Homeostasis Model Assessment Values Research Articles

Metabolic syndrome frequency in inflammatory bowel diseases

Background/Aim:Metabolic syndrome (MetS) is a clinical condition characterized by central obesity, elevated triglycerides, low–high density lipoproteins, impaired fasting glucose, and hypertension. There is insufficient data on the prevalence of MetS in patients with inflammatory bowel disease (IBD). This study sought to determine the prevalence of MetS in a Turkish cohort of patients with IBD and the association between insulin resistance (IR) and the MetS parameters, in this population.Patients and Methods:A total of 177 patients over 18 years of age (62 with Crohn's disease (CD) and 115 with ulcerative colitis (UC)) were enrolled in the study. The presence of at least three criteria of the International Diabetes Federation (IDF) was accepted for the diagnosis of MetS. The Homeostasis Model Assessment (HOMA) was used to determine IR. HOMA values < 1 were considered normal and values > 2.5 indicated a high probability of IR.Results:MetS frequency was higher in patients n=34 (29.5%) with UC than in patients n=11 (17.7%) with CD (P < 0.01). MetS was detected in 12 of the 117 patients (10.3%) with IBD, under 45 years of age, and in 33 of 60 patients (55%) over 45 years of age. HOMA value in n=31 patients (27%) with UC was > 2.5. Body mass index, insulin (P < 0.001), waist circumference, fasting plasma glucose, leukocyte count (P < 0.01), triglycerides, C-reactive protein, and uric acid values (P < 0.05) were significantly higher in UC patients with IR than those without IR.Conclusion:Frequent occurrence of MS with increasing age in IBD, particularly in UC, showed the importance of early diagnosis and treatment of cardiovascular disease risk factors in the long-term follow-up of these diseases.

Raised plasma insulin level and homeostasis model assessment (HOMA) score in cerebral malaria: evidence for insulin resistance and marker of virulence.

To study the glycaemic profile of patients with severe malaria (SM). For this purpose, 110 SM patients were recruited. Pre-treatment random blood glucose and plasma insulin were measured in a subset of donors. An ex-vivo experiment was developed for estimation of glucose consumption by parasitized erythrocytes. Hyperglycaemia was frequent in SM but more commonly associated with cerebral malaria (CM), while hyperinsulinaemia was recognized in severe-malarial-hypotension (median, 25 %-75 %, 188.2, 93.8-336.8 pmol/L). The plasma insulin level was positively correlated with age (CC = 0.457, p < 0.001) and negatively with parasitaemia (CC = -0.368, p = 0.045). Importantly, fatal-CM was associated with hyperglycaemia (12.22, 6.5-14.6 mmol/L), hyperinsulinaemia (141.0, 54.0-186.8 pmol/L) and elevated homeostasis model assessment (HOMA) values. However, there was a trend of higher glucose consumption by parasites in CM compared with that in uncomplicated malaria (UM). Hyperglycaemia, hyperinsulinaemia and elevated HOMA are evidence for insulin resistance and possibly pancreatic B-cell dysfunction in fatal-CM.

Impact of Intensive School-Based Nutrition Education and Lifestyle Interventions on Insulin Resistance, β-Cell Function, Disposition Index, and Subclinical Inflammation Among Asian Indian Adolescents: A Controlled Intervention Study

The present study was designed to assess the impact of intensive and repetitive nutrition education and lifestyle interventions on insulin resistance, β-cell function, disposition index (DI), and subclinical inflammation in Asian Indian adolescents (15-17 years) residing in North India. In this prospective study, two matched schools were randomly allocated to the intervention (n = 56; 31 boys and 25 girls) or control group (n = 50; 30 boys and 20 girls). The intervention consisted of seven components: (1) Dissemination of health-related information through lectures and focused group discussions, (2) planning of activities such as quizzes, (3) individual counseling of students, (4) promotion of physical activity, (5) change in the canteen menu to healthier alternatives, (6) conducting health camps involving parents and teachers, and (7) training of student volunteers for sustainability of the program in school. Impact of intervention was studied on surrogate markers of insulin resistance, β-cell function, disposition index, and subclinical inflammation. At 6 months follow-up, significantly higher (P = 0.037) mean value of homeostasis model assessment denoting β-cell function (HOMA-βCF) was seen in the intervention group compared to the control group, whereas high sensitivity C-reactive protein (hs-CRP) was significantly lowered (P < 0.001). The increase (30.3 ± 73.4; P < 0.037) observed in the DI in adolescents in the intervention group was significantly higher compared to the control group. The Pearson's coefficient of correlation in the intervention group showed that the Δ-decrease in mean waist circumference was significantly correlated (r = 0.267, P < 0.05) with Δ-decrease in homeostasis model assessment of insulin resistance (HOMA-IR). The intervention model developed by us could be used for amelioration of insulin resistance with potential of preventing type 2 diabetes mellitus in Asian Indian adolescents.

Fetuin-A Does Not Explain Ethnic Disparity in Cardiometabolic Risk Factors and Subclinical Atherosclerosis Between Hispanics and Non-Hispanic Whites

Fetuin-A has been associated with insulin resistance and inversely related with vascular calcification. The present study evaluated whether serum fetuin-A explains the ethnic disparity in the subclinical atherosclerosis and risk for diabetes between healthy Hispanic and non-Hispanic white (NHW) subjects. Fetuin-A was measured in serum of 76 age-matched healthy males (41 NHW, 35 Hispanics). Body mass index, blood pressure, serum lipoprotein cholesterol and triglyceride levels, coronary artery calcium (CAC), fasting glucose and insulin concentrations, and plasma glucose levels 2 h after a 75-g oral glucose tolerance test were measured in all participants. Insulin resistance was estimated using the homeostasis model assessment (HOMA). Fasting insulin, fasting and 2-h serum glucose, and HOMA values were all significantly higher in Hispanics (p < 0.05 for all), yet CAC trended lower and the prevalence of very high CAC (>400 Agatston score) was lower (P = 0.03). There was no statistically significant difference in serum fetuin-A when comparing Hispanics and NHW (P = 0.12). Furthermore, there was no correlation between fetuin-A levels and CAC (P = 0.9). Serum fetuin-A concentration was not associated with measures of insulin resistance or with preclinical atherosclerosis in Hispanics and NHW. These data indicate that the disparity in prevalence of insulin resistance, type 2 diabetes, and subclinical atherosclerosis between Hispanics and NHW does not appear attributable to differences in fetuin-A concentrations.

Utility of Childhood Glucose Homeostasis Variables in Predicting Adult Diabetes and Related Cardiometabolic Risk Factors: The Bogalusa Heart Study

We thank d'Annunzio, Russo, and Lorini (1) for their interest in our article (2) related to carbohydrate-insulin variables in youth and later adult pre-diabetes and diabetes. As they noted, normal values of homeostasis model assessment of insulin resistance (HOMA-IR) are increased with sexual maturation. This is consistent with our previous findings in Bogalusa, Louisiana, with children. Svec et al. (3) reported earlier that there was a positive trend of postglucose …

Insulin Resistance in Obese Children and Adolescents: HOMA-IR Cut-Off Levels in the Prepubertal and Pubertal Periods - Original Article

Objective: Childhood obesity is associated with an increased risk for insulin resistance. The underlying mechanism for the physiological increase in insulin levels in puberty is not clearly understood. The aim of the present study was to determine the cut−off values for homeostasis model assessment for insulin resistance (HOMA−IR) in obese children and adolescents according to gender and pubertal status.Methods: Two hundred and eight obese children and adolescents (141 girls, 127 boys) aged between 5 and 18 years were included in the study. The children were divided into prepubertal and pubertal groups. A standard oral glucose tolerance test (OGTT) was carried out in all children. A total insulin level exceeding 300 μU/mL in the blood samples, collected during the test period, was taken as the insulin resistance criterion. Cut−off values for HOMA−IR were calculated by receiver operating characteristic (ROC) analysis.Results: In the prepubertal period, the rate of insulin resistance was found to be 37% in boys and 27.8% in girls,while in the pubertal period, this rate was 61.7% in boys and 66.7% in girls. HOMA−IR cut−off values for insulin resistance in the prepubertal period were calculated to be 2.67 (sensitivity 88.2%, specificity 65.5%) in boys and 2.22 (sensitivity 100%, specificity 42.3%) in girls, and in the pubertal period, they were 5.22 (sensitivity 56%, specificity 93.3%) in boys and 3.82 (sensitivity 77.1%, specificity 71.4%) in girls.Conclusions: Since gender, obesity and pubertal status are factors affecting insulin resistance, cut−off values which depend on gender and pubertal status, should be used in evaluation of insulin resistance.Conflict of interest:None declared.

Preliminary data on the association between waist circumference and insulin resistance in children without a previous diagnosis

The aim of the present work was to study the association between different anthropometric parameters and insulin resistance (IR) in Spanish schoolchildren without a previous diagnosis. A total of 443 Spanish schoolchildren (9-11 years of age) were studied in this cross-sectional study. The anthropometric measurements collected were weight, height, body circumferences and skinfolds. Body mass index (BMI), waist/hip ratio, percentage body fat and fat-free body mass were determined. Overnight-fasted blood lipids, insulin and glucose levels were analysed, and estimation of IR, taking into account the homeostasis model assessment (HOMA), was calculated. The children with IR had higher serum triglycerides and insulin levels, were heavier and taller, and had a higher BMI, a larger waist circumference, a larger hip circumference, a larger waist/hip ratio and thicker bicipital and tricipital skinfolds than those who did not have IR. Age, sex, BMI and waist circumference explained 32.0% of the variance in the HOMA values; only sex, triglycerides and waist circumference independently influenced this variable. A 1-cm increase in waist circumference was associated with approximately a 3.8% increase in the mean HOMA value. The children with a waist circumference of over the p90 for their age and sex were at greater risk of showing IR as measured by the HOMA: odds ratio = 6.94 (2.01-23.91; P < 0.001). In conclusion, according to these results, waist circumference is the best anthropometric parameter associated with IR in children, and those with a waist circumference of over the p90 for their age and sex would appear to be at particular risk.

Erectile Dysfunction, Obesity, Insulin Resistance, and Their Relationship With Testosterone Levels in Eugonadal Patients in an Andrology Clinic Setting

Erectile dysfunction (ED) is associated with metabolic and endocrine diseases including obesity, metabolic syndrome (MS), and type 2 diabetes mellitus (DM2). Insulin resistance (IR), present in patients with obesity, MS, and DM2, causes disturbances in the signaling pathways required for nitric oxide production, with subsequent endothelial dysfunction. In addition, IR appears to alter testosterone production. We evaluated in eugonadal patients with ED: 1) the presence of obesity and IR, 2) testosterone levels and their association with obesity and IR, and 3) the degree of ED according to the presence of IR. In a prospective study, 78 eugonadal patients with ED (group P) were recruited and compared with 17 men without ED as a control group (group C). Erectile function was evaluated according to the International Index of Erectile Function 5 (IIEF-5). IR was measured by homeostasis model assessment (HOMA). IR was defined as HOMA of 3 or greater. Patients with ED had significantly higher body mass index (BMI), waist circumference (WC), HOMA values, and prevalence of IR when compared with group C. Total (TT) and bioavailable testosterone (BT) levels were lower in group P compared with group C. There was a significant negative correlation between HOMA and IIEF-5, HOMA and TT, WC and IIEF-5, WC and TT, and WC and BT. Group P patients with IR had higher WCs and lower IIEF-5 scores when compared with patients in group P without IR. In conclusion, patients with ED showed a higher BMI, WC, and HOMA and lower levels of TT and BT. There is a negative correlation between erectile function and IR and abdominal obesity. The TT levels are lower in patients with increased BMI, WC, and IR. However, a negative correlation was shown only between BT (biologically active fraction) and abdominal obesity.

Variation in metabolic and cardiovascular risk in women with different polycystic ovary syndrome phenotypes

The aim of this study was to compare clinical, hormonal, and metabolic variables in women with classic polycystic ovary syndrome (PCOS), in ovulatory women presenting hirsutism, normal androgen levels, and polycystic ovaries (H+PCO), and in a group with isolated hirsutism (IH) presenting with normal ovaries and androgen levels. Waist circumference, triglycerides, and homeostasis model assessment values were significantly higher in classic PCOS even after adjustment for body mass index, and metabolic syndrome was three times more frequent in classic PCOS than in H+PCO or IH (31.3% vs. 11.9% vs. 9%), but no differences were observed regarding metabolic profile and cardiovascular risk factors between the H+PCO and IH groups, which presented with significantly more metabolic syndrome than normal controls when only overweight and obese women were considered.

Elevated Ambulatory Blood Pressure in a Multi-Ethnic Population of Obese Children and Adolescents

To evaluate the relationship among ambulatory blood pressure (ABP), body mass index (BMI), and homeostasis model assessment (HOMA) in a multi-ethnic population of obese children with clinic blood pressure in the reference range. A total of 43 obese normotensive children (7-17 years old) were recruited. ABP monitoring, oral glucose tolerance test, lipid levels, and urine microalbumin levels were obtained. Fourteen percent of the subjects had elevated 24-hour systolic blood pressure (SBP), 9.3% had elevated daytime SBP, and 32.6 % elevated nighttime SBP. For diastolic blood pressure, 4.7% of the sample had an elevated mean nighttime value. Children with more severe obesity (BMI SD score >2.5) had higher 24-hour and nighttime SBP than children with less severe obesity (BMI SD score < or =2.5). Children with HOMA values in the highest quartile had larger waist circumference and higher clinic blood pressure than children with HOMA values in the lowest quartile, and no difference in the mean ABP values was found in the 2 groups . Multiple linear regression analysis showed that 24-hour and nighttime SBP were significantly correlated with BMI SD score. Obese children with normal clinic blood pressure often exhibit elevated ABP. The risk for ambulatory hypertension appears to be correlated with the degree of obesity.

Influence of G1359A polymorphism of the cannabinoid receptor gene on anthropometric parameters and insulin resistance in women with obesity

A silent polymorphism (1359 G/A) of the cannabinoid receptor gene was reported as a common polymorphism in white populations. The aim of our study was to investigate the influence of this polymorphism (G1359A) of cannabinoid receptor gene on obesity, insulin resistance, and adipocytokines in women with obesity. A population of 290 women was analyzed. Indirect calorimetry, tetrapolar electrical bioimpedance, blood pressure measurement, serial assessment of nutritional intake with 3-day written food records, and biochemical analysis were performed. One hundred fifty-nine patients (54.8%) had the genotype G1359G (wild-type group), and 131 (45.2%) patients had G1359A (116 patients, 40.0%) or A1359A (15 patients, 5.2%) (mutant-type group). Triglycerides (122.3 ± 65.9 vs 107.2 ± 44.8 mg/dL, P < .05), insulin (15.8 ± 9.4 vs 13.6 ± 6.9 mUI/L, P < .05), and homeostasis model assessment values (3.85 ± 2.2 vs 3.33 ± 1.9, P < .05) were higher in the wild-type group than the mutant-type group. High-density lipoprotein cholesterol levels (56.8 ± 24.1 vs 58.3 ± 13.9 mg/dL, P < .05) were higher in the mutant-type group than the wild-type group. The novel finding of this study is the association of the mutant-type group G1359A and A1359A with a better cardiovascular profile (triglyceride, high-density lipoprotein cholesterol, insulin, and homeostasis model assessment levels) than the wild-type group.

Fat Overload Induces Changes in Circulating Lactoferrin That Are Associated With Postprandial Lipemia and Oxidative Stress in Severely Obese Subjects

Lactoferrin is an innate immune system protein with anti-inflammatory and antioxidant activities. We aimed to evaluate circulating lactoferrin levels in association with lipid concentrations, and parameters of oxidative stress and inflammation in subjects with morbid obesity after an acute fat intake. The effects of a 60 g fat overload on circulating lactoferrin and antioxidant activities were evaluated in 45 severely obese patients (15 men and 30 women, BMI 53.4 +/- 7.2 kg/m(2)). The change in circulating lactoferrin after fat overload was significantly and inversely associated with the free fatty acid (FFA) change. In those subjects with the highest increase in lactoferrin (in the highest quartile), high-density lipoprotein (HDL)-cholesterol decreased after fat overload to a lesser extent (P = 0.03). In parallel to lipid changes, circulating lactoferrin concentrations were inversely linked to the variations in catalase (CAT) and glutathione reductase (GSH-Rd). Baseline circulating lactoferrin concentration was also inversely associated with the absolute change in antioxidant activity after fat overload, and with the change in C-reactive protein (CRP). Furthermore, those subjects with higher than the median value of homeostasis model assessment of insulin secretion (HOMA(IS)) had significantly increased lactoferrin concentration after fat load (885 +/- 262 vs. 700 +/- 286 ng/ml, P = 0.03). Finally, we further explored the action of lactoferrin in vitro. Lactoferrin (10 micromol/l) led to significantly lower triglyceride (TG) concentrations and lactate dehydrogenase activity (as expression of cell viability) in the media from adipose explants obtained from severely obese subjects. In conclusion, circulating lactoferrin concentrations, both at baseline and fat-stimulated, were inversely associated with postprandial lipemia, and parameters of oxidative stress and fat-induced inflammation in severely obese subjects.

Fructose and saturated fats predispose hyperinsulinemia in lean male rat offspring

Early exposure to suboptimal nutrition during perinatal period imposes risk to metabolic disorders later in life. Fructose intake has been associated with increases in de novo lipogenesis, dyslipidemia, insulin resistance, and obesity. Excess consumption of saturated fat is associated with metabolic disorders. Objective of this animal study was to investigate morphological, metabolic, and endocrine phenotypes of male offspring born to dams consuming diets containing either 30% fructose, 9.9% coconut fat and 0.5% cholesterol (F + SFA) or 30% glucose, and 11% corn oil (C), 1 month before conception and during gestation and nursing. Proven male and female Sprague Dawley breeders were fed ad libitum with either F + SFA or C diet throughout the study. At weaning, five male pups from each group were sacrificed for determining morphological phenotypes. The other five male offspring from each group were rehabilitated to the C diet for an additional 12 weeks. At the age of 15 weeks, morphological phenotypes and blood biochemistries [glucose, insulin, growth hormone (GH), insulin-like growth factor-1 (IGF-1), corticosterone, and testosterone] of male adult offspring were then assessed. Body weight (BW) and body length of the F + SFA male adult offspring was slightly smaller than the C. The BW-adjusted epididymal and retroperitoneal fat depots of the F + SFA adult offspring were significantly 18 and 44% smaller than the C, respectively. GH and IGF-1 were not different in adult offspring between groups. Fasted plasma insulin of the F + SFA adult offspring was 64% larger than the C (P <or= 0.0001) and homeostasis model assessment value was 55% larger (P = 0.004). There were negative correlations between fat depot sizes and plasma insulin in adult offspring. Our results suggest that, through fetal programming, an early exposure to both fructose and saturated fats may cause hyperinsulinemia and insulin insensitivity in the nonobese male rats later in life.

Serum leptin, lipoprotein levels, and glucose homeostasis between national wrestlers and sedentary males

Leptin is an important controller of the size of fat stores by inhibiting appetite. In wrestling, fat metabolism is important not only for aerobic energy system, but also for weight control and weight loss before competition. The aim of this study was to measure and compare the serum leptin levels, glucose homeostasis, and serum lipoproteins between Turkish national wrestlers and sedentary males. Materials and methods: Forty-five Turkish national wrestlers at the end of Olympic training camp before Beijing 2008 Olympic Games and 43 sedentary students were selected as subjects. Post-exercise levels of serum leptin, HOMA (Homeostasis model assessment) values, triglycerides, total cholesterol, LDL-cholesterol, HDL-cholesterol, and VLDL-cholesterol were measured after overnight fasting. A Mann-Whitney U test was used to test the differences between 2 groups. Pearson Correlation was conducted between leptin and the other parameters. Results: No significant difference was observed among the means of leptin and total cholesterol levels of the 2 groups. Wrestlers had significantly higher fasting insulin, HDL-cholesterol, triglyceride, and HOMA levels, but a lower LDL-cholesterol level compared to the sedentary males. The positive correlation was only found between leptin and fasting insulin levels (r = 0.310, P = 0.043). Conclusion: This study indicated that wrestling training had no effect on resting leptin level after overnight fasting and wrestlers had also decreased insulin sensitivity with higher fasting insulin, HDL-cholesterol, triglyceride, and HOMA levels compared to sedentary males.

Comparison of multiple and novel measures of dietary glycemic carbohydrate with insulin resistant status in older women

BackgroundPrevious epidemiological investigations of associations between dietary glycemic intake and insulin resistance have used average daily measures of glycemic index (GI) and glycemic load (GL). We explored multiple and novel measures of dietary glycemic intake to determine which was most predictive of an association with insulin resistance.MethodsUsual dietary intakes were assessed by diet history interview in women aged 42-81 years participating in the Longitudinal Assessment of Ageing in Women. Daily measures of dietary glycemic intake (n = 329) were carbohydrate, GI, GL, and GL per megacalorie (GL/Mcal), while meal based measures (n = 200) were breakfast, lunch and dinner GL; and a new measure, GL peak score, to represent meal peaks. Insulin resistant status was defined as a homeostasis model assessment (HOMA) value of >3.99; HOMA as a continuous variable was also investigated.ResultsGL, GL/Mcal, carbohydrate (all P < 0.01), GL peak score (P = 0.04) and lunch GL (P = 0.04) were positively and independently associated with insulin resistant status. Daily measures were more predictive than meal-based measures, with minimal difference between GL/Mcal, GL and carbohydrate. No significant associations were observed with HOMA as a continuous variable.ConclusionA dietary pattern with high peaks of GL above the individual's average intake was a significant independent predictor of insulin resistance in this population, however the contribution was less than daily GL and carbohydrate variables. Accounting for energy intake slightly increased the predictive ability of GL, which is potentially important when examining disease risk in more diverse populations with wider variations in energy requirements.

Effects of TCF7L2 polymorphisms on glucose values after a lifestyle intervention

BackgroundTCF7L2 is the strongest locus linked to type 2 diabetes that has been identified thus far, and rs7903146 is the most significantly associated variant. Few intervention studies have shown that it has negative effects on metabolic improvement after lifestyle programs. ObjectiveOur objective was to assess the effects of this variant on lifestyle intervention–induced changes in glucose values and metabolic variables at 1- and 4-y follow-ups. DesignThe rs7903146 variant was genotyped in 335 nondiabetic, dysmetabolic participants in a randomized lifestyle intervention trial. ResultsSubjects with the unfavorable TT genotype showed higher values of fasting glucose and lower homeostasis model assessment of β cell function at baseline. Lifestyle modifications were successful in the amelioration of metabolic traits in all genetic subgroups after 1 y. At 4-y follow-up most of the metabolic benefits had disappeared. In a multiple regression model, values for glucose and homeostasis model assessment of β cell function at 4 y were significantly associated with the T allele (for glucose and homeostasis model assessments, respectively: β = 6.6; 95% CI: 2.5, 10.7; P = 0.001; and β = −0.37; 95% CI: −0.54, −0.20; P < 0.001) but not with intervention. There was no interaction between genotype and intervention. After 1 y, impaired fasting glucose and diabetes incidence were inversely associated with intervention. After 4 y, the presence of a T allele was associated with impaired fasting glucose (odds ratio: 3.04; 95% CI: 1.53, 6.04; P = 0.001) and diabetes (odds ratio: 2.63; 95% CI: 1.00, 6.96; P = 0.05) but not with intervention. ConclusionsLifestyle modifications improved the metabolic pattern in all genetic subgroups. At the end of the trial, however, weight gain occurred, and carriers of the T allele developed first hyperglycemia and decreased insulin secretion, which suggests the need for different “after-care” preventive approaches tailored to each genotype’s metabolic risk.

Myocardial lipid accumulation in patients with pressure-overloaded heart and metabolic syndrome

We evaluated the role of sterol-regulatory element binding protein (SREBP)-1c/peroxisome proliferator activated receptor-gamma (PPARgamma) pathway on heart lipotoxicity in patients with metabolic syndrome (MS) and aortic stenosis (AS). Echocardiographic parameters of heart function and structural alterations of LV specimens were studied in patients with (n = 56) and without (n = 61) MS undergoing aortic valve replacement. Tissues were stained with hematoxylin-eosin (H and E) and oil red O for evidence of intramyocyte lipid accumulation. The specimens were also analyzed with PCR, Western blot, and immunohistochemical analysis for SREBP-1c and PPARgamma. Ejection fraction (EF) was lower in MS compared with patients without MS (P < 0.001); no difference was found in aortic orifice surface among the groups. H and E and oil red O staining of specimens from MS patients revealed several myocytes with intracellular accumulation of lipid, whereas these alterations were not detected in biopsies from patients without MS. Patients without MS have low levels and weak immunostaining of SREBP-1c and PPARgamma in heart specimens. In contrast, strong immunostaining and higher levels of SREBP-1c and PPARgamma were seen in biopsies from the MS patients. Moreover, we evidenced a significative correlation between both SREBP-1c and PPARgamma and EF and intramyocyte lipid accumulation (P < 0.001). SREBP-1c may contribute to heart dysfunction by promoting lipid accumulation within myocytes in MS patients with AS; SREBP-1c may do it by increasing the levels of PPARgamma protein.

A nonsynonymous gene variant in the adiponutrin gene is associated with nonalcoholic fatty liver disease severity

We explored the role of the adiponutrin (PNPLA3) nonsynonymous-rs738409 single nucleotide polymorphism (SNP) in genetic susceptibility to nonalcoholic fatty liver disease (NAFLD) and whether this SNP contributes to the severity of histological disease. Two hundred sixty-six individuals were evaluated in a case-control association study, which included 172 patients with features of NAFLD and 94 control subjects. The rs738409 G allele was significantly associated with NAFLD (P < 0.001; OR 2.8 95%, CI 1.5-5.2), independent of age, sex, body mass index (BMI), and Homeostasis Model Assessment (HOMA) index. When we tested the hypothesis of a relation between the SNP and the histological spectrum of NAFLD, a significant association was observed [chi2 19.9, degree of freedom (df): 2, P < 5 x 10(-5), adjusted for HOMA and BMI]. The degree of liver steatosis, as evaluated by liver biopsy, was significantly associated with the rs738409 G allele. Patients with CC genotype showed a lower steatosis score (14.9% +/- 3.9) in comparison with the CG genotype (26.3% +/- 3.5) and GG genotype (33.3% +/- 4.0) (P < 0.005). The proportion of the total variation attributed to rs738409 genotypes was 5.3% (beta 0.23 +/- 0.07; P < 0.002). Our data suggest that the rs738409 G allele is associated not only with fat accumulation in the liver but also with liver injury, possibly triggered by lipotoxicity.

Determination of insulin resistance in non-diabetic Saudi adults by including fasting free fatty acids into QUICKI

Most available diagnostic methods of insulin resistance are either unsuitable for screening or fail to detect marginal cases. It was reported that including plasma free fatty acids (FFA) into QUICK (quantitative insulin sensitivity check index) I improves its diagnostic power. The aim was to test the effectiveness of modified QUICK I against HOMA (homeostasis model assessment) and QUICK I in identifying insulin resistant subjects in the non-diabetic adult population. 357 healthy adults aged 18 - 50 years were recruited randomly. Their anthropometric and demographic information were taken. Biochemical parameters and FFA (free fatty acid) were measured in fasting blood samples and used to calculate modified QUICK I. Reported cut-off point was used to identify IR subjects, who were matched for age and sex to individuals from the rest of the subjects. 209 subjects satisfied the criteria. 97 individuals were identified to be IR. This group had statistically different anthropometric and biochemical parameters compared to NIR group. Biochemical parameters did not differ significantly when QUICK I was used to identify IR subjects. The modified QUICK I for all subjects correlated significantly (p = 0.01) with HOMA values (r = -0.756) and with QUICK I values (r = 0.758). Modified QUICK I is a more powerful diagnostic index of IR in Saudi non diabetic adults. Key words: Insulin resistance, non diabetic, QUICK, FFA.

The role of family history in clinical symptoms and therapeutic outcomes of women with polycystic ovary syndrome

Objective To investigate the association between family history and clinical symptoms of polycystic ovary syndrome (PCOS) that were thought to be inherited, by treating women with PCOS with contraceptive pills and metformin, and assessing outcomes. Methods Of 164 women with PCOS, 49 with menstrual abnormalities, hyperandrogenism, and abnormal glucose and/or insulin levels underwent a 3-month treatment with contraceptive pills and metformin. Family history was taken, and physical and ultrasound examinations were performed. Serum levels of glucose, insulin, lipoproteins, lipids, and reproductive hormones were measured before and after treatment. Results The serum levels of low-density lipoprotein, total cholesterol, apolipoprotein B, and triglycerides were higher in the patients with a family history of the studied symptoms than in those with no such family history. After treatment, changes in testosterone and glucose levels, glucose area under curve, and homeostasis model assessment value differed in the 2 groups. Conclusion The patients with a family history of PCOS symptoms thought to be inherited were more sensitive to oral contraceptive and metformin treatment.