Insulin Values Research Articles

Hepatic lipid accumulation is associated with multiple metabolic pathway alterations but not dyslipidemia and insulin resistance in central bearded dragons (Pogona vitticeps).

To investigate associations between hepatic fat accumulation, fibrosis, and plasma values of primary metabolites, biochemical measurands, insulin, and lipoproteins in bearded dragons. 48 adult central bearded dragons (Pogona vitticeps). Dragons were sedated with alfaxalone, and a blood sample was collected. Plasma was submitted for untargeted primary metabolomics using gas chromatography time-of-flight mass spectrometry, a biochemistry panel, and a lipoprotein panel determined by PAGE. Hepatic lipid content was quantified by liver attenuation measurements from CT images and digital image analysis of standardized histologic sections of the liver. Fibrosis was quantified by digital image analysis on Masson's trichrome-stained histologic sections. Severity was determined from pathologic review of liver sections according to a standardized grading system. Statistical associations were investigated using serial linear models adjusted for false discovery rate and multivariate statistics. Both hepatic fat and fibrosis had a significant effect on CT liver attenuation values. Several oligosaccharides (maltotriose, maltose, ribose, trehalose) and alkaline phosphatase were significantly and linearly increased with hepatic lipid content (all q < .05). On partial least square-discriminant analysis, β-hydroxybutyric acid was the most important discriminatory variable between fatty liver severity grades on histology. No significant associations were found with insulin, lipoproteins, and succinic acid. Bearded dragons with hepatic lipid accumulation experienced multiple metabolic pathway disruptions, some being compatible with mitochondrial dysfunction. No evidence of insulin resistance or dyslipidemia was found. Hepatic biopsy and histopathology remain recommended for reliably diagnosing and staging fatty liver disease in bearded dragons.

Clinical, radiological, and surgical outcomes of 431 patients with adrenal incidentalomas: retrospective study of a 10-year single-center experience.

The incidence of adrenal tumors is increasing due to the widespread utilization of radiographic imaging techniques. Factors such as tumor size, radiological characteristics, and functionality of adrenal adenomas play crucial roles in diagnosis and subsequent management. In this retrospective study, we investigated the clinical, radiological, and surgical features of patients with adrenal incidentalomas (AIs) and evaluated their follow-up results. We analyzed data from 431 patients diagnosed with AIs (130 males, 301 females) who underwent adrenal hormone evaluation at our center. We compared nonfunctioning and functioning AIs in terms of radiological features. We also compared baseline and follow-up characteristics in nonfunctioning AIs. The mean age of the patients was 55.4 ± 11.5 years, with a mean tumor size of 25.9 ± 14.3 mm. Mean follow-up duration was 3.17 ± 2.07 years. Adenoma localization revealed 165 (38.3%) right-sided, 185 (42.9%) left-sided, and 81 (18.8%) bilateral cases. Most patients (76.6%) had nonfunctioning AIs. During follow-up, nonfunctioning AIs exhibited increased fasting blood glucose, fasting insulin and HOMA-IR values (p = 0.002, <0.001 and 0.004, respectively). Among the functioning AIs cases (23.4%), autonomous cortisol secretion, Cushing's syndrome, pheochromocytoma, and primary aldosteronism were observed in 10.4%, 5.1%, 3.9%, and 3.9% of cases, respectively. Receiver operating characteristic curve analysis determined an adrenal adenoma size of 26.5 mm as the optimal cut-off for distinguishing between functioning and nonfunctioning AIs, with a sensitivity and specificity of 61.4% and 70.0%, respectively. Although the majority of AIs are nonfunctioning, the prevalence of functioning adrenal adenomas is not rare. Our findings suggest that adenoma size emerges as a valuable predictor for early detection of functioning adenomas. In addition, smaller masses appear to carry a lower risk of malignancy.

The Role of GABA and Insulin Regulated Aminopeptidase on Insulin Resistance and GLUT4 in Prediabetes and Type 2 Diabetes Mellitus

Background: Different proposed mechanisms for insulin resistance have been put forth to understand the relationship and changes in insulin resistance. Looking at the levels of insulin, the neurotransmitter gamma-aminobutyric acid, glucose transport type 4, and the newly discovered enzyme insulin regulated aminopeptidase may provide an integrated perspective on insulin resistance. Objectives: To study the role of serum gamma-aminobutyric acid and insulin regulated aminopeptidase enzyme levels in pathogenesis of insulin resistance and translocation of glucose transport type 4 in patients with type2 diabetes mellitus and pre-diabetes ones. Subjects and methods: Ninety individuals were divided into three age- and BMI matched groups (diabetics, prediabetics, healthy) were assessed for glycated hemoglobin (turbidometry method), fasting serum glucose (colorimetric method), serum insulin (electrochemiluminescence immunoassay method), homeostatic model assessment for insulin resistance, serum gamma-aminobutyric acid, glucose transporter type 4, and insulin regulated aminopeptidase measured by the sandwich ELISA method. The cut-off value was adopted according to the World Health Organization, individuals with their fasting serum glucose lower than 110 mg/ml, and glycated hemoglobin level not more than 5.7 % are considered healthy individuals. Result: The mean (±SD) values of serum insulin regulated aminopeptidase, gamma-aminobutyric acid and glucose transport type 4 showed significantly lower levels with greater increases in insulin resistance, represented by the significant decrease in diabetics group who have high insulin resistance compared with pre-diabetics and healthy individuals’ groups (p &lt; 0.05). They also significantly decrease in individuals with the pre-diabetic stage compared to healthy individuals without insulin resistance (p &lt; 0.05). Significant negative correlations were found between HOMA-IR values and each of GABA, IRAP, and GLUT4. Conclusion: Decreasing gamma-aminobutyric acid may promote insulin resistance and prediabetes/diabetes onset. Decreased insulin regulated aminopeptidase levels suggest a role alongside glucose transport type 4 in glucose uptake, allowing screening for prediabetes risk.

Correlation between the cardiometabolic index and arteriosclerosis in patients with type 2 diabetes mellitus

BackgroundThe cardiometabolic index (CMI) is a new metric derived from the triglyceride-glucose index and body mass index and is considered a potential marker for cardiovascular risk assessment. This study aimed to examine the correlation between the CMI and the presence and severity of arteriosclerosis in patients with type 2 diabetes mellitus (T2DM).MethodsThis study involved 2243 patients with T2DM. The CMI was derived by dividing the triglyceride level (mmol/L) by the high-density lipoprotein level (mmol/L) and then multiplying the quotient by the waist-to-height ratio. Multivariate logistic regression was used to analyze the correlations between the CMI and BMI blood biomarkers, blood pressure, and brachial-ankle pulse wave velocity (baPWV).ResultsPatients were categorized into three groups based on their CMI: Group C1 (CMI < 0.775; n = 750), Group C2 (CMI: 0.775–1.355; n = 743), and Group C3 (CMI > 1.355; n = 750). Increased BMI, fasting glucose, insulin (at 120 min), total cholesterol (TC), and baPWV values were observed in Groups C2 and C3, with statistically significant trends (all trends P < 0.05). The CMI was positively correlated with systolic blood pressure (r = 0.74, P < 0.001). Multivariate analysis revealed that an increased CMI contributed to a greater risk for arteriosclerosis (OR = 1.87, 95%CI: 1.66–2.10, P < 0.001). Compared to the C1 group, the C2 group and C3 group had a greater risk of developing arteriosclerosis, with ORs of 4.55 (95%CI: 3.57–5.81, P<0.001) and 5.56 (95%CI: 4.32–7.17, P<0.001), respectively. The association was notably stronger in patients with a BMI below 21.62 kg/m² than in those with a BMI of 21.62 kg/m² or higher (OR = 4.53 vs. OR = 1.59).ConclusionsThese findings suggest that the CMI is a relevant and independent marker of arteriosclerosis in patients with T2DM and may be useful in the risk stratification and management of these patients.

Testosterone therapy reduces insulin resistance in men with adult-onset testosterone deficiency and metabolic syndrome. Results from the Moscow Study, a randomized controlled trial with an open-label phase.

To describe changes in homeostasis model assessment of insulin resistance index (HOMA-IR) following testosterone therapy in men with hypogonadism and metabolic syndrome (MetS). A randomized, placebo-controlled, double-blind randomized controlled trial (RCT) comprising 184 men with MetS and hypogonadism (testosterone undecanoate [TU]: 113 men, placebo: 71 men) was conducted. This was followed by an open-label phase in which all men were given TU. We focused on men who were not receiving antiglycaemic agents (TU: 81 men; placebo: 54 men) as these could affect HOMA-IR. Inter-group comparison of HOMA-IR was restricted to the RCT (30 weeks), whilst intra-group comparison was carried out on men provided TU during the RCT and open-label phases (study cohort) and men given placebo during the RCT and then switched to TU during the open-label phase (confirmatory cohort). Regression analysis was performed to identify factors associated with change in HOMA-IR (∆HOMA-IR). The median HOMA-IR was significantly reduced at almost every time point (after 18 weeks) compared to baseline in men receiving TU in both the study and confirmatory cohorts. There was a significant decrease in median values of fasting glucose (30 weeks: -2.1%; 138 weeks: -4.9%) and insulin (30 weeks: -10.5%; 138 weeks: -35.5%) after TU treatment. Placebo was not associated with significant ∆HOMA-IR. The only consistent predictor of HOMA-IR decrease following TU treatment was baseline HOMA-IR (r2 ≥ 0.64). Baseline HOMA-IR predicted ΔHOMA-IR, with a greater percentage change in insulin than in fasting glucose. In men with MetS/type 2 diabetes (T2DM) not on antiglycaemic therapy, improvements in HOMA-IR may be greater than suggested by change in fasting glucose. Our results suggest that hypogonadism screening be included in the management of men with MetS/T2DM.

Post-COVID syndrome: status of carbohydrate metabolism in patients with hypertension and stable ischemic heart disease

Background. Post-COVID syndrome is associated with a wide range of chronic symptoms or conditions. Coronavirus di­sease 2019 (COVID-19) causes metabolic disorders such as hyperglycemia, insulin resistance. Insulin-like growth factor 1 (IGF-1) is associated with an impaired glucose tolerance and a higher risk of developing type 2 diabetes. Currently, the study of molecules regulating carbohydrate metabolism as potential biomarkers of post-COVID syndrome and targets for therapeutic influence is relevant. The purpose of the study was to assess the level of IGF-1 and its relationship with regulation of carbohydrate metabolism, as well as the dynamics of the evaluated indicators under the influence of drug treatment in patients with hypertension and stable coronary heart disease who suffered from COVID-19. Materials and methods. Fifty-five patients who had a mild and moderate COVID-19 were included in the study; their average age was 55.87 [40; 75] years. The results of routine laboratory tests were registered and analyzed. The content of insulin and IGF-1 was assessed by enzyme immunoassay. The HOMA-IR was calculated. Results. In patients with a mode­rate COVID-19 compared to those with a mild one, a significant decrease in the level of IGF-1 (р = 0.008) was found against the background of increased reference values of glucose, insulin, and HOMA-IR (р &lt; 0.01). The influence of the degree of hypertension on the IGF-1 level was revealed (р = 0.004). An inverse relationship between IGF-1 and glucose level was noted (r = –0.28, p = 0.034). The use of meldonium contributed to a significant decrease in glucose and insulin content (p &lt; 0.001), and an increase in IGF-1. Against the background of taking meldonium, the dynamics of the shift towards a decrease in the HOMA-IR was more significant. Conclusions. An inverse relationship was found between IGF-1 and blood glucose, regardless of the level of insulin and HOMA-IR, in patients with hypertension and stable ischemic heart disease in the post-COVID period. Meldonium has been shown to improve carbohydrate metabolism by normalizing insulin levels and redu­cing the phenomena of insulin resistance as a potential drug target. Meldonium improved the clinical course of ischemic heart disease and demonstrated good tolerability and safety.

Focus on the epidemiology, pathophysiology, diagnosis, and management of insulin dysregulation in horses

Because there are various inter-related disorders of insulin metabolism that all may contribute to the final result of hyperinsulinaemia, the phrase "insulin dysregulation" has become the most acceptable term to use when describing equine metabolic syndrome (EMS). Insulin dysregulation is widespread in horses, and it appears to be more prevalent in physically sedentary horses. Laminitis and hyperinsulinaemia have been linked, as have other components of insulin dysregulation. Diagnosis of insulin dysregulation should be done in stages, beginning with basal testing, which includes baseline values of insulin and glucose, and concluding with dynamic tests, which detect tissue insulin resistance and hyperinsulinaemia. Dietary adjustments are the key to weight loss in the majority of EMS horses. To encourage weight loss, the horse should be given around 1.25% of its body weight every day. Exercise not only aids equid weight loss but also improves insulin sensitivity. The exercise should be tailored to the specific horse, taking into account its breed, fitness level, and owner's resources. When an obese horse is unable to exercise owing to laminitis or when obesity persists after extensive exercise and dietary management, levothyroxine sodium and metformin hydrochloride can be given to help accelerate weight loss and increase insulin sensitivity. Insulin dysregulation is a defining feature of equine metabolic syndrome and has garnered attention due to its direct link to laminitis. There is need for an in-depth understanding of ID in order to prevent the development of clinical laminitis. The current study discusses the epidemiology, pathophysiology, diagnosis, and management of insulin dysregulation in horses.

Influence of Obesity and Insulin Resistance on the Reproductive Outcome of Iraqi Women Undergoing Intracytoplasmic Sperm Injection

Background: Insulin resistance (IR) is commonly associated with obesity, which plays a role in the pathogenesis of reproductive disorders. Objectives: To evaluate the impact of insulin resistance and obesity on ICSI outcomes in Iraqi infertile females. Methods: Ninety women who were unable to conceive received an intracytoplasmic sperm injection and have various infertility causes; Age range: 18–40 participated in this prospective clinical cross-sectional study. Three groups of patients were formed based on their body mass index (BMI) rankings. The ovarian hyperstimulation antagonist protocol was administered to all women. Serum glucose, insulin and HOMA-IR were measured for all participants on the ovum pickup day. In addition, the results of ICSI were determined. Results: The insulin levels and HOMA-IR were significantly higher in obese females than in overweight and normal weight groups. There was significantly lower BMI, waist/hip ratio, and HOMA-IR in pregnant females when compared with non-pregnant ladies. There is a significant negative correlation between fasting insulin, HOMA-IR with metaphase II oocytes, maturation rate, grade 1 embryos and pregnancy outcome. The cutoff values of fasting serum insulin and HOMA-IR levels were ≤ 4.64 (ng/ml) and ≤ 1.1, respectively, as predictors of positive pregnancy in women undergoing ICSI. Conclusions: Insulin resistance impairs the ICSI outcomes of infertile women. Furthermore, obesity may increase the risk of insulin resistance in infertile women; therefore, enhancing HOMA-IR and BMI will positively impact ICSI outcomes.

The effects of a fibre-enriched bakery product on glucose, insulin values and appetite. A pilot randomised cross-over trial

Brewers spent grain (BSG) is a valuable source of arabinoxylans with potential beneficial effects on glucose values. This pilot randomised crossover double-blind trial compared the effects of panettone, a sweet baked-product, enriched with BSG-fibre (p-rich) to unenriched panettone (p-standard) on glucose and insulin blood values and appetite scores. Ten healthy volunteers consumed each food in a random order. Blood variables and appetite scores were assessed at fasting and at different intervals after each food consumption. Glucose values were significantly higher after p-standard intake at 90-min (89.9 ± 16.1 vs 74.6 ± 19.4 mg/dL) and 120-min (81.1 ± 9.85 vs 72.1 ± 14.0 mg/dL). The areas-under-the-curve (AUCs) were lower for both glucose (p = .043) and insulin values (p = .036) with p-rich. At 240-min, satiety was higher (p = .006), and desire-to-eat lower (p = .008) with p-rich; desire-to-eat AUC was lower with p-rich too (p = .029). The integration of a small amount of BSG-derived fibre into a sweet food led to improved glycaemic control and appetite regulation.

Insulin Resistance and Abnormalities in Blood Values of Icelandic Children Receiving Obesity Treatment

Worldwide, the rates of childhood obesity have risen dramatically in recent decades. Obesity may cause serious sequelae during childhood and throughout adulthood. Insulin resistance is prevalent metabolic abnormality in pediatric obesity. The Pediatric Obesity Clinic was established in 2011 at the Children's Medical Center, Landspítali University Hospital. This study aimed to observe metabolic abnormalities and insulin resistance in blood values of children receiving obesity treatment. The study included all children (n = 180) who received obesity treatment at The Pediatric Obesity Clinic between 2016 and 2020 and had at least eight out of the nine following serum values analyzed while fasting: HbA1c, glucose, insulin, ALAT, total cholesterol, HDL-cholesterol, triglycerides, TSH and free T4. HOMA-IR value was calculated from insulin and glucose values. Decreased insulin sensitivity was defined as HOMA-IR > 3.42. 84% of the children had at least one abnormality in their tested blood values. 50% had abnormal insulin values and 44% had abnormal ALAT values. 78% had decreased insulin sensitivity, and their mean HOMA-IR was 7.3 (± 5.0), surpassing twice the normal value. A large majority of the children undergoing obesity treatment already exhibited signs of metabolic sequelae during their treatment. The prevalence of affected children has increased compared to a similar study conducted in 2013. Of particular concern is the growing number of children with decreased insulin sensitivity. Proper measures must be taken to combat this alarming trend.

Nutrient patterns in relation to insulin resistance and endothelial dysfunction in Iranian women.

Prior studies have mainly focused on the association of one specific nutrient with insulin resistance (IR) and endothelial dysfunction and limited studies have assessed the association with different nutrient patterns (NPs). We examined the association between various NPs and IR and endothelial dysfunction among Iranian women. This cross-sectional study was carried out on a sample of 368 female nurses. A 106-items food frequency questionnaire (FFQ) was applied for dietary assessments. Using factor analysis, the relationships between NPs and markers of insulin resistance (HOMA-IR, HOMA-β, and QUICKY), and endothelial dysfunction (E-selectin, sICAM-1, and sVCAM-1) were assessed. Mean age and body mass index of participants were respectively 35.21years and 24.04kg/m2. Three major NPs were identified. NP1, named as "dairy, fruits, and vegetables" had high values of potassium, folate, vitamins A and C, magnesium, and beta carotene. No significant association was observed between this NP and insulin resistance or endothelial dysfunction indices. The second NP was full of chromium, selenium, copper, vitamin B6, monounsaturated fatty acid (MUFA), thiamin, vitamin D, and iron. Adherence to NP2 (named "legumes, nuts, and protein foods") was associated with lower values of insulin (6.8 ± 1.1 versus 8.4 ± 1.1, P = 0.01), homeostasis model assessment-Insulin resistance (HOMA-IR) (1.3 ± 0.2 versus 1.7 ± 0.2, P = 0.02), and vascular adhesion molecule 1 (VCAM-1) (444.2 ± 27.9 versus 475.8 ± 28.4, P = 0.03). However, adherence to the third NP, rich in saturated fatty acid (SFA), cholesterol, sodium, zinc, vitamin E, and B12, described as "animal fat and meat + vitamin E", was associated with higher amounts of homeostasis model assessment-β (HOMA-β) (531.3 ± 176.2 versus 48.7 ± 179.8, P = 0.03). In conclusion, following the NP2, correlated with higher intakes of chromium, selenium, copper, vitamin B6, MUFA and thiamin was associated with lower values of insulin, HOMA-IR, and sVCAM-1. Adherence to NP3, rich in SFA, cholesterol, vitamin E, vitamin B12, and zinc was associated with higher levels of HOMA-β.

The Comparative Effects of Myo-Inositol and Metformin Therapy on the Clinical and Biochemical Parameters of Women of Normal Weight Suffering from Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is a multisystem reproductive-metabolic disorder and the most common endocrine cause of infertility. The objective of our study was to determine the influence of myo-inositol (MI) on insulin resistance (IR), menstrual cycle regularity, and hyperandrogenism in women suffering from PCOS with normal BMI and diagnosed IR. We performed a prospective randomized controlled trial (RCT) that included 60 participants with PCOS who had IR and a normal BMI. Two groups were formed. A group of thirty patients received MI, and thirty patients in the control group received metformin (MET). A statistically significant reduction in the area under the curve (AUC) of insulin values during the oral glucose tolerance test (OGTT) was recorded in both examined groups after the applied therapy with MI and MET. The regularity of the menstrual cycle in both groups was improved in >90% of patients. A statistically significant decrease in androgenic hormones (testosterone, SHBG, free androgen index-FAI, androstenedione) was recorded in both groups and did not differ between the groups. Both MI and MET can be considered very effective in the regulation of IR, menstrual cycle irregularities, and hyperandrogenism in women with PCOS.

Comparative effects of the antioxidant glutathione with metformin and Diane-35 on hormonal, metabolic, and inflammatory indicators in a DHEA-induced PCOS rat model

Objective Comparison of hormonal, metabolic and inflammatory markers of glutathione with metformin and Diane-35 in a rat model of PCOS induced by dehydroepiandrosterone. Methods Twenty-five female rats were randomized into four groups. Group 1 was administered a subcutaneous dose of 0.2 ml saline/day. Group 2 was given 0.2 ml of 1% carboxymethyl cellulose (CMC)/day orally for 28 days. A PCOS model was established with DHEA in rats. Group 3 was given 4.5 mg/kg/day of Diane-35 orally dissolved in 1% CMC for 28 days. Group 4 was given 300 mg/kg/day of metformin orally dissolved in 1 ml of saline for 28 days, and Group 5 was administered 100 mg/kg of glutathione intraperitoneally on days 35, 42, and 49. On day 56, the rats were sacrificed. Serum markers and follicle count were examined. Results Serum IL-6, hs-CRP, insulin, testosterone, SHBG, and MDA values were significantly lower in the glutathione group than in the PCOS group (p = 0.0006, p = 0.023, p = 0.0082, p = 0.0007, p = 0.0048, and p < 0.0001, respectively). The number of all follicles was similar between the control and glutathione groups (p < 0.05). When we compared the other groups with the PCOS group, the number of primary, secondary, atretic, and cystic follicles was significantly lower in the metformin and glutathione groups. The number of primordial and antral follicles was significantly higher than in the PCOS group. Conclusions Glutathione plays anti-inflammatory and antioxidant roles, similar to metformin, by lowering serum IL-6, insulin, testosterone, CRP, and MDA levels; decreasing atretic/cystic follicle count; and improving antral follicle count and folliculogenesis in PCOS patients.

The declining insulinogenic index correlates with inflammation and metabolic dysregulation in non-obese individuals assessed by blood gene expression

AimsDiabetes onset is difficult to predict. Since decreased insulinogenic index (IGI) is observed in prediabetes, and blood gene expression correlates with insulin secretion, candidate biomarkers can be identified. MethodsWe collected blood from 96 participants (54 males, 42 females) in 2008 (age: 52.5 years) and 2016 for clinical and gene expression analyses. IGI was derived from values of insulin and glucose at fasting and at 30 min post-OGTT. Two subgroups were identified based on IGI variation: “Minor change in IGI” group with absolute value variation between –0.05 and +0.05, and “Decrease in IGI” group with a variation between –20 and –0.05. ResultsFollowing the comparison of “Minor change in IGI” and “Decrease in IGI” groups at time 0 (2008), we identified 77 genes correlating with declining IGI, related to response to lipid, carbohydrate, and hormone metabolism, response to stress and DNA metabolic processes. Over the eight years, genes correlating to declining IGI were related to inflammation, metabolic and hormonal dysregulation. Individuals with minor change in IGI, instead, featured homeostatic and regenerative responses. ConclusionsBy blood gene expression analysis of non-obese individuals, we identified potential gene biomarkers correlating to declining IGI, associated to a pathophysiology of inflammation and metabolic dysregulation.

Across-species benefits of adrenalectomy on congenital generalized lipoatrophic diabetes: a review.

Two adrenalectomies py -45erformed fourteen years apart notoriously alleviated insulin resistance in a female teenager with Congenital Generalized Lipoatrophy (CGL, 1988) and in a murine model of CGL (2002). Following a successful therapeutic trial with anti-glucocorticoids, we performed the first surgical procedure on an 18-year-old girl. Before surgery, the anti-glucocorticoid therapy produced a rapid and striking drop in fasting serum insulin levels (from over 400 to 7.0 mU/L) and a slower -but impressive- fall in fasting serum triglycerides from 7,400 to 220-230 mg/dL. In contrast, fasting serum glucose levels dropped more slowly, from 225-290 to 121-138 mg/dL. Two weeks following total adrenalectomy, the fasting serum glucose level was 98 mg/dL, with a corresponding serum insulin level of 10 mU/L. During an Oral Glucose Tolerance Test, the 2-hour serum glucose was 210 mg/dL, and serum insulin values during the test did not exceed 53 mU/L. In 2002, the A-ZIP/F1 hypoleptinemic mouse had its adrenal glands removed. Even though this CGL model does not respond well to leptin replacement, an infusion of recombinant leptin reduced the characteristic hypercorticosteronemia of this murine model of CGL. Adrenalectomy in this transgenic mouse improved insulin sensitivity in the liver and muscle. In summary, adrenalectomy -in both a human and a mouse case of CGL- limited adipose tissue exposure to corticosteroid action and led to a notorious metabolic improvement. On a broader scenario, given that leptin restrains the adrenal axis, the reduced leptin activity of the leptin resistance displayed by obese subjects should lead to adrenal axis overactivity. This overactivity should result in elevated serum levels of free cortisol, free fatty acids, and glycerol. In this manner, leptin resistance should lead to peripheral (adipose tissue, liver, and muscle) insulin resistance and islet beta-cell apoptosis, paving the way to Type 2 diabetes.

Evaluation of hematologic and coagulation system disorders in adolescents with polycystic ovary syndrome

Aim: Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, ovulatory dysfunction, insulin resistance, and obesity, affects 8-26% of adolescent girls. The effects of polycystic ovarian syndrome on the hematologic and coagulation systems have received little attention. We aimed to investigate the hematologic and coagulation system disorders in PCOS. Materials and Methods: The study included 40 adolescents with PCOS and 41 healthy controls. Hemostatic and coagulation system parameters evaluated in both groups and were compared with metabolic parameters. Results: Adolescent’s with PCOS had a significantly higher insulin, HOMA-IR levels, and Hematocrit (Hct) levels than the control group, but no significant difference was found in D-dimer, fibrinogen, protein C, protein S, Antitrombine III levels. A positive correlation was found between insulin and HOMA-IR values and hemoglobin (Hgb), Hct, white blood cell (WBC) levels (r=0.32 p=0.003; r=0.33 p=0.002; r=0.36 p=0.001, respectively); also a positive correlation was found between high-density lipoprotein cholesterol (HDL) and WBC values (r=0.26 p=0.01). A positive correlation was found between follicle stimulating hormone (FSH) and Protein C and Protein S (r=0.41 p=0.008; r=0.31 p=0.04); total testosterone and fibrinogen levels (r=0, 32 p=0.04); Dehydroepiandrostenedione sulfate (DHEAS) and protein S levels (r=0.31 p=0.04). Conclusion: There was no significant difference in the hematologic and coagulation parameters between PCOS and healthy controls. Hypercoagulated state in PCOS is associated with obesity, BMI, inflammation, and insulin resistance, not specific to the disease.

Biochemical Assessment of Insulin and Dopamine 2 Receptors in Patients with Type 2 Diabetes

Dopamine (DA) plays a key role in the body's regulation of insulin production. This study aimed to estimate insulin and dopamine 2 receptors in type 2 diabetic patients. The study included 180 subjects aged (20-65) years during the period from November 2022 to March 2023. They were divided into two groups: 120 patients with type 2 Diabetes mellitus (60 males and 60 females), and 60 healthy individuals (30 males and 30 females) as a control group. The biochemical tests (insulin and dopamine 2) were measured by the Human Insulin ELISA kit and Human Dopamine 2 receptor ELISA kit in Bioassay Technology Laboratory. The HbA1c, urea, and creatinine were measured by the kit from Roche/ Hetachi Diagnostics Ltd Company. The fasting blood glucose and HbA1c were measured to diagnose all patients with T2DM and controls to confirm the subjects with T2DM. The samples were obtained from the AL Kinday Hospital and Endocrine Center in Baghdad, Iraq. The results of this study explained that the patients and controls were comparable in age, gender, and smoking status with no significant differences (P&gt; 0.05). while results reported that there was a greater significant difference (p&lt;0.01) in levels of the mean for fasting blood sugar (FBS), glycated hemoglobin (HbA1c), and a significant difference (p&lt;0.05) in urea and creatinine levels between the type 2 diabetic patients and the controls there was a significant difference detected in values of insulin and dopamine 2(p&lt;0/05) between the patient and control groups. It can be concluded from our study that those who had type 2 diabetes mellitus had higher levels of dopamine and insulin when compared with the control group.

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

Effects of intermittent fasting regimens on glycemic, hepatic, anthropometric, and clinical markers in patients with non-alcoholic fatty liver disease: Systematic review and meta-analysis of randomized controlled trials

ObjectivesIntermittent fasting (IF) regimens have been hypothesized to influence several markers of cardiometabolic and liver function. The objective of our meta-analysis was to investigate the impact of IF regimens on cardiometabolic and liver markers in subjects diagnosed with non-alcoholic fatty liver disease (NAFLD). MethodsWe searched several online databases (PubMed/Medline, Web of Science, Scopus and Embase) in order to identify suitable publications for inclusion in the meta-analysis. Results were expressed as weighted mean differences (WMD). ResultsFrom 12343 articles identified in different databases, a total of 7 RCT arms were entered into the quantitative synthesis. The manuscripts were published between 2019 and 2023. IF regimens (the 5:2 diet, 16/8 time-restricting feeding, and alternate day fasting) varied from 2 months to 3 months. IF regimens reduced steatosis scores (WMD: -33.22 CAP dB/m, 95% CI: -50.72 to -15.72), anthropometric characteristics of obesity (WMD: -0.77 kg/m2, 95% CI: -1.38 to -0.17 for body mass index; WMD: -3.16 kg, 95% CI: -4.71 to -1.61 for body weight; WMD: -1.90 kg, 95% CI: -3.51 to -0.29 for waist circumference), as well as ALT (WMD: -9.10 U/L, 95% CI: -12.45 to -5.75), triglyceride (WMD: -20.83 mg/dl, 95% CI: -39.01 to -2.66), total cholesterol (WMD: -7.80 mg/dl, 95% CI: -15.18), HbA1c (WMD: -0.14%, 95% CI: -0.20 to -0.08) and HOMA-IR (WMD: -1.21, 95% CI: -2.08 to -0.34) levels versus controls. Nevertheless, no between-group differences were detected for other biomarkers, e.g., fasting blood glucose, insulin, AST, HDL-C or LDL-C values, and fibrosis scores. ConclusionIF regimens can improve some markers of cardiometabolic and liver function in patients with NAFLD. However, the available evidence to support the benefits of IF regimens is limited and derived from a small number of studies, thus further research is needed to clarify the impact of IF on the cardiometabolic health of NAFLD patients.