment (HOMA) was utilized to evaluate insulin sensitivity. A total of eighty-four genes related to the insulin signaling pathway were examined for rapid screening. Additionally, the phosphorylated protein expressions of insulin receptors (IR), IR substrate 1 (IRS1), c-Jun N-terminal kinase (JNK), and amyloid were detected in the hippocampus. Cognitive function was assessed through ethological methods. Cognitive function was assessed using both the Morris water maze (MWM) and the Passive avoidance test (PAT). ResultsFour weeks of CUMS exposure significantly increased the HOMA value, indicating reduced insulin sensitivity. The gene expressions of Insr and Lipe were downregulated. Additionally, the analysis revealed a significant interaction between the genotype (wild-type vs. APP/PS1) and CUMS treatment on the phosphorylated protein expressions of insulin receptor substrate 1 (IRS1). Specifically, CUMS exposure increased the inhibitory phosphorylation site (IRS1-pSer636) and decreased the excitatory phosphorylation site (IRS1-pTyr465) in the post-insulin receptor signaling pathway within the hippocampus of both wild-type and APP/PS1 mice. Moreover, CUMS exposure induced and exacerbated cognitive impairments in both wild-type and APP/PS1 mice, as assessed by the Morris water maze (MWM) and Passive avoidance test (PAT). However, there was no significant effect of CUMS on senile plaque deposition or levels of Aβ42 and Aβ40 in wild-type mice. ConclusionsChronic stress significantly affects hippocampal cognitive function through insulin resistance and exacerbates AD pathology. This study reveals the complex relationship between chronic stress, insulin resistance, and AD, providing new insights for developing interventions targeting chronic stress and insulin resistance.

Comparative Effects of Moderate Intensity Continuous Training and High Intensity Interval Training on Serum Levels of Myonectin in Rats

Background: Myonectin (CTRP15), a recently identified myokine, plays a crucial role in regulating glucose metabolism. Objectives: This study aimed to compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on serum myonectin levels, using matched training volumes for both interventions. Methods: Twenty-four male Wistar rats, aged 18 to 20 weeks, were randomly assigned to three groups of eight: Control, MICT, and HIIT. The training groups participated in HIIT and MICT programs (three days per week) on a treadmill for eight weeks. Measurements included serum glucose, insulin, myonectin, and the homeostasis model assessment of insulin resistance (HOMA-IR). Additionally, the weight of the Flexor hallucis longus (FHL), gastrocnemius muscles, and epididymal and retroperitoneal fat pads was recorded. Results: Both HIIT and MICT significantly reduced weight gain and fat mass (epididymal and retroperitoneal) compared to the control group (P &lt; 0.05). Eight weeks of HIIT significantly decreased serum insulin levels and HOMA-IR compared to both the control and MICT groups (P &lt; 0.05). No significant differences in serum myonectin levels were observed between the groups. Conclusions: This study suggests that HIIT is more effective than MICT in improving metabolic status in rats, though it does not significantly affect serum myonectin levels.

Characteristics and pregnancy outcomesofsubtypes of gestational diabetes mellitusbased on HOMA-IR and BMI.

To identify the characteristics and pregnancy outcomes across different subgroups of gestational diabetes mellitus (GDM) categorized by insulin resistance index and body mass index (BMI) in early pregnancy. This retrospective study included 1804 women who underwent a 75g-OGTT during 22-28weeks of gestation, categorized into normal glucose tolerance (NGT) (1487) and GDM (317 [17.57%] of the total cohort). Metabolic parameters were assessed, and equation of homeostatic model assessment (HOMA) were utilized to compute indices of insulin resistance (HOMA-IR), β-cell secretory (HOMA-B), and insulin sensitivity (HOMA-%S) in early and mid-pregnancy. The cut-off value of HOMA-IR (1.61) in early pregnancy was determined via ROC curve analysis. This value, combined with pre-pregnancy BMI, further categorized NGT and GDM into six subgroups respectively, based on HOMA-IR levels (≥ 1.61 or < 1.61) and BMI categories (< 18.5kg/m2, 18.5-25kg/m2, or ≥ 25kg/m2). In comparison to women with NGT, those with GDM were notably older, had higher pre-BMI, fasting plasma glucose (FPG), insulin, and lipid levels in early pregnancy. They also exhibited more pronounced insulin resistance in both early and mid-pregnancy, leading to poorer outcomes. Following an oral glucose load, the peaks of glucose and insulin were out of sync in GDM and its subgroups, accompanied by further increases in HOMA-IR, HOMA-B, and a decrease in HOMA-%S, except for the GDM subgroup with HOMA-IR < 1.61/BMI < 18.5kg/m2. Conversely, glucose and insulin secretion in NGT and its subgroups peaked synchronously at 60min. GDM women with HOMA-IR ≥ 1.61/18.5kg/m2 ≤ BMI < 25kg/m2 had higher rates of neonatal jaundice (34.5% vs 13.9%, p < 0.0001), LGA (28.9% vs 13.2%, p = 0.001), macrosomia (9.8% vs 3.7%, p = 0.025) compared to peers, while in GDM women with HOMA-IR ≥ 1.61/BMI ≥ 25kg/m2, the rates of LGA and macrosomia were 26.6% and 8.4%, respectively. The GDM subgroup with HOMA-IR < 1.61/BMI < 18.5kg/m2 exhibited the highest rates of premature rupture of membrane (46.7%) and postpartum hemorrhage (20%), predominantly with vaginal delivery and a 1min Apgar score of 4.5% in GDM women with HOMA-IR < 1.61/18.5kg/m2 ≤ BMI < 25kg/m2. GDM and its subgroups displayed severe insulin resistance and poorer insulin sensitivity, leading to an increased risk of adverse pregnancy outcomes. GDM women with higher IR and normal or over weight were more likely to experience LGA and macrosomia, while those with lower IR and underweight were prone to premature rupture of membrane and postpartum hemorrhage during vaginal delivery.

Role of Serum Magnesium on Insulin Resistance in Overweight and Obese Children.

Background Childhood obesity has become a global epidemic, with projections indicating it could affect 25% of children under 16 by 2050. This rise poses significant health risks, including early onset of type 2 diabetes and cardiovascular diseases. Recent research has shown a correlation between insulin action and magnesium levels, highlighting the link between low serum magnesium levels and obesity. This study aimed to investigate the relationship between serum magnesium levels and obesity in children aged 5-16 years, to compare overweight and obese adolescents with age- and gender-matched controls, and to determine the association between insulin resistance and decreased serum magnesium levels. Methodology At a tertiary hospital, this 1.5-year cross-sectional comparativestudy investigated the relationship between magnesium levels in the blood and insulin resistance in children aged 5-16. Cases met the 2015 revised Indian Academy of Pediatrics (IAP) growth charts for overweight or obesity in comparison to age-matched healthy controls. Exclusions included secondary causes of obesity and medical complications affecting magnesium. Assessments involved clinical history, examination, and fasting blood tests for insulin resistance indices. Results Compared to the controls, overweight children showed that mean serum magnesium levels are lower (1.03 mEq/l vs. 1.85 mEq/l, p<0.001); they were also reflected in higher anthropometric measures, which include body mass index (BMI) and body fat percentage. Cases had significantly higher metabolic markers like fasting insulin, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index, and lipid profiles, whereas systolic blood pressure although showing recognized differences did not significantly differ. Conclusion The study underscored the importance of detecting magnesium levels on insulin resistance in overweight and obese children.

Effects of Gossypetin on Glucose Homeostasis in Diet-Induced Pre-Diabetic Rats.

Natural flavonoids exert many potential health benefits, including anti-hyperglycaemic effects. However, the effects of gossypetin (GTIN) on glucose homeostasis in pre-diabetes have not yet been investigated. This study examined the effects of GTIN on key markers of glucose homeostasis in a diet-induced pre-diabetic rat model. Pre-diabetes was induced by allowing the animals to feed on a high-fat high-carbohydrate (HFHC) diet supplemented with 15% fructose water for 20 weeks. Following pre-diabetes induction, the pre-diabetic animals were sub-divided into five groups (n = 6), where they were either orally treated with GTIN (15 mg/kg) or metformin (MET) (500 mg/kg), both with and without dietary intervention, over a 12-week period. The results demonstrated that animals in the untreated pre-diabetic (PD) control group exhibited significantly higher fasting and postprandial blood glucose levels, as well as elevated plasma insulin concentrations and increased homeostatic model assessment for insulin resistance (HOMA2-IR) index, relative to the non-pre-diabetic (NPD) group. Similarly, increased caloric intake, body weight and plasma ghrelin levels were observed in the PD control group. Notably, these parameters were significantly reduced in the PD animals receiving GTIN treatment. Additionally, glycogen levels in the liver and skeletal muscle, which were disturbed in the PD control group, showed significant improvement in both GTIN-treated groups. These findings may suggest that GTIN administration, with or without dietary modifications, may offer therapeutic benefits in ameliorating glucose homeostasis disturbances associated with the PD state.

Efficacy and Safety of Pioglitazone/Metformin Fixed-Dose Combination Versus Uptitrated Metformin in Patients with Type 2 Diabetes without Adequate Glycemic Control: A Randomized Clinical Trial.

We aim to evaluate the efficacy and safety of pioglitazone/metformin fixed-dose combination (FDC) versus uptitrated metformin in patients with type 2 diabetes mellitus (T2DM) without adequate glycemic control. A total of 304 patients were recruited from 15 hospitals in China and randomly assigned (1:1) to the test group (pioglitazone/metformin FDC, 15/500mg) or the control group (uptitrated metformin, 2000-2500mg/day). The primary endpoint was the proportion of patients with glycated hemoglobin A1c (HbA1c) ≤ 6.5% and ≤ 7.0% at week 16. The secondary outcomes included the change from baseline in glucose, serum lipids, and liver function. Full analysis set (FAS) and per-protocol set (PPS) were used for analyses. In the test group, 103 (69.59%) patients reached HbA1c ≤ 7.0% (FAS, P = 0.009), with 68 (45.95%) patients achieved HbA1c ≤ 6.5 (FAS, P = 0.043). More reduction in HbA1c, homeostatic model assessment for insulin resistance, and diastolic pressure was found. Bodyweight, body mass index, and high-density lipoprotein cholesterol increased markedly. The changes of triglycerides, alanine transaminase, aspartate aminotransferase, and high-sensitivity C-reactive protein decreased noticeably. There were no significant differences in rates of adverse events between the two groups. Pioglitazone/metformin FDC was superior to uptitrated metformin among patients with T2DM without adequate glycemic control. This trial is registered with the Chinese Clinical Trial Registry (ChiCTR1900028606).

Genistein mitigates diet-induced obesity and metabolic dysfunctions in gonadectomized mice with some sex-differential effects.

Obesity is associated with insulin resistance (IR) and metabolic dysfunction-associated steatotic liver disease (MASLD). Genistein, an isoflavone, is a promising natural compound for preventing and treating obesity and metabolic dysfunctions. We aimed to investigate the sex-specific protective effects of genistein on obesity, IR, and MASLD in a murine model of sex hormone deprivation with diet-induced obesity (DIO), mimicking postmenopausal women or aging men with metabolic syndrome. Gonadectomized and sham-operated C57BL/6NJcl mice were fed a high-fat high-sucrose diet for 4 weeks to induce obesity (7 mice per group). In gonadectomized mice, genistein (16 mg/kg/day) or vehicle (7.5% dimethyl sulfoxide) was orally administered for 45 days. We assessed glucose homeostasis parameters, hepatic histopathology, and hepatic gene expression to investigate the effects of gonadectomy and genistein treatment. Gonadectomy exacerbated adiposity in both sexes. Ovariectomy diminished the protective effects of female gonadal hormones on the homeostatic model assessment for insulin resistance (HOMA-IR), serum alanine transaminase levels, hepatic steatosis score, and the expression of hepatic genes associated with MASLD progression and IR, such as Fasn, Srebf1, Saa1, Cd36, Col1a1, Pck1, and Ppargc1a. Genistein treatment in gonadectomized mice significantly reduced body weight gain and the hepatic steatosis score in both sexes. However, genistein treatment significantly attenuated HOMA-IR and the expression of the hepatic genes only in female mice. Genistein treatment mitigates DIO-related MASLD in both male and female gonadectomized mice. Regarding hepatic gene expression associated with MASLD and IR, the beneficial effect of genistein was significantly evident only in female mice. This study suggests a potential alternative application of genistein in individuals with obesity and sex hormone deprivation, yet pending clinical trials.

The Relationship between Body Compositions and Serum Vitamin D Levels in Obese Adolescents

Purpose: Obesity and vitamin D deficiency is a significant public health problem with increasing frequency in childhood. Although numerous studies explored the correlation between obesity and vitamin D, the study is aimed to investigate such relationship in consideration of few/no studies on vitamin D and body compositions in obese people. Methods: A total of 62 adolescents aged 12 to 18 were included in the study, comprising 33 obese adolescents and 29 with normal weight. Blood samples were analyzed for 25-hydroxyvitamin D (25(OH)D), calcium (Ca), phosphorus (P), magnesium (Mg), alkaline phosphatase (ALP), parathyroid hormone (PTH), insulin, C-reactive protein (CRP), total cholesterol, LDL cholesterol (LDL), triglycerides (TG), and HDL cholesterol (HDL). Body fluid status and composition were assessed using bioimpedance spectroscopy (BIS) for both the obese and control groups. Results: Total body water (TBW), extracellular water (ECW), intracellular water (ICW), ECW/ICW (E/I) ratio, lean tissue index (LTI), adipose tissue index (FTI), lean tissue mass (LTM), adipose tissue mass (ATM), body cell mass (BCM) values were significantly higher in the obese group in comparison with the control group (p ˂ 0.05). There was no significant difference in 25(OH)D levels in the obese and control groups (p ˃ 0.05). The distribution of 25(OH)D values below and above 20 did not differ significantly in the obese and control groups (p ˃ 0.05). Cholesterol, insulin and HOMA-IR values were detected significantly higher in the obese group than in the control group (p ˂ 0.05). HDL and Ca values were significantly lower in the obese group than in the control group (p ˂ 0.05). A significant positive correlation was discovered between BMI value and TBW, ECW, ICW, E/I, LTI, FTI, LTM, ATM, BCM values (p ˂ 0.05). A significant positive correlation was discovered between HOMA IR value and TBW, ECW, ICW, E/I, FTI, FAT, ATM values (p&lt; 0.05). No significant correlation was encountered between ....

The effect of vitamin D supplementation on markers of insulin resistance in women with polycystic ovarian syndrome: a systematic review.

Insulin resistance (IR) is a common pathology in women with polycystic ovarian syndrome (PCOS) involved in increased rates of cardiometabolic disease such as diabetes and cardiovascular disease. Low serum vitamin D is often associated with insulin resistance but there is no consensus on whether vitamin D supplementation can ameliorate markers of IR in PCOS. We assessed evidence on the effects of vitamin D supplementation (≥ 1000 IU/day), without the use of additional supplements or other pharmacological treatments known to affect IR, on markers of IR and glycemic control in women with PCOS. A systematic search was conducted using PubMed, Medline and Web of Science databases from January 2000 up to November 2023. Randomized controlled trials that assessed the effects of vitamin D supplementation in women with PCOS, on fasting glucose, fasting insulin, glycated haemoglobin (HbA1c) or homeostatic model assessment for insulin resistance (HOMA-IR) were included. 9 studies were identified. Study populations ranged from 28 to 180 participants, with mean ages ranging from 22 to 30 years. Daily vitamin D doses ranged from 1714-12,000 IU. Of the included studies, 3 reported statistically significant reductions in fasting glucose, 2 reported reductions in fasting insulin, 2 reported reductions in HOMA-IR, none reported reductions in HbA1c and 5 reported no differences in any of the relevant outcomes. In conclusion, in RCTs of vitamin D supplementation in women with PCOS, the majority of studies do not report statistically significant improvements in fasting glucose, fasting insulin, HbA1c or HOMA-IR. However, as a minority of studies report some statistically significant results, further investigation may be warranted. PROSPERO ID: CRD42023486144.