RESUMO
BACKGROUND: Yoghurt is part of the diet of many people worldwide and is commonly recognised as a 'health food'. Epidemiological studies suggest that yoghurt may be useful as part of weight management programs. In the absence of comprehensive systematic reviews, this systematic review investigated the effect of yoghurt consumption by apparently healthy adults on weight-related outcomes. METHODS: An extensive literature search was undertaken, as part of a wider scoping review, to identify yoghurt studies. A total of 13 631 records were assessed for their relevance to weight-related outcomes. RESULTS: Twenty-two publications were eligible according to the review protocol. Cohort studies (n=6) and cross-sectional studies (n=7) all showed a correlation between yoghurt and lower or improved body weight/composition. Six randomised controlled trials (RCTs) and one controlled trial had various limitations, including small size and short duration. One RCT showed significant effects of yoghurt on weight loss, but was confounded by differences in calcium intake. One trial showed nonsignificant weight gain and the remaining five trials showed nonsignificant weight losses that were greater in yoghurt consumers. CONCLUSIONS: Yoghurt consumption is associated with lower body mass index, lower body weight/weight gain, smaller waist circumference and lower body fat in epidemiological studies. RCTs suggest weight reduction effects, but do not permit determination of a cause-effect relationship. Well-controlled, adequately powered trials in research and community settings appear likely to identify a modest but beneficial effect of yoghurt consumption for prevention of weight gain and management of obesity. The ready availability of yoghurt (a nutrient-dense food) and its ease of introduction to most diets suggests that educating the public to eat yoghurt as part of a balanced and healthy diet may potentially contribute to improved public health. Future carefully designed RCTs could provide proof of principle and large community-based studies could determine the practical impact of yoghurt on body weight/composition.
Assuntos
Dieta Saudável , Dieta Redutora/estatística & dados numéricos , Iogurte , Peso Corporal , Estudos Transversais , Ingestão de Energia , Humanos , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Circunferência da CinturaRESUMO
Human adenovirus 36 (Adv36) increases adiposity and is more prevalent in overweight and obese children. Dietary intake in animal models is comparable regardless of Adv36 status. The effects of Adv36 on obesity treatment outcomes have not been clarified. The aim of this study is to investigate the pre-treatment dietary intake and the response to a 4-week inpatient weight management in 184 obese adolescent girls aged 13.0-17.9 years with respect to the presence of Adv36 antibodies. Evaluation of 3-day dietary records did not show any difference in daily intake of energy and essential nutrients between Adv36 antibody positive and negative girls. After the intervention Adv36 positive girls presented with significantly greater decrease of waist circumference (P=0.020), z-score of waist circumference (P=0.024), waist-to-hip ratio (P=0.007) and weight-to-height ratio (P=0.019) compared with Adv36 negative girls. On the contrary, the sum of four skinfolds decreased significantly more in Adv36 negative than in Adv36 positive individuals (P=0.013). Neither body fat percentage nor metabolic and hormonal parameters showed any significant relevance to Adv36 status in response to weight loss intervention. In conclusion, energy restriction in Adv36 antibody positive girls was associated with greater decrease of abdominal obesity and preservation of subcutaneous fat tissue than in those antibody negative.
Assuntos
Infecções por Adenovirus Humanos/epidemiologia , Adenovírus Humanos/fisiologia , Obesidade Infantil/virologia , Infecções por Adenovirus Humanos/etiologia , Infecções por Adenovirus Humanos/imunologia , Adenovírus Humanos/imunologia , Adolescente , Anticorpos Antivirais/sangue , Biomarcadores/sangue , República Tcheca/epidemiologia , Registros de Dieta , Suscetibilidade a Doenças , Feminino , Humanos , Pacientes Internados , Obesidade Infantil/complicações , Obesidade Infantil/imunologia , Fatores de Risco , Relação Cintura-QuadrilRESUMO
BACKGROUND/OBJECTIVES: Adenovirus-36 (Adv-36) infection is associated with exaggerated adipogenesis in cell culture and the development of obesity in animal models and humans, but a causal relationship remains unproven. Our objective was to determine whether serological evidence of Adv-36 infection in childhood and/or adulthood is associated with adult obesity. SUBJECTS/METHODS: Paired plasma concentrations of Adv-36 antibodies were measured by a novel enzyme-linked immunosorbent assay in a subgroup (n=449) of the Cardiovascular Risk in Young Finns Study in childhood (mean age 11.9 years) and adulthood (mean age 41.3 years). The study group included (1) individuals who had maintained normal-weight status (2) those who became obese adults from a normal-weight status in childhood and (3) those that were overweight/obese as a child and obese as an adult. RESULTS: Mean (s.d.) time between baseline and follow-up was 29.4 (3.2) years (range 21-31 years). A total of 24.4% of individuals who were normal weight throughout life were seropositive for Adv-36 during child and/or adulthood as compared with 32.3% of those who became obese adults (P=0.11). Those who became obese in adulthood were more likely to be Adv-36 seropositive as adults compared with those who maintained normal weight (21.3% vs. 11.6%, P=0.02). This difference was mediated by a decline in Adv-36 seropositivity between child and adulthood in those maintaining normal weight. No differences were observed in body mass index across the life course, nor in waist circumference in adult life, between those who were Adv-36 seronegative or seropositive at any age. CONCLUSIONS: Individuals who gained weight across the life course were more likely to be Adv-36 seropositive in adult life than those who did not gain weight. However, analysis of change in weight status in relation to Adv-36 positivity did not support a causal role for Adv-36 in the development of obesity.
Assuntos
Infecções por Adenoviridae/complicações , Adenoviridae/isolamento & purificação , Doenças Cardiovasculares/etiologia , Obesidade/etiologia , Infecções por Adenoviridae/fisiopatologia , Adolescente , Adulto , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/prevenção & controle , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Obesidade/sangue , Obesidade/fisiopatologia , Fatores de RiscoRESUMO
Human adenovirus Ad36 increases adiposity in several animal models, including rodents and non-human primates. Importantly, Ad36 is associated with human obesity, which has prompted research to understand its epidemiology and to develop a vaccine to prevent a subgroup of obesity. For this purpose, understanding the genomic stability of Ad36 in vivo and in vitro infections is critical. Here, we examined whether in vitro cell passaging over a 14-year period introduced any genetic variation in Ad36. We sequenced the whole genome of Ad36-which was plaque purified in 1998 from the original strain obtained from American Type Culture Collection, and passaged approximately 12 times over the past 14 years (Ad36-2012). This DNA sequence was compared with a previously published sequence of Ad36 likely obtained from the same source (Ad36-1988). Compared with Ad36-1988, only two nucleotides were altered in Ad36-2012: a T insertion at nucleotide 1862, which may induce early termination of the E1B viral protein, and a TâC transition at nucleotide 26 136. Virus with the T insertion (designated Ad36-2012-T6) was mixed with wild-type virus lacking the T insertion (designated Ad36-2012-T5) in the viral stock. The transition at nucleotide 26 136 does not change the encoded amino acid (aspartic acid) in the pVIII viral protein. The rate of genetic variation in Ad36 is â¼2.37 × 10(-6) mutations/nucleotide/passage. Of particular importance, there were no mutations in the E4orf1 gene, the critical gene for producing obesity. This very-low-variation rate should reduce concerns about genetic variability when developing Ad36 vaccines or developing assays for detecting Ad36 infection in populations.
Assuntos
Adenovírus Humanos/genética , Adiposidade/fisiologia , Anticorpos Antivirais/metabolismo , Instabilidade Genômica/genética , RNA Viral/metabolismo , Adenovírus Humanos/fisiologia , Adipogenia , Animais , Variação Genética , Instabilidade Genômica/fisiologia , Humanos , Camundongos , Modelos Animais , PrimatasRESUMO
BACKGROUND: Human adenovirus 36 (Adv36) is associated with obesity in children. Most prior studies have been small and the association of Adv36 status with markers of metabolic risks has been inconsistent. OBJECTIVES: To determine the prevalence of Adv36 antibodies in different weight categories of adolescents and to evaluate the association of Adv36 infection with anthropometric parameters and cardiometabolic health risks. SUBJECTS AND METHODS: In 1179 Czech adolescents (85 underweight, 506 normal weight, 160 overweight and 428 obese), the following variables were evaluated: anthropometric (body weight, height, body mass index, circumferences, fat mass), blood pressure, biochemical and hormonal (lipid profile, glucose, insulin, liver enzymes, adiponectin) and Adv36 antibodies (enzyme-linked immunosorbent assay). RESULTS: Of the total cohort, 26.5% were positive for Adv36 antibodies (underweight: 22.3%; normal weight: 21.5%; overweight: 40.0% and obese: 28.0%). The odds ratio for Adv36 antibody positivity evaluated vs normal weight was 2.61 for overweight (95% confidence interval (CI): 1.77-3.86, P<0.001) and 1.46 for obesity (95% CI: 1.07-1.99, P=0.016). A significantly higher prevalence of Adv36 infection was observed in female subjects (32.5%) in comparison to male subjects (19.7%; P<0.001). Adv36 positivity of the whole cohort was significantly related to body weight (P=0.042), body mass index (P=0.015), hip circumference (P=0.004), body height z-score (P=0.029), and total body fat (P=0.000) and trunk fat (P=0.000). Adv36 antibody-positive girls demonstrated significantly higher body height (167.8 vs 165.0 cm, P=0.01) and waist circumference (77.0 vs 72.0 cm, P=0.01). Infected adolescents exhibited significantly higher levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), but lower levels of blood glucose. Liver enzymes were significantly increased only in Adv36-positive boys. CONCLUSION: These results demonstrated an association of Adv36 antibodies with obesity and an even greater association with overweight. Adv36 positivity was related to increased fat mass, levels of TC and LDL-C, but to decreased level of blood glucose. No relation to adiponectin levels was revealed.
Assuntos
Proteínas E1B de Adenovirus/metabolismo , Adenovírus Humanos/imunologia , Anticorpos Antivirais/sangue , Biomarcadores/sangue , Obesidade Infantil/virologia , Fragmentos de Peptídeos/metabolismo , Proteínas E1B de Adenovirus/imunologia , Adiponectina/sangue , Adolescente , Glicemia/metabolismo , Pressão Sanguínea , Composição Corporal , Índice de Massa Corporal , LDL-Colesterol/sangue , República Tcheca , Suscetibilidade a Doenças , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Insulina/sangue , Masculino , Razão de Chances , Obesidade Infantil/epidemiologia , Obesidade Infantil/imunologia , Fragmentos de Peptídeos/imunologia , Fatores de Risco , Triglicerídeos/sangue , Relação Cintura-QuadrilRESUMO
BACKGROUND: In clinical settings, it is common to measure weight of clothed patients and estimate a correction for the weight of clothing, but we can find no papers in the medical literature regarding the variability in clothing weight of adults with weather, season and gender. METHODS: Fifty adults (35 women) were weighed four times during a 12-month period with and without clothing. Clothing weights were determined and regressed against minimum, maximum and average daily outdoor temperature. RESULTS: The average clothing weight (±s.d.) throughout the year was significantly greater in men than in women (1.2±0.3 vs 0.8±0.3 kg, P<0.0001). The average within-person minimum and the average within-person maximum clothing weights across the year were 0.9±0.2 and 1.5±0.4 kg for men, and 0.5±0.2 and 1.1±0.4 kg for women, respectively. The within-person s.d. in clothing weight was 0.3 kg for both men and women. Over the 55 °C range in the lowest to the highest outdoor temperatures, the regressions predicted a maximal change in clothing weight of only 0.4 kg in women and 0.6 kg in men. CONCLUSION: The clothing weight of men is significantly greater than that of women, but there is little variability throughout the year. Therefore, a clothing adjustment of approximately 0.8 kg for women and 1.2 kg for men is appropriate regardless of outdoor temperature.
Assuntos
Peso Corporal , Vestuário , Adolescente , Adulto , Índice de Massa Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Estações do Ano , Fatores SexuaisRESUMO
BACKGROUND: The macrogeographic distribution of obesity in the United States, including the association between elevation and body mass index (BMI), is largely unexplained. This study examines the relationship between obesity and elevation, ambient temperature and urbanization. METHODS AND FINDINGS: Data from a cross-sectional, nationally representative sample of 422603 US adults containing BMI, behavioral (diet, physical activity, smoking) and demographic (age, sex, race/ethnicity, education, employment, income) variables from the 2011 Behavioral Risk Factor Surveillance System were merged with elevation and temperature data from WorldClim and with urbanization data from the US Department of Agriculture. There was an approximately parabolic relationship between mean annual temperature and obesity, with maximum prevalence in counties with average temperatures near 18 °C. Urbanization and obesity prevalence exhibited an inverse relationship (30.9% in rural or nonmetro counties, 29.2% in metro counties with <250000 people, 28.1% in counties with population from 250000 to 1 million and 26.2% in counties with >1 million). After controlling for urbanization, temperature category and behavioral and demographic factors, male and female Americans living <500 m above sea level had 5.1 (95% confidence interval (CI) 2.7-9.5) and 3.9 (95% CI 1.6-9.3) times the odds of obesity, respectively, as compared with counterparts living ≥ 3000 m above sea level. CONCLUSIONS: Obesity prevalence in the United States is inversely associated with elevation and urbanization, after adjusting for temperature, diet, physical activity, smoking and demographic factors.
Assuntos
Índice de Massa Corporal , Clima , Dieta , Obesidade/epidemiologia , Aptidão Física , Urbanização , Adulto , Demografia , Feminino , Sistemas de Informação Geográfica , Humanos , Masculino , Obesidade/genética , Vigilância da População , Prevalência , Estados Unidos/epidemiologiaRESUMO
Obesity is frequently associated with insulin resistance and abnormal glucose homeostasis. Recent studies in animal models have indicated that TNF-alpha plays an important role in mediating the insulin resistance of obesity through its overexpression in fat tissue. However, the mechanisms linking obesity to insulin resistance and diabetes in humans remain largely unknown. In this study we examined the expression pattern of TNF-alpha mRNA in adipose tissues from 18 control and 19 obese premenopausal women by Northern blot analysis. TNF-alpha protein concentrations in plasma and in conditioned medium of explanted adipose tissue were measured by ELISA. Furthermore, the effects of weight reduction by dietary treatment of obesity on the adipose expression of TNF-alpha mRNA were also analyzed in nine premenopausal obese women, before and after a controlled weight-reduction program. These studies demonstrated that obese individuals express 2.5-fold more TNF-alpha mRNA in fat tissue relative to the lean controls (P < 0.001). Similar increases were also observed in adipose production of TNF-alpha protein but circulating TNF-alpha levels were extremely low or undetectable. A strong positive correlation was observed between TNF-alpha mRNA expression levels in fat tissue and the level of hyperinsulinemia (P < 0.001), an indirect measure of insulin resistance. Finally, body weight reduction in obese subjects which resulted in improved insulin sensitivity was also associated with a decrease in TNF-alpha mRNA expression (45%, P < 0.001) in fat tissue. These results suggest a role for the abnormal regulation of this cytokine in the pathogenesis of obesity-related insulin resistance.
Assuntos
Tecido Adiposo/metabolismo , Expressão Gênica , Resistência à Insulina , Obesidade/metabolismo , Fator de Necrose Tumoral alfa/biossíntese , Adulto , Glicemia/metabolismo , Northern Blotting , Índice de Massa Corporal , Colesterol/sangue , Feminino , Humanos , Insulina/sangue , Pessoa de Meia-Idade , Pré-Menopausa , RNA Mensageiro/biossíntese , Valores de Referência , Análise de Regressão , Magreza/metabolismo , Triglicerídeos/sangue , Fator de Necrose Tumoral alfa/análiseAssuntos
Peso ao Nascer , Índice de Massa Corporal , Aleitamento Materno/estatística & dados numéricos , Macrossomia Fetal/epidemiologia , Promoção da Saúde , Mães/estatística & dados numéricos , Obesidade/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Fumar/epidemiologia , Aumento de Peso , Feminino , Humanos , Masculino , GravidezRESUMO
BACKGROUND: The horse intestinal tract is sensitive and contains a highly complex microbial population. A shift in the microbial population can lead to various issues such as inflammation and colic. The use of nutraceuticals in the equine industry is on the rise and curcumin is thought to possess antimicrobial properties that may help to minimize the proliferation of opportunistic bacteria. METHODS: Four cecally-cannulated horses were utilized to determine the optimal dose of liposomal-curcumin (LIPC) on reducing Streptococcus bovis/equinus complex (SBEC), Escherichia coli K-12, Escherichia coli general, Clostridium difficile, and Clostridium perfringens in the equine hindgut without adversely affecting cecal characteristics. In the first study cecal fluid was collected from each horse and composited for an in vitro, 24 h batch culture to examine LIPC at four different dosages (15, 20, 25, and 30 g) in a completely randomized design. A subsequent in vivo 4 × 4 Latin square design study was conducted to evaluate no LIPC (control, CON) or LIPC dosed at 15, 25, and 35 g per day (dosages determined from in vitro results) for 9 days on the efficacy of LIPC on selected bacterial strains, pH, and volatile fatty acids. Each period was 14 days with 9 d for acclimation and 5 d withdrawal period. RESULTS: In the in vitro study dosage had no effect (P ≥ 0.42) on Clostridium strains, but as the dose increased SBEC concentrations increased (P = 0.001). Concentrations of the E. coli strain varied with dose. In vivo, LIPC's antimicrobial properties, at 15 g, significantly decreased (P = 0.02) SBEC when compared to 25 and 35 g dosages. C. perfringens decreased linearly (P = 0.03) as LIPC dose increased. Butyrate decreased linearly (P = 0.01) as LIPC dose increased. CONCLUSION: Further studies should be conducted with a longer dosing period to examine the antimicrobial properties of curcumin without adversely affecting cecal characteristics.
RESUMO
Apparent ruminal digestibility of forage soybean-based silages, with and without pearl millet, was determined along with evaluation of silages on heifer performance and reproductive function. Fermenters were utilized in a Latin square design and randomly assigned to 1 of the following treatments: 1) control diet of alfalfa haylage (CON), 2) soybean silage (SB) or 3) soybean and pearl millet silage (SB×PM). All diets were formulated to meet or exceed nutrient requirements of replacement beef heifers targeted to gain 0.79 kg/d. These same diets were fed to 90 Angus-Simmental beef replacement heifers [body weight (BW) = 366 kg; body condition score (BCS) = 5.53; age = 377 ± 11 d] 65 d prior to timed artificial insemination (TAI). Heifers were randomly allotted by breed, BCS and BW to 1 of the 3 treatments, with 3 reps/treatment. Diets were terminated 21 d post-TAI and heifers were commingled and placed on a common diet. Pubertal status was determined by progesterone concentrations of 2 blood samples taken 10 d apart prior to both trial initiation as well as initiation of estrous synchronization. Ovulatory follicle diameter was determined at time of breeding by ultrasonography. Pregnancy diagnosis was accomplished 35 and 66 d post-TAI, respectively, to calculate TAI and end of season pregnancy rates. Neither SB nor SB×PM had an effect (P > 0.37) on apparent ruminal digestion of nutrients compared to the CON. Final BW (414 kg; P ≥ 0.10) and BCS (5.28; P ≥ 0.26) for the heifers were similar among treatments. Likewise, there were no differences in TAI (48%; P > 0.43) or overall breeding season (93%; P > 0.99) pregnancy rates. Ovulatory follicle diameters (11.7 mm) was not different (P > 0.19) among treatments. In summary, forage soybean-based silages, with and without pearl millet, was an acceptable alternative forage for developing replacement beef heifers.
RESUMO
Previous studies have shown that tumor necrosis factor (TNF)-alpha production from adipose tissue is elevated in rodent and human obesity and plays an important role in insulin resistance in experimental animal models. In this study, we examined the adipose expression of both TNF receptors (TNFR1 and TNFR2) in human obesity and demonstrated that obese female subjects express approximately twofold more TNFR2 mRNA in fat tissue and approximately sixfold more soluble TNFR2 in circulation relative to lean control subjects. In contrast, TNFR1 expression and protein levels were similar in these subjects. TNFR2 expression levels in adipose tissue were strongly correlated with BMI (r = 0.65, P < 0.001) and level of hyperinsulinemia (P < 0.001), an indirect measure of insulin resistance, as well as level of TNF-alpha mRNA expression in fat tissue (r = 0.56, P < 0.001). These results suggest that TNFR2 might play a role in human obesity by modulating the actions of TNF-alpha.
Assuntos
Tecido Adiposo/metabolismo , Antígenos CD/biossíntese , Regulação da Expressão Gênica , Resistência à Insulina , Obesidade/metabolismo , Receptores do Fator de Necrose Tumoral/biossíntese , Adulto , Northern Blotting , Índice de Massa Corporal , Peso Corporal , Feminino , Humanos , Pré-Menopausa , Receptores Tipo I de Fatores de Necrose Tumoral , Receptores Tipo II do Fator de Necrose Tumoral , Valores de Referência , Análise de RegressãoAssuntos
Aleitamento Materno , Obesidade , Viés de Publicação , Interpretação Estatística de Dados , Feminino , Humanos , Masculino , GravidezRESUMO
Both, common gene variants and human adenovirus 36 (Adv36) are involved in the pathogenesis of obesity. The potential relationship between these two pathogenic factors has not yet been investigated. The aim of our study was to examine the association of obesity susceptibility loci with Adv36 status. Genotyping of ten gene variants (in/near TMEM18, SH2B1, KCTD15, PCSK1, BDNF, SEC16B, MC4R, FTO) and analysis of Adv36 antibodies was performed in 1,027 Czech adolescents aged 13.0-17.9 years. Variants of two genes (PCSK1 and BDNF) were associated with Adv36 seropositivity. A higher prevalence of Adv36 antibody positivity was observed in obesity risk allele carriers of PCSK1 rs6232, rs6235 and BDNF rs4923461 vs. non-carriers (chi(2)=6.59, p=0.010; chi(2)=7.56, p=0.023 and chi(2)=6.84, p=0.033, respectively). The increased risk of Adv36 positivity was also found in PCSK1 variants: rs6232 (OR=1.67, 95 % CI 1.11-2.49, p=0.016) and rs6235 (OR=1.34, 95 % CI 1.08-1.67, p=0.010). PCSK1 rs6232 and BDNF rs925946 variants were closely associated with Adv36 status in boys and girls, respectively (chi(2)=5.09, p=0.024; chi(2)=7.29, p=0.026). Furthermore, PCSK1 rs6235 risk allele was related to Adv36 seropositivity (chi(2)=6.85, p=0.033) in overweight/obese subgroup. In conclusion, our results suggest that obesity risk variants of PCSK1 and BDNF genes may be related to Adv36 infection.
Assuntos
Adenoviridae/genética , Infecções por Adenovirus Humanos/epidemiologia , Infecções por Adenovirus Humanos/genética , Variação Genética/genética , Obesidade/epidemiologia , Obesidade/genética , Adolescente , Fator Neurotrófico Derivado do Encéfalo/genética , Feminino , Estudos de Associação Genética/métodos , Humanos , Masculino , Pró-Proteína Convertase 1/genéticaRESUMO
Adipose tissue derived from open biopsies was used to develop a system for studying insulin resistance in human tissue in vitro. Subcutaneous adipose tissue obtained from obese donors was incubated in Parker's medium 199 in the absence or presence of insulin for 24 h under sterile conditions. Adipocytes were then isolated by collagenase digestion, washed thoroughly, and incubated for 2 h with multiple insulin concentrations in Krebs-Ringer phosphate buffer with 4% bovine serum albumin. Lipolysis was estimated by measuring glycerol. Basal lipolysis in adipocytes cultured with insulin did not differ significantly from that of adipocytes cultured without insulin (2.49 +/- 0.18 vs. 2.67+/- 0.58 mumol glycerol/mmol triglyceride). The maximum acute response in adipocytes prepared from tissue exposed to insulin during culture was 55% inhibition of basal lipolysis, whereas the maximum response in cells prepared from tissue not exposed to insulin chronically was 80%. Statistical analysis by paired t test showed a significant difference (P < 0.01) in the reaction of the two groups of cells to acute exposure to insulin. The insulin dose required to produce the half-maximal effect was increased from 3 to 24 microU/ml. Thus, after chronic exposure to insulin, adipocytes were not as responsive to the acute antilipolytic action of the hormone. We conclude that chronic exposure to insulin induces insulin resistance in human adipocytes.