Insulin Resistance Parameters Research Articles

Impact of Serum Platelet Count on Infertility in Polycystic Ovary Syndrome: A Retrospective Case-Control Study

Background: This study intended to investigate the correlation between insulin resistance (IR) and coagulation parameters in women with polycystic ovary syndrome (PCOS) and their effects on infertility. Methods: We retrospectively included 380 PCOS patients and 143 healthy controls between January 2018 and January 2021. Clinical data, including age; body mass index; white blood cell (WBC), neutrophil (NE), lymphocyte (Lym), and platelet (PLT) counts; and D-dimer, plasma sex hormone, fasting blood sugar, and fasting insulin levels, were collected. The relationship between these markers and PCOS was assessed. Results: Elevated homeostatic model assessment of insulin resistance score was independently related to infertility in women with PCOS (odds ratio [OR] = 1.825, 95% confidence interval [CI]: 1.091–3.055, p = 0.022). WBC (7.29 [5.99–8.59] vs. 6.25 [5.33–7.40], p < 0.001), NE (3.91 [3.22–4.98] vs. 3.36 [2.62–4.51], p = 0.001), PLT (276 [244.5–317.5] vs. 251.5 [219.25–281.5], p < 0.001), and Lym (2.51 [2.02–3.11] vs. 2.08 [1.85–2.53], p < 0.001) counts, and D-dimer levels (0.22 [0.15–0.42] vs. 0.20 [0.12–0.31], p = 0.023) in the serum were markedly higher in PCOS patients with IR. Furthermore, multivariate logistic regression analysis revealed that increased serum PLT count (OR = 3.066, 95% CI: 1.052–8.939, p = 0.040) and BMI (OR = 5.06, 95% CI: 1.166–21.963, p = 0.030) were independently correlated with the risk of IR in PCOS patients. Moreover, increased PLT count was independently related to infertility (OR = 3.380, 95% CI: 1.272‒8.982, p = 0.015). Conclusions: Elevated PLT count serve as an independent responsible role for infertility in PCOS women with IR, which indicate that PLT count might be a potential predictive marker for infertility in PCOS women with IR.

Effectiveness of Probiotics, Prebiotics, and Synbiotics in Managing Insulin Resistance and Hormonal Imbalance in Women with Polycystic Ovary Syndrome (PCOS): A Systematic Review of Randomized Clinical Trials.

Background/Objectives: Polycystic ovary syndrome is a common endocrine disorder in women of reproductive age characterized by insulin resistance and hormonal imbalances. Recent research suggests that probiotics and synbiotics may improve these parameters by modulating the gut microbiota. This study systematically reviewed randomized clinical trials evaluating the impact of probiotic, prebiotic, and synbiotic supplementation on insulin resistance and hormonal parameters in women with PCOS. Methods: Exhaustive searches were conducted in PubMed, Cochrane CENTRAL, Scopus, Web of Science, and Embase, following PRISMA guidelines. Randomized trials assessing supplementation with probiotics, prebiotics, or synbiotics for at least 8 weeks in women diagnosed with PCOS according to the Rotterdam criteria were included. Data on participants, interventions, and outcomes related to insulin resistance and hormones were extracted. Results: Eleven studies from Iran involving overweight or obese women aged 15 to 48 were included. Probiotic and synbiotic supplementation showed significant improvements in insulin resistance (reductions in HOMA-IR, fasting glucose, and insulin), lipid profiles (decreased LDL and triglycerides; increased HDL), and hormonal balance (increased SHBG, decreased total testosterone). Synbiotics had more pronounced effects than probiotics or prebiotics alone. Adherence was high, and side effects were minimal. Conclusions: Despite promising results, limitations such as small sample sizes, homogeneous populations, and short intervention durations limit the generalization of the findings. Larger, longer, multicenter trials with diverse populations and standardized methodologies are needed to confirm the efficacy and safety of synbiotics in managing PCOS. Integrating these interventions could improve clinical management and quality of life for affected women, but additional evidence is required to support widespread use.

Effects of exercise and dietary interventions on asprosin, leptin, and lipid metabolism in males with abdominal obesity, a randomized controlled trial

Addressing abdominal obesity requires multifaceted strategies, with physical activity and diet playing a pivotal role. The objective of this study was to assess alterations in body composition, adipokine concentrations, insulin resistance parameters, and lipid metabolism in males with abdominal obesity following two distinct interventions: exercise alone and exercise combined with a specific diet. The study involved 44 males with abdominal obesity (average age 34.7 ± 5.5 years, waist circumference [WC] 110.3 ± 8.5), randomly assigned to three groups: an experimental group with aerobic-resistance exercise (EG, n = 16), an experimental group with aerobic-resistance exercise combined with a high-protein, low-glycemic index carbohydrate diet (EDG, n = 16), both interventions lasting 6 weeks, and a control group without interventions (CG, n = 12). Body composition (body mass [BM], body fat percentage [BF%], fat-free mass [FFM], android body fat percentage [ANDR]), as well as biochemical blood analyses (asprosin [ASP], leptin [LEP], quantitative insulin sensitivity check index [QUICKI], and total cholesterol [TC]), were conducted at baseline and after 6 weeks of intervention. The impact of interventions on the analyzed variables among groups was assessed using mixed ANOVA tests with post-hoc comparisons. Effect size (ES) was also evaluated using \U0001d702p2. Significant reductions in ASP concentration after intervention were observed in both EG (p = 0.04) and EDG (p = 0.01). However, post-hoc tests revealed a decrease in LEP only in the EDG group (p < 0.01). In EDG substantial decreases after 6 weeks of intervention were noted in BM (p < 0.01), BF% (p < 0.01), ANDR (p < 0.01) and TC (p < 0.01). The most notable increase in FFM was observed in the EDG group (p < 0.01). More favourable metabolic outcomes were confirmed in the group combining diet with exercise, where there was a notable reduction in ASP levels by 16% and LEP by 48% after 6 weeks of intervention, compared to the group undergoing exercise alone.

Triglyceride-glucose index predicts postoperative overall survival in hepatocellular carcinoma: a retrospective cohort study

BackgroundInsulin resistance is important in hepatocellular carcinoma (HCC) carcinogenesis and progression. The triglyceride-glucose (TyG) index, triglyceride to high-density lipoprotein cholesterol (TG/HDL-c) ratio or TyG-body mass index (TyG-BMI) are three non-invasive parameters for insulin resistance. However, their prognostic role in HCC patients undergoing hepatectomy remains unclear.Materials and methodsHCC patients who underwent hepatectomy at the Meizhou People’s Hospital from May 2011 to February 2023 were retrospectively explored. Patients were classified into high and low groups based on different TyG, TG/HDL-c, and TyG-BMI indices. The prognostic role of TyG, TG/HDL-c, and TyG-BMI was evaluated using Kaplan–Meier analysis and Cox regression models. A nomogram incorporating significant prognostic factors was constructed and validated.ResultsA lower TyG, lower TG/HDL-c, and lower TyG-BMI were linked to worse overall survival (OS) in HCC patients. Multivariate analysis indicated the TyG index, but not the TG/HDL-c and TyG-BMI index, could independently predict HCC OS. The nomogram incorporating the TNM stage and TyG index demonstrated good calibration, discriminative ability, and clinical benefit for predicting OS in HCC patients.ConclusionsThe TyG index could independently predict HCC OS after hepatectomy in this cohort. The nomogram incorporating the TyG index may aid in the prognosis management of HCC.

Assessment of Insulin Resistance, HOMA-IR, and QUICKI Levels in Patients with Endometrial Cancer and Hyperplasia

Aim: To analyze insulin resistance and related parameters in patients with endometrial cancer and hyperplasia. Methods: The study included 102 patients in 3 groups. Group I and II included patients with a histologic diagnosis of endometrial cancer (n=41, 40.2%) and endometrial hyperplasia (n=31, 30.4%) based on the final pathology report. Group III was the control group and included patients who had undergone surgery for a benign indication other than endometrial hyperplasia (n=30, 29.4%). Age, body mass index (BMI), menarcheal age, menopausal status, gravidity, parity score, diabetes, oral contraceptive status, fasting glucose levels, insulin levels, endometrial thickness, HOMA-IR and QUICKI scores were assessed. Results: The mean age of group I was statistically higher than that of group II (55.3±9.5 vs. 48.8±7.1, p=0.002). The average BMI of the two groups was similar (p=0.076). When fasting glucose values were evaluated, group I showed significantly higher values compared to group II. The mean insulin and HOMA-IR values in the control group were significantly higher than those in group I (p

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

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

Improvement in Symptoms of Depression and Anxiety and Cardiometabolic Risk Factors in Children and Adolescents with Overweight and Obesity Following the Implementation of a Multidisciplinary Personalized Lifestyle Intervention Program.

Background/Objectives: Childhood obesity is one of the most challenging contemporary public health problems. Children and adolescents with obesity experience multiple psychosocial difficulties, such as low self-esteem, depression, anxiety, and behavioral problems, which persist for a long time. The aim of the study was to assess the effect of a multidisciplinary personalized lifestyle intervention for depressive and anxiety symptoms, as evaluated by psychometric questionnaires, and their effect and association with cardiometabolic parameters in children and adolescents with overweight and obesity before and after the intervention. Methods: Six hundred and eleven (n = 611) children and adolescents (mean age ± SE: 10.39 ± 0.10 years; 51.5% females, 46.6% pubertal) were studied prospectively. Subjects were classified as being obese (50.2%), overweight (33.5%), or having a normal BMI (16.2%) according to IOTF criteria. All participants entered a 1-year lifestyle intervention program; laboratory investigations were obtained at the beginning and end of the study and two psychometric questionnaires were completed, the CDI and SCARED, which evaluate symptoms of depression and anxiety, respectively. Results: Following the lifestyle intervention, a significant decrease was noted in anxiety scores in all subjects and in depression scores in youth with obesity, as well as in adolescents with obesity, while females displayed a reduced response to the intervention. Insulin resistance and metabolic syndrome parameters, cortisol, PRL, and LH concentrations were positive predictors for depressive and anxiety symptoms. Conclusions: The implementation of a multidisciplinary personalized lifestyle intervention program in the management of childhood obesity is associated with a significant decrease in cardiometabolic and psychosocial comorbidities in children with and without excess adiposity. The improvement in mental health is likely mediated by an improvement in energy metabolism with subsequent improvement in neuroinflammation owing to lifestyle changes.

Interaction and combined effect of triglyceride-glucose index and hypertension ontype 2 diabetesindividuals'peripheral arterial disease risk.

The interaction and combined effect of the triglyceride-glucose (TyG) index, an alternative parameter of insulin resistance, along with hypertension (HT), on the risk of peripheral arterial disease (PAD), a specific type of atherosclerotic cardiovascular disease, in individuals with type 2 diabetes (T2D) seems straightforward. However, specific research on this topic remains scarce. In this cross-sectional study, 2027 adult participants with T2D were devided into four groups based on the mean values of TyG index and various blood pressure parameters along with its category. Binary logistic regression, interaction analysis, combined effect size, and goodness-of-fit of the constructed models were performed. The TyG index's individual effect and it's combined effect with HT, or higher systolic blood pressure (SBP) or higher mean arterial pressure in patients with T2D correlated with a higher PAD risk respectively (odds ratio [OR], 0.50, [95% confidence interval {CI} 0.28-0.89]; OR, 0.32, [95% CI 0.12-0.90]; OR, 0.35, [95% CI 0.13-0.94]; OR, 0.35, [95% CI 0.12-0.98], respectively). Only an interaction effect exists between the TyG index and SBP (multiplicative interaction{INTM}: 1.02 [1.002, 1.038]). Combining them can significantly improve the accuracy of predicting PAD (area under the receiver operating characteristic curve {AUC}MAX = 0.7, AUCModel3 + TyG index + SBP-AUCModel3 = 0.027). All P values were < 0.05. This study suggested that TyG index and hypertension, as well as their combined and interaction effect were significantly correlated with the risk of PAD in T2D individuals.

Visceral adipose tissue, epicardial fat, and hepatic steatosis in polycystic ovary syndrome: a study of ectopic fat stores and metabolic dysfunction.

In polycystic ovary syndrome (PCOS), ectopic fat accumulation remains debatable. Therefore, intra-abdominal, hepatic, and epicardial fat were compared between PCOS women and body mass index (BMI)-matched controls and their associations with metabolic and hormonal parameters were explored. Furthermore, the performance of echocardiographic epicardial adipose tissue thickness (EATT) and hepatic steatosis measurement using transient elastography-based controlled attenuation parameter (TE-CAP) in screening abdominal visceral adipose tissue (VAT) was originally evaluated. Women aged 18-39 years with BMI < 35 kg/m² were recruited. PCOS was defined by the Rotterdam criteria. All participants underwent clinical and laboratory exams, dual-energy X-ray absorptiometry (DXA), TE-CAP, and echocardiography. A receiver operating characteristic curve was applied to evaluate the accuracy and optimal cutoff values of TE-CAP and EATT in predicting DXA-measured VAT. The study included 35 women with PCOS and 37 controls. PCOS women exhibited higher levels of androgens, insulin resistance (IR) parameters, LDL-cholesterol, triglycerides, VAT, and EATT. VAT correlated with IR and triglycerides, whereas EATT correlated with HDL-cholesterol. In PCOS women aged 18-29, the cutoff values of CAP and EATT for VAT were 198.0 and 3.07, respectively, with CAP showing higher area under the curves (AUC). In PCOS women aged 30-39, the cutoff values were 209.5 and 3.36, respectively, with EATT showing higher AUC. VAT correlates with more metabolic parameters in PCOS than TE-CAP or EATT. TE-CAP is useful for VAT screening in PCOS patients aged 18-39 years, whereas EATT is effective and outperforms CAP in those aged 30-39 years.

Copper biomarkers and their relationship with parameters of insulin resistance in obese women.

Some studies have demonstrated the involvement of high concentrations of copper in the manifestation of insulin resistance in individuals with obesity. The objective of this study was to evaluate the copper nutritional status and its relationship with parameters of glycemic control in women with obesity. An observational case-control clinical study involving 203 women aged between 20 and 50years, divided into two groups: obese (n = 84) and eutrophic (n = 119). Body weight, height and waist, hip and neck circumferences, dietary copper intake, copper biomarkers, determine ceruloplasmin activity and glycemic control parameters were measured. It was observed that women with obesity had higher copper concentrations in plasma and lower concentrations in erythrocytes when compared to the control group. Analysis of glycemic control parameters revealed a statistically significant difference in fasting blood glucose (p < 0.05) between groups. The study identified a significant positive correlation between plasma copper and fasting insulin values and the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index (p < 0.05). The results of this study demonstrate that obese women have high copper concentrations in plasma and lower concentrations in erythrocytes. Furthermore, the significant positive correlation between plasma copper and fasting insulin and HOMA-IR index suggests the influence of this mineral on glycemic control parameters in obese women.

Sorghum bicolor polyphenol-rich extract improves insulin sensitivity and protect against chronic stress exacerbated diabetic nephropathy through modulation of Nrf2/NF-κB

IntroductionSorghum bicolor leaf sheath is known for its rich phytoconstituents 3-in deoxyanthocyanidins with protective and health benefits in targeting oxidative stress, inflammation and apoptosis. This study aimed to investigate Sorghum bicolor polyphenol-rich extract (SBPE) and its combination with metformin on insulin resistance and diabetic nephropathy in high-fat/streptozotocin-induced diabetic rats exposed to chronic stress. MethodsAntidiabetic and nephroprotective effects of SBPE was investigated in male Wistar rats fed with high-fat diet and injected streptozotocin (35 mg/kg) intraperitoneally. Diabetic rats were exposed to chronic unpredictable mild stress and orally treated with SBPE (200 mg/kg), metformin (250 mg/kg) and SBPE + metformin for 28 days. Kidney function parameters, FBS, insulin, adiponectin, kidney injury marker (KIM-1), triglycerides were determined. Renal tissues inflammatory (TNF-α, IL-1β, IL-10), oxidative stress, apoptotic (caspase-3,-9) and transcriptional factors (Nrf2 and NF-κB) were determined as well as histology. ResultsSBPE significantly reduced FBS, triglycerides insulin and parameters for insulin resistance in diabetic rats exposed to stress. Dysregulated electrolytes, urea, creatinine, adiponectin and KIM-1 were significantly reversed in SBPE and SBPE + metformin groups. SBPE treatment significantly reduced MDA, nitrites, TNF-α, and IL-1β levels, while GSH, catalase, SOD, GST and IL-10 were increased in renal tissues. Increased apoptotic markers (caspase-3, caspase-9) and NF-κB, along with reduced Nrf2 levels, were significantly reversed by SBPE and SBPE + metformin. Distorted kidney histomorphoarchitecture was reversed in SBPE-treated groups. ConclusionSorghum bicolor polyphenol-rich extract and its combination with metformin showed promising antidiabetic effects in stress-exacerbated diabetes in rats through improving insulin sensitivity and nephroprotective mechanisms.

The Potential Diagnostic Utility of SMAD4 and ACCS in the Context of Inflammation in Type 2 Diabetes Mellitus Patients.

The search for new parameters for the prediction of type 2 diabetes mellitus (T2DM) or its harmful consequences remains an important field of study. Depending on the low-grade inflammatory nature of diabetes, we investigated three proteins in T2DM patients: 1-aminocyclopropane-1-carboxylate synthase (ACCS), granulocyte-colony-stimulating factor (G-CSF), and Sma Mothers Against Decapentaplegic homolog-4 (SMAD4). In brief, sixty T2DM and thirty healthy controls had their serum levels of ACCS, G-CSF, SMAD4, and insulin tested using the ELISA method. The insulin resistance (IR) parameter (HOMA2IR), beta-cell function percentage (HOMA2%B), and insulin sensitivity (HOMA2%S) were all determined by the Homeostasis Model Assessment-2 (HOMA2) calculator. The predictability of these protein levels was investigated by neural network (NN) analysis and was associated with measures of IR. Based on the results, ACCS, G-CSF, and SMAD4 increased significantly in the T2DM group compared with the controls. Their levels depend on IR status and inflammation. The multivariate GLM indicated the independence of the levels of these proteins on the covariates or drugs taken. The receiver operating characteristic area under the curve (AUC) for the prediction of T2DM using NN analysis is 0.902, with a sensitivity of 71.4% and a specificity of 93.8%. The network predicts T2DM well with predicted pseudoprobabilities over 0.5. The model's predictive capability (normalized importance) revealed that ACCS is the best model (100%) for the prediction of T2DM, followed by G-CSF (75.5%) and SMAD4 (69.6%). It can be concluded that ACCS, G-CSF, and SMAD4 are important proteins in T2DM prediction, and their increase is associated with the presence of inflammation.

The Association Between Triglyceride Glucose-Body Mass Index and Kidney Impairment in Patients with Type 2 Diabetes Mellitus.

Insulin resistance is associated with kidney impairment in patients with type 2 diabetes mellitus (T2DM). The triglyceride glucose-body mass index (TyG-BMI), which combines the TyG index with body mass index (BMI), has received significant attention as a tool for evaluating insulin resistance. Thus, the aim of this study was to explore the association between TyG-BMI and kidney impairment in patients with type 2 diabetes mellitus (T2DM). The cross-sectional analysis included 1080 patients with T2DM, and data were collected retrospectively. TyG-BMI was calculated by fasting blood glucose, triglyceride, and body mass index. TyG-BMI was significantly higher in T2DM patients with albuminuria than those without albuminuria (232.16 [206.52-268.02] vs 229.83 [206.11-255.64], p =0.023). T2DM patients with chronic kidney disease (CKD) showed a significantly higher value of TyG-BMI compared with those without CKD (232.23 [206.46-268.28] vs 229.73 [206.11-255.49], p=0.014). Correlation analysis showed a significantly positive association between TyG-BMI and metabolic parameters including BMI (r = 0.866, p < 0.001), TG (r = 0.630, p < 0.001), TC (r = 0.119, p < 0.001), HDL-C (r = -0.374, p < 0.001), FBG (r = 0.297, p < 0.001), and HbA1c (r = 0.116, p < 0.001) in patients with T2DM. The binary logistic regression analysis found that TyG-BMI was an independent factor for albuminuria (OR = 1.004, 95% CI: 1.001-1.008, p = 0.010) and CKD (OR = 1.005, 95% CI: 1.001-1.008, p = 0.005) in patients with T2DM respectively. The study suggests that TyG-BMI is associated with kidney impairment in patients with T2DM. Given that TyG-BMI is a novel parameter of insulin resistance, the study results indicates that clinicians should pay close attention to screening for kidney impairment in T2DM patients with insulin resistance.

Serum retinol binding protein 4 in individuals with essential hypertension and type 2 diabetes: A cross-sectional study.

Cardiometabolic disorders, notably primary hypertension and type 2 diabetes, present substantial global health challenges. The intricate interplay between metabolic and cardiovascular pathways has prompted extensive research into molecular mechanisms linking these conditions. The adipokine Retinol Binding Protein 4 (RBP4), initially recognized for retinol transport, has emerged as a potential biomarker in the network of metabolic and cardiovascular dysfunction. Recent studies implicate RBP4 in insulin resistance and its complications, including hypertension. This study explores RBP4 dynamics in patients with primary hypertension and type 2 diabetes, aiming to contribute valuable insights into diagnostic and therapeutic advancements in managing these interconnected disorders. This cross-sectional study, conducted over 2 years in a tertiary healthcare centre of North India, aimed to investigate the serum concentration of Retinol Binding Protein 4 (RBP4) in 119 participants diagnosed with primary hypertension and type 2 diabetes. Ethical guidelines were strictly followed, and comprehensive clinical assessments, including blood pressure measurements, were performed. RBP4 levels were quantified using an ELISA kit, alongside markers of insulin resistance. Statistical analyses, involving t-tests and correlation assessments, sought to unravel potential associations between RBP4, insulin resistance, and blood pressure parameters using SPSS 20.0. The study comprised 61 healthy control (HC) participants and 58 individuals diagnosed with both essential hypertension and type 2 diabetes (EH+T2D). EH+T2D participants were on average older (45.71 ± 9.29 years vs. 40.34 ± 9.47 years, P = 0.002). Dyslipidemia prevalence was markedly higher in EH+T2D (72.4% vs. 11.4%, P < 0.0001), accompanied by disrupted lipid profiles. Serum RBP4 concentration was significantly elevated in EH+T2D (49.17 ± 19.37 mg/L, P < 0.0001), suggesting its potential role in the shared pathophysiology of primary hypertension and type 2 diabetes. Pearson's correlation analysis revealed associations between RBP4 levels, metabolic, and cardiovascular parameters, underscoring its potential as a link between these conditions. Elevated serum RBP4 levels suggest its potential as a novel biomarker in the shared pathophysiology of primary hypertension and type 2 diabetes. The correlation analysis highlights the intricate interplay between metabolic, lipid, and cardiovascular parameters, emphasizing the need for holistic interventions.

MANEJO NUTRICIONAL DA RESISTÊNCIA À INSULINA NA SÍNDROME DE OVÁRIO POLICÍSTICO

Introduction: Polycystic Ovary Syndrome (PCOS) is the most common hormonal disorder among women during the ovulation and menstrual periods. Its origin is still unknown; however, the treatment of the disease involves changes in dietary habits and physical activity practices. Reducing carbohydrate intake has positive effects on PCOS, as this low carbohydrate consumption allows for depletion of muscle and hepatic glycogen stores. Objective: To evaluate the nutritional management of insulin resistance in PCOS. Materials and Methods: Literature reviews were conducted focusing on the last cinco years, using the PubMed, Scielo, and Virtual Health Library (BVS) databases. Result: A hypocaloric diet showed improvements in metabolic rates, menstrual cycle, weight loss, and insulin resistance parameters. Conclusion: Although there is no specific diet for women with insulin resistance and polycystic ovary syndrome, the results of studies have shown that low-calorie diets in conjunction with physical activity can influence the reduction of anthropometric measurements of patients, and therefore assist in the treatment of PCOS and insulin resistance.

The independent association between 25 (OH) vitamin D deficiency, HOMA-IR, and lipid profile with APOE genotyping in obese cases with and without T2DM

IntroductionVitamin D deficiency, insulin resistance, dyslipidemia, and APOE genotyping are implicated in the pathogenesis of obesity and type 2 diabetes mellitus (T2DM). We wanted to find out if there was a link between a lack of 25(OH) vitamin D, HOMA-IR, and lipids and APOE genotyping in obese people with and without T2DM.MethodsWe divided 300 Egyptians of both sexes into three groups in a case-control study: 100 obese cases with a body mass index of more than 30, 100 obese cases diagnosed with T2DM, and 100 controls with a body mass index of less than 30. Levels of 25 (OH) vitamin D, fasting blood sugar (FBS), HbA1C, fasting insulin, HOMA-IR, and lipid profile parameters were measured, and APOE genotypes were assessed using Applied BiosystemsTM TaqMan® SNP Genotyping Assays.ResultsHigher levels of FBS, fasting insulin, HOMA-IR, and dyslipidemia were found in obese people with and without T2DM compared to the control group (p < 0.05). Lower levels of 25(OH) vitamin D were also found. Insulin resistance and lipid profile parameters, particularly in obese cases with T2DM, inversely correlate with vitamin D deficiency. The APOE genotyping analysis revealed strong links between vitamin D levels and certain APOE genotypes. Independent of metabolic parameters, higher vitamin D levels were associated with lower odds of E3/E4 and E4/E4 genotypes among obese cases with T2DM.ConclusionThis study highlights the independent role of vitamin D deficiency in modulating APOE genotypes in obese T2DM individuals. The findings suggest potential implications for personalized interventions targeting vitamin D status to mitigate genetic predispositions to metabolic disorders such as obesity and T2DM.

Correlation of Insulin Resistance and Metabolic Parameters in Masld Patients

Correlation of Insulin Resistance and Metabolic Parameters in Masld Patients

Prenatal arsenic exposure alters EZH2-H3K27me3 occupancy at TNF-α promoter leading to insulin resistance and metabolic syndrome in a mouse model

The global prevalence of Metabolic Syndrome (MetS) is continuously rising and exposure to environmental toxicants such as arsenic could be contributing to this rapid surge. In this study, we have assessed the effects of prenatal arsenic exposure on insulin resistance and MetS parameters in a mouse model, and an underlying mechanism was identified. We found that prenatal arsenic exposure promotes insulin resistance and adipocyte dysfunction which leads to the early onset of MetS in male offspring. Primary adipocytes isolated from 20-week-old arsenic-exposed offspring showed hypertrophy, elevated basal lipolysis, and impaired insulin response along with enhanced expression of Tumor necrosis factor-alpha (TNF-α). TNF-α levels were consistently high at gestational day 15.5 (GD15.5) as well as primary adipocytes of 6-week-old arsenic-exposed male offspring. Along with TNF-α, downstream p-JNK1/2 levels were also increased, which led to inhibitory phosphorylation of IRS1and reduced GLUT4 translocation upon insulin stimulation in adipocytes. Insulin response and downstream signaling were restored upon TNF-α inhibition, confirming its central role. The persistent overexpression of TNF-α in adipocytes of arsenic-exposed mice resulted from diminished EZH2 occupancy and reduced H3K27me3 (gene silencing histone marks) at the TNF-α promoter. This further led to chromatin relaxation, recruitment of c-Jun and CBP/p300, formation of an enhanceosome complex, and TNF-α expression. Our findings show how prenatal arsenic exposure can epigenetically modulate TNF-α expression to promote adipocyte dysfunction and insulin resistance which contributes to the early onset of MetS in offspring.

The impact of a culturally adapted lifestyle intervention on the glycaemic profile of mothers with GDM one year after delivery – a community-based, cluster randomized trial in Sri Lanka

BackgroundA woman with a history of GDM has a high risk of developing type two diabetes (T2DM) in her future life. Lifestyle modifications are known to attenuate the progression of GDM to T2DM. Therefore, the aim of this study was to assess the impact of a simple, cost effective, culturally acceptable lifestyle intervention programme on the trajectory towards T2DM in women with a history of GDM.MethodsThis cluster randomized trial was conducted in 100 postpartum women in three selected districts of Sri Lanka. The subjects were divided into intervention (n = 50) and control groups (n = 50) by cluster randomization method. A culturally adapted protocol (comprised of dietary and physical activity modifications) was administered to the intervention group. The glycemic profile was assessed using fasting and 2-hour post-OGTT plasma glucose and HbA1c, and insulin resistance by HOMA-IR at baseline and after one year of intervention.ResultsThe mean age (SD) of the subjects in the intervention and control groups were 33.0 (5.1) and 34.3 (6.5) years respectively. All glycemic and insulin resistance parameters (i.e. Fasting plasma glucose- FPG, 2-hour post-OGTT plasma glucose, HbA1c and HOMA-ir) were comparable (p > 0.05) between the two groups at baseline. FPG, 2 h post OGTT, HbA1c and HOMA-ir values between intervention vs. control (p) at 12 months were 87.3 vs. 123.2 (< 0.01); 106.5 vs. 156.1 (0.01); 5.3 vs. 6.8 (< 0.01) and 0.9 vs. 2.3 (< 0.01) respectively. All glycemic parameters showed a significant reduction in the intervention group at 12 months compared to baseline. In contrast, the control group showed a significant increase in FPG, 2-hour post-OGTT plasma glucose and HbA1c at 12 months compared to baseline. In multiple linear regression model adjusted for age, parity and family history, the control group showed an approximately 33 times risk of developing insulin resistance compared to the intervention group.ConclusionThe culturally acceptable and individualized lifestyle intervention was able to produce remarkable reductions in glycaemic and insulin resistance parameters among postpartum women with a history of GDM.Trial registrationEthical clearance was obtained from the Ethics Review Committee of the University of Sri Jayewardenepura, Sri Lanka (ERC 52/14), Sri Lanka Clinical trial registration number Sri Lanka Clinical Trials Registry (SLCTR/2015/021 date 25.09.2015).

Metabolic Effects of Synbiotic Supplementation in High Fat Diet Fed Rats: Possible Role of GLP-1 and Serotonin

Abstract High fat diet (HFD) predisposes to many metabolic changes; it may disrupt gut barrier integrity and gut microbiota composition. Synbiotic supplementation may promote host’s metabolic health by selective activation of the healthy microorganisms. This study aimed to probe the interaction between synbiotic supplementation, gut microbiota and GUT hormones in HFD states. Twenty-seven adult male albino rats, 3 groups, group I: control, group II: HFD received HFD for 12 weeks and group III: synbiotic-supplemented HFD received synbiotic in the last 6 weeks. The anthropometric measurments were measured. Liver transaminases, lipid profile, parameters of insulin resistance, serum serotonin, glucagon like polypeptide-1 (GLP-1), oxidant/antioxidant markers (MDA/GPx), zonulin levels and quantitative cecal short chain fatty acids (SCFA) were 3 assessed. Samples of liver and colon were employed for histopathological studies. Compared to HFD group, synbiotic led to a significant reduction in anthropometric measurements, liver enzymes, atherogenic index, HOMA-IR and MDA denoting improved dyslipidemia, insulin resistance and oxidative state. Moreover, synbiotic supplementation decreased serum zonulin and increased both serum serotonin, GLP-1 and cecal SCFAs. Synbiotic supplementation ameliorated the metabolic derangements and the disturbed integrity of the intestinal barrier induced by HFD through reducing serum GLP-1, serotonin and cecal SCFAs.