<div style="text-align:justify;"> <span style="font-family:Verdana;">Visceral adiposity mediates insulin resistance, but their association among adults with prediabetes is scarce in the...<div style="text-align:justify;"> <span style="font-family:Verdana;">Visceral adiposity mediates insulin resistance, but their association among adults with prediabetes is scarce in the literature. This study is aimed to determine the association of visceral adiposity index (VAI) with insulin resistance in adults with prediabetes. This cross-sectional study was done among 117 adults with newly detected prediabetes [m/f;23/94;mean ± SD: Age 36.30 ± 9.99 years, BMI 28.89 ± 4.35 kg/m<sup>2</sup>] based on American Diabetes Association 2018 criteria and 141 matched healthy controls [m/f: 28/113;mean ± SD: 35.30 ± 6.88 years, BMI 25.03 ± 4.58]. Waist circumference, body mass index, fasting triglyceride, HDL cholesterol, fasting blood glucose and insulin were measured in each group to calculate VAI and homeostatic model assessment of insulin resistance (HOMA-IR). People with prediabetes had significantly higher median value of VAI {3.08 (2.26) vs. 1.86 (2.31);p < 0.001} with higher frequency of high VAI (>1) (98.3% vs. 85.8%;p < 0.001) than the control population. HOMA-IR level was significantly higher in prediabetes with high VAI (cut-off of 2.64) than control with normal VAI [2.78 (2.22, 4.15) vs. 2.20 (1.53, 3.36);p = 0.002]. VAI was positively correlated with HOMA-IR in females with prediabetes (r = 0.299, p = 0.003). VAI had predictive association with prediabetes [OR (95% CI: 9.504 (2.173, 41.576);p = 0.03] and high insulin resistance (HOMA-IR ≥ 2.6) in females with prediabetes [OR (95% CI) = 3.50 (1.476, 8.297);p = 0.004] only. It could satisfactorily discriminate prediabetes in both sexes (male: AUC = 0.767, p = 0.001;female: AUC = 0.641, p < 0.001) and high insulin resistance in females with prediabetes (AUC = 0.641;p = 0.019) only. So, VAI was associated with prediabetes and insulin resistance only in females with prediabetes.</span> </div>展开更多
BACKGROUND There is an unmet need to evaluate the burden of cardiometabolic risk factors in young South Asian adults,who are not preselected for glycaemia.AIM To evaluate young North Indian men(aged 20-50 years)for bu...BACKGROUND There is an unmet need to evaluate the burden of cardiometabolic risk factors in young South Asian adults,who are not preselected for glycaemia.AIM To evaluate young North Indian men(aged 20-50 years)for burden of cardiometabolic risk factors,in relation to parameters of homeostatic model assessment for insulin resistance(HOMA-IR)and beta-cell function(oral disposition index[oDI]).METHODS Study participants were invited in a fasting state.Sociodemographic,anthropometric,and medical data were collected,and 75 g oral glucose tolerance test was performed with serum insulin and plasma glucose estimation at 0,30,and 120 min.Participants were divided into quartiles for HOMA-IR and oDI(category 1:Best HOMA-IR/oDI quartile;category 3:Worst HOMA-IR/oDI quartile)and composite HOMA-IR/oDI phenotypes(phenotype 1:Best quartile for both HOMA-IR and oDI;phenotype 4:Worst quartile for both HOMA-IR and oDI)were derived.RESULTS We evaluated a total of 635 men at a mean(±SD)age of 33.9±5.1 years and body mass index of 26.0±3.9 kg/m^(2).Diabetes and prediabetes were present in 34(5.4%)and 297(46.8%)participants,respectively.Overweight/obesity,metabolic syndrome,and hypertension were present in 388(61.1%),258(40.6%),and 123(19.4%)participants,respectively.The prevalence of dysglycaemia,metabolic syndrome,and hypertension was significantly higher in participants belonging to the worst HOMA-IR and oDI quartiles,either alone(category 3 vs 1)or in combination(phenotype 4 vs 1).The adjusted odds ratios for dysglycaemia(6.5 to 7.0-fold),hypertension(2.9 to 3.6-fold),and metabolic syndrome(4.0 to 12.2-fold)were significantly higher in individuals in the worst quartile of HOMA-IR and oDI(category 3),compared to those in the best quartile(category 1).The adjusted odds ratios further increased to 21.1,5.6,and 13.7,respectively,in individuals with the worst,compared to the best composite HOMA-IR/oDI phenotypes(phenotype 4 vs 1).CONCLUSION The burden of cardiometabolic risk factors is high among young Asian Indian men.Our findings highlight the importance of using parameters of insulin resistance and beta-cell function in phenotyping individuals for cardiometabolic risk.展开更多
Insulin resistance is a hallmark of obesity,diabetes,and cardiovascular diseases,and leads to many of the abnormalities associated with metabolic syndrome. Our understanding of insulin resistance has improved tremendo...Insulin resistance is a hallmark of obesity,diabetes,and cardiovascular diseases,and leads to many of the abnormalities associated with metabolic syndrome. Our understanding of insulin resistance has improved tremendously over the years,but certain aspects of its estimation still remain elusive to researchers and clinicians.The quantitative assessment of insulin sensitivity is not routinely used during biochemical investigations for diagnostic purposes,but the emerging importance of insulin resistance has led to its wider application research studies.Evaluation of a number of clinical states where insulin sensitivity is compromised calls for assessment of insulin resistance. Insulin resistance is increasingly being assessed in various disease conditions where it aids in examining their pathogenesis,etiology and consequences. The hyperinsulinemic euglycemic glucose clamp is the gold standard method for the determination of insulin sensitivity,but is impractical as it is labor-and time-intensive.A number of surrogate indices have therefore been employed to simplify and improve the determination of insulin resistance.The object of this review is to highlight various aspects and methodologies for current and upcoming measures ofinsulin sensitivity/resistance.In-depth knowledge of these markers will help in better understanding and exploitation of the condition.展开更多
AIM： To investigate the relationship between insulin resistance （IR）/β-cell dysfunction and diabetic retinopathy （DR） in Chinese patients with type 2 diabetes mellitus （T2DM）, and to explore further whether th...AIM： To investigate the relationship between insulin resistance （IR）/β-cell dysfunction and diabetic retinopathy （DR） in Chinese patients with type 2 diabetes mellitus （T2DM）, and to explore further whether there were differences in the relationship among diabetic patients with higher and lower body mass index （BMI）. METHODS： Cross-sectional study. A total of 1466 subjects with T2DM were recruited in a local Desheng Community of urban Beijing from November 2009 to June 2012 for the cohort of Beijing Desheng Diabetic Eye Study. Standardized evaluation was carried out for each participant, including questionnaire, ocular and anthropometric examinations, and laboratory tests. Seven fields 30° color fundus photographs were used for DR grading according to the Early Treatment Diabetic Retinopathy Study protocols. Homeostatis Model Assessment （HOMA） method was employed for IR and β-cell function assessment. RESULTS： After excluding those participants who were treated with insulin （n=352） or had missing data of fasting insulin （n=96）, and further excluding those with poor quality of retinal photographs （n=10）, a total of 1008 subjects were included for the final analysis, 406 （40.3%） were men and 602 （59.7%） were women, age ranging fiom 34 to 86 （64.87±8.28）y. Any DR （levels 14 and above） was present in 278 （27.6%） subjects. After adjusting for possible covariates, the presence of any DR did not correlate with HOMA IR [odds ratio （OR） 1.51, 95% confidence interval （Cl） 0.87-2.61, P=0.14] or HOMA β-cell （OR 0.71, 95%CI 0.40-1.26, P=0.25）. After stratification by BMI, the presence of any DR was associated positively with HOMA IR （OR 2.46, 95%CI： 1.18-5.12, P=0.016）, and negatively with HOMA β-cell （OR 0.40, 95%CI： 0.19-0.87, P=0.021） in the group of patients with higher BMI （225 kg/m2）. In the group of patients with lower BMI （〈25 kg/m2）, the presence of any DR was not associated with HOMA IR （OR 1.00, 95%C1： 0.43-2.33, P=I.00） or HOMA β-cell （OR 1.41, 95%CI： 0.60-3.32, P=0.43）. CONCLUSION： The data suggest that higher IR and lower 13-cell function are associated with the presence of DR in the subgroup of diabetic patients with higher BMI. However, this association is not statistically significant in diabetic patients with lower BMI.展开更多
AIM: To determine the insulin resistance (IR) and oxidative status in H pylori infection and to find out if there is any relationship between these parameters and insulin resistance. METHODS: Fifty-five H pylori posit...AIM: To determine the insulin resistance (IR) and oxidative status in H pylori infection and to find out if there is any relationship between these parameters and insulin resistance. METHODS: Fifty-five H pylori positive and 48 H pylori negative patients were enrolled. The homeostasis model assessment (HOMA) was used to assess insulin resistance. Serum total antioxidant capacity (TAC), total oxidant status (TOS) and oxidative stress index (OSI) were determined in all subjects. RESULTS: The total antioxidant capacity was significantly lower in H pylori positive group than in H pylori negative group (1.36 ± 0.33 and 1.70 ± 0.50, respectively; P < 0.001), while the total oxidant status and oxidative stress index were significantly higher in H pylori positive group than in H pylori negative group (6.79 ± 3.40 and 5.08 ± 0.95, and 5.42 ± 3.40 and 3.10 ± 0.92, respectively; P < 0.001). Insulin resistance was significantly higher in H pylori positive group than in H pylori negative group (6.92 ± 3.86 and 3.61 ± 1.67, res- pectively; P < 0.001). Insulin resistance was found to be significantly correlated with total antioxidant capacity (r = -0.251, P < 0.05), total oxidant status (r = 0.365, P < 0.05), and oxidative stress index (r = 0.267, P < 0.05). CONCLUSION: Insulin resistance seems to be associated with increased oxidative stress in H pylori infection. Further studies are needed to clarify the mechanisms underlying this association and elucidate the effectof adding antioxidant vitamins to H pylori eradication therapy on insulin resistance during H pylori infection.展开更多
The purpose of this study was to determine the relationship between insulin resistance, obesity and serum prostate-specific antigen （PSA） levels in healthy men with serum PSA level below 4 ng mL-1. The men included ...The purpose of this study was to determine the relationship between insulin resistance, obesity and serum prostate-specific antigen （PSA） levels in healthy men with serum PSA level below 4 ng mL-1. The men included in the study cohort were 11 827 healthy male employees of the Korea Hydro and Nuclear Power Co., LTD who had undergone medical checkups including fasting glucose, fasting insulin and serum PSA between January 2003 and December 2008. Insulin resistance was calculated by homeostasis model assessment （HOMA [fasting glucose × fasting insulin]/22.5） and quantitative insulin sensitivity check index （QUICK/; 1/[log （fasting insulin） ＋ log （fasting glucose）]）. Age-adjusted body mass index （BMI） was significantly increased according to increasing quartile of insulin resistance as determined by HOMA and QUICKI, respectively, in analysis of variance （ANOVA） test and Duncan＇s multiple comparison test （P 〈 0.001）, but age-adjusted serum PSA concentration was significantly decreased according to increasing quartile of insulin resistance as determined by HOMA and QUICK/（P 〈 0.001）. Age, BMI, insulin resistance by HOMA or QUICK/were significantly independent variables to serum PSA level in a multivariate linear regression analysis （P 〈 0.001）. Insulin resistance was a significant independent variable to serum PSA level along with BMI. Insulin resistance and BMI were negatively correlated with serum PSA level in healthy men. Insulin resistance was positively correlated with BMI.展开更多
This prospective study was designed to examine the combined influence of insulin resistance（IR）and inflammatory biomarker levels on type 2 diabetes mellitus（T2DM）among 1,903Inner Mongolians.
Compounds with regulating glucose metabolism and improving insulin resistance(IR)activity are abundant in nature and can be obtained from several sources.They have high potential to be used to treat diabetes mellitus....Compounds with regulating glucose metabolism and improving insulin resistance(IR)activity are abundant in nature and can be obtained from several sources.They have high potential to be used to treat diabetes mellitus.These compounds isolated from natural plants can be classified seven categories:terpenoids,alkaloids,quinones,flavonoids,phenols,phenyl propanoids,steroids,and other types of compounds.They exert biological effects by different ways and mechanisms.This review illustrated the potential natural products as a rich resource in regulation of glucose metabolism and IR,as well as their mechanisms.展开更多
BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses met...BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.展开更多
AIM: To compare resistin mRNA expression in subcutaneous adipose tissue (SAT) and its correlation with insulin resistance (IR) in postmenopausal obese women. METHODS: A total of 68 postmenopausal women (non obese = 34...AIM: To compare resistin mRNA expression in subcutaneous adipose tissue (SAT) and its correlation with insulin resistance (IR) in postmenopausal obese women. METHODS: A total of 68 postmenopausal women (non obese = 34 and obese = 34) were enrolled for the study. The women of the two groups were age matched (49-70 years). Fasting blood samples were collected at admission and abdominal SAT was obtained during surgery for gall bladder stones or hysterectomy. Physical parameters [age, height, weight, body mass index (BMI)] were measured. Biochemical (plasma insulin and plasma glucose) parameters were estimated by enzymatic methods. RNA was isolated by the Trizol method.SAT resistin mRNA expression was done by real time- reverse transcription polymerase chain reaction (RT-PCR) by using Quanti Tect SYBR Green RT-PCR master mix. Data was analyzed using independent Student's t test, correlation and simple linear regression analysis. RESULTS: The mean weight (52.81 ± 8.04 kg vs 79.56 ± 9.91 kg; P < 0.001), BMI (20.23 ± 3.05 kg/m 2 vs 32.19 ± 4.86 kg/m 2 ; P < 0.001), insulin (8.47 ± 3.24 U/mL vs 14.67 ± 2.18 U/mL; P < 0.001), glucose (97.44 ± 11.31 mg/dL vs 109.67 ± 8.02 mg/dL; P < 0.001) and homeostasis model assessment index (2.01 ± 0.73 vs 3.96 ± 0.61; P < 0.001) were significantly higher in postmenopausal obese women compared to postmenopausal non obese women. The mean serum resistin level was also significantly higher in postmeno-pausal obese women compared to postmenopausal non obese women (9.05 ± 5.15 vs 13.92 ± 6.32, P < 0.001). Furthermore, the mean SAT resistin mRNA expression was also significantly (0.023 ± 0.008 vs 0.036 ± 0.009; P < 0.001) higher and over expressed 1.62 fold (upregulated) in postmenopausal obese women compared to postmenopausal non obese women. In postmeno-pausal obese women, the relative SAT resistin mRNA expression showed positive (direct) and significant correlation with BMI (r = 0.78, P < 0.001) and serum resistin (r = 0.76, P < 0.001). Furthermore, the SAT resistin mRNA expression in postmenopausal obese women also showed significant and direct association (r = 0.45, P < 0.01) with IR, while in postmenopausal non obese women it did not show any association (r = -0.04, P > 0.05). CONCLUSION: Increased SAT resistin mRNA expres-sion probably leads to inducing insulin resistance and thus may be associated with obesity-related disorders in postmenopausal obese women.展开更多
Background: In response to the escalating burden of cardiovascular diseases (CVDs) worldwide, exacerbated by lifestyle changes and socioeconomic shifts, acute coronary syndromes (ACS) stand out as a leading cause of m...Background: In response to the escalating burden of cardiovascular diseases (CVDs) worldwide, exacerbated by lifestyle changes and socioeconomic shifts, acute coronary syndromes (ACS) stand out as a leading cause of morbidity and mortality. The pivotal role of insulin resistance in the pathogenesis of atherosclerosis, independent of traditional risk factors, has garnered significant interest. Objective: This review aims to synthesize the recent advancements in the utilization of the triglyceride glucose index (TyG index) as a biomarker for assessing the severity and predicting the prognosis of ACS lesions. Methods: A systematic search was conducted across PubMed, Embase, and Scopus databases, incorporating keywords such as “triglyceride glucose index”, “TyG index”, “acute coronary syndrome”, “cardiovascular disease”, “insulin resistance”, “coronary artery calcification”, “SYNTAX score”, “Gensini score”, and “major adverse cardiac events”. Studies were included from the inception of each database up to July 2024. Selection criteria encompassed observational studies, case-control studies, and randomized controlled trials, with a particular emphasis on evaluating the diagnostic and prognostic value of the TyG index in patients with acute coronary syndromes. Ultimately, 46 publications met the inclusion criteria. Data extraction and quality assessment were performed in accordance with established guidelines. Results: Evidence suggests that the TyG index, reflecting insulin resistance, blood glucose, and lipid levels, is significantly associated with lesion severity in ACS, including coronary artery calcification, SYNTAX score, and Gensini score. Moreover, it demonstrates predictive power for major adverse cardiovascular events, underscoring its potential as a valuable tool in clinical decision-making. Conclusion: The review highlights the emerging role of the TyG index in the assessment and prognosis of ACS, advocating for its incorporation into clinical practice as a complement to existing diagnostic modalities. However, the establishment of standardized reference ranges and further validation across diverse populations are warranted to refine its applicability in personalized medicine. The interdisciplinary approach is essential to advance our understanding of the complex interplay between insulin resistance and cardiovascular disease, paving the way for the development of more effective prevention and treatment strategies.展开更多
Various pathological conditions can cause fatty liver in children. Nonalcoholic steatohepatitis(NASH) in children has been known since 1983. However, NASH diagnosed in childhood does not have a favorable outcome.The p...Various pathological conditions can cause fatty liver in children. Nonalcoholic steatohepatitis(NASH) in children has been known since 1983. However, NASH diagnosed in childhood does not have a favorable outcome.The pathological characteristics of NASH are significantly different between children and adults. Nonalcoholic fatty liver disease(NAFLD)/NASH is accompanied by insulin resistance, which plays a pivotal role in its pathophysiology in both children and adults. In NASH,a "two-hit" model involving triglyceride accumulation(first hit) and liver damage(second hit) has been accepted. Insulin resistance was found to correlate with changes in fat levels; however, it did not correlate with fibrosis or NAFLD activity score in children. Therefore,insulin resistance may be important in the first hit.Because there is obvious familial clustering in NASH,genetic predisposition as well as environmental factors including diet might be the second hit of NAFLD/NASH.展开更多
Liver marker {e.g., alanine aminotransferase (ALT) and aspartate aminotransferase (AST)} levels independently predict insulin resistance. The aim of the present study is to examine how changes in liver markers are ass...Liver marker {e.g., alanine aminotransferase (ALT) and aspartate aminotransferase (AST)} levels independently predict insulin resistance. The aim of the present study is to examine how changes in liver markers are associated with changes in insulin resistance after exercise in Japanese community-dwelling adults. The participants were 76 women aged 67 ± 6 years from a rural village. Nordic walk (NW) exercise of 120 min per week was performed for 12 weeks. Before and at the end of the 12-week intervention, various confounding factors and insulin resistance {e.g., Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)} were measured. The baseline, follow-up, and changes in ALT/AST ratio (β = 0.390, P β = 0.393, P β = 0.321, P = 0.004, respectively) were each significantly and independently associated with HOMA-IR. When the data were further stratified by baseline and change in ASL/AST ratio, changes in HOMA-IR decreased more significantly in participants with baseline ASL/AST ratio ≥ 0.762 and change in ALT/AST ratio of < 0 than those with change in ALT/AST ratio of ≥ 0 (baseline ASL/AST ratio P = 0.002 and ASL/AST ratio ≥ 0.762, P = 0.047). This study is of interest because liver transaminase markers, which are inexpensive and routinely collected in clinical settings, may provide a simple and accurate enhancement to models currently used to identify subjects with changes in insulin resistance. These results suggest that a higher baseline and decreased change in ALT/AST ratio may be a predictor for decreased insulin resistance after a 12-week walking exercise in community-dwelling middle-aged and elderly women.展开更多
文摘<div style="text-align:justify;"> <span style="font-family:Verdana;">Visceral adiposity mediates insulin resistance, but their association among adults with prediabetes is scarce in the literature. This study is aimed to determine the association of visceral adiposity index (VAI) with insulin resistance in adults with prediabetes. This cross-sectional study was done among 117 adults with newly detected prediabetes [m/f;23/94;mean ± SD: Age 36.30 ± 9.99 years, BMI 28.89 ± 4.35 kg/m<sup>2</sup>] based on American Diabetes Association 2018 criteria and 141 matched healthy controls [m/f: 28/113;mean ± SD: 35.30 ± 6.88 years, BMI 25.03 ± 4.58]. Waist circumference, body mass index, fasting triglyceride, HDL cholesterol, fasting blood glucose and insulin were measured in each group to calculate VAI and homeostatic model assessment of insulin resistance (HOMA-IR). People with prediabetes had significantly higher median value of VAI {3.08 (2.26) vs. 1.86 (2.31);p < 0.001} with higher frequency of high VAI (>1) (98.3% vs. 85.8%;p < 0.001) than the control population. HOMA-IR level was significantly higher in prediabetes with high VAI (cut-off of 2.64) than control with normal VAI [2.78 (2.22, 4.15) vs. 2.20 (1.53, 3.36);p = 0.002]. VAI was positively correlated with HOMA-IR in females with prediabetes (r = 0.299, p = 0.003). VAI had predictive association with prediabetes [OR (95% CI: 9.504 (2.173, 41.576);p = 0.03] and high insulin resistance (HOMA-IR ≥ 2.6) in females with prediabetes [OR (95% CI) = 3.50 (1.476, 8.297);p = 0.004] only. It could satisfactorily discriminate prediabetes in both sexes (male: AUC = 0.767, p = 0.001;female: AUC = 0.641, p < 0.001) and high insulin resistance in females with prediabetes (AUC = 0.641;p = 0.019) only. So, VAI was associated with prediabetes and insulin resistance only in females with prediabetes.</span> </div>
文摘BACKGROUND There is an unmet need to evaluate the burden of cardiometabolic risk factors in young South Asian adults,who are not preselected for glycaemia.AIM To evaluate young North Indian men(aged 20-50 years)for burden of cardiometabolic risk factors,in relation to parameters of homeostatic model assessment for insulin resistance(HOMA-IR)and beta-cell function(oral disposition index[oDI]).METHODS Study participants were invited in a fasting state.Sociodemographic,anthropometric,and medical data were collected,and 75 g oral glucose tolerance test was performed with serum insulin and plasma glucose estimation at 0,30,and 120 min.Participants were divided into quartiles for HOMA-IR and oDI(category 1:Best HOMA-IR/oDI quartile;category 3:Worst HOMA-IR/oDI quartile)and composite HOMA-IR/oDI phenotypes(phenotype 1:Best quartile for both HOMA-IR and oDI;phenotype 4:Worst quartile for both HOMA-IR and oDI)were derived.RESULTS We evaluated a total of 635 men at a mean(±SD)age of 33.9±5.1 years and body mass index of 26.0±3.9 kg/m^(2).Diabetes and prediabetes were present in 34(5.4%)and 297(46.8%)participants,respectively.Overweight/obesity,metabolic syndrome,and hypertension were present in 388(61.1%),258(40.6%),and 123(19.4%)participants,respectively.The prevalence of dysglycaemia,metabolic syndrome,and hypertension was significantly higher in participants belonging to the worst HOMA-IR and oDI quartiles,either alone(category 3 vs 1)or in combination(phenotype 4 vs 1).The adjusted odds ratios for dysglycaemia(6.5 to 7.0-fold),hypertension(2.9 to 3.6-fold),and metabolic syndrome(4.0 to 12.2-fold)were significantly higher in individuals in the worst quartile of HOMA-IR and oDI(category 3),compared to those in the best quartile(category 1).The adjusted odds ratios further increased to 21.1,5.6,and 13.7,respectively,in individuals with the worst,compared to the best composite HOMA-IR/oDI phenotypes(phenotype 4 vs 1).CONCLUSION The burden of cardiometabolic risk factors is high among young Asian Indian men.Our findings highlight the importance of using parameters of insulin resistance and beta-cell function in phenotyping individuals for cardiometabolic risk.
文摘Insulin resistance is a hallmark of obesity,diabetes,and cardiovascular diseases,and leads to many of the abnormalities associated with metabolic syndrome. Our understanding of insulin resistance has improved tremendously over the years,but certain aspects of its estimation still remain elusive to researchers and clinicians.The quantitative assessment of insulin sensitivity is not routinely used during biochemical investigations for diagnostic purposes,but the emerging importance of insulin resistance has led to its wider application research studies.Evaluation of a number of clinical states where insulin sensitivity is compromised calls for assessment of insulin resistance. Insulin resistance is increasingly being assessed in various disease conditions where it aids in examining their pathogenesis,etiology and consequences. The hyperinsulinemic euglycemic glucose clamp is the gold standard method for the determination of insulin sensitivity,but is impractical as it is labor-and time-intensive.A number of surrogate indices have therefore been employed to simplify and improve the determination of insulin resistance.The object of this review is to highlight various aspects and methodologies for current and upcoming measures ofinsulin sensitivity/resistance.In-depth knowledge of these markers will help in better understanding and exploitation of the condition.
基金Supported by the Beijing Natural Science Foundation(No.7131007)National Basic Research Program of China(973 ProgramNo.2007CB512201)
文摘AIM： To investigate the relationship between insulin resistance （IR）/β-cell dysfunction and diabetic retinopathy （DR） in Chinese patients with type 2 diabetes mellitus （T2DM）, and to explore further whether there were differences in the relationship among diabetic patients with higher and lower body mass index （BMI）. METHODS： Cross-sectional study. A total of 1466 subjects with T2DM were recruited in a local Desheng Community of urban Beijing from November 2009 to June 2012 for the cohort of Beijing Desheng Diabetic Eye Study. Standardized evaluation was carried out for each participant, including questionnaire, ocular and anthropometric examinations, and laboratory tests. Seven fields 30° color fundus photographs were used for DR grading according to the Early Treatment Diabetic Retinopathy Study protocols. Homeostatis Model Assessment （HOMA） method was employed for IR and β-cell function assessment. RESULTS： After excluding those participants who were treated with insulin （n=352） or had missing data of fasting insulin （n=96）, and further excluding those with poor quality of retinal photographs （n=10）, a total of 1008 subjects were included for the final analysis, 406 （40.3%） were men and 602 （59.7%） were women, age ranging fiom 34 to 86 （64.87±8.28）y. Any DR （levels 14 and above） was present in 278 （27.6%） subjects. After adjusting for possible covariates, the presence of any DR did not correlate with HOMA IR [odds ratio （OR） 1.51, 95% confidence interval （Cl） 0.87-2.61, P=0.14] or HOMA β-cell （OR 0.71, 95%CI 0.40-1.26, P=0.25）. After stratification by BMI, the presence of any DR was associated positively with HOMA IR （OR 2.46, 95%CI： 1.18-5.12, P=0.016）, and negatively with HOMA β-cell （OR 0.40, 95%CI： 0.19-0.87, P=0.021） in the group of patients with higher BMI （225 kg/m2）. In the group of patients with lower BMI （〈25 kg/m2）, the presence of any DR was not associated with HOMA IR （OR 1.00, 95%C1： 0.43-2.33, P=I.00） or HOMA β-cell （OR 1.41, 95%CI： 0.60-3.32, P=0.43）. CONCLUSION： The data suggest that higher IR and lower 13-cell function are associated with the presence of DR in the subgroup of diabetic patients with higher BMI. However, this association is not statistically significant in diabetic patients with lower BMI.
文摘AIM: To determine the insulin resistance (IR) and oxidative status in H pylori infection and to find out if there is any relationship between these parameters and insulin resistance. METHODS: Fifty-five H pylori positive and 48 H pylori negative patients were enrolled. The homeostasis model assessment (HOMA) was used to assess insulin resistance. Serum total antioxidant capacity (TAC), total oxidant status (TOS) and oxidative stress index (OSI) were determined in all subjects. RESULTS: The total antioxidant capacity was significantly lower in H pylori positive group than in H pylori negative group (1.36 ± 0.33 and 1.70 ± 0.50, respectively; P < 0.001), while the total oxidant status and oxidative stress index were significantly higher in H pylori positive group than in H pylori negative group (6.79 ± 3.40 and 5.08 ± 0.95, and 5.42 ± 3.40 and 3.10 ± 0.92, respectively; P < 0.001). Insulin resistance was significantly higher in H pylori positive group than in H pylori negative group (6.92 ± 3.86 and 3.61 ± 1.67, res- pectively; P < 0.001). Insulin resistance was found to be significantly correlated with total antioxidant capacity (r = -0.251, P < 0.05), total oxidant status (r = 0.365, P < 0.05), and oxidative stress index (r = 0.267, P < 0.05). CONCLUSION: Insulin resistance seems to be associated with increased oxidative stress in H pylori infection. Further studies are needed to clarify the mechanisms underlying this association and elucidate the effectof adding antioxidant vitamins to H pylori eradication therapy on insulin resistance during H pylori infection.
文摘The purpose of this study was to determine the relationship between insulin resistance, obesity and serum prostate-specific antigen （PSA） levels in healthy men with serum PSA level below 4 ng mL-1. The men included in the study cohort were 11 827 healthy male employees of the Korea Hydro and Nuclear Power Co., LTD who had undergone medical checkups including fasting glucose, fasting insulin and serum PSA between January 2003 and December 2008. Insulin resistance was calculated by homeostasis model assessment （HOMA [fasting glucose × fasting insulin]/22.5） and quantitative insulin sensitivity check index （QUICK/; 1/[log （fasting insulin） ＋ log （fasting glucose）]）. Age-adjusted body mass index （BMI） was significantly increased according to increasing quartile of insulin resistance as determined by HOMA and QUICKI, respectively, in analysis of variance （ANOVA） test and Duncan＇s multiple comparison test （P 〈 0.001）, but age-adjusted serum PSA concentration was significantly decreased according to increasing quartile of insulin resistance as determined by HOMA and QUICK/（P 〈 0.001）. Age, BMI, insulin resistance by HOMA or QUICK/were significantly independent variables to serum PSA level in a multivariate linear regression analysis （P 〈 0.001）. Insulin resistance was a significant independent variable to serum PSA level along with BMI. Insulin resistance and BMI were negatively correlated with serum PSA level in healthy men. Insulin resistance was positively correlated with BMI.
基金supported by the National Natural Science Foundation of China[Grant No.81773509][Grant No.81102190]
文摘This prospective study was designed to examine the combined influence of insulin resistance（IR）and inflammatory biomarker levels on type 2 diabetes mellitus（T2DM）among 1,903Inner Mongolians.
基金supported by National Natural Science Foundation of China(31900292)Science and Technology Development Program of Henan Province(202102110149,192102110112,and 182102410083)Science and Technology Project of Kaifeng(1908005,and 1803010).
文摘Compounds with regulating glucose metabolism and improving insulin resistance(IR)activity are abundant in nature and can be obtained from several sources.They have high potential to be used to treat diabetes mellitus.These compounds isolated from natural plants can be classified seven categories:terpenoids,alkaloids,quinones,flavonoids,phenols,phenyl propanoids,steroids,and other types of compounds.They exert biological effects by different ways and mechanisms.This review illustrated the potential natural products as a rich resource in regulation of glucose metabolism and IR,as well as their mechanisms.
基金Supported by Suzhou Municipal Science and Technology Program of China,No.SKJY2021012.
文摘BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.
基金Supported by Indian Council of Medical Research, New Delhi,IndiaCentral Council Research in Yoga and Naturopathy,New Delhi, India, to Sadashiv and Tiwari S
文摘AIM: To compare resistin mRNA expression in subcutaneous adipose tissue (SAT) and its correlation with insulin resistance (IR) in postmenopausal obese women. METHODS: A total of 68 postmenopausal women (non obese = 34 and obese = 34) were enrolled for the study. The women of the two groups were age matched (49-70 years). Fasting blood samples were collected at admission and abdominal SAT was obtained during surgery for gall bladder stones or hysterectomy. Physical parameters [age, height, weight, body mass index (BMI)] were measured. Biochemical (plasma insulin and plasma glucose) parameters were estimated by enzymatic methods. RNA was isolated by the Trizol method.SAT resistin mRNA expression was done by real time- reverse transcription polymerase chain reaction (RT-PCR) by using Quanti Tect SYBR Green RT-PCR master mix. Data was analyzed using independent Student's t test, correlation and simple linear regression analysis. RESULTS: The mean weight (52.81 ± 8.04 kg vs 79.56 ± 9.91 kg; P < 0.001), BMI (20.23 ± 3.05 kg/m 2 vs 32.19 ± 4.86 kg/m 2 ; P < 0.001), insulin (8.47 ± 3.24 U/mL vs 14.67 ± 2.18 U/mL; P < 0.001), glucose (97.44 ± 11.31 mg/dL vs 109.67 ± 8.02 mg/dL; P < 0.001) and homeostasis model assessment index (2.01 ± 0.73 vs 3.96 ± 0.61; P < 0.001) were significantly higher in postmenopausal obese women compared to postmenopausal non obese women. The mean serum resistin level was also significantly higher in postmeno-pausal obese women compared to postmenopausal non obese women (9.05 ± 5.15 vs 13.92 ± 6.32, P < 0.001). Furthermore, the mean SAT resistin mRNA expression was also significantly (0.023 ± 0.008 vs 0.036 ± 0.009; P < 0.001) higher and over expressed 1.62 fold (upregulated) in postmenopausal obese women compared to postmenopausal non obese women. In postmeno-pausal obese women, the relative SAT resistin mRNA expression showed positive (direct) and significant correlation with BMI (r = 0.78, P < 0.001) and serum resistin (r = 0.76, P < 0.001). Furthermore, the SAT resistin mRNA expression in postmenopausal obese women also showed significant and direct association (r = 0.45, P < 0.01) with IR, while in postmenopausal non obese women it did not show any association (r = -0.04, P > 0.05). CONCLUSION: Increased SAT resistin mRNA expres-sion probably leads to inducing insulin resistance and thus may be associated with obesity-related disorders in postmenopausal obese women.
文摘Background: In response to the escalating burden of cardiovascular diseases (CVDs) worldwide, exacerbated by lifestyle changes and socioeconomic shifts, acute coronary syndromes (ACS) stand out as a leading cause of morbidity and mortality. The pivotal role of insulin resistance in the pathogenesis of atherosclerosis, independent of traditional risk factors, has garnered significant interest. Objective: This review aims to synthesize the recent advancements in the utilization of the triglyceride glucose index (TyG index) as a biomarker for assessing the severity and predicting the prognosis of ACS lesions. Methods: A systematic search was conducted across PubMed, Embase, and Scopus databases, incorporating keywords such as “triglyceride glucose index”, “TyG index”, “acute coronary syndrome”, “cardiovascular disease”, “insulin resistance”, “coronary artery calcification”, “SYNTAX score”, “Gensini score”, and “major adverse cardiac events”. Studies were included from the inception of each database up to July 2024. Selection criteria encompassed observational studies, case-control studies, and randomized controlled trials, with a particular emphasis on evaluating the diagnostic and prognostic value of the TyG index in patients with acute coronary syndromes. Ultimately, 46 publications met the inclusion criteria. Data extraction and quality assessment were performed in accordance with established guidelines. Results: Evidence suggests that the TyG index, reflecting insulin resistance, blood glucose, and lipid levels, is significantly associated with lesion severity in ACS, including coronary artery calcification, SYNTAX score, and Gensini score. Moreover, it demonstrates predictive power for major adverse cardiovascular events, underscoring its potential as a valuable tool in clinical decision-making. Conclusion: The review highlights the emerging role of the TyG index in the assessment and prognosis of ACS, advocating for its incorporation into clinical practice as a complement to existing diagnostic modalities. However, the establishment of standardized reference ranges and further validation across diverse populations are warranted to refine its applicability in personalized medicine. The interdisciplinary approach is essential to advance our understanding of the complex interplay between insulin resistance and cardiovascular disease, paving the way for the development of more effective prevention and treatment strategies.
文摘Various pathological conditions can cause fatty liver in children. Nonalcoholic steatohepatitis(NASH) in children has been known since 1983. However, NASH diagnosed in childhood does not have a favorable outcome.The pathological characteristics of NASH are significantly different between children and adults. Nonalcoholic fatty liver disease(NAFLD)/NASH is accompanied by insulin resistance, which plays a pivotal role in its pathophysiology in both children and adults. In NASH,a "two-hit" model involving triglyceride accumulation(first hit) and liver damage(second hit) has been accepted. Insulin resistance was found to correlate with changes in fat levels; however, it did not correlate with fibrosis or NAFLD activity score in children. Therefore,insulin resistance may be important in the first hit.Because there is obvious familial clustering in NASH,genetic predisposition as well as environmental factors including diet might be the second hit of NAFLD/NASH.
文摘Liver marker {e.g., alanine aminotransferase (ALT) and aspartate aminotransferase (AST)} levels independently predict insulin resistance. The aim of the present study is to examine how changes in liver markers are associated with changes in insulin resistance after exercise in Japanese community-dwelling adults. The participants were 76 women aged 67 ± 6 years from a rural village. Nordic walk (NW) exercise of 120 min per week was performed for 12 weeks. Before and at the end of the 12-week intervention, various confounding factors and insulin resistance {e.g., Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)} were measured. The baseline, follow-up, and changes in ALT/AST ratio (β = 0.390, P β = 0.393, P β = 0.321, P = 0.004, respectively) were each significantly and independently associated with HOMA-IR. When the data were further stratified by baseline and change in ASL/AST ratio, changes in HOMA-IR decreased more significantly in participants with baseline ASL/AST ratio ≥ 0.762 and change in ALT/AST ratio of < 0 than those with change in ALT/AST ratio of ≥ 0 (baseline ASL/AST ratio P = 0.002 and ASL/AST ratio ≥ 0.762, P = 0.047). This study is of interest because liver transaminase markers, which are inexpensive and routinely collected in clinical settings, may provide a simple and accurate enhancement to models currently used to identify subjects with changes in insulin resistance. These results suggest that a higher baseline and decreased change in ALT/AST ratio may be a predictor for decreased insulin resistance after a 12-week walking exercise in community-dwelling middle-aged and elderly women.
