Insulin Profiles Research Articles

Abstract 14549: Body Mass Index Shift and Associated Cardiometabolic Risk Factors in People With Obesity or Overweight: A Post Hoc Analysis From SURMOUNT-1

Introduction: In SURMOUNT-1, treatment with once weekly GIP and GLP-1 receptor agonist tirzepatide resulted in substantial body weight reductions in people living with obesity. Hypothesis: This post hoc analysis assessed whether participants with obesity (body mass index [BMI] ≥30 kg/m 2 ) or overweight (BMI ≥27 kg/m 2 with at least one weight-related comorbid condition) who shifted to a lower BMI category had improved cardiometabolic factors. Methods: Change in BMI category (<25 kg/m 2 , 25 to <30 kg/m 2 , 30 to <35 kg/m 2 , 35 to <40 kg/m 2 , and ≥40 kg/m 2 ) from baseline to week 72 was assessed in participants from SURMOUNT-1 (N=2539) treated with tirzepatide or placebo. BMI shifts were grouped into “improved” (shift to at least one lower BMI category) or “stable” (no change) or “worse” (shift to a higher BMI category). Cardiometabolic parameters included waist circumference, fasting insulin, fasting glucose, HbA1c, blood pressure, and lipid profile. Results: In SURMOUNT-1, most participants demonstrated improved BMI with tirzepatide treatment (N=1457, 76.8%) while some had stable BMI (N=422, 22.3%) or worsened BMI (N=5, 0.3%) (Table). Furthermore, 38.1% improved by ≥2 BMI categories. Most placebo-treated participants had stable BMI. Compared to those with stable or worsened BMI, participants with improved BMI demonstrated greater improvement in cardiometabolic risk factors, including decreases from baseline in waist circumference, fasting insulin, fasting glucose, HbA1c, systolic and diastolic blood pressure, triglycerides, and cholesterol (non-HDL-c, and LDL-c) and increases from baseline in HDL-c. Conclusions: Substantial shifts to lower BMI categories were observed among tirzepatide-treated people living with obesity or overweight in SURMOUNT-1. Improved BMI and accompanying cardiometabolic risk factors with tirzepatide may lower further cardiovascular outcomes. Relevant outcomes trials are ongoing.

Characterization of Postprandial Bile Acid Profiles and Glucose Metabolism in Cerebrotendinous Xanthomatosis.

Cerebrotendinous xanthomatosis (CTX) is a rare inherited disease characterized by sterol 27-hydroxylase (CYP27A1) deficiency and, thus, a lack of bile acid synthesis with a marked accumulation of 7α-hydroxylated bile acid precursors. In addition to their renowned lipid-emulgating role, bile acids have been shown to stimulate secretion of the glucose-lowering and satiety-promoting gut hormone glucagon-like peptide 1 (GLP-1). In this paper, we examined postprandial bile acid, glucose, insulin, GLP-1 and fibroblast growth factor 19 (FGF19) plasma profiles in patients with CTX and matched healthy controls. Seven patients and seven age, gender and body mass index matched controls were included and subjected to a 4 h mixed meal test with regular blood sampling. CTX patients withdrew from chenodeoxycholic acid (CDCA) and statin therapy three weeks prior to the test. Postprandial levels of total bile acids were significantly lower in CTX patients and consisted of residual CDCA with low amounts of ursodeoxycholic acid (UDCA). The postprandial plasma glucose peak concentration occurred later in CTX patients compared to controls, and patients' insulin levels remained elevated for a longer time. Postprandial GLP-1 levels were slightly higher in CTX subjects whereas postprandial FGF19 levels were lower in CTX subjects. This novel characterization of CTX patients reveals very low circulating bile acid levels and FGF19 levels, aberrant postprandial glucose and insulin profiles, and elevated postprandial GLP-1 responses.

A Cross-sectional Study to Assess Insulin Resistance and Atherogenic Index of Plasma as Predictors of Risk of Cardiometabolic Disease among Undergraduate Medical Students at a Tertiary Care Teaching Hospital, Karnataka

Background: Medical profession is known for stress and challenges due to hectic academic schedules which makes students, high-risk candidates for diabetes mellitus, hypertension and cardiometabolic disease (CMD). Surrogate markers such as homeostatic model assessment insulin resistance (HOMA-IR) and atherogenic index of plasma (AIP) along with routine parameters enable early prediction of the disease. Hence, this study aimed at determining HOMA-IR and AIP along with assessment of their correlation with anthropometric and biochemical parameters associated with CMD risk among undergraduate medical students. Methodology : 460 medical students consented to participate in the study. The data related to socio-demographic profile, anthropometry, blood pressure and biochemical parameters such as fasting plasma glucose (FPG), fasting plasma insulin (FPI) and lipid profile was collected and analyzed. HOMA-IR and AIP were calculated. The strength of association between study variables was determined by relevant statistics. Results: The study showed the prevalence of overweight (17.8%), obesity (20.4%), pre-hypertension (37.82%) and hypertension (3.47%). 98.5% of the participants had normal FPG and FPI, whereas 1.5% had impaired levels. Lipid profile analysis showed hypercholesterolemia (3.7%), hypertriglyceridemia (8.1%), increased LDL-c (33.7%) and reduced HDL-c (55.2%). High HOMA-IR and AIP were contributed by 28.9% and 73.3% respectively. HOMA-IR and AIP showed statistically significant positive correlation with CMD risk factors. Conclusion: HOMA-IR and AIP considered as the better predictors of CMD risk among apparently healthy medical students. Thus, incorporation of these surrogate markers along with routine parameters for regular screening can help in early prediction of the risk of CMD among undergraduate medical students. Keywords: Homeostatic model assessment insulin resistance, Atherogenic index of plasma, Cardiometabolic disease, Medical students

Assessment of Biochemical Parameters in 8- and 9-Year-Old Children with Excessive Body Weight Participating in a Year-Long Intervention Program.

Childhood obesity represents a significant challenge both clinically and socio-economically. This study aimed to assess specific biochemical parameters, particularly glucose, insulin and lipid profile, before and after a year-long intervention program in 8- and 9-year-old children with excessive body weight living in Szczecin, Poland from 2016 to 2018. The research comprised two phases: screening in elementary schools and intervention in the outpatient clinic of the clinical Pomeranian Medical University hospital. Out of 11,494 8- to 9-year-olds in Szczecin, 42.54% (4890) participated in the screening. In the intervention phase, 515 children were examined. Anthropometric measurements were recorded at each visit, and blood samples were collected during the first and fourth visits. In the statistical analysis, the Kolmogorov-Smirnov, t-Student and ANOVA tests were employed (with statistical significance when p ≤ 0.05). Results highlighted a significant proportion of children exhibiting disruptions in carbohydrate and lipid metabolism. A total of 8.6% of participants had elevated total cholesterol, 9.7% had reduced HDL, 13.4% had elevated LDL, and 21.2% had elevated triglycerides. Initially, abnormal fasting glucose was detected in 4.7% of children, and elevated insulin levels in 3.1%. Metabolic disorders persisted post-intervention despite BMI improvement. The results emphasize the necessity for prolonged programs with frequent follow-ups targeting weight normalization in children.

Growth, glucose, insulin and lipid profile in the first two years of term infants with fetal malnutrition

Amaç: Fetal dönemde büyüme kısıtlılığı, ileri yaşlarda metabolik hastalıkların gelişimini etkileyebilir. Bu çalışmada, fetal malnütrisyonu olan ve olmayan term yenidoğan bebeklerin ilk iki yaştaki büyümelerinin ve ikinci yaştaki glukoz, insülin ve lipid profillerinin karşılaştırılması amaçlanmıştır.
 
 Gereç ve Yöntemler: Çalışmaya Mayıs 2019 ile Ekim 2019 tarihleri arasında hastanemizde doğan, CANSCORE yöntemi kullanılarak fetal malnütrisyon saptanan ve saptanmayan term bebekler alındı. Umblikal kord kanında insülin, glukoz, total kolesterol, LDL kolesterol, HDL kolesterol, VLDL kolesterol, trigliserid değerlerine bakıldı. Bu bebeklerin iki yaşına kadar büyümeleri takip edildi. İkinci yıl sonunda aynı paramtrelere yeniden bakıldı.
 
 Bulgular: Fetal malnutrisyon saptanan 40 bebekten 26’sı, fetal malnutrisyon saptanmayan 40 bebekten 22’si iki yıl boyunca takip edildi. Fetal malnütrisyonu olan bebeklerin 6. ayında vücut ağırlığı, boy uzunluğu ve baş çevresinin, fetal malnütrisyonlu olmayan bebeklere göre daha yüksek olduğu ancak 12 ve 24. ayda bu farkın gerilediği görüldü. Yaşamının ikinci yılında bakılan glikoz, insülin, total kolesterol, LDL kolesterol, HDL kolesterol düzeyleri arasında her iki grup arasında anlamlı farklılık yokken, VLDL kolesterol ve trigliserid düzeyleri fetal malnütrisyonu olan grupta anlamlı olarak daha yüksek saptandı.
 
 Sonuç: Fetal malnütrisyonlu bebeklerde yaşamının ilk 6 ayındaki hızlı kilo artışı erken çocukluk dönemindeki lipid profilini etkileyebilir.

Effect of Moderate-Intense Training and Detraining on Glucose Metabolism, Lipid Profile, and Liver Enzymes in Male Wistar Rats: A Preclinical Randomized Study.

Exercise training positively regulates glucose metabolism. This study investigated the impact of training and detraining on glucose metabolism, lipid profiles, and liver enzymes. Twenty-six rats completed an initial 4-week moderate-intense training (T0-T4). Then, the animals were randomly assigned to two groups at the end of week 4: AT4: detraining for 8 weeks; AT8: training for 8 weeks and 4-week detraining. Six animals were sacrificed at T0 and T4, four animals/group at T8, and three/group at T12. The study continued for 12 weeks, and all parameters were assessed at T0, T4, T8, and T12. IPGTT significantly improved after 4 weeks of training (p < 0.01) and was further reduced in AT8 at T8. In AT8, 8-week training significantly reduced total cholesterol at T4 and T12 vs. T0 (p < 0.05), LDL at T4, T8, and T12 vs. T0 (p < 0.01), ALP at T8, T12 vs. T0 (p < 0.01), and increased HDL at T8 and ALT at T8 and T12 vs. T0 (p < 0.05). Triglycerides and hexokinase activity increased significantly at T4 and T8 (p < 0.05) and then decreased at T12 in AT8. Pyruvate and glycogen increased at T12 in AT8 vs. AT4. Eight-week training improved LPL and ATGL expressions. Training positively modulated insulin, glucose metabolism, and lipid profiles, but detraining reduced the benefits associated with the initial training.

Reinstating acute-phase insulin release among sedentary adults at high risk for type 2 diabetes with Yoga and Walking based lifestyle modification

BackgroundWe compared the impact of 2 lifestyle modifying physical activities, yoga (YBLM) or walking (WBLM) on impaired beta cell function (IBF) or insulin resistance (IR) in restoring acute phase insulin release (APIR) among prediabetes at high risk for type 2 diabetes (HRDM). MethodMale and female adults (N = 42, 38.1 ± 4.8 years) with abdominal obesity (Male:103 ± 8.1 cm) Female: 92 ± 11.1 cm), randomized into YBLM (n = 20) and WBLM (n = 22), were monitored for the practice of the intervention, 45 min a day/5 days a week for 12 weeks. Blood sample was collected at 0th minute to estimate the level of Fasting Blood Glucose (FBG), Sr. Insulin and lipid profile and at 10th minute (APIR). IBF, IR and sensitivity (IS) reading were checked in HOMA-2 calculator. ResultWilcoxon sign rank t-test denoted an improved APIR among the subjects with IBF (p = 0.008) and not among the subjects with IR (p = 0.332). However, regression analysis yielded an improved APIR among subjects with IBF (F(1,10) = 7.816, p = 0.002) with the management of body weight and lipid profile and IR (F(1,13) = 17.003, p = 0.001) being found influenced with selected lipid components. In all, during the post assessment period, an impressive boost in APIR was manifested among people shifted to Normoglycemia (n = 14, 35.9%). ConclusionIntriguingly, we postulate the potential role of YBLM over WBLM in the management of lipid profile and body weight on accelerating APIR either through improved Beta cell compensation or by sensitizing skeletal muscles regulating IR, helping improve glucose tolerance resulting in either remission or management of prediabetes.

The effects of Mediterranean diets with low or high glycemic index on plasma glucose and insulin profiles are different in adult men and women: Data from MEDGI-Carb randomized clinical trial

Recent evidence suggests that the ability to regulate glucose and insulin homeostasis is different in men and women. Against this background, it has been hypothesized that the impact on daily plasma glucose and insulin profiles of the glycemic index (GI) of the habitual diet may differ according to sex. The aim of this study is to evaluate whether 8-h average plasma glucose and insulin profiles during a low- or a high-GI diet in individuals at high risk of developing type 2 diabetes are influenced by sex. We conducted a randomized, controlled, parallel group dietary intervention, comparing high-versus low-GI diets in a multi-national (Italy, Sweden, and the United States) sample of 156 adults at risk for type 2 diabetes. For 12 weeks, 82 vs 74 participants consumed either a low-GI or high-GI Mediterranean diet, respectively. The two experimental diets contained the same quantity of available carbohydrate (270g/d) and fiber (35g/d) and the same foods and beverages, except for the major sources of starch that was specific to the low-GI and high-GI groups (pasta, brown rice, flatbread, all bran, and wheat bread plus rye and seeds, vs jasmine rice, potato, couscous, wholegrain bread, and rusks). At baseline and after the intervention plasma glucose and insulin profiles were evaluated for 8h in the two intervention groups - separately for men and women - with both breakfast and lunch resembling food choices of the assigned diet. One hundred fifty-six adults (82 women, 74 men) with at least two traits of the metabolic syndrome completed the intervention. In women, the high-GI induced significantly higher (23%, p<0.05) 8-h average plasma glucose concentrations in comparison to the low-GI dietalready on the first day of the intervention; the difference increased up to 37% (p<0.05) after 12 weeks of diet. Conversely, there were no significant differences between the two diets in men. These results were confirmed by the two-way analysis of variance showing a statistically significant interaction between the effects of sex and diet on the glucose profile after breakfast and lunch (F=7.887, p=0.006). The results of our intervention show that women, compared to men, are more sensitive to the metabolic effects of the dietary GI. This has a strong clinical and scientific relevance and, if confirmed in further studies, it might have important implications for dietary strategies for diabetes and cardiovascular disease prevention in the context of personalized nutrition. Clinicaltrials.gov n. NCT03410719.

The Role of Transferrin, Iron and Some Biochemical Variables in Obese Males

The condition of obesity is a persistent ailment characterized by the atypical or excessive buildup of adipose tissue, resulting in compromised well-being and an elevated likelihood of morbidity and chronic health issues. The global incidence of individuals with obesity and overweight conditions has been on the rise for numerous decades. The goal of the study is to identify the relationship between body mass index (BMI), insulin, transferrin, iron, and lipid profile in obese males. Ninety males were recruited into the study; forty participants were assigned to the obese group were have BMI&gt;30 kg/m2, twenty to overweight group were have BMI between 25-30 kg/m2, and another thirty to the control group were have slow BMI&lt;25 kg/m2. The serum Transferrin, serum fasting insulin, serum iron, lipid profile and fasting glucose was evaluated in each of studied groups. The Obese group showed significant increase of the serum insulin concentration compared with the control group (16.77±7.68 vs. 11.7 ±2.79, p &lt;0.001). As well as in transferrin and lipid profile significant change was detected. No prominent differences were detected in the three groups in iron and glucose concentration. Investigation of serum transferrin can be participated in future as iron deficiency marker in obese subject in conjugation with serum iron and serum ferritin.

Asparagus gonoclados Baker (AGAF) Root Tubers Improve Glycemic Control and Hyperlipidemia in Streptozotocin-Induced Diabetic Rats

This study aimed to investigate the antidiabetic and antihyperlipidemic activity of the active fraction of Asparagus gonoclados root tubers (AGAF) in streptozotocin-induced diabetic rats. After 45 days of treatment with the active fraction (AGAF) of Asparagus gonoclados at a dose of 50 mg/kg b.w.t., the levels of fasting blood glucose (FBG), hemoglobin, HbA1c, insulin, serum lipid profiles, and renal and hepatic function markers were measured in all experimental groups of rats. Treatment with AGAF remarkably normalized the FBG, insulin, and lipid profile levels. AGAF also normalized the hepatic and renal function markers in STZ-induced diabetic-treated rats. The findings from our current study confirm that AGAF successfully alleviates diabetes mellitus and its associated complications by improving insulin secretion and action with no apparent toxic effects on the liver or kidney.

Influence of Garlic on the Glycemic Control and Lipid Profile in Animals with Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis.

Nonalcoholic fatty liver disease is the hepatic sign of metabolic syndrome. Here, we aimed to assess the effects of garlic and its major components on fasting plasma glucose, fasting insulin, and lipid profile levels in animal models of nonalcoholic fatty liver disease. A systematic search in PubMed, Scopus, ProQuest, and Web of Science was performed. After the screening process and data extraction, the pooled effect sizes were estimated using a random-effect model and stated as standardized mean differences and a 95% confidence interval. Out of 839 reports, 22 articles were included in the present study. The pooled results revealed that garlic and its components significantly decreased fasting plasma glucose (standardized mean difference: - 0.77, 95% confidence interval: - 1.42 to - 0.12, I2 : 58.85%), fasting insulin (standardized mean difference: - 1.88, 95% confidence interval: - 3.07 to - 0.69, I2 : 70.42%), serum triglyceride (standardized mean difference: - 1.01, 95% confidence interval: - 1.43 to - 0.59, I2 : 61.41%), cholesterol (standardized mean difference: - 1.00, 95% confidence interval: - 1.39 to - 0.60, I2 : 52.12%), and low-density lipoprotein cholesterol (standardized mean difference: - 0.98, 95% CI: - 1.63 to - 0.32, I2 : 71.58%) and increased high-density lipoprotein cholesterol (standardized mean difference: 1.05, 95% confidence interval: 0.52 to 1.58, I2 : 59.39%) levels. The type of animal, nonalcoholic fatty liver disease induction model, kind and duration of intervention, study model, and risk of bias were detected as possible sources of heterogeneity across studies. We conclude that garlic and its major components have a favorable impact on glycemic control and lipid profile in diet-induced nonalcoholic fatty liver disease animal models.

616-P: Glucose Metabolism—Does Chronotype Matter?

Glucose and insulin follow circadian-mediated metabolic profiles. Accumulating evidence has demonstrated significant associations between circadian disruption-related lifestyles and an increased risk of type 2 diabetes typical of Evening-types (E-types), more active in the last part of the day, compared to Morning-types (M-types). However, few studies have examined the contribution of chronotype to abnormalities of glucose profile considering both lifestyle factors and body composition. We conducted a cross-sectional study on 575 adults (71% females, 48.5±12.8 years, BMI 29.3±6.0 kg/m2) with no endocrine diseases and no consumption of medications affecting endocrine function. Chronotype was assessed through the reduced Morningness-Eveningness Questionnaire (rMEQ), glycemia, insulinemia and HbA1c plasma levels HOMA-IR were estimated. Anthropometric parameters were collected and abdominal fat distribution was measured by ultrasonography. Smoking and physical activity habits were collected by a medical history and adherence to Mediterranean diet was assessed by MEDAS questionnaire. Logistic regression models were used to investigate the association between glycemia, insulinemia and chronotype. Sex, age, BMI, total body fat, visceral and subcutaneous fat, physical activity, smoking habits and MEDAS were included in all models. Insulin levels were significantly higher in the E-Types compared to M-Types. We did not find a significant interaction between chronotype, glycemia and HbA1c, however insulin and HOMA-IR decreased with increasing rMEQ score and morningness, indicating that E-Types have +5,6 and +1,4 points of insulinemia and HOMA-IR, respectively, compared to M-Types (β=−0.28 [−0.5; −0.1], p=0.003; β=−0.07 [−0,12; −0,02], p=0.005). Chronotype is independently associated with abnormalities in insulin profile, pointing to the importance of understanding the mechanisms underlying the impact of circadian disruption on glucose metabolism, which may contribute to improved glycemic control. Disclosure R.De amicis: None. A.Battezzati: None. A.Foppiani: None. A.Leone: None. L.Galasso: None. A.Montaruli: None. E.Roveda: None. L.Castelli: None. F.Esposito: None. S.Bertoli: None. Funding Italian National Recovery and Resilience Plan Mission 4 Component 2 Investment 1.3 - Call for Proposals (341) of 15 March 2022 of Italian Ministry of University and Research funded by the European Union - NextGenerationEU (PE00000003) Concession Decree (1550) of 11 October 2022 adopted by the Italian Ministry of University and Research (CUP D93C22000890001)

1302-P: Predicting Insulin Time-Course Profiles for Early Prediabetes Interception Using a Mechanistic Mathematical Model

Early detection of prediabetes using blood glucose remains difficult as individuals often present with slight elevations or even normoglycaemia. However, their insulin profiles usually show marked elevations, suggesting that insulin is a more sensitive biomarker for prediabetes. We developed a mechanistic whole-body model that can predict an individual’s insulin time-course and insulin sensitivity from a given glucose time-course. The model describes the absorption, distribution, metabolism and excretion of glucose and the relevant hormones, while various homeostatic processes such as insulin secretion were dynamically represented by sub-models. Matched glucose and insulin data were obtained from 7 oral glucose tolerance test studies. Model predictions of insulin time-course using glucose data as inputs were compared with observed data for validation (Fig 1). Both population and individual simulation results indicated robust prediction of insulin profiles and demonstrate that it is possible to utilize glucose data (easy to obtain) to predict insulin data (difficult to obtain) for prediabetes screening. Disclosure K.Hor cheng: None. J.C.Y.Chan: None.

1112-P: Soluble Suppression of Tumorigenicity 2 Is Directly Correlated with Body Fat, Metabolic Dysfunction, and Inflammation in Children and Adolescents

Purpose: Childhood obesity is a major risk factor for chronic diseases such as type 2 diabetes (T2D) and cardiovascular disease. Elevated soluble suppression of tumorigenicity 2 (sST2) is associated with obesity, diabetes, and cardiovascular disease in adults, and is used as a biomarker of cardiometabolic disease. Such biomarkers play an important role in the management of obesity and cardiometabolic disease. In this cross-sectional study, we examined the levels of circulating sST2 in children and adolescents, as well as its association with inflammatory and metabolic markers. Methods: A total of 85 children and adolescents (aged 5-16 years) were included. Participants' characteristics included being of normal weight (body mass index, BMI &amp;lt;85th percentile; n=13), overweight (BMI 85-94th percentile; n=2), or obese (BMI ≥95th percentile; n=70; a total of 8 with confirmed T2D). Clinical and biochemical markers (including plasma glucose, glycated hemoglobin (HbA1c), insulin, vitamin D, and lipid, liver, and renal profiles) were assessed using established procedures on peripheral blood samples. The levels of sST2, interleukin (IL)-33, IL-6, C-reactive protein (CRP), leptin, and adiponectin, were quantified using commercially available ELISA kits. Results: sST2 level was directly correlated with body fat % (r=0.3, P=0.016, n=64) and fat to muscle ratio (r=0.37, P=0.01, n=45), but inversely correlated with muscle mass % (r=-0.34, P=0.02, n=45). sST2 level was directly correlated with insulin (r=0.29, P=0.04, n=50), HbA1c (r=0.29, P=0.04, n=51), and urea (r=-0.34, P=0.01, n=54). sST2 level was directly correlated with the inflammatory markers CRP (r=0.34, P=0.008, n=59) and IL-6 (r=0.32, P=0.0045, n=77). The data were consistent after adjustment for age and sex. Conclusion: Increased circulating levels of sST2 is associated with increased body fat, metabolic dysfunction, and inflammation in children and adolescents. Disclosure A.Hasan: None. S.P.Kochumon: None. I.D.Albasiri: None. F.Almulla: None. R.Ahmad: None. Funding The Kuwait Foundation for the Advancement of Sciences (RA2011-018)

Serum adiponectin profile in obese Bangladeshi children attending an obesity clinic

Background and objective: Childhood obesity plays major role in the pathogenesis of various cardiovascular and metabolic diseases. Serum adiponectin has been found to be associated with several cardiometabolic risk factors. The study investigated the serum adiponectin levels and its relationship with obesity and cardiometabolic risk factors in Bangladeshi obese children. Material and methods: Overweight or obese children, between 6-18 years of age, attending the obesity clinic of the Department of Endocrinology, BSMMU were enrolled. Waist circumference (WC) and blood pressure (BP) were measured and blood samples were taken for estimation of glucose, insulin, lipid profile and adiponectin. Fasting plasma glucose (FPG), serum insulin and lipid profile were estimated by automated analyzer. Insulin resistance (HOMA-IR) was calculated from fasting insulin and fasting plasma glucose values. Serum adiponectin (total) was measured by ELISA method using DRG ELISA kit, Germany. Results:A total of 78 overweight or obese children of 6-18-year of age were enrolled. The mean (±SD) age of the study population was 12.22 ± 2.56 years and the mean BMI was 28.79 ± 4.54 kg/m2. Mean (±SD) serum adiponectin was 36.93 ± 17.85 µg/ml in 78 overweight/obese children. One way ANOVA showed no significant (P= 0.582) difference of adiponectin levels among children with overweight and different grades of obesity. There was no significant correlation between adiponectin and measures of generalized (r=0.035, p=0.763) or central (r=0.098, p=0.392) obesity. Also, no significant correlation was found between serum adiponectin level and any of cardiovascular risk factors of obesity or metabolic health. Conclusion: The study showed high serum adiponectin level in obese Bangladeshi children. Also, no association was found between serum adiponectin levels with grades of obesity and cardiometabolic risk factors among obese children of Bangladesh. IMC J Med Sci. 2023; 17(2):009. DOI: https://doi.org/10.55010/imcjms.17.019 *Correspondence: Palash Chandra Sutradhar, Department of Medicine, Sir Salimullah Medical College Mitford Hospital, Kotwali, Dhaka-1000, Bangladesh. Email: palashdmc@gmail.com

Antidiabetic Activity of &lt;i&gt;Vasant Kusumakar Ras&lt;/i&gt; in Streptozotocin and High Fat Diet Induced Type 2 Diabetes Mellitus in Sprague Dawley Rats

Background: VasantKusumakar Ras (VK Ras) is a traditional Ayurvedic preparation used in the treatment of Type-2 diabetes mellitus. Despite its clinical anti-diabetic claims, no pre-clinical attempts were made to rule out its efficacy as an antidiabetic agent. Objectives: The present study was carried out to find the anti-diabetic effect of VK Ras against a High-Fat Diet (HFD), and low-dose streptozotocin (STZ) induced type 2 diabetes and to explore the mode of action of VK Ras. Materials and Methods: Different doses of VK Ras were administered to diabetic rats for 35 days. The biochemical markers analysis, intestinal glucose uptake, and liver glycogen content were estimated at the end of the study and also vital organs were weighed and subjected to histopathological evaluation. Results: VK Ras treatment reduced blood glucose in a dose-dependent manner. The insulin, HbA1C, HOMA-IR, and lipid profiles were improved in VK Ras-treated animals as compared to diabetic control animals. The relative organ weights were changed in diabetic rats, and treatment with VK Ras corrected the organ weights. Intestinal glucose uptake and liver glycogen content were decreased with treatment. Further, the histopathological analysis of the pancreas and other vital organs had shown that dose-dependent restoration of organ function with VK Ras treatment. Conclusions: VK Ras treatment reduces insulin resistance as well as corrects the lipid, hepatic and renal abnormalities that arise from diabetes, these effects may be mediated by interfering with glucose transport from the gut and insulin release from the β pancreatic cells.

Renoprotective effects of genetically proxied fibroblast growth factor 21: Mendelian randomization, proteome-wide and metabolome-wide association study

BackgroundFibroblast growth factor 21 (FGF21) has demonstrated efficacy for reducing liver fat and reversing non-alcoholic steatohepatitis in phase 2 clinical trials. It is also postulated to have anti-fibrotic effects and therefore may be amenable to repurposing for the prevention and treatment of chronic kidney disease (CKD). MethodsWe leverage a missense genetic variant, rs739320 in the FGF21 gene, that associates with magnetic resonance imaging-derived liver fat as a clinically validated and biologically plausible instrumental variable for studying the effects of FGF21 analogs. Performing Mendelian randomization, we ascertain associations between instrumented FGF21 and kidney phenotypes, cardiometabolic disease risk factors, as well as the circulating proteome (Somalogic, 4907 aptamers) and metabolome (Nightingale platform, 249 metabolites). ResultsWe report consistent renoprotective associations of genetically proxied FGF21 effect, including higher glomerular filtration rates (p = 1.9 × 10−4), higher urinary sodium excretion (p = 5.1 × 10−11), and lower urine albumin-creatinine ratio (p = 3.6 × 10−5). These favorable effects translated to lower CKD risk (odds ratio per rs739320 C-allele, 0.96; 95%CI, 0.94–0.98; p = 3.2 × 10−4). Genetically proxied FGF21 effect was also associated with lower fasting insulin, waist-to-hip ratio, blood pressure (systolic and diastolic BP, p < 1.0 × 10−07) and blood lipid (low-density lipoprotein cholesterol, triglycerides and apolipoprotein B, p < 6.5 × 10−24) profiles. The latter associations are replicated in our metabolome-wide association study. Proteomic perturbations associated with genetically predicted FGF21 effect were consistent with fibrosis reduction. ConclusionThis study highlights the pleiotropic effects of genetically proxied FGF21 and supports a re-purposing opportunity for the treatment and prevention of kidney disease specifically. Further work is required to triangulate these findings, towards possible clinical development of FGF21 towards the treatment and prevention of kidney disease.

The effects of trans fat diet intake on metabolic parameters and pancreatic tissue in offspring of prenatal bisphenol A exposed rats

Bisphenol A (BPA) is a plasticiser used in the manufacturing of many products and its effects on human health remain controversial. Up till now, BPA involvement in metabolic syndrome risk and development is still not fully understood. In this study, we aimed to investigate the effect of prenatal BPA exposure with postnatal trans-fat diet intake on metabolic parameters and pancreatic tissue histology. Eighteen pregnant rats were divided into control (CTL), vehicle tween 80 (VHC), and BPA (5 mg/kg/day) from gestational day (GD) 2 until GD 21, then their weaning rat’s offspring were fed with normal diet (ND) or trans-fat diet (TFD) from postnatal week (PNW) 3 until PNW 14. The rats were then sacrificed and the blood (biochemical analysis) and pancreatic tissues (histological analysis) were collected. Glucose, insulin, and lipid profile were measured. The study has shown that there was no significant difference between groups with regard to glucose, insulin, and lipid profiles (p > 0.05). All pancreatic tissues showed normal architecture with irregular islets of Langerhans in TFD intake groups compared to offspring that consumed ND. Furthermore, the pancreatic histomorphometry was also affected whereby the study findings revealed that there was a significant increase in the mean number of pancreatic islets in rats from BPA-TFD group (5.987 ± 0.3159 islets/field, p = 0.0022) compared to those fed with ND and BPA non-exposed. In addition, the results have found that prenatal BPA exposure resulted in a significant decrease in the pancreatic islets diameter of the BPA-ND group (183.3 ± 23.28 µm, p = 0.0022) compared to all other groups. In conclusion, prenatal BPA exposure with postnatal TFD in the offspring may affect glucose homeostasis and pancreatic islets in adulthood, and the effect may be more aggravated in late adulthood.

Chronic spontaneous urticaria and metabolic syndrome: a relationship conundrum.

Chronic spontaneous urticaria (CSU) and metabolic syndrome (MetS) are associated with low-grade inflammation. Despite intensive research and various hypothesis, there is lack of specific pathomechanisms of urticaria. Previous studies have suggested low-grade inflammation in obesity which may be linked to urticaria. However, there is limited literature on association of MetS and CSU. So, this study was conducted to evaluate the association of MetS and its components in patients with CSU. This was a hospital-based and cross-sectional cohort study in which 481 patients of CSU and 240 age- and gender-matched controls were recruited. MetS was defined using the revised National Cholesterol Education Program Adult Treatment Panel III. BMI, waist circumference, blood pressure, fasting blood sugar, plasma insulin, and lipid profile were measured after overnight fasting. Pearson's Chi-squared test was used to calculate significance. Logistic regression analysis was done to assess MetS as a predictor of CSU. All patients were started on antihistamines according to the severity of the disease. CSU patients comprised 220 men (45.7%) and 261 women (54.3%) with 97 patients (20.12%) qualifying criteria for metabolic syndrome compared with 73 (30.42%) controls without any significant difference (p = 0.177). CSU was significantly associated with a higher prevalence of central obesity (p = 0.003) but CSU patients with central obesity did not have a higher urticaria activity score (p = 0.727) or serum IgE levels (p = 0.359). In conclusion, our study found an increased association of central obesity with CSU that was not related to the severity of urticaria. This is of significance as obesity is the most prevalent and first component of MetS to be developed. There was no increase in the overall prevalence of MetS in patients with CSU. The increased association of obesity and urticaria in our study can be partially explained by the role of antihistamines in modulation of metabolic pathway and appetite. Future research into the same can give better insights and thus can aid in better management options in CSU patients.

New biomarkers for diagnosis of polycystic ovary syndrome

Background and aim The popular endocrine syndrome happening in women of reproductive age is polycystic ovary syndrome (PCOS). It is long understood that chronic ovaries with many tiny cysts, hyper vascularized androgen-secreting stroma, signs of extra androgen, and menstrual cycle irregularity are all related. The aim was to compare several biochemical measures in women with PCOS and age-matched control for a definite diagnosis of PCOS by using by using anti-müllerian hormone (AMH), sex hormone binding globulin (SHBG), total testosterone, serum insulin and lipid profile. Patients and methods Case-control research had been performed for patients who were admitted to El-Hussein University Hospital and EI-Minia University Hospital, Department of Obstetrics and Gynecology. The study included two matched groups: group (1) involved 40 eligible women sonographically evaluated and biochemically diagnosed with PCOS (cases group). Group (2): equal number of normal women 40 in a ratio of 1 : 1 had been chosen in the (control group). Results Mean value of triglycerides, low-density lipoprotein (LDL), total cholesterol, and very LDL had been greater between the cases group than the control one although there had been no variation among cases and controls regarding high density lipoprotein (HDL). Mean value of serum insulin and homeostasis model assessment-estimated insulin resistance (HOMA-IR) had been greater between cases group than the control. Conclusion This research confirms that obese women having PCOS have atherogenic lipoprotein profiles that are marked by elevated levels of cholesterol, LDL, and triglycerides and could be a danger point for later leading to cardiovascular complications.