Surrogate indices of insulin resistance using the Matsuda index as reference in adult men-a computational approach.

Background: Overweight and obesity, high blood pressure, hyperglycemia, hyperlipidemia, and insulin resistance (IR) are strongly associated with non-communicable diseases (NCDs), including type 2 diabetes, cardiovascular disease, stroke, and cancer. Different surrogate indices of IR are derived and validated with the euglycemic-hyperinsulinemic clamp (EHC) test. Thus, using a computational approach to predict IR with Matsuda index as reference, this study aimed to determine the optimal cutoff value and diagnosis accuracy for surrogate indices in non-diabetic young adult men. Methods: A cross-sectional descriptive study was carried out with 93 young men (ages 18-31). Serum levels of glucose and insulin were analyzed in the fasting state and during an oral glucose tolerance test (OGTT). Additionally, clinical, biochemical, hormonal, and anthropometric characteristics and body composition (DEXA) were determined. The computational approach to evaluate the IR diagnostic accuracy and cutoff value using difference parameters was examined, as well as other statistical tools to make the output robust. Results: The highest sensitivity and specificity at the optimal cutoff value, respectively, were established for the Homeostasis model assessment of insulin resistance index (HOMA-IR) (0.91; 0.98; 3.40), the Quantitative insulin sensitivity check index (QUICKI) (0.98; 0.96; 0.33), the triglyceride-glucose (TyG)-waist circumference index (TyG-WC) (1.00; 1.00; 427.77), the TyG-body mass index (TyG-BMI) (1.00; 1.00; 132.44), TyG-waist-to-height ratio (TyG-WHtR) (0.98; 1.00; 2.48), waist-to-height ratio (WHtR) (1.00; 1.00; 0.53), waist circumference (WC) (1.00; 1.00; 92.63), body mass index (BMI) (1.00; 1.00; 28.69), total body fat percentage (TFM) (%) (1.00; 1.00; 31.07), android fat (AF) (%) (1.00; 0.98; 40.33), lipid accumulation product (LAP) (0.84; 1.00; 45.49), leptin (0.91; 1.00; 16.08), leptin/adiponectin ratio (LAR) (0.84; 1.00; 1.17), and fasting insulin (0.91; 0.98; 16.01). Conclusions: The computational approach was used to determine the diagnosis accuracy and the optimal cutoff value for IR to be used in preventive healthcare.

Study of the Ghrelin/LEAP-2 Ratio in Humans and Rats during Different Phases of Pregnancy.

The Liver-Expressed Antimicrobial Peptide 2 (LEAP-2) has emerged as an endogenous GHS-R antagonist and blunts the orexigenic action of ghrelin. This study aimed to determine the Ghrelin/LEAP-2 ratio in humans and rats during pregnancy. In humans, we conducted a nested case-control study within an observational prospective cohort. Healthy and mild preeclamptic pregnant women were studied at each trimester of gestation and three months postpartum. In addition, a group of non-pregnant women was studied into the follicular and luteal phases of the menstrual cycle. Furthermore, Ghrelin/LEAP-2 ratio was investigated in non-pregnant rats and at different periods of rat pregnancy. Human and rat serum ghrelin and LEAP-2 levels were determined using the commercially available ELISA kits. The Ghrelin/LEAP-2 ratio peak around the second trimester of gestation in healthy pregnant women (p < 0.05). Additionally, there were no statistically significant differences in Ghrelin/LEAP-2 ratio between healthy and preeclamptic pregnant women at each trimester of gestation (p > 0.05). The Ghrelin/LEAP-2 ratio in pregnant rat reached the peak around mid-gestation with a similar pattern to the human pregnancy. LEAP-2 was visualized by immunohistochemistry in human term placenta and rat placentas on days 12, 16 and 21 of pregnancy. In conclusion, this study provides the first evidence of a Ghrelin/LEAP-2 ratio peak around the half-way point of pregnancy onwards during human and rat pregnancy, and it might be associated with increased rates of weight gain during pregnancy. Thus, this study suggests that LEAP-2 and Ghrelin/LEAP-2 ratio might play an important role in maternal physiology adaptation of weight gain during pregnancy.

Maternal Serum Angiopoietin-Like 3 Levels in Healthy and Mild Preeclamptic Pregnant Women.

Objective: Angiopoietin-like protein 3(ANGPTL3) is an important regulator of lipoprotein metabolism in the fed state by inhibiting the enzyme lipoprotein lipase in oxidative tissues. However, the possible role of ANGPTL3 throughout gestation and its relationship with hormonal and biochemical variables are still unknown. The aim of this study was to determinate serum ANGPTL3 level in healthy non-pregnant women, during healthy and preeclamptic pregnancy and postpartum. Methods: Serum ANGPTL3 was analyzed by enzyme-linked immunosorbent assay (ELISA), in a prospective cohort of healthy pregnant women (n = 52) and women with mild preeclampsia (n = 21), and women at three months postpartum (n = 20) and healthy non-pregnant women (n = 20). The results obtained were correlated with biochemical, hormonal and anthropometric variables and insulin resistance indices. Results: Levels of ANGPTL3 were not different between the follicular and the luteal phases of the cycle in healthy non-pregnant women. There was a significant reduction in serum ANGPTL3 levels from the first to the third trimester in healthy pregnant women compared with healthy non-pregnant and postpartum women (p <0.01). ANGPTL3 levels do not differ significantly during the three trimesters of pregnancy neither in healthy women nor in preeclamptic women. The serum levels of ANGPTL3 in women who developed preeclampsia are not statistically different from those observed in healthy pregnant women in each trimester of pregnancy. A significant lineal positive correlation was observed between serum ANGPTL3 levels and triglyceride (P =0.0186, r =0.52), very low-density lipoprotein cholesterol (P =0.0224, r =0.50), and total cholesterol levels (P =0.0220, r =0.50) in healthy non-pregnant women (P 0.05). Besides, there were no significant correlations between serum ANGPTL3 and body mass index (BMI), high-density lipoprotein cholesterol, glucose, insulin, leptin, or HOMA-IR (P >0.05). Conclusions: We describe for the first time the profile of ANGPTL3 throughout pregnancy and postpartum as well as and discussed about explore their potential contribution interactions with lipoprotein metabolism throughout pregnancy and postpartum. Thus, low levels of ANGPTL3 during pregnancy might favor lipid uptake in oxidative tissues as the main maternal energy source, while may helping to preserve glucose for use by the fetus and placenta.

Serum angiopoietin-like 3 levels are elevated in obese non diabetic men but are unaffected during an oral glucose tolerance test.

This study aimed to determine ANGPTL3 serum levels in healthy young lean and obese non-diabetic men during an oral glucose tolerance test (OGTT) and correlate them with anthropometric, biochemical and hormonal parameters. A case-control study was carried out and 30 young obese non-diabetic (23.90 ± 3.84 years and BMI 37.92 ± 4.85 kg/m2) and 28 age-matched healthy lean (24.56 ± 3.50 years and BMI of 22.10 ± 1.72 kg/m2) men were included in this study. The primary outcome measures were serum basal ANGPTL3 and ANGPTL3-area under the curve (AUC) levels. The percentage of body fat was measured by dual-energy X-ray absorptiometry and biochemical, hormonal and insulin resistance indices were determined. Basal ANGPTL3 and ANGPTL3-AUC levels were significantly elevated (p < 0.05) in young obese subjects compared with lean subjects and were positively and significantly associated with different anthropometric measurements. Fasting ANGPTL3 serum levels were positively correlated with fasting insulin, leptin, Leptin/Adiponectin index and triglyceride-glucose index. Moreover, ANGPTL3-AUC was negatively correlated with Matsuda index. In this regard, chronically high ANGPTL3 levels in young obese subjects might favor triglyceride-rich lipoprotein clearance to replenish triglyceride stores by white adipose tissue rather than oxidative tissues.

Niveles séricos de 25-hidroxivitamina D y su relación con síndrome metabólico en una población de hombres jóvenes no diabéticos / Serum levels of 25-hydroxy vitamin D and their relationship to metabolic syndrome in a population of young nondiabetic men

Resumen Introducción: los niveles no suficientes de vitamina D (VD) se han asociado a varias patologías no osteomusculares; sin embargo, es motivo de controversia si éstos se asocian a mayor prevalencia de síndrome metabólico (SM). Objetivo: determinar y comparar la frecuencia de insuficiencia y deficiencia de 25-hidroxivitamina D (25(OH)D) entre hombres jóvenes obesos no diabéticos y controles con peso normal, y su correlación con el estado de SM. Material y métodos: estudio de corte transversal, que incluyó 62 individuos con peso normal y 47 en obesidad, se determinaron los niveles séricos de 25(OH)D y se midieron parámetros antropométricos y bioquímicos para establecer criterios de SM. Resultados: de los 47 sujetos con obesidad, 25 tenían SM, mientas que ninguno de los sujetos de peso normal cumplía con dichos criterios. No se encontraron diferencias estadísticamente significativas en cuanto a la presencia de síndrome en correlación con los niveles de vitamina D (p=0.94). La media de los niveles séricos de 25(OH)D para la población total fue 30.6±8.3 ng/ mL; en sujetos normopeso 30.8±8.5 ng/mL y entre los obesos con SM fue 30.1±9.2 ng/mL y sin SM de 30.6±7.5 ng/mL. Por otro lado no hubo una correlación significativa entre los parámetros individuales de síndrome metabólico y los niveles séricos de VD, tanto de manera global, como en el análisis por subgrupos. Conclusión: no hubo una correlación significativa entre los niveles séricos de 25(OH)D con el estado de SM, tampoco se identificó ningún tipo de correlación significativa entre éstos y los parámetros antropométricos y bioquímicos estudiados.(Acta Med Colomb 2020; 45. DOI:doi.org/10.36104/amc.2020.1323).

Abstract Introduction: insufficient levels of vitamin D (VD) have been associated with several non-musculoskeletal diseases. However, whether they are associated with a greater prevalence of metabolic syndrome (MS) is a matter of controversy. Objective: to determine and compare the frequency of 25-hydroxy vitamin D (25(OH)D) insufficiency and deficiency in young, obese nondiabetic men and normal weight controls, and its correlation with metabolic syndrome. Material and methods: a cross-sectional study which included 62 normal weight and 47 obese individuals. Serum levels of 25(OH)D were ascertained and anthropometric and biochemical parameters were measured to establish MS criteria. Results: of the 47 obese subjects, 25 had MS, while none of the normal weight subjects met the criteria. There were no statistically significant differences in the presence of the syndrome related to the vitamin D levels (p=0.94). The mean serum 25(OH)D level for the total population was 30.6±8.3 ng/mL; in normal weight subjects it was 30.8±8.5 ng/mL, in obese subjects with MS it was 30.1±9.2 ng/mL, and in obese subjects without MS it was 30.6±7.5 ng/mL. Furthermore, there was no significant correlation between the individual MS parameters and serum VD, either globally or on subgroup analysis. Conclusion: there was no significant correlation between serum 25(OH)D levels and MS, nor was any significant correlation found between these and the anthropometric and biochemical parameters studied.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1323).

Serum 25-hydroxyvitamin D levels throughout pregnancy: a longitudinal study in healthy and preeclamptic pregnant women.

BACKGROUND: Worldwide there is a high prevalence of 25-hydroxyvitamin D (25OHD) deficiency and has been associated with adverse outcomes during pregnancy. OBJECTIVE: This is a nested, case-control study in a longitudinal cohort to compare the serum 25OHD levels and other biomarkers throughout pregnancy in a group of 20 preeclamptic women and 61 healthy pregnant women. An additional group of 29 healthy non-pregnant women were also studied during the two phases of the menstrual cycle. RESULTS: Mean 25OHD levels in non-pregnant women were 31.9 ng/mL and 34.9 ng/mL during follicular and luteal phase, respectively (P < 0.01). Mean serum 25OHD levels in healthy pregnant women were 26.5, 30.1 and 31.9 ng/mL, at first, second and third trimester, respectively (P < 0.001). The first trimester levels of 25OHD were lower than those of healthy non-pregnant women (P < 0.001), showing a significant recovery at third trimester. In the group of healthy pregnant women, the 25OHD levels were 25.7 ng/mL and 27.2 ng/mL at 3 and 6 months postpartum, respectively; both values were lower than those observed in the non-pregnant women (P < 0.001). In preeclamptic women, 25OHD serum levels were similar to those of healthy pregnant women; nevertheless, they remained almost unchanged throughout pregnancy. CONCLUSION: There were no significant differences between healthy and preeclamptic pregnant women in terms of 25OHD levels throughout the pregnancy. Serum 25OHD levels in non-pregnant women were higher during luteal phase compared with follicular phase. The 25OHD levels of non-pregnant women tended to be higher than those of pregnant women.

Maternal Serum Meteorin Levels and the Risk of Preeclampsia.

BACKGROUND: Meteorin (METRN) is a recently described neutrophic factor with angiogenic properties. This is a nested case-control study in a longitudinal cohort study that describes the serum profile of METRN during different periods of gestation in healthy and preeclamptic pregnant women. Moreover, we explore the possible application of METRN as a biomarker. METHODS AND FINDINGS: Serum METRN was measured by ELISA in a longitudinal prospective cohort study in 37 healthy pregnant women, 16 mild preeclamptic women, and 20 healthy non-pregnant women during the menstrual cycle with the aim of assessing serum METRN levels and its correlations with other metabolic parameters. Immunostaining for METRN protein was performed in placenta. A multivariate logistic regression model was proposed and a classifier model was formulated for predicting preeclampsia in early and middle pregnancy. The performance in classification was evaluated using measures such as sensitivity, specificity, and the receiver operating characteristic (ROC) curve. In healthy pregnant women, serum METRN levels were significantly elevated in early pregnancy compared to middle and late pregnancy. METRN levels are significantly lower only in early pregnancy in preeclamptic women when compared to healthy pregnant women. Decision trees that did not include METRN levels in the first trimester had a reduced sensitivity of 56% in the detection of preeclamptic women, compared to a sensitivity of 69% when METRN was included. CONCLUSIONS: The joint measurements of circulating METRN levels in the first trimester and systolic blood pressure and weight in the second trimester significantly increase the probabilities of predicting preeclampsia.

Vaciamiento gástrico y diabetes mellitus tipo 2 / Gastric emptying and Type 2 diabetes mellitus

El adecuado control de la diabetes mellitus tiene una gran importancia desde muchos puntos de vista. En los últimos años, se ha destacado el impacto que tienen los niveles de la glucemia postprandial sobre el manejo y las complicaciones de esta enfermedad. Controlar la hiperglucemia postprandial y, por lo tanto, su participación en el deterioro clínico de los pacientes con diabetes puede conseguirse retardando el vaciamiento gástrico y estimulando el efecto incretina, los cuales se pueden promover utilizando los análogos del péptido similar al glucagón tipo 1 (GLP-1). En este artículo se revisa el concepto del efecto incretina y la utilidad de los análogos GLP-1 en el control de la glicemia en los pacientes con diabetes mellitus tipo 2.

Proper control of diabetes mellitus is very important from many points of view. In recent years, the impact of postprandial blood glucose levels on the treatment and complications of this disease has been highlighted. Controlling postprandial hyperglycemia-and, therefore, its participation in the clinical deterioration of patients with diabetes-can be achieved by delaying gastric emptying and stimulating the incretin effect, which can be promoted using the analogues of glucagon-like peptide-1 (GLP-1). In this article, the concept of the incretin effect and usefulness of GLP-1 analogues for glycemic control in patients with type 2 diabetes mellitus is reviewed.

Relación entre la grasa abdominal medida por dexa y factores de riesgo metabólico / Abdominal fat and metabolic risk

La obesidad se ha relacionado epidemiológicamente con trastornos como diabetes mellitus, hipertensión arterial, enfermedad cerebro vascular o enfermedad aterosclerótica coronaria y se ha postulado que el mecanismo fisiopatológico subyacente en todos ellos esté mediado por alteraciones metabólicas de la grasa depositada en el ámbito visceral. Tradicionalmente las determinaciones de la grasa corporal se han efectuado con parámetros objetivos como medición de pliegues corporales o con el cálculo del índice cintura - cadera. En los últimos años se han desarrollado técnicas diversas, entre las cuales cabe mencionar la densitometría dual con Rx (DEXA) que permite cuantificar la composición corporal grasa tanto global como regional. Este método ha demostrado ser seguro, preciso, de bajo nivel de radiación y capaz de localizar el área central del abdomen (L2 - L4), en donde se registra la mayor concentración de grasa. El objetivo del presente estudio fue determinar la relación existente entre los factores de riesgo conocidos para enfermedad coronaria y la cantidad de grasa visceral, determinada mediante técnicas convencionales y DEXA, en una muestra de población colombiana