Homeostasis Model Assessment Of Insulin Resistance Score Research Articles

Associations between cardiometabolic indices and the risk of diabetic kidney disease in patients with type 2 diabetes

BackgroundThis study was designed to assess the associations between emerging cardiometabolic indices—the atherogenic index of plasma (AIP), the stress hyperglycemia ratio (SHR), the triglyceride-glucose (TyG) index, and the homeostasis model assessment of insulin resistance (HOMA-IR)—and the incidence of diabetic kidney disease (DKD) in type 2 diabetes (T2D) patients.MethodsWe consecutively enrolled 4351 T2D patients. The AIP, SHR, TyG index, and HOMA-IR were calculated from baseline parameters. DKD was defined as a urine albumin/creatinine ratio > 30 mg/g or an eGFR < 60 mL/min per 1.73 m. All participants were categorized into tertiles based on the cardiometabolic indices. Multivariate logistic regression models, restricted cubic splines, and receiver operating characteristic (ROC) curves were used for analysis.ResultsA total of 1371 (31.5%) patients were diagnosed with DKD. A restricted cubic spline showed a J-shaped association of the AIP and TyG index with DKD, a log-shaped association between HOMA-IR and DKD, and a U-shaped association between the SHR and DKD incidence. Multivariate logistic regression revealed that individuals in the highest tertile of the four cardiometabolic indices had a significantly greater risk of DKD than did those in the lowest tertile (AIP: OR = 1.08, 95% CI = 1.02–1.14, P = 0.005; SHR: OR = 1.42, 95% CI = 1.12–1.81, P = 0.004; TyG index: OR = 1.86, 95% CI = 1.42–2.45, P < 0.001; HOMA-IR: OR = 2.24, 95% CI = 1.52–3.30, P < 0.001). The receiver operating characteristic curves showed that the HOMA-IR score was better than other indices at predicting the risk of DKD, with an optimal cutoff of 3.532.ConclusionsElevated AIP, SHR, TyG index and HOMA-IR are associated with a greater risk of DKD in patients with T2D. Among these indices, the HOMA-IR score demonstrated the strongest association with and predictive value for DKD incidence.

Prospective study of the association between chronotype and cardiometabolic risk among Chinese young adults

BackgroundThe association of evening chronotype with cardiometabolic disease has been well established. However, the extent to which circadian rhythm disturbances independently result in risk remains unclear. This study aimed to investigate the cross-sectional and prospective longitudinal associations between chronotype and cardiometabolic risk among Chinese young adults.MethodsFrom April to May 2019, a total of 1 135 young adults were selected to complete the self-administered questionnaire, and 744 fasting blood samples were collected to quantify cardiometabolic parameters. From April to May 2021, 340 fasting blood samples were collected to quantify cardiometabolic parameters. The Morning and Evening Questionnaire 5 (MEQ-5) was used to assess chronotype. The cardiometabolic (CM)-risk score was the sum of standardized Z scores based on gender for the 5 indicators: waist circumference (WC), mean arterial pressure (MAP), triglyceride (TG), homeostasis model assessment for insulin resistance (HOMA-IR), and high-density lipoprotein cholesterol (HDL-C), where the HDL-C is multiplied by-1. The generalized linear model was used to determine the cross-sectional and prospective longitudinal associations between chronotype and each cardiometabolic parameter.ResultsCross-sectional association analysis showed that lower MEQ-5 scores were correlated with higher fasting insulin (β=-1.420, 95%CI: -2.386~-0.453), higher HOMA-IR (β=-0.301, 95%CI: -0.507~-0.095), and higher CM risk score (β=-0.063, 95%CI: -0.122~-0.003), even after adjustment for covariates. Prospective longitudinal association analysis also showed that lower MEQ-5 scores were associated with 2 years later higher fasting glucose (β=-0.018, 95%CI: -0.034~-0.003), higher fasting insulin (β=-0.384, 95%CI: -0.766~-0.003), higher HOMA-IR (β=-0.089, 95%CI: -0.176~-0.002), and higher CM-risk score (β=-0.109, 95%CI: -0.214~-0.003) after adjustment for covariates.ConclusionsEvening chronotype was significantly correlated with higher CM risk among young adults. Our findings suggest that biologically and socially affected sleep timing misalignment is a contributing factor to cardiovascular disease risk.

Insulin resistance and central obesity determine hepatic steatosis and explain cardiovascular risk in steatotic liver disease.

Metabolic dysfunction-associated steatotic liver disease (MASLD) has recently been proposed to replace non-alcoholic fatty liver disease and focus on patients with progressive disease due to the presence of metabolic dysfunction. However, it is unclear whether the new definition actually identifies patients with hepatic steatosis at increased cardiovascular risk. A total of 4,286 asymptomatic subjects from the SAKKOPI study aged 45-80 years undergoing screening colonoscopy were analyzed. Steatosis was diagnosed by abdominal ultrasound. MASLD was diagnosed according to the recent expert consensus. Insulin resistance was assessed by homeostasis model assessment-insulin resistance score (HOMA-IR) (cutoff: ≥2.5), subclinical inflammation was estimated by ferritin/CRP/uric acid, and cardiovascular risk was assessed using SCORE2/ASCVD. Mean age was 59.4 ± 8.5 years, 51.6% were male; mean BMI was 27.0 ± 4.5 kg/m², 9.2% had type 2 diabetes mellitus. In total, 1,903 (44.4%) were diagnosed with hepatic steatosis and were characterized by more severe metabolic dysfunction including insulin resistance (47.1% vs. 12.2%, p < 0.001) and central obesity (waist circumference ≥102/88 cm, 71.8% vs. 37.1%, p < 0.001). This translated into higher (subclinical) inflammation (ferritin 153 vs. 95 mg/dL, p < 0.001, uric acid 6.3 mg/dL vs. 5.2 mg/dL, p < 0.001) and 10-year cardiovascular risk (SCORE2 7.8 points vs. 5.1 points, p < 0.001, ASCVD 17.9 points vs. 10.8 points, p < 0.001). 99.0% of subjects with steatosis met the MASLD definition, 95.4% met the MAFLD definition, and 53.6% met the definition of metabolic syndrome, while 95.4% of subjects without steatosis also met the MASLD criteria for metabolic dysfunction compared to 69.0% and 17.4% who met the MAFLD and metabolic syndrome criteria, respectively. Forward stepwise regression indicated that waist circumference, HOMA-IR, and triglycerides were most relevant in explaining the presence of hepatic steatosis across all subgroups of increasing metabolic dysfunction. At the same time, hepatic steatosis was not associated with cardiovascular risk in the overall cohort (SCORE2: B = 0.060, 95% CI: -0.193-0.314, and p = 0.642) and in patients with metabolic dysfunction after adjusting for age, sex, and these three metabolic dysfunction components. Although hepatic steatosis is associated with increased central obesity and insulin resistance, metabolic dysfunction per se rather than hepatic steatosis explains cardiovascular risk in these patients.

Cross-sectional observational study on correlation of obesity and overweight in children with insulin resistance based on HOMA-IR score

With improvements in lifestyle and healthcare throughout the world, there has been an increasing incidence of obesity among adults and children. It is important that obesity and its adverse effects be recognized in childhood and measures be taken right from childhood to tackle the long-term outcomes of the same. We have studied the correlation of scores like Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) and its relation with Insulin resistance in children. Which helps as a tool in early recognition of lifestyle diseases in children. It was seen that of a total of 50 children of which 40 children were obese (BMI greater than 95th centile) and 10 children were overweight (BMI greater than 85th centile), 43 children had insulin resistance based on HOMA-IR score (cut-off=2.5) and 7 were non-insulin resistant. From our study, it has been concluded that HOMA-IR has a strong correlation with BMI and can be used as a surrogate marker of Insulin resistance.

Effects of Endurance Exercise and Vitamin D Supplementation on Insulin Resistance and Plasma Lipidome in Middle-Aged Adults with Type 2 Diabetes.

(1) Background: We investigated the effects of a 12-week exercise intervention with or without vitamin D supplementation on insulin resistance and the plasma lipidome of participants with type 2 diabetes. We further explored whether the effects of the intervention on glycemic parameters could be associated with the baseline lipidome. (2) Methods: Sixty-one participants were randomly allocated to control (Con), exercise (EX), vitamin D (VD), and EX + VD groups. Multiple glycemic and anthropometric parameters were evaluated before and after intervention. The homeostasis model assessment of insulin resistance (HOMA-IR) was the primary outcome. The plasma lipidome was analyzed before, after, and at an additional 12-week follow-up. Machine learning was applied to establish prediction models for responsiveness of glycemic control. (3) Results: Our interventions failed to improve the HOMA-IR index while fasting glucose was reduced in the EX + VD group (change%, -11.9%; effect size, 0.65; p < 0.05). Both EX and VD interventions altered the plasma lipidome, with EX + VD intervention considerably affecting levels of lyso-phosphatidylcholines and triglycerols containing long-chain unsaturated fatty acids. Such effects could last until 12 weeks after intervention. Notably, there was high inter-individual variability in glycemic parameters including HOMA-IR in response to the interventions, which could be predicted with great accuracy using an optimal panel of baseline lipid predictors alone or in combination with clinical indices, as assessed by an area under the receiver operating characteristic curve value of over 0.9. (4) Conclusions: Although substantial alterations were observed in the plasma lipidome related to glycemic control, our intervention failed to improve HOMA-IR scores, which may have been predominately due to the large inter-individual variability in responses. Basal plasma lipid levels could potentially predict an individual's response to intervention, highlighting the necessity of personalized nutrition.

Hyperinsulinemia Impaired Coronary Collateral Circulation in Patients with Chronic Total Coronary Occlusion.

Hyperinsulinemia impaired cardiovascular system and endothelial function in the population. The purpose of this study was to explore the relationship between hyperinsulinemia and coronary collateral circulation in patients with chronic total coronary occlusion. Patients with stable angina and at least one total coronary occlusion were enrolled in this study. Collateral grade was determined according to Rentrop's classification. Patients were divided into a good coronary collateral circulation (CCC) group (grade 2 or 3 collateral vessels, n = 223) and a poor CCC group (grade 0 or 1 collateral vessels, n = 115). Fasting insulin level (FINS) and fasting glucose level (FBS) were measured. Endothelial function evaluated by flow-mediated dilation (FMD). Serum FINS level was significantly increased in the poor CCC group (P < 0.01). Patients in the poor CCC group had higher levels of FBS, HbA1C, and homeostasis model assessment for insulin resistance (HOMA-IR) than patients in the good CCC group. The poor CCC group also had lower levels of FMD, lower LVEF and higher syntax scores than the good CCC group. Hyperinsulinemia (T3, FINS ≥15.22 μIU/mL) increased OR for the incidence of the poor CCC group (OR 2.419, 95% CI 1.780-3.287) in multivariate analysis. Multivariate logistic regression also revealed that diabetes, HbA1c, HOMA-IR, HDL-C and Syntax score were independent predictors of poor CCC (all P < 0.05). Hyperinsulinemia is a valuable predictor of poor collateral formation in patients with chronic total coronary occlusion.

Sonic hedgehog N-terminal level correlates with adiponectin level and insulin resistance in adolescents.

Extracellular vesicles (EVs) are small vesicles released by nearly all types of cells. They deliver different types of substances, including proteins and nucleic acids, to nearby or distant cells and play a role in the mediation of cell-to-cell communication. The aim of this study was to explore the association between EVs and insulin resistance in adolescents with obesity or type 2 diabetes mellitus (DM2). The subjects were eight adolescents with DM2(DM2 group; four males and four females; age: 18.1±2.3years), 18 adolescents with simple obesity (obesity group; 12 males and six females; age: 12.2±3.4years), and 20 controls (control group; 10 males and 10 females; age: 13.0±1.4years). As markers of EVs, serum CD9/CD63 and sonic hedgehog N-terminal (Shh-N) levels were measured using enzyme-linked immunosorbent assay. The CD9/CD63 level in the control group was similar to that in the DM2 group, whereas the obesity group had a significantly higher CD9/CD63 level. In the entire study group, correlations were observed between serum Shh-N level and Homeostasis Model Assessment of insulin resistance (HOMA-IR) score (r=0.371, p=0.0143), Homeostasis Model Assessment-β cell function score (r=0.382, p=0.0115), serum insulin level (r=0.350, p=0.0171), and serum adiponectin level (r=0.367, p=0.0122). Multiple regression analysis revealed that serum Shh-N level was the most significant riskfactor for HOMA-IR score and serum insulin level. Shh is correlated with insulin resistance viaits association with adiponectin in adolescents.

HOMA estimated insulin resistance as a marker for angiographic severity of coronary artery disease in non-diabetic and non-obese patients.

Insulin resistance (IR) examined by homeostasis model assessment of insulin resistance (HOMA-IR) measures increased carotid atherosclerosis risks in non-diabetic and non-obese persons. The information about the relationship between IR and coronary atherosclerosis severity among non-diabetic and non- obese population showed conflicting results. The goal of the current study was to assess the relationship that links IR and coronary artery disease (CAD) among non-diabetic and non-obese Egyptian populations. 112 non-diabetic and non-obese patients were included in this study. These patients underwent coronary angiogram (CA) either due to acute coronary syndrome (ACS) or chronic stable angina with positive exercise tests. Our study found a strong association between HOMA-IR and Gensini score (r = 0.831,with p<0.001) in general population. The HOMA-IR was the most influential independent predictor for the presence of extensive coronary atherosclerosis. Non-diabetic and non-obese people carrying the risk of developing the three-vessel disease (3VD) may be identified with a HOMA-IR score of over 5.9 according to the ROC curve analysis with a sensitivity of 67.7%. IR that developes in non-diabetic non-obese individuals coincides with more severe and more outspread CAD. In non-diabetic non-obese populations who need a CA, a single HOMA-IR value is higher than 5.9 may imply an elevated risk for clinically significant CAD. As insulin resistance is a reversible process, risk stratifications of CAD in non-diabetic non-obese populations could include HOMA-IR as one of its parameters.

Quantitatively Evaluating the Relationships between Insulin Resistance and Retinal Neurodegeneration with Optical Coherence Tomography in Early Type 2 Diabetes Mellitus

Introduction: The aim of this study was to quantitatively assess retinal neurodegenerative changes with optical coherence tomography (Cirrus HD-OCT) in type 2 diabetes mellitus (T2DM) patients without diabetic retinopathy (DR) and evaluate their relationships with insulin resistance (IR) and associated systemic indicators. Methods: 102 T2DM patients without DR and 48 healthy controls were included in this observational cross-sectional study. The OCT parameters of macular retinal thickness (MRT) and ganglion cell-inner plexiform layer (GCIPL) thicknesses were evaluated between diabetic and normal eyes. The receiver operating characteristics (ROC) curve was generated to evaluate the discrimination power of early diabetes. Correlation and multiple regression analysis were performed between ophthalmological parameters and T2DM-related demographic and anthropometric variables, and serum biomarkers and homeostasis model assessment of insulin resistance (HOMA-IR) scores. Results: MRT and GCIPL thicknesses showed significant thinning in patients, especially in inferotemporal area. High body mass index (BMI) correlated with decreased GCIPL thicknesses and elevated intraocular pressure (IOP). A negative correlation between waist-to-hip circumference ratio (WHR) and GCIPL thicknesses was also found. High-density lipoprotein (HDL) and fasting C-peptide (CP0) were associated with GCIPL thickness but only in inferotemporal region (r = 0.20, p = 0.04; r = −0.20, p = 0.05, respectively). Multiple regression analysis showed that increased HOMA-IR scores independently predicted both average (β = −0.30, p = 0.05) and inferotemporal (β = −0.34, p = 0.03) GCIPL thinning. Conclusion: Retinal thinning in early T2DM was associated with obesity-related metabolic disorders. IR as an independent risk factor for retinal neurodegeneration may increase the risk of developing glaucoma.

Pluchea indica Leaf Extract Alleviates Dyslipidemia and Hepatic Steatosis by Modifying the Expression of Lipid Metabolism-Related Genes in Rats Fed a High Fat-High Fructose Diet.

This study evaluated the effect of Pluchea indica leaf extract (PIE) on dyslipidemia and lipid accumulation in the liver, emphasizing its molecular mechanisms in regulating lipid metabolism in rats fed a high fat-high fructose diet (HFFD). Male rats were fed HFFD (40% lard and 20% fructose) for ten weeks. They were then divided into four groups receiving distilled water, PIE (100 or 300 mg/kg/d), and pioglitazone (10 mg/kg/d) for a further six weeks, during which the HFFD was continued. After the experiment, fasting blood glucose (FBG), oral glucose tolerance (OGT), serum insulin and leptin levels, lipid profiles, and hepatic triglyceride content were measured. Histological examination and expression levels of lipid metabolism-related genes in the liver were measured. HFFD-fed rats indicated a significantly increased FBG, serum leptin, and homeostasis model assessment of insulin resistance (HOMA-IR) scores with impaired OGT and dyslipidemia compared to rats fed a normal diet. PIE significantly reduced FBG, serum leptin, and HOMA-IR scores and improved OGT. Additionally, PIE significantly improved dyslipidemia and decreased serum-free fatty acids and liver triglyceride content. Hepatic histological examination showed a marked reduction lipid accumulation in relation to HFFD controls. Interestingly, PIE significantly downregulated the expression of lipid synthesis-related genes and upregulated the expression of fatty-acid oxidation-related genes. In conclusion, PIE alleviates dyslipidemia and hepatic steatosis in HFFD rats plausibly by increasing insulin resistance and modifying the gene expression associated with lipid metabolism. PIE may be used as preventive nutrition for dyslipidemia and hepatic steatosis.

Взаимосвязь между уровнем тиреотропного гормона, инсулинорезистентностью и сердечно-сосудистыми факторами риска у пациентов с ожирением и субклиническим гипотиреозом

Актуальность. Эпидемия избыточного веса и ожирения представляет собой серьезную проблему для системы здравоохранения во всем мире и требует проведения профилактических мероприятий. Предполагаемые взаимо­связи между гормонами щитовидной железы, массой тела и гомеостазом жировой ткани находятся в центре внимания нескольких исследований в последние годы, однако причинно-следственные связи между этими параметрами четко не установлены. Цель: изучить взаимосвязь между уровнем тиреотропного гормона (ТТГ), инсулинорезистентностью (ИР) и факторами риска сердечно-сосудистых заболеваний в выборке лиц с ожирением и субклиническим гипотиреозом. Материалы и методы. Проведен ретроспективный продольный анализ 145 лиц с ожирением. Проанализированы уровни ТТГ и свободного тироксина (свT4), антропометрические измерения и результаты лабораторных тестов. Результаты. У 23 человек уровень ТТГ был выше нормы (субклинический гипотиреоз). Окружность талии (ОТ) у них была достоверно выше, чем у людей в состоянии эутиреоза. Уровень ТТГ в сыворотке положительно коррелировал с индексом инсулинорезистентности (HOMA-IR), содержанием триглицеридов и холестерина липопротеинов высокой плотности (ЛПВП). С использованием ТТГ и индекса массы тела в качестве независимых переменных было показано, что уровни ТТГ независимо связаны с HOMA-IR (p = 0,002) и содержанием триглицеридов (p = 0,006). Среди эутиреоидных пациентов лица со значениями ТТГ &lt; 2,5 мМЕ/мл демонстрировали статистически значимое снижение соотношения ОТ и охвата бедер, уровня ЛПВП и показателей HOMA-IR, а также тенденцию к более низким значениям ОТ. Выводы. Субклинический гипотиреоз у людей с ожирением связан с избыточным наличием висцеральной жировой ткани. В настоящей выборке людей с ожирением уровни ТТГ связаны с инсулинорезистентностью.

IS SERUM FERRITIN LEVEL DIFFERENT BETWEEN HEALTHY INDIVIDUALS AND NEWLY DIAGNOSED PATIENTS WITH TYPE 2 DIABETES MELLITUS?: A CASE-CONTROL STUDY

Introduction: This study aims to evaluate whether serum ferritin levels differ between recently diagnosed patients with type 2 diabetes mellitus (DM) and healthy controls, and to assess the relationship between serum ferritin level, insulin resistance and metabolic control in patients with type 2 DM.&#x0D; Material and methods: This study included 40 patients with recently diagnosed type 2 DM and 40 healthy controls. The Homeostasis Model Assessment of insulin resistance (HOMA-IR) score was used for evaluation of insulin resistance. HOMA-IR scores ≥2.7 were accepted as insulin resistance. The patient and control groups were compared in terms of age, gender, BMI, serum ferritin, insulin, HbA1c, and HOMA-IR scores. If ferritin levels correlated with other parameters was assessed in the patient group. Furthermore, patients with good (HbA1c

Insulin Resistance in Association with Thyroid Function, Psychoemotional State, and Cardiovascular Risk Factors.

Background: Individuals with insulin resistance (IR) have a high risk of diabetes or metabolic syndrome, and they are more likely to have depression. Furthermore, IR by itself is a major cardiovascular risk factor in healthy persons. Thus, we aimed to investigate IR in association with thyroid function, psychoemotional state, and cardiovascular risk factors among 45–84-year-old citizens of Palanga. Methods: A randomized epidemiological study was performed with 850 subjects. All participants were evaluated for sociodemographic, clinical, and cardiovascular risk factors and biochemical analysis. IR was evaluated by the homeostasis model assessment of IR (HOMA-IR). Results: All study participants were stratified into groups without IR (HOMA-IR ≤ 2.7) and with IR (HOMA-IR > 2.7). The analysis of parameters between the two study groups showed some statistically significant relationships between IR and cardiovascular risk factors. The predictable accuracy was presented using receiver performance characteristic curves for HOMA-IR scores in women and men separately. If the HOMA-IR score is higher than 3.45, individuals are significantly more likely to have type 2 diabetes mellitus (T2DM). Conclusions: An increase of fasting glucose and more frequent incidence of metabolic syndrome, diabetes, and cardiovascular diseases in subjects with IR are associated with the prevalence of cardiovascular risk factors. There was no significant association between thyroid function and HOMA-IR. HOMA-IR cut-offs could predict the presence of T2DM.

Serum magnesium and visfatin levels in newly diagnosed non-obese type 2 diabetes without insulin resistance: a cross-sectional study

Background. Previous studies demonstrated that type 2 diabetes (T2D) patients have low serum magnesium and high serum levels of visfatin. This study aimed to show the relationship between serum levels of insulin, visfatin, and magnesium in T2D patients characterized by a non-insulin resistance status. Methods. This was a cross-sectional study conducted in the Hawler Medical University, Kurdistan Region, Iraq from April 2019 to March 2020. A total number of 130 T2D patients and 45 healthy subjects were enrolled in the study. T2D patients with scores of homeostasis model assessment — insulin resistance (HOMA-IR) of < 2.5 were included. Serum levels of magnesium, visfatin, and glycemic indices, including fasting serum glucose, insulin, visfatin, and glycated hemoglobin were determined. Results. The serum level of visfatin is significantly higher in T2D patients than the corresponding values of the healthy subjects. Serum magnesium level is significantly correlated with the percentage of the glycated hemoglobin (Spearman’s correlation factor = 0.184, P = 0.036), and a positive significant correlation between serum insulin and visfatin (r = 0.216, P = 0.014) was observed. Multivariate regression analysis of the association of fasting serum insulin as a dependent variable with serum magnesium and visfatin as independent variables showed a non-significant positive correlation (r = 0.197, P = 0.082). Conclusion. Significant low serum levels of magnesium and visfatin are observed in non-insulin resistant T2D patients with a HOMA-IR score of < 2.5. Serum visfatin and magnesium levels showed significant correlations with glycemic indices.

Insulin resistance is associated with poor functional outcome after acute ischemic stroke in non-diabetic patients

Insulin resistance is associated with the occurrence of stroke and atherosclerotic disease. However, the relationship between insulin resistance and the prognosis of acute ischemic stroke in non-diabetic patients is unclear. We hypothesized that insulin resistance might affect short-term functional recovery after acute ischemic stroke in non-diabetic patients. Between May 2014 and December 2016, 1377 consecutive patients with acute ischemic stroke were enrolled from a prospectively maintained stroke registry. After excluding patients with transient ischemic attacks (TIA), pre-stroke disabilities, diabetes mellitus, and patients with incomplete evaluations, 517 patients were included in the study. The homeostasis model assessment of insulin resistance (HOMA-IR) score was used to evaluate the degree of insulin resistance. The patients with the highest quartile of log HOMA-IR index scores were younger and had higher fasting blood glucose, total cholesterol, triglycerides, low-density lipoprotein, and HbA1c levels. Multivariable logistic regression analysis revealed that log HOMA-IR scores were independently associated with poor prognosis after adjusting for age and sex and p < 0.1 in univariable analysis. Insulin resistance was associated with the poor functional outcome of non-diabetic stroke patients. This evidence supports treating insulin resistance in acute ischemic stroke patients with blood glucose levels within the normal range.

Fasting serum free glycerol concentration is a potential surrogate marker of visceral obesity and insulin sensitivity in middle-aged Japanese men

Triglyceride (TG) is a tri-ester composed of a glycerol and 3 fatty acids. Degradation of TG in adipose tissue is increased in the fasting state but inhibited in the postprandial state. Although insulin suppresses adipose TG degradation, patients with insulin resistance have high concentrations of insulin and free glycerol (FG) in the fasting state. We examined whether the fasting FG concentration reflects visceral obesity and insulin sensitivity in middle-aged Japanese men. We measured the fasting serum FG concentration in 72 males aged 30 to 50years using a simple enzymatic method. The subjects were divided into tertiles according to their homeostasis model assessment of insulin resistance (HOMA-IR). Besides routine glucose- and lipid-related parameters, we determined insulin sensitivity as the rate of glucose disappearance in a 2-step hyperinsulinemic-euglycemic clamp and the abdominal visceral fat area (VFA) by magnetic resonance imaging. The highest HOMA-IR tertile group had a higher fasting FG concentration than the middle- and lowest-tertile groups (0.077±0.024 vs 0.063±0.017 and 0.061±0.016mmol/L, P<.05 and P<.01). The FG concentration was positively correlated with VFA (rs=0.36; P<.01) and the HOMA-IR score (rs=0.26, P<.05) but negatively correlated with insulin sensitivity (rs=-0.26, P<.05). Multivariate regression analysis revealed that the FG concentration is independently associated with VFA and insulin sensitivity. The fasting FG concentration reflects VFA and insulin sensitivity in middle-aged Japanese men. The fasting FG concentration may be a potential surrogate marker of visceral obesity and insulin resistance in outpatients.

Relationship between ghrelin and obestatin levels and ghrelin/obestatin ratio in patients with asthma.

This study aimed to evaluate serum levels of ghrelin and obestatin as well as the ghrelin/obestatin ratio in non-obese patients with asthma and in healthy non-asthmatic controls and analyzed the relationships to clinical outcomes. 51 patients with stable persistent asthma and 36 healthy controls were included to the study. Pulmonary function tests were conducted in all case. Skin prick test and an asthma control test were conducted in patients with asthma. All patients and controls were compared in terms of ghrelin and obestatin levels, as well as the ghrelin/obestatin ratio. Plasma concentrations of ghrelin and obestatin were detected by enzymelinked immunosorbent assay. Homeostasis model assessment-insulin resistance (HOMA-IR) scores were calculated as an index of insulin resistance. No differences in ghrelin or obestatin levels or the ghrelin/obestatin ratio were detected between patients with asthma and the control group. Ghrelin levels were significantly lower in obese patients. The HOMA-IR score was significantly higher in patients with asthma than in controls. Ghrelin and obestatin levels, and the ghrelin/obestatin ratio, were similar in controls and patients with stable asthma. Although the groups were similar in terms of body mass index and waist circumference, the HOMA-IR score was significantly higher in patients with asthma.

Hip circumference correlates negatively with insulin resistance in type 2 diabetic patients

Background: Body adiposity is a known factor in the development of insulin resistance. Not much is known on the association between insulin resistance and indices of obesity in type 2 diabetic African population. Objective: This study investigated the relationship between insulin resistance and anthropometric measurements in the black African population using the homeostasis model assessment of insulin resistance (HOMA-IR). Materials and Methods: A descriptive cross-sectional design was used to study a random sample of 183 type 2 diabetic patients and 96 nondiabetic controls. Anthropometric parameters were measured using an appropriate technique. Fasting blood glucose was estimated using a glucose oxidase method. Serum insulin level was estimated using enzyme-linked immunosorbent assay kits. Data were analyzed using the Statistical Package for the Social Sciences version 23.0. HOMA-IR score was used to determine insulin resistance. Results: Diabetic males had greater waist–hip ratio than their normal controls (percentage difference: −3.23, P = 0.02) while diabetic females had greater body mass index (BMI) (percentage difference: 7.62, P = 0.04) and waist circumference (percentage difference: 10.6, P = 0.001) than their normal controls. There were a negative correlation between hip circumference (HC) and insulin resistance in the type 2 diabetic patients and a positive correlation between BMI and insulin resistance in the nondiabetic controls. However, there was no significant correlation between other anthropometric parameters and insulin resistance in both the type 2 diabetic and control groups. Conclusion: HC has a negative correlation with insulin resistance in the black African type 2 diabetic patients. There is a need for further research in this area to reduce diagnostic costs in low-resource settings.

The association of the visceral adiposity index with insulin resistance and beta-cell function in Korean adults with and without type 2 diabetes mellitus.

This study was conducted to assess the association of the visceral adiposity index (VAI) with insulin resistance and beta cell function in Korean adults with and without type 2 diabetes mellitus. The study was carried out using data from the 2015 Korean National Health and Nutrition Examination Survey (KNHANES VI-3) and included 4,922 adults, aged 20 or older. There were several key findings in the present study. First, in subjects without type 2 diabetes mellitus, homeostasis model assessment of insulin resistance (HOMA-IR) (p < 0.001) and beta cell function (HOMA-B) (p < 0.001), insulin (p < 0.001), fasting blood glucose (FBG) (p < 0.001), and metabolic syndrome (MetS) score (p < 0.001) were positively associated with quartiles of VAI. Second, in subjects with type 2 diabetes mellitus, HOMA-IR (p = 0.038), FBG (p = 0.007), and MetS score (p < 0.001) were positively associated with quartiles of VAI, but associations with HOMA-B (p = 0.879) and insulin (p = 0.104) were not significant. In conclusions, the visceral adiposity index is positively associated with insulin resistance and beta cell function in Korean adults without type 2 diabetes mellitus. The visceral adiposity index is positively associated with insulin resistance but not beta cell function in Korean adults with type 2 diabetes mellitus.

Impact of lifetime marijuana use on fasting plasma insulin levels and HOMA-IR score in obese adults with and without insulin resistance.

To explore the association of marijuana use with mean plasma fasting insulin levels and homeostasis model assessment of insulin resistance (HOMA-IR) score in obese adults with different HOMA-IR. The National Health and Nutrition Examination Survey (NHANES) is a survey research program designed to assess the health and nutrition status of individuals in the United States and to track changes over time. We abstracted data from NHANES 2009-2016. We estimated the minimal lifetime marijuana use (MLU) using the duration of regular exposure and the frequency of use. We assessed the association of MLU and both plasma fasting insulin and HOMA-IR score using log-linear regression models. A total of 65,209 obese individuals aged 18 to 59years were included. In obese individuals who never used marijuana (reference), the mean value (± standard deviation) was 19.0 (± 12.8) μU/mL for plasma fasting insulin and 4.78 (± 3.49) for HOMA-IR. In individuals with HOMA-IR < 2.13 or ≥ 5.72, we found no association of marijuana use with HOMA-IR. In those with HOMA-IR < 5.72, the highest tertile of MLU (i.e., ≥ 1799times) was associated with 12% decrease (95% confidence intervals, 4-19%) in the fasting insulin and 10% decrease in HOMA-IR (95% CI 1-19%), as compared with their counterparts who never used marijuana. In those with HOMA-IR ≥ 2.13, we found a marked impact of marijuana use only in adults who used marijuana ≥ 1799 times, with 13% decrease (95% CI 5-19%) in fasting insulin and 10% decrease (95% CI 3-18%) in HOMA-IR score. Marijuana use is associated with reduced fasting insulin levels and HOMA-IR score in US obese adults with HOMA-IR ≥ 2.13, but not in those with HOMA-IR < 2.13 or ≥ 5.72. The impact of marijuana use is the greatest after long-term exposure and is independent of BMI.