Homeostasis Model Assessment Of Insulin Resistance Research Articles

Hyperplasia of fat-containing cells with mature adipocyte marker is associated with pancreatic fat enlargement

Abstract Objectives: The purpose was to elucidate the specific characteristics of fat-containing cells in the pancreas and the mechanism of intra-pancreatic fat deposition (IPFD) in humans. Methods: 15 Japanese patients who had undergone pancreatic resection were enrolled and the normal region of pancreatic samples from each patient was examined. To evaluate the characteristics of fat-containing cells, immunostaining for adiponectin and perilipin 1 was performed and the relationships between the pancreatic fat-cell area or clinical parameters, and the density or the diameter of the fat cells was analyzed. Results: Expression of adiponectin in the cytoplasm and perilipin 1 along the plasma membrane were observed in fat-containing cells in the pancreas. The fat-containing cell area had a significant positive correlation with cell density (r = 0.58, p = 0.023). In addition, fat-containing cell density was significantly positively correlated with homeostasis model assessment insulin resistance (HOMA-IR) (r = 0.61, p = 0.045). Fat-containing cell area was not significantly correlated with cell diameter (r = 0.45, p = 0.095). The diameter of fat-containing cells had significant positive correlations with BMI (r = 0.79, p < 0.001), fasting immunoreactive insulin (r = 0.65, p = 0.029) and HOMA-IR (r = 0.80, p = 0.003). Of all fat-containing cells, 10.4% were intralobular cells, and the diameter of intralobular cells showed a tendency for positive correlation with age (r = 0.52, p = 0.057). Conclusions: The characteristics of fat-containing cells in the pancreas indicate that some of them may be mature adipocytes, and fat volume may be increased by hyperplasia of fat-containing cells associated with insulin resistance. Key terms: pancreatic fat, adipocytes markers, hyperplasia of fat-containing cells, insulin resistance.

The association of objective daytime sleepiness with impaired glucose metabolism in patients with obstructive sleep apnea: a multi-omics study.

To examine the joint effect of obstructive sleep apnea (OSA) and objective excessive daytime sleepiness (EDS) on glucose metabolism and the underlying mechanisms. We included 127 patients with OSA. The multiple sleep latency test (MSLT) and Epworth sleepiness scale (ESS) were used to assess objective and subjective EDS, respectively. Disordered glucose metabolism was defined as either a physician diagnosis or having fasting blood glucose levels ≥ 5.6 mmol/L. Values of fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) higher than the median values of our sample were defined as high fasting insulin and insulin resistance. Serum metabolomics and fecal microbiota were used to explore underlying mechanisms. Lower MSLT values were associated with higher levels of fasting blood glucose, fasting insulin, and HOMA-IR. Furthermore, objective EDS was associated with increased odds of disordered glucose metabolism, elevated fasting insulin, and insulin resistance. Dysregulation of serum valine degradation and dysbiosis of fecal Bacteroides thetaiotaomicron were associated with impaired glucose metabolism in OSA with objective EDS. No association between subjective EDS and impaired glucose metabolism was observed. OSA with objective, but not subjective, EDS is associated with an increased risk of disordered glucose metabolism and insulin resistance. Dysregulation of valine degradation and dysbiosis of Bacteroides thetaiotaomicron appear to link objective EDS and disordered glucose metabolism in OSA.

The dietary phytochemical index and its relation to polycystic ovary syndrome: a case-control study.

Polycystic ovary syndrome (PCOS), a hormonal disorder affecting women of reproductive age, can be significantly impacted by diet. This study explores the relationship between a diet rich in phytochemicals, measured by the Dietary Phytochemical Index (DPI), and PCOS, along with associated health markers. A case-control study design was implemented with 480 individuals diagnosed with PCOS based on the Rotterdam criteria, paired with 480 controls matched in terms of age and BMI. The evaluation encompassed dietary intake, anthropometric measurements, and hormonal/metabolic markers. Additionally, the DPI score was determined based on the consumption of phytochemical-rich foods. The study also examined PCOS-related complications like acne and irregular menstrual cycles, as well as mental health using the Beck Depression Inventory (BDI-II) scores. Women with PCOS had significantly lower DPI scores (32.42 vs 43.87, p < 0.001) compared to the control group, indicating a less phytochemical-rich diet. The DPI scores coincided with higher levels of hormones typically associated with PCOS, including Luteinizing Hormone (LH), Dehydroepiandrosterone Sulfate (DHEA-S), and testosterone. Additionally, these scores were associated with markers of metabolic dysfunction such as C-reactive Protein (CRP), Fasting Blood Sugar (FBS), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), while positively correlating with Sex Hormone-Binding Globulin (SHBG) (all p < 0.050).). Higher DPI scores were associated with a significantly reduced risk of PCOS (OR: 0.13, 95% CI: 0.08, 0.23, P for trend: 0.001) and its complications, including acne and irregular menstrual cycles. Interestingly, a positive association emerged, suggesting better mental health (lower BDI-II scores) with higher DPI scores. In conclusion, this study indicates that lower DPI scores are associated with a higher incidence and severity of PCOS, suggesting that a phytochemical-rich diet could potentially benefit the management of PCOS by enhancing hormonal profiles, metabolic health, and mental well-being in women.

Metabolic phenotype and risk of obesity-related cancers in the Women's Health Initiative.

Body mass index (BMI) may misclassify obesity-related cancer (ORC) risk, as metabolic dysfunction can occur across BMI levels. We hypothesized that metabolic dysfunction at any BMI increases ORC risk compared to normal BMI without metabolic dysfunction. Postmenopausal women (n=20,593) in the Women's Health Initiative with baseline metabolic dysfunction biomarkers (blood pressure, fasting triglycerides, high-density lipoprotein-cholesterol, fasting glucose, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and high sensitive C-reactive protein (hs-CRP)) were included. Metabolic phenotype (metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy overweight/obese (MHO), metabolically unhealthy overweight/obese (MUO)) was classified using four definitions of metabolic dysfunction: (1) Wildman criteria, (2) National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III), (3) HOMA-IR, and (4) hs-CRP. Multivariable Cox proportional hazards regression, with death as a competing risk, was used to assess the association between metabolic phenotype and ORC risk. After a median (IQR) follow-up duration of 21 (IQR 15-22) years, 2,367 women developed an ORC. The risk of any ORC was elevated among MUNW (HR 1.12, 95% CI: 0.90-1.39), MHO (HR 1.15, 95% CI: 1.00-1.32), and MUO (HR 1.35, 95% CI: 1.18-1.54) compared with MHNW using Wildman criteria. Results were similar using ATP III criteria, hs-CRP alone, or HOMA-IR alone to define metabolic phenotype. Individuals with overweight or obesity with or without metabolic dysfunction were at higher risk of ORCs compared with metabolically healthy normal weight individuals. The magnitude of risk was greater among those with metabolic dysfunction, although the confidence intervals of each category overlapped.

Impact of Gut Microbiome Interventions on Glucose and Lipid Metabolism in Metabolic Diseases: A Systematic Review and Meta-Analysis

Background: The gut microbiome is increasingly recognized as a key player in metabolic health, influencing glucose and lipid metabolism through various mechanisms. However, the efficacy of gut microbiota-targeted interventions, such as probiotics, prebiotics, fecal microbiota transplantation (FMT), and diet-based treatments, remains unclear for specific metabolic outcomes. In this study, the aim was to evaluate the impact of these interventions on the glucose and lipid parameters in individuals with metabolic diseases such as diabetes mellitus (DM), obesity, and metabolic syndrome. Methods: This systematic review and meta-analysis included 41 randomized controlled trials that investigated the effects of gut microbiota-targeted treatments on metabolic parameters such as fasting glucose, glycated hemoglobin (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides. A comprehensive search was conducted using databases like PubMed, Google Scholar, and Scopus, focusing on interventions targeting the gut microbiota. A meta-analysis was performed using random-effects models, with effect sizes calculated for each outcome. Risk of bias was assessed using the Cochrane Risk of Bias tool. Results: Gut microbiota-targeted interventions significantly reduced fasting glucose, HbA1c, HOMA-IR, total cholesterol, LDL-C, and triglycerides, with moderate heterogeneity observed across studies. The interventions also led to modest increases in HDL-C levels. Probiotic and synbiotic interventions showed the most consistent benefits in improving both glucose and lipid profiles, while FMT yielded mixed results. Short-term interventions showed rapid microbial shifts but less pronounced metabolic improvements, whereas longer-term interventions had more substantial metabolic benefits. Conclusions: In this study, it is demonstrated that gut microbiota-targeted interventions can improve key metabolic outcomes, offering a potential therapeutic strategy for managing metabolic diseases. However, the effectiveness of these interventions varies depending on the type, duration, and population characteristics, highlighting the need for further long-term studies to assess the sustained effects of microbiota modulation on metabolic health.

Impact of Meal Frequency on Insulin Resistance in Middle-Aged and Older Adults: A Prospective Cohort Study.

Insulin resistance (IR) is central to metabolic disorders and significantly influenced by diet. Studies on meal frequency (MF) and metabolic indicators have shown mixed results. This study explores the link between MF and IR in middle-aged and older adults. This prospective cohort study included 4,570 adults aged 40 to 69 years from the Korean Genome and Epidemiologic Study. MF were divided into two groups based on whether they consumed three or more, or fewer than three, meals daily. IR was evaluated using the homeostasis model assessment of insulin resistance (HOMA-IR); participants were classified as IR if their HOMA-IR value was ??.5. Multiple Cox proportional hazard regression analyses were conducted to examine the association between MF and the incidence of IR. After adjusting for all variables, individuals in the MF ?? group showed a reduced incidence of IR compared to those in the MF <3 group (hazard ratio, 0.880; 95% confidence interval, 0.782 to 0.990). Additionally, subgroup analyses by sex, diabetes mellitus (DM), and body mass index (BMI) showed that this association persisted only in men, individuals without DM, and those with a BMI <25. Our findings indicate that a higher MF among middle-aged and older adults is associated with a reduced incidence of IR. However, this association was maintained only in men, individuals without DM, and those without obesity.

Gestational diabetes mellitus (GDM): diagnosis using biochemical parameters and anthropometric measurements during the first trimester in the Indian population.

The objective of the study was to use anthropometric measurements (age, BMI, and subcutaneous fat) inconjunction with biochemical parameters (sex hormone-binding globulin (SHBG), homeostasis model assessment-insulin resistance (HOMA-IR), fasting glucose, serum insulin, and total cholesterol) to predict the probability of gestational diabetes mellitus (GDM) in the first trimester. The study enrolled 48 pregnant women with GDM and 64 high-risk pregnant women without GDM. During the first-trimester examination, maternal blood samples were collected to measure SHBG, fasting blood glucose, serum insulin, and total cholesterol levels. Regression model analysis was used to examine the variables that showed statistically significant differences between the groups and were independent predictors of GDM. Receiver operating characteristic (ROC) curve analysis was employed to determine the risk of developing GDM based on cut-off values. The levels of SHBG, HOMA-IR, serum insulin, fasting glucose, and total cholesterol were identified as significant independent markers for predicting GDM. Meanwhile, age, body mass index, and subcutaneous fat values were found to be non-independent predictors of GDM. The areas under the ROC curve were calculated to determine the predictive accuracy of total cholesterol, HOMA-IR, SHBG, and subcutaneous fat for developing into GDM, and were 0.869, 0.977, 0.868, and 0.822 respectively. The sensitivities for a false positive rate of 5 % for predicting GDM were 68.7 , 91.67, 91.7, and 97.9 % for total cholesterol, HOMA-IR, SHBG, and subcutaneous fat, respectively. The independent predictors for the subsequent development of GDM in high-risk pregnancies are HOMA-IR, SHBG, Total cholesterol, and subcutaneous fat (SC) levels. These parameters can be used to create a regression model to predict the occurrence of GDM.

Serum level of myostatin and type I interferon-inducible gene expression in dermatomyositis patients and its relation to insulin resistance

Abstract Background Data regarding the relation between serum myostatin level, type I interferon-inducible gene expression and insulin resistance in dermatomyositis patients are limited. This study aimed to assess serum myostatin level, homeostatic model assessment of insulin resistance (HOMA-IR) and type I interferon-inducible gene expression in dermatomyositis patients. We evaluated the role of serum myostatin level, and type I interferon-inducible gene expression in the pathogenesis of dermatomyositis as well as the relation of serum myostatin level and type I interferon-inducible gene expression to the occurrence of insulin resistance. We evaluated serum levels of myostatin and HOMA-IR utilizing ELISA as well as IFIT1 and Mx1(MxA) gene expression with RT-PCR in 25 dermatomyositis patients (group A) and 25 obviously sound subjects as controls (group B). Results Among group A, body mass index, serum levels of myostatin, fasting insulin, HOMA-IR, IFN-inducible genes Mx1 and IFIT1 were more significantly increased as well as; serum level of myostatin was positively correlated with age, gender, fasting insulin level, body mass index, and HOMA-IR. Conclusions Serum level of myostatin, Mx1 and IFIT1 gene expression act as hazard factors of insulin resistance in group A.

Association between different insulin resistance surrogates and osteoarthritis: a cross-sectional study from NHANES 1999-2018.

Previous studies have demonstrated a relationship between prevalence of Osteoarthritis (OA) and insulin resistance (IR). The correlation between IR surrogates indices and gold standard tool for IR evaluation (Hyperinsulinemic-euglycemic clamp (HIEC)) have been well demonstrated. However, few studies evaluated the relationship between IR surrogates and OA. The aim of this study is to investigate the potential associations between different IR surrogates (the homeostatic model assessment of insulin resistance (HOMA-IR) index, the triglyceride glucose (TyG) index, the triglyceride glucose with body mass (TyG-BMI) index, the triglyceride glucose with waist circumference (TyG-WC) index, and the triglyceride glucose with the ratio of waist circumference divided by height (TyG-WtHR) index) and OA. This study used data from the National Health and Nutrition Examination Survey (NHANES). Multivariate logistic regression analysis was used to assess the associations of different IR surrogates with OA. After adjusting for covariates, TyG-BMI index (OR = 1.006, 95% CI [1.004, 1.007], P < 0.0001), TyG-WC index (OR = 1.002, 95% CI [1.002, 1.003], P < 0.0001) and TyG-WtHR index (OR = 1.425, 95%CI [1.292,1.572], P < 0.0001) still showed robust positive correlation with IR. The risk of OA in the fourth quartile of the TyG-BMI index, TyG-WC index, and TyG-WtHR index are 2.634-fold, 2.651-fold, and 2.433-fold higher than that in the first quartile, respectively. Compared to the HOMA-IR index and the TyG index, the association between the TyG-BMI, TyG-WC, and TyG-WtHR indices and OA is closer and more stable. The TyG-WtHR index has the highest accuracy in predicting OA, followed by the TyG-WC and TyG-BMI index.

Study on the correlation between the level of insulin resistance and changes in the degree of cerebral atherosclerosis in non-diabetic patients.

Cerebral infarction is a health problem of global concern and brings a particular burden to medical treatment. To analyze the correlation between insulin resistance (IR) levels and changes in cerebral atherosclerosis (AS) degree in non-diabetic patients with cerebral infarction. A total of 134 non-diabetic patients with cerebral infarction who visited the Department of Neurology of our hospital from May 2019 to October 2020 were selected and underwent MRA/CTA (Magnetic resonance angiography/Computed tomography angiography) of cerebral arteries to refine the cerebrovascular imaging data, and according to the results of cerebral AS load, the patients were divided into mild AS group and severe AS group, and the insulin resistance index was calculated with HOMA-IR (homeostasis model assessment of insulin resistance) to evaluate the IR level and HOMA-IR was compared between the two groups. Spearman correlation was used to analyze the correlation between the levels of IR in patients and the changes in cerebral AS load. 54 individuals had severe AS and 80 patients had mild AS, according to an MRA/CTA of the cerebral arteries. There was a significant difference (P< 0.05) in HOMA-IR between the difficult and gentle AS groups. A significant link between HOMA-IR and the severity of cerebral AS in patients was found using Spearman correlation analysis (r= 0.850, P< 0.05). The IR phenomenon was prevalent in non-diabetic patients with cerebral infarction, and the level of IR was closely related to the severity of cerebral AS.

Metabolic stress in patients with acute severe ulcerative colitis - a single-center cohort study

Background and aimsAcute severe ulcerative colitis (ASUC) is characterized by systemic inflammation, which may initiate an acute-phase response leading to hypercatabolism. Patients with ASUC are usually treated with high-dose steroids that may further accelerate the metabolic response and lead to hyperglycemia and insulin resistance. Nevertheless, the degree of synergy between inflammation and steroid treatment and their influence on the insulin resistance remains unknown. We aimed to measure the degree of metabolic stress including insulin resistance in patients with ASUC during admission and three weeks after discharge.MethodsThis single-center cohort study was conducted in adult patients with ASUC, defined and assessed by Truelove and Witt’s criteria. Indirect calorimetry, bioelectrical impedance analysis, and the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) were applied at baseline and at follow-up three weeks after discharge.ResultsAmong the 22 patients admitted during the project period, 15 provided consent for participation in the study. Median C-reactive protein at inclusion was 37.6 [4; 154.7]. Both median HOMA-IR and fasting plasma glucose were markedly increased at inclusion (median 8.6 [3.8; 14.1] and 7.1 [6; 8.7], respectively), and both had decreased significantly three weeks after discharge (p=0.0036 and p=0.0039, respectively). No significant differences were observed in resting energy expenditure or anthropometric measurements from baseline to follow-up.ConclusionPatients with ASUC presented with marked insulin resistance, indicating that the days following admission and high-dose steroid treatment are particularly vulnerable. Despite improvement at three-week follow-up, patients still exhibited insulin resistance compared with relevant control groups.Clinical trial registrationClinicalTrials.gov, identifier NCT0527183.

Exploring the associations and potential mediators between lipid biomarkers and the risk of developing gout: NHANES 2007–2018

BackgroundGout stands as a prevailing manifestation of inflammatory arthritis. While it is linked to several well-established risk factors, the associations between lipid profiles and the risk of gout remain unclear.MethodsThis research involved National Health and Nutrition Examination Survey data (2007–2018). The cardiometabolic index, which incorporates the Triglycerides (TG)/High-density lipoprotein cholesterol (HDL) ratio and waist to height ratio (WHtR), was used to assess lipid profiles and metabolic health. Multivariate logistic regression analysis, propensity score matching, and mediation analyses were utilized to evaluate the associations of lipid profiles and the cardiometabolic index with the risk of developing gout.ResultsAmong 11,032 participants, each 1-unit increase in TG levels was associated with a 65% increase in the odds of developing gout before matching [1.65 (1.15–2.38), P = 0.007] and a 155% increase in the odds of developing gout after matching [2.55 (1.59–4.09), P = 0.007]. Each 1-unit increase in the cardiometabolic index was linked to an 81% increase in the odds of developing gout before matching [1.81 (1.22–2.70), P = 0.004] and a 215% increase in the odds of developing gout after matching [3.15 (1.84–5.40), P < 0.001]. The participants with HDL levels in the third quartile presented a 35% reduction in gout risk relative to those with HDL levels in the first quartile before matching [0.65 (0.46–0.92), P = 0.014] and a 51% reduction in gout risk after matching [0.49 (0.32–0.75), P < 0.001]. Mediation analyses revealed that BMI, WHtR, and homeostatic model assessment for insulin resistance (HOMA-IR) mediated the relationships between TG levels and the risk of developing gout at 18.75%, 24.28%, and 5.35%, respectively. For the association between HDL levels and the risk of developing gout, the mediating effects of BMI, WHtR, leukocytes, γ-glutamyltransferase (in those with HDL < 56 mmol/L), and HOMA-IR were 57.98%, 69.03%, 8.77%, 5.18%, and 11.14%, respectively.ConclusionThis study reveals the relationship between lipid profiles and the risk of developing gout. Regularly checking TG and HDL levels and actively managing obesity, insulin resistance, oxidative stress and inflammation are important for lowering the risk of developing gout.

Relationship of serum iron and thyroid hormone in obesity and after laparoscopic sleeve gastrectomy

BackgroundIron is an essential element for thyroid function. However, no study focuses on the association between iron and thyroid in individuals with obesity. Our research aimed to investigate the iron status in relation to baseline thyroid hormone levels and after laparoscopic sleeve gastrectomy (LSG).MethodsA total of 216 subjects with obesity were enrolled and divided into low and high iron groups depending on the median value. The association between iron and thyroid hormone was analyzed and compared before and after LSG at the 6-month follow-up in patients who underwent LSG.Results1) In all, Total Triiodothyronine (TT3) was significantly higher in high iron than low iron group (P = 0.008). TT3 and thyroid stimulating hormone (TSH) were significantly higher in high iron than low iron group (1.92 ± 0.61 vs. 1.69 ± 0.28 nmol/l, P = 0.029; 2.93 ± 1.66 vs. 1.88 ± 1.03 mU/l, P = 0.002) in females while not in males (all P > 0.05). 2) Iron was significantly positively associated with free triiodothyronine (FT3), free thyroxine (FT4), TT3 and TSH (all P < 0.05). Adjusted for body mass index (BMI), total cholesterol (TCH), high-density lipoprotein cholesterol (HDL-C), fasting insulin (FINS) and homeostatic model assessment of insulin resistance (HOMA-IR), FT3, FT4 and TSH were still significantly associated with iron (all P < 0.05). 3). Regression analysis showed that iron was significantly associated with FT4 (β = 0.338, P = 0.038). 3) LSG led to decreased FT3, FT3, TT3, total thyroxine (TT4) and TSH at 6 months follow-up (all P < 0.05). Changed FT4 was significantly associated with changed iron (r = 0.520, P = 0.009). Subjects with iron decreased had more significant decreased TT4 than subjects without iron decreased (P = 0.021).ConclusionSerum iron overload is significantly associated with impaired thyroid function in subjects with obesity. LSG led to improved thyroid function which is associated with a change in iron.Trial RegistrationNCT04548232 registration date is on October 9, 2022, registered in https://register.clinicaltrials.gov/.

Lack of Efficacy of Pomegranate Supplementation on Insulin Resistance and Sensitivity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The objective of this study is to assess the impact of pomegranate supplements on insulin resistance (IR) and insulin sensitivity through a systematic review and meta-analysis of randomized controlled trials (RCTs). Additionally, we aim to analyze the differences in efficacy among various pomegranate extracts and the sensitivity of different diseases to pomegranate supplementation. We conducted searches in PubMed, Embase, Web of Science, and Cochrane Library up to October 30, 2023, for relevant studies published in English. The treatment group required the intake of pomegranate extract for a minimum of 4 weeks, with no restrictions on the extract type. The control group received a placebo or a treatment excluding pomegranate extract. The primary outcome was homeostatic model assessment for insulin resistance (HOMA-IR) and fasting insulin (FI), and the secondary outcome was quantitative insulin sensitivity check index (QUICKI). RoB 2 was used to assess the risk of bias in the original studies. We pre-specified subgroup analyses based on types of intervention, intervention duration, health condition, and intervention dose. Sensitivity analysis was conducted to validate result stability, utilizing Begg's test and Egger's test for publication bias. Data synthesis and analysis were performed using Stata 15.1 software. This study included a total of 15 RCTs with 673 participants conducted in 7 countries. Risk of bias results indicated an overall low risk of bias of the articles. Participants included healthy individuals, overweight and obese individuals, non-alcoholic fatty liver disease (NAFLD) patients, type 2 diabetes (T2DM) patients, polycystic ovary syndrome (PCOS) patients, metabolic syndrome (MS) patients, and individuals with hyperlipidemia. Pomegranate extract variations included pomegranate juice (PJ), pomegranate seed oil (PSO) capsule, pomegranate/pomegranate peel (PP) extract capsule, and pomegranate peel-added bread. The control groups primarily received placebo treatments with varying dosage and frequency. No adverse reactions were reported in any of the studies. The summary results showed that compared to the control groups, pomegranate extract had no significant impact on improving HOMA-IR levels in participants (WMD = -0.03, 95%CI: -0.37 to 0.31, and p = 0.851) and FI (WMD = -0.03, 95%CI: -0.42 to 0.36, and p = 0.862). Additionally, there was no significant advantage of pomegranate extract on QUICKI changes in T2DM and PCOS patients (WMD = 0.00, 95%CI: 0.00 to 0.01, and p = 0.002). Subgroup analysis results indicated that pomegranate extract could improve HOMA-IR levels in PCOS patients (WMD = -0.42, 95%CI: -0.54 to -0.29, and p < 0.001) and FI levels in T2DM, PCOS, and NAFLD patients. Our results indicate that pomegranate extract only improves HOMA-IR and FI levels in PCOS patients and FI levels in T2DM and NAFLD patients. No significant difference has been found for HOMA-IR, FI, or QUICKI in other metabolic diseases. The current evidence suggests that we should interpret the value of pomegranate extract in regulating IR and sensitivity cautiously. In the future, there is a need for more rigorously designed RCTs to specifically evaluate the impact of pomegranate supplementation on insulin sensitivity in patients with NAFLD, PCOS, and T2DM.

The relationship between the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and metabolic health status in adolescents with overweight and obesity: results from a cross-sectional study in Iran.

Few studies investigated the association between Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and metabolic health status, particularly among adolescents. The present study was designed to investigate the association of MIND diet with metabolic health status in Iranian adolescents with overweight/obesity. This cross-sectional study was done among 203 adolescents with overweight/obesity (12-18 years) in Isfahan, Iran. A validated FFQ was applied to collect dietary intakes. Anthropometric indices and blood pressure were also measured by standard procedures. Fasting blood samples were obtained to determine serum insulin, glucose and lipid profile. To categorise participants as being with metabolically healthy overweight/obesity (MHO) or metabolically unhealthy overweight/obesity (MUO), two methods including International Diabetes Federation (IDF) criteria and IDF plus Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) were applied. Participants had a mean age of 13·98 years and 50·2 % of them were girls. In fully adjusted models, participants with highest MIND diet adherence had lower odds of MUO status based on IDF (OR = 0·20; 95 % CI 0·08, 0·51) and IDF/HOMA-IR (OR = 0·22; 95 % CI 0·08, 0·59) criteria. Stratified analyses revealed that this association was stronger among girls and was only significant among individuals with overweight. An inverse association was also found between MIND diet score and odds of hyperglycaemia and insulin resistance (IR). Higher MIND diet adherence was associated with lower odds MUO in adolescents with overweight/obesity. Inverse associations were also found between MIND diet and odds of hyperglycaemia and IR. Future longitudinal prospective studies are necessary to confirm our results.

The Effects of Vitamin D Supplementation on Glycemic Indices, Lipid Profile and Blood Pressure of Pregnant Women with Vitamin D Deficiency: A Single Arm Clinical Trial

Introduction: Vitamin D Deficiency (VDD) is a global problem among pregnant women in many populations. There is an association between VDD and some pregnancy outcomes, as well as gestational diabetes mellitus (GDM) and pre-eclampsia. We aimed to evaluate the effect of vitamin D supplementation on metabolic status (Fasting Blood Sugar (FBS), insulin, Homeostasis model of assessment-insulin resistance (HOMA-IR) and lipid profile) and blood pressure (BP) among pregnant women with VDD. Methods: A clinical trial was carried out on 30 pregnant women with VDD referring to the Gynecology &amp; Obstetrics Clinic of Baqiyatallah Hospital, Tehran, Iran. The present study had two phases of vitamin D3 supplementation (50000 IU / week for 12 weeks and then 50000 IU / month for three months). Serum total cholesterol, triglyceride, Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL), 25-hydroxyvitamin D (25(OH) D) level, insulin, Fasting Blood Sugar (FBS) and both systolic and diastolic blood pressure were measured. Homeostasis model of assessment-insulin resistance (HOMA-IR) was also determined. Results: The results showed that mean levels of Insulin (p=0.010), HOMA-IR (p=0.020), 25(OH) D level (p=0.001), cholesterol (p=0.001), triglyceride (p=0.001) and LDL (p=0.001) significantly increases during study period. However, Diastolic and systolic blood pressure, FBS, and HDL levels did not change significantly over time. Conclusion: The results of this investigation showed that weekly and monthly vitamin D3 supplementation in pregnant women with VDD had beneficial effects on glycemic status, lipid profile and blood pressure.

A Comparative Study of Serum Adiponectin and Insulin Resistance In Patients With Polycystic Ovary Syndrome

Objective: To assess correlation between serum adiponectin levels and insulin resistance in patients with Polycystic ovary syndrome. Study Design: Comparative Cross-Sectional study. Place and Duration of Study: PNS Hafeez Hospital, Islamabad Pakistan, and Multidisciplinary Lab-I, Department of Biochemistry, Army Medical College Rawalpindi, Pakistan from Feb 2018 to Jan 2019. Methodology: Three groups (35 females each) were formed from selected one hundred and five females (puberty till 25 years) who had Polycystic ovary syndrome. After overnight fast, blood samples were collected to measure serum levels of insulin and adiponectin. Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was used to calculate insulin resistance. Results: The over-weight PCOS subgroup displayed lowest serum adiponectin level (8.73±2.13 mg/L; 13.87±3.60 mg/L in normal weight PCOS and 15.09±3.07 mg/L in controls). There was statistical significance of serum Fasting Blood Glucose (mmol/L, p=0.002), serum Insulin (mIU/L; p=0.003) andserum Adiponectin levels (mg/L; p˂0.001) and HOMA-IR (p&lt;0.001) among three groups. The over-weight PCOS subgroup presented with highest HOMA-IR (1.71±0.19; 1.35±0.25 in normal weight PCOS subgroup and 1.12±0.26 in controls). There is negative correlation between serum adiponectin and HOMA-IR with r= -0.46. Conclusion: In PCOS-affected females, HOMA-IR correlates inversely with serum adiponectin levels, signifying that abdominal adiposity indirectly favors insulin resistance in PCOS through decrease in adiponectin secretion. Serum adiponectin level is negatively associated with severity of IR in PCOS.

Insulin Resistance and Impaired Insulin Secretion Predict Incident Diabetes: A Statistical Matching Application to the Two Korean Nationwide, Population-Representative Cohorts.

To evaluate whether insulin resistance and impaired insulin secretion are useful predictors of incident diabetes in Koreans using nationwide population-representative data to enhance data privacy. This study analyzed the data of individuals without diabetes aged >40 years from the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2010 and 2015 and the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS). Owing to privacy concerns, these databases cannot be linked using direct identifiers. Therefore, we generated 10 synthetic datasets, followed by statistical matching with the NHIS-HEALS. Homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment of β-cell function (HOMA-β) were used as indicators of insulin resistance and insulin secretory function, respectively, and diabetes onset was captured in NHIS-HEALS. A median of 4,580 (range, 4,463 to 4,761) adults were included in the analyses after statistical matching of 10 synthetic KNHANES and NHIS-HEALS datasets. During a mean follow-up duration of 5.8 years, a median of 4.7% (range, 4.3% to 5.0%) of the participants developed diabetes. Compared to the reference low-HOMA-IR/high-HOMA-β group, the high-HOMA-IR/low- HOMA-β group had the highest risk of diabetes, followed by high-HOMA-IR/high-HOMA-β group and low-HOMA-IR/low- HOMA-β group (median adjusted hazard ratio [ranges]: 3.36 [1.86 to 6.05], 1.81 [1.01 to 3.22], and 1.68 [0.93 to 3.04], respectively). Insulin resistance and impaired insulin secretion are robust predictors of diabetes in the Korean population. A retrospective cohort constructed by combining cross-sectional synthetic and longitudinal claims-based cohort data through statistical matching may be a reliable resource for studying the natural history of diabetes.

Is there any association between vitamin D status and PCOS disease?

Introduction Polycystic ovary syndrome (PCOS) is a common hormonal disorder among women of reproductive age. The current study sought to assess vitamin D status in women with PCOS compared to the control group and to describe the association between vitamin D deficiency and the features of PCOS. Material and methodology A descriptive retrospective study about 176 women of reproductive age was conducted. The sample was divided into two groups: individuals with PCOS (82 women) and healthy individuals without PCOS (94 women). Vitamin D deficiency was defined as a serum concentration less than 10 ng/ml. We used the Statistical Package for the Social Sciences (SPSS), version 21 for all analyses. Results In our study, vitamin D deficiency was observed in 40.2% PCOS patients and 24% controls. The 25(OH)D level was lower in PCOS women and the incidence of vitamin D deficiency and insufficiency were significantly higher in comparison with the control group (p < 0.05). Furthermore, PCOS women with insulin resistance or obesity had lower 25(OH)D levels in comparison with PCOS individuals without IR or obesity. Furthermore, a significant correlation was found between homeostatic model assessment for insulin resistance (HOMA-IR)/body mass index (BMI) and vitamin D status. Discussion and conclusion Vitamin D deficiency could be one of the etiological mechanisms of PCOS. In fact, the prevalence of vitamin D deficiency in PCOS women is evident, principally in those with obesity or IR. Also, the serum 25(OH)D level was correlated with parameters of insulin resistance and metabolic syndrome. Therefore, it is proposed that vitamin D supplementation may be beneficial for the management of PCOS patients.

Lack of glycemic control in type two diabetes mellitus patients is associated with reduced serum epidermal growth factor level and increased insulin resistance.

The prevalence of type 2 diabetes mellitus (T2DM) is steadily increasing worldwide in an alarming fashion. Importantly, poor glycemic control is associated with development of various health sequalae's due to glucolipotoxicity, oxidative stress and increased inflammatory cytokines. The aim of the present study was to examine the effect of glycemic control on the relative abundance of inflammatory markers in patients with controlled and uncontrolled T2DM, and to test their association with the glycemic status in diabetic patients in Jordan. An observational cross-sectional study design was used. Patients with T2DM with controlled diabetes [glycated hemoglobin (HbA1c) ≤7.0%, n=110] and age-, sex- and body mass index (BMI)-matched uncontrolled diabetic patients (HbA1c >7.0%, n=105) were recruited. An antibody membrane array was used to examine the relative abundance of inflammatory cytokines and growth factors in the sera of the study subjects, followed by enzyme-linked immunosorbent assay (ELISA) to confirm the results. Fasting blood glucose, serum insulin, triglyceride and homeostatic model assessment for insulin resistance (HOMA-IR) score were significantly elevated in the uncontrolled T2DM group (P<0.05). Antibody membrane array showed that serum epidermal growth factor (EGF) is significantly decreased in the uncontrolled T2DM group, and this was confirmed by ELISA (158.77±111.7 vs. 95.9±82.7 pg/ml, P=0.002). The binary logistic model was used to predict the likelihood of being uncontrolled diabetic based on EGF levels. After controlling for age, sex and BMI, EGF was statistically associated with diabetes control, where lower EGF levels predicted uncontrolled diabetes. Additionally, Pearson's product-moment correlation showed a statistically significant negative correlation between EGF and HbA1c (r=-0.25, P<0.0001), and a positive correlation between HOMA-IR and HbA1c, (r=0.32, P<0.0001). The current data identify a novel link between serum EGF levels and the status of HbA1c indicative of diabetic control.