Insulin Resistance Homeostasis Model Research Articles

Major clinical outcomes of the regulation of metainflammation in patients with obesity in the light of nutrology: a systematic review

Introduction: Obesity stands out as a multifactorial disease that can cause several public health problems. There are 2.0 billion overweight and obese people in the world, and Brazil is in fifth place in the world ranking. A healthy nutritional status promotes immune function and can prevent the onset of a serious inflammatory process and severe infections, especially in times of pandemics such as COVID-19. Objective: It was to highlight the main clinical outcomes of the regulation of meta-inflammation in patients with obesity in the light of nutrology. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from August to September 2023 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 130 articles were found. A total of 42 articles were fully evaluated and 29 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 29 studies at high risk of bias and 21 studies that did not meet the GRADE. Most studies showed homogeneity in their results, with X2=71.7%>50%. Research has shown that unbalanced eating patterns, such as the Western diet, rich in simple sugars, refined carbohydrates, and saturated and trans fatty acids, lead to chronic inflammatory responses, increased adipose deposition, and future comorbidities associated with overweight and obesity. Calorie restriction decreased CRP in obese patients and diet administration over 12 weeks had a beneficial effect. Furthermore, obese patients with antioxidant supplementation had lower values of BMI, waist circumference, fasting blood glucose level, and assessment of the homeostasis model of insulin resistance when compared to the placebo group, as well as having lower levels of total cholesterol, triglycerides, LDL, malondialdehyde and tumor necrosis factor-alpha. n-3 PUFA supplementation can significantly reduce serum C-reactive protein (CRP), tumor necrosis factor α (TNFα), and interleukin 6 (IL-6) concentrations.

Revisiting the predictability of follicular fluid leptin and related adiposity measures for live birth in women scheduled for ICSI cycles: a prospective cohort study

BackgroundOur research question is could follicular fluid (FF) leptin solely or contemporaneously with other clinical, biochemical, and sonographic adiposity measures predict the probability of having a live birth during ICSI cycles? This is a prospective cohort study that enrolled infertile women without polycystic ovary syndrome scheduled for ICSI. At baseline, women had an assessment of obesity using different metrics: clinical, serum biochemical, and sonographic. Clinical measures encompassed waist circumference and body mass index. Biochemical evaluation comprised an assessment of the homeostasis model for insulin resistance, visceral adiposity index, and lipid accumulation product. Preperitoneal and subcutaneous abdominal fat were measured using ultrasound and body fat index was calculated. On the day of oocyte retrieval, pooled FF was sampled to assess FF leptin. Our primary outcome was live birth after one fresh embryo transfer cycle.ResultsOut of 91 women analyzed in this study, 28 have a live birth (30.8%). No difference in FF leptin concentration was found between women with and without live birth (mean ± SD; 20336 ± 8006 vs 18493 ± 6655 pg/ml; P = 0.2). None of the assessed adiposity markers was a predictor for live birth. Substantially, follicular fluid leptin was positively correlated with insulin resistance in women with and without live birth (r = 0.21, P = 0.04). In logistic regression analysis, the outcome of the prior cycle, the ability to have cryopreserved embryos, and the oocyte maturation index were the predictors for live birth in our study.ConclusionsThe present work could not find evidence that follicular fluid leptin, preperitoneal fat, and other evaluated adiposity measures could impact live births after ICSI cycles.

Correlation Between Insulin Resistance and Urinary Incontinence in Female Patients with Type 2 Diabetes Mellitus.

Patients with type 2 diabetes mellitus (T2DM) are at a high risk of developing urinary incontinence; however, its pathogenesis is unclear. The purpose of this study is to explore the relationship between insulin resistance and urinary incontinence and its severity in female patients with T2DM. A total of 366 women with T2DM aged ≥18 years were enrolled in this study. Insulin resistance was evaluated by the homeostasis model insulin resistance (HOMA-IR) index and urinary incontinence was assessed by the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF). All subjects were divided into four groups according to HOMA-IR quartiles. Logistic regression analysis was performed to investigate the relationship between insulin resistance and urinary incontinence and its severity. Among the 366 patients, 186 (50.8%) had urinary incontinence. The prevalence of urinary incontinence increased significantly with HOMA-IR quartiles (p < 0.001). Adjusted logistic regression analysis showed that compared with HOMA-IR ≤ 1.76, 2.81 ≤ HOMA-IR ≤ 4.27 was associated with a significantly increased risk of moderate incontinence (OR = 2.197, 95% CI 1.031-4.683, p = 0.041), and HOMA-IR ≥ 4.28 was associated with a significantly increased risk of severe incontinence (OR = 5.699, 95% CI 1.685-19.276, p = 0.005). Binary logistic regression analysis showed that HOMA-IR was the independent risk factor for urinary incontinence (p < 0.001). Higher levels of insulin resistance are associated with urinary incontinence and its severity in female patients with type 2 diabetes mellitus.

Changes of biochemical parameters in normal weight and overweight/obese women with polycystic ovary Syndrome

Objectives: Polycystic ovary syndrome (PCOS) is an endocrine disease in reproductiveage women, which interferes with fertility, menstruation, and body composition. Some biochemical parameters change in women with PCOS, a feature which can be a consequence of the disease itself or of the accompanying obesity. This study investigated the glucose and lipid profiles, sex hormones, and hsCRP in normal weight and overweight/ obese Iranian women with and without PCOS.&#x0D; Methods: 314 women with PCOS and 138 healthy and fertile women were recruited for the study. The patients and controls were divided according to body mass index (BMI) into two groups as follows: BMI&lt;25 Kg/m2 and BMI≥ 25 Kg/m2 . Blood samples were collected from all participants to assess fasting blood glucose, fasting insulin, lipid profile, FSH, LH, free testosterone, and hs-CRP levels. The homeostasis model of insulin resistance (HOMA-IR) was calculated for assessing insulin sensitivity.&#x0D; Results: BMI, fasting insulin, HOMA-IR, triglyceride, FT, LH, and hs-CRP levels were significantly higher in the PCOS group, while lower levels of FSH were observed in comparison to non-PCOS women. Among overweight PCOS women, hs-CRP levels were significantly elevated compared to normal-weight PCOS women. However, there was no significant difference in circulating hs-CRP levels between normal-weight and overweight participants in the control group.&#x0D; Conclusion: The study results suggest that both insulin resistance and an increase in hs-CRP may be relevant to PCOS. Moreover, the findings indicated that chronic inflammation in PCOS is not solely dependent on the pathogenesis of the disease but may be exacerbated by increased body weight.

Additive interaction of urinary total arsenic concentrations with being overweight/obesity on the risk of insulin resistance: NHANES 2007-2016.

Arsenic exposure has been associated with the risk of diabetes or insulin resistance (IR), which are also related with overweight/obesity. This study aimed to explore the interaction between arsenic exposure and being overweight/obesity on diabetes or IR risk. Data from the National Health and Nutrition Examination Survey (NHANES) in cycles 2007-2016 were used to assess the interaction between arsenic exposure and being overweight/obesity on IR or diabetes risk among adults. Urinary total arsenic concentrations (UTAs) were used as a biomarker for arsenic exposure. The homeostasis model of insulin resistance (HOMA-IR) was calculated to index IR. Survey-weighted logistic regression and restricted cubic spline (RCS) analyses were performed to determine the association and dose-response relationship between UTAs and IR or diabetes risk. Additive interaction was evaluated by relative excess risk due to interaction (RERI), attributable proportion of interaction (AP), and synergy index (S). A total of 3,133 participants were included. The median (interquartile range) UTAs were 6.61 (3.83, 13.95) μg/L. The adjusted OR of IR was 1.40 (95% CI: 0.99-1.97) for UTAs, comparing the highest with the lowest quartile. And significant additive interaction was observed between high UTAs and being overweight/obesity on IR risk (RERI = 2.47, 95% CI: 0.30-4.63; AP = 0.29, 95% CI: 0.07-0.50; S = 1.48, 95% CI: 1.03-2.13). Our results suggested that there might be a potential additive interaction between high UTAs with being overweight/obesity on diabetes risk (AP = 0.27, 95%CI: 0.04-0.51). Our results indicated an additive interaction between arsenic exposure and being overweight/obesity on IR risk.

Investigating Adiposity-Related Metabolic Health Phenotypes in Patients with Hidradenitis Suppurativa: A Cross-Sectional Study.

Obesity and hidradenitis suppurativa (HS) are related through meta-inflammation and are both associated with increased cardiometabolic risk. Notwithstanding, cardiometabolic pathology is not uniform in obesity and a subset of individuals with excess adiposity exhibit a healthy metabolic profile. Whilst the incidence of cardiometabolic endpoints and transitions across different adiposity-related body composition phenotypes within several populations and across different ethnicities have been investigated, data regarding metabolic health (MetH) and body composition phenotypes in individuals with HS are lacking. The objective of this study was to evaluate the relationship between different body composition phenotypes in individuals with HS. This was a cross-sectional study of 632 individuals with and without HS from a population with a high prevalence of both obesity and HS. A total of four body composition phenotypes were generated based on BMI and metabolic status (defined using either the metabolic syndrome definition or the homeostasis model of insulin resistance (HOMA-IR)): metabolically healthy overweight/obese (MHOWOB), metabolically unhealthy overweight/obese (MUOWOB), metabolically healthy normal weight (MHNW), and metabolically unhealthy normal weight (MUNW). Generally, subjects with HS exhibited a worse metabolic profile with higher levels of indices of central adiposity measures (including Visceral Adiposity Index and waist circumference), systolic blood pressure and markers of insulin resistance, as well as a higher prevalence of the metabolic syndrome. Moreover, when sub-stratified into the different body composition phenotypes, individuals with HS typically also demonstrated adverse metabolic characteristics relative to controls matched for both adiposity and metabolic health, particularly in the normal weight category and despite being classified as metabolically healthy. Being metabolically unhealthy in addition to being overweight/obese increases an individual's risk of HS. Metabolic risk-assessment should be prioritized in the clinical management of individuals with HS even in those who are lean. Patients attending HS clinics provide a valuable opportunity for targeted cardiovascular risk reduction with respect to the management of both obesity and metabolic health.

Diabetic cardiac autonomic neuropathy: insulin resistance, lipid profile, and omega-3 polyunsaturated fatty acids

The significance of cardiac autonomic neuropathy (CAN) in patients with type 2 diabetes mellitus (T2DM) has been not fully appreciated and there is no unified treatment algorithm. Aim: The aim of study was to investigate the effects of -3 polyunsaturated fatty acids (-3 PUFAs) on blood lipid profile and insulin resistance (IR) parameters in patients with T2DM and definite CAN. The study involved 33 patients with T2DM and definite CAN. Patients were allocated into two treatment groups: 1st group - 15 patients received standard hypoglycaemic therapy - control (n = 15); 2nd group (n = 18) - standard hypoglycaemic therapy and 1 capsule/day of the ω-3 PUFAs (1 g, including 90 % ω-3 PUFAs) for three months. The concentrations of glucose, glycated haemoglobin A1c, immunoreactive insulin in the blood were determined. Lipid metabolism was assessed by the concentration of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) measurements. The insulin resistance Homeostasis model assessment, atherogenic coefficient (AC), TG/LDL-C, TG/TC, TG/LDL-C and TG glucose (TyG) index were calculated. Obtained results of our study could witness that the prescription of -3 PUFAs was accompanied by a statistically significant decrease in TG concentration; AC, TG/LDL-C, TG/TC, TG/LDL-C, TyG index parameters and increase in HDL-C levels (compared to control). Conclusions. Obtained results justify the appropriateness of -3 PUFAs prescriptions to patients with T2DM and definite CAN.

Role of glycemic status and insulin resistance indices on cognition

Introduction and Aim: Type 2 Diabetes Mellitus (T2DM) is presently the commonest and most prevalent disorder of metabolism which, if unmanaged, can lead to macro and micro-vascular disorders as complications. The preventive and therapeutic options for the same have been drastically improved than before and the life expectancy of the affected population has risen, but with the emergence of few other new complications like cognitive impairment and dementia. Insulin Resistance (IR) is a preclinical stage during diabetes and can potentially affect cognition. Cognition is the capability of an individual to process the given information through perception. Cognition is a broad spectrum including different cognitive domains like learning, attention, memory, language, reasoning, decision making, visuospatial skills etc., which forms the basis of intellectual development. Our present aim is to study the relationship between the glycemic profile and cognition status in diabetics. Materials and Methods: The study population included a total of 232 subjects with the age of 40-70 years of both genders. They were recruited after obtaining the informed written consent. Fasting blood glucose, Insulin levels, HbA1C were analyzed. The insulin resistance indices such as The HOmeostasis Model of IR (HOMA-IR), QUantitative Insulin-sensitivity Check Index (QUICKI) and HOMA percent beta-cell function (HOMA-beta) were derived. Cognition status was assessed and scored using the Modified Mini Mental Status (3MS) test. Results: HbA1c score and the 3MS score showed an association where both were negatively correlated. Insulin resistance induces too were negatively correlated with cognitive function. Conclusion: Thus, our study suggests that unmanaged diabetes mellitus type 2 may affect the cognition. Accordingly, early diagnosis of the condition and its management is crucial to bring down the incidence of cognitive impairment, further dementia, and other neurodegenerative diseases.

Evaluation of Dry Fasting Effect during Ramadan on Protein Glycation in Saudi Individuals

Introduction: The non-enzymatic protein glycation alters protein function and contributes to many biochemical disorders. The accumulation of advanced glycation end-products (AGEs) is associated with the complications of diabetes, kidney disease, metabolic disorders and degenerative diseases. &#x0D; Objectives: This study was designed to measure the level of some glycated proteins such as glycated insulin and glycated hemoglobin in Saudi volunteers before and after dry fasting in Ramadan.&#x0D; Methods: Blood samples were collected twice; first sample (before) and second sample (after) dry fasting. The study included 45 Saudi male volunteers, whose ages ranged between23 and 52 years They were divided into four groups: healthy, type II diabetic patients, smokers, and obese individuals. Plasma glucose level and HbA1c were measured immediately using (Beckman coulter). Assessment of insulin resistance was determined using the equation of homeostasis model for insulin resistance (HOMA-IR). Plasma insulin level and glycated insulin % were assayed by TSQ Vantage Triple Stage Quadruple LC/MS Mass Spectrometer from Thermo Scientific.&#x0D; Results: Level of HbA1c, HOMA IR and glycated insulin in healthy, type II diabetic patients, smokers, and obese individuals showed significant decrease in the second sample. The level of HbA1c showed a significant decrease (p-value &lt;0.0001) after dry fasting (5.69 ± 1.55 %), (6.14 ± 1.77%). The level of HOMA IR showed significant decrease (p-value &lt;0.0001) after dry fasting (1.97 ± 1), (2.46 ± 1.28). The level of glycated insulin showed significant decrease (p-value &lt;0.0001) after dry fasting (6.25 ± 2%), (7.71 ± 2.48%).&#x0D; Conclusion: Glucose, HbA1c, HOMA IR, and glycated insulin levels showed a significant decrease after dry fasting. Reduced protein glycation and formation of advanced glycation end products, can improve the clinical course of many medical disorders. More researches are needed to understand the molecular mechanisms behind glycation-induced clinical disorders and diseases, as well as to correlate these mechanisms to the diagnosis and prevention of lifestyle-related diseases.

Association Between Insulin Resistance and the Inflammatory Marker C-reactive Protein in a Representative Healthy Adult Canadian Population: Results From the Canadian Health Measures Survey

ObjectivesInsulin resistance (IR) leads to type 2 diabetes mellitus. Multiple IR causes have been identified, including inflammation. This study determines the association between IR and the inflammatory marker C-reactive protein (CRP) in a healthy Canadian population and examines potential differences by sex and age. MethodsParticipants were adults with no self-reported history of diabetes, a glycated hemoglobin (A1C) of <6.5%, and a fasting blood glucose of <7 mmol/L, and who had participated in the Canadian Health Measures Survey, cycles 1 to 4 (2007–2015). IR was calculated using the Homeostasis Model of Insulin Resistance (HOMA-IR) assessment. The crude geometric mean HOMA-IR was calculated using a one-way analysis of variance. The association between CRP levels and HOMA-IR was examined using multivariate linear regression. ResultsA total of 4,024 eligible nondiabetic adults (1,994 [49.5%] men and 2,030 [50.4%] women) were identified. Eighty percent of the subjects were Caucasian. Among all subjects, 36% had a CRP of ≥2 mg/L. The crude geometric mean HOMA-IR was 1.33 in men and 1.24 in women. Participants with a CRP of <0.7 mg/L had a crude geometric mean HOMA-IR of 1.15 (1.13 to 1.16), compared with 1.41 (1.39 to 1.43) for those with a CRP of ≥2 mg/L. After adjusting for sex, age, race, high-density lipoprotein cholesterol, triglycerides, body mass index, smoking, and diastolic blood pressure, the HOMA-IR–CRP association remained significant. A positive trend for CRP values in men with increasing values of HOMA-IR was observed. However, this trend was not consistent with the increase in women’s CRP levels. ConclusionsElevated CPR levels are independently associated with IR in men. Prospective cohort studies can confirm the causal relationship between high CRP levels and IR and identify the underlying mechanisms.

Metabolic syndrome and risk of incident heart failure in non-diabetic patients with established cardiovascular disease

BackgroundIn patients with established cardiovascular disease (CVD), the relation between metabolic syndrome (MetS) and incident heart failure (HF) in the absence of diabetes mellitus (DM) is largely unknown. This study assessed this relation in non-diabetic patients with established CVD. MethodsPatients from the prospective UCC-SMART cohort with established CVD, but without DM or HF at baseline were included (n = 4653). MetS was defined according to the Adult Treatment Panel III criteria. Insulin resistance was quantified using the homeostasis model of insulin resistance (HOMA-IR). The outcome was a first hospitalization for HF. Relations were assessed using Cox proportional hazards models adjusted for established risk factors: age, sex, prior myocardial infarction (MI), smoking, cholesterol, and kidney function. ResultsDuring a median follow-up of 8.0 years, 290 cases of incident HF were observed (0.81/100 person years). MetS was significantly related to an increased risk of incident HF independent of established risk factors (hazard ratio [HR] 1.32; 95% confidence interval [CI] 1.04–1.68, HR per criterion 1.17; 95% CI 1.06–1.29), as was HOMA-IR (HR per standard deviation [SD] 1.15; 95% CI 1.03–1.29). Of the individual MetS components, only higher waist circumference independently increased the risk of HF (HR per SD 1.34; 95% CI 1.17–1.53). Relations were independent of the occurrence of interim DM and MI, and were not significantly different for HF with reduced vs preserved ejection fraction. ConclusionIn CVD patients without a current diagnosis of DM, MetS and insulin resistance increase the risk of incident HF independent of established risk factors.

Compositional isotemporal substitution analysis of physical activity, sedentary behaviour and cardiometabolic biomarkers in US adults: A nationally representative study

ABSTRACT Substantial evidence links physical activity and sedentary behaviour (SB) with cardiovascular health. However, studies usually examine time-use behaviours independently, rather than considering daily activities as a 24-hour time-use composition. This study aimed to use compositional data models to investigate how time reallocations from SB to moderate-to-vigorous physical activity (MVPA)/ light physical activity (LPA) were associated with changes in cardiometabolic biomarkers. Compositional isotemporal substitution analysis was conducted using data from a representative cross-sectional sample of adults aged 20 years or older (n = 5213 full sample; n = 2221 fasting subsample) from the 2003–2004 and 2005–2006 cycles of the National Health and Nutrition Examination Survey. Overall as well as gender- and age-specific estimates were obtained for reallocating time between the behaviours associated with cardiometabolic outcomes. Replacing SB with MVPA was associated with decreased levels of C-reactive protein (CRP), white blood cells (WBCs), red blood cell distribution width (RDW), insulin, insulin resistance homeostasis model assessment (HOMA-IR) and 2-hour glucose, and increased high-density lipoprotein cholesterol (HDL-C), except for WBCs in older adults, insulin and HOMA-IR in females and older adults, 2-hour glucose in young and older adults, and HDL-C in older adults. Substituting LPA for SB resulted in lower CRP in older adults, lower RDW in males and older adults, lower insulin in young and middle-aged adults, lower HOMA-IR in females and middle-aged adults, and higher HDL-C in males and young adults. Our findings provide new evidence for the potential benefits of LPA and MVPA in cardiovascular health and help make population-specific recommendations for physical activity. Highlights Shorter sedentary behaviour (SB) time and longer active behaviours time are associated with a lower cardiovascular disease risk profile. Although replacing SB with MVPA has stronger positive health effects, LPA, as a simpler and more feasible activity, may has greater potential in promoting cardiovascular health. The expected changes in cardiometabolic biomarkers caused by time reallocations from SB to MVPA/LPA vary with gender and age, and physical activity guidelines with specific recommendations should be tailed to the subpopulations.

Study interplay between Asprosin with Vitamin D in metabolic syndrome

Objective: The study aims to in investigating the role of the asprosin hormone and its relationship with vitamin D in patients with metabolic syndrome and clinical parameters. &#x0D; Methods: The study included measurement asprosin hormone, vitamin D, and some biochemical variable levels in metabolic syndrome patients with age matching to the control group (35 - 65 years). The study includes (95) samples of metabolic syndrome patients [49female, 46 males] who were attending the abdominal consultation unit at the Ibn Sina Teaching Hospital in Mosul, Iraq . MetS were diagnosed in compliance with the criteria of the NCEP (ATP III) and AHA/ NHLB . Samples were collected during the period from January 2021 to December 2021. Also, the study was carried out on 76 samples of apparently healthy (40 female, 36 male) as a control group.&#x0D; Results: The findings revealed a significant increase in the concertation of the asprosin hormone in metabolic syndrome patients compared to the control group. Also, it has been found that was a significant increase in the concertation of fasting glucose, insulin, homeostasis model for insulin resistance (HOMA-IR), Triglycerides , low-density lipoprotein-cholesterol, very low-density lipoprotein-cholesterol , total cholesterol and urea. In addition to a decline in high-density lipoprotein cholesterol , non-high-density lipoprotein cholesterol (Non-HDL), (HOMA-B ), vitamin D and Calcium among metabolic syndrome patients. there is also a significant inverse correlation between asprosin hormone with the Vitamin D.&#x0D; Conclusion: The study concluded that the hormone asprosin is a good indicator that reflects the status of metabolic syndrome patients and vitamin D appeared to be associated with MetS, as well as the Insulin resistance (IR) and lipid profile.

Evening chronotype is associated with hormonal and metabolic disorders in polycystic ovary syndrome.

Despite current treatments for polycystic ovary syndrome (PCOS), a considerable number of women with this syndrome do not reach the treatment goal, suggesting the presence of other probable misdiagnosed features of this syndrome that are not taken into account in the assessment and therefore in the therapeutical approach. The aim of this study was to investigate the prevalence of chronotype categories in women with PCOS and their role in determining hormonal and metabolic aspects of PCOS.This observational case-control study was conducted on 112 women with PCOS and 112 healthy women matched for age and body mass index (BMI). At baseline anthropometric parameters such as weight, height, BMI and waist circumference, clinical parameters such as Ferriman-Gallwey (FG) score, biochemical parameters such as fasting plasma glucose, insulin levels and assessment of the homeostasis model of insulin resistance (HoMA-IR), inflammatory parameters such as C-reactive protein (CRP) and hormonal parameters such as testosterone levels were evaluated.Women with PCOS had a lower chronotype score (p < .001) which indicates a higher prevalence of evening chronotype (EC) category (p = .037) compared to controls. After adjustment for BMI, chronotype score was significantly negatively correlated with CRP levels (r = -0.418, p < .001), testosterone levels (r = -0.543, p < .001) and FG score (r = -0.514, p < .001). Linear regression analysis showed that high testosterone levels were among the factors most associated with a lower chronotype score (p < .001), followed by BMI (p < .001) and HoMA-IR (p < .05).In conclusion, there is a higher prevalence of EC in women with PCOS than in women without the condition, which in turn was associated with a worse hormonal and metabolic profile. These findings provide support for the relevance of including chronotype assessment in the treatment of women with PCOS.

Evaluation of Triglyceride Glucose Index and Homeostasis Model of Insulin Resistance in Patients with Polycystic Ovary Syndrome.

To use the triglyceride glucose (TyG) index to evaluate insulin resistance (IR) in patients with polycystic ovary syndrome (PCOS) and to explore alternative indicators for early identification of IR. This study included 114 patients with PCOS and 61 healthy volunteers. Pearson or Spearman correlations were calculated to compare the association between the TyG index and triglyceride glucose body mass index (TyG-BMI) with homeostatic model assessment for IR (HOMA-IR), homeostasis model assessment for β-cell function (HOMA-β), quantitative insulin sensitivity check index (QUICKI), and fasting glucose-to-insulinratio (FG-IR). The receiver operating characteristic (ROC) curve was used to evaluate the sensitivity and specificity of the TyG index and TyG-BMI in identifying IR (defined as HOMA-IR ≥2.5) in patients with PCOS. Correlation analyses revealed that the TyG index of the PCOS group was positively correlated with HOMA-IR (r=0.515, P<0.01) and HOMA-β (r=0.348, P<0.01), but negatively correlated with QUICKI (r=-0.532, P<0.01) and FG-IR (r=-0.394, P<0.01). The ROC curve of IR defined by HOMA-IR showed that the AUC value of TyG-BMI was the highest, at 0.796 (95% confidence interval (CI): 0.710-0.866, P<0.001) when the cut-off point was 191.53, with 85.3% sensitivity and 73.9% specificity values. For the TyG index, the AUC was 0.781 (95% CI: 0.693-0.853, P<0.001) when 8.51 was the cut-off point, with a sensitivity of 63.2% and specificity of 87.0%. This study found that the TyG index and TyG-BMI performed better than traditional lipid ratios, such as triglycerides/high density lipoprotein cholesterol (TG/HDL-C), in predicting IR and may be used as markers of IR in Chinese patients with PCOS.

Major evidence of nutrological regulation in obese patients with meta-inflammation: a systematic review

Introduction: Obesity stands out as a multifactorial disease that can cause several public health problems. There are 2.0 billion overweight and obese people in the world, and Brazil ranks fifth in the world. A healthy nutritional status promotes immune function and can prevent the onset of a serious inflammatory process and severe infections, especially in times of a pandemic such as COVID-19. Objective: It was to highlight the main clinical considerations of nutrological and dietary regulation in obese patients with marked inflammatory processes and meta-inflammation through a systematic review. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from August to September 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 127 articles were found. A total of 74 articles were fully evaluated and 29 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 32 studies at high risk of bias and 25 studies that did not meet the GRADE. Research has shown that unbalanced dietary patterns, such as the Western diet, rich in simple sugars, refined carbohydrates, and saturated and trans fatty acids, lead to chronic inflammatory responses, increased fat deposits, and future comorbidities associated with overweight and obesity. Caloric restriction decreased polymerase chain reaction (PCR) in obese patients and diet administration over 12 weeks had a beneficial effect. Furthermore, obese patients with antioxidant supplementation had lower values of BMI, waist circumference, fasting blood glucose level, and insulin resistance homeostasis model assessment when compared to the placebo group, as well as lower total cholesterol levels, triglycerides, LDL, malondialdehyde and tumor necrosis factor-alpha. Supplementation of n-3 PUFA can significantly reduce serum PCR, tumor necrosis factor α (TNFα), and interleukin 6 (IL-6) concentrations.

Association between vitamin D serum levels and insulin resistance assessed by HOMA-IR among non-diabetic adults in the United States: Results from NHANES 2007-2014.

Insulin resistance, a pathological response to insulin hormone in insulin-dependent cells, is characterized by the presence of high glucose and insulin concentrations. The homeostasis model of insulin resistance (HOMA-IR) is one of the most used indexes to estimate insulin resistance by assessing the fasting glucose and insulin levels. An association was observed between vitamin D levels and insulin resistance, which varied in different ethnic groups, and there is some evidence that vitamin D supplementation could contribute to the improvement of insulin resistance. This study assessed the association between 25-hydroxyvitamin D (25[OH]D) concentration and HOMA-IR in American adults aged 20 years and older, without diabetes and other chronic diseases that can influence insulin resistance. The data from the National Health and Nutrition Examination Survey (NHANES) 2007–2014 were used by exploiting the free and publicly-accessible web datasets. Linear regression models were performed to evaluate the association between serum 25(OH)D concentration and HOMA-IR, and a negative association was observed, which remained significant following the adjustment for age, gender, race/ethnicity, education, body mass index (BMI), physical activity, the season of examination, current smoking, hypertension, the use of drugs which can influence insulin resistance, serum bicarbonates, triglycerides, and calcium and phosphorus levels. Only in non-Hispanic Blacks was this inverse association between vitamin D and HOMA-IR not observed in the fully adjusted model. Further studies are needed to explain the mechanisms of the observed ethnic/racial differences in the association of vitamin D levels with HOMA-IR.

EVALUATION OF INSULIN RESISTANCE IN PATIENTS WITH PREMATURE ADRENARCHE

Purpose: There is a conflicting result in terms of insulin resistance (IR) in children with Premature Adrenarche (PA). The study aimed to investigate the IR and Trıglycerıde-Glucose (Ty-G) index in patıents wıth PA.&#x0D; &#x0D; Material and Methods: This cross-sectional study was conducted in a tertiary pediatric endocrinology clinic with 160 children aged 6-8 years old. The study group (n=75) were selected cases diagnosed with PA. Seventy-nine age and sex-matched children were also selected as a control group. Ty-G İndex, Homeostasis Model of Insulin Resistance (HOMA-IR), and atherogenic index of plasma (AIP) were calculated. &#x0D; &#x0D; Results: Trıglycerıde-Glucose index, AIP, and HOMA-IR were similar (p&gt;0.05). Ty-G İndex was positively correlated with AIP (r=0.61, p

Effect of Multidisciplinary Team Continuous Nursing on Glucose and Lipid Metabolism, Pregnancy Outcome, and Neonatal Immune Function in Gestational Diabetes Mellitus.

Objective To investigate the effect of multidisciplinary team (MDT) continuous nursing on glucose and lipid metabolism, pregnancy outcome, and neonatal immune function in gestational diabetes mellitus (GDM). Methods A total of 90 patients with gestational diabetes mellitus (GDM) from January 2018 to December 2019 were recruited and assigned to receive routine care (routine group) or MDT continuous care (study group) according to different nursing methods. Outcome measures included glucose and lipid metabolism, pregnancy outcomes, and neonatal immune function. Results There were no significant differences in glucose and lipid metabolism indices and self-rating anxiety scale (SAS) scores, before nursing. After nursing, MDT continuous care resulted in significantly lower levels of fasting blood glucose (FBG), 2 h postprandial blood glucose (2hPBG), glycosylated hemoglobin (HbAlc), triglyceride (TG), and homeostasis model insulin resistance index (HOMA-IR) versus routine care. After nursing, the SAS scores in the two groups were significantly decreased, with lower results in the study group. Patients in the study group showed better compliance than those in the routine group. MDT continuous care was associated with a significantly lower incidence of premature rupture of fetal membranes, cesarean section, premature delivery, macrosomia, and hypoglycemia versus routine nursing. There were no significant differences in immunoglobulin (Ig) A and IgM levels. Patients in the study group showed a higher IgG level and lower CD3, CD4, CD8, and CD4/CD8 levels than those in the routine group. Conclusion MDT continuous nursing could effectively regulate glucose and lipid metabolism and improve pregnancy outcomes and neonatal immune function in patients with GDM.

Effects Of Metformin On Training Adaptations In Hyperglycemic Individuals With Metabolic Syndrome

PURPOSE: To determine if chronic metformin use interferes with the improvements in insulin resistance and cardiorespiratory fitness of intense aerobic training in hyperglycemic metabolic syndrome individuals (MetS). METHODS: Sixty-three middle-aged (53 ± 7 y) MetS with obesity (BMI, 32.8 ± 4.5 kg·m-2) completed 16-weeks of supervised high intensity interval exercise-training (3 days·week-1, 43 min per session). Participants were either taking metformin (EXER+MET; n = 29) or free of any pharmacological treatment for their MetS factors (EXER; n = 34). Groups were similar in their initial cardiorespiratory fitness (VO2MAX), age, percent of women, BMI, and MetS deviation from normality (Z score). We measured the effects of exercise-training on fasting glucose and insulin concentrations, homeostasis model of insulin resistance (HOMA-IR), MetS Z score, VO2MAX, maximal fat oxidation during exercise (FOMAX) and maximal aerobic power output (POMAX). RESULTS: HOMA-IR decreased similarly in both groups with training (EXER+MET, -12.9%; EXER, -14.8%; P time = 0.023 and P time x group = 0.761). MetS Z score improved similarly in both groups with training (EXER+MET, -0.19 ± 0.49; EXER, -0.25 ± 0.25; P time < 0.001 and P time x group = 0.541). However, metformin use reduced by half VO2MAX improvements with training (i.e., EXER+MET 12.7%, 0.22 ± 0.27 L·min-1; EXER 25.3%, 0.44 ± 0.29 L·min-1, P time x group =0.002). FOMAX increased similarly in both groups (EXER+MET, -20.7%; EXER, 25.3%; P time < 0.001 and P time x group = 0.569). CONCLUSIONS: In summary chronic metformin treatment does not affect fasting insulin sensitivity improvements with aerobic exercise-training in hyperglycemic individuals with high cardiovascular risk (i.e., MetS). Although metformin use attenuates training VO2MAX improvements this does not preclude MetS improvements with training.