Homeostatic Model Assessment-insulin Resistance Index Research Articles

Quercetin decreases fructose drinking in model of fructose-induced insulin resistance. Unexpected uric acid and TBARS lowering effect of methyl cellulose vehicle and fructose combination.

The aim of this study was to improve insulin sensitivity in fructose-treated animals by ingestion of flavonoid quercetin. Several signs of insulin resistance have been developed in rats by drinking 10% fructose solution for 9 weeks. The effect of 6-week-gavage-administrated quercetin (20 mg/kg/day in 1% methyl cellulose solution) was monitored. Rats of the control groups received methyl cellulose vehicle as well. The most striking result of the quercetin treatment was the normalization of the fructose solution drinking to the level of drinking water intake. In addition, quercetin supplementation considerably decreased the plasma glucose and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index in rats consuming fructose. Surprisingly, fructose ingestion did not elevate plasma uric acid, thiobarbituric acid reactive substances, nitrotyrosine, or advanced glycation end products fluorescence. Instead, a reduction of the above parameters was observed. In summary, these results indicate that quercetin supplementation reduces fructose drinking and decreases plasma glucose and the HOMA-IR index. Furthermore, methyl cellulose, in combination with fructose, causes uric acid - lowering, antioxidant and anti-glycation effects. Thus, methyl cellulose possibly shifts fructose metabolism in favor of the utilization of antioxidant features of fructose. Our results call for using methyl cellulose in sweetened beverages and other sweetened food.

MATERNAL SERUM LEPTIN LEVELS IN SUBJECTS WITH GESTATIONAL DIABETES MELLITUS

Objectives: To determine serum leptin levels and its correlation with pre-pregnancy BMI, BMI, and insulin resistance at 24 - 28 weeks of gestation and before delivery in subjects with gestational diabetes mellitus (GDM). Methods: A cross-sectional descriptive, longitudinal follow-up study with a control group on 115 pregnant women with GDM and 115 pregnant women with normal glucose tolerance (NGT) enrolled at 24 - 28 weeks of gestation and completed the study. The subjects' serum leptin levels were measured using the enzyme-linked immunosorbent assay (ELISA) method at 24 - 28 weeks of pregnancy and before delivery. The clinical characteristics, serum insulin levels, and homeostatic model assessment of insulin resistance (HOMA-IR) were also performed at both study time points. Results: Serum leptin levels in subjects with GDM were significantly higher than those in normal pregnant women at 24 - 28 weeks of gestation and before delivery (p < 0.001). At both study time points, there was a positive correlation between serum leptin levels and pre-pregnancy BMI, maternal weight, serum insulin levels, and HOMA-IR index in subjects with GDM (p < 0.05). Multivariable logistic regression showed that pre-pregnancy BMI and serum insulin levels were associated with hyperleptinemia (p < 0.05). Conclusion: Serum leptin levels were higher in GDM and had a positive correlation with pre-pregnancy BMI, BMI, and insulin resistance at the time of the study. Pre-pregnancy BMI and serum insulin levels were independent factors related to increased serum leptin levels.

Relationship between serum apelin, visfatin levels, and body composition in Polycystic Ovary Syndrome patients

ObjectiveTo investigate the relationship between body composition and serum visfatin and apelin levels in patients with polycystic ovary syndrome (PCOS). MethodsIn this prospective observational study, the differences in body composition, levels of gonadal hormone concentrations, glucose metabolism, apelin, and visfatin were compared between PCOS patients and the control group. PCOS patients were further divided into different subgroups according to different obesity criteria and the differences between serum visfatin and apelin levels in different subgroups were compared. Finally, the correlation of serum visfatin levels and apelin levels with body composition, and metabolism-related indicators in PCOS patients was explored. ResultsA total collected 178 cases of PCOS patients and 172 cases of healthy women (control group) between 2020 July and 2021 November. In PCOS patients, their weight, Body Mass Index (BMI), Waist Hip Rate (WHR), Fat-Free Mass Index (FFMI), Percent Body Fat (PBF), Fat mass index (FMI), PBF of Arm, PBF of Leg, PBF of the Trunk, Visceral Fat Level (VFL), fasting insulin (FINS), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and Luteinizing hormone (LH) were significantly higher than in the control group (all P < 0.001), Percent Skeletal Muscle (PSM), PSM of Leg, and PSM of the Trunk were significantly decreased than in the control group (all P < 0.001). The PCOS patients had significantly higher serum visfatin levels and apelin levels compared with the control group (all P < 0.001). In PBF > 35 % PCOS patients, the apelin and visfatin levels were significantly higher than the PBF ≤ 35 % PCOS patients. In WHR ≥ 0.85 and BMI ≥ 24 kg/m2 PCOS patients, the visfatin levels were significantly higher than the WHR < 0.85 and BMI < 24 kg/m2 PCOS patients. Serum apelin and visfatin positively correlated with BMI level, WHR, FFMI, PBF, FMI, PBF of arms, PBF of legs, PBF of the trunk, VFL, FBG, HOMA-IR index and negatively correlated with PSM, PSM of legs, and PSM of the trunk (all P < 0.001). ConclusionsCompared with healthy women, Patients with PCOS have an increased fat content in various parts of the body, reduced skeletal muscle content, and are often complicated by metabolic abnormalities. Serum visfatin and apelin correlated not only with obesity, fat mass, and fat distribution but also with muscle mass and distribution. It may be possible to reduce the long-term risk of metabolic disease in PCOS through the monitoring and management of the body composition in PCOS patients or to reflect the therapeutic effect of PCOS.

Effect of complex micronutrient supplement and vitamin D as adjunct to insulin therapy in patients with gestational diabetes mellitus

Purpose: To determine the effect of complex micronutrient supplements and vitamin D as adjunct therapy on pancreatic function, oxidative stress, glucose metabolism and pregnancy outcomes in patients diagnosed with gestational diabetes mellitus (GDM). &#x0D; Methods: 100 GDM patients admitted to Hangzhou Linping District Maternal and Child Health Care Hospital, China between March 2022 and February 2023, were randomly allocated to control and study groups (50 patients each). Control group received insulin injections, whereas study group received complex micronutrients with vitamin D as supplements to insulin. Differences in terms of pancreatic function (homeostatic model assessment-insulin resistance index (HOMA-IR), homeostatic model assessment-beta-cell function index (HOMA-β)), oxidative stress (total antioxidant capacity (TAC), malondialdehyde (MDA)), glucose metabolism indicators (fasting blood glucose (FBG), 2-hour postprandial glucose (2hPG), glycated hemoglobin (HbA1c)) and pregnancy outcomes was assessed. &#x0D; Results: After treatment, both groups showed reductions in serum levels of FBG, 2hPG and HbA1c, but study group exhibited a considerably greater decrease (p &lt; 0.05). In addition, study group had lower HOMA-IR and MDA levels as well as higher HOMA-β and TAC levels (p &lt; 0.05). Negative delivery outcomes occurred less frequently in study group than in control group (p &lt; 0.05). &#x0D; Conclusion: Complex micronutrient supplements (rich in magnesium, calcium, and zinc) in combination with vitamin D as adjunct to insulin treatment effectively reduce pancreatic function and oxidative stress, significantly control blood glucose levels and lower the occurrence of adverse pregnancy outcomes in GDM patients. Further studies will be required in a larger more diverse population to determine the mechanism of enhancing pancreatic function.

A Randomized Trial of the Efficacy of Three Weight Loss Diet Interventions in Overweight/Obese with Polycystic Ovary Syndrome

Background: Polycystic Ovary Syndrome (PCOS) is a highly prevalent, complex, heterogeneous, polygenic endocrine disorder characterized by metabolic and reproductive dysfunction that affects 8-13% of women of reproductive age worldwide. The pathogenesis of PCOS has not been fully clarified and includes genetics, obesity, and insulin resistance (IR). Oxidative stress (OS) of PCOS is independent of obesity. It can induce IR through post-insulin receptor defects, impair glucose uptake in muscle and adipose tissue, and exacerbate IR by reducing insulin secretion from pancreatic β-cells. Objective: To investigate the effects of Calorie Restricted Diet (CRD), High Protein Diet (HPD), and High Protein and High Dietary Fiber Diet (HPD+HDF) on body composition, insulin resistance, and oxidative stress in overweight/obese PCOS patients. Methods: A total of 90 overweight/obese patients with PCOS were selected to receive an 8- week medical nutrition weight loss intervention at our First Hospital of Peking University, and we randomly divided them into the CRD group (group A), the HPD group (group B), and the HPD+HDF group (group C), with 30 patients in each group. We measured their body composition, HOMA-IR index, and oxidative stress indicators. The t-test, Mann-Whitney U test, analysis of variance (ANOVA), and Kruskal-Wallis H test were used to compare the efficacy of the three methods. Results: After eight weeks, the body weights of the three groups decreased by 6.32%, 5.70% and 7.24%, respectively, and the Visceral Fat Area (VFA) values decreased by 6.8cm2, 13.4cm2 and 23.45 cm2, respectively, especially in group C (p &lt;0.05). The lean body mass (LBM), also known as the Fat-Free Mass (FFM) values of group B and group C after weight loss, were higher than that of group A (p &lt;0.05). After weight loss, the homeostatic model assessment of insulin resistance (HOMA-IR) index and malondialdehyde (MDA) were decreased. Superoxide dismutase (SOD) was increased in all three groups (p &lt;0.05), and the changes in SOD and MDA in group B and group C were more significant (p &lt;0.05). HOMA-IR index positively correlated with body mass index (BMI) (r=0.195; p &lt;0.05); MDA positively correlated with percent of body fat (PBF) (r=0.186; p &lt;0.05) and HOMA-IR index (r=0.422; p &lt;0.01); SOD positively correlated with LMI/FFMI (r=0.195; p &lt;0.05), negatively correlated with HOMA-IR index (r=-0.433; p &lt;0.01). Conclusion: All three diets were effective in reducing the body weight of overweight/obese patients with PCOS by more than 5% within 8 weeks and could improve both insulin resistance and oxidative stress damage. Compared with CRD, HPD and HPD+HDF diets could better retain lean body mass and significantly improve oxidative stress damage.

Evaluation of the Effectiveness of Liraglutide on Metabolic Parameters in the Treatment of Obesity.

Background One of the essential chronic diseases is obesity, which negatively affects the individual and society. Liraglutide (LG) is an effective treatment for both obesity treatment and metabolic control. This study aims to show the effect of a 3.0 mg dose of LG, injected subcutaneously once a day, on weight loss and metabolic parameters. Methods This retrospective single-center study included 67 patients (60 women and seven men) with a BMI of at least 27 kg/m2 with comorbidities or a BMI of at least 30 kg/m2. Demographic characteristics, anthropometric measurements, and biochemical data of the participants were evaluated at the end of the four and 16 weeks. Results The mean body weight (BW) loss of patients using LG at 16 weeks was -11.71±2.21 kg. After the four and 16 weeks of beginning the LG use, the patients who lost more than 5% of initial BW were 38.8% vs. 76.1%, respectively (p=0.034). The mean baseline Homeostatic Model Assessment-Insulin Resistance Index, hemoglobin A1c, low-density lipoprotein, and triglycerides values were significantly higher than the 4 and 16 weeks (p<0.001). Twenty-two (32.8 %) patients experienced side effects (SE) after starting LG treatment, and the most common SE was found to be nausea (29.4%). Conclusion The use of LG, which is not covered by insurance, together with diet and exercise, has been shown to have clinically significant weight loss and a positive effect on glycemic values ​​and lipid profile.

Altered Vitamin D Status and Bone Mineral Density in Obese and Non-obese Patients With Polycystic Ovary Syndrome: A Cross-Sectional Study in Turkey.

Background Polycystic ovary syndrome (PCOS) is the most common endocrinological disease in women of reproductive age. In addition to providing the basis for comorbidities such as metabolic and cardiovascular diseases, it also affects bone metabolism. This study aimed to determine whether there is a relationship between bone mineral density (BMD), vitamin D status, insulin resistance, sex hormones, and calcium metabolism disorders in women with PCOS. Methodology Fifty-six non-obese women with PCOS, 67 obese women with PCOS, and 45 normal weight controls participated in the study. Circulating levels of gonadotropins, estradiol, prolactin, dehydroepiandrosterone sulfate, total testosterone, thyroid stimulating hormone, sex hormone-binding globulin, insulin, glucose, and calcium metabolism parameters were assessed. We used the Homeostatic Model Assessment-Insulin Resistance Index to detect insulin resistance. BMD values in the various body regions were measured by dual X-ray absorptiometry. Results Women with PCOS had significantly lower vitamin D values and lumbar spine BMD than controls (p <0.001 and p <0.05, respectively). Among the patients with PCOS subgroups, vitamin D deficiency (VDD) was more frequent in obese PCOS patients (67.1%) than in non-obese patients (58.9%). We found significantly lower BMD at all sites only in the subgroup of the non-obese PCOS women than in controls (p <0.001). Conclusions VDD is prevalent in PCOS women in those with obesity and hyperandrogenemia. Non-obese PCOS women have significantly lower BMD measurements than healthy controls, but obese PCOS women have BMD values comparable with normal-weight eumenorrheic controls. Body mass index is the most important factor determining BMD in women with PCOS.

Upregulation in Inflammation and Collagen Expression in Perirenal but Not in Mesenteric Adipose Tissue from Diabetic Munich Wistar Frömter Rats

Perirenal adipose tissue (PRAT) surrounding the kidney is emerging as a player and novel independent risk factor in diabetic kidney disease (DKD); DKD is a complication of diabetes and is a major cause of increased cardiovascular (CV) risk and CV mortality in affected patients. We determined the effect of diabetes induction on (i) kidney and CV damage and (ii) on the expression of proinflammatory and profibrotic factors in both the PRAT and the mesenteric adipose tissue (MAT) of Munich Wistar Frömter (MWF) rats. The 16-week-old male MWF rats (n = 10 rats/group) were fed standard chow (MWF-C) or a high-fat/high-sucrose diet for 6 weeks together with low-dose streptozotocin (15 mg/kg i.p.) at the start of dietary exposure (MWF-D). Phenotyping was performed at the end of treatment through determining water intake, urine excretion, and oral glucose tolerance; use of the homeostatic model assessment–insulin resistance index (HOMA-IR) evidenced the development of overt diabetes manifestation in MWF-D rats. The kidney damage markers Kim-1 and Ngal were significantly higher in MWF-D rats, as were the amounts of PRAT and MAT. A diabetes-induced upregulation in IL-1, IL-6, Tnf-α, and Tgf-β was observed in both the PRAT and the MAT. Col1A1 was increased in the PRAT but not in the MAT of MWF-D, whereas IL-10 was lower and higher in the PRAT and the MAT, respectively. Urinary albumin excretion and blood pressure were not further increased by diabetes induction, while heart weight was higher in the MWF-D. In conclusion, our results show a proinflammatory and profibrotic in vivo environment in PRAT induced by diabetes which might be associated with kidney damage progression in the MWF strain.

Insulin resistance is acardiovascular risk factor in hypertensive adults without type2 diabetes mellitus.

Metabolic syndrome refers to the association among several cardiovascular risk factors: obesity, dyslipidemia, hyperglycemia, and hypertension. It is associated with increased cardiovascular risk and the development of type2 diabetes mellitus. Insulin resistance is the underlying mechanism of metabolic syndrome, although its role in increased cardiovascular risk has not been directly identified. We investigated the association between insulin resistance and increased cardiovascular risk in hypertensive adults without diabetes mellitus. We enrolled participants without diabetes from an outpatient setting in aretrospective, longitudinal study. Several demographic, clinical, and laboratory parameters were recorded during the observation period. Plasma insulin and homeostatic model assessment for insulin resistance (HOMA-IR) were used to determine insulin resistance and four cardiovascular events (acute coronary disease, acute cerebrovascular disease, incident heart failure, and cardiovascular mortality) were combined into asingle outcome. Logistic regression and Cox proportional hazards models were fitted to evaluate the association between covariates and outcomes. We included 1899 hypertensive adults without diabetes with an average age of 53years (51.3% women, 23% had prediabetes, and 64.2% had metabolic syndrome). In alogistic regression analysis, male sex (odds ratio, OR = 1.66) having high levels of low-density lipoprotein (LDL, OR = 1.01), kidney function (OR = 0.97), and HOMA-IR (OR = 1.06) were associated with the incidence of cardiovascular events; however, in asurvival multivariate analysis, only HOMA-IR (hazard ratio, HR1.4, 95% confidence interval, CI: 1.05-1.87, p = 0.02) and body mass index (HR 1.05, 95% CI: 1.02-1.08, p = 0.002) were considered independent prognostic variables for the development of incident cardiovascular events. Insulin resistance and obesity are useful for assessing cardiovascular risk in hypertensive people without diabetes but with preserved kidney function. This work demonstrates the predictive value of the measurement of insulin, and therefore of insulin resistance, in an outpatient setting and attending to high-risk patients.

Association between dinner timing and glucose metabolism in rural China: A large-scale cross-sectional study

ObjectivesMeal timing is a major risk factor for metabolic disease. The aim of this study was to assess the relationship between dinner timing and glucose metabolism in the rural Chinese population. MethodsThis cross-sectional study included 7701 participants from a Henan rural cohort study. Basic information was collected by in-person questionnaires. Multiple linear regression analysis was used to evaluate the relationship between dinner timing and fasting insulin (FINS), fasting plasma glucose (FPG), and homeostatic model assessment for insulin resistance (HOMA-IR). Restricted cubic spline was employed to investigate the dose–response relationship between dinner timing and FINS, FPG, and HOMA-IR. A generalized linear model was used to explore the interaction effect of age and dinner timing on FINS, FPG, and HOMA-IR. ResultsAfter adjusting for confounding factors, FINS concentration was reduced by 0.482 mmol/L (P < 0.001) for each hour delay in dinner timing. Furthermore, the HOMA-IR index decreased by 0.122 mmol/L for each hour delay. The results indicated a noticeable trend of decreasing values associated with later dinner timing (FINS: Poverall association < 0.001, Pnonlinear association = 0.144; HOMA-IR: Poverall association = 0.001, Pnonlinear association = 0.186). The interaction between age and dinner time significantly correlated with FINS and HOMA-IR (P < 0.05). This relationship was statistically significant before 69 y (P < 0.05). ConclusionA significant association between dinner timing and glucose metabolism was observed in the rural Chinese population. Delayed dinner timing may be associated with lower fasting insulin. The negative effect of dinner timing on FINS and HOMA-IR was diminished with age.

Insulin resistance is associated with cognitive dysfunction in multiple sclerosis patients: A cross-sectional study.

Multiple sclerosis (MS) is a progressive inflammatory neurodegenerative disease of the nervous system accompanied by demyelination. MS-associated cognitive impairments mainly involve recent memory, information processing speed, stable memory, and executive function. Moreover, MS is associated with impaired glucose and insulin metabolism, which can exacerbate cognitive decline. The present study aimed to compare the cognitive status of MS patients with and without insulin resistance. In this cross-sectional study, 74 relapsing-remitting multiple sclerosis diagnosed patients were enrolled. Indicators of insulin resistance, including fasting blood glucose, insulin level, and homeostatic model assessment of insulin resistance (HOMA-IR) index, were measured. They were then divided into two groups based on the results of the HOMA-IR index. Cognition status was evaluated by the minimal assessment of cognitive function in multiple sclerosis battery. The prevalence of insulin resistance was 37.8%, and the prevalence of cognitive decline was estimated to be 67.56%. Mean scores of the California verbal learning test (CVLT), CVLT delayed free recall, controlled oral word association test, and judgment of line orientation tests were significantly lower in MS patients with insulin resistance than without. In addition, a negative correlation was demonstrated between the results of the CVLT, CVLT delayed free recall, controlled oral word association test, judgment of line orientation tests, brief visuospatial memory test, and Delis-Kaplan executive function system sorting tests and fasting insulin levels. Greater verbal memory and spatial comprehension impairments were observed in MS patients with insulin resistance.

The effect of high-intensity interval, aerobic, resistance and spirulina supplement consumption on levels of UCP-1, TRPV1 and HOMA-IR in the white adipose tissue of diabetic rats

The purpose of this study was to investigate the effect of high-intensity interval, aerobic, and resistance training, and spirulina supplement consumption on the levels of Uncoupling Protein-1 (UCP1), Transient Receptor Potential Vanilloid (TRPV1) and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) in the white adipose tissue of diabetic rats. A total of 42 male rats with diabetes type II were randomly assigned into seven groups as follows: aerobic training (n=6), resistance training (n=6), interval training (n=6), aerobic training combined with supplementation (n=6), resistance training combined with supplementation (n=6), interval training combined with supplementation (n=6) and control (n=6) groups. The training groups carried out the training (8 weeks/5 days) on a rodent treadmill and ladder. The paired sample t-test and one-way ANOVA were employed for data analysis. The three kinds of training, with and without supplementation, significantly reduced mass, glucose, insulin, and insulin resistance. In the three supplementation-combined training groups the difference on the HOMA-IR index was significant; however, the decline was larger in the resistance training with supplementation group. The concentration of UCP-1 and TRPV1 proteins significantly increased in all training groups, with and without supplementation. Nonetheless, the significant increase in the UCP-1 levels in the interval training with supplementation group was more than in the other groups. Furthermore, the TRPV1 protein levels were higher in the resistance training with supplementation group. Eight weeks of training, with and without Spirulina supplementation, reduced insulin resistance and gave rise to significant changes in UCP-1 and TPRV1 concentrations.

Evaluation of serum telomerase activity in normal-weight young girls with polycystic ovarysyndrome and its relation to metabolic parameters.

This study investigated the discriminative value of serum telomerase levels in polycystic ovary syndrome (PCOS) and its relation to metabolic parameters. Patients aged 16-23years old who visited an adolescent outpatient clinic were included in the study. Our study consisted of 45 non-obese girls with polycystic ovary syndrome (PCOS), while our control group consisted of 45 healthy girls with normal menstrual cycles and no signs of hyperandrogenism. During the early follicular phase, all individuals were analyzed for serum telomerase levels, blood cell count, biochemical parameters, basal hormone levels, lipid profile and homeostatic model assessment of insulin resistance (HOMA-IR) index. Serum telomerase levels in PCOS patients were considerably lower (80.0±52.8IU/mL) than in the controls (113.1±54.9IU/mL) (p=0.004). We observed that blood telomerase levels less than 108.6 distinguished PCOS group from healthy controls with a sensitivity of 73.33% and a specificity of 57.78%. Low-density lipoprotein cholesterol, HOMA-IR index, Ferriman-Gallwey score and dehydroepiandrosterone sulfate values were higher in the study group. Moreover, serum telomerase levels were inversely correlated with body mass index (r=-0.339, p=0.023) and triglycerides (r=-0.511, p=0.002) in this group. Telomerase levels were also considerably lower in patients with metabolic syndrome (p=0.005). Serum telomerase activity is lower in PCOS patients than in healthy controls. Furthermore, decreased serum telomerase levels may correlate well with the metabolic complications of PCOS.

Fructose consumption correlates with triglyceride-glucose index and glycemic status in healthy adults

The aim of this study was to evaluate the glycemic parameters, lipid profiles, uric acid levels, and triglyceride-glucose (TyG) index of individuals who consume different amounts of fructose. Additionally, the relationship between the TyG index and the homeostatic model assessment for insulin resistance (HOMA-IR) values was investigated. This cross-sectional study was conducted on healthy adults aged between 18 and 55 who applied to a university hospital in Istanbul, Turkey. Demographic characteristics and food consumption were recorded using the face-to-face interview method. Participants were divided into two groups according to their fructose consumption (≤50g/day: moderate; >50g/day: high). The glycemic parameters, lipid profiles, and uric acid levels were measured and TyG index was calculated. Fructose consumption of >50g/day was reported by 25% of the participants. There was no relationship between lipid profile, uric acid, and fructose consumption. The fasting blood glucose (FBG), fasting insulin, HOMA-IR, and TyG index values in the moderate fructose consumption group were significantly lower than those for the high fructose consumption group (P<0.05). The TyG index was associated with fructose consumption and HOMA-IR (P<0.05). High fructose consumers exhibited FBG and HOMA-IR levels 1.18 (95% confidence interval [95% CI]=1.01-1.37) and 1.42 (95% CI=1.09-1.84) times higher than those for the moderate fructose consumers (P<0.05). The results of this study confirmed that high fructose consumption negatively affects glycemic status in healthy adults. Additionally, this study revealed that there is a significant association between daily fructose consumption and TyG index.

Comparison of the Effect of Endurance, Strength and Endurance-Strength Training on Glucose and Insulin Homeostasis and the Lipid Profile of Overweight and Obese Subjects: A Systematic Review and Meta-Analysis.

The most effective type of training to improve cardiometabolic parameters in overweight subjects is unknown. This meta-analysis compared the effect of endurance, strength and combined training on glucose, insulin metabolism and the lipid profile of overweight and obese adults. The Cochrane, PubMed, Scopus and Web of Science databases were searched to identify randomised trials assessing the effect of training intervention on fasting and 2 h glucose and insulin levels, glycated haemoglobin (HbA1c), homeostatic model assessment of insulin resistance (HOMA), C-peptide, total cholesterol (TC), low- (LDL-C) and high-density lipoprotein cholesterol and triglycerides (TG). Forty-six studies were included showing that endurance training more favourably reduced HbA1c (p = 0.044), and LDL-C (p = 0.021) than strength training. Endurance-strength training more effectively decreased glucose (p = 0.002), HbA1c (p = 0.032), HOMA (p = 0.002), TC (p = 0.039), LDL-C (p = 0.046), HDL (p = 0.036) and TG levels (p = 0.025) than strength training. Combined training significantly reduced the HOMA index (p = 0.009) and TG levels (p = 0.039) compared with endurance training. Endurance and endurance-strength training have a more favourable effect on glucose and insulin homeostasis and lipid profile than strength training in overweight and obese adults. However, the results from this meta-analysis should be interpreted cautiously due to significant heterogeneity among included studies.

Associations between different heart rate variability ratios and cardiometabolic risk factors in young adults.

To study the association of two different heart rate variability (HRV) ratios with cardiovascular disease (CVD) risk factors in young adults. A total of 132 participants (89 women) were included in this cross-sectional study. We assessed their HRV and computed the low frequency-to-high frequency ratio (LF/HF) and, from the Poincaré plot, the ratio of the inverse of the longitudinal (SD2) to the transversal (SD1) axes ([1000/SD2]/SD1; sympathetic: parasympathetic [S:PS] ratio). From blood samples, we determined total cholesterol, high-density (HDL-C) and low-density lipoprotein-cholesterol, triglycerides, glucose, insulin, and the homeostatic model assessment of insulin resistance (HOMA) index. Multiple linear regression models were adjusted for age. Both, the LF/HF and the S:PS ratios, were positively associated with glucose metabolism markers (glucose, insulin, HOMA index), and negatively associated with HDL-C in women but not in men. We showed that the LF/HF and the S:PS are associated similarly with CVD risk factors in young women.

426.5: Regular Physical Activity in the Prevention of Post-transplant Diabetes Mellitus and Associated Metabolic Conditions in Kidney Transplant Recipients

Introduction: Post-transplant diabetes mellitus (PTDM) is significant risk factor for the survival of graft recipients and occurs in 10-30% of patients after kidney transplant (KT). PTDM is associated with premature cardiovascular morbidity and mortality. Insulin resistance (IR) at the time of KT is the most significant risk factor for the development of PTDM in patients after KT, as demonstrated by several analyzes. It is possible to reduce the high incidence of PTDM and affect the long-term survival of patients and grafts by influencing just modifiable risk factors, including obesity and the associated IR. The aim of this work is to determine the effect of regular physical activity on the development of PTDM and its risk factors in patients after KT. Methods: This was a prospective controlled analysis, which included 44 patients after primary KT in the Martin Transplant Center. Half consisted of a study group (n = 22) whose patients were assigned to perform regular physical activity. The primary goal was to complete at least 150 minutes of moderate intensity physical exertion per week. They performed an aerobic or combined (aerobic + strength) type of sports activity. Monitoring was provided by a sports tracker (Xiaomi Mi Band 4 compatible with Mi Fit mobile application). The other half was made up of a control group. The exclusion criterion at that time was already diagnosed with diabetes mellitus or a pre-diabetic condition. IR was assessed using the HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) index from fasting blood glucose and insulinemia values. Each patient underwent an oral glucose tolerance test (oGTT) at the end of follow-up. Patients in both groups have the same immunosuppressive protocol. The duration of follow-up was 6 months. Results: We confirmed a statistically significantly higher IR at 6 months (P = 0.0202) and fasting blood glucose at 3 and 6 months (P = 0.0279) by multivariate analysis in the control group (figure 1, 2). After the end of the follow-up, there were significantly fewer patients with normal oGTT in the control group compared to the study group at 6 months (P < 0.0001), significantly more patients with pre-diabetic condition (impaired plasma glucose, impaired glucose tolerance) (P = 0.0078) and diagnosed with PTDM (P = 0.0212) (figure 3). Significantly lower waist circumference at 3 and 6 months (P = 0.0437, P = 0.0372) and low-density lipoprotein at 6 months (P = 0.0444) were found in the study group compared to the control group. In the study group, the subgroup performing intensive training achieved a significant additional effect on the reduction of waist circumference (P = 0.0173). Patients practicing only aerobic activity achieved significant decrease in triglycerides compared to those practicing combined activity (P = 0.046). Conclusion: In our study, we confirmed a significant effect of regular physical activity in preventing the development of PTDM and associated pre-diabetic conditions.

TyG Index Performs Better Than HOMA-IR in Chinese Type 2 Diabetes Mellitus with a BMI < 35 kg/m2: A Hyperglycemic Clamp Validated Study

Background and objectives: Chinese type 2 diabetes mellitus (T2DM) patients are characterized by a low body mass index (BMI), and significant insulin resistance (IR). The triglyceride glucose (TyG) index has not been studied as a means of assessing IR in Chinese T2DM patients with a BMI < 35 kg/m2. Materials and Methods: An open-label cross-sectional study recruited 102 Chinese T2DM patients with a BMI < 35 kg/m2. The hyper-insulinemic euglycemic clamp, homeostatic model assessment of IR (HOMA-IR), and TyG index were used to determine the level of IR. Based on Pearson’s correlations, glucose disposal rate (GDR), TyG index, and HOMA-IR were analyzed. HOMA-IR and TyG index for IR were evaluated using multiple linear regression and multivariate logistic regression analyses. On the basis of the receiver operating characteristic (ROC) curve, the sensitivity, specificity, and optimal cut-off value of HOMA-IR and the TyG index were determined. Results: The mean values of GDR, HOMA-IR, and TyG index were 4.25 ± 1.81, 8.05 ± 7.98, and 8.12 ± 0.86 mg/kg/min, respectively. Pearson’s correlation coefficient was −0.418 between GDR and TyG index and −0.324 between GDR and HOMA-IR. ROC curve analysis showed that, among both sexes, the TyG index was a better discriminator of IR than HOMA-IR. The area under the ROC curve (AUC) of the TyG index (0.785, 0.691–0.879) was higher than that of HOMA-IR (0.73, 0.588–0.873) in all genders. The optimal cut-off values of the TyG index and HOMA-IR were 7.99 and 3.39, respectively. Conclusions: The TyG index showed more effectiveness in identifying IR in Chinese T2DM patients with a BMI < 35 kg/m2 compared to HOMA-IR.

Homeostatic Model Assessment for Insulin Resistance Is Associated With Late Miscarriage in Non-Dyslipidemic Women Undergoing Fresh IVF/ICSI Embryo Transfer.

ObjectiveTo evaluate the associations between homeostatic model assessment for insulin resistance (HOMA-IR) and pregnancy outcomes in non-dyslipidemic infertile women undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET).Materials and MethodsThis is a retrospective study involving 3,615 non-dyslipidemic infertile women who attend to the Reproductive Medicine Center of Xiangya Hospital, Central South University (CSU) between January 2014 and October 2021. Eligible participants were divided into three groups according to the quartiles of HOMA-IR: Group 1 (HOMA-IR <1.46), Group 2 (1.46 to <2.71) and Group 3 (HOMA-IR ≥2.71). Baseline data, clinical characteristics during the assisted reproductive technology (ART) procedure, pregnancy, and neonatal outcomes were compared among the three groups. Subgroup analysis based on presence or absence of the polycystic ovary syndrome (PCOS) status was also performed to analyze the effects of HOMA-IR among non-PCOS populations.ResultsThe late miscarriage rate and percentage of macrosomia increased with the HOMA-IR group (for late miscarriage rate: 2.23% vs. 3.04% vs. 7.35%, P<0.001; for macrosomia: 0.21% vs. 1.70% vs. 3.23%, P=0.002). Increased HOMA-IR (HOMA-IR≥2.71) was positively associated with late miscarriage (crude OR 3.50, 95% CI 1.64-7.47, P=0.001; adjusted OR 3.56, 95% CI 1.56-8.15, P=0.003). In the subgroup analysis, there were 3,165 participants in the non-PCOS group and 450 were assigned to the PCOS group. Late miscarriage rate increased with the HOMA-IR group among non-PCOS populations (2.20% vs. 3.03% vs. 7.67%, P<0.001). Late miscarriage rate of PCOS women were comparable among the three HOMA-IR groups (2.50% vs. 3.06% vs. 5.71%, P=0.634). Among non-PCOS women, increased HOMA-IR (HOMA-IR≥2.71) was positively associated with late miscarriage (crude OR 3.71, 95% CI 1.66-8.30, P=0.001; adjusted OR 3.82, 95% CI 1.59-9.17, P=0.003).ConclusionsLate miscarriage rate and prevalence of macrosomia increased with the HOMA-IR index. Preconception HOMA-IR is an independent risk factor for late miscarriage in normolipidemic women undergoing IVF/ICSI-ET. Controlling insulin resistance before ART might prevent the occurrence of late miscarriage and macrosomia.

Demodicosis Cutis and Metabolic Disturbances

Summary Cutaneous demodicosis (CD) is a pilosebaceous unit disease, overlapping clinically with other facial dermatoses, mainly rosacea, and acne. It is usually improved by acaricidal monotherapy. This study investigates the association of CD with metabolic disturbances. It was conducted with 141 patients with primary and secondary CD. The study investigated the correlation between CD and dyslipidemia based on disturbances in total cholesterol (TC) and Low-Density Lipoproteins (LDL) and between CD and impaired glucose tolerance, diagnosed with elevated fasting blood sugar levels, 120 minutes blood sugar levels in oral glucose tolerance test (OGTT) and the mathematically calculated Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index. The study results were verified with control groups. It was established that patients with CD do not show statistically significant deviations in serum lipoproteins compared with the control group. However, the patients with CD tended to have impaired glucose tolerance, demonstrated with elevated fasting glucose levels and elevated HOMA-IR, compared to the control group. Interestingly enough, the tendency towards prediabetes and diabetes was not confirmed by the 120 minutes blood glucose levels of the OGTT. The presented data confirm the need for testing impaired glucose tolerance in every patient with cutaneous demodicosis. Based on the presented evidence, it is recommended to perform the screening by evaluating fasting glucose levels and fasting insulin levels, followed by calculating the HOMA-IR index.