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We studied if midlife insulin resistance (IR) and APOE genotype would predict brain beta-amyloid (Aß) accumulation and Aß change in late-life in 5-year follow-up [11C]PIB-PET study. 43 dementia-free participants were scanned twice with [11C]PIB-PET in their late-life (mean age at follow-up 75.4 years). Participants were recruited from the Finnish Health2000 study according to their HOMA-IR values measured in midlife (mean age at midlife 55.4 years; IR+ group, HOMA-IR > 2.17; IR- group, HOMA-IR <1.25), and their APOEε4 genotype. At late-life follow-up, [11C]PIB-PET composite SUVr was significantly higher in IR+ group than IR- group (median 2.3 (interquartile range 1.7-3.3) vs. 1.7 (1.5-2.4), p = 0.03). There was no difference between IR- and IR+ groups in [11C]PIB-PET SUVr 5-year change, but the change was significantly higher in IR+/APOEε4+ group (median change 0.8 (0.60-1.0)) than in IR-/APOEε4- (0.28 (0.14-0.47), p = 0.02) and in IR+/APOEε4- group (0.24 (0.06-0.40), p = 0.046). These results suggest that APOEε4 carriers with midlife IR are at increased risk for late-life Aß accumulation.
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Enfermedad de Alzheimer , Resistencia a la Insulina , Humanos , Anciano , Persona de Mediana Edad , Estudios de Seguimiento , Resistencia a la Insulina/genética , Péptidos beta-Amiloides/metabolismo , Encéfalo/diagnóstico por imagen , Encéfalo/metabolismo , Genotipo , Apolipoproteínas E/genética , Tomografía de Emisión de Positrones/métodos , Compuestos de AnilinaRESUMEN
PURPOSE: Prior studies testing the association between insulin resistance (IR) and prostate cancer (PC) risk are inconsistent. We examined the association between Homeostatic Assessment of Insulin Resistance (HOMA-IR; calculated from fasting baseline insulin and glucose) and PC in REDUCE, a 4-year randomized trial of dutasteride vs. placebo for PC prevention. EXPERIMENTAL DESIGN: All patients had prestudy negative biopsies and underwent study mandated biopsies at 2 and 4 years regardless of prostate-specific antigen. Multivariable logistic regression models were used to investigate the associations between log-transformed or categorized HOMA-IR scores and PC risk. Multinominal regression was used to assess associations between HOMA-IR scores and tumor grade (low grade [grade group 1]; high-grade [grade groups 2-5]). RESULTS: Among 5430 REDUCE participants (1212 with PC; 856 low- and 356 high-grade), higher HOMA-IR was associated with lower PC risk (log-HOMA-IR: OR, 0.89; 95% CI, 0.80-0.99; p = .03; categorized HOMA-IR: p-trend = .04). When stratified by grade, HOMA-IR was significantly associated with reduced low-grade PC risk (log-HOMA-IR: OR, 0.84; 95% CI , 0.74-0.94; p = .003; categorized HOMA-IR: p-trend = .002) but was unrelated to high-grade PC (log-HOMA-IR: OR, 1.02; 95% CI, 0.86-1.21; p = .81; categorized HOMA-IR: p-trend = .26). Results were similar in placebo and treatment arms. CONCLUSIONS: In summary, higher HOMA-IR was associated with a reduced risk of low-grade PC but was not associated with high-grade disease. The mechanisms to explain these findings are unclear.
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BACKGROUND: Interpregnancy interval (IPI) is associated with a variety of adverse maternal and infant outcomes. However, reports of its associations with early infant neurodevelopment are limited and the mechanisms of this association have not been elucidated. Maternal-fetal glucose metabolism has been shown to be associated with infant neurodevelopmental. The objective of this study was to determine whether this metabolism plays a role in the relationship between IPI and neurodevelopment. METHODS: This prospective birth cohort study included 2599 mother-infant pairs. The IPI was calculated by subtracting the gestational age of the current pregnancy from the interval at the end of the previous pregnancy. Neurodevelopmental outcomes at 12 months in infants were assessed by the Ages and Stages Questionnaire Edition 3 (ASQ-3). Maternal fasting venous blood was collected at 24-28 weeks and cord blood was collected at delivery. The association between IPI and neurodevelopment was determined by logistic regression. Mediation and sensitivity analyses were also conducted. RESULTS: In our cohort, 14.0% had an IPI < 12 months. IPI < 12 months increased the failure of the communication domain, fine motor domain, and personal social domain of the ASQ (relative risks (RRs) with 95% confidence interval (CI): 1.73 [1.11,2.70]; 1.73 [1.10,2.72]; 1.51 [1.00,2.29]). Maternal homeostasis model assessment of insulin resistance (HOMA-IR) and cord blood C-peptide was significantly associated with failure in the communication domain [RRs with 95% CI: 1.15 (1.02, 1.31); 2.15 (1.26, 3.67)]. The proportion of the association between IPI and failure of the communication domain risk mediated by maternal HOMA-IR and cord blood C-peptide was 14.4%. CONCLUSIONS: IPI < 12 months was associated with failing the communication domain in infants. Maternal-fetal glucose metabolism abnormality may partially explain the risk of neurodevelopmental delay caused by short IPI.
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Nacimiento Prematuro , Embarazo , Lactante , Femenino , Humanos , Estudios de Cohortes , Nacimiento Prematuro/etiología , Intervalo entre Nacimientos , Péptido C , Estudios Prospectivos , GlucosaRESUMEN
BACKGROUND: Females are generally less prone to cardiovascular (CV) events than males, but this protection is trumped by diabetes. The mechanism behind the increased relative risk in females with diabetes is not fully understood. Insulin resistance (IR) is suggested to be a more important contributor to CV morbidity in females than in males. We aim to investigate differences in the association between IR indexes (Homeostatic Model Assessment of IR - HOMA-IR, visceral adiposity index - VAI, and triglycerides/high-density lipoprotein-cholesterol - TG/HDL-C index), and a first non-fatal myocardial infarction (MI) across different glycaemic states. METHODS: IR indexes were calculated in a population with (n = 696) and without (n = 707) a first non-fatal MI, free from known diabetes. MI cases were investigated at least six weeks after the event. All participants were categorized by an oral glucose tolerance test as having normal glucose tolerance, impaired fasting glucose, impaired glucose tolerance, or newly diagnosed diabetes. Comparison of proportion of glycaemic states by sex was tested by chi-square test. The associations between sex, a first non-fatal MI, IR indexes, and traditional CV risk factors were analysed by multivariate logistic regression models. Continuous variables were logarithmically transformed. RESULTS: Of the total population 19% were females and 81% males, out of whom 47% and 50% had a first non-fatal MI, respectively. Compared with males, females were older, less often smokers, with lower body mass index and higher total cholesterol and high-density lipoprotein cholesterol levels. The proportion of glycaemic states did not differ between the sexes (p = 0.06). Females were less insulin resistant than males, especially among cases and with normal glucose tolerance. In logistic regression models adjusted for major CV risk factors including sex, the associations between VAI and TG/HDL-C index and a first non-fatal MI remained significant only in females (odds ratios and 95% confidence intervals: 1.7, 1.0-2.9, and 1.9, 1.1-3.4 respectively). CONCLUSIONS: These results support the assumption that IR indexes based on anthropometrics and lipid panel, i.e., VAI and TG/HDL-C, could be a better measure of IR and CV-predictor for non-fatal MI in females, even without glycaemic perturbations.
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Resistencia a la Insulina , Infarto del Miocardio , Estado Prediabético , Humanos , Masculino , Femenino , Caracteres Sexuales , Biomarcadores , Glucosa , Lipoproteínas HDL , Triglicéridos , HDL-Colesterol , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/epidemiología , Índice de Masa Corporal , Glucemia/análisisRESUMEN
BACKGROUND: There is a growing body of evidence on associations between one-carbon metabolism (OCM) and diabetes-related parameters. For this reason, we aimed to examine the associations of plasma choline, betaine, trimethylamine N-oxide (TMAO), glutathione (GSH), serum folate, vitamin B12, DHFR (rs70991108) genotype, MTHFR (rs180113) genotype, MTHFD1 (rs2236225) genotype, PEMT (rs7946 and rs12325817) genotype with fasting glucose level insulin level, and diabetes related indices. METHODS: The study group consisted of 421 Polish adults aged 20-40 years old. Food intake was assessed using a three-day food diary. Plasma concentrations of choline, betaine, and TMAO were determined using ultra-high-performance liquid chromatography electrospray ionization mass spectrometry. Total plasma GSH level was measured using high-performance liquid chromatography. Insulin, folate and vitamin B12 concentrations were estimated using an enzyme-linked immunosorbent assay method. Genotyping was performed using TaqMan probes. RESULTS: GSH level was negatively associated with insulin (ß = -0.11, p < 0.05) and gamma-glutamyltransferase (ß = -0.12, p < 0.05), and positively associated with fasting glucose (ß = 0.11, p < 0.05). Betaine intake was negatively associated with serum insulin concentration (ß = -0.13, p < 0.05) and HOMA-IR (ß = -0.12, p < 0.05). Choline intake was negatively associated with insulin (ß = -0.17, p < 0.01). Serum folate level was negatively associated with GGTP (ß = -0.11; p < 0.05). The MTHFR CC genotype was associated with higher serum insulin level (ß = 0.15; p < 0.01) and higher HOMA-IR (ß = 0.15, p < 0.01), while the MTHFD1 AA genotype was negatively associated with QUICKI (ß = -0.11, p < 0.05). CONCLUSIONS: Our findings suggest that higher GSHl higher intake of betaine, B12, and choline; as well as TT genotype of MTHFR and AA genotype of MTHFD1 are associated with lower diabetes-related parameters among adults.
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Insulin resistance (IR) is a well-recognized covariate of Polycystic Ovarian Syndrome (PCOS) with varying burden and risk factors among populations. The relationship of insulin secretory defect or ISD with PCOS is less understood. The presence of IR and ISD as well as their covariates have been explored in the present case-control study among young adult to early middle-aged, normal weight to obese, Bangalee women with PCOS. A number of 158 PCOS [age 23 (15-34) years, Median (Range)] and 126 Non-PCOS [24 (19-34) years] females were recruited purposively with PCOS diagnosed following Modified Rotterdam Criteria 2003. Hormones were measured by CLIA method and lower abdominal ultrasonography was done by trained personnel. IR and ISD were assessed by homeostasis model assessment with 75th percentile values of HOMA-IR (2.4) and HOMA%B (143) in Non-PCOS group considered as the cut-off values. Hyperandrogenism (HA) was measured by calculating Fasting Androgen Index (FAI). HOMA-IR was high among 52% of PCOS and 28% of Non-PCOS women. Body Mass Index (BMI) and HA were independently associated covariates of IR (p < 0.001). HOMA%B was compromised among 48% of PCOS subjects and the deficiency showed independent association (p < 0.001) with 2 h glycemia on OGTT in Non-PCOS and HA in PCOS groups. The data suggest insulin resistance as a major risk factor for PCOS among Bangalee women with obesity and hyperandrogenemia as its major covariates. The findings also indicate that presence of impaired insulin secretion is a major determinant of hyperglycemia and, consequently, of higher T2DM risk among young women in this population.
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Resistencia a la Insulina , Síndrome del Ovario Poliquístico , Humanos , Femenino , Síndrome del Ovario Poliquístico/metabolismo , Síndrome del Ovario Poliquístico/complicaciones , Síndrome del Ovario Poliquístico/epidemiología , Estudios de Casos y Controles , Adulto , Adulto Joven , Adolescente , Insulina/sangre , Índice de Masa Corporal , Hiperandrogenismo , India/epidemiología , Secreción de Insulina , Factores de Riesgo , Glucemia/análisis , Glucemia/metabolismoRESUMEN
BACKGROUND: Hyperuricaemia is common among obese children and adolescents, and is closely related to insulin resistance. The aim of this study was to explore the relationships between youth insulin resistance and hyperuricaemia, as well as their relationships with lifestyle factors in youths, to provide early guidance on the risk factors for hyperuricaemia in adolescents. METHODS: This study included 233 adolescents aged 10 to 20 years. Insulin resistance was evaluated via the homeostasis model assessment-insulin resistance (HOMA-IR) method. Binary logistic regression analysis was used to assess the associations of HOMA-IR with hyperuricaemia status and serum uric acid (UA) levels. The participants were subsequently divided into two groups, the noninsulin resistant group (HOMA-IR ≤ 3.2) and the insulin resistant group (HOMA-IR > 3.2), to further explore the factors that may affect the serum UA level. Finally, the predictive ability of different indicators of hyperuricaemia was evaluated via the ROC curve. RESULTS: Binary logistic regression analysis revealed a significant increase in the risk of developing hyperuricaemia for individuals with elevated HOMA-IR (p < 0.001) and insulin resistance (p < 0.01). Spearman's correlation analysis revealed a significant positive linear correlation between HOMA-IR and serum UA levels (r = 0.4652, p < 0.001). Among insulin-resistant adolescents, UA levels were positively correlated with weight ratings, frequency of staying up late, and sugary beverages intake. Notably, individuals who engaged in 1-3 h of weekly exercise had the lowest UA levels. The area under the ROC curve for HOMA-IR was 0.847 (cut-off value = 2.165, p < 0.001), and the optimal prediction model included HOMA-IR, BMI z-score, and other lifestyle factors (AUC: 0.870, p < 0.001)). CONCLUSION: HOMA-IR was identified as an independent risk factor for the development of hyperuricaemia and could be used as a sensitive indicator for the prediction its development in adolescents. In insulin-resistant adolescents with hyperuricaemia, maintaining normal weight, engaging in physical exercise for 1-3 h per week, avoiding staying up late and limiting sugary beverages intake are recommended to reduce the prevalence of hyperuricaemia among adolescents.
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Hiperuricemia , Resistencia a la Insulina , Estilo de Vida , Humanos , Adolescente , Hiperuricemia/epidemiología , Hiperuricemia/etiología , Hiperuricemia/sangre , Masculino , Femenino , Niño , Factores de Riesgo , Adulto Joven , Obesidad/sangre , Biomarcadores/sangre , Pronóstico , Estudios Transversales , Ácido Úrico/sangre , Obesidad Infantil/sangreRESUMEN
OBJECTIVES: Metabolic dysfunction-associated fatty liver disease (MAFLD), a globally prevalent disease, is closely linked to insulin resistance (IR). Physical activity (PA) is closely linked to both MAFLD and IR. We aim to explore the dose-response relationship between metabolic score for IR (METS-IR)/homeostasis model assessment of IR (HOMA-IR) and MAFLD, and investigate the relationship between PA, IR and MAFLD. METHODS: Participants from the NHANES study were included in this cross-section study. Logistic regression and the receiver operating characteristic were used to assess the predictive performance of METS-IR/HOMA-IR for MAFLD. Restrictive cubic splines were performed to visualize their dose-response relationship. Decision tree analysis was used to identify high-risk populations of MAFLD. PA's mediating effect in the association between METS-IR/HOMA-IR and MAFLD was also examined. RESULTS: Of all 1,313 participants, 693 had MAFLD (52.78%). There were a positive association between METS-IR (OR = 1.162, 95% CI = 1.126-1.199) and HOMA-IR (OR = 1.630, 95% CI = 1.431-1.856) and MAFLD risk. The AUCs of the METS-IR and HOMA-IR were 0.831 (0.809, 0.853) and 0.767 (0.741, 0.791), respectively, with significantly different predictive performance (P < 0.001). Adding METS-IR/HOMA-IR to the basic model greatly improved the statistical significance for MAFLD. Five high-risk subgroups were identified for MAFLD. PA mediated about 0.81% and 0.78% (indirect effect/total effect) in the association between METS-IR/HOMA-IR and MAFLD. CONCLUSIONS: MAFLD risk might be predicted by METS-IR/HOMA-IR, among which METS-IR performed better. And PA mediated the association between them. More attention should be paid to the therapeutic effect of lifestyle changes on MAFLD. HIGHLIGHTS: 1. Positive associations were found between METS-IR and HOMA-IR and MAFLD risk. 2. METS-IR has better predictive performance for MAFLD risk than HOMA-IR. 3.Two high-risk subgroups were identified for MAFLD by METS-IR: individuals with METS-IR ≥ 40; Hispanic black individuals with 34 ≤ METS-IR < 40 and aged ≥ 46. 4. In the significant association between METS-IR/HOMA-IR and MAFLD, about 0.81% and 0.78% (indirect effect/total effect), respectively, were mediated by physical activity.
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Ejercicio Físico , Resistencia a la Insulina , Síndrome Metabólico , Enfermedad del Hígado Graso no Alcohólico , Humanos , Masculino , Femenino , Estudios Transversales , Persona de Mediana Edad , Adulto , Estados Unidos/epidemiología , Síndrome Metabólico/epidemiología , Enfermedad del Hígado Graso no Alcohólico/epidemiología , Enfermedad del Hígado Graso no Alcohólico/metabolismo , Encuestas Nutricionales , Pronóstico , Factores de RiesgoRESUMEN
BACKGROUND: A woman with a history of GDM has a high risk of developing type two diabetes (T2DM) in her future life. Lifestyle modifications are known to attenuate the progression of GDM to T2DM. Therefore, the aim of this study was to assess the impact of a simple, cost effective, culturally acceptable lifestyle intervention programme on the trajectory towards T2DM in women with a history of GDM. METHODS: This cluster randomized trial was conducted in 100 postpartum women in three selected districts of Sri Lanka. The subjects were divided into intervention (n = 50) and control groups (n = 50) by cluster randomization method. A culturally adapted protocol (comprised of dietary and physical activity modifications) was administered to the intervention group. The glycemic profile was assessed using fasting and 2-hour post-OGTT plasma glucose and HbA1c, and insulin resistance by HOMA-IR at baseline and after one year of intervention. RESULTS: The mean age (SD) of the subjects in the intervention and control groups were 33.0 (5.1) and 34.3 (6.5) years respectively. All glycemic and insulin resistance parameters (i.e. Fasting plasma glucose- FPG, 2-hour post-OGTT plasma glucose, HbA1c and HOMA-ir) were comparable (p > 0.05) between the two groups at baseline. FPG, 2 h post OGTT, HbA1c and HOMA-ir values between intervention vs. control (p) at 12 months were 87.3 vs. 123.2 (< 0.01); 106.5 vs. 156.1 (0.01); 5.3 vs. 6.8 (< 0.01) and 0.9 vs. 2.3 (< 0.01) respectively. All glycemic parameters showed a significant reduction in the intervention group at 12 months compared to baseline. In contrast, the control group showed a significant increase in FPG, 2-hour post-OGTT plasma glucose and HbA1c at 12 months compared to baseline. In multiple linear regression model adjusted for age, parity and family history, the control group showed an approximately 33 times risk of developing insulin resistance compared to the intervention group. CONCLUSION: The culturally acceptable and individualized lifestyle intervention was able to produce remarkable reductions in glycaemic and insulin resistance parameters among postpartum women with a history of GDM. TRIAL REGISTRATION: Ethical clearance was obtained from the Ethics Review Committee of the University of Sri Jayewardenepura, Sri Lanka (ERC 52/14), Sri Lanka Clinical trial registration number Sri Lanka Clinical Trials Registry (SLCTR/2015/021 date 25.09.2015).
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Glucemia , Diabetes Gestacional , Estilo de Vida , Humanos , Femenino , Adulto , Sri Lanka , Glucemia/análisis , Glucemia/metabolismo , Embarazo , Diabetes Gestacional/sangre , Resistencia a la Insulina , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/sangre , Estudios de Seguimiento , Periodo Posparto , Ejercicio Físico , MadresRESUMEN
There is equivocal evidence that psyllium can prevent or attenuate increases in fasting blood sugar. Therefore, this systematic review and meta-analysis sought to investigate the influence of psyllium on hemoglobin A1C (HbA1c), fasting blood sugar (FBS), insulin, and Homeostatic Model Assessment of Insulin Resistance (HOMA IR). We searched PubMed, ISI Web of Science (WOS), and Scopus for eligible publications, up to 15 July 2022, including randomized controlled trials (RCT) assessing the effect of psyllium on HbA1c, FBS, insulin, and HOMA IR levels in adults. Using a random effects model, we report the weighted mean differences (WMD) with 95% confidence intervals (CI). In this article, 19 RCT studies, consisting of 962 participants, were included. Psyllium significantly decreased FBS, HbA1c, and HOMA IR levels, but not insulin levels, as compared to placebo (FBS: WMD): -6.89; 95% CI: -10.62, -3.16; p < .001), HbA1c: (WMD: -0.75; 95% CI: -1.21, -0.29; p < .001), HOMA IR: (WMD: -1.17; 95% CI: -2.11, -0.23; p < .05), and insulin: (WMD: -2.08; 95% CI: -4.21, -0.035; p > .05)). Subgroup analyses illustrated differences in the effects of psyllium on FBS: dosages less than and more than 10 g/d showed significant differences (p value < 0.05). However, it was not significant in intervention durations less than 50 days (p value > 0.05). For HbA1c: psyllium consumption less than 10 g/d (p value > 0.05) was non-significant. For HOMA IR and insulin: no significant changes were noted with psyllium consumption less than vs. more than 10 g/d. In conclusion, we found that psyllium could significantly decrease FBS, HbA1c, and HOMA IR levels, but not insulin levels, as compared to placebo.
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Glucemia , Ayuno , Hemoglobina Glucada , Resistencia a la Insulina , Insulina , Psyllium , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Psyllium/uso terapéutico , Hemoglobina Glucada/análisis , Insulina/sangre , Glucemia/análisis , Glucemia/metabolismo , Glucemia/efectos de los fármacos , Ayuno/sangreRESUMEN
BACKGROUND: Outdoor artificial light at night (ALAN) has been linked to an elevated risk of diabetes, but the available literature on the relationships between ALAN and glucose homeostasis in pregnancy is limited. METHODS: A prospective cohort study of 6730 pregnant women was conducted in Hefei, China. Outdoor ALAN exposure was estimated using satellite data with individual addresses at a spatial resolution of approximately 1 km, and the average ALAN intensity was calculated. Gestational diabetes mellitus (GDM) was diagnosed based on a standard 75-g oral glucose tolerance test. Multivariable linear regression and logistic regression were used to estimate the relationships between ALAN and glucose homeostasis. RESULTS: Outdoor ALAN was associated with elevated glucose homeostasis markers in the first trimester, but not GDM risk. An increase in the interquartile range of outdoor ALAN values was related to a 0.02 (95% confidence interval [CI]: 0.00, 0.03) mmol/L higher fasting plasma glucose, a 0.42 (95% CI: 0.30, 0.54) µU/mL increase in insulin and a 0.09 (95% CI: 0.07, 0.12) increase in homeostatic model assessment of insulin resistance (HOMA-IR) during the first trimester. Subgroup analyses showed that the associations between outdoor ALAN exposure and fasting plasma glucose, insulin, and HOMA-IR were more pronounced among pregnant women who conceived in summer and autumn. CONCLUSIONS: The results provided evidence that brighter outdoor ALAN in the first trimester was related to elevated glucose intolerance in pregnancy, especially in pregnant women conceived in summer and autumn, and effective strategies are needed to prevent and manage light pollution.
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Diabetes Gestacional , Resistencia a la Insulina , Humanos , Embarazo , Femenino , Glucemia , Contaminación Lumínica , Estudios Prospectivos , Diabetes Gestacional/epidemiología , Diabetes Gestacional/etiología , Insulina , HomeostasisRESUMEN
BACKGROUND AND AIMS: This study aimed to investigate the association between birth weight (BW) and abnormal HOMA-IR in US adolescents aged 12-15 years. The role of concurrent body mass index (BMI) in adolescence was also examined. METHODS AND RESULTS: This retrospective cohort study included 3429 participants from NHANES with data in 1999-2020. HOMA-IR ≥2.3 was considered abnormal. Participants were classified as low (LBW; <2.5 kg), normal (NBW; 2.5-4.0 kg), or high (HBW; >4.0 kg) BW. Logistic regression was used to explore the association between BW and HOMA-IR. Mediation analysis was used to examine whether BMI z-score in adolescence mediated the association between BW and HOMA-IR. Compared with those in NBW, the odds ratios (95 % CI) of abnormal HOMA-IR in LBW and HBW groups were 1.26 (0.99-1.60), and 0.62 (0.47-0.83) respectively. The association between BW and abnormal HOMA-IR was consistent in all subgroups with no significant interactions. Mediation analysis showed that BW is associated with lower risk of HOMA-IR directly, but with higher risk indirectly via BMI in adolescence. CONCLUSION: There was a negative linear relationship between BW and the prevalence of abnormal HOMA-IR in adolescents aged 12-15 independent of concurrent BMI. Children who were born with LBW but had high BMI in adolescence were of particularly higher risk of insulin resistance.
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Resistencia a la Insulina , Niño , Humanos , Adolescente , Índice de Masa Corporal , Peso al Nacer , Estudios Retrospectivos , Encuestas NutricionalesRESUMEN
BACKGROUND AND AIMS: We aimed to investigate the relationship between triglyceride glucose (TyG) index and intracoronary thrombus burden in patients with ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). METHODS AND RESULTS: A total of 468 consecutive patients who were admitted with STEMI and underwent primary PCI were included in the study. TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. According to the angiographic reclassified thrombolysis in myocardial infarction (TIMI) thrombus grade, patients were divided into two groups as small thrombus burden (STB) with TIMI thrombus grade 0-3, and large thrombus burden (LTB) with TIMI thrombus grade 4-5. TyG index was significantly higher in the LTB group than in the STB group (9.11 ± 0.86 vs 8.89 ± 0.62; p = 0.002). In multivariate analysis, TyG index was found to be an independent predictor of LTB in STEMI patients who underwent primary PCI [OR (95 % CI): 1.470 (1.090-1.982), p = 0.012]. The area under the curve (AUC) of TyG index predicting LTB was 0.568 (95 % CI 0.506-0.631; p = 0.023), with the best cut-off value of 8.87. In the classification according to TyG index cut-off value, the frequency of LTB was found to be significantly higher in the high TyG index group than in the low TyG index group (33.6 % vs 21.2 %; p = 0.003). CONCLUSION: TyG index, a valid surrogate marker of insulin resistance, is an independent predictor of LTB in STEMI patients who underwent primary PCI and can be used as an indicator of increased intracoronary thrombus burden.
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Infarto del Miocardio , Intervención Coronaria Percutánea , Infarto del Miocardio con Elevación del ST , Trombosis , Humanos , Infarto del Miocardio con Elevación del ST/diagnóstico por imagen , Infarto del Miocardio con Elevación del ST/terapia , Glucosa , Intervención Coronaria Percutánea/efectos adversos , Triglicéridos , Factores de Riesgo , Estudios Retrospectivos , Angiografía CoronariaRESUMEN
Prenatal glucocorticoid exposure has been shown to alter hypothalamic-pituitary-adrenal axis function resulting in altered fetal development that can persist through adulthood. Fetal exposure to excess dexamethasone, a synthetic glucocorticoid, has been shown to alter adult behaviour and metabolism. This study investigated the effects prenatal dexamethasone exposure had on adult offspring cardiac and liver metabolism and oxidative stress. Pregnant C57BL/6 mice received a dose of 0.4 mg/kg dexamethasone on gestational days 15-17. Once pups were approximately 7 months old, glucose uptake was determined using positron emission tomography and insulin resistance (IR) was determined by homeostatic model assessment (HOMA) IR calculation. Oxidative stress was assessed by measuring 4-hydroxynonenal protein adduct formation and total reactive oxygen species. Female dexamethasone group had significantly increased glucose uptake when insulin stimulated compared to vehicle-treated mice. HOMA IR revealed no evidence of IR in either male or female offspring. There was also no change in oxidative stress markers in either cardiac or liver tissues of male or female offspring. These data suggest that prenatal dexamethasone exposure in male mice does not alter oxidative stress or metabolism. However, prenatal dexamethasone exposure increased glucocorticoids, cardiac glucose uptake, and pAkt signaling in female heart tissues in adult mice, suggesting there are sex differences in prenatal dexamethasone exposure.
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Glucocorticoides , Resistencia a la Insulina , Femenino , Masculino , Embarazo , Animales , Ratones , Ratones Endogámicos C57BL , Glucocorticoides/efectos adversos , Sistema Hipotálamo-Hipofisario , Sistema Hipófiso-Suprarrenal , Estrés Oxidativo , Glucosa , Dexametasona/toxicidadRESUMEN
PURPOSE: The aim of the present study was to investigate the association between muscle fiber composition, body composition, resting glycemic-lipidemic blood profiles, in apparently healthy, young, active females. METHODS: Thirty-four young healthy female volunteers were allocated into two groups, depending on their Vastus Lateralis type IIx muscle fibers percent cross-sectional area (%CSA; H: high type IIx %CSA; L: low type IIx %CSA). Body composition was determined via dual-energy X-ray absorptiometry. Venous blood samples were collected for the determination of resting serum glucose, Insulin, Apo-A1, HOMA-IR, triglycerides (TG), total cholesterol (TC), High-density lipoprotein (HDL-C), and Low-density lipoprotein (LDL-C) concentrations. Nutritional intake was also evaluated. RESULTS: Individuals of the H group have significantly higher body mass, body fat percentage-mass, and resting blood indices of glycemic and lipidemic profiles, compared to those of L group (p < 0.001). Increased type IIx and low type I, IIa muscle fibers %CSAs were linked with poorer body composition, glycemic and lipidemic blood profiles (r: - 0.722 to 0.740, p < 0.001). Linear regression analyses revealed that the impact of muscle fibers %CSA (B coefficients ranged between - 0.700 and 0.835) on the above parameters, was at least, of the same or even of greater magnitude as that of body composition and daily nutritional intake (B: - 0.700 to 0.666). CONCLUSION: Increased type IIx and low Type I, IIa %CSAs are associated with poorer body composition and glycemic-lipidemic profiles in young healthy females. The contribution of the muscle fiber %CSA on health status seems to be comparable to that of nutrition and body composition.
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Composición Corporal , Fibras Musculares Esqueléticas , Humanos , Femenino , Fibras Musculares Esqueléticas/fisiología , Músculo Cuádriceps/fisiología , Insulina , Estado NutricionalRESUMEN
Sedentary behavior (SB) has been linked to risk factors of cardiometabolic disease, with inconsistent findings reported in the literature. We aimed to assess the associations of SB with multiple biomarkers of inflammation and insulin resistance in adults. Domain-specific SB, sitting time and moderate-to-vigorous physical activity (MVPA) were measured in 78 adults (mean ± SD 52.0 ± 10.8 y). Body fat percentage (BF%) was assessed using multi-frequency bioelectrical impedance. A blood draw assessed glucose, insulin, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), leptin, and adiponectin. Adiponectin-leptin ratio (ALR), homeostasis model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-ß) were calculated. Multivariable linear regression analyses, controlling for age, sex, MVPA, and BF%, were used to assess associations. After adjustment for age, sex and MVPA, total SB (7.5 ± 2.5 h/day) was positively associated with leptin, insulin, HOMA-IR, HOMA-ß (Standardized Beta (ß) range 0.21-0.32) and negatively associated with ALR (ß = -0.24, p < 0.05 for all). Similarly, total sitting time (7.2 ± 2.9 h/day) was associated with TNF-α (ß = 0.22) and ALR (ß = -0.26). These associations were attenuated to non-significance after adjustment for BF%. Leisure screen time was detrimentally associated with IL-6 (ß = 0.24), leptin (ß = 0.21), insulin (ß = 0.37), HOMA-IR (ß = 0.37), and HOMA-ß (ß = 0.34), independent of age, sex and MVPA (p < 0.05 for all). Only the associations with insulin (ß = 0.26), HOMA-IR (ß = 0.26), and HOMA-ß (ß = 0.23) remained significant after further controlling BF% (p < 0.05). Self-reported SB is associated with biomarkers of inflammation and insulin resistance, independent of MVPA, and in some cases BF%.
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Biomarcadores , Proteína C-Reactiva , Inflamación , Resistencia a la Insulina , Leptina , Tiempo de Pantalla , Conducta Sedentaria , Humanos , Masculino , Femenino , Persona de Mediana Edad , Biomarcadores/sangre , Inflamación/sangre , Leptina/sangre , Proteína C-Reactiva/análisis , Insulina/sangre , Adiponectina/sangre , Interleucina-6/sangre , Adulto , Ejercicio Físico , Factor de Necrosis Tumoral alfa/sangre , GlucemiaRESUMEN
OBJECTIVES: To estimate C-reactive protein (CRP) levels in Saudi women with and without polycystic ovary syndrome (PCOS), and to investigate the associations between CRP and metabolic syndrome (MetS) components. METHODS: We randomly recruited 200 women with and without PCOS, between 18 and 38 years, in this age-matched case-control study. Study subjects were allocated to 1 of 4 groups according to the presence or absence of MetS. Interviews were conducted with all participants, and anthropometric measurements and blood samples were obtained for subsequent analysis of biochemical variables. RESULTS: Two-thirds of the study population and all study subjects had central obesity. Fasting insulin and homeostasis model assessment insulin resistance index were significantly higher in PCOS and MetS groups than all other groups (P < 0.05). CRP levels were significantly higher among women with PCOS than their age-matched controls, regardless of the presence of MetS (P < 0.05). Body mass index was the only independent predictor of serum high-sensitivity-CRP, accounting for 17% of the variability in circulating levels (ß = 0.407; 95% CI 0.248-0.472, P < 0.0001). CONCLUSIONS: Obesity and insulin resistance are important risk factors for MetS in PCOS. The presence of MetS in PCOS subjects aggravates the proinflammatory state reflected by CRP levels.
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Resistencia a la Insulina , Síndrome Metabólico , Síndrome del Ovario Poliquístico , Humanos , Femenino , Síndrome Metabólico/complicaciones , Síndrome Metabólico/epidemiología , Síndrome del Ovario Poliquístico/complicaciones , Síndrome del Ovario Poliquístico/epidemiología , Proteína C-Reactiva/metabolismo , Estudios de Casos y Controles , Obesidad/complicaciones , Índice de Masa CorporalRESUMEN
PURPOSE: Myo-inositol (MI) is an insulin-sensitizing dietary supplement, enhancing the transfer of glucose into the cell. Gestational diabetes mellitus (GDM) is characterized by abnormal glucose tolerance, which is associated with elevated insulin resistance. The present study aimed to assess the effect of MI supplementation during pregnancy on the incidence of GDM. METHODS: We performed a single-center, open-label, randomized controlled trial. A cohort of 200 pregnant women at 11-13+6 weeks of gestation were randomly assigned in two groups: MI group (n = 100) and control group (n = 100). The MI group received MI and folic acid (4000 mg MI and 400 mcg folic acid daily), while the control group received folic acid alone (400 mcg folic acid daily) until 26-28 weeks of gestation, when the 75 g Oral Glucose Tolerance Test (OGTT) was performed for the diagnosis of GDM. Clinical and metabolic outcomes were assessed. RESULTS: The incidence of GDM was significantly higher in the MI group (14.9%) compared to the control group (28.5%) (P = 0.024). Women treated with MI had significantly lower OGTT glucose values, than those not treated with MI (P < 0.001). The insulin resistance as assessed by HOMA-IR was significantly lower in the MI group versus control (P = 0.045). Furthermore, MI group had significantly higher insulin sensitivity as measured by the Matsuda Index, compared to the control group (P = 0.037). CONCLUSION: MI supplementation seems to be an effective option to improve the glycemic control of pregnant women and prevent the onset of GDM. TRIAL REGISTRATION: ISRCTN registry: ISRCTN16142533. Registered 09 March 2017.
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Diabetes Gestacional , Suplementos Dietéticos , Ácido Fólico , Prueba de Tolerancia a la Glucosa , Inositol , Resistencia a la Insulina , Humanos , Femenino , Diabetes Gestacional/prevención & control , Diabetes Gestacional/sangre , Embarazo , Inositol/uso terapéutico , Inositol/administración & dosificación , Adulto , Ácido Fólico/administración & dosificación , Ácido Fólico/uso terapéutico , Glucemia/metabolismo , Glucemia/efectos de los fármacos , Incidencia , Complejo Vitamínico B/uso terapéutico , Complejo Vitamínico B/administración & dosificaciónRESUMEN
This study aims to investigate the potential association between serum levels of cytokines, HSP60, HSP70 and IR (HOMA-IR) in postmenopausal women. We conducted a cross-sectional study involving 381 postmenopausal women, including 94 with a breast cancer diagnosis and 278 without. We analyzed anthropometric and laboratory measurements. Immunoassays were used to measure cytokines (TNF-α, IL-10, and IL-6) as well as heat shock proteins (HSP) 60 and 70 in the serum using the ELISA technique. Women diagnosed with breast cancer showed higher levels of HOMA-IR, IL-6, TNF, and HSP60, and lower levels of IL-10 and HSP70 compared to women without cancer. An association was found between HSP70 and HOMA-IR only in women with breast cancer (ß = 0.22, p = .030; without cancer: ß = 0.04, p = .404), regardless of age, waist circumference, smoking, and physical activity. No associations were observed between cytokines, HSP60, and HOMA-IR in both groups of women. HSP70 is positively associated with IR in women diagnosed with breast cancer.
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Neoplasias de la Mama , Chaperonina 60 , Proteínas HSP70 de Choque Térmico , Resistencia a la Insulina , Posmenopausia , Humanos , Femenino , Neoplasias de la Mama/sangre , Estudios Transversales , Posmenopausia/sangre , Persona de Mediana Edad , Proteínas HSP70 de Choque Térmico/sangre , Chaperonina 60/sangre , Anciano , Citocinas/sangre , Interleucina-6/sangre , Interleucina-10/sangre , Factor de Necrosis Tumoral alfa/sangreRESUMEN
Prenatal stress (PNS), which alters the hypothalamic-pituitary-adrenal axis function in the offspring, predisposes to insulin resistance (IR) in later life and is associated with numerous disorders, including cognitive and memory impairments. At present, our main goal is to assess the effects of chronic piromelatine (Pir) administration, a melatonin analogue, on PNS-provoked IR in the periphery and the hippocampus in male and female offspring. Pregnant Sprague-Dawley rats were exposed to chronic stress (one short-term stressor on a daily basis and one long-term stressor on a nightly basis) from the first gestation week until birth. Vehicle or Pir 20 mg/kg were administered intraperitoneally for 21 days. Plasma glucose, serum insulin levels, and the homeostasis model assessment of insulin resistance (HOMA-IR) were determined as markers of peripheral IR. For the hippocampal IR assessment, insulin receptors (IRs) and glucose transporter 4 (GLUT4) were examined. Prenatally stressed offspring of both sexes indicated enhanced plasma glucose and serum insulin concentrations, increased HOMA-IR, and decreased hippocampal GLUT4 only in male rats. The PNS-induced changes were corrected by chronic treatment with Pir. The present results suggest that the melatoninergic compound Pir exerts beneficial effects on altered glucose/insulin homeostasis in PNS-exposed offspring.