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OBJECTIVE Hyperuricemia is closely associated with insulin resistance syndrome (and its many cardiometabolic sequelae); however, whether they are causally related has long been debated. We undertook this study to investigate the potential causal nature and direction between insulin resistance and hyperuricemia, along with gout, by using bidirectional Mendelian randomization (MR) analyses. METHODS We used genome-wide association data (n = 288,649 for serum urate [SU] concentration; n = 763,813 for gout risk; n = 153,525 for fasting insulin) to select genetic instruments for 2-sample MR analyses, using multiple MR methods to address potential pleiotropic associations. We then used individual-level, electronic medical record-linked data from the UK Biobank (n = 360,453 persons of European ancestry) to replicate our analyses via single-sample MR analysis. RESULTS Genetically determined SU levels, whether inferred from a polygenic score or strong individual loci, were not associated with fasting insulin concentrations. In contrast, genetically determined fasting insulin concentrations were positively associated with SU levels (0.37 mg/dl per log-unit increase in fasting insulin [95% confidence interval (95% CI) 0.15, 0.58]; P = 0.001). This persisted in outlier-corrected (β = 0.56 mg/dl [95% CI 0.45, 0.67]) and multivariable MR analyses adjusted for BMI (β = 0.69 mg/dl [95% CI 0.53, 0.85]) (P < 0.001 for both). Polygenic scores for fasting insulin were also positively associated with SU level among individuals in the UK Biobank (P < 0.001). Findings for gout risk were bidirectionally consistent with those for SU level. CONCLUSION These findings provide evidence to clarify core questions about the close association between hyperuricemia and insulin resistance syndrome: hyperinsulinemia leads to hyperuricemia but not the other way around. Reducing insulin resistance could lower the SU level and gout risk, whereas lowering the SU level (e.g., allopurinol treatment) is unlikely to mitigate insulin resistance and its cardiometabolic sequelae.

Type 2 diabetes (T2D) is highly prevalent and is a strong contributor for cardiovascular disease. However, there is significant heterogeneity in disease pathogenesis and the risk of complications. Enormous progress has been made in our ability to catalog genetic variation associated with T2D risk and variation in disease-relevant quantitative traits. These discoveries hold the potential to shed light on tractable targets and pathways for safe and effective therapeutic development, but the promise of precision medicine has been slow to be realized. Recent studies have identified subgroups of individuals with differential risk for intermediate phenotypes (eg, lipid levels, fasting insulin, body mass index) that contribute to T2D risk, helping to account for the observed clinical heterogeneity. These "partitioned genetic risk scores" not only have the potential to identify patients at greatest risk of cardiovascular disease and rapid disease progression, but also could aid patient stratification bridging the gap toward precision medicine for T2D.

Purpose of Review A number of recent studies have suggested that intermittent fasting is as effective as traditional calorie restriction (CR) for weight loss and for cardioprotection. However, it is still unclear whether IF improves diabetes risk indicators as does CR. This review provides an overview of various patterns of intermittent fasting and shows the effect of intermittent fasting on human anthropometric such as excess body weight and biochemical parameters for example high glucose and fasting insulin, which are risk factors for diabetes. Recent Findings There is a growing body of evidence pointing to the benefits of intermittent fasting for glucose and insulin homeostasis, but this should be confirmed by further studies in population groups with (or at high risk) type II diabetes and insulin resistance. Long-term studies are also needed that could reveal potential negative health effects that some studies report. Summary Eleven studies in overweight/obese adult people that included changes in weight, body composition, and diabetic parameters (fasting glucose, fasting insulin, HbA1c concentration, and HOMA-IR index) were published between 2012 and 2020. Seven studies concerning the effects of alternate day fasting (ADF) on weight loss and diabetic parameters were analyzed. All of them have shown the effects of ADF on weight loss and slight improvement in diabetic parameters. For time-restricted feeding (TRF), a significant improvement in the HOMA-IR index was observed in 2 studies. One study saw an increase in fasting glucose. An analysis of 2 studies using a complete alternate day fasting (CADF) was performed. One study showed decrease in fasting glucose and insulin, and in one a decrease in glycosylated hemoglobin (HbA1c) was observed. Conclusion Different types of intermittent fasting reduce body weight and reduce diabetes parameters such as fasting glucose, fasting insulin, HOMA-IR index, and glycated hemoglobin (HbA1c).

Current knowledge of the link between dietary carbohydrate intake and insulin regulation in individuals after an attack of pancreatitis is limited. We aimed to investigate the associations between dietary carbohydrate intake and insulin traits in post-pancreatitis versus healthy individuals, taking into account intrapancreatic fat deposition (IPFD).All participants underwent magnetic resonance imaging (using the same protocol and 3T scanner) to quantify IPFD. Dietary carbohydrate intake was assessed using a validated 131-item food frequency questionnaire. Insulin, HOMA-IR, HOMA-β were determined in the fasted state. Linear regression and effect modification analyses were conducted in unadjusted and adjusted models (accounting for age, sex, body mass index, daily energy intake, use of anti-diabetic medications, and recurrence of acute pancreatitis).The study included 111 post-pancreatitis individuals (categorized into low IPFD (n = 33), moderate IPFD (n = 40), high IPFD (n = 38)) and 47 healthy controls. In the high IPFD group, starch intake was negatively associated with fasting insulin and HOMA-β in both the unadjusted (p 0.001 both) and fully adjusted models (p 0.001 both); and with HOMA-IR in the fully adjusted model (p 0.001) only. Total sugar intake was positively associated with fasting insulin (p = 0.015) and HOMA-β (p = 0.007) in the fully adjusted model but not associated with HOMA-IR. None of the above associations was statistically significant in the low IPFD, moderate IPFD, and healthy controls groups. The studied associations were more pronounced in the high IPFD group but not in the moderate IPFD or low IPFD groups (when compared with the healthy controls group).Dietary carbohydrate intake is differentially associated with insulin traits in individuals after an attack of pancreatitis and the associations are modified by IPFD. These findings will be helpful for the development of dietary guidelines specifically for individuals after an attack of pancreatitis.

Background: Thyroid hormone inuences glucose homeostasis by modications of the circulating insulin levels and peripheral tissues uptake of glucose. Thyroid function has been associated with insulin resistance. There is infrequent information about thyroid function in relation with glucose homeostasis in young adults. Objective: To evaluate the thyroid prole, fasting serum insulin, HOMA-IR, Fasting blood sugar among newly detected hypothyroid adults (cases) in comparison with normal healthy adults (controls). Methodology: A case control study of 164 subjects was carried out on hypothyroid adults (n=82) and controls (n=82), general medicine OPD, RRMC & hospital, Bengaluru. Fasting blood samples were taken. Thyroid prole, serum fasting insulin was done with CLIA. HOMA-IR was employed to assess the level of insulin resistance. Results: The study subjects with mean age of 35 years and female predominance. TSH levels were higher in cases as compared to controls (p

Infants with congenital deficiency have high risk of glucose metabolism disorder, and often experience rapid growth in early childhood. However, the role of rapid growth on glucose metabolism is controversial. We conducted a systematic review and meta-analysis to examine the association of rapid growth with fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR). We searched EMBASE and Medline for English articles, and CNKI and WANFANG database for Chinese articles. Studies measuring the associations between rapid growth and insulin or HOMA-IR were included. Relevant information was extracted independently by two reviewers. Random effects model was adopted for combined and stratified analyses. At last, twenty-two relevant studies for insulin and 20 for HOMA-IR were identified. Rapid growth was associated with high insulin (weighted mean differences [WMD] 5.544, 95% confidence interval [CI] [1.436, 9.653], P = 0.008) and high HOMA-IR (WMD 0.194, 95% CI [0.098, 0.290], P 0.001). This elevated association was statistically significant in rapid growth subjects that were6 years old, full-term, and from developed countries. However, rapid growth among low birth weight subjects did not lead to high insulin and HOMA-IR, but decreased HOMA-IR among preterm children (WMD -0.305, 95% CI [-0.607, -0.004], P = 0.047). Follow-up age was positively correlated with HOMA-IR (r = 0.095, P 0.001). This meta-analysis suggested that rapid growth would result in high insulin and HOMA-IR, especially for full-term infants. However, rapid growth is relatively harmless for subjects who are6 years old, low birth weight or SGA, and is even protective for preterm subjects.

Background Chemerin a novel adipokine is linked to insulin resistance and adiposity which are major characteristics of polycystic ovary syndrome (PCOS). Results Chemerin level was found to be significantly higher in PCOS group than in control group (94.99 ± 12.52 ng/dl vs 73.41 ± 6.95 ng/dl) (P < 0.001) being the highest in obese PCO group, also chemerin positively correlated with BMI, fasting insulin, and HOMA-IR (P < 0.001), Multivariate linear regression analysis for factors affecting chemerin level in both PCO groups showed that the most important factor was fasting insulin (P = 0.042). Conclusion Chemerin correlates with insulin resistance and may be involved in the pathogenesis of insulin resistance in PCOS patients.

Enzyme-linked immunosorbent assay (ELISA) has long been the standard for quantitative analysis of metabolic hormones and cytokines. LUMINEX multiplex bead array assays were developed as cost- and time-effective alternatives to ELISA, but they are the only cost- and time-effective if they provide informative data. Here, I show that using half-volume of reagents for an adiponectin single-plex LUMINEX assay and a 6-plex LUMINEX xMAP mouse metabolic bead assay, produces reliable data and increases assay cost-effectiveness. I provide direct comparisons between LUMINEX assay and ELISA for quantitation of mouse leptin and insulin, and evaluate glucagon, GLP-1, IL-6, and TNFα data obtained using the 6-plex LUMINEX assay for a high-fat diet-induced obesity study. Good correlations between assays were obtained for fasting leptin and non-fasting insulin. However, the LUMINEX assay proved unsuitable for quantitating fasting insulin. ELISA proved suitable for quantitating fasting male, but not female, insulin. The LUMINEX assay gave lower values for leptin and higher values for insulin, compared with ELISA. The mouse metabolic LUMINEX assay proved unsuitable for quantitating glucagon, GLP-1, IL-6, and TNFα, due to undetectable levels in most fasting and non-fasting plasma. Overall, quantitative leptin levels were the only reliable data obtained from the mouse metabolic LUMINEX assay.

Intermittent fasting has grown in popularity as a weight loss strategy in recent years. In particular, time restricted eating (TRE) has been popularized in the diet industry with dozens of books touting its ability to promote weight loss and improve glucose regulation. TRE involves confining the eating window to a specified number of hours per day (usually 4-10 h), and fasting (with zero-calorie beverages) for the remaining hours of the day. While several studies of TRE have been performed in rodent models, human studies are only now emerging. The goal of this review is to summarize the effects of TRE on body weight and cardiometabolic disease risk factors in human subjects. Accumulating evidence shows that TRE may spontaneously decrease energy intake by 20-30% under ad libitum conditions, producing small but statistically significant weight loss of 1-4%. In addition, TRE may significantly decrease systolic and diastolic blood pressure independent of weight loss. Further, improvements in fasting insulin and insulin resistance have also been reported. Taken together, these preliminary data suggest that TRE produces mild weight loss, and also may improve some aspects of cardiometabolic health by lowering blood pressure and insulin resistance.

OBJECTIVE This study aimed to determine whether higher membrane capacitance (CM ), a bioelectrical measure of cell membrane function, is associated with insulin resistance (IR) and/or metabolic syndrome (MetS). METHODS Cross-sectional analyses were performed on 2,191 relatively healthy adults from the National Health and Nutrition Examination Survey. The CM of those with low/no disease risk was compared with those with IR, MetS, or both IR and MetS using ANCOVA. The associations between CM and related clinical measures were assessed with multiple linear regression. RESULTS Compared with those with low/no risk, women and men with IR (P

Background: Some studies have revealed an improvement in glucose metabolism after proton-pump inhibitors (PPI) therapy; however, this evidence is inconclusive and limited. Objective: The study aimed to examine the effect of PPI on glucose and insulin metabolism in patients with type 2 diabetes through a systematic review and meta-analysis. Methods: Only randomized controlled trials evaluating the impact of PPI on glucose or insulin concentrations in type 2 diabetes were searched in PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases. A meta-analysis was conducted using a random-effects model and generic inverse variance method. Sensitivity analysis was performed using the leave-one-out method. Results: Meta-analysis revealed no significant effect of PPI intervention on fasting glucose (mean difference [MD] -11.42 [95% CI, -29.68 to 6.83], I2 = 80%, p = 0.22), fasting insulin (MD 1.51 [95% CI, -0.36 to 3.37], I2 = 32%, p = 0.11), HOMA-IR (MD -0.16 [-0.98 to 0.65], I2 = 0%, p = 0.70), HOMA-β (MD 19.97 [-21.59 to 61.52], I2 = 71%, p = 0.35), and HbA1c concentrations (MD -0.34 [-0.99 to 0.31], I2 = 89%, p = 0.30). Conclusion: The treatment with PPI, in the short term, had no significant effects on glucose and insulin metabolism in patients with type 2 diabetes.

PURPOSE This study examined interrelationships among insomnia, stress, anxiety, and metabolic risk factors. Methods: A total of 124 college students were included in the analysis (age = 21 ± 1 years). Insomnia, stress of life events, and anxiety were assessed using self-reported questionnaires. Fasting blood samples were assayed for glucose, insulin, total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-cholesterol), and low-density lipoprotein cholesterol (LDL-cholesterol). Results: Insomnia was positively associated with stress of life events (β = 0.28, p

Background The relationship between selenium (Se) and insulin resistance remains unclear. We aim to explore the association between toenail Se levels and insulin resistance through a cross-sectional study comprising Chinese vegetarians and matched omnivores. Methods In this study, we enrolled 220 vegetarians and 220 omnivores matched by age and sex from Shanghai. The inductively coupled plasma mass spectrometry method was used to measure toenail Se levels. Dietary Se intakes were assessed by the 24-h dietary recall method. Blood samples were collected to measure fasting blood glucose level and fasting insulin concentrations. Insulin resistance index (HOMA-IR) and insulin secretion index (HOMA-B) were calculated to evaluate insulin resistance. Multi-linear regression analysis was performed to determine the association between toenail Se levels and insulin resistance, after adjusting for confounders. Results The mean ages of vegetarians (76 vegans, 144 lacto-ovo-vegetarians) and omnivores were 35.96 ± 8.73 years and 35.23 ± 8.93 years, respectively. Of these, 180 (81.8%) were female and 40 (18.2%) were male. No association was found between toenail Se levels and insulin resistance in vegetarians. However, the concentration of Se in toenails was positively correlated with fasting insulin levels (β = 1.030, 95%CI: 0.393 to 1.667) and HOMA-IR (β = 0.245, 95%CI: 0.098 to 0.392) in omnivores, after multivariate adjustment for age, sex, BMI, alcohol consumption, income, and daily dietary intakes (energy, protein, fat, carbohydrate, and fiber). This positive relationship persisted only in omnivores whose dietary Se intake was above 60 μg/d. Conclusions Higher toenail Se levels were associated with increased insulin resistance risk in Chinese omnivores whose dietary Se intake was above 60 μg/d, but not in vegetarians. These findings create awareness on the association of dietary Se intake above 60 μg/d with the risk of insulin resistance.

Metabolic syndrome (MS) is a condition that includes obesity, insulin resistance, dyslipidemias among other, abnormalities that favors type 2 Diabetes Mellitus (T2DM) and cardiovascular diseases development. Three main diet-induced metabolic syndrome models in rats exist: High carbohydrate diet (HCHD), high fat diet (HFD), and high carbohydrate-high fat diet (HCHHFD). We analyzed data from at least 35 articles per diet, from different research groups, to determine their effect on the development of the MS, aimed to aid researchers in choosing the model that better suits their research question; and also the best parameter that defines obesity, as there is no consensus to determine this condition in rats. For the HCHD we found a mild effect on body weight gain and fasting blood glucose levels (FBG), but significant increases in triglycerides, fasting insulin, insulin resistance and visceral fat accumulation. HFD had the greater increase in the parameters previously mentioned, followed by HCHHFD, which had a modest effect on FBG levels. Therefore, to study early stages of MS a HCHD is recommended, while HFD and HCHHFD better reproduce more severe stages of MS. We recommend the assessment of visceral fat accumulation as a good estimate for obesity in the rat.

Background/Objectives: We hypothesized that physical activity (PA) improves insulin sensitivity in adolescents with severe obesity beyond that attributable to metabolic bariatric surgery (MBS). Subjects/Methods: StepWatch™ monitors objectively measured PA in 88 participants in the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study. Primary outcomes included absolute change in fasting insulin, HOMA-IR, and fasting glucose from pre-surgery (baseline) to 6, 12, 24, and 36 months post-MBS. SAS PROC TRAJ generated activity trajectories based on probability and individual participant step count trajectories. Linear regression models were used, adjusted for baseline value, visit, surgical procedure, sex, and percent change in BMI. Additional models adjusted for percent change in iliac waist circumference (IWC) or percent body fat (BF), measured by bio-impedance. Results: Two activity trajectories were identified: more active (MA, n=13) and less active (LA, n=75). MA baseline mean daily step count was >6 000, increasing to > 9 000 at 2 years. LA mean daily step count remained at approximately 4 000. Few participants recorded moderate step activity (cadence >80 steps/minute). Still, fasting insulin and HOMA-IR differed in association with activity trajectory. MA was associated with a greater absolute decrease in fasting insulin (−7.8μU/ml [95% CI: (−11.8, −3.7)], p =

Background: Polycystic ovarian syndrome has emerged as a cardiometabolic disorder and aim of this study was to evaluate various surrogate indices and their diagnostic potential to determine the most convenient and cost-effective marker of IR, CVD, and MetS in these women.Materials and methods: Ninety-five PCOS women and 45 age matched healthy women were enrolled. Measures included anthropometric and biochemical parameters, BMI, WHR, WHtR, BAI, VAI, LAP, HOMA-IR, and lipid profile.Results: LAP has highest AUC value 0.781 with cut-off value = 39.73 (sensitivity = 75% and specificity = 79.5%) for predicting IR and AUC value 0.83 with cut-off value = 35.63 (sensitivity = 94.4% and specificity = 77.3%) for predicting MetS in women with PCOS. LAP had statistically strong positive correlation with WC, BMI, WHR, fasting glucose, fasting insulin, HOMA-IR, TC, TG, and SBP.Conclusions: LAP is a powerful and reliable marker for assessment of IR, CVD, and MetS risk in young Indian women with PCOS.

While the co-morbidity between metabolic and psychiatric behaviors is well-established, the mechanisms are poorly understood, and exposure to early life adversity (ELA) is a common developmental risk factor. ELA is associated with altered insulin sensitivity and poor behavioral inhibition throughout life, which seems to contribute to the development of metabolic and psychiatric disturbances in the long term. We hypothesize that a genetic background associated with higher fasting insulin interacts with ELA to influence the development of executive functions (e.g., impulsivity in young children). We calculated the polygenic risk scores (PRSs) from the genome-wide association study (GWAS) of fasting insulin at different thresholds and identified the subset of single nucleotide polymorphisms (SNPs) that best predicted peripheral insulin levels in children from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort [N = 467; pt– initial = 0.24 (10,296 SNPs), pt– refined = 0.05 (57 SNPs)]. We then calculated the refined PRS (rPRS) for fasting insulin at this specific threshold in the children from the Maternal Adversity, Vulnerability and Neurodevelopment (MAVAN) cohort and investigated its interaction effect with adversity on an impulsivity task applied at 36 months. We found a significant effect of interaction between fasting insulin rPRS and adversity exposure predicting impulsivity measured by the Snack Delay Task at 36 months [β = −0.329, p = 0.024], such that higher PRS [β = −0.551, p = 0.009] was linked to more impulsivity in individuals exposed to more adversity. Enrichment analysis (MetaCoreTM) of the SNPs that compose the fasting insulin rPRS at this threshold was significant for certain nervous system development processes including dopamine D2 receptor signaling. Additional enrichment analysis (FUMA) of the genes mapped from the SNPs in the fasting insulin rPRS showed enrichment with the accelerated cognitive decline GWAS. Therefore, the genetic background associated with risk for adult higher fasting insulin moderates the impact of early adversity on childhood impulsivity.

Hippocampal integrity is highly susceptible to metabolic dysfunction, yet its mechanisms are not well defined. We studied 126 healthy individuals aged 23–61 years. Insulin resistance (IR) was quantified by measuring steady-state plasma glucose (SSPG) concentration during the insulin suppression test. Body mass index (BMI), adiposity, fasting insulin, glucose, leptin as well as structural neuroimaing with automatic hippocampal subfield segmentation were performed. Data analysis using unsupervised machine learning (k-means clustering) identified two subgroups reflecting a pattern of more pronounced hippocampal volume reduction being concurrently associated with greater adiposity and insulin resistance; the hippocampal volume reductions were uniform across subfields. Individuals in the most deviant subgroup were predominantly women (79 versus 42 %) with higher BMI [27.9 (2.5) versus 30.5 (4.6) kg/m2], IR (SSPG concentration, [156 (61) versus 123 (70) mg/dL] and leptinemia [21.7 (17.0) versus 44.5 (30.4) μg/L]. The use of person-based modeling in healthy individuals suggests that adiposity, insulin resistance and compromised structural hippocampal integrity behave as a composite phenotype; female sex emerged as risk factor for this phenotype.

A great global concern is currently focused on the coronavirus disease 2019 (COVID-19) pandemic and its associated morbidities. The goal of this study was to determine the frequency of newly diagnosed diabetes mellitus (DM) and its different types among COVID-19 patients, and to check the glycemic control in diabetic cases for three months. After excluding known cases of DM, 570 patients with confirmed COVID-19 were studied. All participants were classified as non-diabetic or newly discovered diabetic. According to hemoglobin A1c (HbA1c) and fasting insulin, newly discovered diabetic patients were further classified into pre-existing DM, new-onset type 1 DM, and new-onset type 2 DM. Glycemic control was monitored for three months in newly diagnosed diabetic patients. DM was diagnosed in 77 patients (13.5%); 12 (2.1%) with pre-existing DM, 7 (1.2%) with new-onset type 1 DM, and 58 (10.2%) with new-onset type 2 DM. Significantly higher rates of severe infection and mortality (p < 0.001 and p = 0.046) were evident among diabetic patients. Among survived diabetic patients (n = 63), hyperglycemia and the need for anti-diabetic treatment persisted in 73% of them for three months. COVID-19 was associated with a new-onset of DM in 11.4% of all participants and expression of pre-existing DM in 2.1% of all participants, both being associated with severe infection. COVID-19 patients with newly diagnosed diabetes had high risk of mortality. New-onset DM persisted for at least three months in more than two-thirds of cases.

Type 2 diabetes (T2D) prevalence increases unabated even as interventions focused on individuals at high risk can prevent T2D (1). Best approaches to identify individuals at high risk continue to be refined. Current risk assessment focuses on elevated glycemia, commonly estimated by fasting glucose (FG) and HbA1c levels, despite imperfect sensitivity and specificity (2). We previously showed that risk for T2D increases progressively as HbA1c increases, independently and in addition to increasing FG (3,4). As risk assessment for T2D depends on more than glycemia alone, simultaneous consideration of another physiological axis may improve biomarker-based diagnostic precision. Here, we test the hypothesis that simultaneous consideration of HbA1c and insulin resistance (IR), assessed with fasting insulin as HOMA of IR (HOMA-IR), can substantially improve risk assessment for T2D. We have previously detailed our statistical approach, IR and T2D diagnostic criteria, and particulars of the Framingham Heart Study (FHS) (3). Using the same FHS data and excluding those with T2D at baseline, we categorized individuals according to HbA1c

Type 2 diabetes mellitus harbors heterogeneity. This study describes the phenotypic subgroups based on anthropometric and biochemical characteristics. This was a cross-sectional study involving 96 patients with early type 2 diabetes conducted from July 2017 to December 2018. Clinical history was recorded and anthropometric measurements were done. Beta cell function was estimated using oral disposition index (DIo). Homeostatic model assessment for insulin resistance (HOMA-IR) was calculated using the fasting plasma glucose and fasting insulin levels. The cut off to define insulin resistance was 1.93. The median age was 53.5 years. Fifty-five (57.3%) patients were males. Thirty-two percent of females and 33% of males had a BMI of less than 23 kg/m2. The average DIo was 0.54. Insulin resistance was present in 59 (61.5%) of the total patients. Three subgroups of patients were discernible. One, predominantly insulin resistant (HOMA-IR > 1.93)]: 61.45%; second, predominant beta cell dysfunction (HOMA-IR 1–1.93)]: 26%; and third, severely reduced beta cell function (HOMA-IR

Background With the widely implementation of universal two-child policy, the number of pregnant women in advanced maternal age (AMA) will increase gradually. We aimed to assess the association of vitamin D levels and insulin resistance (IR) during the late pregnancy in AMA. Methods A total of 80 pregnant women were consecutively enrolled in the cross-sectional study before delivery from the August 2016 to June 2017 at the department of gynecology and obstetrics in the hospital of ZhongDa, affiliated to Southeast University. At delivery, serum 25(OH) D and metabolism parameters including glucose and lipid levels were measured. IR was calculated by the method of homeostasis model assessment 2(HOMA2). Results Pregnant women in AMA with vitamin D deficiency have higher fasting insulin (14.70(8.76–34.65) and 10.89(7.15–16.12), respectively, P = 0.031) and HOMA-IR indices (1.78(1.07–4.14) and 1.30(0.83–1.89), respectively, P = 0.024) than those with vitamin D non-deficiency. Serum 25(OH) D levels were inversely associated with HOMA-IR indices (r = − 0.25, P = 0.025). In multivariable analysis for adjusting confounder factors, vitamin D non-deficiency was also negatively correlated with HOMA-IR compared to vitamin D deficiency (β = − 1.289, P = 0.026). Conclusions Taken together, our findings suggest that serum 25(OH) D levels were inversely associated with HOMA-IR in AMA. Furthermore, pregnant women in AMA with vitamin D deficiency might have higher HOMA-IR levels than those with vitamin D non-deficiency. Trial registration Chinese Clinical Trial Registry (No. ChiCTR-RRC-16008714). retrospectively registered.

Background The shape of the glucose response curve during an oral glucose tolerance test (OGTT) can predict β-cell function and insulin resistance. However, there have been few studies conducted on Chinese people. Thus, we aimed to verify the usefulness of the glucose response curve in a large Chinese population. Methods A total of 9059 OGTT (3-h tests) were categorized into either a monophasic or a multiphasic group based on the shape of the glucose response. Homeostasis model assessments of fasting insulin resistance, the Matsuda Index, the insulinogenic index, and the disposition index were assessed by plasma glucose and serum insulin concentration obtained at fasting or during an OGTT. Results The shape of the OGTT glucose response curve was monophasic in 87.3% and multiphasic in 12.7% of participants. Individuals in the multiphasic group were younger compared to those in the monophasic group (38.6 ± 13.6 vs. 35.4 ± 13.5, P P P P P Conclusion The monophasic OGTT glucose response curve could reflect impaired β-cell function in a large Chinese population.

Background: Identification of insulin resistance is very important in management of type 2 diabetes. The euglycemic insulin clamp method, intravenous glucose tolerance tests (IVGTT) and minimal model approximation of glucose (MMAMG) are standard methods of measurement of insulin resistance in research. However, they are impractical in clinical practice and are difficult to perform in population-based research studies. So, a simple scoring system was designed to estimate the insulin resistance. Methods: 200 type 2 diabetes individuals who attended Karnataka Institute of endocrinology and research outpatient department. Fasting plasma glucose, post prandial plasma glucose, fasting insulin, lipid profile, BMI, waist circumference and BP of these subjects were checked. Results: Out of 200 type 2 diabetes subjects 69.5% were males and age group ranging from 26 to 85 years. Duration of diabetes range from 0 to 20 years and 53% of patients had hypertension and 46.5% have hypertriglyceridemia. Insulin resistance calculated by KIER scoring system, HOMA-1, QUICKI, HOMA2 and Fasting Insulin was present in 82%, 63%, 63.5%, 33.5% and 37.5% 0f individuals respectively. KIER scoring system had a statistically significant correlation with HOMA and QUICKY indices. (P value < 0.001) Conclusions: (1) KIER scoring system detects insulin resistance in 82% of type 2 diabetes individuals. (2) HOMA 1 and QUICKI are identical and similarly HOMA 2 and fasting insulin levels are almost identical in estimation of insulin resistance. (3) The KIER scoring system designed is very simple and economical. It takes into consideration the different factors which contribute to insulin resistance.

Autophagy is a critical molecular process in promoting cell survival against apoptosis. This study examined whether maximal aerobic exercise-mediated apoptosis in obesity might be underlying the involvement of autophagy in the peripheral blood mononuclear cells (PBMCs). Twelve healthy male subjects (6 obese and 6 normal-weight) were recruited to participate in a maximal graded exercise test on a treadmill. Obese subjects exhibited a significantly lower Bax, but a higher Bcl-2 protein level in conjunction with a reduced Bax/Bcl-2 AUCi compared to normal-weight subjects following exercise. Furthermore, a greater LC3-II/LC3-I ratio and LC3-II/LC3-I AUCi was observed in obese subjects compared to normal-weight subjects. LC3-II/LC3-I AUCi was also positively associated with obesity-associated parameters (BMI, waist/hip circumference, and fasting insulin level), but was negatively correlated with Bax/Bcl-2 AUCi. These findings demonstrate that maximal aerobic exercise differentially mediates the intrinsic apoptotic pathway and autophagic activity in human PBMCs isolated from obese compared to normal-weight individuals.

To evaluate pancreatic β-cell function (βf) in patients with normoglycemia (NG) and normal glucose tolerance (NGT) and related risk factors.An observational and comparative study in 527 patients with NG and NGT that were divided by quartiles of βf according to the disposition index derived from OGTT. Anthropometrical, clinical, nutritional, and biochemical variables were measured and associated with βf.Quartiles of βf were Q1 = DI 1.93 n = 131, Q2 = DI 1.93-2.45 n = 134, Q3 = DI 2.46-3.1 n = 133, and Q4 = DI 3.1 n = 129. There was a progressive reduction in pancreatic β-cell function and it is negatively correlated with age, weight, BMI, total body fat and visceral fat, waist circumference, total cholesterol, LDL, and triglycerides (p 0.01). Glucose levels during OGTT had a negative correlation with βf; the product of fasting glucose by 1-h glucose had the best correlation with βf (r = 0.611, p 0.001) and was the best predictor of βdf (AUC 0.816, CI 95% 0.774-0.857), even better than 1-h glucose (r = 0.581, p 0.001). Energy, fat, and carbohydrate intake were negatively correlated with βf (p 0.05). Glucose levels at 1-h OGTT 110 mg/dl were positively associated with pancreatic βdf (OR 6.85, CI 95% 3.86-12.4). In the multivariate analysis, glucose levels during OGTT, fasting insulin, and BMI were the main factors associated with βf.A subgroup of patients with NG and NGT may have a loss of 40% of their βf. Factors related to this βdf were age, adiposity, glucose during OGTT, and the product of fasting and 1-h glucose, as well as food intake.

BACKGROUND An association between essential hypertension and defective insulin secretion has been identified. To study the fasting insulin levels in non-obese, non-diabetic Hypertensive subjects. Although hyperinsulinemia, a surrogate of insulin resistance, may play a role in the pathogenesis of hypertension (HTN), the association between fasting insulin level and HTN development is still controversial. We examined the relation between fasting insulin and incidence of HTN in nonobese individuals. To correlate insulin levels with hypertension and its complications. METHODS 50 patients diagnosed to have hypertension stage I and above as per jNC - 7 report and 50 controls who are sex matched normal healthy controls. This study is conducted in Bangalore medical college Victoria hospital, Bangalore. Patients of essential hypertension of varying duration admitted to medical wards or treated at OPD department were chosen randomly for this study. All patients who are detected to have hypertension as per report of the JNC7 and are non-obese with BMI

Background The objective of this study was to develop and validate a short, self-administered questionnaire to assess diet quality in clinical settings, using the Alternative Healthy Eating Index (AHEI) as reference. Methods A total of 1040 men and women (aged 44.6 ± 14.4 y) completed a validated web-based food frequency questionnaire (webFFQ) and had their height and weight measured (development sample). Participants were categorized arbitrarily according to diet quality (high: AHEI score ≥ 65/110, low: AHEI score

To explore the association of marijuana use with mean plasma fasting insulin levels and homeostasis model assessment of insulin resistance (HOMA-IR) score in obese adults with different HOMA-IR. The National Health and Nutrition Examination Survey (NHANES) is a survey research program designed to assess the health and nutrition status of individuals in the United States and to track changes over time. We abstracted data from NHANES 2009–2016. We estimated the minimal lifetime marijuana use (MLU) using the duration of regular exposure and the frequency of use. We assessed the association of MLU and both plasma fasting insulin and HOMA-IR score using log-linear regression models. A total of 65,209 obese individuals aged 18 to 59 years were included. In obese individuals who never used marijuana (reference), the mean value (± standard deviation) was 19.0 (± 12.8) μU/mL for plasma fasting insulin and 4.78 (± 3.49) for HOMA-IR. In individuals with HOMA-IR

Exercise is non-pharmacological management for Diabetes Mellitus (DM) type-2. Previous study found that both eerobic and interval training improved insulin resistance. The aim of this study was to analyze the chronic effect various type of exercises to fasting blood glucose (FBG) and insulin resistance in DM type-2 model rats. It was an experimental study, twenty male Wistar rats, age 8 weeks, weight 150-180 gram as the object. Rats were given high fed diet for 4 weeks then injected streptozocin dose 30 mg/kgBB in citrate buffer pH 4.5 i.p, and 45 mg/kgBB at the following week. Groups were divided into i.e moderate continous training (MCT), severe continous training (SCT), slow interval training (SIT), and fast interval training (FIT). All groups were treated with ran on the treadmill three times a week for 8 weeks. Fasting blood glucose and fasting insulin were checked before and after intervention. Insulin resistance was determined by calculating HOMA-IR. Data analized with paired t-test (p

Background and aims Potential associations of vegetarian diet patterns with fasting insulin (FI) and insulin sensitivity remain unclear. We aimed to investigate whether vegetarian diets were associated with FI and insulin sensitivity in a cross-sectional study in Chinese vegetarians and matched omnivores and then to test whether it is independent of body mass index (BMI). Methods and results This study included 279 vegetarians (73 vegans, 206 lacto-ovo-vegetarians) and 279 age- and sex-matched omnivores. Fasting blood glucose (FG) and FI concentrations were measured, and β-cell function (HOMA-β) and insulin resistance index (HOMA-IR) were used to evaluate insulin sensitivity. All blood glucose and insulin sensitivity indices were naturally log-transformed, and multiple-linear regression was used to determine the association between vegetarian diet patterns and insulin sensitivity after adjusting for confounders including BMI, visceral fat area, physical activity, sedentary time, income, alcohol consumption, and daily dietary intakes of macronutrients. Compared to omnivores, both vegan diet [ β = −0.25, 95% CI: (−0.38, −0.14)] and lacto-ovo-vegetarian diet [ β = −0.10, 95% CI: (−0.18, −0.01)] were negatively associated with HOMA-IR after adjusting for BMI. Vegan diet remained negatively associated with FI [ β = −0.16, 95% CI: (−0.30, −0.01)] and HOMA-IR [ β = −0.17, 95% CI: (−0.32, −0.03)] after adjusting for all confounders. Conclusion Vegetarian diet, especially vegan diet, is negatively associated with FI and IR, independent of BMI.

AIM We aimed to assess the influence of fasting insulin resistance on metabolically healthy obesity (MHO) prevalence in adolescents and to identify associated factors. METHODS This retrospective, registry-based, cross-sectional study included 418 (51.9% girls) 10- to 18-year-old adolescents with obesity from a tertiary outpatient clinic in Sao Paulo, Brazil, between 2009 and 2013. The prevalence of MHO was estimated according to two definitions: (i) no cardiometabolic risk factors (CMRF) by the International Diabetes Federation parameters and (ii) no CMRF and homeostatic model assessment for insulin resistance

Polycystic ovary syndrome (PCOS) patients have left ventricular dysfunction (LVD) in an earlier stage. Myocardial performance index (MPI) reflects both systolic and diastolic dysfunction. A presystolic wave (PSW) detected on late diastole has been found to be associated with LVD.We sought to determine whether there is an association between PSW and subclinical LVD assessed by MPI in PCOS patients.We prospectively enrolled 106 patients diagnosed with PCOS in this study. Patients were divided into two groups based on the presence of PSW. Both groups were compared with respect to demographic, clinical, and echocardiographic properties. Univariable and multivariable regression analyses were performed to detect predictors of subclinical LVD.The study included 58 patients with PSW-positive (54.7%, mean age: 23) and 48 patients with PSW-negative (45.3%, mean age: 25). PSW-positive patients had a higher waist-to-hip ratio, fasting insulin, and HOMA-IR compared to PSW-negative patients. Higher MPI velocities and more frequent subclinical LVD were observed in PSW-positive group than in PSW-negatives (p 0.001, p = 0.0031, respectively). PSW velocity was significantly correlated with MPI velocity (r:.404, p = 0.0016). The presence of PSW, HOMA-IR, and waist-to-hip ratio 85 were predictors of subclinical LVD in univariate logistic regression analysis. Only the presence of PSW was an independent predictor of subclinical LVD in multivariable logistic regression analysis (OR:3.257, p = 0.028).PSW prevalence was 54.7% in PCOS patients. PSW velocity was significantly correlated with MPI velocity. The presence of PSW was independently associated with subclinical LVD in PCOS women.

Patients with NAFLD are characterized by insulin resistance (IR) and hyperinsulinism. However, prior studies have been unable to predict NAFLD based on IR measurements. The aim of this study was to explore the application of a newly validated measurement of intact insulin by mass spectrometry to predict NAFLD in patients without diabetes. Ninety-eight patients were recruited and underwent: a 2-hour OGTT with measurements of insulin every 30 min, and a liver magnetic resonance spectroscopy (1H-MRS) to measure liver fat and diagnose NAFLD. A mass spectrometry method was used to measure intact molecules of insulin. A total of 62 patients had NAFLD (48±11 yr, 66% male, BMI: 34.4±4.6kg/m2, A1c: 5.8±0.4%); and 36 did not have NAFLD (52±12 yr, 56% male, BMI: 30.5±6.8kg/m2, A1c: 5.5±0.4%). Fasting insulin levels were higher in NAFLD patients (17±10 vs. 7±3 μU/ml, p Conclusions: In patients without diabetes, accurate measurement of fasting intact insulin levels by mass spectrometry constitutes an easy and non-invasive strategy to predict presence of NAFLD. Disclosure F. Bril: None. M. J. Mcphaul: Employee; Self; Quest Diagnostics. S. Kalavalapalli: None. R. Lomonaco: None. D. Barb: None. E. Godinez: None. K. Cusi: None. Funding The Obesity Society; University of Florida

Nonalcoholic fatty liver disease (NAFLD) is one of the risk factors for erectile dysfunction (ED). We aimed to predict the risk of ED in patients with NAFLD. The study included 146 male patients complaining impotence admitted to the urology outpatient clinic aged 24-80 years without a history of alcohol use who underwent abdominal ultrasonography between February 2018 and January 2019. 106 patients with NAFLD and 40 men without NAFLD were included in the study. Clinical and laboratory parameters, ED status according to International Index of Erectile Function-5 were compared between patients with and without NAFLD. The mean age of patients was 51.47 ± 10.34 years. NAFLD was detected in 72.6% of the patients. No statistically significant difference was found regarding mean age, BMI, IIEF-5 scores, DM status, serum glucose levels (p > .05). Fasting insulin levels, hypertension (HT), insulin resistance (IR) and ED status of the patients with NAFLD were significantly higher than patients without NAFLD (p < .05). NAFLD was found to be a significantly independent associated with ED. We also found that patients with NAFLD have risk of ED 2.92 times higher than without NAFLD (OR: 2.92). For the patients presenting with erectile dysfunction, hepatic steatosis should also be considered.

Objective We aimed to investigate whether patients with polycystic ovary syndrome (PCOS) and a family history (FH) of type 2 diabetes mellitus (T2DM) are at increased risk of endocrinological and metabolic abnormalities, and whether this risk differs between first-degree and second-degree relatives, and between maternal and paternal transmission. Methods A total of 680 patients with PCOS were enrolled in this retrospective, single-center study. Endocrine and glycolipid metabolism parameters were compared. Results The free androgen index (FAI), and levels of fasting blood glucose (FBG), fasting insulin (FINS), homeostatic model assessment-insulin resistance (HOMA-IR), total cholesterol (TC), and low-density lipoprotein cholesterol were significantly higher, whereas sex hormone binding globulin (SHBG) levels were significantly lower in patients with PCOS and a FH of T2DM. In patients with PCOS with a FH of T2DM in first-degree relatives, age and levels of FBG, FINS, and HOMA-IR were significantly higher than those who had a FH of T2DM in second-degree relatives. A maternal history of T2DM was associated with a higher body mass index, FAI, and TG levels, and lower SHBG levels. Conclusions Patients with PCOS and a FH of T2DM have more severe hyperandrogenism and metabolic disorders, especially in those with maternal transmission.

Lifestyle interventions, including meal replacement, are effective in the prevention and treatment of type-2-diabetes and obesity. Since insulin is the key weight regulator, we hypothesised that the addition of meal replacement to a lifestyle intervention reduces insulin levels more effectively than lifestyle intervention alone. In the international multicentre randomised controlled ACOORH (Almased Concept against Overweight and Obesity and Related Health Risk) trial, overweight or obese persons who meet the criteria for metabolic syndrome (n = 463) were randomised into two groups. Both groups received nutritional advice focusing on carbohydrate restriction and the use of telemonitoring devices. The intervention group substituted all three main meals per day in week 1, two meals per day in weeks 2–4, and one meal per day in weeks 5–26 with a protein-rich, low-glycaemic meal replacement. Data were collected at baseline and after 1, 3, 6 and 12 months. All datasets providing insulin data (n = 446) were included in this predefined subanalysis. Significantly higher reductions in insulin (−3.3 ± 8.7 µU/mL vs. −1.6 ± 9.8 µU/mL), weight (−6.1 ± 5.2 kg vs. −3.2 ± 4.6 kg), and inflammation markers were observed in the intervention group. Insulin reduction correlated with weight reduction and the highest amount of weight loss (−7.6 ± 4.9 kg) was observed in those participants with an insulin decrease &gt, 2 µU/mL. These results underline the potential for meal replacement-based lifestyle interventions in diabetes prevention, and measurement of insulin levels may serve as an indicator for adherence to carbohydrate restriction.

The risk of developing Type 2 Diabetes Mellitus in people living with HIV (PLWH) can be four times greater and can occur at an earlier age and even without the presence of obesity compared to those without HIV. Therefore, the purpose of this analytical cross-sectional study was to determine the relationship between HIV duration and glucose metabolism among PLWH. Eighty-two PLWH were categorized into shorter (≤15 years) or longer HIV duration (≥16 years) and then compared for differences in demographics, physical and clinical characteristics, biomarkers, and dietary intake. Compared to those with shorter HIV duration (n = 34), those with longer HIV duration (n = 48) were on average older (p = 0.02), reported lower consumption of alcohol (p = 0.05), had higher levels of homeostasis model assessment of insulin resistance (HOMA-IR, p = 0.02), were also more likely to be a woman (p = 0.06), and have higher levels of fasting insulin (p = 0.06). When adjusted for age and body weight, the levels of HOMA-IR and fasting insulin were higher (p = 0.02 and p = 0.04) with longer compared to shorter HIV duration, respectively. Longer exposure to HIV infection is associated with impaired insulin sensitivity. Continuing research aimed at the long-term effects of HIV infection and (antiretroviral therapy) is required.

Purpose:To examine the prospective relevance of dietary sugar intake (based on dietary data as well as urinary excretion data) in adolescent years for insulin sensitivity and biomarkers of inflammation in young adulthood.Methods:Overall 254 participants of the DONALD study who had at least two 3-day weighed dietary records for calculating intakes of fructose, glucose, sucrose, total, free, added sugars, total sugars from sugar-sweetened beverages (SSB), juice, and sweets/sugar or at least two complete 24 h urine samples (n= 221) for calculating sugar excretion (urinary fructose and urinary fructose + sucrose) in adolescence (females: 9–15 years, males: 10–16 years) and a fasting blood sample in adulthood (18–36 years), were included in multivariable linear regression analyses assessing their prospective associations with adult homeostasis model assessment insulin sensitivity (HOMA2-%S) and a pro-inflammatory score (based on CRP, IL-6, IL-18, leptin, chemerin, adiponectin).Results:On the dietary intake level, no prospective associations were observed between adolescent fructose, sucrose, glucose, added, free, total sugar, or total sugar from SSB, juice or sweets/sugar intake and adult HOMA2-%S (p> 0.01). On the urinary level, however, higher excreted fructose levels were associated with improved adult HOMA2-%S (p= 0.008) among females only. No associations were observed between dietary or urinary sugars and the adult pro-inflammatory score (p> 0.01).Conclusion:The present study did not provide support that dietary sugar consumed in adolescence is associated with adult insulin sensitivity. The one potential exception was the moderate dietary consumption of fructose, which showed a beneficial association with adult fasting insulin and insulin sensitivity.

To investigate the correlation between serum 25-hydroxyvitamin D3 and abnormal insulin secretion in patients with type 2 diabetes mellitus. Eight type 2 diabetes mellitus patients treated from January 2018 to November 2020 (observation group) and another 80 healthy volunteers receiving physical examination in the same period (control group) were included. Fasting venous blood sample was collected to detect serum 25-hydroxyvitamin D3, fasting blood glucose, glycosylated hemoglobin, fasting insulin, insulin resistance index and insulin secretion index. According to insulin secretion index, observation group was divided into normal and abnormal insulin secretion groups and their serum 25-hydroxyvitamin D3, fasting blood glucose, glycosylated hemoglobin, fasting insulin and insulin resistance index were compared. Based on serum 25-hydroxyvitamin D3 level, observation group was divided into serum 25-hydroxyvitamin D3 positive and negative groups and their fasting blood glucose, glycosylated hemoglobin, fasting insulin, insulin resistance index and insulin secretion index were compared. The correlations of serum 25-hydroxyvitamin D3 with fasting blood glucose, glycosylated hemoglobin, fasting insulin, insulin resistance index and insulin secretion index were analyzed. Observation group had lower serum 25-hydroxyvitamin D3 level and insulin secretion index and higher fasting blood glucose, glycosylated hemoglobin, fasting insulin and insulin resistance index than those of control group (p

Background: The relationship between insulin resistance (IR) and prognostic factors in breast cancer (BC) in premenopausal (pre-M) and postmenopausal (post-M) women is still controversial. We evaluated the potential association between hemoglobin A1c (HbA1c), fasting blood glucose (FBG), fasting insulin levels (FILs), the homeostasis model assessment index (HOMA), and the prognostic factors of BC in nondiabetic patients with pre-M and post-M breast tumors. Methods: We compared 80 nondiabetic patients with pre-M and post-M breast tumors to 60 women with normal mammography as a control. Results: Age, body mass index (BMI), FBG, and HbA1c did not differ between the groups. FIL (P < 0.001) and HOMA-IR (P < 0.001) of the BC group were significantly higher than in the control group. FIL (P < 0.001) and HOMA-IR (P < 0.001) of the BC group were significantly higher than in the control group, for both pre- and post-M patients. FIL and HOMA-IR values were found to be significantly higher in the patients with stage IV BC than in other stages of BC. FIL and HOMA-IR are highly specific and sensitive parameters in their ability to diagnose BC. Conclusions: FIL and HOMA-IR are associated with BC risk in nondiabetic patients with pre-M and post-M breast tumors. When BC risk was evaluated according to the stage of menopause, no difference was observed; only the disease stage was significant. FIL and IR may function as potential biomarkers and therapeutic targets for human cancers. J Endocrinol Metab. 2021;11(2):42-48 doi: https://doi.org/10.14740/jem729

Objective: Monogenic diabetes is a heterogeneous disease that causes functional problems in pancreatic beta cells and hyperglycemia. The aim of this study was to determine the clinical and laboratory features, the admission characteristics and distribution of monogenic form of diabetes in childhood in Turkey. Methods: Patients aged 0-18 years, who were molecularly diagnosed with monogenic diabetes, and consented to participate, were included in the study. Results: Seventy-seven (45.6\%) female and 92 male cases with a mean age of 8.18 +/- 5.05 years at diagnosis were included. 52.7\% of the cases were diagnosed with monogenic diabetes by random blood glucose measurement. The reason for genetic analysis in 95 (56.2\%) of cases was having a family member diagnosed with diabetes under the age of 25. At the time of diagnosis, ketone was detected in urine in 16.6\% of the cases. Mean hemoglobin A1c on admission, fasting blood glucose, fasting insulin, and c-peptide values were 7.3 +/- 2.1\%, 184.9 +/- 128.9 mg/dL, 9.4 +/- 22.9 IU/L, 1.36 +/- 1.1 and ng/L respectively. GCK-MODY was found in 100 (59.2\%), HNF1A-MODY in 31 (18.3\%), and variants in ABCC8 in 6 (3.6\%), KCNJ11 in 5 (3\%), HNF4A in 2 (1.2\%), and HNF1B in 2 (1.2\%). Conclusion: Recent studies have indicated HNF1A-MODY is the most frequent of all the MODY-monogenic diabetes cases in the literature (50\%), while GCK-MODY is the second most frequent (32\%). In contrast to these reports, in our study, the most common form was GCK-MODY while less than 20\% of cases were diagnosed with HNF1A-MODY.

Introduction: Poly- and perfluoroalkyl substances (PFAS) are persistent organic pollutants with pervasive exposure and suspected associations with metabolic abnormalities and adverse pregnancy outcomes. The goal of the present study was to examine the relationship between serum-PFAS concentrations measured in late pregnancy with relevant outcomes. Methods: The study sample included 433 pregnant women enrolled in the Vanguard Pilot Study of the National Children's Study. Six PFAS were measured in primarily third trimester serum, as well as fasting insulin, total cholesterol, and triglycerides. The PFAS were examined in quartiles in relation to serum biomarkers, gestational age at birth and birth weight standardized for gestational age using multivariable-adjusted regression models. Results: Over 98% of the study population had detectable concentrations of four of the PFAS, and concentrations varied by race/ethnicity. Total cholesterol was positively associated with PFDA, PFNA, and PFOS, and triglycerides with PFDA, PFNA, PFOS, and PFOA, but PFAS were not associated with fasting insulin in adjusted models. Only PFNA was associated with an increased odds of birth at

This experiment was conducted in the city of Amara in southern Iraq at Al-Sadr Hospital. The study aimedto evaluate the effect of administering Ascorbic Acid on 50 diabeticpatients who had insulin resistance afterthey were diagnosed clinicallyof 25 patients were treated with Ascorbic acid at dose 500 mg twice a day for12 days and the others 25 were considered as control.The study group demonstrated a significant decrease in the fasting patient’s blood sugar (F.B.S), insulin andfasting blood, and Insulin resistance at the end of 12 weeks (P0.05) as compared to baseline measurements.The reduction in F.B.S, Fasting Insulin, and Insulin resistance was significantly reduced in the ascorbic acidgroup at week 12 of the study relative to the control group (P

Fasting duration has been associated with lower fasting blood glucose levels, but higher 2-h post-load levels, and research has indicated an adverse effect of ‘weekend behavior’ on human metabolism. We investigated associations of fasting duration and weekday of examination with glucose, insulin, glucagon and incretin responses to an oral glucose tolerance test (OGTT). This cross-sectional study is based on data from the ADDITION-PRO study, where 2082 individuals attended a health examination including an OGTT. Linear regression analysis was applied to study the associations of overnight fasting duration and day of the week with glucose, insulin, glucagon, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) responses to an OGTT. We found that a 1 h longer fasting duration was associated with 1.7% (95% CI: 0.8,2.5) higher 2-h glucose levels, as well as a 3.0% (95% CI: 1.3,4.7) higher GIP and 2.3% (95% CI: 0.3,4.4) higher GLP-1 response. Fasting insulin levels were 20.6% (95% CI: 11.2,30.7) higher on Mondays compared to the other weekdays, with similar fasting glucose levels (1.7%, 95% CI: 0.0,3.4). In this study, longer overnight fasting duration was associated with a worsening of glucose tolerance and increased incretin response to oral glucose. We found higher fasting insulin levels on Mondays compared to the other days of the week, potentially indicating a worsened glucose regulation after the weekend.

BackgroundPrevious studies have found that women with polycystic ovary syndrome (PCOS) have some degree of brain function change as well as cognitive function and emotions, such as poor executive functioning and memory, anxiety and depressive symptoms. However, the neurobiological mechanisms underlying these alterations have not yet been clarified.MethodFasting serum hormone testing, neuropsychological testing and resting-state magnetic resonance imaging (rs-fMRI) were performed in 41 women with newly diagnosed PCOS and 41 healthy controls matched by age and education during their 2–5 days of menstrual period. Analysis of the amplitude of low-frequency fluctuation (ALFF) was used to calculate the seed points. Then, the functional connectivity (FC) values between these abnormal seed points and other voxels in the whole brain were calculated. Finally, the correlations among clinical indexes, neuropsychological evaluation scores, and neuroimaging data were analyzed.ResultsCompared with the control group, the PCOS group showed higher luteinizing hormone (LH) and serum insulin levels, worse sleep quality, increased depressive and anxiety state scores, and memory and executive function impairments. Pearson’s correlation analysis showed that the decreased ALFF value in the left middle frontal gyrus (MFG.L), which is related to poor executive performance and depressive disorders, was negatively correlated with the plasma insulin level in subjects with insulin resistance. Furthermore, the increased FC strength between the MFG.L and left inferior frontal gyrus (IFG.L) was positively correlated with the serum testosterone level. The enhanced FC strength between the left posterior cingulate gyrus (PCG.L) and triangular part of the left inferior frontal gyrus (IFGtriang.L) was negatively correlated with the plasma LH level. When use the right middle occipital gyrus (MOG.R) as the seed point, the FC strength with the right inferior occipital gyrus (IOG.R), which is associated with impaired memory, was decreased.ConclusionThe ALFF and FC results elucidated brain functional abnormalities at the regional and network levels in women with PCOS, while correlation analyses simultaneously demonstrated that these alterations were associated with serum hormones and cognitive function. These results may provide useful information regarding the potential mechanisms of cognitive impairment and emotional changes in this population.

Introduction Chronic inflammation is associated with the development, progression and long-term complications of type 2 diabetes. Hyperglycemia is associated with chronic low-grade inflammation, and thus has become the focus of many screening and treatment recommendations. We hypothesize that insulin may also be associated with inflammation and may be an additional factor to consider in screening and treatment. Methods This study used National Health and Nutrition Examination Survey data from 2005 to 2010 to analyze the association between fasting insulin and C-reactive protein (CRP). A two-part model was used due to the high number of values reported as 0.1 mg/L. Two models were analyzed, both with and without the addition of waist circumference to other covariates in the model. Results The final sample included 4527 adults with a mean age of 43.31 years. In the first model, higher fasting insulin was associated with increased odds of CRP > 0.1 mg/L (OR = 1.02, p 0.1 mg/L (OR = 1.00, p = .307) but the association between higher fasting insulin and higher continuous CRP remained significant (β = 0.01, p = .012). Conclusion This study found that higher fasting insulin is associated with higher CRP. These results suggest that treatment approaches that simultaneously decrease insulin levels as well as glucose levels may provide additive anti-inflammatory effects, and therefore may improve long-term outcomes for adults with type 2 diabetes.

The authors wish to correct some minor errors in this article: 1. The fasting insulin secretion rate was correctly shown in Table 1 to be slightly increased after lixisenatide treatment, whereas the text of the Results and Conclusions sections incorrectly reported that it was decreased. 2. Change …

Introduction: Insulin Resistance (IR) can develop into type 2 diabetes mellitus and is closely associated with obesity. However, the non-obese population has also shown a predisposition to the risk of IR due to genetics. Aim: To assess the relationship between IR and obesity in Type 2 Diabetes Mellitus (T2DM) by comparing the proportion of subjects with IR in lean and obese T2DM and to identify the factors predicting IR in T2DM. Materials and Methods: A cross-sectional, hospital-based study was done at Department of Medicine of RL Jalappa hospital, Kolar, Karnataka on 106 T2DM patients aged >18 years. The study population was grouped into lean (BMI 30 kg/m2). IR was calculated using Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) and was considered as primary outcome variable. Obesity was considered as primary explanatory variable. Age, Gender, fasting insulin, C-peptide, Fasting Blood Sugar, Glycated haemoglobin (GHB or HbA1c) were the other explanatory variables. Descriptive analysis was carried out using mean and standard deviation for quantitative variables, frequency and proportion for categorical variables. Chi-square test was used to test statistical significance between the groups. Univariate logistic regression analysis was done to identify the predictors of IR. IBM Statistical Package for Social Sciences (SPSS) version 22 was used for statistical analysis. The p-value