Homeostasis Model Assessment Values Research Articles

A Study of FoxO1, mTOR, miR-21, miR-29b, and miR-98 Expression Levels Regarding Metabolic Syndrome in Acne Vulgaris Patients.

Acne vulgaris (AV) is an inflammatory skin disease caused by the mechanistic target of rapamycin complex 1 (mTORC1). forkhead box protein (Fox) O1 is known to regulate the relationship between the mTORC1 signaling pathway and insulin resistance (IR). Increased mTORC1 signaling is known to predispose one to diseases such as insulin resistance (IR), obesity, and diabetes mellitus. One of the major components of mTORC1 is mTOR. FoxO1 and mTOR play key roles in the onset and progression of metabolic syndrome (MetS). In this study, we aimed to elucidate the relationship between AV and MetS through FoxO1 and mTOR signaling pathways and microRNAs (miRs) associated with these signaling pathways. We examined 20 AV patients without MetS, 16 AV patients with MetS, and 20 healthy controls. The demographic characteristics of the patients, MetS parameters, clinical severity of AV (Global Acne Grading System, GAGS), and the homeostasis model assessment (HOMA) values were compared between the groups. In addition, the expression levels of FoxO1 and mTOR genes, along with the expression levels of miR-21, miR-29b, and miR-98, were assessed in skin biopsy samples from all groups using real-time polymerase chain reaction methods. FoxO1, mTOR, andmiRNAexpression levels were recorded as fold change. The mean age of patients with AV without MetS was statistically lower. In AV patients with MetS, those with moderate GAGS scores had statistically significantly higher HOMA values than those with mild GAGS scores. FoxO1 expression was significantly lower in AV patients compared to controls. The mTOR expression levels of AV patients with MetS were significantly higher than the other two groups. The expression levels of miR-21 and miR-29b were significantly increased in the group of AV patients with MetS compared to the group of AV patients without MetS. These results suggested that the mTOR pathway may play an important role in explaining the relationship between AV and MetS in acne pathogenesis. They also suggested that miR-21 and miR-29b play a role in the inflammatory process of AV.

Mutual effect modification between insulin-resistance and endothelial dysfunction in predicting incident heart failure in hypertensives

Abstract Both type-2 diabetes mellitus and endothelial dysfunction are associated with heart failure (HF); in addition, a strong interplay between endothelial dysfunction and insulin-resistance status that precedes of many years the clinical appearance of type-2 diabetes mellitus, has been well-demonstrated. Thus, the aim of this study was to investigate whether endothelial dysfunction and insulin-resistance are independent predictors of incident HF and if exists a possible interaction between them. For this study we selected 705 white never-treated hypertensive outpatients free from HF, type-2 diabetes mellitus, chronic kidney disease, previous cardiovascular events and other chronic diseases potentially impacting on HF development. Endothelium-dependent vasodilation was investigated by intra-arterial infusion of acetylcholine, and laboratory determinations were obtained by standard procedures. Insulin-resistance was evaluated by the homeostasis model assessment (HOMA). During the follow-up [median 117 months (range 31–211)], there were 223 new cases of HF (3.3 events/100 patient-years). Stratifying the study population in progressors and non-progressors, we observed that progressors were older and had a higher prevalence of females, baseline glucose, insulin, HOMA, creatinine, and hs-CRP mean values, while estimated glomerular filtration rate and endothelium-dependent vasodilation were lower. In the multiple Cox regression analysis, serum hs-CRP (HR=1.362,(95% CI=1.208-1.536), HOMA (HR=1.293, 95% CI=1.142-1.465), maximal ACh-stimulated FBF (100% of increase, HR=0.807,(95% CI=0.697-0.934) and e-GFR (10 ml/min/1.73m2 increase, HR=0.552, 95% CI=0.483-0.603) maintained an independent association with incident HF. The subsequent analysis demonstrated that HOMA and endothelial dysfunction interact between them in a competitive manner (HR = 6.548, 95% CI = 4.034-10.629), showing also a mutual effect modification. These interaction analyses revealed that, in crude and adjusted models, HOMA significantly modified the effect of acetylcholine-stimulated FBF on incident HF and, given the mutualistic nature of the effect modification, also acetylcholine-stimulated FBF significantly modified the effect of HOMA on HF development. Our findings demonstrate that both endothelial dysfunction and HOMA are independent and strong predictors of incident HF in hypertensives; we also demonstrated that these two risk factors interact between them with a competitive mechanism.Figure 1Figure 2

Body mass index is a good predictor of metabolic abnormalities in polycystic ovary syndrome.

To assess which parameters among hyperandrogenism (total testosterone-tT-or free androgen index-FAI), sex hormone binding globulin (SHBG) or body mass index (BMI) could better predict a worse metabolic profile in women with polycystic ovary syndrome (PCOS). Five hundred and eighty-six women with PCOS and clinical or biochemical hyperandrogenism were included. Receiver Operating Characteristics (ROC) curves with tT, FAI, SHBG and BMI were performed for metabolic parameters and a cut-off with sensitivity and specificity was obtained for each parameter. The women were then divided into three groups and compared according to their BMI. Based on the ROC curves, tT proved not to be a good predictor of metabolic alterations. FAI and SHBG resulted to be good predictors of some markers of metabolic damage. The area under the curves (AUC) of SHBG were greater than those of FAI. SHBG levels affects the values of homeostasis model assessment of insulin resistance (HOMA-IR), fasting insulin, high density lipoproteins (HDL), low density lipoproteins (LDL), and total cholesterol also when corrected for BMI. However, the highest AUCs of the ROC curves were observed when BMI was used, which was significantly related to all the metabolic parameters analyzed. Dividing women according to their BMI, BMI between 25.00 and 30.00 kg/m2 had a worse metabolic profile but still in a normal range, while BMI≥30 kg/m2 women had a significant metabolic derangement. BMI is a good predictor factor of metabolic changes in PCOS women at any age, and obesity is associated to the appearance of metabolic complications. Overweight and obese PCOS women should be addressed to perform a complete metabolic assessment.

Retracted: Predictive Value of Homeostasis Model Assessment of Insulin Resistance, Visceral Fat Index, and Prepregnancy Body Mass Index in Gestational Metabolic Syndrome.

[This retracts the article DOI: 10.1155/2021/6709725.].

Metabolic syndrome, HOMA-IR and adiponectin in obese adolescents

Background: Homeostasis model assessment (HOMA) is a method used to measure insulin resistance (IR). Adiponectin is involved in the development of atherosclerosis. Objectives: This study aimed to assess metabolic syndrome (MetS) prevalence in adolescents with obesity; correlate HOMA-IR and IR incidence with MetS biochemical parameters and MetS components; as well as correlate adiponectin levels and hypoadiponectinemia incidence with MetS biochemical parameters and MetS components. Methods: This study was conducted at the Outpatient Installation Unit of Nutrition and Metabolic Diseases, Child Health Department, Dr. Soetomo General District Hospital, Surabaya, Indonesia with a cross-sectional study design. It lasted for nine months and focused on obese adolescents aged 13-18 years. Anthropometric measurements and blood biochemistry analyses were done. HOMA-IR was calculated using the formula [glucose (mg/dL) x Insulin (µu/L)]/405. Results: A total of 216 obese adolescents took part in the study. MetS was found in 81 subjects (37.96%). There was weak correlation between HOMA-IR ​​with anthropometric measurements, lipid profiles, fasting blood glucose, and serum adiponectin levels (p<0.05). IR was found to increase the risk of MetS development by 1.661-times, dyslipidemia by 1.845-times, and abdominal obesity by 3.077-times. IR increased the risk of MetS incidence with more than three IDF criteria by 9.368-times. There was a correlation between adiponectin levels with the HDL-c. Hypoadiponectinemia was correlated with the incidence of MetS, abdominal obesity, and hypertriglyceridemia. It also increased the risk of developing MetS by 2.220-times. There was a positive relationship between IR HOMA value ​​and the anthropometric parameters of obesity and MetS parameters. Conclusions: IR was found to be associated with dyslipidemia, abdominal obesity, and MetS incidence with more than three IDF criteria. There was a relationship between hypoadiponectinemia and waist circumference, hip circumference, HDL-c, and triglycerides. Insulin resistance and hypoadiponectinemia were associated with Mets and hypertriglyceridemia incidence.

Association Between Triglyceride-Glucose Index and Serum Uric Acid Levels: A Biochemical Study on Anthropometry in Non-Obese Type 2 Diabetes Mellitus Patients.

The triglyceride-glucose index (TyG) is positively correlated with serum uric acid (SUA) in patients with type 2 diabetes mellitus (T2DM). However, whether this relationship exists in non-obese T2DM patients remains unknown. The study investigated the relationship between TyG and SUA in Chinese non-obese T2DM patients and examined the prognostic value of TyG in hyperuricemia (HUA). In total, 719 T2DM patients who were not obese were enrolled from among those who visited the Hebei General Hospital. The patients were categorized into groups according to their SUA levels. The relationship between TyG and clinical parameters was examined through correlation analysis. To consider covariates and examine the independent impact of TyG on HUA, logistic regression was performed. The receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of TyG and homeostasis model assessment of insulin resistance (HOMA-IR) for HUA. The HUA prevalence was 12.10%. TyG was statistically different among the four SUA groups, with lower TyG levels in the Q1, Q2, and Q3 groups than that in the Q4 group. TyG was positively correlated with SUA (r = 0.176, P < 0.001). Logistic regression exhibited that TyG and SUA were independently correlated (OR = 2.427, 95% CI = 1.134-5.195, P = 0.022) even after adjustment for confounding factors. The ROC curve showed that the predictive value of TyG for HUA was higher than that of HOMA-IR (AUROC = 0.613, P = 0.001). TyG was positively correlated with SUA in non-obese T2DM patients. TyG may better predict HUA in non-obese T2DM patients than HOMA-IR.

Baseline Insulin Resistance Is a Determinant of the Small, Dense Low-Density Lipoprotein Response to Diets Differing in Saturated Fat, Protein, and Carbohydrate Contents.

Individual responses to diet vary but causes other than genetics are poorly understood. This study sought to determine whether baseline values of homeostasis model assessment (HOMA-IR) was related to changes in small, dense low-density lipoprotein (sdLDL, i.e., LDL4, d = 1.044–1.063 g/mL) amounts quantified by isopycnic density profiling, in mildly hypercholesterolemic subjects (n = 27) consuming one of three low saturated fatty acid (SFA) diets: Dietary Approaches to Stop Hypertension (DASH), Beef in an Optimal Lean Diet (BOLD) and BOLD plus extra protein (BOLD+) when compared to a higher-SFA healthy American diet (HAD). The diets were consumed in random order for 5 wk, with 1 wk between diets. BOLD+ reduced fractional abundance (%) LDL4 (p < 0.05) relative to HAD, DASH and BOLD, and reductions in % LDL4 correlated with reductions in triglycerides (p = 0.044), total cholesterol (p = 0.014), LDL cholesterol (p = 0.004) and apolipoprotein B (p < 0.001). Responses to the four diets were similar (~12% decrease in % LDL4, p = 0.890) in the lower (<2.73 median) HOMA-IR subgroup but differed across diet conditions in the higher HOMA-IR subgroup (p = 0.013), in which % LDL4 was reduced with BOLD+ (−11%), was unchanged in BOLD and increased with the HAD (8%) and DASH (6%) diets (p < 0.05 for BOLD+ vs. HAD). Individual responses to diet interventions are influenced by presence and degree of insulin resistance as measured by HOMA-IR.

Insulin resistance quantified by the value of HOMA-IR and cardiovascular risk in patients with type 2 diabetes.

Cardiovascular disease (CVD) is recognized as a leading cause of death worldwide. Obesity, dyslipidemia, insulin resistance (IR), interconnected pathological conditions constitute risk factors that are closely associated with CVD. The aim of the present study was to highlight the association of IR with cardiovascular risk (CVR). The epidemiological, cross-sectional, non-interventional study was conducted over 12 months (2019-2020) within a research grant and included a sample of 400 subjects divided into 2 subgroups: group 1 (control) subjects did not have diabetes (n=200) and group 2 had type 2 diabetes (T2DM) (n=200). The Framingham risk score (FRS) was calculated according to the 2008 general CVD risk model from the Framingham Heart Study. Subsequent to a correlation of the value of homeostasis model assessment of insulin resistance (HOMA-IR) with the degree of CVR, the IR was higher in both groups, and CVR also increased. After being quantified by the Spearman correlation coefficient, the correlation in group 2 was higher at 0.625 compared to group 1 where this coefficient had a value of 0.440. A high FRS (FRS of 20%) was significantly associated with IR. The results therefore show that HOMA-IR is an independent risk factor for high FRS. New therapies focused on decreasing IR may contribute to decreased CVD.

Predictive Value of Homeostasis Model Assessment of Insulin Resistance, Visceral Fat Index, and Prepregnancy Body Mass Index in Gestational Metabolic Syndrome.

Objective To explore the diagnostic value of homeostasis model assessment of insulin resistance (HOMA-IR), visceral fat index (VAI), and prepregnancy body mass index (BMI) in gestational metabolic syndrome (GMS). Methods From December 2019 to March 2021,122 GMS high-risk pregnant women who received routine antenatal clinic visits and planned to give birth in our hospital were selected as the research objects. Pregnant women were divided into the GMS group (n = 79) and the control group (n = 43) according to GMS diagnostic criteria during the gestation period of 32–36 weeks. The general information such as age and gestational week of pregnant women as well as HOMA-IR, VAI, and BMI before pregnancy were compared between the two groups. The glucose and lipid metabolism indexes of pregnant women in two groups were analyzed, the detection rates of HOMA-IR, VAI, and prepregnancy BMI in GMS between the two groups were compared. Logistic regression was used to analyze the risk factors for GMS in pregnant women, and receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of HOMA-IR, VAI, prepregnancy BMI, and the combination of the three for GMS. Results The body weight, systolic blood pressure, and diastolic blood pressure of the GMS group were higher than those of the control group, and the differences were statistically significant (P < 0.05). There was no significant difference in age, gestational week, and height between the two groups (P > 0.05). The levels of FPG, FINS, TC, TG, LDL-C, and FFA in the GMS group were higher than the control group, the level of HDL-C in the GMS group was lower than the control group, and the difference was statistically significant (P < 0.05). The levels of HOMA-IR, VAI, and prepregnancy BMI in the GMS group were higher than those in the control group, and the differences were statistically significant (P < 0.05). The positive detection rates of HOMA-IR, VAI, and prepregnancy BMI in the GMS group were 83.54%, 86.07%, and 81.01%, respectively. There was no significant difference in the positive detection rates of HOMA-IR, VAI, and prepregnancy BMI between the two groups (P > 0.05). High levels of HOMA-IR, VAI, and prepregnancy BMI were risk factors for GMS in pregnant women (P < 0.05). ROC curve showed area under the curve for HOMA-IR was 0.810, area under the curve for VAI was 0.771, and area under the curve for prepregnancy BMI was 0.749. The AUC for the combination of HOMA-IR, VAI, and prepregnancy BMI was 0.918. Conclusion HOMA-IR, VAI, and prepregnancy BMI in GMS have a high detection rate and certain diagnostic value, and the combination of the three has higher clinical value.

Genistein for glycolipid metabolism in postmenopausal women: a meta-analysis

Objective This study aimed to evaluate the effects of genistein on glycolipid metabolism in postmenopausal women. Methods Electronic databases were searched and relevant reports were hand-screened. We included only randomized controlled trials of isolated genistein for glycolipid metabolism. The primary outcome for lipid metabolism included a changed value of low-density lipoprotein cholesterol (LDL-C), and for glucose metabolism was a changed value of homeostasis model assessment for insulin resistance (HOMA-IR). Secondary outcomes included a changed value of total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), fasting blood insulin (INS), and body mass index (BMI). Results Ten trials with 11 articles were included. The level of LDL-C was not decreased in the genistein group compared with the placebo group (standardized mean difference [SMD] = −0.58; 95% confidence interval [CI] − 1.19, 0.02; p = 0.06). No statistical significance was found in subgroup analyses. HOMA-IR was obviously improved in the genistein group with SMD of −0.51 (95% CI −0.88, −0.14; p = 0.006). In subgroup analyses, HOMA-IR was improved more in women with BMI <30 kg/m2 and without metabolic disorders (p < 0.0001). For secondary outcomes, there were significant differences in total cholesterol, HDL-C, FBG, and INS, but not triglyceride or BMI. Conclusions Genistein was effective in ameliorating glycolipid metabolism by increasing HDL-C levels and decreasing total cholesterol levels and improving insulin sensitivity.

The Effect of Exogenous Free Nε-(Carboxymethyl)Lysine on Diabetic-Model Goto-Kakizaki Rats: Metabolomics Analysis in Serum and Urine.

The current study investigated the effects of exogenous free Nε-(carboxymethyl) lysine (CML) from daily diet on diabetic-model Goto-Kakizaki rats. Rats were fed with free CML (2 mg/kg body weight) for 8 weeks, then metabolomics evaluation was performed on serum and urine, and biochemical and histopathologic examinations were conducted to verify metabolic results. Diabetic rats fed with free CML showed significantly increased (P < 0.05) fasting blood glucose (11.1 ± 1.07 mmol/L) and homeostasis model assessment values (homeostatic model assessment of insulin resistance: 16.0 ± 4.24; homeostatic model assessment of beta cell function: 6.66 ± 2.01; and modified beta cell function index: 11.5 ± 2.66) and a significantly altered (P < 0.05) oxidative stress level when compared to the control group. Serum and urine metabolomics showed a significantly altered (P < 0.05) level of aminomalonic acid, 2-oxoadipic acid, l-malic acid, β-alanine, 2-oxoglutaric acid, d-threitol, N-acetyl-leucine, methylmalonic acid, l-cysteine, thymine, glycine, l-alanine, 4-hydroxyproline, hexadecane, succinic acid, l-ornithine, gluconolactone, maleic acid, l-lactate, tryptophan, 5-methoxyindoleacetate, γ-aminobutyric acid, homoserine, maltose, and quinolinic acid. Our results indicated that these metabolites altered by exposure to exogenous free CML were mapped to the citric acid cycle and amino acid and carbohydrate metabolism, which might be related to increased progression of diabetes and some other diabetic complications, including diabetic brain and neurological diseases, retinopathy, nephropathy, and impaired wound healing.

A preliminary study about neurofilament light chain and tau protein levels in psoriasis: Correlation with disease severity.

BackgroundStudies investigating cognitive dysfunction in psoriatic patients remain inconclusive.ObjectiveTo investigate the risk of cognitive decline in plaque‐type psoriasis patients.MethodsSerum neurofilament light chain (NFL) and tau protein concentrations in 45 patients with plaque‐type psoriasis and forty‐five healthy controls were measured by enzyme‐linked immunosorbent assay (ELISA).ResultsMean homeostasis model assessment (HOMA‐IR) values (6.82 vs 3.25) and serum levels of insulin (28.19 vs 15.71), NFL (5.74 vs 1.98), and tau (348.17 vs 207.30) in patients with psoriasis were found to be significantly higher than those of in healthy controls. There was a significant positive correlation between NFL and tau (r = .257, P = .015). There was significant correlation between NFL, tau and PASI (r = .310, P = .040) and (r = .383, P = .010), respectively. Significant correlations between NFL and insulin, TC, HDL‐C, TG, VLDL‐C, and BMI were found. NFL (9.38 vs 3.08) and tau (439.28 vs 281.58) concentrations and PASI values (23.94 vs 14.18) in patients with disease onset before 40 years were significantly higher than that of the patients with disease onset after 40 years. C‐reactive protein (CRP) was significantly correlated with BMI (r = .449, P < .001), LDL‐C (r = .240, P = .026), TG (r = .244, P = .024), and VLDL‐C (r = .241, P = .025) in patients with psoriasis.ConclusionsIncreased serum NFL and tau protein levels and the presence of positive correlations between NFL, tau protein and PASI score show cognitive decline risk may be higher in moderate‐to‐severe psoriasis.

Serum lipoprotein(a) levels and insulin resistance have opposite effects on fatty liver disease

Background and aimsHigh lipoprotein(a) [Lp(a)] levels are associated with increased risk of cardiovascular disease. However, the association between Lp(a) and fatty liver disease (FLD) remains controversial. Therefore, we analyzed the relationship between FLD and serum Lp(a) levels in Korean adults. MethodsA total of 22,534 participants who underwent a routine health screening program at Kangbuk Samsung Hospital in 2010 and 2014 were enrolled. Anthropometric and biochemical parameters, including Lp(a), were measured. The presence of FLD was assessed using abdominal ultrasonography. Odds ratios (ORs) for the presence of FLD were analyzed in quartile groups of serum Lp(a) levels using logistic regression. We divided the participants into four groups according to the median values of Lp(a) and homeostasis model assessment for insulin resistance (HOMA-IR). ResultsAmong the total study population, 3030 (13.4%) participants had fatty liver disease. The mean Lp(a) level was lower in subjects with FLD than in those without (70.0 vs 73.8 nmol/L, p < 0.001). The OR for FLD was the lowest in the fourth Lp(a) quartile group, using the first quartile group as the reference group after adjusting for confounding factors [0.815; 95% confidence interval (CI) 0.725–0.916]. When the OR for FLD was analyzed in four groups divided by the median values of Lp(a) and HOMA-IR, the low Lp(a)-high HOMA-IR group had the greatest OR for FLD, using the high Lp(a)-low HOMA-IR group as the reference (1.903; 95% CI 1.679–2.158). ConclusionsSerum Lp(a) levels were inversely associated with the presence of FLD. Subjects with low Lp(a) and high insulin resistance (IR) showed higher risk of FLD than those with high Lp(a) and low IR, suggesting the opposite associations of Lp(a) and IR with FLD.

Inverse correlation between serum high-molecular-weight adiponectin and proinsulin level in a Japanese population: The Dynamics of Lifestyle and Neighborhood Community on Health Study.

Serum high‐molecular‐weight adiponectin (HMWA) has a positive correlation with insulin secretion in the Japanese population. To validate this correlation, we investigated the correlation between serum HMWA and proinsulin, a marker of β‐cell dysfunction, in this population. A total of 488 participants (53.9% women) aged 35–79 years not taking oral hypoglycemic agents and/or insulin were enrolled. HMWA was significantly and inversely correlated with proinsulin adjusted for age and sex (partial regression coefficient β = −0.37; 95% confidence interval −0.46 to −0.28). When the participants were divided into two groups by median values of body mass index (23.2 kg/m2), serum insulin (4.3 µU/mL) or homeostasis model assessment of insulin resistance (1.0), similar inverse correlations were observed adjusted for age and sex in both groups. Our results showed that the HMWA level was inversely correlated with the proinsulin level in a general Japanese population.

Potential roles of psychological and oxidative stress in insulin resistance: a cohort-based study

BackgroundThe present study investigated the relationships between psychological stress indices and oxidative stress marker, also when combined with emergent insulin resistance (IR), in the non-diabetic, middle-aged subjects, exposed to frequent/chronic psychological stressors.MethodsCross-sectional data from a cohort of non-diabetic police officers (n = 234; 19F), aged 27–56 years, were used. Plasma inflammatory (CRP, TNF-α), oxidative stress (free 8-iso-prostaglandin F2α; 8-iso-PGF2α) markers, and insulin were measured. The value of homeostasis model assessment of IR index (HOMA-IR) was assumed the threshold value of IR, i.e. 2.04. Free cortisol in urine and perceived stress (psychological stress indices) were also measured.ResultsIn the IR subjects, most biochemical variables, inflammatory markers and urine cortisol were significantly higher, as compared to the non-IR ones. Psychological stress indices were associated with plasma 8-iso-PGF2α [B = 0.139, 95% CI (0.048, 0.230), p = 0.002, and B = 0.007, 95% CI (0.0006, 0.014), p = 0.03; for perceived stress level and cortisol, respectively]. Positive associations were established between plasma 8-iso-PGF2α [B = 0.069, 95% CI (0.016–0.120), p = 0.01] and urine cortisol [B = 0.003, 95% CI (0.0003, 0.005), p = 0.02] with HOMA-IR. Metabolic syndrome, as defined by IDF criteria, was established in 110 study subjects, whereas 136 of them were hypertensive. Waist circumference [B = 0.056, 95% CI (0.039, 0.074), p < 0.0001], and systolic blood pressure [B = 0.009, 95% CI (0.00003, 0.018), p = 0.04] were positively associated with HOMA-IR, whereas the association of HDL cholesterol [B = − 0.597, 95% CI (− 1.139, − 0.055), p = 0.03] was a negative one. Cortisol [OR = 1.007, 95% CI (1.002, 1.012), p = 0.006], and 8-iso-PGF2α [OR = 1.103, 95% CI (1.010, 1.201), p = 0.02] affected the incidence of IR. After adjustment for metabolic syndrome (or its components), age, sex, and current smoking, the effects became non-significant. Out of metabolic syndrome components, waist circumference [OR 4.966, 95% CI (2.29, 10.751), p = 0.00004] and hypertriglyceridemia [OR 1.993, 95% CI (1.063, 3.736), p = 0.03] increased the chance of IR incidence.ConclusionsBoth psychological stress indices were associated with oxidative stress, but only cortisol with HOMA-IR. In the subjects exposed to frequent/chronic psychological stressors, cortisol and oxidative stress marker affected IR incidence, being statistically attenuated, though, following adjustment for metabolic syndrome, or its components.

Optimal reference values for insulin sensitivity indices in Iranian healthy females: a population-based study

To define reference values for various insulin sensitivity (IS) indices in healthy women in a population-based study of the five provinces in Iran In this cross-sectional study, 250 normal-weighted women without hypertension, diabetes, polycystic ovary syndrome, hormonal disorders, pregnancy, or menopause were evaluated in this study. After a 12-h fasting, blood samples were obtained from all participants, levels of metabolic markers (fasting plasma glucose, lipid profile, insulin, etc.) were measured using enzymatic colorimetric and ultrasensitive enzyme-linked radioimmunoassay methods. Multiple insulin sensitivity indices were calculated using well-known predetermined formulas. K-means cluster analysis was used to determine reference values for each insulin sensitivity index. The threshold values of homeostasis model assessment (HOMA-%β, HOMA-βcell) and fasting insulin resistance index (FIRI) were 400.41, 198.55, and 2.57 corresponding to 97th, 93rd, and 92nd percentiles, respectively. Reference values of quantitative insulin sensitivity check index (QUICKI) and TG/HDL-c were 0.44 and 4.40, both of which relate to 92nd percentile. The recently introduced single-point insulin sensitivity estimator (SPISE) was analyzed and showed a threshold of 10.10 (87th percentile) in this study. Threshold values of reciprocal insulin (1/Insulin) and glucose-to-insulin ratio (G/I) were 0.51 (95th percentile) and 76.91 (99th percentile), respectively. This study determined reference values for various insulin sensitivity indices in healthy Iranian women. These values can be used to define insulin sensitivity in women in epidemiological and clinical studies.

Rs7903146 (C/T) polymorphism of Transcription factor 7 like 2 (TCF7L-2) gene is independently associated with non-alcoholic fatty liver disease in Asian Indians

Background and aimsTranscription factor 7 like 2 (TCF7L-2) polymorphism has been associated with adipocyte metabolism and insulin resistance. Genetic investigations of non-alcoholic fatty liver disease (NAFLD) with obesity, type 2 diabetes mellitus (T2DM) and atherosclerosis are unknown. This study was designed to investigate the association of rs7903146 (C/T) polymorphism of TCF7L-2 gene with non-alcoholic fatty liver disease (NAFLD) in Asian Indians. MethodsIn this case-control study 162 non-diabetic subjects with NAFLD and 173 body mass index (BMI)-matched controls without NAFLD were recruited. Abdominal ultrasound, clinical and biochemical investigations, fasting insulin levels and value of homeostasis model assessment of insulin resistance (HOMA-IR) was measured. Single nucleotide polymorphism rs7903146 (C/T) was genotyped by polymerase chain reaction–restriction fragment length polymorphisms. ResultsThe distribution of rs7903146 (C/T) alleles, the dominant model (CT + TT) and higher frequency (31%) of C/T genotype were significantly associated with NAFLD. C/T genotype of TCF7L2 gene was associated with significantly higher levels of BMI (p = 0.02), abdominal obesity (p < 0.05), fasting blood glucose (p = 0.05), hepatic transaminases (p < 0.05) and markers of insulin resistance (p < 0.05) in subjects with NAFLD. Using a multivariate analysis after adjusting for age and sex, TCF7L2 polymorphism was independently associated with presence of NAFLD [(OR: 3.234 (95% CI: 1.219-4.160, p = 0.002)]. ConclusionTCF7L2 (C/T) gene was Independently associated with NAFLD in Asian Indians.

Influence of post-Roux-en-Y gastric bypass weight recidivism on insulin resistance: a 3-year follow-up.

Although some early metabolic benefits provided by bariatric surgery are known tooccur regardless of weight loss, the impact of mid- to long-term weight recidivism after Roux-en-Y gastric bypass (RYGB) on metabolic outcomes is not profoundly understood. To investigate the effect of weight recidivism on insulin resistance among nondiabetic individuals with morbid obesity after RYGB during a 3-year follow-up. Public tertiary university hospital. This is a cohort study based on a prospectively collected database of a public tertiary university hospital, which enrolled individuals with morbid obesity who underwent RYGB and were followed-up for 3 years. Weight loss was classified into the following 3 categories: (1) no weight regain; (2) expected regain (regain ≤20% of the maximum weight loss); and (3) obesity recidivism (regain >20% of the maximum weight loss). Homeostasis model assessment (HOMA) values were compared over time. Of 100 patients, 20% presented obesity recidivism and 52% an expected regain after 3 years of surgery; 28% showed no regain. The recidivism group presented a significant increase in HOMA 3 years after surgery (P = .02). The recidivism group presented a significantly higher HOMA 3 years after surgery than the observed in the other groups (P < .001), as well as a significantly higher percentage of HOMA variation throughout the follow-up (P = .02). Weight recidivism after RYGB was significantly associated with a worsening of insulin resistance among nondiabetic individuals with morbid obesity. Thus, weight loss seems to play a significant role in the maintenance of the early metabolic improvement achieved after RYGB.

The HOMA-IR cut-off values for diagnosis of insulin resistance and relationship of metabolic syndrome with insulin resistance in elderly people in Minhang District of Shanghai

Objective To investigate the threshold values of insulin resistance (IR) assessed by homeostasis model and the prevalence of IR in elderly people over 60 years old in Minhang district of Shanghai, and to evaluate the relationship between IR and metabolic syndrome (MS). Methods A total of 3 003 elderly people aged 60 and over in the Jiangchuan community of Minhang District, Shanghai, were recruited, including 1 286 males and 1 717 females. Blood pressure, waist circumference, BMI, blood routine, serum creatinine, blood lipids, glucose, and fasting insulin were measured in all populations studied. Homeostasis model assessment (HOMA) was used to estimate IR, and MS, and defined according to three diagnostic criteria including NCEP-ATPIII, IDF, and CDS. Results 75th percentile, 80th percentile and 90th percentile of HOMA values in 268 subjects with normotensive and normal BMI, glucose tolerance were considered as the thresholds of IR. The cut-off values were 2.78, 3.01 and 3.56, respectively. And the prevalence of IR were 50.0%, 42.1%, and 27.2%, respectively. IR level was significantly higher in people with MS. Based on the receiver operating characteristic(ROC) curve analysis, HOMA-IR and QUICKI index predicted MS well, and the optimal thresholds for diagnosing MS of HOMA-IR were 3.17 for NCEP-ATPⅢ, 3.02 for IDF and 3.03 for CDS. BMI was the best factor for diagnosing IR among different MS components. Logistic regression analysis showed that gender, WC, BMI, SBP, HDL-C, TG, FBG and WBC were independent risk factors for IR. FBG≥5.84 mmol/L was the most dangerous factor of IR (OR=3.603, P<0.01), followed by WC≥85.4 cm(OR=2.152, P<0.01) and BMI≥24.6 kg/m2(OR=2.150, P<0.01). Conclusion The cut-off values of IR estimated by HOMA and the prevalence of IR were higher in elder subjects than other populations. IR was significantly positively correlated with MS. Excluding the conditions that insulin measurement were affected by external factors, HOMA-IR may predict the risk of MS. The components of MS were relative specific measurements of IR, FBG, BMI and WC were important risk predictors of IR in the elderly. Key words: Elderly Population; Insulin resistance; Metabolic syndrome

Mediation role of cardiorespiratory fitness on the association between fatness and cardiometabolic risk in European adolescents: The HELENA study

PurposeThis study was aimed to analyze the mediation role of cardiorespiratory fitness (CRF) on the association between fatness and cardiometabolic risk scores (CMRs) in European adolescents. MethodsA cross-sectional study was conducted in adolescents (n = 525; 46% boys; 14.1 ± 1.1 years old, mean ± SD) from 10 European cities involved in the Healthy Lifestyle in Europe by Nutrition in Adolescence study. CRF was measured by means of the shuttle run test, while fatness measures included body mass index (BMI), waist to height ratio, and fat mass index estimated from skinfold thicknesses. A clustered CMRs was computed by summing the standardized values of homeostasis model assessment, systolic blood pressure, triglycerides, total cholesterol/high-density lipoprotein cholesterol ratio, and leptin. ResultsLinear regression models indicated that CRF acted as an important and partial mediator in the association between fatness and CMRs in 12–17-year-old adolescents (for BMI: coefficients of the indirect role β = 0.058 (95% confidence interval (95%CI): 0.023–0.101), Sobel test z = 3.11 (10.0% mediation); for waist to height ratio: β = 4.279 (95%CI: 2.242–7.059), z =3.86 (11.5% mediation); and for fat mass index: β = 0.060 (95%CI: 0.020–0.106), z = 2.85 (9.4% mediation); all p < 0.01). ConclusionIn adolescents, the association between fatness and CMRs could be partially decreased with improvements to fitness levels; therefore, CRF contribution both in the clinical field and public health could be important to consider and promote in adolescents independently of their fatness levels.