QUICKI Index Research Articles

Relationship between per-fluoroalkyl and polyfluoroalkyl substance exposure and insulin resistance in nondiabetic adults: Evidence from NHANES 2003–2018

BackgroundStudies have linked per- and polyfluoroalkyl substances (PFAS) to chronic metabolic diseases. However, the relationship between PFAS exposure and insulin resistance (IR), a key pathophysiological basis of these metabolic diseases, in nondiabetic individuals have yet to be determined. MethodsThis study analyzed data from 3909 participants (aged ≥20) from the NHANES 2003–2018 to investigate the associations between serum levels of seven PFAS and and IR indicators, including including HOMA-IR, HOMA-β, fasting insulin, QUICKI, and TyG index. Linear and logistic regression models were used, along with a restricted cubic spline to assess dose-response. Weighted quantile sum (WQS) regression and quantile g-computation (qgcomp) models were used to assess the association between mixed PFAS exposure and IR. ResultsLinear regression revealed that elevated exposure to PFOS [β (95 % CI): 0.04 (0.02, 0.06)], PFOA [0.04 (0.01, 0.06)], and Me_PFOSA_AcOH [0.04 (0.02, 0.06)] was associated with a higher TyG index in adults. Notably, Me_PFOSA_AcOH was negatively associated with IR when assessed by HOMA-IR >2.6 [OR (95 % CI): 0.88 (0.79, 0.98)], although this was not supported by linear regression findings. When IR was defined by a TyG index >8.6, exposure to the highest quartiles of PFOS, PFOA, and Me_PFOSA_AcOH was associated with an increased risk of IR by 63 %, 42 %, and 85 %, respectively [1.63 (1.21, 2.20); 1.42 (1.06, 1.92); 1.85 (1.37, 2.50)]. PFOS, PFOA, and Me_PFOSA_AcOH demonstrated a nonlinear dose-response relationship with IR risk. The WQS and qgcomp models revealed significant positive correlations with the TyG index. ConclusionMixed PFAS exposure in US nondiabetic adults was positively associated with IR, as indicated by the TyG index, particularly for PFOS, PFOA, and Me_PFOSA_AcOH. Further research is needed to establish causality, and reinforcing environmental risk mitigation strategies to reduce PFAS exposure is recommended.

Investigating the Correlation Between Cognitive Function and Fasting Blood Sugar, Fasting Insulin Level and Insulin Sensitivity in Patients With Multiple Sclerosis.

There has been a surge in interest in identifying the factors that impact cognitive impairment (CI) in patients with multiple sclerosis (MS). The purpose of our study was to examine the correlation between fasting blood sugar (FBS), fasting insulin level, as well as insulin sensitivity and cognitive function in patients with MS. A total of 85 patients with MS enrolled in this cross-sectional study. Insulin sensitivity (IS) was determined using the quantitative insulin sensitivity check index (Quicki) formula. Cognitive function was evaluated using the Persian version of the Brief International Cognitive Assessment for MS (BICAMS). Spearman correlation test was employed to examine the correlation between cognition and FBS, insulin and IS. The mean ± SD age of the participants was 39.4 ± 10.2 years, and 62 (72.9%) were female. The participants had a FBS level of 87.05 ± 11.73 mg/dL, insulin level of 10.14 ± 7.57 μU/mL and a Quicki index of 0.36 ± 0.05. A higher score on the BVMT-R and BVMT-R-Delayed subtests showed a significant negative correlation with FBS (r: -0.32; p: 0.003 and r: -0.31; p: 0.004, respectively). Conversely, a significant negative correlation (r: -0.24; p: 0.031) was observed between higher fasting insulin levels and the CVLT_II score. IS showed a positive correlation with the CVLT-II (r: 0.24; p: 0.027) and BVMT_R (r: 0.21; p: 0.054) subtests. Our data indicate that elevated fasting glucose, developed fasting insulin levels and reduced insulin sensitivity may serve as potential predictors for CI in patients with MS.

A single bout of physical exercise improves 1-hour post-load plasma glucose in healthy young adults.

Physical exercise is a key component in the treatment of type 2 diabetes and plays an important role in maintaining a healthy glucose metabolism even in healthy subjects. To date, no studies have investigated the effect of a single bout of aerobic physical exercise on glucose metabolism in young, moderately active, healthy adults. We performed an OGTT 7 days before and 24h after a single bout of physical exercise, to evaluate 1-hour post-load plasma glucose and surrogate indexes of insulin sensitivity and insulin secretion. Glucose levels were significantly reduced after exercise at baseline and one hour after glucose load; similarly, insulin was significantly lower 1h after glucose load. We found a significant increase in the Matsuda index, confirmed by OGIS index, QUICKI index, and by significant reduction in HOMA-IR. Conversely, we observed a trend to increase in HOMA-B. This is the first study to evaluate the effect of a single bout of exercise on 1-hour glucose levels following OGTT. We found a significant reduction in 1-hour glucose levels following OGTT together with an increased insulin sensitivity. A single 30-minute bout of aerobic exercise also seemed to improve the insulin secretion pattern. Modifications in beta cell secretory capacity during exercise are likely secondary to an improvement in insulin action in insulin dependent tissues.

Impaired insulin sensitivity measured by estimated glucose disposal rate is associated with decreased myocardial mechano-energetic efficiency in non-diabetic individuals

Background and aimsImpaired myocardial mechano-energetic efficiency (MEE) has been associated with cardiac insulin resistance measured by dynamic positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) combined with euglycemic–hyperinsulinemic clamp. Estimate glucose disposal rate (eGDR) index has a good correlation with whole-body insulin sensitivity. It remains unsettled whether eGDR index is a suitable proxy of cardiac insulin sensitivity as well as its association with myocardial MEE. The aims of this study were: 1) to compare eGDR index with HOMA-IR, QUICKI and FIRI indexes for association with myocardial glucose metabolic rate (MrGlu); and 2) to determine the association of eGDR index with myocardial MEE. MethodsWe evaluated MrGlu using PET with 18F-FDG combined with euglycemic–hyperinsulinemic clamp in 50 individuals without history of coronary heart disease. Myocardial MEE per gram of left ventricular mass (MEEi) was measured in 1181 subjects by echocardiography. eGDR (mg kg-1/min) was calculated as: 21.158 - (0.09 × waist circumference in cm) - (3.407 × hypertension, 1 = yes 0 = no) - (0.551 × HbA1c%). ResultseGDR index was more strongly associated with myocardial MrGlu than HOMA-IR, QUICKI, and FIRI indexes (r = -0.662, r = -0.492, r = 0.570, and r = -0.492, respectively). Individuals in the lower tertiles of eGDR exhibited a significant reduction of MEEi as compared to those in the highest tertile (P < 0.001). In a stepwise multivariate linear regression analysis eGDR index was the major determinant of MEEi independently of well-established cardio-metabolic risk factors. ConclusionsThese data suggest that the eGDR index may be a useful marker to identifying individuals at high cardiovascular risk.

Effects of High-Intensity Intermittent Training on Metabolic Parameters and Irisin Levels in High-Fat-Fed Rats

Objective: To investigate the effects of high-intensity intermittent training (HIIT) on preventing significant weight gain and provide scientific theoretical support and practical guidance for reducing the occurrence of obesity. Methods: Twenty-four Sprague-Dawley rats were randomly divided into four groups: the control sedentary group (CS), the high-fat sedentary group (HS), the high-fat continuous exercise group (HE), and the high-fat intermittent exercise group (HI). The HE and HI groups underwent five days of continuous low-intensity exercise and eight weeks of high-intensity intermittent exercise. Weekly monitoring included measurements of food intake and body weight. An automatic biochemical analyzer was used to assess blood lipid and glucose levels, while ELISA kits measured serum insulin and irisin content. H&amp;E staining was used to observe adipocyte size. Results: In the HS group, body weight, blood lipid levels, blood glucose levels, and adipocyte size significantly increased, while the QUICKI index decreased. In the HI group, body weight, blood lipid levels, blood glucose levels, and adipocyte size decreased, and the QUICKI index increased. The effects of high-intensity intermittent exercise were superior to those of continuous low-intensity exercise. In the HI group, serum irisin levels did not change significantly after exercise, while in the HE group, there was a slight upward trend in irisin levels. Conclusion: A high-fat diet induced abnormal metabolism in rats. HIIT effectively prevents metabolic abnormalities induced by a high-fat diet, and its effects are more pronounced than those of low-intensity exercise. HIIT stimulates the secretion of blood irisin, affecting secretion levels, and may represent a novel mechanism for maintaining metabolic homeostasis. This has important implications for controlling significant weight gain.

Changes in Metabolic and Inflammatory Markers after a Combined Exercise Program in Workers: A Randomized Controlled Trial.

We investigated the effects of a 16-week combined exercise training on body composition, metabolic and inflammatory markers in sedentary middle-aged workers. We also assessed whether significant alterations in metabolic markers were associated with changes in health-related outcomes. This randomized controlled trial involved 46 participants randomly allocated into control and exercise groups. The exercise group performed 16-week combined aerobic and resistance training for 75 min/session, 3 times/week. Fasting blood samples were collected at baseline and after 16-week intervention to determine lipid profile, metabolic and inflammatory markers as primary outcomes. A total of 36 participants completed the intervention (53.70 ± 6.92 years old) (n = 18 in each group). Waist circumference (interaction effect: F = 7.423, p = 0.002), fat mass (interaction effect: F = 5.070, p = 0.011), and muscle mass (interaction effect: F = 5.420, p = 0.007) were improved in the exercise group compared to the control group. Fasting glucose increased after the 16-week follow-up (time effect: F = 73.253, p < 0.001), without an intergroup difference. Insulin levels were greater in the control compared to exercise group (group effect: F = 6.509, p = 0.015). The control group tended to increase the HOMA-IR index (interaction effect: F = 3.493, p = 0.070) and to decrease the QUICKI index (interaction effect: F = 3.364, p = 0.075) to a greater extent compared to the exercise group. Exercise group reduced leptin (interaction effect: F = 11.175, p = 0.002) and adiponectin (interaction effect: F = 4.437, p = 0.043) concentrations in a greater magnitude than control group. IL-6 (time effect: F = 17.767, p < 0.001) and TNF-α (time effect: F = 9.781, p = 0.004) concentrations decreased after the intervention, without an intergroup difference. IL-17A levels increased in the control compared to exercise group (interaction effect: F = 5.010, p = 0.033). Effects on adiponectin, IL-6 and IL-17A levels seem to depend on baseline BMI, age, and sex. Percentage changes in leptin correlated positively with changes in HOMA-IR index in the exercise (r = 0.565, p = 0.015) and control (r = 0.670, p = 0.002) groups. A combined training program can be an effective strategy to improve body composition and inflammatory markers and prevent marked reductions in insulin sensitivity among middle-aged workers.

239 Variation in muscle protein synthesis in growing gilts is partially associated with insulin resistance and sensitivity

Abstract Pigs with similar body weight (BW), same genetic background and sex vary in protein deposition (PD) overgrowth. We aimed to study metabolic factors influencing PD in 65 kg BW gilts. Gilts were fed ad libitum a diet balanced to maximize PD. Dual X-rays were conducted to estimate body protein mass on d 1 and 21, allowing calculation of PD by difference. On d 23, the gilts were categorized into Low (157 g/d) and High (219 ± 9.97 g/d) PD groups. In each group, eight pigs underwent jugular vein cannulation. After a 48-h recovery period, where they were fed at 90% of the measured feed intake, they were fasted for 8 h. All pigs were then given a 300 g meal at time 0, and blood samples were collected at 10, 15, 20, 30, 40, 50, 60, 75, 90, 120, 150, 178, and 178 min, to study insulin and glucose responses. At 180 min post-meal, a solution of L-13C valine was administered i.v. (18 ape – flooding dose), and liver, duodenum, and longissimus dorsi muscle samples were collected within 5 minutes of slaughter. The fractional synthesis rate (FSR, %/d), absolute synthesis rate (ASR, g/d), ribosomal capacity for protein synthesis (Cs), and the efficiency of protein synthesis (KRNA) based on total RNA concentration in skeletal muscle were calculated. The insulin resistance index (HOMA-B) and insulin sensitivity index (QUICKI) were also determined. The difference between Low and High PD gilts was compared using a F-test. The longissimus dorsi muscle exhibited a 31% greater (P = 0.01) FSR in High compared with Low PD group. No significant differences were observed in the FSR of the jejunum and liver. High PD gilts showed a 55% greater ASR in whole-body muscles (P = 0.003) and 42% greater ASR in the liver (P = 0.04) compared with Low PD gilts, with no difference for the ASR in the jejunum. The KRNA in the longissimus dorsi was 48% greater in High PD gilts (P = 0.01), with no differences in KRNA for the jejunum or liver. Cs did not differ between Low and High PD gilts. The QUICKI index tended to be greater in High PD gilts (P = 0.10). Spearman’s correlation revealed that longissimus dorsi FSR was negatively correlated with the HOMA-B index (r = -0.53; P = 0.04). Increases in the HOMA-B index tended to be associated with greater KRNA (r = -0.49; P = 0.06). These correlations highlight the complex interplay of metabolic and hormonal factors involved in the observed differences in protein synthesis and efficiency in growing gilts. Insulin resistance and sensitivity may play a role in influencing skeletal muscle PD variations.

Dysglycaemia prediction using readily available clinical, anthropometric, and biochemical measurements

Background & aimsA 2-hour postprandial glucose (2-h PG) concentration greater than 140 mg/dL is associated with a greater risk of type-2 diabetes (TD2) and cardiovascular disease. An oral glucose tolerance test (OGTT) is the method most used for detecting either prediabetes or T2D; however, its use in clinical practice is limited due to the 2-h testing period. Therefore, the aim of the study was to assess dysglycaemia, through a prognostic assessment of body composition, biochemical and clinical parameters as predictors of an abnormal 2-h PG. MethodsParticipants underwent a physical examination in which their anthropometric measurements were obtained, and a blood sample was taken for biochemical and hormonal analysis. All patients underwent a 75-g OGTT after 8 h of fasting, and the levels of glucose and insulin were measured. The results were compared statistically by dividing the participants’ 2-h postprandial glucose (2-h PG) into the following groups: normoglycaemia (NGT), < 140 mg/dL; prediabetes, 140 to 199 md/dL; and T2D, ≥ 200 mg/dL. ResultsAmong 381 participants 220 belonged to the NGT group, 131 to the prediabetes group, and 30 to the diabetes group. As expected, fasting glucose, 1-h PG, 2-h PG, haemoglobin glycosylated (A1c) and QUICKI index were significantly higher as the stages of glycaemic dysregulation progressed. Interestingly, 53.4% of the NGT group had a monophasic type of curve in the OGTT and a QUICKI index of 0.32. Subsequently, associative models of 2-h PG were performed, and 4 models were obtained. The best model had a coefficient of determination of 0.747 (p = 0.001) and included the variables A1c, C-reactive protein (CRP), body fat mass, and total cholesterol. ConclusionsThe use of A1c, CRP, body fat mass, and total cholesterol in a model might associate with 2-h PG without the need for a 2-h OGTT.

Biochemical Evaluation of Hypoglycemic Effect of Stingless Bee Pollen in High Fat Diet Fed-Low Dose STZ Induced Experimental Type 2 Diabetes in Rats

The present study was aimed to evaluate the hypoglycemic properties of stingless bee pollen in HFD fed-low dose STZ induced experimental type 2 diabetes in rats. Healthy, male wistar rats weighing between 160-180g were used in the present study. The rats were divided into four groups of six animals each. Group I served as control rats fed with normal pellet diet. Group II fed with a high fat diet for two weeks and intraperitoneally injected with a low dose of STZ (35mg/kg. b.w.) to induce experimental type 2 diabetes. Group III were induced with diabetes and treated with stingless bee pollen (100 mg/kg b.w/rat/day) for oral administration, respectively. Group VI was diabetic rats treated with metformin (50mg/kg.b.w.), a standard drug used for the treatment of type 2 diabetes. Body weight, food and fluid consumption were recorded periodically. At the end of the experimental period, the animals were starved overnight and OGTT was performed. After 30 days of experimental period, the animals were overnight fasted, anesthetized and scarified by cervical decapitation. Blood was collected with and without anticoagulants for the separation of plasma and serum, respectively. The biochemical analysis performed includes fasting blood glucose, HbA1c, plasma insulin, C-peptide and urine sugar. Insulin resistance, β-cell function and insulin sensitivity were also manipulated from HOMA-IR, HOMA β-cell function and QUICK-I index. The results of the present study clearly indicate that the stingless bee pollen significantly decreased the levels of fasting blood glucose and HbA1c. Stingless bee pollen improves the plasma insulin and C-peptide levels. From the arithmetic data, stingless bee pollen reduces the insulin resistance and enhances β-cell function and insulin sensitivity. The antidiabetic efficacy was more pronounced in rats treated with stingless bee pollen. The results obtained clearly evidenced that the stingless bee pollen significant antidiabetic properties used in the present study.&#x0D; Keyword: Type 2 diabetes mellitus, High fat diet, stingless bee pollen, Antidiabetic properties

Insulin resistance prior to term age in very low birthweight infants: a prospective study

ObjectiveTo explore the glucose-related hormone profile of very low birthweight (VLBW) infants and assess the association between neonatal hyperglycaemia and insulin resistance during the admission period.DesignA prospective observational study—the Very...

Understanding the predictive accuracy of the InsuTAG index over other surrogate indices in normoglycaemic, non-obese males from Southern India

We aimed to evaluate the predictive accuracy of InsuTAG index against M value of the hyperinsulinaemic-Euglycaemic clamp (HEC) procedure and fasting surrogate indices of insulin sensitivity/resistance in young, normoglycaemic, Asian Indian males. HEC studies were done in young (mean age 19.7 ± 1 years), non-obese (mean BMI 19.2 ± 2.6 kg/m2), normoglycemic Asian Indian males (n = 110) and the M value was calculated. Surrogate indices namely InsuTAG index, HOMA-IR, FG-IR, QUICKI and McAuley index were calculated. Pearson’s correlation and ROC-AUC at 95% CI were applied. Significant negative correlation was observed for InsuTAG index with the M value (r − 0.23, p = 0.01), McAuley index (r − 0.65, p < 0.01), QUICKI (r − 0.34, p < 0.01) and FGIR (r − 0.35, p < 0.01). Significant positive correlations of InsuTAG index were observed for BMI and waist circumference. The ROC-AUC was higher for InsuTAG index (0.75) than FGIR (0.30), QUICKI (0.31), and McAuley index (0.20). The InsuTAG cut-off value ≥ 19.13 showed 66.7% sensitivity and 69.2% specificity in this study group.

Whole-Body Cryotherapy Improves Asprosin Secretion and Insulin Sensitivity in Postmenopausal Women-Perspectives in the Management of Type 2 Diabetes.

Type 2 diabetes (T2DM) is a global problem. The effect of whole-body cryotherapy (WBC) on metabolism in humans is postulated. The aim of this study was to determine the effect of WBC on asprosin concentrations, glucose homeostasis and insulin resistance in postmenopausal women with T2DM. Changes in fasting blood glucose (FBG), glycated haemoglobin (HbA1c), insulin, asprosin, insulin-resistance indices (HOMA-IR, Quicki), the triglyceride-glucose index (TyG) and C-reactive protein (CRP) were determined. Determination was carried out after 30 WBCs (3 min, -120 °C), applied in six series of five treatments, with 2-day breaks in postmenopausal women with T2DM and the results were compared to changes in postmenopausal women without T2DM (CON). Blood was collected before 1 WBC (T0), after 30 WBCs (T1) and 2 weeks after their completion (T2). In the T2DM group, there was a significant decrease in FBG and HbA1c in T1 and T2, as well as a significant decrease in insulin, HOMA-IR and CRP, and an increase in the Quicki index in T2. In the CON group, the concentration of asprosin at T2 was significantly lower than at T0. There was a significantly positive correlation between asprosin and FBG and HOMA-IR, and a trend towards a decrease of asprosin concentration in T2 in postmenopausal women with T2DM.

THU074 Plasma Spexin In Metabolic Syndrome Related To Adult Growth Hormone Deficiency: A Cross-sectional Study

Abstract Disclosure: E. Vergani: None. A. Oliva: None. C. Bruno: None. D. Currò: None. A. Mancini: None. Adult growth hormone deficiency (aGHD) shares with metabolic syndrome some clinical features such as higher fat mass percentage, increased total cholesterol, LDL, triglycerides, reduced HDL, and higher risk of developing type 2 diabetes mellitus and cardiovascular complications. Spexin, also known as neuropeptide Q, is a 14-aminoacid polypeptide, related to the galanin-kisspeptin family, produced in several human tissues. It is also secreted along with insulin by pancreatic beta cells; via paracrine effects they blunted reciprocal secretion. In type 2 diabetes mellitus spexin is closely correlated to fasting and post prandial glucose, glycosylated hemoglobin and HOMA index. Moreover, spexin infusion seems to ameliorate ALT and AST levels in non-alcoholic fatty liver disease. Given its controversial role in condition of metabolic impairment, we aimed to evaluate spexin plasmatic levels in aGHD. Thirty-eight subjects were included in the study, 18 aGHD patients (7 females and 11 males) and 20 healthy controls (12 females and 8 males). aGHD was diagnosed by a GHRH plus arginine test. Etiologies of GHD were as follows: 7 empty sellas, 5 post-surgical hypopituitarism, and 6 idiopathic with negative MRI scans. GHRH plus arginine stimulation tests were repeated twice in idiopathic aGHD to confirm the diagnosis. They were evaluated for glucose and insulin, HOMA and QUICKI index, total/LDL/HDL cholesterol, triglycerides, uric acid and IGF-1. Spexin was measured by ELISA, according to manufacturers’ protocols. Fat mass percentage was evaluated by DXA. Mean±SEM age of aGHD group was 59.7±2.7 years, while BMI was 30.2±2.2 kg/m2; control group aged 47.1±2.5 years, while BMI was 24.5±0.9 kg/m2. As expected, aGHD patients showed higher HOMA index, triglycerides and lower HDL than controls. Furthermore mean±SEM fat mass percentage was significantly higher in aGHD than controls (44.41±3.15 vs 32.2±3.64). Spexin levels were similar in the two groups (aGHD 1.17±0.21 vs controls 1.25±0.10 ng/ml). significant correlations were found in both populations. These results, although preliminary, seem to exclude a possible role of spexin in aGHD; however, spexin could represent another possible element of differentiation between aGHD and metabolic syndrome. Such controversial topic requires further evaluations. Presentation: Thursday, June 15, 2023

ЛЕПТИНОРЕЗИСТЕНТНОСТЬ И ЕЕ КЛИНИКО-ПРОГНОСТИЧЕСКУЮ ЗНАЧИМОСТЬ ВО ВЗАИМОСВЯЗИ С МЕТАБОЛИЧЕСКИМИ НАРУШЕНИЯМИ В ГОСПИТАЛЬНОМ ПЕРИОДЕ ИНФАРКТА МИОКАРДА

Introduction. Leptin resistance (LR) is characterized by a weakening of the positive metabolic effect of leptin, despite its elevated level, while maintaining some of the pleiotropic effects, including those on the cardiovascular system. However, since most of the data have been obtained in cellular and animal models, the role of LR in cardiovascular diseases remains unclear. The lack of precise diagnostic criteria for assessing LR limits the study of this phenomenon. As a result, data on the incidence and contribution of LR in MI are critically scarce today, in addition, they are extremely contradictory. Purpose: to evaluate the prevalence of LR and its clinical and prognostic significance in conjunction with metabolic disorders in the hospital period of myocardial infarction (MI). Materials and methods. The study included 114 men with an established diagnosis of ST elevation MI. Patients on the 1st and 12th day of MI measured the concentration of leptin, the leptin receptor. The free leptin index (FLI) was calculated as the ratio of leptin concentration (ng/mL) to the concentration of soluble leptin receptor (ng/mL) multiplied by 100. LR was recorded at leptin &gt; 6.45 ng/mL and LL &gt;25. Assessment of glucose, lipid spectrum (total cholesterol, TAG, LDL-C, VLDL-C, HDL-C, FFA) in blood serum was performed using standard test systems from Thermo Fisher Sientific on an automatic biochemical analyzer Konelab 30i (Finland) , the content of C-peptide and insulin were determined using enzyme immunoassay (Monobind, USA) according to the protocol established by the manufacturer. To determine insulin resistance (IR), the QUICKI index was calculated, the severity of IR was assessed according to A. Katz et al. A comparative analysis of clinical and anamnestic characteristics and cardiovascular prognosis between patients with and without PR was carried out. Data analyzed using Statistica 10.0. Results. In patients with MI in the whole group in the hospital period, there was an increased content of leptin relative to the reference interval of 2.0-5.6 ng/ml. On the 1st and 12th days of the disease, the leptin concentration in patients with MI was 11.6 [6.6;20.5] ng/ml and 11.5 [5.4;13.9] ng/ml, respectively. . The content of the leptin receptor did not go beyond the established reference interval. LSI on the 1st day of the disease was 32.7 [14.3; 70.5], on the 12th day - 31.9 [16.2; 64.5]. The prevalence of LR in the hospital period for MI was 64%. LR was associated with CVD risk factors - hereditary burden for cardiovascular pathology (p=0.02), arterial hypertension (p=0.01), dyslipidemia (p=0.001), obesity (p=0.001). When assessing the metabolic profile, a statistically significant increase in the content of glucose (p=0.02), insulin (p=0.02) and C-peptide (p=0.03) on the 1st day of MI, insulin (p=0 .01) and C-peptide (p=0.03) on the 12th day of the disease, a decrease in the QUICKI index (p=0.03) throughout the hospital period in patients with PR compared with patients without PR. In the group of patients with PR, 45 people (61.8%) had a moderate and severe degree of IR, in patients without PR - in 12 patients (29.2%). When conducting a correlation analysis, a significantly significant direct relationship was found between the level of insulin on the 12th day of MI and LSI (r=0.509, p=0.02), as well as an inverse correlation between the QUICKI index on the 12th day and LSI (r= -0.367, p=0.01). Among the studied parameters of lipid metabolism, only the content of FFA on the 1st day of the disease in the group of patients with LR was higher than in the group without LR (p=0.03). Patients with LR were more often prone to early postinfarction angina (p=0.03), recurrent MI (p=0.001), rhythm and conduction disturbances (p=0.03) during the hospital period of MI. Prognostic significance in relation to the risk of adverse cardiovascular events in the hospital period of MI, according to logistic regression analysis, had LSI both on the 1st and 12th days of the disease, as well as FFA levels on the 1st day of the disease. Conclusion. Patients with MI are characterized by a high prevalence of LR in the hospital period. LR is associated with CVD risk factors, metabolic disorders, and IR formation. The identified features in the presence of LR can probably contribute to the development of adverse cardiovascular events in the hospital period of MI.

Calcium-phosphate homeostasis and insulin resistance in men

Background and aimsData on P homeostasis in insulin resistance (IR) are still conflicting. We investigated calcium-phosphate homeostasis parameters in men with/without IR. Methods and results177 volunteers (aged 61.62 ± 12.11), whose body mass index (BMI) was 29.97 ± 6.35, were studied. On fasting blood and spot urine samples, we measured serum creatinine, sodium (sNa), potassium (sK), chloride (sCl), calcium (sCa), phosphate (sP), alkaline phosphatase total activity (ALP), glucose, insulin, parathyroid hormone (PTH), 25-hydroxy-vitamin D [25(OH)D], and urinary electrolytes corrected for creatinine (uNa/Cr, uK/Cr, uCl/Cr, uCa/Cr, and uP/Cr). Through the QUICKI index, we separated subjects with (IR+, n = 68) or without (IR-, n = 109) IR, and their parameters were compared. Associations were assessed by age-adjusted partial correlation, whose coefficients were compared by Fisher's transform.IR + had higher sP (3.54 ± 0.65 vs. 3.35 ± 0.47, p = 0.044) and lower uCa/Cr levels (0.073 ± 0.056 vs. 0.095 ± 0.072, p = 0.047) than IR-. BMI correlated with sP (r = 0.21, p < 0.05) and PTH (r = 0.29, p < 0.01). QUICKI negatively correlated with sCa (r = −0.22, p < 0.05) and positively with uCa/Cr (r = 0.21, p < 0.05), in turn correlating with uNa/Cr (r = 0.45, p < 0.001). In both groups, uCa/Cr correlated with eGFR and uNa/Cr (p < 0.05 to p < 0.001). In IR + only, sP correlated with BMI, PTH with insulin, and uP/Cr (p < 0.05 for all). IR+ and IR-coefficients differed (p < 0.05 to p < 0.001) for the correlation of sP with BMI and of PTH with insulin and uP/Cr. ConclusionThe higher sP and lower uCa/Cr levels found in men with IR + suggest that IR could modulate calcium-phosphate homeostasis, likely by affecting their renal handling.

Effects of virgin coconut oil consumption on serum brain-derived neurotrophic factor levels and oxidative stress biomarkers in adults with metabolic syndrome: a randomized clinical trial

ABSTRACT Background and aim Metabolic syndrome is associated with health conditions and neurological disorders. Brain-derived neurotrophic factor (BDNF) plays a protective role on the nervous system. Decreased levels of BDNF have been shown in MetS and neurodegenerative diseases. There is promising evidence regarding the anti-inflammatory antioxidant, and neuroprotective properties of virgin coconut oil (VCO). The aim of this study was to evaluate the effects of VCO consumption on serum BDNF levels, oxidative stress status, and insulin resistance in adults with MetS. Methods This randomized controlled clinical trial was conducted on 48 adults with MetS aged 20–50 years. The intervention group received 30 ml of VCO daily to substitute the same amounts of oil in their usual diet. The control group continued their usual diet. Serum BDNF levels, total antioxidant capacity (TAC), malondialdehyde (MDA) as well as HOMA-IR and QUICKI index were measured after four weeks of intervention. Results VCO consumption significantly reduced serum levels of MDA (p = .01), fasting insulin (p < .01) and HOMA-IR index (p < .01) and increased serum TAC (p < .01) and QUICKI index (p = .01) compared to the control group. Serum BDNF levels increased significantly in VCO group compared to the baseline (p = .02); however, this change was not significant when compared to the control group (p = .07). Conclusion VCO consumption improved oxidative stress status and insulin resistance and had a promising effect on BDNF levels in adults with MetS. Further studies are needed to understand the long-term effects of VCO consumption.

Lower serum zinc level is associated with higher fasting insulin in type 2 diabetes mellitus (T2DM) and relates with disturbed glucagon suppression response in male patients

AimsZinc ion can play critical role in glycemic control in diabetes mellitus (DM), contributing to both insulin synthesis and secretion. In this study, we aimed to investigate the level of zinc in diabetic patients and its association with glycemic parameters, insulin, and glucagon level. Methods: 112 individuals (59 cases of type 2DM and 53 non-diabetic controls) were included in this study. Biochemical parameters (FBG, 2hpp, HbA1C), and zinc level in the serum were measured using colorimetric assays. Insulin and glucagon were measured by ELISA method. HOMA-IR, HOMA-B, reciprocal HOMA-B, and Quicki indices were calculated using appropriate formula. For further analysis, patients were divided into two groups: high (>135.5 μg/dl) and low (<135.5 μg/dl) zinc. Glucagon suppression was considered yes if 2hpp glucagon < fasting glucagon. Results: Our results showed that serum Zn level in type 2 DM patients was lower than control (P value=0.02). Patients with lower Zn had higher fasting insulin (P value=0.006) and higher β-cell activity index (HOMA-B, p value=0.02), however fasting glucagon and parameters of hyperglycemia (FBG, 2hpp, Hba1C) were not different. Moreover, insulin sensitivity and resistance indices (Quicki, HOMA-IR,1/HOMA-IR) showed non-significantly improved status in high Zn group. We found non-significant association between glucagon suppression and Zn level in both genders (N = 39, p value = 0.07), however, it was significant in males (N = 14, p value = 0.02). Conclusion: Altogether, our results indicated reduced serum Zn in type 2DM can exacerbate hyperinsulinemia and glucagon suppression (only significant in the male), highlighting its importance in type 2DM control.

RAS BLOCKERS PLUS CCB COMBINATIONS ON HOMA-IR, HOMA-B, HOMA-S AND QUICKI INDICES IN PREDIABETIC HYPERTENSIVE PATIENTS, A RANDOMIZED 12-WEEK OPEN-LABEL COMPARATIVE STUDY

Objective: Hypertensive patients often suffer from other metabolism related comorbidities characterized by insulin resistance (e.g., diabetes mellitus, metabolic syndrome). Dual combination treatment is advised with current treatment guidelines for the management of Hypertension. ARB or ACE-i plus CCB combinations are considered to have a beneficial effect on glucose homeostasis. We present comparative data of the effect of delapril/manidipine versus telmisartan/amlodipine versus valsartan/amlodipine combination treatments, in HOMA-IR, HOMA-B, HOMA-S and QUICKI indices before and after a 12-week treatment, in hypertensive prediabetic patients. Design and method: Data were collected from 158 patients from the outpatient clinic for patients with lipid disorders, hypertension and diabetes of our hospital, during the period 2014-2018. A total of 53 patients was randomized in the delapril/manidipine (DEL/MANI) group 30/10 mg per day while 51 patients had been randomized in the group of telmisartan/amlodipine (TEL/AMLO) 80/5mg per day and 54 patients in the valsartan/amlodipine (VAL/AMLO) 160/5 mg per day. All patients successfully completed the study. Baseline characteristics are presented in Table 1A. Results: The resulting alternations in HOMA-IR, HOMA-B, HOMA-S, QUICKI, before and after the 12-week treatment are presented on Table 1B for all treatment groups. Conclusions: comparison between the treatment groups showed a statistically significant difference in the change of HOMA-IR (from the beginning of treatment to its end) between the TEL/AMLO treatment group and the DEL/MANI treatment group (p-value&lt;0.05), with increased insulin sensitivity in the TEL/AMLO group. Furthermore, HOMA-B was significantly increased in the DEL/MANI group compared with the TEL/AMLO group (p&lt;0.05). No other significant changes were evident. Patients in the TEL/AMLO group had significantly lower insulin resistance as shown by the HOMA-IR index compared with the patients that received VAL/AMLO (p &lt;0.001). Furthermore, QUICKI index was significantly increased in the TEL/AMLO group compared with the VAL/AMLO group (p&lt;0.01).

Assessment of circulating insulin using liquid chromatography-mass spectrometry during insulin glargine treatment in type 2 diabetes: Implications for estimating insulin sensitivity and β-cell function.

To determine the potential impact of the cross-reactivity of insulin glargine U-100 and its metabolites on insulin sensitivity and β-cell measures in people with type 2 diabetes. Using liquid chromatography-mass spectrometry (LC-MS), we measured concentrations of endogenous insulin, glargine and its two metabolites (M1 and M2) in fasting and oral glucose tolerance test-stimulated plasma from 19 participants and fasting specimens from another 97 participants 12 months after randomization to receive the insulin glargine. The last dose of glargine was administered before 10:00 PM the night before testing. Insulin was also measured on these specimens using an immunoassay. We used fasting specimens to calculate insulin sensitivity (Homeostatic Model Assessment 2 [HOMA2]-S%; QUICKI index; PREDIM index) and β-cell function (HOMA2-B%). Using specimens following glucose ingestion, we calculated insulin sensitivity (Matsuda ISI[comp] index) and β-cell response (insulinogenic index [IGI], and total incremental insulin response [iAUC] insulin/glucose). In plasma, glargine was metabolized to form the M1 and M2 metabolites that were quantifiable by LC-MS; however, the analogue and its metabolites cross-reacted by less than 100% in the insulin immunoassay. This incomplete cross-reactivity resulted in a systematic bias of fasting-based measures. By contrast, because M1 and M2 did not change following glucose ingestion, a bias was not observed for IGI and iAUC insulin/glucose. Despite glargine metabolites being detected in the insulin immunoassay, dynamic insulin responses can be used to assess β-cell responsiveness. However, given the cross-reactivity of the glargine metabolites in the insulin immunoassay, fasting-based measures of insulin sensitivity and β-cell function are biased.

A discriminant analysis of plasma metabolomics for the assessment of metabolic responsiveness to red raspberry consumption.

Many studies show that the intake of raspberries is beneficial to immune-metabolic health, but the responses of individuals are heterogeneous and not fully understood. In a two-arm parallel-group, randomized, controlled trial, immune-metabolic outcomes and plasma metabolite levels were analyzed before and after an 8-week red raspberry consumption. Based on partial least squares discriminant analysis (PLS-DA) on plasma xenobiotic levels, adherence to the intervention was first evaluated. A second PLS-DA followed by hierarchical clustering was used to classify individuals into response subgroups. Clinical immune and metabolic outcomes, including insulin resistance (HOMA-IR) and sensitivity (Matsuda, QUICKI) indices, during the intervention were assessed and compared between response subgroups. Two subgroups of participants, type 1 responders (n = 17) and type 2 responders (n = 5), were identified based on plasma metabolite levels measured during the intervention. Type 1 responders showed neutral to negative effects on immune-metabolic clinical parameters after raspberry consumption, and type 2 responders showed positive effects on the same parameters. Changes in waist circumference, waist-to-hip ratio, fasting plasma apolipoprotein B, C-reactive protein and insulin levels as well as Matsuda, HOMA-IR and QUICKI were significantly different between the two response subgroups. A deleterious effect of two carotenoid metabolites was also observed in type 1 responders but these variables were significantly associated with beneficial changes in the QUICKI index and in fasting insulin levels in type 2 responders. Increased 3-ureidopropionate levels were associated with a decrease in the Matsuda index in type 2 responders, suggesting that this metabolite is associated with a decrease in insulin sensitivity for those subjects, whereas the opposite was observed for type 1 responders. The beneficial effects associated with red raspberry consumption are subject to inter-individual variability. Metabolomics-based clustering appears to be an effective way to assess adherence to a nutritional intervention and to classify individuals according to their immune-metabolic responsiveness to the intervention. This approach may be replicated in future studies to provide a better understanding of how interindividual variability impacts the effects of nutritional interventions on immune-metabolic health.