Plasma Insulin Values Research Articles

Is Nutritional Status Associated with Quantitative Insulin Sensitivity Check Index in the First Trimester of Gestation?

Background: As pregnancy progresses, insulin sensitivity (SI) might slowly decrease to 50% of the average value, which could result in gestational diabetes. As weight gain is associated with reduced SI and vice versa, we evaluated the possible correlation between nutritional status and SI, especially in early pregnancy. Methods: This cross-sectional study was conducted on 138 healthy primiparous women between 6 and 10 weeks of gestation. By using a researcher-made questionnaire, the characteristics of the participants were gathered. A digital scale was used to measure participants’ weights. Nutrient intake was estimated based on the 72-hour dietary recall by Nutritionist 4 software. We used the pregnancy physical activity scale to estimate physical activity. In addition, fasting plasma glucose (FPG) and insulin values were included in the relevant formula to calculate the quantitative index of SI. Results: After adjusting for significant maternal characteristics, the quantitative insulin sensitivity check index (QUICKI) in the first trimester was correlated with participants’ weight and household income. Furthermore, the QUICKI index had a significant inverse relationship with saturated and polyunsaturated fatty acids (PUFAs) intake while total fat intake was positively correlated. Also, consuming vitamin C, glucose, fructose, sugar, and carbohydrates increased the QUICKI index, while vitamin E intake decreased it. Conclusion: The results showed that weight management may prevent gestational diabetes mellitus (GDM) during the first trimester. Moreover, the significant correlation between the above-mentioned nutrients and household income with the QUICKI index can be further examined in future studies.

Bariatric surgery induces pancreatic cell transdifferentiation as indicated by single-cell transcriptomics in Zucker diabetic rats.

Bariatric surgery results in rapid recovery of glucose control in subjects with type 2 diabetes mellitus. However, the underlying mechanisms are still largely unknown. The present study aims to clarify how bariatric surgery modifies pancreatic cell subgroup differentiation and transformation in the single-cell RNA level. Male, 8-week-old Zucker diabetic fatty (ZDF) rats with obesity and diabetes phenotypes were randomized into sleeve gastrectomy (Sleeve, n = 9), Roux-en-Y gastric bypass (RYGB, n = 9), and Sham (n = 7) groups. Two weeks after surgery, the pancreas specimen was further analyzed using single-cell RNA-sequencing technique. Two weeks after surgery, compared to the Sham group, the metabolic parameters including fasting plasma glucose, plasma insulin, and oral glucose tolerance test values were dramatically improved after RYGB and Sleeve procedures (p < .05) as predicted. In addition, RYGB and Sleeve groups increased the proportion of pancreatic β cells and reduced the ratio of α cells. Two multiple hormone-expressing cells were identified, the Gcg+/Ppy + and Ins+/Gcg+/Ppy + cells. The pancreatic Ins+/Gcg+/Ppy + cells were defined for the first time, and further investigation indicates similarities with α and β cells, with unique gene expression patterns, which implies that pancreatic cell transdifferentiation occurs following bariatric surgery. For the first time, using the single-cell transcriptome map of ZDF rats, we reported a comprehensive characterization of the heterogeneity and differentiation of pancreatic endocrinal cells after bariatric surgery, which may contribute to the underlying mechanisms. Further studies will be needed to elucidate these results.

Assessment of the Risk of Future Metabolic Syndrome among Non-Hypertensive and Non-Diabetic Nigerian Pregnant Women Presenting with either Glycosuria or Proteinuria at Different Trimesters

BackgroundIn pregnancy, women experience physiological changes which could increase the risk of insulin resistance, and metabolic syndrome later in life. This study assessed the risk of future metabolic syndrome among pregnant women with either glycosuria or proteinuria at different gestational ages. MethodsEight-Six participants were recruited from health facilities in South-west, Nigeria and they were in three categories: those with glycosuria (n = 32), proteinuria (n = 27), and control (n = 27), based on urinalysis result. Data were analyzed using IBM SPSS Statistics for Windows version 25.0 (IBM Corp, Armonk, NY, USA). Groups were compared using one way ANOVA. Association between the variables was determined using Pearson correlation. Linear regression analysis was performed to predict the risk of future metabolic syndrome.ResultsParticipants with glycosuria, proteinuria and control were 29.19 (SD 6.04), 27.15 (SD 4.37) and 25.74 (SD 4.67) years respectively. Glycosuria group had higher (P = 0.01) triglycerides, HOMA-IR, and a-positive association (P = 0.001) between, FBG and HBA1C. Linear regression analysis predicted future risk of metabolic syndrome (P&lt; 0.05) for those with glycosuria and proteinuria respectively with their plasma insulin values. ConclusionHealthy volunteers with glycosuria and proteinuria are at greater risk of developing metabolic syndrome.Rwanda J Med Health Sci. 2023;6(3): 315-325

The Triglycerides-Glucose Index Shows a Stronger Correlation with Serum Adiponectin Levels than Homeostasis Model Assessment of Insulin Resistance and Quantitative Insulin Sensitivity Check Index.

Purpose: To evaluate the association between diverse surrogate markers of insulin resistance and adiponectin concentrations. Methods: Four hundred healthy participants were included. Two different cohorts were formed according to the body mass index (BMI) values. Group 1 (n = 200) consisted of individuals with normal BMI values (18.50-24.99 kg/m2), whereas in Group 2 (n = 200) there were overweight or obese individuals (BMI ≥25.00 kg/m2). Homeostasis model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and triglycerides-glucose index (TyG) were calculated. Serum adiponectin levels were measured by ELISA. A correlation analysis was performed to assess the association between serum adiponectin and HOMA-IR, QUICKI, and TyG. Results: Participants in Group 2 were older (age in years: Group 1, 33.3 ± 6.8 vs. Group 2, 36.4 ± 7.0, P < 0.001). There was no gender difference between groups. Overweight or obese participants had higher BMI, waist circumference, fat mass, fat ratio, fasting plasma glucose, fasting plasma insulin, triglycerides, total cholesterol, and low-density lipoprotein cholesterol values, whereas high-density lipoprotein cholesterol was higher in participants with normal BMI measures. Overweight or obese subjects were more insulin resistant (higher TyG index and HOMA-IR) and less insulin sensitive (lower QUICKI), P < 0.001 for all. Serum adiponectin levels were lower in Group 2 (serum adiponectin in ng/mL: Group 1, 11,880 ± 6838 vs. Group 2, 9115 ± 5766, P < 0.001). The correlation between TyG index and adiponectin was stronger than the correlation between QUICKI and adiponectin, and HOMA-IR and adiponectin (r for TyG and adiponectin -0.408, r for QUICKI and adiponectin 0.394, r for HOMA-IR and adiponectin -0.268, respectively, P < 0.001 for all correlations). Conclusions: TyG has a stronger association with adiponectin than HOMA-IR and QUICKI.

Mild Aromatic L-Amino Acid Decarboxylase Deficiency: As A Reason For Hypoketotic Hypoglycemia In A 4-Year-Old Girl.

Aromatic L-amino acid decarboxylase (AADC) deficiency is a disease in which neurological findings are dominant due to deficiencies in neurotransmitter synthesis; hypoglycemia caused by autonomic dysfunction is one of the symptoms that may be encountered. Here we report a mild AADC deficiency presenting with hypoglycemia without a neurological sign. A 4-year-old girl presented with recurrent hypoglycemia. Her growth and development were normal. Plasma insulin and cortisol values were normal in the sample at the time of hypoglycemia. The C8:1-Carnitine elevation was detected in the acylcarnitine profile. The clinic exome panel was performed with the suggestion of a fatty acid oxidation defect. However, a homozygous variant in the DDC gene was detected. On top of that, CSF neurotransmitter analysis revealed low 5-hydroxy indol acetic ( 5 HIAA ) and homovanillic acid ( HVA ) and high 3-O-methyl-dopa and methyltetrahydrofolate ( 5 MTHF ) consistent with AADC deficiency. Plasma AADC enzyme activity was low. The episodes of hypoglycemia were treated with uncooked cornstarch. Our case emphasizes that AADC deficiency should be considered in patients with hypoglycemia.

Conditional Synthesis of Blood Glucose Profiles for T1D Patients Using Deep Generative Models

Mathematical modeling of the glucose–insulin system forms the core of simulators in the field of glucose metabolism. The complexity of human biological systems makes it a challenging task for the physiological models to encompass the entirety of such systems. Even though modern diabetes simulators perform a respectable task of simulating the glucose–insulin action, they are unable to estimate various phenomena affecting the glycemic profile of an individual such as glycemic disturbances and patient behavior. This research work presents a potential solution to this problem by proposing a method for the generation of blood glucose values conditioned on plasma insulin approximation of type 1 diabetes patients using a pixel-to-pixel generative adversarial network. Two type-1 diabetes cohorts comprising 29 and 6 patients, respectively, are used to train the generative model. This study shows that the generated blood glucose values are statistically similar to the real blood glucose values, mimicking the time-in-range results for each of the standard blood glucose ranges in type 1 diabetes management and obtaining similar means and variability outcomes. Furthermore, the causal relationship between the plasma insulin values and the generated blood glucose conforms to the same relationship observed in real patients. These results herald the aptness of deep generative models for the generation of virtual patients with diabetes.

Pancreatic fat infiltration, β-cell function and insulin resistance: A study of the young patients with obesity

ObjectiveThis study aimed to investigate the relationship between pancreatic fat infiltration (PFI) and glucose metabolism disorder, β-cell function and insulin resistance in patients with obesity. MethodsPancreatic fat fraction (PFF) was quantified by MRI IDEAL-IQ technique. PFF greater than 6.2 % was defined as PFI, and 34 obese patients were divided into PFI and non-PFI groups. The 5-point plasma glucose and insulin values during oral glucose tolerance test (OGTT) were recorded. OGTT-derived indices of insulin resistance and β-cell function were calculated. ResultsGlucose values levels at 0–120 min during OGTT were significantly higher and β-cell function variables were lower in PFI group than non-PFI group. While indices of insulin resistance were not significantly different between two groups. Correlation analysis showed that PFF was positively correlated with glucose levels at 0, 30 and 60 min, negatively correlated with β-cell function variables and not significantly correlated with indices of insulin resistance. However, these associations of PFF with β-cell function and glucose levels were only present in type 2 diabetes mellitus (T2DM) group but not in non-T2DM group. ConclusionThere is an association between PFI and impaired β-cell function, and increased pancreatic fat may be a potential risk factor for the development of T2DM.

Effect of electromyostimulation on intramyocellular lipids of the vastus lateralis in older adults: a randomized controlled trial

BackgroundExcessive intramyocellular lipid (IMCL) accumulation is a primary cause of skeletal muscle insulin resistance, especially in older adults, and interventions that reduce IMCL contents are important to improve insulin sensitivity. Electromyostimulation (EMS)-induced changes in IMCL content in older adults remain unknown. The purpose of this study was to clarify the effects of a single bout of EMS on the IMCL content of the vastus lateralis muscle in older adults.MethodsTwenty-two physically active, non-obese older men and women were randomly assigned to an EMS intervention group (69.0 ± 5.2 years, n = 12) or a control group (68.4 ± 3.5 years, n = 10). EMS was applied to the vastus lateralis (7 s on and 7 s off) for 30 min; control participants sat quietly for 30 min. IMCL content within the vastus lateralis was quantified with 1H-magnetic resonance spectroscopy (n = 7 per group). Fasting plasma glucose and insulin values were determined from blood samples collected before and after the EMS intervention.ResultsEMS induced a significant reduction in plasma glucose (93.1 ± 9.6 to 89.5 ± 9.1 mg/dL, p < 0.01), but not IMCL content (15.7 ± 15.7 to 15.8 ± 13.1 mmol/kg wet weight, p = 0.49) or insulin (5.4 ± 2.4 to 4.7 ± 2.7 μIU/mL, p = 0.18). In the control group, no changes in IMCL content in the vastus lateralis was observed after prolonged quiet sitting.ConclusionEMS intervention for 30 min induces changes in plasma glucose, but no changes in IMCL content in older adults.Trial registrationUniversity hospital Medical Information Network (UMIN) Center ID: UMIN000020126. Retrospectively registered on December 222,015. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000023242

Coating beef tallow with calcium soap improves dietary pellet quality and promotes an effective diet-induced obese mouse model

The obesity model is predominantly formed by feeding animals that are prone to obesity with high-fat diets, but this dietary intervention is not standardized. It is very difficult to pellet most high-fat diets, as they become rapidly oxidized due to their high-fat content. This study aimed to use calcium soap (Ca-soap) of beef tallow as a source of fat in high-fat mouse diets and to investigate its effects on pellet quality and its effectiveness in an obesity model. In the experiment, three diets were formed: a control diet (CD), a high-fat diet with beef tallow (HFD), and a high-fat diet containing beef tallow and Ca-soap of beef tallow (Ca-HFD). A total of 36 male C57BL/6 J mice aged six weeks were randomly divided into 3 groups: the Control (C), High-Fat (HF), and High-Fat with Ca-soap (Ca-HF) groups. The experiment lasted 20 weeks. Ca-HFD and HFD had higher hardness and pellet durability index (PDI) values than CD. Ca-HFD had a lower peroxide value than that of the HFD. At the end of the study, average body weight, body weight gain, food consumption, and calorie consumption were found to be the highest in the HF group and the lowest in the C group. The highest epididymal white adipose tissue (eWAT) ratio of the mice was seen in the Ca-HF group. Plasma triglyceride and insulin values ​​were higher in the HF group than in the C group. The highest level of steatosis was observed in the HF group. High body weight gain, fat deposition, hypercholesterolemia, hyperglycemia, glucose tolerance, and hepatic steatosis were observed in C57BL/6 J male mice fed the high-fat diets, but only HFD caused hyperinsulinemia. HFD and Ca-HFD can be used to model obesity, but only HFD can be used in type 2 diabetes modeling.

The influence of RS738409 I148M polymorphism of patatin-like phospholipase domain containing 3 gene on the susceptibility of non-alcoholic fatty liver disease

We aimed to elucidate the frequency of polymorphic genotypes and alleles of patatin-like phospholipase domain containing 3 rs738409 polymorphism and its possible associations with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis in a cohort from Turkey.We enrolled 200 patients diagnosed with NAFLD and genotyped for rs738409 I148M polymorphism by real-time polymerase chain reaction, particularly by melting curve analysis. SPSS analysis software was used for statistical significance. Continuous variable values were expressed as mean ± standard deviation. Significant statistical level was chosen as p = 0.05.Our results demonstrate in a cohort from Turkey that rs738409 C > G polymorphism (I148M) of patatin-like phospholipase domain containing 3 gene is significantly able to affect individuals to have NAFLD in unadjusted regression model.Consistent with the previous studies in other populations, our study group showed a significantly higher risk of having NAFLD in unadjusted regression model but not in the adjusted model indicating that non-genetic factors such as age and sex may be responsible for the association. However, independent studies need to validate our findings with a larger group of NAFLD patients, as well as in different ethnic cohorts.

Effect of Tamsulosin Use on Plasma Insulin Status in Benign Prostatic Hyperplasia Patients in Sokoto, Nigeria

The objective of this paper was to determine the effect of tamsulosin use on plasma insulin status in benign prostatic hyperplasia (BPH) patients in Sokoto, Nigeria. Standard methods and procedures were used. At 2nd and 3rd months of tamsulosin use, there was a significant increase (P&lt;0.05) in plasma insulin values compared to baseline. Likewise, at 4th month of tamsulosin use, a significant increase (P&lt;0.05) in plasma insulin values was revealed compared to baseline and 2nd month values. Other inter-mean values comparisons were not significantly different (P&gt;0.05). Plasma insulin at 4th months of the study in BPH patients (45-54 years) treated with tamsulosin revealed a significant increase (P&lt;0.05) compared to baseline values. Other inter-mean values comparisons were not significantly different (P&gt;0.05). BPH patients (aged 55-64 years) at 3rd month showed a significant increase (P&lt;0.05) in plasma insulin values compared to baseline values. Likewise, at 4th month of tamsulosin use, a significant increase (P&lt;0.05) in plasma insulin values was seen compared to baseline and 1st month values. Other inter-mean values comparisons were not significantly different (P&gt;0.05). In BPH patients aged 65 and above, there was no significant difference (P&gt;0.05) in plasma insulin values from 1st through 4th month compared to baseline and other inter mean values comparisons. Plasma insulin at 0th , 1st , 2nd , 3rd and 4th months of BPH patients of different age groups treated with tamsulosin revealed no significant differences (P&gt;0.05). This study revealed that tamsulosin use in the patients lead to significant increase in plasma insulin level (hyperinsulinemia). Careful and routine monitoring of BPH patients should be done. Patients need enough exercise activities and some drugs can be administered to alleviate elevated glucose or insulin.&#x0D; Keywords: Tamsulosin, hyperinsulinemia, benign prostatic hyperplasia patients, insulin resistance

The Effect of a Maternal Mediterranean Diet in Pregnancy on Insulin Resistance is Moderated by Maternal Negative Affect.

There is inconsistent evidence that healthy dietary interventions can effectively mitigate the risk of adverse outcomes associated with elevated insulin resistance in pregnancy, suggesting that other moderating factors may be at play. Maternal psychological state is an important factor to consider in this regard, because stress/mood state can directly influence glycemia and a bidirectional relationship may exist between nutrition and psychological state. The objective of this study was to examine the interaction between maternal negative affect and diet quality on third trimester insulin resistance. We conducted a prospective longitudinal study of N = 203 women with assessments in early and mid-pregnancy, which included an ecological momentary assessment of maternal psychological state, from which a negative affect score (NAS) was derived, and 24-h dietary recalls, from which the Mediterranean Diet Score (MDS) was computed. The homeostasis model assessment of insulin resistance (HOMA-IR) was computed from third trimester fasting plasma glucose and insulin values. Early pregnancy MDS was inversely associated with the HOMA-IR, but this did not maintain significance after adjusting for covariates. There was a significant effect of the mid-pregnancy MDS*NAS interaction term with the HOMA-IR in the adjusted model, such that a higher negative affect was found to override the beneficial effects of a Mediterranean diet on insulin resistance. These results highlight the need to consider nutrition and affective state concurrently in the context of gestational insulin resistance.

PCOS without hyperandrogenism is associated with higher plasma Trimethylamine N-oxide levels

BackgroundPolycystic ovary syndrome (PCOS) is an endocrine and metabolic disorder, and its pathogenesis is still under debate. Trimethylamine-N-oxide (TMAO) is a small, organic compound generated by the gut microbiome with a hypothesized relation to insulin resistance (IR) and low-grade inflammation in PCOS. By comparing plasma TMAO levels in non-PCOS participants and PCOS patients without hyperandrogenism (HA), we aimed to determine whether plasma TMAO levels correlate with PCOS without HA and to analyze their relationship with low-grade inflammation and IR.MethodsA total of 27 PCOS patients without HA and 23 non-PCOS participants were enrolled in this study and subdivided into “nonobese” and “obese” arms for each group. Levels of plasma TMAO were quantified, and basic clinical characteristics and plasma biomarkers of inflammation were assessed.ResultsFirst, plasma TMAO levels, insulin levels and homeostatic model assessment of insulin resistance (HOMA-IR) values were higher in PCOS patients without HA, especially in the obese subgroup. Second, the levels of the inflammatory factors interleukin (IL)-17A, IL-18 and interferon gamma (IFN-γ) were significantly increased in obese PCOS patients without HA. Third, plasma TMAO levels were associated with body mass index (BMI) in the normal-weight groups, and the obese groups had higher fasting plasma insulin (FINS) and HOMA-IR values. Finally, logistic regression showed that the plasma levels of TMAO and luteinizing hormone/follicle-stimulating hormone (LH/FSH) were independent predictors of PCOS and indicated an increased risk of PCOS.ConclusionsElevated plasma TMAO levels may be associated with the pathogenesis of PCOS without HA and correlated with increased systemic inflammation. Further studies are needed to determine the suitability of TMAO as a predictive biomarker and to identify possible therapies for PCOS.

Role of circulating S100A4 protein in obesity: a case-control study in prepuberal children

AbstractIntroduction:Childhood obesity is considered one of the most serious public health problems of the 21st century. Obesity-associated inflammation could be one of the mechanisms that triggers insulin resistance that could drive systemic alterations such as metabolic disorder. Recently, circulating levels of S100A4 has been associated with insulin resistance and subcutaneuous white adipose tissue inflammation independently of body mass index (BMI) in a cohort of obese adults. Nonetheless, the link between S100A4 and insulin resistance in children is still not known yet. Thus, the aim of the study was to determine if S100A4 plasma levels were associated with insulin resistance status in a cohort of prepuberal children.Material and methods:In this case-control multicentre study, 250 prepuberal children took part and were stratified in six groups according to sex, obesity stage and insulin resistance status. Blood samples were withdrawn in resting conditions after an overnight fasting. Anthropometric measurements and a routine biochemical analyses were performed. Homeostasis model assessment for insulin resistance index (HOMA-IR) was calculated using fasting plasma glucose and insulin values. S100A4 plasma levels were determined by ELISA CSBEL02032HU (Cusabio Biotech, Wuhan, China).Results:A lineal multiple regresión (α = 0.05) identified a significative association between S100A4 plasma levels and HOMA-IR in the cohort; each HOMA-IR increasing unit correlated with an increase of 0.008mg/dL in S100A4 plasma levels. (SE = 0.003 and p = 0.02). Moreover, we also observed a positive significative association between S100A4 plasma levels and glucose blood levels (p = 0.005) and BMI (p = 0.008). Inter-group comparations analyses revealed significative differences between normal-weight and insulino-resistant obese boys (p = 0.024). The same result was obtained between normal-weight and insulino-resistant obese girls (p = 0.04), finding a higher S100A4 concentration in insulino- resistant children. As expected, plasma S100A4 levels were also higher in obese children versus normal-weight children (p = 0.02).Discussion:These data could be clinical relevant due to the possible potential of S100A4 protein as a new circulating biomarker of resistance insulin in a cohort of prepuberal children. These results are supported by other studies in obese adults and adolescents. In conclusion, these results suggest that S100A4 is associated with obesity and insulin resistance in prepuberal children. However, more studies are needed to study the implication and mechanism of this protein in the development of insulin resistance.

Electromyostimulation Induced Changes In Intramyocellular Lipid Of Vastus Lateralis In Older Adults

Intramyocellular lipid (IMCL) is an important energy substrate during physical activity for young as well as older adults. However age-related changes in lipid metabolism can cause excess IMCL accumulation that can induce insulin resistance. Our previous studies have reported that IMCL content is inversely correlated with physical activity level in young, while it is not in the older adults (Hioki et al. 2018). In contrast, electromyostimulation (EMS) has been used to improve muscle mass, strength, and metabolism after spinal cord injury or chronic heart failure. PURPOSE: We aimed to prove the hypothesis that EMS can induce changes in the IMCL content of the vastus lateralis (VL) in older adults. METHODS: Fourteen physically active, non-obese older men and women were randomly assigned to an EMS group (70.4 ± 1.8 years) or a control group (without EMS) (68.0 ± 1.4 years) (n = 7 each). We applied EMS to the VL of the right leg for 30 min at a frequency of 30 Hz, pulse duration 300 μs, and contraction/relaxation durations of seven seconds on and seven seconds off. IMCL content in the VL was quantified by 1H-magnetic resonance spectroscopy before and immediately after the EMS in the EMS group, as well as in the control group. 1H-MRS spectra with and without water suppression were taken, and calculation of IMCL contents and creatine (Cr) (mM) was performed by the LCModel software. Fasting plasma glucose and insulin values were also determined from blood samples collected before and immediately after EMS. RESULTS: In the EMS group, values for IMCL/Cr increased significantly from 4.8 ± 2.1 to 6.9 ± 2.5 (p < 0.05) and plasma glucose decreased significantly from 96.4 ± 4.0 to 93.0 ± 3.4 mg/dL (p < 0.05); whereas, insulin did not change significantly (5.6 ± 1.1 vs. 5.2 ± 1.2 μIU/mL; p = 0.43). Values for IMCL/Cr did not change significantly after resting for 30 min in the control group (4.9 ± 2.1 vs. 5.0 ± 1.1, p = 0.95). Creatine values did not change after EMS in the EMS group (63.3 ± 3.4 vs. 62.9 ± 8.4 mM, p = 0.96) or after resting in the control group (63.3 ± 7.4 vs. 65.6 ± 8.9 mM, p = 0.76). CONCLUSION: The findings suggested that a single bout of EMS induces an increase in the IMCL content in the VL of older adults. This study was supported by a Grant in Aid (KAKENHI No. 23650432) and the Descente and Ishimoto Memorial Foundation for the Promotion of Sports Science.

The effect of Ramipril and Telmisartan on blood pressure and insulin resistance in hypertensive patients

Background: Angiotensin converting enzyme (ACE) inhibitors and Angiotensin II Receptor Blockers (ARBs) have become keystones of therapy for hypertension but there are very few studies where they have been compared with each other. This study attempted to compare the effect of Ramipril and Telmisartan on Blood Pressure and Insulin Resistance in Hypertensive patients (JNC 8).Methods: An open label, randomized, prospective and comparative study of twelve- week duration was conducted on 60 patients of hypertension (JNC-8), with the collaboration of Department of Pharmacology and Department of Medicine, Government Medical College, Amritsar. Group A and B were given Telmisartan 40mg and Ramipril 2.5 mg OD respectively. Blood Pressure was recorded on every visit, whereas, fasting plasma insulin and HOMA-IR values were recorded at the baseline and at the end of the study. Fasting blood sugar was done at 0, 4 and 12 weeks.Results: At the end of 12 weeks, a significant reduction in Systolic/Diastolic blood pressure was observed in group A with a drop of ~14/9 mmHg (p&lt;0.001) and in group B too, the fall of ~11.6/7.2 mmHg was significant (p&lt;0.001). However, in inter-group comparison only SBP difference was significant between two groups (p&lt;0.05). Change in HOMA-IR value was also significant in both the groups (p&lt;0.001). The inter-group difference for HOMA-IR between both the groups (A vs B) was also statistically significant (p&lt;0.01).Conclusions: Telmisartan 40 mg OD was more effective than Ramipril 2.5 mg OD in controlling the SBP and improving Insulin resistance at the end of 12 weeks.

OR31-5 Characterization of the One-Hour Plasma Glucose and Plasma Insulin during an Oral Glucose Tolerance Test (OGTT) in Obese Hispanic Children and Adolescents Diagnosed with Prediabetes (Hba1c ≥ 5.7% &amp; ≤ 6.4%)

Background: OGTT is still considered the gold standard test to detect prediabetes and /or Type 2 diabetes (T2D). American Diabetes Association criteria for prediabetes: a) Hba1c 5.7- 6.4% b) fasting plasma glucose (FPG) ≥ 100 mg/dl and/or post-prandial PG ≥ 140, Impaired glucose tolerance (IGT) during an OGTT. In adults the 1-hour(1hr) glucose level (≥ 155 mg/dl) is a strong predictor of future T2D risk than the two-hour level and is associated with diabetes complication. The ideal cut-off for pediatrics is not established though studies have found 1hPG ≥ 132.5 mg/dl, as predictive for risk of T2D (1) Objective: a. To study the dynamic profile of Plasma Glucose (PG) and plasma Insulin (PI) values at time 0,1 and 2 hour during an OGTT b. to assess whether degree of insulin resistance in Hispanic children and adolescents can be predict an abnormal I hr glucose level. Methods: We reviewed OGTT results of 43 obese Hispanic youths; 7-18 years of age with prediabetes. PG and PI values were obtained at 0, 1 and 2hr during OGTT (glucola: dose of 1.75 g/kg body weight up to a maximum of 75 g). The Homeostasis Model Assessment of fasting insulin resistance (HOMA-IR), an index of insulin resistance was calculated using (fasting glucose (mg/dl) X fasting insulin(µIU/ml)/405) and values ≥3.4 were taken as insulin resistance(2). Independent T test was used to study differences between means for group1: HOMA-IR< 3.4 and group 2: HOMA-IR≥ 3.4. Results: Forty-three obese Hispanic youths; 7-18 years of age; mean age of 11.5 ± 0.7; BMI=42.2 ± 4.9; 47% male and 53% female. a) OGTT results: Only one subject had abnormal fasting plasma glucose, 3 subjects had IGT (7%), and 11(26%) had an abnormal 1 h PG during the OGTT b) 1hr glucose and 1hr insulin was different between HOMA-IR groups (p=0.001) even though 2-hr was not. PG: grp#1: 1hr=108 ± 27, 2hr=107 ± 33 mg/dl; grp #2: 1hr=136 ± 33, 2hr=120 ± 32. PI: grp#1: 1hr= 80 ± 61, 2hr= 78 ± 70; grp#2: 1hr= 213 ±171, 2hr= 99 ± 375. Conclusion: In our Hispanic children and adolescents, 1& 2-hr plasma insulin and plasma glucose were clearly abnormal, more so, in the HOMA- IR group ≥ 3.4. This demonstrate that at least in the IR children and adolescents, 1-hour values add value to the interpretation of the OGTT. 26 % of Hispanic children and adolescents had an abnormal 1-hr glucose which is a novel finding of our study. These results validate the recent reports of the plasma 1-hr glucose threshold ≥132.5 mg/dl in Pediatrics and prospective follow up of these Hispanic patients will be able to demonstrate the predictive value of 1 hr values of insulin and glucose to development of T2D.Reference: ADDIN EN.REFLIST 1. Manco M, Miraglia Del Giudice E, et al. 1-Hour plasma glucose in obese youth. Acta diabetologica. 2012;49(6):435-43. 2. Brar PC, Screening obese children and adolescents for prediabetes and/or type 2 diabetes in pediatric practices: a validation study. Clinical pediatrics. 2014;53(8):771-6.

SAT-149 The Metabolic Impairments Caused by Fructose and Prednisolone Intake Are Reversible After the Interruption of Exposure

Regular ingestion of fructose and continuous glucocorticoid (GC) treatment, separately, may result in metabolic adverse effects (1,2), but their combined impact is not yet understood. Thus, we aimed to evaluate the impact of a combination of fructose and prednisolone ingestion on glucose and lipid metabolism as well as the effect of the interruption of this combined treatment. Male Wistar rats were divided into five groups as follows: control (C) group, fructose (F) group (20% fructose in the drinking water), prednisolone (P) group (12.5 μg/mL prednisolone in the drinking water), fructose plus prednisolone (FP) group (a combination of fructose and prednisolone in the drinking water as for F and P groups) for 90 consecutive days. Half of the rats (group R) from the FP group were maintained for 90 more days with a discontinuation of fructose and prednisolone to monitor the parameters. The combination of fructose and GC intake led to an increase in the circulating triacylglycerol from the fourth week of treatment until the end of treatment (P<0.05, n=10). The FP group also exhibited higher abdominal adiposity and plasma insulin values, reduced insulin sensitivity, increased uricemia, and impaired hepatic redox balance that paralleled with augmented fat content in the liver (p<0.05, n=10). No major impact on blood glucose or glucose tolerance was observed in the FP group. These results observed in the FP group were associated with increased beta-cell mass (p<0.05, n=8). Moreover, the combination of sugar and GC treatment led to a reduction in the total hepatic protein kinase B (PKB) content and to a reduction in the phosphorylated 5’ AMP-activated protein kinase (AMPK) content in the epididymal adipose tissue (p<0.05, n=6). Combination of fructose and GC intake did not impact on proinflammatory protein contents in the adipose tissue. Complete cessation of treatments resulted in the normalization of plasma triacylglycerol and uric acid levels in the R group (p<0.05, n=10). Interruption of sugar and GC treatments also led to normalization of the peripheral insulin sensitivity, hepatic fat content and the hepatic redox state (p<0.05, n-10). We conclude that the combination of fructose and prednisolone intake induces a metabolic syndrome-like phenotype and that interruption of fructose and GC intake recover practically all metabolic impairments. These findings point to the risk of associating GC-based therapies with a regular intake of sweetened beverages and draws attention to the plasticity of the organism and the benefits of removing the causal factors, whenever possible. Reference: (1) Zhang et al., Nutrients. 2017 Mar 29;9(4). pii: E335. (2) Pasieka et al., Metabolites. 2016 Aug 3;6(3). pii: E24. Sources of Research Support: CNPq and CAPES.

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The relationship between high intake of rapidly fermentable carbohydrates and the subsequent response on plasma glucose, insulin sensitivity and clinical signs of laminitis in dairy heifers was studied. Ten dairy heifers with a mean body weight of 275 kg (SD 13.8 kg), were parallelly subjected (n=5/treatment group) to either a total mixed ration (TMR) low (LC, 130 g DM/kg) or high (HC, 480 g DM/kg) in cassava (starch). Results showed that mean DM intake, rectal temperature, heart rate, respiration rate and rumen contractions were not affected by the dietary treatments. All heifers fed the HC-TMR had diarrhea while all the heifers fed the LC-TMR had a pasty, soft consistency of feces. Three of the 5 heifers fed the HC-TMR displayed clinical signs of acute laminitis compared to none in the LC-TMR group. Mean postprandial rumen pH values of heifers fed the HC-TMR, but not the LC-TMR, were lower than 6.0 at all the time points measured. The reduction in rumen pH was associated with 49% greater concentration of total VFA and a concomitant shift from acetic to propionic acid and increased rumen lactic acid concentrations. Moreover, the HC-TMR caused greater plasma insulin levels and insulin resistance. The three laminitis animals had 1.9 greater basal plasma insulin values and a 46% lower insulin sensitivity values, respectively compared to their non-laminitis counterparts fed the HC-TMR. Insulin sensitivity was shown to be associated with clinical signs of laminitis in heifers only when plasma insulin concentrations were greater than ~ 700 pmol/L.

Low serum vitamin D associated with prediabetes

Background: This study is performed to evaluate vitamin D levels and metabolic parameters in patients with prediabetes, compared to healthy controls.Methods: This study was conducted between October and December 2013 in İstanbul Haseki Training and Research Hospital, internal medicine department. We enrolled total 247 individuals, 122 prediabetic (PreDM) patients (79 female, 43 male) and 125 control healthy individuals (94 female, 31 male) between 20-65 ages who admitted randomizely to the outpatient clinic with non spesific complaints. FPG, urea, creatinine, calcium, phosphate, albumin, alkaline phosphatase, thyriod stimulan hormon (TSH), 25 hydroxy vitamin D (25[OH]D), parathormon (PTH), c-peptide, insulin were analyzed.Results: Pre DM patients’ mean plasma 25[OH]D level (25.7±14.9 nmol/l) was statistically lower than the control group (31.4±17.8 nmol/l). Pre DM patients’ mean plasma insulin, c-peptide, calcium, PTH, HOMA-IR (10.8±8.7 IU/ml, 3.3±2.0 ng/ml, 9.7±0.4 mg/dl, 56.5±22.5 pg/ml, 3.0±2.68, respectively) levels were statistically higher than the control group’s (6.3±3.8 IU/ml, 2.4±1.0 ng/ml, 9.5±0.5 mg/dl, 44.0±16.0 pg/ml, 1.4±0.8, respectively) mean levels. There were negative correlations between 25[OH]D and BMI (r:- 0.13, p:0.03), FBG (r:- 0.14, p:0.02) and plasma insulin (r:-0.16, p:0.01) values. A multivariate logisitic regression model for prediabetes was performed and variables as female gender, age, HOMA-IR and lower 25[OH]D values were risk factors for pre DM.Conclusions: Serum low 25[OH]D level correlated with insulin resistance and metabolic parameters in prediabetic patients. Also, it may play an important role in the development of type 2 diabetes.