Homeostatic Model Assessment Of Insulin Resistance Levels Research Articles

Comparison of Triglyceride–Glucose (TyG) Index and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) Index in Prediction of Male Hypogonadism

Several studies have shown the association between decreased insulin sensitivity and the risk of male hypogonadism. Homeostatic model assessment of insulin resistance (HOMA-IR) is a well-established marker of decreased insulin sensitivity. The triglyceride–glucose index (TyG), calculated as ln fasting triglyceride mg/dL× fasting glucose mg/dL/2, was recently suggested to be a cheaper and a reliable surrogate marker to detect insulin resistance (IR). Our aim was to compare the performance of those two indexes in the prediction of male hypogonadism. The data on 192 men from infertile couples (18–50 years; sperm concentration <20 x 106/mL) and 199 population-based matched controls collected during the years 2009–2012 (baseline) were evaluated retrospectively. Half of these subjects (72 subfertile men and 122 controls) were reinvestigated 5–10 years later (median year (range): 7 (5–10)). The patients receiving any hormonal therapy were excluded. Hypogonadism was defined as fasting, morning serum testosterone below 12 nmol/L. In receiver operating characteristic curve analysis, the optimal diagnostic cutoff values for baseline HOMA-IR and TyG to predict MetS at re-examination were 2.68 (Area Under Curve (AUC) = 0.886, p < 0.001) and 8.60 (AUC = 0.816, p <0.001), respectively. Moreover, in binary logistic regression analysis performed on the whole cohort using these thresholds for high values of HOMA-IR and high TyG, the odds-ratios (ORs) for hypogonadism were 6.48 (95% Confidence Interval (CI): 3.77–11.2; p <0.001) and 3.58 (95% CI: 2.17–5.94; p <0.001), respectively. Even though high HOMA-IR levels provided better risk estimates, high TyG was also highly related to the risk of hypogonadism. These markers can be utilized to identify men being at high risk of hypogonadism.

Increased diabetogenic risk of recovered COVID-19 infection and unexposed respondents in the Central Region of Ghana

IntroductionIn spite of the negative effects of the coronavirus disease 2019 (COVID-19) on the global health system, its long-term impact on the evolution of diabetes is not fully ascertained. The current study was therefore designed to examine the diabetogenic risk of adults who had recovered from COVID-19 compared with their counterparts without any history of the condition in the Cape Coast metropolis of Ghana. Research design and methodsThis cross-sectional study involved 110 recovered COVID-19 and 110 COVID-19 unexposed respondents. Weight, height, hip circumference (HC) and waist circumference (WC) were measured for computation of body mass index (BMI), waist-to-hip ratio (WHR), and weight-to-height ratio (WtHtR). Also, systolic blood pressure, insulin, C-reactive protein (CRP), fasting blood glucose (FBS), lipid profile, 2-hour oral glucose tolerance test (2hr OGTT), total and visceral fat levels were measured. Homeostatic model assessment of beta-cell function (HOMAB) was applied to assess the secretory function of beta cells with insulin resistance determined by the homeostatic model assessment of insulin resistance (HOMA-IR), fasting insulin resistance index (FIRI), quantitative insulin sensitivity check index (QUICKI), and triglyceride-glucose index (TyG). ResultsRecovered COVID-19 respondents exhibited higher (P < 0.05) levels of BMI, WC, HC, WtHtR, CRP, FIRI, HOMA-IR, HOMAB and insulin but lower level of QUICKI than their unexposed counterparts. Compared with the recovered COVID-19 respondents, the overweight/obese COVID-19 unexposed group demonstrated higher insulin resistance but lower beta-cell function. Irrespective of COVID-19 background, FBS and insulin remained independent predictors for FIRI, QUICKI and HOMA-IR as TyG was predicted by FBS and selected components of lipid profile. ConclusionThe recovered COVID-19 respondents demonstrated a higher risk of developing type 2 diabetes mellitus through increased insulin resistance and beta-cell dysfunction than their uninfected counterparts. Urgent measures are needed to mitigate the identified risk.

The Role of Probiotics in Managing Glucose Homeostasis in Adults with Prediabetes: A Systematic Review and Meta-Analysis.

The Preferred Reporting Items for Systematic Reviews and Analysis checklist was used. A comprehensive literature search of the PubMed, Embase, and Cochrane Library databases was conducted through August 2022 to assess the impact of probiotics on blood glucose, lipid, and inflammatory markers in adults with prediabetes. Data were pooled using a random effects model and were expressed as standardized mean differences (SMDs) and 95% confidence interval (CI). Heterogeneity was evaluated and quantified as I2. Seven publications with a total of 550 patients were included in the meta-analysis. Probiotics were found to significantly reduce the levels of glycosylated hemoglobin (HbA1c) (SMD -0.44; 95% CI -0.84, -0.05; p = 0.03; I2 = 76.13%, p < 0.001) and homeostatic model assessment of insulin resistance (HOMA-IR) (SMD -0.27; 95% CI -0.45, -0.09; p < 0.001; I2 = 0.50%, p = 0.36) and improve the levels of high-density lipoprotein cholesterol (HDL) (SMD -8.94; 95% CI -14.91, -2.97; p = 0.003; I2 = 80.24%, p < 0.001), when compared to the placebo group. However, no significant difference was observed in fasting blood glucose, insulin, total cholesterol, triglycerides, low-density lipoprotein cholesterol, interleukin-6, tumor necrosis factor-α, and body mass index. Subgroup analyses showed that probiotics significantly reduced HbA1c in adults with prediabetes in Oceania, intervention duration of ≥3 months, and sample size <30. Collectively, our meta-analysis revealed that probiotics had a significant impact on reducing the levels of HbA1c and HOMA-IR and improving the level of HDL in adults with prediabetes, which indicated a potential role in regulating blood glucose homeostasis. However, given the limited number of studies included in this analysis and the potential for bias, further large-scale, higher-quality randomized controlled trials are needed to confirm these findings. This trial is registered with CRD42022358379.

Insulin resistance and osteocalcin associate with the incidence and severity of postoperative delirium in elderly patients undergoing joint replacement.

While insulin sensitivity plays an important role in maintaining glucose metabolic homeostasis and cognitive function, its impact on postoperative delirium (POD) remains unclear. This study aimed to investigate the association between POD and indicators of insulin sensitivity, including insulin resistance and osteocalcin. A total of 120 elderly patients undergoing joint replacement were recruited and divided into delirium and non-delirium groups. Plasma and cerebrospinal fluid (CSF) samples were collected for the analysis of biomarkers, including insulin, uncarboxylated osteocalcin (ucOC), total osteocalcin (tOC), and glucose. Insulin resistance was assessed through the homeostatic model assessment of insulin resistance (HOMA-IR). Out of the total, 28 patients (23.3%) experienced POD within 5 days after surgery. Patients with delirium exhibited higher levels of preoperative HOMA-IR and ucOC in CSF and plasma, and of tOC in CSF (P = 0.028, P < 0.001, P = 0.005, P = 0.019). After adjusting for variables, including age, Mini-Mental State Examination score, surgical site and preoperative fracture, only preoperative ucOC in CSF and HOMA-IR were significantly linked to the incidence of delirium (OR = 5.940, P = 0.008; OR = 1.208, P = 0.046, respectively), both of which also correlated with the severity of delirium (P = 0.007, P < 0.001). Receiver operating curve analysis indicated that preoperative HOMA-IR and ucOC in CSF might partly predict POD (area under the curve [AUC] = 0.697, 95% confidence interval [CI] = 0.501-0.775, AUC = 0.745, 95% CI = 0.659-0.860). We observed that preoperative elevated HOMA-IR and ucOC in CSF were associated with the incidence and severity of POD. While these preliminary results need confirmation, they suggest a potential involvement of insulin resistance and osteocalcin in the pathological mechanism of POD. Geriatr Gerontol Int 2024; 24: 421-429.

A comparison of the effects of green tea and cocoa on glycaemic control and insulin sensitivity in patients with type 2 diabetes mellitus: a systematic review and meta-analysis

BACKGROUND: Type 2 Diabetes Mellitus (T2DM) is among the most frequent chronic diseases in virtually all countries, posing a global health threat. Therefore, Preventive interventions are critical for reducing the enormous burden of diabetes. Flavanols may assist people with metabolic disorders to maintain glucose homeostasis by inhibiting digestive enzymes and glucose transporters. Green Tea (GT) and cocoa have gotten much attention since their flavanols are high. OBJECTIVES: To investigate the effects of polyphenols from GT and cocoa (&gt;4 weeks) on reducing the incidence of complications and improving glycaemic control and insulin sensitivity in adult patients with T2DM through outcomes Fasting Blood Glucose (FBG), Fasting Blood Insulin (FBI), Haemoglobin A1c (HbA1c) and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). METHODOLOGY: An electronic research programme was applied, using different databases (including Web of Science, PubMed/Medline, Scopus, and Cochrane Reviews) to find studies that have evaluated the impact of polyphenols from GT and cocoa on reducing the incidence of complications and improving glycaemic control and insulin sensitivity in adult patients with T2DM. Articles published between 2005 and 2021 in English were selected. RESULTS: 15 and 7 studies involved 738 participants on GT (348 male/390 female). In contrast, the ones focused on cocoa had 331 participants (83 male/ 248 female) with T2DM aged 18–65 years, and a BMI range of 25–34.9 kg/m2 was identified and included in the present review. 43 and 27% of studies were low-risk bias in cocoa and GT, respectively. The results of the meta-analysis showed no significant difference in FBG levels following GT and cocoa consumption compared to the control group (SMD: –0.08; 95% CI: –0.43 to 0.28; P = 0.68 and SMD: –0.65; 95% CI, –1.40 to 0.10; P = 0.09, respectively). Also, the results showed no significant difference for GT and cocoa intervention (SMD: 0.18; 95% CI: –0.27 to 0.64; P = 0.43 and SMD: –0.80; 95% CI: –1.92 to 0.31; P = 0.16, respectively). In addition, the results of the HbA1c analysis showed no significant reduction after GT and cocoa consumption (SMD: –0.41; 95% CI: –0.85 to 0.03; P = 0.07 and SMD, –0.37; 95% CI, –0.77 to 0.04; P = 0.08, respectively). There was no evidence that GT and cocoa interventions effectively improved HOMA-IR (SMD: 0.02; 95% CI: –0.16 to 0.20; P = 0.80 and SMD, –1.65; 95% CI, –3.77 to 0.46; P = 0.13, respectively CONCLUSION: The evidence shows that the short-term administration of cocoa and GT did not significantly reduce the FBG, FBI, HbA1c, and HOMA-IR levels in adult patients with T2DM.

Telomere length as a modifier in the relationship between phthalate metabolites exposure and glucose homeostasis

Given the rising concern over the potential impact of environmental factors on metabolic heath, we conducted a cross-sectional analysis among 645 adults aged 20 and older in the National Health and Nutrition Examination Survey (NHANES), examining the association between nine phthalate metabolites (Mono-n-butyl phthalate (MBP), Mono-ethyl phthalate (MEP), Mono-(2-ethyl)-hexyl phthalate (MEHP), Mono-benzyl phthalate (MBzP), Mono-n-methyl phthalate (MnMP), Mono-(3-carboxy propyl) phthalate (MCPP), Mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), Mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), Mono-isobutyl phthalate (MiBP)) and six glucose homeostasis indices (fasting glucose, fasting insulin, hemoglobin A1C (HbA1C), homeostatic model assessment of insulin resistance (HOMA-IR), single Point Insulin Sensitivity Estimator (SPISE), and HOMA-β). Latent Class Analysis identified three phthalate metabolites exposure patterns: high MEP-low MEOHP (n = 282), high MBzP-low MEHHP (n = 214), and high MEHHP, MEOHP (n = 149). The high MBzP-low MEHHP and high MEHHP, MEOHP, versus the high MEP-low MEOHP, exposure groups showed significantly higher levels of fasting insulin (β = 0.126, 95% CI: 0.023–0.228), SPISE (β = 0.091, 95% CI: 0.018–0.164), and HOMA-IR (β = 0.091, 95% CI: 0.018–0.164). In the shorter telomere length group, high MEHHP, MEOHP exposure showed an increase in SPISE levels (β = 0.153, 95% CI: 0.037–0.269), while in the overweight/obese subgroup, high MEHHP, MEOHP exposure was significantly positively associated with HOMA-IR (β = 0.392, 95% CI: 0.150–0.735). Bayesian kernel machine regression analyses showed positive associations between higher combined phthalate exposure and increased glucose homeostasis indices (fasting glucose, HbA1C, fasting insulin, SPISE, and HOMA-IR). The quantile of g-calculation analysis also supported the positive associations with HbA1C, HOMA-IR, and fasting insulin. Our findings indicate that phthalate exposure was positively associated with glucose homeostasis indices, which strengthen the call for proactive measures to reduce phthalate exposure and mitigate potential risks to glucose metabolism.

Clinical observation of laparoscopic sleeve gastrectomy and metformin treatment in obese PCOS patients.

To observe the basic metabolic characteristics of obese patients with polycystic ovarian syndrome (PCOS), and observe and compare the effect of laparoscopic sleeve gastrectomy and metformin treatment after 3 months. In January to December 2018, the Second Hospital of Hebei Medical University selected 104 women who were classified as obese with a body mass index (BMI) of 28 kg/cm2 or higher and had PCOS. They were divided into obese PCOS group (53 cases) and obese non-PCOS group (51 cases). 1. There was no significant difference in waist circumference and WHR between patients who are obese with PCOS and patients who are obese without PCOS (P > 0.05). Obese PCOS patients were significantly higher in anti-Müllerian hormone (AMH), LH/FSH, T, FAI, homa-ir, triglyceride (TG), low density lipoprotein (LDL), Apo-B and uric acid than the group of non-PCOS patients who were obese. (P<0.05). The SHBG levels of obese patients with PCOS were obviously lower when contrasted with the levels in obese patients without PCOS (P < 0.05). 2. Body weight, BMI, INS, homa-ir and TG of obese PCOS patients were significantly decreased 3 months after laparoscopic sleeve gastrectomy compared with that before surgery (P < 0.05). After three months of medical treatment with metformin, the patients' homeostatic model assessment of insulin resistance (HOMA-IR) was obviously reduced when contrasted with the pre-treatment HOMA-IR levels (P < 0.05), and there was no significant difference in the improvement degree of homa-ir between the two groups (P > 0.05). 1. Obese patients with PCOS demonstrated higher expression of AMH, LH/FSH, T, SHBG, and FAI when contrasted with the control group. Additionally, they experienced more severe insulin resistance and lipid metabolism disorders. 2. The weight and BMI of obese PCOS patients were significantly decreased after weight loss, while IR and blood lipid were significantly improved, while IR was improved in metformin group, and no significant discrepancy was observed in the degree of improvement of insulin resistance between both groups.

Comparative effects of acupuncture and metformin on insulin sensitivity in overweight/obese and lean women with polycystic ovary syndrome and insulin resistance: a post hoc analysis of a randomized trial.

This study explored the efficacy of acupuncture and metformin in enhancing insulin sensitivity among women with polycystic ovary syndrome (PCOS) and insulin resistance (IR), distinguishing between overweight/obese and lean groups. A post-hoc analysis of a randomized trial (NCT02491333) was undertaken. Participants were women aged 18-40 with PCOS and IR. They were randomized to receive true acupuncture with a placebo, metformin with sham acupuncture, or sham acupuncture with a placebo for 4 months, with follow-up visits over 3 months. Our study, involving 339 women, assessed the differential impact of acupuncture and metformin on insulin sensitivity in overweight/obese [body mass index (BMI) ≥ 24] versus lean women (BMI < 24). Primary outcomes measured changes in the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) at 4 and 7 months. Secondary outcomes assessed changes in glucose area under the curve (glucoseAUC) during the oral glucose tolerance test (OGTT) and BMI changes at 4 months. Overweight/obese participants were generally older with higher measurements in various health metrics, but lower levels in specific hormonal metrics compared to lean women (p < 0.05). Among overweight/obese women, metformin outperformed acupuncture in reducing HOMA-IR levels (p = 0.004) and showed a significant drop from the baseline after 4 months (p < 0.05). In contrast, acupuncture's effect on HOMA-IR did not significantly differ from sham acupuncture at 4 and 7 months. For lean women, metformin and acupuncture showed comparable improvements in HOMA-IR, with notable declines at 4 and 7 months (p < 0.05). Acupuncture proved more beneficial for lean women than their overweight/obese counterparts after 4 months (p = 0.021). In overweight/obese women with PCOS and IR, acupuncture was less effective than metformin in enhancing insulin sensitivity. However, in lean women, acupuncture's efficacy was comparable to metformin. Further studies are required to validate these observations.

Brown Seaweed Consumption as a Promising Strategy for Blood Glucose Management: A Comprehensive Meta-Analysis

Diabetes is a chronic condition that can lead to various complications; therefore, there is a need to emphasize prevention and management. Dietary interventions, such as the Mediterranean diet or calorie-restricted regimens, coupled with exercise-induced weight reduction, have been recommended for enhancing diabetes management. Seaweeds contain various functional components, such as polyphenols and fucoidan, which have been reported to exert multiple benefits, including blood glucose regulation, improved intestinal health, and enhanced of lipid profiles. The association between blood glucose and seaweed consumption has been established in previous research. We searched the PubMed, RISS, Google Scholar, ScienceDirect, and Cochrane Library databases to identify relevant studies after applying the selection/exclusion criteria, and 23 studies were ultimately included in this analysis. Comprehensive Meta-Analysis (CMA) software version 4.0 was used to assess statistical significance and heterogeneity. In this meta-analysis, postprandial blood glucose, glycated hemoglobin (HbA1c), and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) levels demonstrated significant improvements in the seaweed group compared to the control group. Conversely, fasting blood glucose and insulin levels did not show significant associations with seaweed consumption. Subgroup analysis revealed that a high dose (1000 mg or more) was more beneficial than a low dose, and seaweeds such as Laminaria digitata, Undaria pinnatifida, Acophyllum nodosum, and Fucus vesiculosus were found to be more effective at improving blood glucose levels than control treatments. Therefore, based on our research, seaweed supplementation appears to be a promising strategy for reducing postprandial blood glucose, HbA1c, and HOMA-IR levels, thereby enabling better blood glucose management and leading to a decreased risk of type 2 diabetes.

Determinants of Bone Mineral Density in Iranian Women with Polycystic Ovary Syndrome.

Whether the endocrine aberrations caused by polycystic ovary syndrome (PCOS) might influence bone density in women of reproductive age is controversial. The present study aimed to compare PCOS women to a control group matched in terms of age and body mass index (BMI) regarding bone indices and to clarify the potential relationship between their hormonal changes and bone density. This case-control study consisted of 61 PCOS patients, and 35 women with normal ovulatory function served as controls. Bone parameters, including bone mineral content (BMC) and bone mineral density (BMD) in addition to T- and Z-scores, were measured at the lumbar vertebrae, neck of the left femur, hip, and distal part of the radial bone, using dual-energy X-ray absorptiometry. Blood samples were taken to be tested for biochemical parameters and serum concentrations of insulin, osteocalcin, parathyroid hormone (PTH), vitamin D, follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone, dehydroepiandrosterone sulfate (DHEAS), and estradiol were measured. Insulin resistance was evaluated through the homeostatic model assessment of insulin resistance (HOMA-IR). The results revealed greater levels of HOMA-IR and total testosterone in PCOS women than in controls. Nevertheless, the two groups were comparable in terms of bone parameters. In the control group, BMI was the only determinant of bone density at most of the skeletal sites. Nonetheless, BMI and HOMA-IR were independently and positively associated with bone indices at the femoral neck (FN) and total hip in the PCOS group. Parathyroid hormone and vitamin D concentrations were not different in the two groups. However, phosphate levels were higher in PCOS patients (P = 0.025). Osteocalcin was inversely correlated to BMI, and both groups had a negative correlation between DHEAS and PTH. Serum phosphate was inversely and independently associated with estrogen in the PCOS group (r = -0.377, P = 0.004). Body mass index and HOMA-IR were independent and positive determinants of FN and total hip bone density in the PCOS subjects. Nonetheless, in the non-PCOS women, BMI was the only independent determinant of bone density at most of the skeletal sites. Additionally, osteocalcin was inversely correlated with BMI in both groups.

Roux-en-Y Gastric Bypass Improves Insulin Sensitivity in Obese Rats with Type 2 Diabetes Mellitus by Regulating the Grin3a/AMPK Signal Axis in Hypothalamic Arcuate Nucleus.

The objective of this study was to explore the effects and related mechanisms of Roux-en-Y gastric bypass (RYGB) on insulin sensitivity in obese rats with type 2 diabetes mellitus (T2DM). The obese T2DM rat model was constructed by feeding a high-fat diet and injecting streptozotocin (STZ), and treated with RYGB. Grin3a shRNA was injected into the bilateral hypothalamic arcuate nucleus (ARC) to knockdown the Grin3a expression on T2DM rats. Eight weeks after operation, the body weight, fasting blood glucose (FBG), fasting serum insulin (FSI), homeostatic model assessment of insulin resistance (HOMA-IR), and plasma triglyceride (TG) levels were assessed. Hematoxylin & eosin (H&E) staining was adopted to observe the white adipose tissue (WAT) of rats. Western blot and qRT-PCR were used to detect the expression of Grin3a, adenosine 5' monophosphate-activated protein kinase (AMPK) and p-AMPK in ARC of rats. Later, the plasmid over-expressing or knocking down Grin3a was transfected into differentiated 3T3-L1 adipocytes, and the TG level and the formation of lipid droplets in adipocyte were assessed by TG kit and oil red O staining. The expression of lipogenic transcription factors in cells was detected by qRT-PCR. RYGB reduced FBG, FSI, HOMA-IR and plasma TG levels in T2DM rats while increasing Grin3a expression and p-AMPK/AMPK ratio in ARC. Knockdown of Grin3a not only reversed the decrease of FBG, FSI, HOMA-IR and plasma TG levels in T2DM rats induced by RYGB, but also reversed the up-regulation of p-AMPK/AMPK ratio in ARC affected by RYGB. Moreover, knocking down Grin3a significantly increased the TG level, promoted the formation of lipid droplets and up-regulated the expressions of lipogenic transcription factors in adipocytes. RYGB improved the insulin sensitivity, reduced the plasma TG level and lessens the fat accumulation in obese T2DM rats by regulating the Grin3a/AMPK signal in ARC.

Anti-Müllerian hormone and HOMA-IR in different phenotypes of polycystic ovary syndrome on insulin resistance

Aims: To examine the link between serum anti-mullerian hormone (AMH) levels and homeostatic model assessment of insulin resistance (HOMA-IR) in different phenotypes of polycystic ovary syndrome (PCOS).&#x0D; Methods: This retrospective study included 120 patients aged 18-30 who visited our polyclinics between June 2021 and December 2022. Patients were divided into four groups based on the Rotterdam criteria for PCOS phenotypes. A control group of 24 individuals was also included. Clinical data, hormonal profiles, and metabolic parameters were obtained from medical records.&#x0D; Results: There were significant differences in AMH, follicle stimulating hormone (FSH), luteinizing hormone (LH), and high-density lipoprotein (HDL) levels among the PCOS phenotypes and control group. AMH levels were highest in phenotype 1 (oligo/anovulation + hyperandrogenism + polycystic ovaries) and lowest in the control group. FSH were highest in phenotype 4 (oligo/anovulation + polycystic ovaries) and lowest in the control group. LH were highest in phenotype 2 (oligo/anovulation + hyperandrogenism). HOMA-IR was highest in phenotype 1. However, there were no significant differences in AMH or HOMA-IR levels among the PCOS phenotypes.&#x0D; Conclusion: Our study found hormone level differences among PCOS phenotypes but no significant differences in AMH or HOMA-IR. This suggests AMH may not distinguish between phenotypes and insulin resistance may not differ significantly among phenotypes.

Effect of Resistance Training on Adipose Tissue and Serum METRNL Levels in Sucrose Solution Fed Rats

Background: Meteorin-like protein (METRNL) is a novel adipomyokine that may improve glucose tolerance, and its circulating levels are affected by changes in body weight. Objectives: This study aimed to evaluate the effects of eight weeks of resistance training (RT) and high sucrose consumption on serum and adipose tissue METRNL levels in male rats. Methods: In this study, 32 Wistar male rats were divided into normal diet and high sucrose diet groups. After 4 weeks, each group was divided into control and training groups. The rats in the training group were subjected to the RT program (3 days/week, for 8 weeks). In addition to serum and adipose tissue levels of METRNL, we measured epididymal and mesenteric fat mass, serum glucose, insulin, and homeostatic model assessment of insulin resistance (HOMA-IR). Results: High sucrose diet increased fat weights and serum levels of glucose, insulin, and IR index; nevertheless, it reduced the serum levels of METRNL. RT decreased serum insulin concentrations and HOMA-IR. The result of two-way ANOVA and the t-test showed that eight weeks of RT decreased serum levels of METRNL, insulin, and HOMA-IR in sugar solution-fed rats. Conclusions: The results suggest that RT may be an effective intervention to reduce serum METRNL and HOMA-IR levels, which is associated with improving body composition.

The significance of ratio between serum triglycerides and HDL cholesterol as a common man’s bio marker of insulin resistance in type 2 diabetes mellitus: A cross sectional comparative study

Introduction: Insulin resistance is the most common abnormality associated with obesity, as a major pathophysiological factor in the development and progression of cardiovascular diseases and diabetes mellitus. This study is undertaken to know the significance of ratio of triglycerides (TG) to high-density lipoprotein (HDL) cholesterol as a serum biomarker in assessing the insulin resistance compared to homeostatic model assessment of insulin resistance (HOMA-IR) in type 2 diabetes mellitus (DM) subjects. Materials and methods: This was a cross sectional comparative study done at Mysore Medical College and Research Institute, Mysuru on 180 subjects of type 2 DM from April 2022 to October 2022. The blood sample was subjected for laboratory tests, such as complete blood count (CBC), fasting blood sugar (FBS), post prandial blood sugar (PPBS), HbA1c, lipid profile, ECG, serum insulin level and HOMA-IR, renal function tests (RFT), liver function tests (LFT). The results were tabulated and compared between the HOMA-IR value and triglycerides/HDL cholesterol ratio of type 2 DM subjects. The cut off value of HOMA-IR to assess insulin resistance was 2.50 and triglycerides to HDL ratio was 3.0. Results: The majority of patients i.e. 112(62.22%) had TG/HDL ratio of &gt;3.0 and 116(64.44%) patients had HOMA-IR of &gt;2.5.The patients with uncontrolled type 2 DM had significantly higher TG/HDL ratio [p value 0.01] and HOMA-IR (p value- 0.01). Conclusion: This study concludes that, the ratio of serum triglycerides /HDL cholesterol is a cost effective blood biomarker and it’s correlating significantly with the HOMA-IR and serum fasting insulin levels, while assessing the insulin resistance in type 2 DM subjects.

Examining the associations between testosterone and biomarkers as men age.

Testosterone concentrations in men decline with advancing age. However, the cause of the decline is yet to be fully elucidated. Therefore, the aims of this study were to examine the associations between chronic diseases such as obesity and type 2 diabetes mellitus (T2DM) with total testosterone (TT) and sex hormone-binding globulin (SHBG), using a large nationally-representative data set (National Health and Nutrition Examination Survey; NHANES). NHANES is a cross-sectional survey, physical examination, and laboratory evaluation of a nationally-representative sample of a non-institutionalized United States population. Male participants aged ≥18 years during the NHANES 2013-2014 and NHANES 2015-2016 survey periods were selected for this analysis. The analysis included the following data: body mass index (BMI), oral glucose tolerance test (OGTT), homeostatic model assessment of insulin resistance (HOMA-IR), insulin, glucose, and age. An overweight or obese condition was significantly inversely associated with TT and SHBG, even after adjusting for other variables. Several variables associated with T2DM (OGTT, HOMA-IR, insulin, and glucose) were also inversely associated with TT; however, only the associations between OGTT and insulin with TT remained significant after adjusting for the other variables. Insulin and HOMA-IR levels were significantly inversely associated with SHBG; however, only the association between SHBG and pre-diabetic HOMA-IR levels remained significant after adjusting for the other variables. OGTT became significantly associated with SHBG after adjusting for the other variables. Age was significantly inversely associated with TT, but positively associated with SHBG, even after adjusting for other variables. The results of the present study, which is the largest to date, indicate that a marker of obesity, BMI, and some markers of T2DM are both independently and significantly inversely associated with TT and SHBG.

Associations of healthful and unhealthful plant-based diets with plasma markers of cardiometabolic risk.

Plant-based diets, particularly when rich in healthy plant foods, have been associated with a lower risk of type 2 diabetes and cardiovascular disease. However, the impact of plant-based diets that distinguish between healthy and unhealthy plant foods on cardiometabolic biomarkers remains unclear. Dietary information was collected by two 24-h recalls among 34,785 adults from a nationwide cross-sectional study. Plasma levels of insulin, C-peptide, glucose, C-reactive protein (CRP), white blood cell (WBC) count, triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) were measured. Linear regression was used to evaluate the percentage difference in plasma marker concentrations by three plant-based diet indices, namely the overall plant-based diet index (PDI), the healthful PDI (hPDI), and the unhealthful PDI (uPDI). Greater hPDI-adherence scores (comparing extreme quartiles) were associated with lower levels of insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), TG/HDL-C ratio, CRP, WBC count, and TG, and higher levels of HDL-C, with the percentage differences of - 14.55, - 15.72, - 11.57, - 14.95, - 5.26, - 7.10, and 5.01, respectively (all Ptrend ≤ 0.001). Conversely, uPDI was associated with higher levels of insulin, C-peptide, HOMA-IR, TG/HDL-C ratio, CRP, WBC count, and TG, but lower HDL-C, with the percentage differences of 13.71, 14.00, 14.10, 10.43, 3.32, 8.00, and - 4.98 (all Ptrend ≤ 0.001), respectively. Overall PDI was only associated with lower levels of CRP and WBC count (all Ptrend ≤ 0.001). Our findings suggest that hPDI may have positive, whereas uPDI may have negative impacts on multiple cardiometabolic risk markers, and underscore the need to consider the quality of plant foods in future PDI studies.

Triazine herbicides exposure, natural immunoglobulin M antibodies, and fasting plasma glucose changes: Association and mediation analyses in general Chinese urban adults

The effects of triazine herbicides on glucose metabolism remain unclear. In this study, we aimed to assess the associations between serum triazine herbicides and glycemia-related risk indicators in general adults, and to evaluate the mediating role of natural immunoglobulin M antibodies (IgM) in the above associations among uninfected participants. We measured the concentrations of atrazine, cyanazine, and IgM in serum, as well as fasting plasma glucose (FPG), and fasting plasma insulin in 4423 adult participants from the Wuhan-Zhuhai cohort baseline population, enrolled in 2011–2012. Generalized linear models were used to evaluate the associations of serum triazine herbicides with glycemia-related risk indicators, and mediation analyses were performed to evaluate the mediating role of serum IgM in the above associations. The median levels of serum atrazine and cyanazine were 0.0237 μg/L and 0.0786 μg/L, respectively. Our study found significant positive associations of serum atrazine, cyanazine, and Σtriazine with FPG levels, risk of impaired fasting glucose (IFG), abnormal glucose regulation (AGR), and type 2 diabetes (T2D). Additionally, serum cyanazine and Σtriazine were found to be significant positive associated with the homeostatic model assessment of insulin resistance (HOMA-IR) levels. Significant negative linear relationships were observed in associations of serum IgM with serum triazine herbicides, FPG, HOMA-IR levels, the prevalence of T2D, and AGR (P < 0.05). Furthermore, we observed a significant mediating role by IgM in the associations of serum triazine herbicides with FPG, HOMA-IR, and AGR, with the proportions ranging from 2.96% to 7.71%. To ensure the stability of our findings, we conducted sensitivity analyses in normoglycemic participants and found that the association of serum IgM with FPG and the mediating role by IgM remained stable. Our results suggest that triazine herbicides exposure is positively associated with abnormal glucose metabolism, and decreasing serum IgM may partly mediate these associations.

Body Fat-Reducing Effects of Whey Protein Diet in Male Mice.

This study investigated the mechanism of reducing body fat via whey protein diet. Pregnant mice were fed whey or casein, and their offspring were fed by birth mothers. After weaning at 4 weeks, male pups received the diets administered to their birth mothers (n = 6 per group). At 12 weeks of age, body weight, fat mass, fasting blood glucose (FBG), insulin (IRI), homeostatic model assessment of insulin resistance (HOMA-IR), cholesterol (Cho), triglyceride (TG), the expression levels of lipid metabolism-related genes in liver tissues and metabolomic data of fat tissues were measured and compared between the groups. The birth weights of pups born were similar in the two groups. Compared to the pups in the casein group, at 12 weeks of age, pups in the whey group weighed less, had significantly lower fat mass, HOMA-IR and TG levels (p < 0.01, p = 0.02, p = 0.01, respectively), and significantly higher levels of the antioxidant glutathione and the anti-inflammatory 1-methylnicotinamide in fat tissues (p < 0.01, p = 0.04, respectively). No differences were observed in FBG, IRI, Cho levels (p = 0.75, p = 0.07, p = 0.63, respectively) and expression levels of lipid metabolism-related genes. Whey protein has more antioxidant and anti-inflammatory properties than casein protein, which may be its mechanism for reducing body fat.

Impact of Dietary Advanced Glycation End-Product Restriction on Insulin Resistance and Anthropometric Indices in Coronary Artery Patients Treated with Percutaneous Coronary Intervention: A Randomized Controlled Trial.

Insulin resistance (IR), even in its subclinical state, is a significant risk factor for the onset and progression of coronary artery disease (CAD). IR is a multifactorial condition, and dietary composition is a factor associated with its development. Elevated advanced glycation end products (AGEs) in the body, secondary to highly processed food consumption, can impair glucose metabolism. The present study investigated whether a restricted AGE diet could affect insulin sensitivity and anthropometric indices reflecting visceral adipose tissue in nondiabetic CAD patients. This trial randomly allocated 42 angioplasty-treated patients to follow either low-AGE or control diets based on the AHA/NCEP guidelines for 12 weeks. Serum levels of total AGEs, insulin, HbA1c, and fasting blood sugar, as well as anthropometric measurements, were evaluated before and after the intervention. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and anthropometric indices were calculated according to the proposed formula. The patients' health status was assessed using the Seattle Angina Questionnaire (SAQ) at baseline and after the intervention. Our study showed a significant reduction in anthropometric indices in the low-AGE group after 12 weeks. Insulin levels and IR decreased during the low-AGE diet. No significant changes were observed in the other serum biochemical markers. All SAQ domains significantly decreased in both groups, except for Treatment Satisfaction. A low-AGE diet for 12 weeks had beneficial effects on HOMA-IR and insulin levels in patients with CAD. Regarding the fundamental role of AGE in IR development and body fat distribution, AGE restriction may positively affect these patients.

Correlation between insulin resistance and cerebral microbleeds among Chinese patients with cerebral small vessel disease

Background and objectivesInsulin resistance (IR) plays an important role in the pathogenesis of cerebral small vessel disease (CSVD); however, little is known about the relationship between IR and the incidence of cerebral microbleeds (CMBs) in Asian populations. The aim of this study is to investigate the relationship between CMBs and IR in Chinese patients with CSVD. MethodsThis retrospective study included 240 patients with CSVD. Patients were categorized by the homeostatic model assessment of insulin resistance (HOMA-IR): Quartile 1 (≤1.26), Quartile 2 (1.27–1.92), Quartile 3 (1.93–2.89), and Quartile 4 (>2.89). The medical record of each patient was reviewed, and demographic, clinical and laboratory information was abstracted. All patients completed an MRI scan, and CMBs were defined as round or ovoid hypointense lesions on SWI sequence. ResultsCMBs were present in 82 (34.17%) of the 240 patients that were included in the study (mean age, 71 years; male, 54.89%). After adjustment for potential confounding variables, insulin resistance was associated with the presence of CMBs (adjusted odds ratio 2.298, 95% confidence interval 1.017–5.194 for Q4:Q1; P = 0.046). According to receiver operating characteristic analysis, the best discriminating factor for CMBs was a HOMA-IR level ≥2.215 (area under the curve 0.595; sensitivity 51.2%; specificity 65.2%). ConclusionsIR is significantly associated with the presence of CMBs, suggesting the potential role of IR as a predictive marker for CMBs in patients with CSVD.