Insulin Resistance In Male Patients Research Articles

Sex Hormone Binding Globulin is an Independent Predictor for Insulin Resistance in Male Patients with Newly Diagnosed Type2 Diabetes Mellitus.

This study explored the correlation between sex hormones, sex hormone binding globulin (SHBG), and insulin resistance in male patients with newly diagnosed type2 diabetes mellitus (T2DM). A total of 48 male patients with newly diagnosed T2DM were enrolled in this study between March 2022 and December 2022. Clinical characteristics, sex hormones, and SHBG levels were collected. All enrolled subjects received intensive hypoglycemic treatment with insulin pump for 1week to achieve glycemic control, then the steady-state glucose infusion rate (GIR), an indicator of insulin sensitivity, was determined by the hyperinsulinemic-euglycemic clamp. Correlation analysis and multivariate logistic regression analysis were performed to explore the association of clinical characteristics, sex hormones, and SHBG with insulin sensitivity. The optimal cutoff value to predict insulin resistance was calculated using receiver operating characteristic (ROC) curve. According to the GIR cut-point value of 5.700mg/(kgmin), there were 40 patients with insulin resistance (IR group) and 8 patients without (non-IR group). The IR group exhibited lower testosterone and SHBG levels than the non-IR group (all p < 0.050). Correlation analysis showed that insulin sensitivity was positively associated with testosterone and SHBG, while negatively associated with body mass index, fasting blood glucose, alanine aminotransferase, aspartate aminotransferase, total cholesterol, triglyceride, and apolipoproteinB (all p < 0.050). Multivariate logistic regression analysis demonstrated that SHBG is an independent predictor for insulin resistance (p = 0.029). Further ROC curve analysis revealed that the optimal cutoff value of SHBG to predict insulin resistance is 17.200nmol/L, with the corresponding area under the curve (AUC) and its 95% confidence interval (CI) being 0.813 and 0.691-0.934. SHBG is an independent predictor for insulin resistance in male patients with newly diagnosed T2DM. KY20220314-01.

The application value of serum 25(OH)D3, uric acid, triglyceride, and homeostasis model assessment of insulin resistance in male patients with hyperuricemia combined with hypogonadism

BackgroundThe purpose of this study was to investigate the application value of serum 25(OH)D3, uric acid, triglyceride (TG), and homeostasis model assessment of insulin resistance (HOMA-IR) in male patients with hyperuricemia combined with hypogonadism.MethodsFrom August 2018 to August 2020, a total of 198 male patients with primary hyperuricemia were prospectively enrolled in our hospital for inpatient treatment in the department of Metabolism and Endocrinology. They are divided into normal gonadal function group (normal group, n = 117) and hypogonadal function group (hypogonadism group, n = 81), according to free testosterone (FT) level, International Index of Erectile Function (IIEF-5), and androgen deficiency in the aging male (ADAM) questionnaires. Laboratory indexes were compared between two groups. Multivariate logistic regression was applied to analyze the influencing factors of hypogonadism.ResultsAmong the 198 hyperuricemia patients, 40.91 % were hypogonadism. Compared with the normal group, the BMI, waist circumference (WC), and the prevalence of non-alcoholic fatty liver disease (NAFLD), hyperlipidemia (HLP), and obesity (OB) in the hypogonadism group were higher, and the difference was statistically significant (P < 0.05, respectively). The levels of fasting plasma glucose (FPG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), triacylglycerol (TG), serum uric acid (SUA), alanine transaminase (ALT) of hypogonadism group were higher than those of normal group, while the levels of TT, FT, E2, 25(OH)D3 of hypogonadism group were lower than those of normal group (P < 0.05, respectively). Pearson’s linear correlation was used to analyze the correlation between the indicators with significant differences in general data and laboratory indicators and hypogonadism. BMI, WC, HOMA-IR, TG, SUA, TT, FT, 25(OH)D3, E2 were positively correlated with hypogonadism (r = 0.556, 0.139, 0.473, 0.143, 0.134, 0.462, 0.419, 0.572, 0.601, P = 0.012, 0.027, 0.018, 0.019, 0.028, 0.029, 0.030, 0.009, 0.003, respectively). Taking the above indicators as independent variables and hypogonadism as the dependent variable, logistic regression analysis found that the risk factors for hypogonadism were SUA, WC, BMI, HOMA-IR, TG, TT, FT, E2, and 25(OH) D3.ConclusionsSerum 25(OH)D3, SUA, HOMA-IR, TG levels were positively correlated with male hyperuricemia patients with hypogonadism. They have important application value in the diagnosis of male hyperuricemia patients with hypogonadism.

Could SCGF-Beta Levels Be Associated with Inflammation Markers and Insulin Resistance in Male Patients Suffering from Obesity-Related NAFLD?

One of the pathologic hallmarks of obesity is macrophage infiltration of adipose tissue that has been confirmed as source of multipotent adult stem cells. Stem cell growth factor-beta (SCGF-β) shows activity on granulocyte/macrophage progenitor cells in combination with granulocyte macrophage colony-stimulating factor (GM-CSF) and macrophage colony-stimulating factor (M-CSF). Obesity-associated inflammation induces insulin resistance (IR), which is central to nonalcoholic fatty liver disease (NAFLD) or hepatic steatosis (HS). We searched for relationship between levels of SCGF-β and those of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-β (TNF-β), interleukin-12p40 (IL-12p40), interleukin-10 (IL-10), ferritin, GM-CSF and M-CSF and between SCGF-β concentrations and IR in obese patients with HS. Eighty obese patients were retrospectively studied. Serum cytokines levels were appreciated by magnetic bead-based multiplex immunoassays. IR was evaluated by homeostatic model assessment (HOMA), HOMA-derived β-cell function (HOMA-B%), quantitative insulin sensitivity check Index (QUICKI) and single point insulin sensitivity estimator (SPISE). HS and spleen volume were assessed by ultrasonography (US). SCGF-β and IL-6 levels predicted HOMA values (p = 0.032 and 0.041, respectively) only in males. In male patients, CRP and IL-6 levels (p = 0.007) predicted SCGF-β concentrations (p = 0.03 and 0.007, respectively), which in turn predicted HS at US, p = 0.037. SCGF-β levels were linked to IR and HS severity with the mediation role of CRP. IL-10 levels negatively predicted SCGF-β concentrations (p = 0.033). M-CSF levels predicted serum concentration of both TNF-β and IL-12p40 (p = 0.00), but did not predict serum IL-10 (p = 0.30). Prediction of HOMA values by SCGF-β levels, likely mediated by markers of inflammation, characterizes this study, shedding some light on mechanisms inducing/worsening IR of male patients with obesity-related NAFLD.

Relationships between Upper Limb, Lower Limb and Trunk Muscle Mass and Insulin Resistance in Male Patients with Type 2 Diabetes

Relationships between Upper Limb, Lower Limb and Trunk Muscle Mass and Insulin Resistance in Male Patients with Type 2 Diabetes

GW29-e0911 Body fat mass is an important predictor of insulin resistance in male patients with idiopathic hypogonadotropic hypogonadism and normal glucose tolerance

Male patients with idiopathic hypogonadotropic hypogonadism (IHH) characterized with low serum testosterone(T) might have higher risks of diabetes and coronary heart disease partly due to the high level of plasma insulin. Low serum T might also affect the body fat mass(BFM) in patients with IHH.

Clinical efficacy of free androgen index, a surrogate hallmark of circulating free testosterone level, in male patients with HCV-related chronic liver disease.

The role of free testosterone, that not bound to sex hormone-binding globulin, in male patients with HCV infection remains uncertain. We investigated whether free testosterone is involved in the progression to hepatic fibrosis/steatosis or insulin resistance in male patients with HCV-related chronic liver disease or not. Free androgen indices, which reflect circulating free testosterone levels, were calculated as 100 × total testosterone levels/sex hormone-binding globulin levels in 30 male patients with HCV-related chronic liver disease. Degrees of hepatic fibrosis and steatosis were evaluated by the New Inuyama Classification and the classification proposed by Brunt and colleagues, respectively. Insulin resistance was estimated by HOMA-IR values. Serum total testosterone levels were independent of hepatic fibrosis staging in the enrolled patients. However, circulating sex hormone-binding globulin levels were significantly increased in proportion to the severity of hepatic fibrosis. Therefore, free androgen indices were inversely correlated with the severity of hepatic fibrosis. Moreover, free androgen indices were inversely correlated with the grades of hepatic steatosis and HOMA-IR values in those patients. Our data suggest that lower circulating free testosterone levels may be recognized as the risk factor for more advanced hepatic fibrosis, steatosis and/or higher insulin resistance in male patients with HCV-related chronic liver disease.

Sex-Specific Association of Serum 25-Hydroxyvitamin D3 with Insulin Resistance in Chinese Han Patients with Newly Diagnosed Type 2 Diabetes Mellitus.

This study aimed to explore the association between serum 25-hydroxyvitamin D (25(OH)D) and insulin resistance as well as β-cell function in Chinese Han patients with newly diagnosed type 2 diabetes mellitus (T2DM). A total of 264 patients was included in this study. Serum 25(OH)D, plasma glucose, serum insulin and other biochemical parameters were assayed. Postprandial venous blood was collected after a mixed-nutrient load. Insulin resistance was assessed by the homeostasis model assessment for insulin resistance (HOMA-IR) and Matsuda insulin sensitivity index (Matsuda ISI). The β-cell function was assessed by the homeostasis model assessment for insulin secretion (HOMA-β) and the change in insulin divided by change in glucose from 0 to 30 min (ΔI0-30/ΔG0-30). Patients were divided into three groups according to tertiles of serum 25(OH)D levels. There were significant differences in HOMA-IR and Matsuda ISI among the three groups (HOMA-IR, p=0.005; Matsuda ISI, p=0.009). Pearson correlation analyses showed that serum 25(OH)D was negatively correlated with fasting serum insulin (FIns) (r=-0.209, p=0.012) and HOMA-IR (r=-0.273, p=0.001), and positively correlated with Matsuda ISI (r=0.219, p=0.009) only in the male population. Multiple stepwise regression analyses showed that in the male population, serum 25(OH)D was an independent predictor for both HOMA-IR and Matsuda ISI before and after adjustment for confounding factors, respectively (p<0.05 for both). This study indicates the association of vitamin D with insulin resistance in male patients with newly diagnosed T2DM, which may contribute to the understanding of the mechanism underlying the onset of T2DM in the Chinese Han population.

Increased resting energy expenditure and insulin resistance in male patients with moderate-to severe obstructive sleep apnoea.

Obstructive sleep apnoea (OSA) has been associated with disturbances in energy metabolism and insulin resistance, nevertheless, the links between OSA severity, resting energy expenditure (REE) and insulin resistance (homeostasis model assessment, HOMA-IR) remained unexplored. Therefore, we investigated the effects of OSA severity on REE, and relationships between REE and HOMA-IR in patients with OSA. Forty men [mean (SD) age 49.4 (11.4) years] underwent overnight polysomnography; REE was assessed using indirect calorimetry. REE adjusted for fat-free mass (FFM) was higher in patients with moderate-to severe OSA [n=24; body mass index (BMI) 31.1 (2.7) kg.m(-2); apnoea-hypopnoea index (AHI)>/=15 episodes.h(-1)] compared to participants with no clinically significant OSA (n=16; BMI 30.3 (2.2) kg.m(-2); AHI<15 episodes.h(-1)) [median (interquartile range) 30.4 (26.1-31.3) versus 25.8 (24.6-27.3) kcal.kg(-1).24 h(-1), p=0.005)]. AHI and oxygen desaturation index (ODI) were directly related to REE/FFM (p=0.001; p<0.001, respectively) and to HOMA-IR (p<0.001 for both). In stepwise multiple linear models, REE/FFM was independently predicted by ODI (p<0.001) and age (p=0.028) (R(2)=0.346); HOMA-IR was independently predicted by ODI only (p<0.001, R(2)=0.457). In conclusion, male patients with moderate-to severe OSA have increased REE paralleled by impaired insulin sensitivity. Severity of nocturnal intermittent hypoxia reflected by ODI is an independent predictor of REE/FFM and HOMA-IR.

Insulin Resistance and Metabolic Syndrome in Young Men With Acne.

Robust evidence of the association of insulin resistance and metabolic syndrome with acne in male patients is lacking. To assess the prevalence of metabolic syndrome and insulin resistance in male patients 20 years or older with acne. We performed a cross-sectional study in 100 male patients with acne and 100 age-matched male controls without acne from a dermatology outpatient department of a tertiary care institute. Postadolescent patients were recruited only to negate the effects of physiologic insulin resistance that are seen at the time of puberty and adolescence. Twenty-five patients were included in each of the 4 individual severity groups according to the Global Acne Grading System and were age matched to 100 male controls without acne. Clinical examination, Global Acne Rating System, National Cholesterol Education Programme Adult Treatment Panel III (NCEP-ATP III), and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR). Metabolic syndrome was diagnosed as per the criteria of the modified NCEP-ATP III. Insulin resistance was assessed by the HOMA-IR. A HOMA-IR value greater than 2.5 was arbitrarily considered as insulin resistance. Prevalence of insulin resistance was significantly higher in cases (22%) compared with controls (11%) (P = .03). The prevalence of metabolic syndrome was comparable between cases (17%) and controls (9%) (P = .09). Prevalence of insulin resistance and metabolic syndrome did not differ significantly among the acne severity groups. Postadolescent male patients with acne more commonly have insulin resistance. This resistance may be a stage of prediabetes, and the patients may develop hyperinsulinemia or type 2 diabetes in the future. These patients should be followed up for a prolonged time to determine whether they develop conditions associated with insulin resistance.

Abdominal visceral fat area and its relationship with insulin resistance in male patients with type 2 diabetes and normal body mass index

Objective To investigate abdominal visceral fat area and its relationship with insulin resistance in male patients with type 2 diabetes and normal body mass index (BMI). Methods Seven male patients with type 2 diabetes and normal BMI were divided into two groups according to the abdominal visceral fat area (VFA) measured by CT: visceral obesity group (VFA≥100 cm2) and non-visceral obesity group. Indicators of glucose and lipids metabolism were measured in two groups. Results Among 70 patients 50 (71%) had visceral obesity. In 59 patients who had normal BMI and normal waist circumference (≤90 cm), 41 presented visceral obesity (69%). Compared with non-visceral obesity group, the waist circumference, homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride, and VFA were significantly higher in visceral obesity group [(86.4±5.6) vs. (81.2±4.8) cm, t=-2.980, P 0.05). Multiple linear regression analysis showed that after adjustment for age and body mass index, abdominal VFA was positively correlated with HOMA-IR (r=0.240, P<0.05). Conclusion Male type 2 diabetic patients have a high rate of visceral obesity even when their body mass index and waist circumference are normal. Abdominal visceral fat area is closely associated with insulin resistance. Key words: Diabetes mellitus, type 2; Intra-abdominal fat; Insulin resistance; Male; Obesity

Dose- and time-dependent association of smoking and its cessation with glycemic control and insulin resistance in male patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry.

ObjectiveCigarette smoking is an important modifiable risk factor for cardiovascular diseases. However, the effect of smoking and its cessation on glycemic control in diabetic patients has not been fully examined yet. The aim of the present study was to examine the association of smoking status with glycemic level and markers of insulin resistance and secretion in patients with type 2 diabetes mellitus.Research Design and MethodsA total of 2,490 Japanese male patients with type 2 diabetes mellitus aged ≥20 years were divided according to smoking status, amount of cigarettes smoked and years since quitting. The associations with glycemic level and markers of insulin resistance and secretion were examined cross-sectionally.ResultsHbA1c levels increased progressively with increases in both number of cigarettes per day and pack-years of cigarette smoking compared with never smokers (P for trend = 0.001 and <0.001, respectively), whereas fasting plasma glucose did not. On the other hand, HbA1c, but not fasting plasma glucose, decreased linearly with increase in years after smoking cessation (P for trend <0.001). These graded relationships persisted significantly after controlling for the confounders, including total energy intake, current drinking, regular exercise, depressive symptoms, and BMI. In addition, a homeostasis model assessment of insulin resistance and high-sensitivity C-reactive protein also showed similar trends.ConclusionsSmoking and its cessation showed dose- and time-dependent relationship with glycemic control and insulin resistance in patients with type 2 diabetes mellitus. These findings may highlight the importance of smoking cessation in the clinical management of diabetes mellitus.

The association of obesity with insulin resistance in male patients with obstructive sleep apnea syndrome in Korea.

ObjectiveObstructive sleep apnea syndrome (OSAS) has been associated with cardiovascular complications and insulin resistance has been implicated in the pathogenesis and progression of atherosclerosis. We investigated whether insulin resistance is associated with OSAS independent of obesity.MethodsA total of 183 male patients with OSAS and 52 healthy controls were assessed by nocturnal polysomnography (NPSG). After NPSG, serum concentrations of total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, glucose and insulin were measured. Insulin resistance was determined by calculating the homeostasis model assessment for insulin resistance (HOMA-IR).ResultsSubjects were divided into normal control, mild-to-moderate OSA group (n=96) and severe OSA group (n=87). There were no significant differences among groups in age, body mass index (BMI), neck circumference or waist circumference. Serum concentrations of total cholesterol, LDL cholesterol, triglycerides, glucose, insulin and HOMA-IR scores of normal controls did not differ from those of the mild-to-moderate or severe OSAS groups. HOMA-IR significantly correlated with anthropometric variables, oxygen desaturation index, triglyceride and LDL cholesterol. Stepwise multiple linear regression analysis showed that waist circumference (β=0.35) and triglycerides (β=0.27) were significant determinants of HOMA-IR (adjusted R2=20%, p<0.01).ConclusionInsulin resistance was related to obesity itself rather than OSAS severity or nocturnal hypoxemia-related variables. In preventing cardiovascular complications in OSAS patients, weight reduction should be considered.

Branched-chain amino acid-enriched supplementation improves insulin resistance in patients with chronic liver disease

Increased insulin resistance is a therapeutic target in patients with chronic liver disease. Branched-chain amino acids (BCAA) have been reported to improve insulin resistance in in vivo experiments. Thus, we investigated the effects of BCAA on insulin resistance in patients with chronic liver disease. Twelve patients with chronic liver disease were enrolled. Each patient was given one sachet of a BCAA-enriched supplement after breakfast and another at bedtime. The effects of the BCAA-enriched supplementation on insulin resistance were examined 30, 60 and 90 days after administration by the homeostasis model assessment method for insulin resistance (HOMA-IR) and for beta cell function (HOMA-%B). The HOMA-IR and HOMA-%B values were elevated at baseline, however, these parameters showed no significant changes after administration of the BCAA-enriched supplement in the overall patient population. By stratification via gender, patients in the male group showed a significantly greater elevation in the HOMA-IR value compared to the female patients at baseline. After the administration, the HOMA-IR and HOMA-%B values were significantly decreased only in the male group (9.4+/-4.8 vs. 2.4+/-0.7, 657+/-345 vs. 126+/-36, respectively; P<0.05). We found that there was a gender difference in chronic viral liver disease-related insulin resistance. Moreover, a BCAA-enriched supplement improved insulin resistance and beta cell function in male patients with chronic viral liver disease. Thus, a BCAA-enriched supplement may be a useful therapeutic agent for decreasing insulin resistance in male patients with chronic viral liver disease.

Retinol-binding protein 4 is associated with components of the metabolic syndrome, but not with insulin resistance, in men with type 2 diabetes or coronary artery disease

Retinol-binding protein 4 (RBP4) has recently been reported to be associated with insulin resistance and the metabolic syndrome. This study tested the hypothesis that RBP4 is a marker of insulin resistance and the metabolic syndrome in patients with type 2 diabetes or coronary artery disease (CAD) or in non-diabetic control subjects without CAD. Serum RBP4 was measured in 365 men (126 with type 2 diabetes, 143 with CAD and 96 control subjects) and correlated with the homeostasis model assessment of insulin resistance index (HOMA-IR), components of the metabolic syndrome and lipoprotein metabolism. RBP4 was detected by ELISA and validated by quantitative Western blotting. RBP4 concentrations detected by ELISA were shown to be strongly associated with the results gained in quantitative Western blots. There were no associations of RBP4 with HOMA-IR or HbA(1c) in any of the groups studied. In patients with type 2 diabetes there were significant positive correlations of RBP4 with total cholesterol, LDL-cholesterol, VLDL-cholesterol, plasma triacylglycerol and hepatic lipase activity. In patients with CAD, there were significant associations of RBP4 with VLDL-cholesterol, plasma triacylglycerol and hepatic lipase activity, while non-diabetic control subjects without CAD showed positive correlations of RBP4 with VLDL-cholesterol and plasma triacylglycerol. RBP4 does not seem to be a valuable marker for identification of the metabolic syndrome or insulin resistance in male patients with type 2 diabetes or CAD. Independent associations of RBP4 with pro-atherogenic lipoproteins and enzymes of lipoprotein metabolism indicate a possible role of RBP4 in lipid metabolism.