Objective decline of resistance whether H Type 2 diabetes has been recently recognized as an important risk factor for cognitive patients with Alzheimer＇s disease （AD）. But the roles of hyperinsulinemia （HI） and...Objective decline of resistance whether H Type 2 diabetes has been recently recognized as an important risk factor for cognitive patients with Alzheimer＇s disease （AD）. But the roles of hyperinsulinemia （HI） and insulin （IR） in the development of AD are still controversial. This study was designed to evaluate or IR influenced the cognitive functions of older cohort. Methods The cognitive functions of 328 consecutive elderly patients were evaluated with a battery of cognitive rating scales. Their fasting blood glucose （FBG） and fasting insulin （FINS） were analyzed and IR was calculated with modified-Homa. The cognitive scores in different groups and the correlation of cognitive functions with HI or IR were analyzed. Results In our study, there were 180 participants with HI and 148 without HI, and 192 with iR and 136 without IR. The participants with HI showed worse cognitive functions than those without HI in MMSE, MOCA, CDR, orientation, delayed memory, and attention/calculation domains. Similarly, the elderly with IR had lower cognitive scores than those without IR in MMSE, MOCA, CDR, GDS, orientation, delayed memory, and attention/calculation domains. The insulin levels and Homa IR had negative correlation with the scores of MMSE and delayed memory, not only in the model I adjusted for FBG and diabetes history, but also in the model 2 adjusted for all nine demographic characteristics. Conclusion HI and IR are important risk factors for cognitive decline of the elderly, especially for the dysfunctions in delayed memory domains.展开更多
Nutritional supplementation has long been studied as a possible treatment alternative or as an adjunct to the standard treatments for common ailments and diseases.According to the latest research,the Chilean maqui ber...Nutritional supplementation has long been studied as a possible treatment alternative or as an adjunct to the standard treatments for common ailments and diseases.According to the latest research,the Chilean maqui berry,Aristotelia chilensis,has been shown to reduce postprandial insulin levels by as much as fifty percent.The berry,which has been shown to be as effective as metformin at increasing insulin sensitivity and controlling blood glucose levels,follows a simple mechanism of action that involves the inhibition of sodium dependent glucose transporters in the small intestine,slowing the rate at which sugars enter the bloodstream and thereby decreasing blood sugar spikes and the corresponding increase in insulin levels.Chronically high blood glucose levels have been proven to play a significant role in the development of cancers,as diabetics and prediabetics have been proven to have elevated risk of developing cancerous growth.Consistent dietary supplementation with maqui berry may therefore indirectly reduce the risk of cancer,as well as other diseases which respond negatively to hyperglycemia and hyperinsulinemia.展开更多
45 female patients with polycystic ovary syndrome took thioctic acid (Thioctacid-HR), 600 mg (n = 25) or high protein diet (n = 20). Fast insulin and glucose stimulus insulin were investigated before and after 3 month...45 female patients with polycystic ovary syndrome took thioctic acid (Thioctacid-HR), 600 mg (n = 25) or high protein diet (n = 20). Fast insulin and glucose stimulus insulin were investigated before and after 3 months taken treatment. The use of thioctic acid, 600 mg is a new effective pathogenetics therapy of polycystic ovary syndrome on influence of hyperinsulinemia, HOMA-IR index and ovary volume in female patients with polycystic ovary syndrome.展开更多
Background: Previous evidences support to inflammatory process associated with the IR those important factors in the development of fibrosis and hepatic damage in patients with HCV infection. Objectives: Determine the...Background: Previous evidences support to inflammatory process associated with the IR those important factors in the development of fibrosis and hepatic damage in patients with HCV infection. Objectives: Determine the presence of immunological or histological differentces between hyperinsulinemic and non-hyperinsulinemic chronic HCV-infected patients with at least 10 years of evolution. Material and Methods: The body mass index, Child-Puigh score, liver function tests, and biochemical profile were evaluated in 30 control, 40 chronic HCV-infected patients with hyperinsulinemia, and in 40 normoinsulinemic chronic HCV-infected patients with at least 10 years of evolution. In addition, HCV genotype and viral load were established with the Amplicor System. In addition, nitrites in plasma, and TNF-α, IL-1β, TGF-β, IL-6, and insulin levels were determined. Results: No differences were found in BMI, Child-Pugh “A” scores, ALT, viral load, or genotype between the hyperinsulinemic (>25 IU/ml) and normoinsulinemic ( Hyperinsulinemia patients had a higher HOMA- IR value (13.6) than normoinsulinemia patients (3.4), and none had a glycemia > 126 mg/dl. Cy- tokines concentration did not show differences with respect to controls. Nitrites showed a slight increase only in patients with HCV infection. Conclusions: Absence of changes in the proinflammatory cytokines concentration or in some inflammation markers in chronic HCV patients with hyperinsulinemia suggests that long-term insulin levels, in presence of HCV, cannot explain by themselves the hepatic alterations observed in the patient with HCV infection, the presence of others elements (alcoholism, cirrhosis, etc.) is necessary to onset hepatic damage in these patients.展开更多
Inflammation induces insulin resistance and hyperinsulinemia due to elevation of serum cytokines such as tumor necrosis factor-α and interleukins. Chronic myeloproliferative diseases including myelofibrosis show high...Inflammation induces insulin resistance and hyperinsulinemia due to elevation of serum cytokines such as tumor necrosis factor-α and interleukins. Chronic myeloproliferative diseases including myelofibrosis show higher serum interleukin levels than healthy subjects, which has been suggested to be the useful markers for disease activity. However, an association between myelofibrosis and insulin resistance has not ever been discussed anywhere. Here we report a case of type 2 diabetes showing remarkable hyperinsulinemia and insulin resistance possibly due to myelofibrosis.展开更多
Brain-specific serine/threonine-protein kinase 2(BRSK2)plays critical roles in insulin secretion andβ-cell biology.However,whether BRSK2 is associated with human type 2 diabetes mellitus(T2DM)has not been determined....Brain-specific serine/threonine-protein kinase 2(BRSK2)plays critical roles in insulin secretion andβ-cell biology.However,whether BRSK2 is associated with human type 2 diabetes mellitus(T2DM)has not been determined.Here,we report that BRSK2 genetic variants are closely related to worsening glucose metabolism due to hyperinsulinemia and insulin resistance in the Chinese population.BRSK2 protein levels are significantly elevated inβcells from T2DM patients and high-fat diet(HFD)-fed mice due to enhanced protein stability.Mice with inducibleβ-cell-specific Brsk2 knockout(βKO)exhibit normal metabolism with a high potential for insulin secretion under chow-diet conditions.Moreover,βKO mice are protected from HFD-induced hyperinsulinemia,obesity,insulin resistance,and glucose intolerance.Conversely,gain-of-function BRSK2 in matureβcells reversibly triggers hyperglycemia due toβ-cell hypersecretion-coupled insulin resistance.Mechanistically,BRSK2 senses lipid signals and induces basal insulin secretion in a kinase-dependent manner.The enhanced basal insulin secretion drives insulin resistance andβ-cell exhaustion and thus the onset of T2DM in mice fed an HFD or with gain-of-function BRSK2 inβcells.These findings reveal that BRSK2 links hyperinsulinemia to systematic insulin resistance via interplay betweenβcells and insulin-sensitive tissues in the populations carrying human genetic variants or under nutrient-overload conditions.展开更多
目的探讨高胰岛素血症(HINS)与亚临床甲状腺功能减退(SCH)患者发生颈动脉粥样硬化的关系。方法收集2020年9月至2022年12月于潍坊医学院附属医院住院的305例SCH患者的临床资料,按照HINS发生情况将其分为HINS组(n=166)和NHINS组(n=139)。...目的探讨高胰岛素血症(HINS)与亚临床甲状腺功能减退(SCH)患者发生颈动脉粥样硬化的关系。方法收集2020年9月至2022年12月于潍坊医学院附属医院住院的305例SCH患者的临床资料,按照HINS发生情况将其分为HINS组(n=166)和NHINS组(n=139)。收集患者的相关指标,采用Pearson或Spearman分析SCH患者颈动脉内膜中层厚度(CIMT)的影响因素,应用Logistic回归模型分析SCH合并HINS患者发生颈动脉粥样硬化的危险因素。结果两组患者糖尿病、高血压、收缩压(SBP)、舒张压(DBP)、体重指数(BMI)、稳态模型胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、2 h胰岛素(2 h INS)、空腹C肽、2 h C肽、CIMT、颈动脉粥样硬化发生率比较,差异均有统计学意义(P﹤0.05)。Pearson或Spearman相关性分析结果显示,CIMT与年龄、高血压、HOMA-IR、FINS、2 h INS、空腹C肽、2 h C肽、LDL-C、促甲状腺激素(TSH)均呈正相关(P﹤0.05)。Logistic回归模型分析结果显示,HINS、年龄、TSH均是发生颈动脉粥样硬化的影响因素(P﹤0.05)。结论HINS、年龄、TSH均是SCH患者发生颈动脉粥样硬化的影响因素,SCH合并HINS患者发生颈动脉粥样硬化风险更高。展开更多
Glucose is derived from three sources： intestinal absorption, glycogenolysis, and gluconeogenesis.Hypoglycemia in child is often attributed to depletion of glycogen stores. However, recently, congenital hyperinsulini...Glucose is derived from three sources： intestinal absorption, glycogenolysis, and gluconeogenesis.Hypoglycemia in child is often attributed to depletion of glycogen stores. However, recently, congenital hyperinsulinism becomes an important cause of hypoglycaemia in early infancy.展开更多
BACKGROUND Nesidioblastosis usually refers to a series of clinical manifestations caused by the proliferation ofβ-cells in pancreatic islets,and these clinical manifestations are hyperinsulinemia and persistent hypog...BACKGROUND Nesidioblastosis usually refers to a series of clinical manifestations caused by the proliferation ofβ-cells in pancreatic islets,and these clinical manifestations are hyperinsulinemia and persistent hypoglycemia.According to the size of the lesion,nesidioblastosis is divided into focal nesidioblastosis,diffuse nesidioblastosis and atypical nesidioblastosis,and its pathogenesis is still unclear.Nesidioblastosis is mainly seen in infants and rarely reported in adults,especially focal nesidioblastosis,which is difficult to distinguish from insulinoma.CASE SUMMARY We report a case of adult focalβ-cell nesidioblastosis in which the preoperative diagnosis was insulinoma.The patient was a 48-year-old male who suffered from repeated morning and fasting palpitations,sweating,and severe disturbance of consciousness for 5 years.His blood glucose was found to be as low as 1.79 mmol/L during an attack.However,abdominal computed tomography showed no abnormalities.Magnetic resonance imaging and endoscopic ultrasonography demonstrated a nodular mass in the head of the pancreas,combined with hyperinsulinemia and high serum C-peptide.The patient was diagnosed with insulinoma and underwent Beger surgery;however,the postoperative pathological results showed nesidioblastosis.CONCLUSION Although surgical resection is the preferred option for nesidioblastosis,some cases can be treated non-surgically.In order to increase clinicians’understanding of nesidioblastosis,it is necessary to review the pathogenesis,diagnosis and treatment of this disease.展开更多
基金supported by the Medical College Natural Science Foundation of Shanghai Jiao Tong University (09XJ21028)the Shanghai Jiaotong University Interdisciplinary Study Foundation Medicine and Engineer
文摘Objective decline of resistance whether H Type 2 diabetes has been recently recognized as an important risk factor for cognitive patients with Alzheimer＇s disease （AD）. But the roles of hyperinsulinemia （HI） and insulin （IR） in the development of AD are still controversial. This study was designed to evaluate or IR influenced the cognitive functions of older cohort. Methods The cognitive functions of 328 consecutive elderly patients were evaluated with a battery of cognitive rating scales. Their fasting blood glucose （FBG） and fasting insulin （FINS） were analyzed and IR was calculated with modified-Homa. The cognitive scores in different groups and the correlation of cognitive functions with HI or IR were analyzed. Results In our study, there were 180 participants with HI and 148 without HI, and 192 with iR and 136 without IR. The participants with HI showed worse cognitive functions than those without HI in MMSE, MOCA, CDR, orientation, delayed memory, and attention/calculation domains. Similarly, the elderly with IR had lower cognitive scores than those without IR in MMSE, MOCA, CDR, GDS, orientation, delayed memory, and attention/calculation domains. The insulin levels and Homa IR had negative correlation with the scores of MMSE and delayed memory, not only in the model I adjusted for FBG and diabetes history, but also in the model 2 adjusted for all nine demographic characteristics. Conclusion HI and IR are important risk factors for cognitive decline of the elderly, especially for the dysfunctions in delayed memory domains.
文摘Nutritional supplementation has long been studied as a possible treatment alternative or as an adjunct to the standard treatments for common ailments and diseases.According to the latest research,the Chilean maqui berry,Aristotelia chilensis,has been shown to reduce postprandial insulin levels by as much as fifty percent.The berry,which has been shown to be as effective as metformin at increasing insulin sensitivity and controlling blood glucose levels,follows a simple mechanism of action that involves the inhibition of sodium dependent glucose transporters in the small intestine,slowing the rate at which sugars enter the bloodstream and thereby decreasing blood sugar spikes and the corresponding increase in insulin levels.Chronically high blood glucose levels have been proven to play a significant role in the development of cancers,as diabetics and prediabetics have been proven to have elevated risk of developing cancerous growth.Consistent dietary supplementation with maqui berry may therefore indirectly reduce the risk of cancer,as well as other diseases which respond negatively to hyperglycemia and hyperinsulinemia.
文摘45 female patients with polycystic ovary syndrome took thioctic acid (Thioctacid-HR), 600 mg (n = 25) or high protein diet (n = 20). Fast insulin and glucose stimulus insulin were investigated before and after 3 months taken treatment. The use of thioctic acid, 600 mg is a new effective pathogenetics therapy of polycystic ovary syndrome on influence of hyperinsulinemia, HOMA-IR index and ovary volume in female patients with polycystic ovary syndrome.
基金partially supported by grants IN-202508-3 from DGAPA-UNAMCONACyT grant SA-LUD-2006-CO1-44569.
文摘Background: Previous evidences support to inflammatory process associated with the IR those important factors in the development of fibrosis and hepatic damage in patients with HCV infection. Objectives: Determine the presence of immunological or histological differentces between hyperinsulinemic and non-hyperinsulinemic chronic HCV-infected patients with at least 10 years of evolution. Material and Methods: The body mass index, Child-Puigh score, liver function tests, and biochemical profile were evaluated in 30 control, 40 chronic HCV-infected patients with hyperinsulinemia, and in 40 normoinsulinemic chronic HCV-infected patients with at least 10 years of evolution. In addition, HCV genotype and viral load were established with the Amplicor System. In addition, nitrites in plasma, and TNF-α, IL-1β, TGF-β, IL-6, and insulin levels were determined. Results: No differences were found in BMI, Child-Pugh “A” scores, ALT, viral load, or genotype between the hyperinsulinemic (>25 IU/ml) and normoinsulinemic ( Hyperinsulinemia patients had a higher HOMA- IR value (13.6) than normoinsulinemia patients (3.4), and none had a glycemia > 126 mg/dl. Cy- tokines concentration did not show differences with respect to controls. Nitrites showed a slight increase only in patients with HCV infection. Conclusions: Absence of changes in the proinflammatory cytokines concentration or in some inflammation markers in chronic HCV patients with hyperinsulinemia suggests that long-term insulin levels, in presence of HCV, cannot explain by themselves the hepatic alterations observed in the patient with HCV infection, the presence of others elements (alcoholism, cirrhosis, etc.) is necessary to onset hepatic damage in these patients.
基金The Grant of National Center for Global Health and Medicine, No. 22-120
文摘Inflammation induces insulin resistance and hyperinsulinemia due to elevation of serum cytokines such as tumor necrosis factor-α and interleukins. Chronic myeloproliferative diseases including myelofibrosis show higher serum interleukin levels than healthy subjects, which has been suggested to be the useful markers for disease activity. However, an association between myelofibrosis and insulin resistance has not ever been discussed anywhere. Here we report a case of type 2 diabetes showing remarkable hyperinsulinemia and insulin resistance possibly due to myelofibrosis.
基金supported by research grants from the National Natural Science Foundation of China(81420108007 and 81830024 to X.H.,82270844,82070843,and 81870531 to Y.Zhu).
文摘Brain-specific serine/threonine-protein kinase 2(BRSK2)plays critical roles in insulin secretion andβ-cell biology.However,whether BRSK2 is associated with human type 2 diabetes mellitus(T2DM)has not been determined.Here,we report that BRSK2 genetic variants are closely related to worsening glucose metabolism due to hyperinsulinemia and insulin resistance in the Chinese population.BRSK2 protein levels are significantly elevated inβcells from T2DM patients and high-fat diet(HFD)-fed mice due to enhanced protein stability.Mice with inducibleβ-cell-specific Brsk2 knockout(βKO)exhibit normal metabolism with a high potential for insulin secretion under chow-diet conditions.Moreover,βKO mice are protected from HFD-induced hyperinsulinemia,obesity,insulin resistance,and glucose intolerance.Conversely,gain-of-function BRSK2 in matureβcells reversibly triggers hyperglycemia due toβ-cell hypersecretion-coupled insulin resistance.Mechanistically,BRSK2 senses lipid signals and induces basal insulin secretion in a kinase-dependent manner.The enhanced basal insulin secretion drives insulin resistance andβ-cell exhaustion and thus the onset of T2DM in mice fed an HFD or with gain-of-function BRSK2 inβcells.These findings reveal that BRSK2 links hyperinsulinemia to systematic insulin resistance via interplay betweenβcells and insulin-sensitive tissues in the populations carrying human genetic variants or under nutrient-overload conditions.
文摘目的探讨高胰岛素血症(HINS)与亚临床甲状腺功能减退(SCH)患者发生颈动脉粥样硬化的关系。方法收集2020年9月至2022年12月于潍坊医学院附属医院住院的305例SCH患者的临床资料,按照HINS发生情况将其分为HINS组(n=166)和NHINS组(n=139)。收集患者的相关指标,采用Pearson或Spearman分析SCH患者颈动脉内膜中层厚度(CIMT)的影响因素,应用Logistic回归模型分析SCH合并HINS患者发生颈动脉粥样硬化的危险因素。结果两组患者糖尿病、高血压、收缩压(SBP)、舒张压(DBP)、体重指数(BMI)、稳态模型胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、2 h胰岛素(2 h INS)、空腹C肽、2 h C肽、CIMT、颈动脉粥样硬化发生率比较,差异均有统计学意义(P﹤0.05)。Pearson或Spearman相关性分析结果显示,CIMT与年龄、高血压、HOMA-IR、FINS、2 h INS、空腹C肽、2 h C肽、LDL-C、促甲状腺激素(TSH)均呈正相关(P﹤0.05)。Logistic回归模型分析结果显示,HINS、年龄、TSH均是发生颈动脉粥样硬化的影响因素(P﹤0.05)。结论HINS、年龄、TSH均是SCH患者发生颈动脉粥样硬化的影响因素,SCH合并HINS患者发生颈动脉粥样硬化风险更高。
基金This study was supported by a grant from the Beijing Natural Science Foundation, China （No. 7092085）.
文摘Glucose is derived from three sources： intestinal absorption, glycogenolysis, and gluconeogenesis.Hypoglycemia in child is often attributed to depletion of glycogen stores. However, recently, congenital hyperinsulinism becomes an important cause of hypoglycaemia in early infancy.
文摘BACKGROUND Nesidioblastosis usually refers to a series of clinical manifestations caused by the proliferation ofβ-cells in pancreatic islets,and these clinical manifestations are hyperinsulinemia and persistent hypoglycemia.According to the size of the lesion,nesidioblastosis is divided into focal nesidioblastosis,diffuse nesidioblastosis and atypical nesidioblastosis,and its pathogenesis is still unclear.Nesidioblastosis is mainly seen in infants and rarely reported in adults,especially focal nesidioblastosis,which is difficult to distinguish from insulinoma.CASE SUMMARY We report a case of adult focalβ-cell nesidioblastosis in which the preoperative diagnosis was insulinoma.The patient was a 48-year-old male who suffered from repeated morning and fasting palpitations,sweating,and severe disturbance of consciousness for 5 years.His blood glucose was found to be as low as 1.79 mmol/L during an attack.However,abdominal computed tomography showed no abnormalities.Magnetic resonance imaging and endoscopic ultrasonography demonstrated a nodular mass in the head of the pancreas,combined with hyperinsulinemia and high serum C-peptide.The patient was diagnosed with insulinoma and underwent Beger surgery;however,the postoperative pathological results showed nesidioblastosis.CONCLUSION Although surgical resection is the preferred option for nesidioblastosis,some cases can be treated non-surgically.In order to increase clinicians’understanding of nesidioblastosis,it is necessary to review the pathogenesis,diagnosis and treatment of this disease.
