Insulin Resistance Index Research Articles

The potential of insulin resistance indices to predict non-alcoholic fatty liver disease in patients with type 2 diabetes

BackgroundThe triglyceride-glucose (TyG) index and related parameters, as well as the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), have been developed as insulin resistance markers to identify individuals at risk for non-alcoholic fatty liver disease (NAFLD). However, its use for predicting NAFLD in patients with type 2 diabetes mellitus (T2DM) remains unclear. In this study, we aimed to observe the performance of insulin resistance indices in diagnosing NAFLD combined with T2DM and to compare their diagnostic values in clinical practice.Patients and methodsOverall, 268 patients with T2DM from the Endocrinology Department of Jiangsu Provincial Hospital of Traditional Chinese Medicine were enrolled in this study and divided into two groups: an NAFLD group (T2DM with NAFLD) and a T2DM group (T2DM without NAFLD). General information and blood indicators of the participants were collected, and insulin resistance indices were calculated based on these data. Receiver operating characteristic (ROC) analysis was conducted to calculate the area under the curve (AUC) for insulin resistance-related indices, aiming to assess their ability to discriminate between T2DM patients with and without NAFLD.ResultsROC analysis revealed that among the five insulin resistance-related indices, four parameters (TyG, TyG-body mass index [BMI], TyG-waist circumference [WC], and TyG- (waist–hip ratio [WHR]) exhibited high predictive performance for identifying NAFLD, except for HOMA-IR (AUCs:0.710,0.738,0.737 and 0.730, respectivly). TyG-BMI demonstrated superior predictive value, especially in males. For males, the AUC for TyG-BMI was 0.764 (95% confidence interval [CI] 0.691–0.827). The sensitivity and specificity for male NAFLD were 90.32% and 47.89%, respectively. Moreover, in the Generalized linear regression models, there were positive associations of TyG, TyG-BMI, TyG-WC, TyG-WHR, and HOMA-IR with controlled attenuation parameter (CAP), with β values of 21.30, 0.745, 0.247, and 2.549 (all P < 0.001), respectively.ConclusionTyG-BMI is a promising predictor of NAFLD combined with T2DM, particularly in lean male patients.

Bariatric Surgery-Induced Weight Loss Reduces CD36 Expression in Association with the Improvement of Insulin Resistance in Monocytes of Obese Subjects

Obesity is often associated with oxidative stress and lipid peroxidation, which are known risk factors for insulin resistance and type 2 diabetes. Cell differentiating-36 (CD36) is a cell membrane receptor that is also implicated in early stages of insulin resistance and diabetes due to its ability to bind and internalize oxidatively modified low-density lipoprotein (oxLDL). Bariatric surgery is an effective procedure that induces substantial weight loss and improves obesity-associated comorbidities. This study investigated the effect of Roux-en-Y Gastric Bypass Surgery (RYGB) on plasma oxLDL and CD36 expression and assessed possible link with insulin activity.Th study was conducted prospectively in thirty-six obese subjects who underwent RYGB. Weight loss was recorded before and at 6 and 12 months postoperatively. The expression of CD36 in monocytes was analyzed by flow cytometry and polymerase chain reaction (PCR). The concentrations of blood lipids, glucose, insulin and oxLDL were assayed in plasma, and the homeostatic model assessment insulin resistance index (HOMA-IR) was determined.There was a significant reduction of monocyte CD36 levels at 6 months (-48%) and 12 months (-63%) post-surgery. The concentrations of plasma insulin, oxLDL and triglycerides were reduced after 6 months (-38%, -41% and -29%, respectively) and after 12 months (-51%, -61% and -36%, respectively) post-surgery. The level of monocyte CD36 was positively correlated with body mass index (BMI), blood insulin and HOMA-IR.The reduction of monocyte CD36 expression and plasma oxLDL level following RYGB-induced weight loss may contribute to the improvement of insulin resistance cardiovascular disease risk factors.

Effect of Zinc on Blood Biochemical and mTOR Gene Expression in Rats with Polycystic Ovarian.

Zinc (Zn) is a significant element of the reproductive system and is associated with several enzymes that regulate different metabolic pathways. Organic Zn can significantly affect polycystic ovarian syndrome (PCOS) pathogenesis. Insulin resistance (IR) is a common complication of PCOS. Mammalian target of rapamycin (mTOR), which controls crucial cell functions, is regulated by insulin and nutrients. It has two complexes, namely, mTORC1 and mTORC2. mTOR associates with its binding partner's regulatory associated protein of mTOR (Raptor) and rapamycin-insensitive companion of mTOR (Rictor), which form these distinct complexes, respectively, and is activated in PCOS. This research aimed to evaluate the effect of Zn on the expression of mTOR signaling genes (Raptor and Rictor) and IR in PCOS model rats. Different Zn supplements, including standard diet (SD): (control - or + , SD without supplementation), Zn25, Zn75, and Zn175 (daily given three levels of 25, 75, and 175mg Zn methionine (ZnMet)/kg for 6weeks, respectively), were applied to the control and PCOS groups. Fasting glucose (FG), fasting insulin (FI), IR indices, and Raptor and Rictor expression levels were measured in both groups. The results showed that PCOS induction dramatically increased FG, FI, IR indices, and mTOR-related gene expression; however, different Zn supplementation concentrations, especially at 75mg/kg, reduced the effects of PCOS induction. Organic Zn collectively exerted positive effects on Estradiol Valerate (EV)-induced PCOS rats by reducing IR and mTOR signaling gene (i.e., Raptor and Rictor) expression. Moreover, this study revealed a correlation between Zn and IR. Therefore, Zn supplementation could be a valuable therapeutic method for treating PCOS.

The association between triglyceride glucose index and the risk of cardiovascular disease in obstructive sleep apnea

PurposeThe triglyceride glucose (TyG) index is a dependable indicator of insulin resistance (IR), serves as a valuable biomarker for identifying obstructive sleep apnea (OSA) and predicting its comorbidities. Both OSA and the TyG index are significantly related to the incidence and development of cardiovascular disease (CVD). We focus on investigating the relationship between the TyG index and the incidence of CVD risk in OSA.MethodsThe TyG index, homeostatic model assessment of IR (HOMA-IR) index, and polysomnography were assessed in 191 participants with OSA and without pre-existing CVD. To estimate the lifetime CVD risk, we employed the ‘Prediction for Atherosclerotic CVD Risk in China’ equation. The TyG index’s association with CVD risk was scrutinized using multivariable logistic regression models, contrasting it with the HOMA-IR index. We compared the predictive power for high lifetime CVD risk of the TyG index and the HOMA-IR index using receiver-operating characteristic (ROC) curve analysis.ResultsA total of 89 participants had high lifetime CVD risk. In fully adjusted model and additionally adjusted for HOMA-IR index, participants situated within the fifth quantile of the TyG index exhibited an increased lifetime CVD risk, with OR of 4.32 (95% CI, 1.19–15.67). The TyG index demonstrated significant predictive power for high lifetime CVD risk across varying severities of OSA and outperformed the HOMA-IR index, as evidenced by a larger area under the ROC curve.ConclusionThe TyG index, independent of the HOMA-IR index and obesity, was linked to an increased lifetime CVD risk. In predicting cardiovascular outcomes, the TyG index could potentially outperform the HOMA-IR index among individuals with OSA.

Association between various insulin resistance indices and cardiovascular disease in middle-aged and elderly individuals: evidence from two prospectives nationwide cohort surveys

Association between various insulin resistance indices and cardiovascular disease in middle-aged and elderly individuals: evidence from two prospectives nationwide cohort surveys

The effect of green tea on patients with type 2 diabetes mellitus: A meta-analysis

Background: To systematically evaluate the effect of green tea on patients with type 2 diabetes. Methods: A computer search Cochrane, PubMed, Embase, CNKI, Wanfang, VIP, and other Chinese and English databases were conducted for randomized controlled trials of green tea in the treatment of patients with type 2 diabetes. The duration of these trials spanned from the establishment of the database to January 10, 2024. The obtained data were subjected to meta-analysis using Stata15.1 software. A total of 15 articles were included, encompassing 722 patients. Results: The meta-analysis results showed that compared to the control group, green tea intervention significantly improved the improvement of fasting blood glucose (SMD = −0.41, 95% CI: −0.67 to −0.19, P = .001), glycated hemoglobin (SMD = −0.68, 95% CI: −1.15 to 0.21, P = .004) and insulin resistance index (SMD = −0.70, 95% CI: −1.18 to −0.22, P = .005) in the experimental group compared to the control group. The differences were statistically significant (P &lt; .05). Conclusion: Green tea significantly improves fasting blood glucose, glycated hemoglobin and insulin resistance in patients with type 2 diabetes.

HM-Chromanone Alleviates Hyperglycemia by Activating AMPK and PI3K/AKT Pathways in Mice Fed a High-Fat Diet.

We investigated potential antihyperglycemic effects of HM-chromanone (HMC), a homoisoflavonoid isolated from Portulaca oleracea, in mice fed a high-fat diet (HFD). Five-week-old male C57BL/6J mice (n = 24) were divided into three groups: controls, mice fed an HFD (11 weeks), and HFD-fed mice receiving HMC supplementation (8 weeks). Various analyses assessed liver and skeletal muscle proteins, pancreatic β-cell histology, blood glucose and HbA1c levels, and homeostatic index of insulin resistance (HOMA-IR). HMC supplementation significantly reduced fasting blood glucose and postprandial blood glucose levels in HFD-fed mice. HbA1c and serum insulin levels reduced significantly, and HOMA-IR improved. Compensatory β-cell hyperplasia was reduced, and pancreatic β-cell function improved. AMP-activated protein kinase (AMPK) was significantly activated in skeletal muscle and liver tissues. IRS-1tyr612 expression increased significantly. PI3K activation and Akt phosphorylation in skeletal muscles improved insulin signaling. Forkhead box protein O1 phosphorylation increased through hepatic AMPK activation. Phosphoenolpyruvate carboxykinase and glucose-6-phosphatase expression was inhibited. Glycogen synthase kinase 3β phosphorylation increased. HMC supplementation alleviated hyperglycemia by activating the AMPK and PI3K/Akt pathways in skeletal muscles and the AMPK pathway in the liver of HFD-fed mice.

Comparative analysis of bone health and glycemic control in postmenopausal women: insights from clinical data

Abstract Background Menopause leads to significant physiological and biochemical alterations that impact different aspects of health, such as bone mineral metabolism and glycemic control. It is imperative to comprehend these alterations in order to identify potential health hazards and develop preventative measures. This comparative cross-sectional study aimed to evaluate bone-associated markers and glycemic control indices in postmenopausal women (PMP). Methods A sample of 100 women aged 30 years or older was randomly selected and categorized into three groups: PMP (n = 60), premenopausal (PRM) (n = 20), and women in the reproductive age group (RWA) (n = 20). Venous blood samples were collected, and fasting blood glucose (FBG), calcium, phosphorus, uric acid, and alkaline phosphatase (ALP) levels were analyzed using standard laboratory techniques. The insulin and estrogen levels were evaluated using enzyme-linked immunosorbent assay (ELISA), and Homeostasis model assessment of insulin resistance (HOMA-IR), Quantitative insulin sensitivity check index (QUICKI), and Fasting insulin resistance index (FIRI) were calculated. A significance level of p &lt; 0.05 was used in the statistical analysis conducted using SPSS version 25.0. Results The PMP and PRM groups showed significantly greater mean values of FBG, insulin, and HOMA-IR when compared to RWA (p &lt; 0.05), while these groups had lower QUICKI levels. Similar trends were noted for bone-associated markers, with significant differences among the groups (p &lt; 0.05). The correlation results showed that QUICKI had positive correlations with both ALP and phosphorus, while FBG and FIRI had negative connections with both. Conclusion Postmenopausal women demonstrated higher levels of glycemic control indices and bone-related markers compared to premenopausal and reproductive-age women, indicating potential risks for osteoporosis and obesity.

G12/13-mediated signaling stimulates hepatic glucose production and has a major impact on whole body glucose homeostasis

Altered hepatic glucose fluxes are critical during the pathogenesis of type 2 diabetes. G protein-coupled receptors represent important regulators of hepatic glucose production. Recent studies have shown that hepatocytes express GPCRs that can couple to G12/13, a subfamily of heterotrimeric G proteins that has attracted relatively little attention in the past. Here we show, by analyzing several mutant mouse strains, that selective activation of hepatocyte G12/13 signaling leads to pronounced hyperglycemia and that this effect involves the stimulation of the ROCK1-JNK signaling cascade. Using both mouse and human hepatocytes, we also show that activation of endogenous sphingosine-1-phosphate type 1 receptors strongly promotes glucose release in a G12/13-dependent fashion. Studies with human liver samples indicate that hepatic GNA12 (encoding Gα12) expression levels positively correlate with indices of insulin resistance and impaired glucose homeostasis, consistent with a potential pathophysiological role of enhanced hepatic G12/13 signaling.

Longitudinal analysis of insulin resistance and sarcopenic obesity in Chinese middle-aged and older adults: evidence from CHARLS.

The correlation between surrogate insulin resistance (IR) indices and sarcopenic obesity (SO) remains uncertain. This study aimed to assess the association between six IR surrogates-triglyceride-glucose (TyG), TyG-waist circumference (TyG-WC), TyG-waist-to-height ratio (TyG-WHtR), triglyceride-to-high-density lipoprotein-cholesterol ratio (TG/HDL), metabolic score for insulin resistance (METS-IR), and Chinese visceral adiposity index (CVAI)-and SO risk in a middle-aged and older population in China. The study employed longitudinal data obtained from the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2015, involving 6,395 participants. We used multivariate logistic regression models to examine the link between six surrogates and SO. Nonlinear relationships were evaluated using restricted cubic spline analysis, and subgroup analyses were conducted for validation. Receiver operating characteristic (ROC) curves were used to assess predictive capabilities. Over the course of a 4-year follow-up period, 319 participants (5.0%) developed SO. In the fully adjusted model, all six surrogates were significantly associated with SO. The adjusted odds ratios (ORs) with a 95% confidence interval (95% CI) per standard deviation increase were 1.21 (1.08-1.36) for TyG, 1.56 (1.39-1.75) for TyG-WC, 2.04 (1.81-2.31) for TyG-WHtR, 1.11 (1.01-1.21) for TG/HDL, 1.67 (1.50-1.87) for METS-IR, and 1.74 (1.55-1.97) for CVAI. Notably, TyG-WC, TyG-WHtR, TG/HDL, METS-IR, and CVAI exhibited nonlinear correlations with SO. Conversely, TG/HDL did not exhibit a significant association during subgroup analysis. Furthermore, TyG-WHtR had a significantly larger area under the receiver operating characteristic curve than other indices. The results indicated that TyG, TyG-WC, TyG-WHtR, METS-IR, and CVAI were significantly and positively associated with SO incidence. Meanwhile, TyG-WC, TyG-WHtR, METS-IR, and CVAI showed nonlinear relationships with SO. Specifically, TyG-WHtR may be the most appropriate indicator for predicting SO among middle-aged and older Chinese adults.

Neurometabolic Profile in Obese Patients: A Cerebral Multi-Voxel Magnetic Resonance Spectroscopy Study.

Background and Objectives: Obesity-related chronic inflammation may lead to neuroinflammation and neurodegeneration. This study aimed to evaluate the neurometabolic profile of obese patients using cerebral multivoxel magnetic resonance spectroscopy (mvMRS) and assess correlations between brain metabolites and obesity markers, including body mass index (BMI), waist circumference, waist-hip ratio, body fat percentage, and indicators of metabolic syndrome (e.g., triglycerides, HDL cholesterol, fasting blood glucose, insulin, and insulin resistance index (HOMA-IR)). Materials and Methods: This prospective study involved 100 participants, stratified into two groups: 50 obese individuals (BMI ≥ 30 kg/m2) and 50 controls (18.5 ≤ BMI < 25 kg/m2). Anthropometric measurements, body fat percentage, and biochemical markers were evaluated. All subjects underwent long- and short-echo mvMRS analysis of the frontal and parietal supracallosal subcortical and deep white matter, as well as the cingulate gyrus, analyzing NAA/Cr, Cho/Cr, and mI/Cr ratios, along with absolute concentrations of NAA and Cho. Results: Obese participants exhibited significantly decreased NAA/Cr and Cho/Cr ratios in the deep white matter of the right cerebral hemisphere (p < 0.001), while absolute concentrations of NAA and Cho did not differ significantly between groups (p > 0.05). NAA levels showed negative correlations with more reliable obesity parameters (waist circumference and waist-to-hip ratio) but not with BMI, particularly in the deep frontal white matter and dorsal anterior cingulate gyrus of the left cerebral hemisphere. Notably, insulin demonstrated a significant negative impact on NAA (ρ = -0.409 and ρ = -0.410; p < 0.01) and Cho levels (ρ = -0.403 and ρ = -0.392; p < 0.01) at these locations in obese individuals. Conclusions: Central obesity and hyperinsulinemia negatively affect specific brain regions associated with cognitive and emotional processing, while BMI is not a reliable parameter for assessing brain metabolism.

Association Between Zinc Status and Insulin Resistance/Sensitivity Check Indexes in Gestational Diabetes Mellitus.

Gestational diabetes mellitus (GDM) is considered the most common metabolic disorder of the pregnancy period. It is characterized by pancreatic beta-cell dysfunction in the setting of chronic insulin resistance. Zinc is a nutrient involved in numerous metabolic processes and shows a relationship with glycometabolic disorders and GDM. The latest data have demonstrated the association of zinc with insulin sensitivity and resistance. The exact role of zinc in the connection with indexes of insulin resistance and insulin sensitivity is still not fully clarified. The aim of the study is to analyze the newly calculated indexes Glu/Zn, Ins/Zn, and HOMA-IR/Zn as surrogate markers to explore the correlation between serum zinc status and some indexes of insulin sensitivity and insulin resistance. The possible role of these indexes as markers of insulin resistance in pregnant women was analyzed too. An ROC analysis demonstrated that HOMA-IR/Zn with AUC 0.989, p < 0.001 (95% CI 0.967-1.000) and Ins/Zn with AUC 0.947, p < 0.001 (95% CI 0.889-1.000) in the GDM group, and only HOMA-IR/Zn index with AUC 0.953, p < 0.001 (95% CI 0.877-1.000) in healthy pregnant women, have good power as markers of insulin resistance in both groups. We speculate that these new ratios could be suitable for the assessment of pregnant women at high risk of insulin resistance development and, probably, for the evaluation of the specific pathophysiologic characteristics of women with GDM.

Do sociodemographic and health predictors affect the non-insulin-based insulin resistance index? A cross-sectional study.

Insulin resistance (IR) is considered a risk factor for cardiovascular diseases (CVD). Therefore, early diagnosis of IR is clinically significant for primary and secondary CVD prevention initiatives. In addition, non-insulin metabolic indices may be useful for diagnosing IR. The first objective was to estimate the triglyceride and glucose (TyG) index and the metabolic score for insulin resistance (METS-IR) index values in a local community with high social deprivation and increased cardiovascular risk according to the Systematic Coronary Risk Evaluation scale. The second objective was to identify significant sociodemographic and health predictors for the TyG index and METS-IR index. This cross-sectional study was conducted in the local community of Janów district in eastern Poland and consisted of 2 stages. The 1st stage involved basic research (n = 4,040), while the 2nd stage involved enhanced diagnostics (n = 2,657). Data from the 2nd stage was used for the analyses. Anthropometric and physiological measurements were taken, blood was drawn for laboratory tests, selected sociodemographic and health variables were evaluated, and the TyG index and METS-IR index were calculated. The mean TyG index score in the study group was 8.65 (±0.58), and the mean METS-IR index score was 41.45 (±9.02). Both indices were significantly associated with age, male sex, smoking, and systolic blood pressure (SBP) in a multivariable model. In addition, alcohol consumption and body mass index (BMI) were significantly correlated with the TyG index, whereas education was significantly associated with the METS-IR index. Our results show the association between IR and sociodemographic and health variables in a group with a high social deprivation rate and increased cardiovascular risk. Early detection of cardiometabolic risk is important for both primary and secondary CVD prevention. In primary healthcare, this can be accomplished through surrogate markers of IR.

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

BackgroundPrevious 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.MethodsThis 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.ResultsAfter 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.ConclusionsCompared 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.

Sodium-Glucose Cotransporter 2 Inhibitors Improve Body Composition by Increasing the Skeletal Muscle Mass/Fat Mass Ratio in Patients with Type 2 Diabetes: A 52-Week Prospective Real-Life Study.

Sodium-glucose cotransporter 2 inhibitors (SGLT2is) induce body weight loss, but their effect on skeletal muscle mass (SMM) and strength needs to be better elucidated. This study aimed to evaluate the effects of SGLT2i on SMM in a real-life population setting of patients with type 2 diabetes (T2D). Secondary outcomes included changes in liver steatosis and in anthropometric and glucometabolic parameters. Seventy-one patients were treated with SGLT2is as an add-on to metformin for 52 consecutive weeks. Visits were scheduled at baseline (T0) and after 6 (T6) and 12 months of therapy (T12) and included the checking of laboratory tests, measurement of anthropometric parameters, bioimpedance analysis of body composition, and abdominal ultrasound (US). Fat mass (FM) and visceral adipose tissue (VAT) progressively decreased compared to the baseline (FM: -2.9 ± 0.6 kg at T6; -2.8 ± 0.6 kg at T12; VAT: -0.3 ± 0.1 L at T6; -0.4 ± 0.1 L at T12; all p < 0.01). Changes in SMM were less pronounced (-0.4 ± 0.3 kg at T6, ns; -0.7 ± 0.4 kg at T12, p < 0.05), yielding a beneficial increase in the SMM/FM ratio (+0.3 ± 0.05 at T6 and +0.2 ± 0.05 at T12, all p < 0.01). No significant changes in sarcopenia, sarcopenic obesity, fat-free mass, muscle strength, and water compartments were observed at the end of the follow-up period. Anthropometric and glucometabolic parameters, insulin resistance, liver enzymes, and biometric indices and US grading of hepatic steatosis improved throughout this study. In a real-life setting, SGLT2i therapy is associated with weight loss attributable to FM rather than SMM loss without any relevant deterioration in muscle strength. In addition, SGLT2is proved to have beneficial effects on steatotic liver disease.

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.

Insulin level, glycemia, insulin resistance and β-cell function in relation to the lifestyle of Arctic indigenous people. Are there conditions for diabetes and which type?

Modern studies suggest that lifestyle changes of the indigenous Arctic residents lead to the loss of the "adaptive polar type of metabolism", which is characterized by the intensification of protein metabolism, optimization of lipid metabolism, and minimization of carbohydrate metabolism at low insulin concentrations. How to survive the era of change? To assess insulinemia, glycemia, β-cell secretory activity, and insulin sensitivity in Arctic indigenous people in relation to their lifestyle. A cross-sectional study of a population of indigenous Arctic residents (Nenets, Komi) aged from 22 to 60 years was conducted. Insulin levels were studied in blood serum using ELISA, and glucose levels using the spectrophotometric method. Insulin resistance (HOMA-IR) and β-cell function (HOMA1-%β) indices were calculated. 397 people were examined; 89 (22%) of them were nomadic people (NP) and 44 (49%) were male. Another 308 (78%) were sedentary people (SP), and 69 (22%) were male. The insulin level was significantly lower in NP (6.0 [3.5-11.8] µU/ml) compared to SP (8.3 [4.6-13.1] µU/ml), p=0.006. There was no difference in glycemia (4.6 [4.2-5.0] in NP and 4.6 [4.1-5.2] in SP) between lifestyles.The HOMA-IR was significantly lower in NP (1.3 [0.7-2.4]) than in SP (1.8 [0.95-2.8]), p=0.013. IR-HOMA &gt;2 units was 1.8 times more frequent in the SP than in NP, with adjusted for sex, age, and BMI OR=0.56; 95% CI: 0.33-0.96, p=0.034. The median HOMA1-%β was 128 [67-241] % in NP and 144 [93-236]% in SP with no significant differences between groups. The proportion of individuals with HOMA1-%β &lt;48.9 was 17% in NP versus 5% in SP, p&lt;0.001. The adjusted odds of having HOMA1-%β &lt;48.9 in NP are 3.5 times higher than in SP; 95% CI: 1.56-7.92, p=0.002. Fifty-six cases of glycemia ≥5.6 mmol/l were identified: 13.5% in NP and 14.3% in SP. The ratio IR-HOMA &gt;2/ HOMA1-%β &lt;48.9/BMI was 1.8 units/45%/25.2 kg/m2 in NP and 3.0 units/88%/29.6 kg/m2 in SP. Maintaining a nomadic lifestyle helps keep lower insulin concentrations; at the same time, glycemic levels in the groups were similar. In the NP group, there was a high proportion of individuals with low β-cell secretory activity, predominantly men; in the SP group, more individuals were insulin-resistant. Analysis of cases of glycemia ≥5.6 mmol/l confirmed, that hyperglycemia in a nomadic lifestyle was associated with β-cell hypofunction and the absence of obesity; on the contrary, in a sedentary lifestyle, it was associated with increased insulin resistance and obesity.

Qinlian Hongqu Decoction Modulates FXR/TGR5/GLP-1 Pathway to Improve Insulin Resistance in NAFLD Mice: Bioinformatics and Experimental Study.

Background: Qinglian Hongqu decoction (QLHQD), a traditional Chinese herbal remedy, shows potential in alleviating metabolic issues related to nonalcoholic fatty liver disease (NAFLD). However, its precise mode of action remains uncertain. Objective: This study aims to evaluate the efficacy and mechanisms of QLHQD in treating NAFLD. Methods: This study utilized a NAFLD mouse model to assess the effects of QLHQD on lipid metabolism, including blood lipids and hepatic steatosis, as well as glucose metabolism, including blood glucose levels, OGTT results, and serum insulin. Network pharmacology, bioinformatics, and molecular docking were used to explore how QLHQD may improve NAFLD treatment. Key proteins involved in these mechanisms were validated via WB and immunohistochemistry. Additionally, the expression of downstream pathway targets was examined to further validate the insulin resistance mechanism by which QLHQD improves NAFLD. Results: Animal studies demonstrated that QLHQD alleviated lipid abnormalities, hepatic steatosis, blood glucose levels, the insulin resistance index, and the OGTT results in NAFLD mice (P < 0.05 or 0.01). Network pharmacology and bioinformatics analyses indicated that the effects of QLHQD on NAFLD might involve bile acid secretion pathways. Subsequent validation through Western blotting, immunohistochemistry, and qPCR demonstrated that QLHQD may influence fat metabolism and insulin sensitivity in NAFLD mice via the FXR/TGR5/GLP-1 signaling pathway. Conclusion: QLHQD significantly alleviates glucose and lipid metabolism disorders in a high-fat diet-induced NAFLD mouse model. Its mechanism of action may involve the activation of the FXR/TGR5/GLP-1 signaling pathway in the gut, which reduces lipid accumulation and insulin resistance.

Association Between Different Insulin Resistance Indices and Heart Failure in US Adults With Diabetes Mellitus.

This study aims to scrutinize the association between various Insulin Resistance (IR) indices and heart failure (HF) risk in adult diabetics within the United States. The National Health and Nutrition Examination Survey (NHANES) (2005-2018) dataset was used in this study. Weighted logistic regression analysis and restricted cubic spline were employed to ascertain the correlation between IR indices and the incidence of HF in diabetic patients. The predictive capability of the IR indices was evaluated using the Receiver Operating Characteristic curve. This study included a total of 2574 diabetic patients, out of which 209 (8.1%) were diagnosed with HF. After the adjustment of potential confounders, TyG-BMI (OR: 1.005, 95% CI: 1.002-1.009), TG/HDL-C (OR: 1.138, 95% CI: 1.024-1.265), and METS-IR index (OR: 1.035, 95% CI: 1.015-1.057) were significantly associated with HF risk. RCS curves revealed nonlinear dose-response relationship between TyG, TyG-BMI, TG/HDL-C, and the occurrence of HF in diabetic patients. Subgroup analyses showed that four IR indices were positively associated with the risk of HF in the elderly diabetic population. Unfortunately, all IR indices failed to improve the predictive performance of the underlying risk model for HF in diabetic patients. Four IR markers may be important predictors of HF risk in diabetics.

Regional and ethnic factors of obesity and diabetes mellitus in women of re-productive age in the Pribaikal region

Introduction. Overweight is currently one of the leading global medical problems. Overweight and obesity contribute significantly to the development of diseases such as diabetes, cardiovascular disorder and can also cause premature death. Obesity has a negative impact on reproductive function; almost a quarter of women of childbearing age are overweight and about a third of them are obese.Aim. To study the characteristics of carbohydrate metabolism, hormonal indicators, and clinical-metabolic profiles, as well as to assess the potential risk of developing diabetes mellitus in women of fertile age with overweight and obesity residing in the Baikal region.Materials and methods. The study involved 60 overweight and obese women of reproductive age in the Pribaikalye region, including 33 women of Russian nationality (group 1) and 27 women of Buryat nationality (group 2). Anthropo-metric, sociodemographic and behavioural criteria were analysed, as well as questionnaires using the FINDRISC Scale. General clinical analyses of blood and urine were performed, lipid profile parameters, glucose, insulin, creatinine, transaminases, estradiol, thyroid hormone, leptin levels in blood plasma were studied. In addition, an oral glucose tolerance test was performed and the insulin resistance index (HOMA-IR) was calculated.Results. In the group of Buryat women with lower body weight as compared to Russians, higher levels of leptin, HOMA- IR index, and larger waist circumference are observed. In Buryat women, low physical activity makes a significant contribution to the development of overweight and obesity, while for Russian women, excessive caloric intake is more important. In accordance with the results of the FINDRISC scale survey, the greatest contribution to the potential development of diabetes mellitus in the Russian group is body mass index (weight), and in the Buryat group, in addition to these indicators, waist circumference and reduced physical activity.Conclusions. The results of the study will be of great help in the development of pro-grammes for the prevention of diabetes and obesity, taking into account regional and ethnic differences among the population.