Secretion Index Research Articles

Effects of Moringa oleifera Seed Oil on Cultured Human Sebocytes In Vitro and Comparison with Other Oil Types.

The seeds of Moringa oleifera (horseradish tree) contain about 40% of one of the most stable vegetable oils (Moringa seed oil). Therefore, the effects of Moringa seed oil on human SZ95 sebocytes were investigated and were compared with other vegetable oils. Immortalized human SZ95 sebocytes were treated with Moringa seed oil, olive oil, sunflower oil, linoleic acid and oleic acid. Lipid droplets were visualized by Nile Red fluorescence, cytokine secretion via cytokine antibody array, cell viability with calcein-AM fluorescence, cell proliferation by real-time cell analysis, and fatty acids were determined by gas chromatography. Statistical analysis was performed by the Wilcoxon matched-pairs signed-rank test, the Kruskal-Wallis test and Dunn's multiple comparison test. The vegetable oils tested stimulated sebaceous lipogenesis in a concentration-dependent manner. The pattern of lipogenesis induced by Moringa seed oil and olive oil was comparable to lipogenesis stimulated by oleic acid with also similar fatty acid secretion and cell proliferation patterns. Sunflower oil induced the strongest lipogenesis among the tested oils and fatty acids. There were also differences in cytokine secretion, induced by treatment with different oils. Moringa seed oil and olive oil, but not sunflower oil, reduced the secretion of pro-inflammatory cytokines, in comparison to untreated cells, and exhibited a low n-6/n-3 index. The anti-inflammatory oleic acid detected in Moringa seed oil probably contributed to its low levels of pro-inflammatory cytokine secretion and induction of cell death. In conclusion, Moringa seed oil seems to concentrate several desired oil properties on sebocytes, such as high content level of the anti-inflammatory fatty acid oleic acid, induction of similar cell proliferation and lipogenesis patterns compared with oleic acid, lipogenesis with a low n-6/n-3 index and inhibition of secretion of pro-inflammatory cytokines. These properties characterize Moringa seed oil as an interesting nutrient and a promising ingredient in skin care products.

Unilaterally Selective Adrenal Vein Sampling for Identification of Surgically Curable Primary Aldosteronism.

Adrenal venous sampling is recommended for the identification of unilateral surgically curable primary aldosteronism but is often clinically useless, owing to failed bilateral adrenal vein cannulation. To investigate if only unilaterally selective adrenal vein sampling studies can allow the identification of the responsible adrenal. Among 1625 patients consecutively submitted to adrenal vein sampling in tertiary referral centers, we selected those with selective adrenal vein sampling results in at least one side and surgically cured unilateral primary aldosteronism, used as gold reference. The accuracy of different values of the relative aldosterone secretion index (RASI), which estimates the amount of aldosterone produced in each adrenal gland corrected for catheterization selectivity, was examined. We found prominent differences in RASI values distribution between patients with and without unilateral primary aldosteronism. The diagnostic accuracy of RASI values estimated by the area under receiver operating characteristic curves was 0.714 and 0.855, respectively, in the responsible and the contralateral side; RASI values >2.55 and ≤0.96 on the former and the latter side furnished the highest accuracy for detection of surgically cured unilateral primary aldosteronism. Moreover, in the patients without unilateral primary aldosteronism, only 20% and 16% had RASI values ≤0.96 and >2.55. With the strength of a large real-life data set and use of the gold reference entailing an unambiguous diagnosis of unilateral primary aldosteronism, these results indicate the feasibility of identifying unilateral primary aldosteronism using unilaterally selective adrenal vein sampling results. URL: https://www. gov; Unique identifier: NCT01234220.

Assessment of glucose homeostasis in young adult female β-thalassemia major patients (β-TM) with acquired hypogonadotropic hypogonadism (AHH) never treated with sex steroids compared to eugonadal β-TM patients with spontaneous menstrual cycles.

Acquired ypogonadotropic hypogonadism (AHH) is the most prevalent endocrine complication in thalassemia major (TM). Considering the detrimental effect of estrogen deficiency on glucose metabolism, the ICET-A Network promoted a retrospective study on the long-term effects of estrogen deficiency on glucose homeostasis in female β-TM patients with HH without hormonal replacement therapy (HRT). Seventeen β-TM patients with AHH (4 had arrested puberty; Tanners' breast stage 2-3), never treated with sex steroids, and 11 eugonadal β-TM patients with spontaneous menstrual cycles at the time of referral were studied. A standard 3-h OGTT was performed in the morning, after an overnight fast. Six-point plasma glucose and insulin level determinations, indices of insulin secretion and sensitivity, early-phase insulin insulinogenic index (IGI), HOMA-IR and β-cell function (HOMA-β), oral disposition index (oDI), glucose and insulin areas under the OGTT curves were evaluated. Abnormal glucose tolerance (AGT) or diabetes was observed in 15 (88.2%) of 17 patients with AHH and 6 (54.5%) of 11 patients with eumenorrhea. The difference between the two groups was statistically significant (P: 0.048). However, the group of eugonadal patients was younger compared to AHH patients (26.5 ± 4.8 years vs. 32.6 ± 6.2 years ; P: 0.010). Advanced age, severity of iron overload, splenectomy, increased ALT levels and reduced IGF-1 levels were the main clinical and laboratory risk factors for glucose dysregulation observed in β-TM with AHH compared to eugonadal β-TM patients with spontaneous menstrual cycles. These data further support the indication for an annual assessment of OGTT in patients with β-TM. We believe that a registry of subjects with hypogonadism is necessary for a better understanding of the long-term consequences of this condition and refining treatment options.

Importance of residual insulin secretion in type 1 diabetes

Finland has the highest incidence of type 1 diabetes in the world, which has led to many important studies of type 1 diabetes in the Finnish population and to the formation of several study groups. In The Lancet Diabetes & Endocrinology, Minna Harsunen and colleagues 1 Harsunen M Haukka J Harjutsalo V et al. Residual insulin secretion in individuals with type 1 diabetes in Finland: longitudinal and cross-sectional analyses. Lancet Diabetes Endocrinol. 2023; (published online June 5.)https://doi.org/10.1016/S2213-8587(23)00123-7 Google Scholar present longitudinal and cross-sectional analyses of random C-peptide (an index of insulin secretion and β-cell function) measurements in three Finnish cohorts: 957 newly diagnosed patients seen at Helsinki University Hospital, in collaboration with the Finnish Pediatric Diabetes Registry (FPDR), for the longitudinal analysis; and 3984 study participants from the FinnDiane study group and 645 from the DIREVA regional diabetes registry in western Finland for the cross-sectional analysis. Data from these studies were used to examine which parameters were associated with residual insulin secretion. Residual insulin secretion in individuals with type 1 diabetes in Finland: longitudinal and cross-sectional analysesAlthough children with multiple autoantibodies and HLA risk genotypes progressed to absolute insulin deficiency rapidly, many adolescents and adults had residual random serum C-peptide decades after the diagnosis. Polygenic risk of type 1 and type 2 diabetes affected residual random serum C-peptide. Even low residual random serum C-peptide concentrations seemed to be associated with a beneficial complications profile. Full-Text PDF

UNILATERALLY SELECTIVE ADRENAL VEIN SAMPLING FOR IDENTIFICATION OF SURGICALLY CURABLE PRIMARY ALDOSTERONISM

Objective: Adrenal venous sampling (AVS) is recommended for the identification of unilateral surgically curable primary aldosteronism (PA) but, owing to failed bilateral adrenal vein cannulation, is often clinically useless. Design and method: We investigated if only unilaterally selective AVS studies can allow identification of the responsible adrenal. Methods: Among 1625 patients consecutively submitted to AVS in tertiary referral centers, we selected those with a unilaterally selective AVS result and a final diagnosis of unilateral PA. Using the latter as gold reference, we examined the accuracy of the relative aldosterone secretion index (RASI), which estimates the amount of aldosterone produced in each adrenal gland corrected for catheterization selectivity. Results: The RASI values distribution showed prominent differences between patients with and without unilateral PA. The area under ROC curves (AUROC) was 0.714 and 0.855 for RASI values of the responsible and the contralateral side, respectively. While RASI values >2.55 on the culprit side and less than 0.96 on the contralateral side furnished the highest accuracy for detection of surgically cured unilateral PA, only 20% and 16% had RASI values less than 0.96 and >2.55, respectively, in the patients without unilateral PA. Conclusions: With the strength of the gold standard entailing an unambiguous diagnosis of unilateral PA and large real-life dataset, these results indicate the feasibility of identifying unilateral PA using unilaterally selective AVS results.

Adrenocorticotropic hormone application lowered aldosterone/cortisol value on dominant side without superior surgical outcomes during adrenal venous sampling.

Adrenal venous sampling (AVS) is thought to be the gold standard for primary aldosteronism (PA) subtype discrimination, during which the application of adrenocorticotropic hormone (ACTH) arouses heated debate. We aimed to identify the effect of ACTH on AVS and surgical outcomes. After propensity score matching (PSM), a total of 220 patients diagnosed with PA and completed AVS were included (110 without ACTH stimulation and 110 with ACTH stimulation). According to AVS results, surgeries were conducted in appropriate patients. ACTH stimulation significantly increased almost all selectivity index (SI) in both left adrenal vein (LAV) and right adrenal vein (RAV). We discovered that aldosterone/cortisol (A/C) value on dominant side significantly reduced after ACTH stimulation, with a reduction in lateralization index (LI) observed. Finally, 39 patients in unstimulated group and 32 patients in stimulated group completed surgery and enough follow-up. The comparison between surgical outcomes with and without ACTH stimulation was analyzed and the difference was not significant (p=.464). In conclusion, ACTH application significantly lowered A/C value instead of the relative aldosterone secretion index (RASI) value on dominant side, which did not yield superior surgical outcomes and might render confusing AVS interpretation.

High 1-h glucose in youths with obesity as marker of prediabetes and cardiovascular risk.

Testing 1-h glucose (1HG) concentration during oral glucose tolerance test is cost-effective to identify individuals at risk of incident type 2 diabetes. Aim of the study was to define 1HG cutoffs diagnostic of incident impaired glucose tolerance (IGT) in youths with obesity, and to evaluate prevalence and association of cutoffs identified in the cohort and from the literature (133 and 155mg/dl) to cardiovascular disease (CVD) in a population of youths with obesity. This is a longitudinal study of 154 youths to identify 1HG cutoffs, and cross-sectional study of 2295 youths to estimate prevalence of high 1HG and association to CVD. Receiver-operating characteristic curves (ROC) were used to establish 1HG cutoffs, and univariate regression analysesto testassociation of 1HG to blood pressure, lipids and aminotransferases. ROC analysis identified the 1HG cutoff of 159mg/dl as having diagnostic accuracy of IGT with area under the ROC 0.82 (95% CI 0.66-0.98), sensitivity 0.86% and specificity 0.79%. In the cross-sectional population, prevalence of high 1HG was 36% and 15% for 133 and 155mg/dl cutoffs, respectively, and 17% for the 159mg/dl value. All the examined cutoffs were significantly associated with worse lipid profile, liver function test, reduced insulin sensitivity, secretion and disposition index. High 1HG is marker of persistent IGT and increased risk of metabolic abnormalities in youths. The 155mg/dl cutoff is a convenient estimate in young people but longitudinal studies with retinopathy and overt diabetes as end points are advised to verify the 1HG cutoff with the best diagnostic accuracy.

Significantly Lower Saliva Secretion in Females With Gastroesophageal Reflux Disease and Healthy Subjects Than in Males.

Saliva secretion in healthy subjects is lower in females than in males. The present study investigated sex differences in saliva secretion in patients with gastroesophageal reflux disease (GERD) and healthy controls. This case-control study included 39 (male/female: 16/23) with non-erosive reflux disease (NERD), 49 (25/24) patients with mild reflux esophagitis, 45 (23/22) with severe reflux esophagitis (A1), and 46 (24/22) healthy controls. Saliva secretion was examined as follows: before endoscopy, patients chewed sugar-free gum for three minutes, and the amount and pH of saliva before and after acid loading as an index of acid-buffering capacity were evaluated. The relationships between saliva secretion and body mass index, height, and weight were also examined. The amount of saliva secreted was significantly lower in females than in males in all four groups (NERD, mild reflux esophagitis, severe reflux esophagitis, and healthy controls). Salivary pH and acid-buffering capacity were similar in all groups. The amount of saliva secreted positively correlated with height and body weight, albeit more strongly with height. A sex difference in saliva secretion exists in GERD patients, similar to healthy controls. Saliva secretion was significantly lower in female GERD patients than in male GERD patients.

Subtypes of gestational diabetes based on indices of insulin sensitivity and insulin secretion

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Effects of different doses of exercise and diet-induced weight loss on beta-cell function in type 2 diabetes (DOSE-EX): a randomized clinical trial

Diet-induced weight loss is associated with improved beta-cell function in people with type 2 diabetes (T2D) with remaining secretory capacity. It is unknown if adding exercise to diet-induced weight loss improves beta-cell function and if exercise volume is important for improving beta-cell function in this context. Here, we carried out a four-armed randomized trial with a total of 82 persons (35% females, mean age (s.d.) of 58.2 years (9.8)) with newly diagnosed T2D (<7 years). Participants were randomly allocated to standard care (n = 20), calorie restriction (25% energy reduction; n = 21), calorie restriction and exercise three times per week (n = 20), or calorie restriction and exercise six times per week (n = 21) for 16 weeks. The primary outcome was beta-cell function as indicated by the late-phase disposition index (insulin secretion multiplied by insulin sensitivity) at steady-state hyperglycemia during a hyperglycemic clamp. Secondary outcomes included glucose-stimulated insulin secretion and sensitivity as well as the disposition, insulin sensitivity, and secretion indices derived from a liquid mixed meal tolerance test. We show that the late-phase disposition index during the clamp increases more in all three intervention groups than in standard care (diet control group, 58%; 95% confidence interval (CI), 16 to 116; moderate exercise dose group, 105%; 95% CI, 49 to 182; high exercise dose group, 137%; 95% CI, 73 to 225) and follows a linear dose–response relationship (P > 0.001 for trend). We report three serious adverse events (two in the control group and one in the diet control group), as well as adverse events in two participants in the diet control group, and five participants each in the moderate and high exercise dose groups. Overall, adding an exercise intervention to diet-induced weight loss improves glucose-stimulated beta-cell function in people with newly diagnosed T2D in an exercise dose-dependent manner (NCT03769883).

Multiple beneficial effects of 1-year nutritional-behavioral intervention on anthropometric and metabolic parameters in overweight and obese boys.

Childhood obesity is on the rise worldwide increasing the risk for metabolic, cardiovascular and liver diseases in children. Eating habits and lifestyle changes are currently the standard of care for treating pediatric obesity. Our study aimed to determine the impact of a dietary intervention based on the Mediterranean Diet (MD) and the Health Eating Plate, on anthropometric and metabolic parameters in obese and overweight boys. We studied 126 overweight/obese boys with anthropometric measurements, blood biochemistry and nutrient intakes evaluation by means of Food Frequency Questionnaire (FFQ) at baseline, at 6 and 12months after a nutritional-behavioral intervention. We observed a significant reduction in energy, macronutrients and micronutrients intakes. BMI-SDS significantly decreased after 1year with the proportion of obese boys decreasing by 33% and of overweight boys by 41%, while also all fat mass measures decreased both in obese and overweight individuals. In obese boys, ALT decreased significantly after 1-year nutritional intervention and these changes correlated with BMI-SDS reduction. Insulin-resistance and secretion indexes correlated with fat mass and BMI-SDS. In obese boys, significant changes were observed at 6months for insulin concentrations, 1/HOMA-IR and QUICKI. With regard to the lipid profile, significant decreases were observed for total and LDL cholesterol in obese boys. Metabolic and anthropometric risk factors in overweight and obese boys can be improved by a nutritional-behavioral intervention of 1-year duration.

Gastroprotective Activity of Aerial Leaves of Allium cepa

The present study was performed to evaluate the Antiulcer activity of Methanolic extract of Allium cepa leaves (MEAC) in Albino rats. Antiulcer activity of MEAC was investigated by using Ethanol induced gastric mucosal damage and Pylorous ligated gastric ulcers. Evaluation was done on both models comparing with reference standard Omeprazole (20mg/kg). The parameters taken to assess anti-ulcer for pylorus ligation method were volume gastric secretion, pH, free acidity, total acidity and ulcer index. In vivo studies were carried on the plant extract and results were found that protection of the Methanolic extract of Allium cepa leaves against characteristic lesions may be due to both reduction in gastric acid secretion and gastric cycloprotein and this may be due to the presence of Flavanoids. In this study we observed that, Methanolic extract of leaves of Allium cepa (MEAC) provides significant antiulcer activity against gastric ulcers in rats. The result of MEAC showed significant reduction in the ulcer index, when compared to control. The antiulcer activity extract may be attributed to their flavanoids content and antioxidant property. These findings indicate that MEAC display potential antiulcerogenic activity.

Low-density lipoprotein cholesterol levels are associated with first-phase insulin release

AimsPrior studies provided evidence that low-density lipoprotein (LDL)-cholesterol-lowering statins reduce cardiovascular events while conveying an increased risk of type 2 diabetes. The aim of this study was to investigate the association between LDL levels and both insulin sensitivity and insulin secretion in a cohort of 356 adult first-degree relatives of patients with type 2 diabetes. MethodsInsulin sensitivity was assessed by euglycemic hyperinsulinemic clamp and first-phase insulin secretion was measured by both intravenous glucose tolerance test (IVGTT) and OGTT. ResultsLDL-cholesterol levels were not independently associated with insulin-stimulated glucose disposal. After adjusting for several potential confounders, LDL-cholesterol concentration exhibited a positive independent association with acute insulin response (AIR) during IVGTT and with the OGTT derived Stumvoll first-phase insulin secretion index. When insulin release was adjusted for the underlying degree of insulin sensitivity, using the disposition index (AIR × insulin-stimulated glucose disposal), β-cell function was significantly associated with LDL-cholesterol levels, even after further adjusting for several potential confounders. ConclusionsThe present results suggest that LDL cholesterol is a positive modulator of insulin secretion. The deterioration in glycemic control observed during treatment with statins might thus be explained by an impairment in insulin secretion due to the cholesterol-lowering effect of statins.

Development and validation of risk prediction models for large for gestational age infants using logistic regression and two machine learning algorithms.

Large for gestational age (LGA) is one of the adverse outcomes during pregnancy that endangers the life and health of mothers and offspring. We aimed to establish prediction models for LGA at late pregnancy. Data were obtained from an established Chinese pregnant women cohort of 1285 pregnant women. LGA was diagnosed as >90th percentile of birth weight distribution of Chinese corresponding to gestational age of the same-sex newborns. Women with gestational diabetes mellitus (GDM) were classified into three subtypes according to the indexes of insulin sensitivity and insulin secretion. Models were established by logistic regression and decision tree/random forest algorithms, and validated by the data. A total of 139 newborns were diagnosed as LGA after birth. The area under the curve (AUC) for the training set is 0.760 (95% confidence interval [CI] 0.706-0.815), and 0.748 (95% CI 0.659-0.837) for the internal validation set of the logistic regression model, which consisted of eight commonly used clinical indicators (including lipid profile) and GDM subtypes. For the prediction models established by the two machine learning algorithms, which included all the variables, the training set and the internal validation set had AUCs of 0.813 (95% CI 0.786-0.839) and 0.779 (95% CI 0.735-0.824) for the decision tree model, and 0.854 (95% CI 0.831-0.877) and 0.808 (95% CI 0.766-0.850) for the random forest model. We established and validated three LGA risk prediction models to screen out the pregnant women with high risk of LGA at the early stage of the third trimester, which showed good prediction power and could guide early prevention strategies.

Association between tea consumption and glucose metabolism and insulin secretion in the Shanghai High-risk Diabetic Screen (SHiDS) study

IntroductionThe relationship between tea consumption and glucose metabolism remains controversial. This study investigated the associations of tea consumption with impaired glucose regulation, insulin secretion and sensitivity in Shanghai High-risk Diabetic...

Increased Carotid Intima-media Thickness and Its Association with Carbohydrate Metabolism and Adipocytokines in Children Treated with Recombinant Growth Hormone.

Reports on the association between growth hormone therapy and cardiovascular risk factors in children are limited. This study aimed to evaluate carotid intima-media thickness (cIMT) in children treated with recombinant human growth hormone (rhGH) and assess the effects of rhGH therapy and changes in serum carbohydrate metabolism, lipid profile and adipocytokines on cIMT. Seventy-one isolated idiopathic GH deficiency (GHD) children and 44 age- and sex-matched, healthy controls were enrolled in this study. The study group was divided into two subgroups according to insulin resistance (IR) on oral glucose tolerance tests. Insulin secretion (HOMA B, total insulin) and sensitivity (HOMA-IR, QUICKI, Matsuda) indices were calculated. cIMT was measured and the standard deviation scores (SDS) were calculated. Associations between cIMT-SDS and insulin secretion and sensitivity indices, serum lipid levels, adipocytokines (leptin, resistin, ghrelin), and the other rhGH treatment-related factors were evaluated. The cIMT-SDS was increased in GHD children treated with rhGH compared to controls (0.02 (2.27) vs -1.01 (1.63), p=0.003). cIMT-SDS did not differ between children on rhGH treatment with or without IR. High cIMT-SDS was significantly associated with higher serum ghrelin level and lower serum high density lipoprotein level (ß=0.491, p=0.001 and ß= -0.027, p=0.017), but not with BMI-SDS, blood pressure, insulin secretion and sensitivity indices, or dose and duration of rhGH therapy. Our findings showed that GHD children treated with rhGH have increased cIMT. Alterations in carbohydrate metabolism were not associated with cIMT in children treated with rhGH. GH therapy per se appears to be associated with this increased cIMT but causality should be elucidated in further studies. cIMT also appears to be associated with higher ghrelin and lower HDL levels.

Proinsulin-to-C-Peptide Ratio as a Marker of β-Cell Function in African American and European American Adults.

The primary purpose of the current study was to test the hypothesis that the proinsulin-to-C-peptide (PI-to-CP) ratio, as an index of proinsulin secretion, would be higher and associated with indices of β-cell function in African American adults relative to European American adults without type 2 diabetes. Participants were 114 African American and European American adult men and women. A 2-h oral glucose tolerance test was conducted to measure glucose, insulin, C-peptide, and proinsulin and derive indices of β-cell response to glucose. The Matsuda index was calculated as a measure of insulin sensitivity. The disposition index (DI), the product of insulin sensitivity and β-cell response, was calculated for each phase of β-cell responsivity. Pearson correlations were used to investigate the relationship of the PI-to-CP ratio with each phase of β-cell response (basal, Φb; dynamic, Φd; static, Φs; total, Φtot), disposition indices (DId, DIs, DItot), and insulin sensitivity. Multiple linear regression analysis was used to evaluate independent contributions of race, BMI, and glucose tolerance status on PI-to-CP levels before and after adjustment for insulin sensitivity. African American participants had higher fasting and 2-h PI-to-CP ratios. The fasting PI-to-CP ratio was positively associated with Φb, and the fasting PI-to-CP ratio and 2-h PI-to-CP ratio were inversely associated with DId and insulin sensitivity only in African American participants. The PI-to-CP ratio could be useful in identifying African American individuals at highest risk for β-cell dysfunction and ultimately type 2 diabetes.

Effect of glucagon-like peptide-1 receptor agonist on insulin secretion index and serum Wnt5a protein in patients with new-onset type 2 diabetes mellitus

ObjectivePrevious studies have found that wnt5a promotes β-cell insulin secretion and reduced concentrations in patients with type 2 diabetes. GLP-1RA (Glucagon-like peptide-1 receptor agonists) can regulate insulin secretion. However, the evidence that GLP-1RA affect insulin secretion through the Wnt5a is inconclusive. Therefore, this study aimed to evaluate the effect of GLP-1 RA on wnt5a levels in patients with type 2 diabetes.MethodsA total of 56 onset diabetics were selected our study, 29 of them were treated by GLP-1RAs (1.2mg subcutaneous injection once a day, liraglutide, Novo Nordisk), the rest (27 case) treated by Metformin (0.5 g twice a day, Glucophage, Merck). Individuals who were using medications to manage platelet (Aspirin) and cholesterol (Statins) were enrolled and continued treatment throughout the study.ResultsOur study found that the waist circumference and insulin secretion index in the GLP-1RA intervention group were significantly increased, and the insulin resistance index was lower than that of the control group. More interestingly, the serum Wnt5a protein level increased dramatically after the GLP-1RA intervention, and the level of Secreted frizzled-related protein 5 (Sfrp5) decreased compared with the control group. Multivariate linear regression analysis showed that the change of HOMA-β (Homeostasis model assessment- β) was significantly correlated with the changes of Wnt5a and Sfrp5, and the change of Wnt5a protein was positively correlated with HOMA-β.ConclusionOur results confirmed that GLP-1RA may improve HOMA-β in patients with type 2 diabetes by affecting the level of Wnt5a protein.

Pathologic subtypes in Japanese women with gestational diabetes

It has been suggested that two pathologic conditions, increased insulin resistance (IR) and impaired insulin secretion (IIS), are involved in the development of gestational diabetes mellitus (GDM). We attempted to classify women with GDM according to those pathologic subtypes and examine the association between the subtypes and perinatal and postpartum risk. We conducted a retrospective study of singleton women with GDM whose insulin were measured at a 75-g oral glucose tolerance test (OGTT) both during pregnancy and early postpartum. Homeostasis model assessment (HOMA) - IR and insulinogenic index (IGI) were used as indices of IR and insulin secretion, respectively. We defined IR as HOMA-IR ≥75%tile values of women with a normal OGTT result, and IIS as IGI < 0.4. The pathologic subtypes were classified into IR, IIS, mixed, and normal types. We examined the association between those subtypes and intensive insulin therapy (IIT) during pregnancy defined as requiring insulin ≥20 U/day and early postpartum abnormal glucose tolerance (AGT). 253 subjects were classified as follows: IR, 34%; IIS, 25%; mixed, 4%; normal, 37% during pregnancy. Compared with the normal subtype, women with the IR, IIS and mixed types were significantly associated with the IIT, while the incidence of postpartum AGT did not differ significantly (Table). 61% and 75% of women with the IR/mixed and IIS type during pregnancy persisted the same subtypes in the postpartum, respectively. Women with GDM with the pathologic subtypes were associated with the risk of insulin therapy. More than 60% of those women persisted the same abnormal subtypes in the early postpartum.

“Ogtt-Plus” – A Novel Web-App for Model Assessment of Cardio-Vascular Risk in Obesity, Dysmetabolism & Dysglycemia

We developed this web based ‘Dysmetabolism-Risk Calculator’ after analysing 1800 individuals, who underwent ‘standard two hour 75 gram OGTT’ along with insulin levels. It calculates the basal and post-glucose indexes of insulin secretion (ISec), insulin resistance (IRes) and beta cell function (BCF), based on areas under the curve of both glucose (AUCg) and insulin (AUCi). It generates dynamic graphs of glucose and insulin along with population-norm values and determines various stages of dys-insulinemia, obesity, and diabetes. On the dysmetabolism time-line, ‘Euglycemic Hyperinsulinemia’ and ‘Midzone Hyperglycemia’, are specially important categories. These categories, characteristically, occur before ‘Prediabetes’ stage, (Pre-Prediabetes), and are known to be associated with increased cardio-vascular morbidity such as hypertension, dyslipidemia, endothelial dysfunction, and stroke. IRes is calculated using “AUCg*AUCi*k” formula. ISec and central IRes is calculated by measuring ‘rate of rise of insulin’ and the angle theta, which is subtended by the 30 min insulin curve with ‘x’ axis. Insulin disposal and peripheral IRes is determined by calculating angle zeta which is subtended by the 90-120 min insulin curve with ‘y’ axis. Disposition index (Isec*Ires*k) is calculated by the formula “1/(AUCg) 2”, which, noticeably, is independent of AUCi. The discordance between Insulin Secretion Index and OGTT Disposition Index will be useful in predicting the reversibility of diabetes and dysmetabolism. BMI, 0-30 & 90-120 min AUCis are used as parameters, while calculating the probable site of ‘Tissue IRes’. Cardio-Vascular risk calculations are based on hyperinsulinemia (as macrovascular risk), hyperglycemia (as microvascular risk), and their combination as they occur on dysmetabolism time-time.