Search

Abstract There is a relative scarcity of large-scale population studies investigating the relationship between the insulin resistance index of homeostasis model assessment (HOMA-IR) and vascular damage. Therefore, we assessed the association between HOMA-IR and vascular damage in adults aged 18 years and older in China. A total of 17,985 research subjects were included. Vascular damage markers and relevant laboratory tests were measured. HOMA-IR was calculated as (fasting insulin * fasting blood glucose)/22.5. Vascular damage included arteriosclerosis (ba-PWV > 1800 cm/s), peripheral artery disease (ABI 30 mg/g). The relationship between HOMA-IR and vascular damage was analyzed using the RCS. The restricted cubic spline (RCS) analysis suggested that HOMA-IR was nonlinearly associated with arteriosclerosis (P for no-liner

Objective(s): Obesity is a metabolic syndrome that leads to many chronic diseases worldwide. In this study, we investigate the antihyperlipidemic activities of chitosan nanoparticles (CH NPs) on silymarin (SIL) as a carrier in the drug delivery system that can improve some biochemical parameters and hormones in the model of hyperlipidemic rats receiving a high-fat diet (HFD). Materials and Methods: Physicochemical characterization of silymarin-loaded chitosannanoparticles (CH-SIL NPs) was done by Fourier-transform infrared (FTIR) spectroscopy, dynamic light scattering (DLS), and drug loading efficiency (LE). Diet-induced hyperlipidemic rats were treated with SIL (15 mg/kg/day) and CH-SIL NPs(15 mg/kg/day) for twelve weeks orally daily. The body weight loss (BW), food consumption, serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), levels of fasting blood glucose (FBG) in serum, serum insulin, cortisol, testosterone, and brain neuropeptide Y (NPY), Y1 and Y5 receptor mRNA expression were analyzed. Results: A significant reduction in BW and food consumption from 417 ± 16 g and 33 ± 1.03 in group HFD to 338 ± 10 g and 17.33 ± 1.02 in group CHS+HFD was observed, respectively. This data revealed that CH-SIL NPs improved hyperlipidemia, hyperinsulinemia, and hyperglycemia, reduced serum cortisol, and down-regulated NPY and Y1R with a significant increase in HDL and testosterone hormones compared to the control group. Conclusion: The developed Sil-loaded CH NPs were good agents for improving efficacy. It is the first report of the proposed weight loss mechanism of SIL CH NPs, thereby providing information about the anti-hyperlipidemic and antihyperglycemic effects of silymarin-loaded chitosan nanoparticles, a natural food with proper effects against metabolic disorders in case of hyperlipidemia that may lead to obesity and up-regulation of brain NPY.

Objective: To investigate triglyceride glucose index (TyG index) as a predictor of insulin resistance (IR) in comparison with homeostasis model assessment for insulin resistance (HOMA-IR) for the screening of DM in healthy adult population Study Design: Cross-sectional comparative study. Place and Duration of Study: The study was done at Chemical Pathology & Endocrinology Department, Armed Forces Institute of Pathology, Rawalpindi from 01st June 2022 to 31st May 2023 over a period of one year. Materials and Methods: The study comprised 307 healthy individuals coming for laboratory investigations to our laboratory after routine annual checkup at Combine Military Hospital, Rawalpindi. Individuals of both genders aged between 18 and 35 years were included and initial history of any previous medical condition was taken. All the participants with previous history of any chronic disease were excluded. Healthy individuals who were disease free were included. Blood sample was taken in clot activator and sodium fluoride tube for lipid profile, serum insulin fasting and blood glucose fasting, respectively. Formula used for estimation of HOMA-IR was: The equation used for TyG index was natural log of fasting plasma glucose and triglycerides divided by 2 i.e. .... Results: A comparative analysis was done using SPSS version 29.0 and revealing a significant positive correlation between the TyG index and HOMA-IR with an r value of 0.79 and p value = 0.001 where p value

Polycystic ovary syndrome involves oligomenorrhea and/ or anovulation due to excess testosterone or LH, in addition to metabolic disorders that may result in decreased levels of important vitamins and minerals, including Zinc and Magnesium levels. objetives: To show if metformin treatment for polycystic ovarian women can change zinc and magnesium levels in those women. Methods: this study involves 23 early-diagnosed polycystic ovarian women not on metformin and 16 polycystic ovarian women on metformin 850 mg twice daily for at least three months. FSH, LH, testosterone, estradiol, prolactin, SHBG, fasting insulin, fasting glucose, magnesium and zinc are measured on the second day of the cycle. Results: the patients without metformin showed significant increases in LH, LH: SH ratio, and free testosterone at P-values of 0.03, 0.037 and 0.009 respectively. Zinc showed a direct correlation with estradiol in patients not on metformin and an indirect correlation with body mass index in patients on metformin treatment. Conclusion: Zinc is an important element for female fertility as it may enhance estradiol level may be due to its antioxidant activity which decreases the inflammatory reaction in the pelvic region and enhance ovary function. The increase in zinc level has an inverse effect on body mass index. However, metformin treatment in this study showed no effect on the level of magnesium and zinc in polycystic ovarian women.

Objectives: This study aimed to investigate serum atherogenic indices as novel cardiovascular risk factors associated with retinal vein occlusion (RVO). Materials and Methods: This retrospective case-control study included 57 patients with newly diagnosed RVO whose plasma lipid profile (low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], total cholesterol [TC], and triglycerides [TG]) and insulin resistance were examined. Serum atherogenic indices (LDL-C/HDL-C, TC/HDL-C, TG/HDL-C, and non-HDL-C/HDL-C ratios) and presence of insulin resistance were compared between the patients and 63 healthy subjects. Cut-off values were determined by receiver operating characteristic curve analysis. Results: The mean age of the RVO patients was 63.7±9.4 years. Plasma levels of LDL-C, HDL-C, TC, and TG showed no significant difference between the patient and control groups (p>0.05). However, LDL-C/HDL-C, non-HDL-C/HDL-C, and TC/HDL-C ratios were higher in the RVO group compared to healthy subjects (p=0.015, p=0.036, and p=0.015, respectively). Fasting insulin concentrations, plasma insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) index were higher in the RVO patients compared to controls (p=0.003, p=0.001, and p=0.001, respectively). Conclusion: LDL-C/HDL-C, TC/HDL-C, and non-HDL-C/HDL-C ratios were found to be increased in RVO. Compared to the traditional plasma lipid profile, serum atherogenic indices were found to be superior predictors of RVO development. Measurement of HOMA-IR index should be taken into consideration in the evaluation of insulin resistance. High serum atherogenic indexes in RVO patients reveal the need to take precautions against the risk of cardiovascular disease and stroke.

Abstract Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting 5–20% of reproductive-age women. However, the treatment of PCOS is mainly based on symptoms and not on its pathophysiology. Neuroendocrine disturbance, as shown by an elevated LH/FSH ratio in PCOS patients, was thought to be the central mechanism of the syndrome, especially in lean PCOS. LH and FSH secretion are influenced by GnRH pulsatility of GnRH neurons in the hypothalamus. Kisspeptin is the main regulator of GnRH secretion, whereas neurokinin B (NKB) and dynorphin regulate kisspeptin secretion in KNDy neurons. This study aims to deepen the understanding of the neuroendocrine disorder in lean PCOS patients and its potential pathophysiology-based therapy. A cross-sectional study was performed at Dr. Cipto Mangunkusumo Kencana Hospital and the IMERI UI HRIFP cluster with 110 lean PCOS patients as subjects. LH, FSH, LH/FSH ratio, kisspeptin, NKB, dynorphin, leptin, adiponectin, AMH, fasting blood glucose, fasting insulin, HOMA-IR, testosterone, and SHBG were measured. Bivariate and path analyses were performed to determine the relationship between variables. There was a negative association between dynorphin and kisspeptin, while NKB levels were not associated with kisspeptin. There was no direct association between kisspeptin and the LH/FSH ratio; interestingly, dynorphin was positively associated with the LH/FSH ratio in both bivariate and pathway analyses. AMH was positively correlated with the LH/FSH ratio in both analyses. Path analysis showed an association between dynorphin and kisspeptin levels in lean PCOS, while NKB was not correlated with kisspeptin. Furthermore, there was a correlation between AMH and the LH/FSH ratio, but kisspeptin levels did not show a direct significant relationship with the LH/FSH ratio. HOMA-IR was negatively associated with adiponectin levels and positively associated with leptin and FAI levels. In conclusion, AMH positively correlates with FAI levels and is directly associated with the LH/FSH ratio, showing its important role in neuroendocrinology in lean PCOS. From the path analysis, AMH was also an intermediary variable between HOMA-IR and FAI with the LH/FSH ratio. Interestingly, this study found a direct positive correlation between dynorphin and the LH/FSH ratio, while no association between kisspeptin and the LH/FSH ratio was found. Further research is needed to investigate AMH and dynorphin as potential therapeutic targets in the management of lean PCOS patients.

Abstract The relationship between remnant cholesterol (RC) and homeostasis model assessment-insulin resistance (HOMA-IR) in the context of metabolic-associated fatty liver disease (MAFLD) remains an area of ambiguity. This investigation was designed to elucidate the potential association between RC and HOMA-IR in a cohort of American adults diagnosed with MAFLD. Data from 5533 participants were procured from the 2017–2018 US National Health and Nutrition Examination (NHANES) databases. A weighted linear regression model was employed to analyze the association between RC and HOMA-IR in the context of MAFLD. Preliminary analysis revealed that 44.67% of the participants were diagnosed with MAFLD, with a higher prevalence observed in individuals aged 50–64 years (31.84%, p

Abstract Background Interpregnancy interval (IPI) is associated with a variety of adverse maternal and infant outcomes. However, reports of its associations with early infant neurodevelopment are limited and the mechanisms of this association have not been elucidated. Maternal–fetal glucose metabolism has been shown to be associated with infant neurodevelopmental. The objective of this study was to determine whether this metabolism plays a role in the relationship between IPI and neurodevelopment. Methods This prospective birth cohort study included 2599 mother-infant pairs. The IPI was calculated by subtracting the gestational age of the current pregnancy from the interval at the end of the previous pregnancy. Neurodevelopmental outcomes at 12 months in infants were assessed by the Ages and Stages Questionnaire Edition 3 (ASQ-3). Maternal fasting venous blood was collected at 24–28 weeks and cord blood was collected at delivery. The association between IPI and neurodevelopment was determined by logistic regression. Mediation and sensitivity analyses were also conducted. Results In our cohort, 14.0% had an IPI

Abstract Background Insulin resistance (IR) had been reported to be associated with age; however, few studies have explored the association between IR and biological age (BA). The HOMA-IR value is a useful indicator of the extent of IR. This cross-sectional study is to explore the relationship between HOMA-IR and BA/advanced aging in the US population. Methods This study is a cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) data. The survey comprised 12,266 people from the NHANES, and their full HOMA-IR data as well as BA data were extracted. Four multiple linear regressions were performed to analyze the association between HOMA-IR and BA, and four multiple logistic regression models were performed to analyze the association between HOMA-IR and advanced aging. In addition, trend tests and stratified analysis were performed and smoothed fitted curves were plotted to test the robustness of the results. Results HOMA-IR was positively correlated with BA [β: 0.51 (0.39, 0.63)], and it was the same to advanced aging [OR: 1.05 (1.02, 1.07)], and both showed a monotonically increasing trend. The trend tests showed that the results were stable (all P for trend

Abstract Objectives This study investigated the effects of levothyroxine replacement therapy on insulin resistance, lipid profile, and thyroid function in patients with untreated primary hypothyroidism. 105 patients with hypothyroidism with indication for levothyroxine replacement were enrolled in the present study. Insulin, fasting blood glucose and lipid profile were assessed at the beginning of diagnosis and three months after levothyroxine replacement. Insulin resistance was calculated by hemostasis model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI). Results Our data revealed a significant reduction in body mass index (27.18 ± 4.27 versus 26.81 ± 4.18 kg/m2, p = 0.028), cholesterol (199.79 ± 37.61 versus 178.10 ± 32.25 mg/dl, p

Purpose: By analyzing long-term laboratory data, we aim to evaluate the relationship between the TyG and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) in the adult population with isolated impaired fasting glucose (IFG), and also to determine the cut off value of The triglyceride (TG) to glucose index (TyG) to estimate the IR in our population. Materials and Methods: In this study, data were evaluated retrospectively from medical records. Fasting glucose, lipid panel [Total cholesterol, TG, High-density lipoprotein (HDL), Low-density lipoprotein (LDL)] and insulin levels were analyzed with commercially reagents. (Roche Cobas C701, Roche Diagnostic, Germany). High-Performance Liquid Chromatography (HPLC) method was used for hemoglobin A1c (HbA1c) (Lifotronic H9, Lifotrophic Technology, China). TyG, HOMA-IR, and TG/HDLcholesterol were calculated. IR was defined as HOMA-IR ≥2.5. Results: A total of 440 subject, (controls: 230 and IFG:210), were included in our study. The average age of the subjects was 42.5±12.0 years and 44.7±10.7 years for IFG and control, respectively. Glucose, total cholesterol, TG, LDL-cholesterol, insulin, HbA1c, TG/HDL-cholesterol, HOMA-IR, and TyG were significantly higher in the IFG group (p

Background: Repetitive episodes of apnea and hypopnea during sleep in patients with obstructive sleep apnea (OSA) are known to increase the risk of atherosclerosis. Underlying obesity and related disorders, such as insulin resistance, are indirectly related to the development of atherosclerosis. In addition, OSA is independently associated with insulin resistance; however, data regarding this relationship are scarce in Japanese populations. Methods: This study aimed to examine the relationship between the severity of OSA and insulin resistance in a Japanese population. We analyzed the data of consecutive patients who were referred for polysomnography under clinical suspicion of developing OSA and who did not have diabetes mellitus or any cardiovascular disease. Multiple regression analyses were performed to determine the relationship between the severity of OSA and insulin resistance. Results: The data from a total of 483 consecutive patients were analyzed. The median apnea-hypopnea index (AHI) was 40.9/h (interquartile range: 26.5, 59.1) and the median homeostasis model assessment for insulin resistance (HOMA-IR) was 2.00 (interquartile range: 1.25, 3.50). Multiple regression analyses revealed that the AHI, the lowest oxyhemoglobin saturation (SO2), and the percentage of time spent on SO2 < 90% were independently correlated with HOMA-IR (an adjusted R-squared value of 0.01278821, p = 0.014; an adjusted R-squared value of −0.01481952, p = 0.009; and an adjusted R-squared value of 0.018456581, p = 0.003, respectively). Conclusions: The severity of OSA is associated with insulin resistance assessed by HOMA-IR in a Japanese population.

Background: A new inflammation mediator called secreted frizzled-related protein 4 (SFRP4), was recently found, the secretion of which is regulated by interleukin-1β. SFRP4 as a potential biomarker of early β-cell dysfunction can help to identify high-risk individuals who are going to develop diabetes in the future. It is highly expressed in β-cells of islets and its levels increase several years before diabetes diagnosis. Objectives: This study was conducted with an objective to estimate and correlate SFRP4 in pre-diabetes, type 2 diabetes, and non-diabetes persons, and evaluate the predictive risk assessment of SFRP4 as a novel biomarker. Materials and Methods: In this cross-sectional observational study, a total of 300 human participants were included among which 100 were prediabetic, 100 were diabetic, and 100 were age- and gender-matched control individuals from a community, all of whom were selected through a predesigned screening questionnaire and inclusion and exclusion criteria from January 2020 to January 2022 in Banke district, Nepal. Serum SFRP4 and IL-1β levels were determined by ELISA. Results: There was a statistically significant difference in body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), fasting insulin, fasting plasma glucose (FPG), two-hour post-load plasma glucose (2hPG), glycosylated hemoglobin (HbA1c), insulin resistance (HOMA-IR), Homeostasis model assessment of β cell function (HOMA-β%), high-sensitivity C-reactive protein (hs-CRP), total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL) between the three groups, with a progressive increase from the normal glucose tolerance (NGT) to impaired glucose tolerance (IGT) groups and with the highest value in the type 2 diabetes mellitus (T2DM) groups (P < 0.05). However, diastolic blood pressure (DBP) and IL-1β showed a significant difference between the NGT and T2DM groups (P < 0.001) and the NGT and IGT groups (P < 0.001). The median serum SFRP4 concentrations showed a significant difference among three groups (all P < 0.05) and were positively correlated with FPG, HbA1c, hs-CRP, and IL-1 β (P < 0.05). Conclusion: Our study presumes importance as we report increased SFRP4 levels in Asian Nepalis even at the stage of IGT. These findings propose that the increased serum SFRP4 may be a good biomarker of decline in β-cell function and insulin resistance.

Introduction/Objective. The development of acute insulin resistance after surgery intervention is associated with the type and magnitude of operation and tissue injury. The aim of our study was to compare insulin sensitivity assessed by homeostatic model assessment of insulin resistance (HOMA-IR) and C-reactive protein (CRP) before and after laparoscopic and open cholecystectomy during seven days follow-up. Methods. In total, 92 patients were divided into two groups: laparoscopic cholecystectomy (Group 1) (n = 61) and open cholecystectomy (Group 2) (n = 31). Glucose, insulin and CRP levels were measured at day 0 and at postoperative days one, three and seven. Glucose, insulin and CRP were determined using commercial assay on Roche Cobas 6000 automated analyzer (Roche Diagnostics, Manheim, Germany). Results. There was no statistical difference between studied groups concerning age (p = 0.626), body mass index (p = 0.548), glucose (p = 0.947), insulin (p = 0.212), HOMA-IR (p = 0.390) and CRP (p = 0.546) at day 0. At day one, higher values of CRP were found in group 2 compared with group 1 (p = 0.046). At day three, significantly higher values of glucose and HOMA-IR were found in group 2 compared with group 1 (p = 0.025, p = 0.036, respectively). Conclusion. Increase in CRP precedes deterioration of insulin sensitivity measured by HOMA-IR after cholecystectomy. Impairment of insulin sensitivity was more pronounced at postoperative day three in group with open cholecystectomy. On the basis of our results, laparoscopic cholecystectomy induced less impairment in insulin sensitivity and lower inflammatory response.

Aim: The Rotterdam criteria are used in the diagnosis of polycystic ovary syndrome (PCOS). However, since menstrual irregularities and acne are seen more frequently in adolescents, it is theoretically difficult to use the Rotterdam criteria. The aim of this study was to investigate whether the Rotterdam criteria are sufficient for the diagnosis of PCOS in adolescence. Material and Methods: Thirty patients and thirty healthy individuals between the ages of 16 and 18 years were included in the study. Anthropometric measurements, Ferriman Gallwey score (FGS), ultrasonographic ovarian volumes, androgens, and other hormone levels of the participants were recorded. Results: There was a statistically significant positive correlation between the homeostatic model assessment of insulin resistance (HOMA-IR) and waist circumference/hip circumference ratio in the patient group (r=0.656, p

Abstract Objective To assess the correlation between the insulin-based and C-peptide based HOMA-IR in the general population without diabetes in sub-Saharan Africa as well as to identify factors associated with IR. Results This was a cross-sectional study in urban settings in Yaoundé, Cameroon. We included 84 people with a body mass index (BMI) ≥ 18.5 Kg/m² and without diabetes (females: 72.6%; mean age: 37 years). IR was assessed using the following formulae: HOMA-IRINS = fasting insulin (mU/ml) x fasting plasma glucose (FPG) (mmol/L)/ 22.5; HOMA-IRCP1 = fasting C-peptide (mU/ml) x FPG (mmol/L)/ 22.5; and HOMA-IRCP2 = 1.5 + (FPG (mg/dl) x fasting C-peptide (ng/ml))/ 2800. Correlation (rho) between HOMA-IRINS and C-peptide based HOMA-IR was investigated using the Spearman rank test. The median (25th -75th percentiles) HOMA-IRINS, HOMA-IRCP1, and HOMA-IRCP2 were: 1.94 (1.36–3.50), 0.18 (0.11–0.27) and 9.91 (6.81–14.52), respectively. There was no correlation between the insulin-based and C-peptide-based HOMA-IR indices: rho = 0.043, p = 0.697. IR (HOMA-IRINS ≥ 2.8) was associated with obesity: A BMI ≥ 30 Kg/m² (adjusted odds ratio (aOR): 16.9, 95% confidence intervals (CI): 3.1–92.5) and being a student (aOR: 8.9, 95%CI: 2.1–38.2) were associated with IR.

INTRODUCTION: Obese patients are followed up with periodic laboratory tests. Insulin resistance is also a parameter used in these tests. There is a need for parameters that can determine insulin resistance more easily and practically. The aim of our study is to investigate the discriminative power of triglyceride (Tg) and triglyceride/high-density lipoprotein cholesterol ratio (Tg/HDL) for Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) in our patient population by examining the laboratory findings. METHODS: In this retrospective study, the laboratory data of patients who applied to the Family Medicine Obesity Polyclinic of Düzce University Hospital between April 2018 and April 2019 with the desire to lose weight and/or have healthy lifestyle suggestions were examined. RESULTS: Of the 512 patients included in our study, 66.40% (n=340) were female and 33.59% (n=172) were male. In the examination performed on patients grouped according to their Body Mass Index (BMI), Total cholesterol, HDL, Low-density lipoprotein (LDL), Tg, HOMA-IR, Insulin and Tg/HDL ratios were significantly different between the groups. The cut-off value in the ROC analysis of the Tg/HDL parameter between patients with and without insulin resistance was found to be 2.29 with 66% sensitivity and 55% specificity (AUC: 0.634, p

Objective: To evaluate various lipid, lipoprotein and apolipoprotein ratios among participants with and without metabolic syndrome. Study Design: Comparative cross-sectional study. Place and Duration of Study: Naval Hospital, Islamabad Pakistan, from Jan 2019 to Dec 2020. Methodology: We selected 164 patients with metabolic syndrome. Metabolic syndrome was diagnosed as per “NCEP-defined metabolic syndrome criteria”. Insulin resistance was calculated using Homeostasis Model Assessment for Insulin Resistance (HOMA-IR). Various apolipoproteins were calculated using the turbidimetric method on Humastar-200 and lipoproteins by direct detergent methods. Results: The differences for Apo-B/Apo-A1 were found to be higher among metabolic syndrome subjects [{Metabolic syndrome (n=83):0.55±0.22} vs {Non-Metabolic syndrome (n=81):0.50±0.29}, p=0.271]. Area Under Curve (AUC) was highest for the atherogenic index of plasma [0.744], followed by both total cholesterol/HDLc [0.641], Cholesterol Retention Factor (CRF) having [0.641], Apo-B/Apo-A1[0.593] and HDLc/LDLc [0.418]. Conclusion: Differences between subjects with and without NCEP-defined metabolic syndrome were significant for the atherogenic index of plasma (AIP), HDLc/LDLc, and Cholesterol Retention Factor (CRF).

Background: Insulin resistance plays an important role in the development of post-transplantation diabetes mellitus (PTDM) in kidney transplant recipients (KTRs). Current methods for the direct determination of insulin resistance are complicated and invasive. Therefore, this study aimed to investigate the relevance of indirect insulin resistance indices in relation to the development of PTDM in KTRs. Methods: We included 472 stable outpatient KTRs without diabetes at baseline from a prospective cohort study. Four indirect insulin resistance indices, namely homeostasis model assessment–insulin resistance (HOMA-IR), visceral adiposity index (VAI), lipid accumulation product (LAP), and triglycerides–glucose (TyG) index, were assessed. We analyzed each measure using the receiver operating characteristic (ROC) curve for PTDM development. The optimal cut-off value for each parameter was determined using the Youden index. Results: After a median of 9.6 years (interquartile range (IQR) 6.6–10.2) of follow-up, 68 (14%) KTRs developed PTDM. In Cox regression analyses, all indirect insulin resistance indices associated with incident PTDM were independent of potential confounders. ROC curve was 0.764 (95% CI, 0.703–0.826) for HOMA-IR, 0.685 (95% CI, 0.615–0.757) for VAI, 0.743 (95% CI, 0.678–0.808) for LAP, and 0.698 (95% CI, 0.629–0.766) for TyG index, with respective optimal cut-off values of 2.47, 4.01, 87.0, and 4.94. Conclusions: Indirect insulin resistance indices can be used to predict incident PTDM in KTRs. In addition to HOMA-IR, insulin-free surrogates of insulin resistance might serve as useful methods to identify KTRs at risk of PTDM, thus obviating the necessity to measure insulin.

Background: Insulin resistance is a major cause for developing type 2 diabetes but is not synonymous with the type 2 diabetes. Pancreatic beta cell dysfunction probably needs to be sets in for clinical occurrence of type 2 diabetes. So knowledge regarding residual beta cell function and degree of insulin resistance is essential. Aims and Objectives: The objectives are as follows: (1) To estimate degree of insulin resistance (HOMA-IR) and pancreatic beta cell functional capacity (HOMA-B %) among newly detected Type 2 diabetics and (2) to identify different clinical phenotypic presentations of type 2 diabetes on the basis of these parameters. Materials and Methods: This present study was conducted in newly diagnosed type 2 diabeticpatients. After obtaining informed consent, anthropometric and clinical examination was carried out in all patients. Venous blood samples were drawn for fasting plasma glucose,c-peptide,fasting insulin level,HbA1c,lipid profile, etc.HOMA-IR and HOMA-B% were calculated with HOMA 2 calculator. Results: A total 100 newly diagnosed type 2 diabetic patients were studied. About 71% pt of study population had HOMA-B% value below 50% and half of study population had significant amount of insulin resistance. Three distinct clinical phenotypes had identified. Insulin resistance predominant group (30%), beta cell dysfunction predominant group (45%), and both abnormalities coexist group (25%). Conclusion: By the time of diagnosis of Type 2 diabetes, more than two-third study population had

Objective: To assess the effect of adjuvant chemotherapy on insulin resistance in patients with early breast cancer. Material and Methods: Twenty-three non-diabetic patients were included. Patients were prospectively evaluated before, during, and after chemotherapy. Demographic, anthropometric, histopathological features, and treatment data were recorded. Blood samples were taken to evaluate fasting blood glucose, fasting insulin levels, and HbA1c. Homeostatic model assessment for insulin resistance (HOMA-IR) score measured using fasting blood glucose and fasting insulin levels. Results: Overall, pre- and post-chemotherapy mean weights were comparable (70.17 kg vs. 71.43). Prechemotherapy mean HOMA-IR was 4.99 and significantly higher than the control group of the healthy population (p=0.008). The mean values of the HOMA-IR score before, during, and after chemotherapy were 4.99, 3.47, and 3.13, respectively. Although the mean HOMA-IR decreased after chemotherapy, these decreases were not statistically significant (p=0.089). The mean fasting glucose levels before, during, and after chemotherapy were 95.5, 101.9, and 94.1 mg/dL, respectively. Before, during, and after chemotherapy, the mean fasting insulin levels were 21.43, 13.32, and 13.28 μIU/mL, respectively. Conclusion: In the study, we observed a higher rate of insulin resistance in patients with breast cancer. The mean values of the HOMA-IR score decreased during and after chemotherapy.

Amaç: GDM’lu ve sağlıklı gebelerde anne serumunda YKL-40 düzeyini ölçerek bu gebelerdeki insülin direnci üzerindeki rolünü açıklığa kavuşturmaktır. Yöntem: Haziran 2012 ile Haziran 2013 tarihleri arasında Cerrahpaşa Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı'nda takip edilen 40 GDM ve 40 sağlıklı term gebe çalışmaya dahil edildi. Gebelere ait demografik ve klinik parametreler hasta dosyalarından alındı. Bu gebelerde açlık glukoz, HbA1C, açlık insülin ve YKL-40 düzeyi ölçüldü. HOMA-IR değeri hesaplandı. GDM’li ve sağlıklı gebelerdeki parametreler karşılaştırıldı. Serum YKL-40 düzeyinin insülin direnci parametreleriyle ilişkisi araştırıldı. Bulgular: GDM’lu ve sağlıklı gebeler arasında yaş, sistolik ve diyastolik kan basıncı, gebelik haftası, doğum ağırlığı, lökosit sayısı ve açlık glukoz düzeyi açısından istatistiksel bir fark saptanmadı (tümü için p > 0.05). GDM'lu gebelerin VKİ, HbA1c, açlık insülin düzeyi, HOMA-IR değeri ve YKL-40 düzeyi istatiksel açıdan anlamlı olacak şekilde yüksek saptandı ( sırasıyla, 31.8 ± 4.3, 28.1 ± 2.4, p:0,001; 5.86 ± 1.85, 5.11 ± 0.25, p:0,001; 12.74 ± 6.52, 7.44 ± 2.12, p:0,001, 3.12 ± 1.94, 1.81 ± 0.48, p:0,001). Serum YKL-40 düzeyi VKİ, HbaA1C, açlık insülin,ve HOMA-IR değeri ile pozitif korele saptandı(sırasıyla, r:0,507, p:0,001; r:0,668, p:0,001; r:0,556, p:0,001; r:0,379, p:0,009). Sonuç: GDM’lu gebelerde serum YKL-40 düzeyinin arttığı ve bu düzeyin insülin direnci parametreleriyle pozitif korele olduğu tespit edilmiştir.

Insulin resistance, which is involved in the pathogenesis of Type 2 Diabetes (T2DM), is considered to be associated with betatrophin. Moreover, it is known that betatrophin levels may be affected by environmental factors. In this study, the changes in pre-Ramadan and post-Ramadan betatrophin levels, HOMA-IR levels, and metabolic parameters were evaluated in patients with T2DM, using oral antidiabetic (OAD) and wanting to fast during Ramadan. 50 patients with T2DM receiving OAD treatment and 40 healthy volunteers were included in the study. Glucose, cholesterol, HDL, LDL, triglyceride measurements were performed with AU-5800 autoanalyzer. Insulin levels were measured with DXI-800 and HbA1c levels with the Premier HB920 device. Furthermore, betatrophin levels were measured using the enzyme-linked immunosorbent assay method. At the beginning and the end of Ramadan, betatrophin levels were detected to be higher in the diabetic group compared to the control group. It was revealed that the post-Ramadan insulin and HOMA-IR levels were lower than the pre-Ramadan values in both of the groups. A positive correlation was found between betatrophin levels and triglyceride (r: 0.289, p= 0.042), and insulin (r: 0.276, p= 0.053) levels in the diabetic group. The study indicated that Ramadan fasting reduced the body mass index and average glucose. Thus, insulin resistance decreased. Betatrophin levels, which may be affected by environmental factors, displayed no changes. Ramadan fasting of diabetic patients in the low and moderate risk group did not disrupt metabolic order and glucose regulation. [Med-Science 2022; 11(1.000): 394-8]

Background: A substantial proportion of health burden in diabetic individuals can be attributed to cardiovascular complications. The increasing risk of cardiovascular complications along the spectrum of dysglycemia warrants the need to devise novel markers for early assessment and management. Activin A is a multifunctional cytokine with an important role in glucose homeostasis and vascular diseases. It can thus serve as a guide for early identification of cardiovascular disease (CVD) risk in prediabetes. Objective: The aim of the study was to measure serum levels of activin A in prediabetics, compare them with normoglycemic controls and find the correlation of activin A with markers of insulin resistance such as the homeostatic model assessment of insulin resistance (HOMA-IR). Methods: Sixty prediabetic patients and similar age-, sex-, blood pressure–, and BMI-matched controls were recruited in the study. In both groups, serum levels of fasting blood glucose and post prandial glucose, glycated hemoglobin (HbA1c) and fasting insulin were measured. HOMA-IR values were calculated. Serum activin A levels were measured in both groups using ELISA. The obtained values were compared between the two groups. Results: The median (IQR) of s. fasting insulin (mIU/L) in the case group was 15.3 (12.2–18.62) which was significantly higher than that in the control group, which was 6 (4.2–7.3). The median (IQR) of s. activin A (ng/mL) in the case group was 263.55 (227.18–279.56) which was significantly higher than that in the control group, which was 159.9 (150.73–178.75) (P < 0.001). There was a very strong positive correlation of s. activin A (ng/mL) with s. fasting insulin (mIU/L) and HOMA-IR (rho = 0.67 and 0.75, respectively, P < 0.001). Conclusion: Activin A, if combined with other atherosclerotic markers, might improve the assessment of insulin resistance and cardiovascular risk in prediabetics and lead to focus on lifestyle modifications and preventive medical therapy, thereby contributing to the prevention of CVD-related mortality and morbidity in these patients.

Background: Hypothyroidism is found to be more prevalent in women than men. There is an increasing evidence that subclinical hypothyroidism and metabolic syndrome are independent risk factors for cardiovascular disease and insulin resistance is the main pathophysiological basis for metabolic syndrome. Limited and conflicting data are available regarding the status of metabolic syndrome and insulin resistance in female patients with subclinical hypothyroidism. Aim and Objectives: The current study was conducted to evaluate metabolic syndrome and insulin resistance in women with subclinical hypothyroidism. Material and Methods: Fifty newly diagnosed subclinical hypothyroid women between the age group 18-45 years and fifty age-matched healthy women volunteers as controls were selected and enrolled for the study. Results: The mean values of diastolic blood pressure, total cholesterol, Low Density Lipoprotein-C (LDL-C), Triglycerides (TG), fasting glucose, insulin, and Homeostasis Model Assessment-Estimated Insulin Resistance (HOMA-IR) were significantly increased, whereas waist circumference, systolic blood pressure, and High Density Lipoprotein-C (HDL-C) were not significantly changed in women with subclinical hypothyroidism as compared to control group. Conclusion: Women with subclinical hypothyroidism are having a significantly higher prevalence of metabolic syndrome and insulin resistance which may result in a compounded risk of cardiovascular disease in these patients.

Amaç: Umblikal kordon kanı serum apelin düzeyinin yenidoğanın doğum ağırlığı ve insülin direnci üzerinde etkisini belirlemektir. Gereç ve Yöntem: Benzer vücut kitle indeksine(VKİ) sahip, gestasyonel diyabeti bulunmayan annelerin gebelik haftasına göre büyük (GHB) ve gebelik haftasıyla uyumlu (GHU) yenidoğanlarından umblikal kordon kanı alındı. İşlem sonrası umblikal kordon kanı serumunda glukoz, insülin ve apelin düzeyi ölçüldü. Sonuçlarla HOMA-IR hesaplandı. Gruplar arasında demografik, klinik ve laboratuvar sonuçları karşılaştırıldı. Bulgular: Umblikal kordon kanı serum glukoz düzeyi açısından gruplar arasında fark saptanmadı. Ancak, umblikal kordon kanı serum insülin ve apelin düzeyi yüksek saptandı (sırasıyla, 11,7 ± 3,1 mIU/L, 6,8 ± 1,1 mIU/L, p:0,001, 10,4±4,2 ng/ml, 7,8±1,7 ng/ml, p:0,011). HOMA-IR değeri GHB grubunda daha yüksek hesaplandı (sırasıyla 3,0±1,2, 1,7±0,6, p:0,001). Umblikal kordon kanı serum apelin düzeyi ile doğum ağırlığı (r = 0.399, p = 0.006), umblikal kordon kanı serum insülin düzeyi (r:0,873, p:0,001) ve HOMA- IR değeri (r: 0,938, p:0,001) arasında istatistiksel açıdan anlamlı pozitif korelasyon saptanırken umblikal kordon kanı serum glukoz düzeyiyle herhangi bir korelasyon saptanmadı. Sonuç: GHB grubunda umblikal kordon kanı serum apelin düzeyinin daha yüksek olduğu tespit edildi. Bu düzeyin yenidoğanın doğum ağırlığı ve insülin direnciyle pozitif korele olduğu belirlendi.

Objective:The prevalence of vitamin D deficiency is ever-increasing throughout the world. Vitamin D deficiency is associated with disorders such as diabetes, insulin resistance, obesity, dyslipidemia, and hypertension. This research study was carried out to assess serum vitamin D levels of patients with type 2 diabetes, insulin resistance, obesity, and impaired fasting glucose.Method:This study was carried out on 504 patients, who were newly diagnosed and did not receive medication before, aged 18 to 80 years, and who had type 2 diabetes, insulin resistance, obesity, and impaired fasting glucose. Their fasting glucose, fasting insulin, total cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein-cholesterol, triglyceride, 25(OH)D concentration, height and body weight measurements were analyzed retrospectively. Body mass index, homeostatic model assessment (HOMA) for insulin resistance and HOMA beta (B) values of the patients were calculated.Results:It was found that 89.9% of the patients with type 2 diabetes, 90.6% of the insulin resistance patients, 91.7% of the obesity patients and 94.1% of the impaired fast glucose patients had less than 30 ng/mL of serum 25(OH)D concentration. It was seen that the serum 25(OH)D concentrations of the patients were negatively correlated with their fasting insulin concentrations and HOMA B values, and positively correlated with their HDL-cholesterol levels.Conclusion:Based on this study, vitamin D deficiency was found to be common in the patients with type 2 diabetes, insulin resistance, obesity, and impaired fasting glucose. Serum 25(OH)D concentrations were correlated with the levels of fasting insulin, HDL-cholesterol, and beta-cell function.

Background and aims: Many findings have shown the potential relation between osteocalcin (OCN) and regulating energy metabolism. In addition, it has been revealed that physical activity increases OCN levels. Therefore, the present study aimed to investigate the effects of different exercise trainings on β-cell function, insulin resistance, and OCN levels in overweight men. Methods: In this study, 33 overweight, young men [Body mass index (BMI): 29.32±0.75 and age range of 31.50±2.23] were randomly divided into control (n=11), aerobic exercise (n=11), and resistance exercise (n=11) groups. Participants of the exercise group were on the 8-week supervised exercise training program for three sessions per week. Weight, body fat percentage, and BMI were analyzed, and then OCN, insulin, and the homeostasis model assessment of insulin resistance (HOMA-IR) were assessed from fasting blood samples before and after the 8-week exercise program. Finally, data were analyzed by t test and analysis of covariance (ANCOVA). Results: Based on the results, BMI and body weight, insulin, glucose, and HOMA-IR reduced following the exercise (P

The aim of the study was to evaluate the plasma profile of arachidonic acid (AA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA), as well to analyze the relationship of Omega 6/Omega 3 ratio with anthropo-metric parameters and insulin resistance markers.

Background: Hyperinsulinemia and insulin resistance occurs in obese patients with primary hypertension independent of diabetes and obesity. This study was aimed at assessing serum fasting insulin levels, the homeostatic model assessment for insulin resistance (HOMA-IR), and serum lipid levels in non-obese patients with primary hypertension when compared to normotensive subjects. Methods: This observational study comprised 100 patients over 18 years of age, divided into two groups. The hypertensive group comprised non-obese patients with primary hypertension (n=50); the normotensive group comprised normotensive age- and sex-matched individuals (n=50). Patients with diabetes, impaired fasting glucose, obesity, and other causative factors of insulin resistance were excluded from the study. Serum fasting insulin levels and fasting lipid profiles were measured, and insulin resistance was calculated using HOMA-IR. These data were compared between the two groups. Pearson’s correlation coefficient was used to assess the extent of a linear relationship between HOMA-IR and to evaluate the association between HOMA-IR and systolic and diastolic blood pressures. Results: Mean serum fasting insulin levels (mIU/L), mean HOMA-IR values, and fasting triglyceride levels (mg/dL) were significantly higher in the hypertensive versus normotensive patients (10.32 versus 6.46, P

ABSTRACT Objective: There are discrepancies about the relationship of IL-6, clusterin and irisin with obesity and obesity associated insulin resistance and also about their sexual dimorphism. This study aimed at evaluating the circulating levels of IL-6, clusterin and irisin in obese subjects of both sexes who had different grades of obesity and examining their sexual dimorphism and their association with insulin resistance. Subjects and methods: This study included 176 non-diabetic subjects of both sexes who were classified according to their sex into two groups; the male and the female groups. The male group (88 men) was classified according to BMI into; group 1 (22 lean men), group 2 (22 class I obese men), group 3 (22 class II obese men) and group 4 (22 class III obese men). The female group (88 women) was classified according to BMI exactly as the male group. Metabolic parameters, IL-6, clusterin, and irisin levels were measured. Data were analyzed by ANOVA test, post hoc Tukey’s test and independent t-test. Pearson correlation was used to assess the association between variables. Results: In obese subjects of both sexes, circulating IL-6, clusterin and irisin levels were significantly elevated and positively correlated with HOMA-IR. Obese males showed significantly higher HOMA-IR, IL-6, clusterin and irisin levels than obese females. Conclusion: Obesity in both sexes, especially in males was associated with high levels of IL-6, clusterin and irisin and worsened the metabolic pattern. Circulating IL-6, clusterin and irisin may represent possible therapeutic targets for insulin resistance in obese subjects.

Diabetes is a chronic disease and a public health problem globally. L-Carnitine is synthesized in the liver, promotes fatty acids oxidation and currently is used as a supplement against weight gain. Carnitine level is found to be reduced in diabetic patients and to be beneficial as a supplement at diabetes, but the mechanisms­ of this effect is not fully understood. Therefore, we evaluated the oral L-carnitine supplementation on expression of AMP-activated protein kinase (AMPK), peroxisome proliferator-activated receptor gamma (PPARγ), adaptor protein APPL1 genes in the liver and insulin and adiponectin levels in the serum of diabetic rats. Rats were randomly divided into three groups (n = 8) as follow: group 1 – control without any treatment, group 2 – diabetic control rats which received STZ (45 mg/kg) and nicotinamide (200 mg/kg) by i.p. injection, group 3 – diabetic rats which received 600 mg/kg/day carnitine orally for 35 days. It was found that L-carnitine supplementation reduced the level of fasting glucose compared to that in control and diabetic groups (P = 0.001, P = 0.0001 respectively) and increased adiponectin level compared to diabetic nontreated rats (P = 0.0001). Homeostasis model assessment of insulin resistance (HOMA-IR) was significantly increased in the diabetic group and reduced in the group that received L-carnitine. These promising beneficial effect of L-carnitine on the type 2 diabetes in rats’ model was shown to be conducted through the up-regulation of AMPK, PPARγ and APPL1 genes expression in the liver and elevation of serum adiponectin level.

Objective Diabetes mellitus (DM), characterized by chronic hyperglycemia, is attributed to relative insulin deficiency or resistance, or both. Studies have shown that yoga can modulate parameters of insulin resistance. The present study explored the possible beneficial effects of integrated yoga therapy with reference to glycemic control and insulin resistance (IR) in individuals with diabetes maintained on standard oral medical care with yoga therapy, compared to those on standard oral medical care alone. Methods In this study, the subjects on yoga intervention comprised 35 type 2 diabetics, and an equal number of volunteers constituted the control group. Subjects ranged in age from 30 to 70 years, with hemoglobin A1c (HbA1c) test more than 7%, and were maintained on diabetic diet and oral hypoglycemic agents. Blood samples were drawn prior to and after 120 days of integrated yoga therapy intervention. Fasting blood glucose (FBG), post-prandial blood glucose (PPBG), HbA1c, insulin, and lipid profile were assessed in both the intervention and control groups. Results The intervention group revealed significant improvements in body mass index (BMI) (0.7 kg/m2 median decrease; P=0.001), FBG (20 mg/dL median decrease; P

OBJECTIVE: To assess the effect of low and high dose of glycyrrhizin on body weight, fasting blood sugar level (FBSL), serum insulin and glycemic indices in high fat diet induced type 2 diabetic rats. METHODS: In this experimental study with intervention period of 34 weeks, rats were grouped into four experimental groups; Group-A: normal control; Group-B: diabetic control; Group-C: glycyrrhizin-150 and Group-D: glycyrrhizin-300. Diabetes mellitus was induced in rats by giving high fat diet with injection dexamethasone. At 32 weeks, body weight, FBSL, serum insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), Homeostatic Model Assessment of beta cells (HOMA-β) and Quantitative Insulin Sensitivity Check Index (QUICKI) were estimated. Two experimental groups received glycyrrhizin 150 mg/kg and 300 mg/kg per oral per day till completion of 34 weeks in addition to the high fat diet. At 34 weeks all the parameters were re-estimated. RESULTS: It was observed that both doses of glycyrrhizin significantly reduced FBSL and insulin levels in group-C (95.00±8.23 mg/dl, 671.60±55.51 µIU/ml) and group-D (94.00±6.27 mg/dl, 675.00±44.96 µIU/ml) as compared to group-B (236.10±13.26 mg/dl, 1052.80±37.82 µIU/ml) [p-value0.05) but significantly in group-D (293.20±42.54) as compared to group-B (372.00±24.03) [P-value

Background: Prediabetes is increasingly being studied in the context of its association with cardiovascular disease (CVD). Besides raised HbA1c and sugar levels, the major underlying defect seems to be insulin resistance (IR). Subclinical atherosclerosis, measured by high sensitivity C reactive protein (hsCRP) and carotid artery intima media thickness (CIMT) underlies the pathogenesis of CVD in prediabetes. Heart-type fatty acid binding protein (H-FABP), a novel cardiac biomarker also might have a role in predictin prediabetic heart disease. Aims: The aim of the study is to compare serum levels of H-FABP in prediabetics and controls and correlate them with the atherosclerotic markers, hsCRP and CIMT. Setting and Design: 50 prediabetic patients and 50 age, sex and BMI matched controls were employed in the case control study. Serum F & PPBS, (HbA1c), fasting insulin levels were measured in cases and controls. Serum H-FABP was measured in both cases and controls. All cases and controls were subjected to bilateral CIMT measurements and Serum hsCRP levels. The values were compared between both the groups and subjected to appropriate statistical analysis. Statistical Analysis Used: Categorical variables were presented in number and percentage (%) and continuous variables were presented as mean ± SD and median. Normality of data was tested by Kolmogorov-Smirnov test. If the normality was rejected then non parametric test was used. Quantitative variables were compared using Independent t test/Mann-Whitney Test (when the data sets were not normally distributed) between the two groups. Qualitative variables were correlated using Chi-Square test/Fisher's Exact test. Spearman rank correlation coefficient was used to find out the correlation of various parameters with each other. Univariate linear regression was used to find out the cause and effect relationship between various parameters. A p

Background: Diabetes mellitus (DM) is the seventh leading cause of death in the world (the occuring rate has reached 400 million people). Type2 DM is caused by the body cells’ inability to respond normally to insulin (insulin resistance). Homeostatic Model Assessment-Insuline Resistance (HOMA-IR) is a calculation method which function is to measure the body insulin resistance. Diabetes mellitus can cause lipid metabolism disorders (dyslipidemia) resulting in an increased level of LDL cholesterol and decreased HDL cholesterol. The apoprotein B/apoprotein A-I ratio is the result of comparisons of apoprotein B (LDL protein constituent) and apoprotein A-I (HDL protein constituent). The apo B/apo A-I ratio represents a balance between LDL cholesterol (atherogenic) and HDL (anti-atherogenic). It is astrong signifier in predicting heart disease. Purpose: This study aim to determine the correlation between the apoprotein B/apoprotein A-I ratio with HOMA-IR in patients with type 2 diabetes mellitus. Methods: Observasional, consecutive, 100 people with type 2 diabetes mellitus who is examined in apoprotein B, apoprotein A-I test that calculating the ratio in which ratio are calculated, as well as HOMA-IR in Parahita Clinical Laboratory Surabaya. This study uses Pearson correlation test method with SPSS 22.0 for Windows program. Results: The result of Pearson correlation test between apoprotein B/apoprotein A-I ratio with HOMA-IR in 100 samples is a strong and significant correlation value (r=0,610, p

Abstract Objectives In an aging population, an increase in the number of elderly cancer patients with cognitive impairment is expected. The possible association between cancer and cognitive impairment is important to elucidate, because it can have a serious impact on quality of life. Here, we focused on glucose metabolism as a factor that links cancer and cognitive impairment. Results Thirteen subjects with solid cancers and cognitive impairment were recruited. As a control group, 14 subjects with cognitive impairment alone and 8 subjects with cancer alone were recruited. A Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and that of β-cell function (HOMA-B) were used. In comparison with patients with solid cancer alone, those with cognitive impairment alone and those with both cancer and cognitive impairment had increased HOMA-IR values. Insulin resistance was increased in patients with cognitive impairment alone and those with both cognitive impairment and solid cancer than in patients without cognitive impairment; however, β-cell function was not affected. The present data indicated that elderly cancer patients with high HOMA-IR score may be at a relatively high risk for developing cognitive impairment. Furthermore, early treatment to reduce insulin sensitivity may prevent cognitive impairment.

Chronic obstructive pulmonary disease (COPD) is usually associated with a variety of extra-pulmonary manifestations. Metabolic syndrome (MetS) is one such entity that has been scarcely studied in Indian patients. Availability of a good screening marker may help in timely detection of this co morbidity in COPD patients. We conducted a cross sectional study to evaluate the prevalence of MetS among COPD patients and to evaluate the role of Interleukin-6 and insulin resistance (as measured by HOMA-IR) as screening markers for MetS in COPD. A total of 100 stable COPD patients were evaluated for MetS using US National Cholesterol Education Program Adult Treatment Panel III (2005) guidelines. Interleukin-6 and HOMA-IR (for insulin resistance) were measured and compared between COPD patients with and without MetS. ROC analysis was done to find the best cut-off value and sensitivity and specificity of both the molecules in detecting MetS. In the results, the mean age of the study cohort was 59.9+8.7yrs (males=93). Forty five COPD patients (45%) fulfilled the criteria for MetS. Patients with MetS were comparatively younger (57.9+9.5 v/s 61.6+7.8 years; p=0.037) but had longer duration of preceding COPD (9.9+2.8 v/s 6.0+2.2 years; p

Objective: To investigate the ability of homeostasis model assessment of insulin resistance (HOMA-IR) in early pregnancy for predicting gestational diabetes mellitus (GDM) in Chinese women with different first-trimester body mass index (FT-BMI) values. Methods: Baseline characteristics and laboratory tests were collected at the first prenatal visit (6–12 weeks of gestation). GDM was diagnosed by a 75 g oral glucose tolerance test (OGTT) at 24–28 weeks of gestation. Partial correlation analysis and binary logistic regression were applied to identify the association between HOMA-IR and GDM. The cutoff points for predicting GDM were estimated using receiver operating characteristic (ROC) curve analysis. Results: Of the total of 1343 women, 300 (22.34%) were diagnosed with GDM in the 24–28 weeks of gestation. Partial correlation analysis and binary logistic regression verified HOMA-IR as a significant risk factor for GDM in the normal weight subgroup (FT-BMI < 24 kg/m2) (adjusted OR 2.941 [95% CI 2.153, 4.016], P < 0.001), overweight subgroup (24.0 kg/m2 ≤ FT-BMI < 28.0 kg/m2) (adjusted OR 3.188 [95% CI 2.011, 5.055], P < 0.001), and obese subgroup (FT-BMI ≥ 28.0 kg/m2) (adjusted OR 9.415 [95% CI 1.712, 51.770], p = 0.01). The cutoff values of HOMA-IR were 1.52 (area under the curve (AUC) 0.733, 95% CI 0.701–0.765, p < 0.001) for all participants, 1.43 (AUC 0.691, 95% CI 0.651–0.730, p < 0.001) for normal weight women, 2.27 (AUC 0.760, 95% CI 0.703–0.818, p < 0.001) for overweight women, and 2.31 (AUC 0.801, 95% CI 0.696–0.907, p < 0.001) for obese women. Conclusions: Increased HOMA-IR in early pregnancy is a risk factor for GDM, and HOMA-IR can be affected by body weight. The cutoff value of HOMA-IR to predict GDM should be distinguished by different FT-BMI values.

(1) Background: Type 2 diabetes mellitus (T2DM) contributes to cardiovascular disease and related mortality through the insidious effects of insulin resistance and chronic inflammation. Mitral annular calcification (MAC) is one such degenerative process promoted by T2DM. (2) Methods: This is a post hoc analysis of insulin resistance, inflammation, and hepatic steatosis markers in T2DM patients without atherosclerotic manifestations, but with incidental echocardiographic detection of mild MAC. (3) Results: 138 consenting patients were 49.3% men, 57.86 years old, with a history of T2DM of 6.16 years and HbA1c 8.06%, of whom sixty had mild MAC (43.47%). The statistically significant differences between patients with/without MAC were higher HOMA C-peptide and C-peptide index for insulin resistance, higher TNF-α for inflammation, and lower estimated glomerular filtration rate. High-sensitive C-reactive protein (hsCRP) was significantly associated with insulin resistance and the strength of the relationship was higher in the MAC group. Predictive of MAC were TNF-α, HOMA C-peptide, and especially hepatic steatosis and hypertension. (4) Conclusions: MAC was more prevalent than reported in the literature. Insulin resistance and inflammation were predictive of MAC, but significant markers differ across studies. Widely available routine tests and echocardiographic assessments are useful in the early identification of mitral annular calcifications in diabetes patients.

Introduction: Incidence of diabetes mellitus has increased over the past few years, mainly due to our eating habits and physical inactivity. This also includes the use of artificial sweetening agents which have broadly replaced other forms of sugars and have shown a paradoxical, negative effect on blood glucose. Ingestion of these artificial sweeteners (AS) results in the release of insulin from pancreas which is mistaken for glucose (due to their sweet taste). This increases the levels of insulin in blood eventually leading to decreased receptor activity due to insulin resistance. Methodology: It is a crosssectional study that was conducted on patients diagnosed with type-2 diabetes mellitus of a tertiary care hospital in Central India. All the diabetics that presented in the OPD were divided into 2 groups based on whether they use AS (group A) or not (group B). Insulin resistance was calculated for each group using HOMA-IR and graphs were plotted. Results: The HOMAIR values for Group A and B ranged from 0.9–24.33 and 0.12–10.83 with mean values 7.39 and 2.6, respectively, showing that the ones who used AS had a higher insulin resistance. The study also showed that the duration of use of artificial sweeteners had a direct impact on insulin resistance.

Background. Metabolic syndrome (MS), a collection of cardiovascular risk factors, is a major worldwide public health problem. The gathered data prove that serum gamma-glutamyl transferase (γGT) activity is a true marker of atherosclerotic cardiovascular disease (CVD) and is of a prognostic importance as well as the high-sensitivity C-reactive protein (hs-CRP). Objectives. In the study, we sought to evaluate serum γGT activity, hs-CRP and insulin resistance in patients with MS. Methods. The study involved 50 persons with metabolic syndrome and 50 healthy age and sex matched controls. Fasting serum samples of all participants were investigated for γGT, hs-CRP, insulin, blood glucose, lipid profile and liver function tests. Anthropometric measurements and BMI were also calculated Results. In that case 50% showed significantly high γGT compared to the controls, 30% proved increased hs-CRP levels above >0.5 mmol/L, whereas 94% of the controls were within the reference range. 74% of cases revealed the presence of insulin resistance while 32% of the controls showed insulin resistance. High γGT levels were also observed in that case with deranged lipids levels and high BMI. Conclusions. The study suggests that the patients with MS have a higher serum γGT activity. This study also proves that hs-CRP and HOMA-IR, which are independent risk factors of CVD, are also associated with MS. The correlation between γGT and the components of MS are also found significant compared to hs-CRP. Thus, γGT can be considered as an inexpensive and authentic predictor of MS, which can be a manifestation of CVD in near future.

In this study, it is aimed to estimate not just the uncertainty measurement for the parameters of glucose and insulin having role when calculating HOMA-IR, but also true positiveness and negativeness in terms of cut-off values. The evaluation of the acceptability of the uncertainty value was also among the goals of the study. The uncertainty measurement for glucose and insulin is calculated as uncertainty measurement of HOMA-IR based on Eurochem/CITAC Guide CG 4. The uncertainty measurement for glucose and insulin was estimated as 3.83% and 4.16%, respectively. The measurement uncertainty for the calculated test HOMA-IR was calculated with cut-off values as 27% (0.27). Based on the cut-off value for HOMA-IR of 2.5%, IR(+) and IR(-) patients were 155 and 265, respectively. If the uncertainty measurement for HOMA-IR was added to its calculation, the cut-off value was detected as 2.23-2.77%. We reported the measurement uncertainty of the calculated test HOMA-IR at 95 % CI as 0.27 between 2.23 - 2.77. Especially for the tests used for screening; determination of cut-off values as a range including measurement uncertainty instead of a single value will be more suitable. No data is found in the literature for the calculated test HOMA-IR up to date. [Med-Science 2019; 8(1.000): 32-6]

Our purpose is to study the evolution of mitochondrially derived peptides (MDPs) and their relationship with changes in insulin sensitivity from the early stages of pregnancy in a cohort of pregnant women with and without gestational diabetes (GDM). MDPs (humanin and MOTSc) were assessed in the first and second trimesters of gestation in 28 pregnant women with gestational diabetes mellitus (GDM) and a subgroup of 45 pregnant women without GDM matched by BMI, age, previous gestations, and time of sampling. Insulin resistance (IR) was defined as a HOMA-IR index ≥70th percentile. We observed a significant reduction in both humanin and MOTSc levels from the first to the second trimesters of pregnancy. After adjusting for predefined variables, including BMI, statistically nonsignificant associations between lower levels of humanin and the occurrence of a high HOMA-IR index were obtained (adjusted OR = 2.63 and 3.14 for the first and second trimesters, linear p-trend 0.260 and 0.175, respectively). Regarding MOTSc, an association was found only for the second trimester: adjusted OR = 7.68 (95% CI 1.49–39.67), linear p-trend = 0.012. No significant associations were observed in humanin change with insulin resistance throughout pregnancy, but changes in MOTSc levels were significantly associated with HOMA-IR index: adjusted OR 3.73 (95% CI 1.03–13.50). In conclusion, MOTSc levels, especially a strong decrease from the first to second trimester of gestation, may be involved in increasing insulin resistance during early gestation.

Objective: This study aimed to compare obesity, insulin sensitivity, clinical, and metabolic parameters between CPP and age-matched control girls, with or without obese girls and to determine correlations between these factors. Methods: CPP and control girls were recruited and were allocated into obese and non-obese groups. There were 3 groups of comparison including non-obese control girls (n=29), non-obese CPP girls (n=20), and obese CPP girls (n=6), because obese controls could not be recruited. Results: Body mass index (BMI), body weight, and height percentiles were higher in obese CPP and non-obese CPP girls compared to control girls. Lipid profiles, glucose, insulin, the homeostasis model assessment-estimated insulin resistance (HOMA-IR), and the quantitative insulin sensitivity check index (QUICKI) were not different between all groups. Insulin and the HOMA-IR were positively but the QUICKI was negatively correlated with metabolic and anthropometric parameters mainly in the control group, while these parameters were significantly correlated with LH and FSH in the CPP group. From multivariate regression, insulin and the HOMA-IR were associated with reproductive indices in CPP and with fat mass in controls. Conclusion: Insulin sensitivity and insulin resistance were related to metabolic factors in prepubertal stage, but were more associated with the reproductive status during pubertal advancement.

Objective(s): Diabetes is a metabolic syndrome which is associated with the worldwide major public health problems. There are many natural compounds from the sea-market, as a valuable aquatic source, along with the variety of health and therapeutic benefits. In the present research, with respect to the traditional and ethnic uses of Sargassum oligocystum algae for healing of some diseases which have similar metabolic mechanism to the diabetes, its anti-diabetic effects in animal model was proposed. Materials and Methods: The animals (rat) were divided into the normal control, diabetic control, positive control and, the test groups. The test groups were gavaged with oral doses of 150 and 300 mg/kg of algae hydroalcoholic extracts. After 30 days of intervention the serum glucose, cholesterol, triglyceride, HDLC, LDLC, insulin, insulin resistance, β-cells function and, the histopathology of pancreatic tissue were evaluated. Results: In animals that were fed with algae extracts a significant decrease in the fasting blood glucose, triglyceride and HOMA-IR and an increase in the HOMA-B with no significant impacts on the insulin, cholesterol and HDL were observed. Also, the histopathology evaluations in the groups which were treated with algae extract revealed the regeneration and reconstitution of damaged pancreatic β-cells. Conclusion: The results give evidence that, the S. oligocystum algae extract has a healing effect on diabetes which can be considered as a new research prospect for the natural therapy of diabetes.

Abstract Background Polycystic ovarian syndrome (PCOS) is known to be one of the most prevalent endocrine disorders affecting reproductive age women. One of the endocrine disorder is hyperinsulinemia, which corresponds with the severity of PCOS. However, the pathogenesis of PCOS is not fully understood, but one theory of anti-mullerian hormone (AMH) has been proposed as one of the factor related to the degree of severity of PCOS. However, there are no clear correlation between levels of AMH with the incidence of insulin resistance in PCOS patients especially in Indonesia. Methods This is a cross-sectional study involving reproductive age women aged 18–35 years. Subjects were recruited consecutively at Dr. Cipto Mangunkusumo General Hospital between 2011 until 2014. PCOS women diagnosed using 2003 Rotterdam criteria were categorized into four different PCOS phenotypes. Subsequently, serum level of AMH and HOMA-IR was measured and evaluated with correlation tests performed using SPSS 11.0 Results A total of 125 PCOS patients were included in a study conducted within a 3-year period. Phenotype 1 (anovulation, hyperandrogenism, and polycystic ovaries) shows the highest levels of AMH and HOMA-IR, which decreases in accordance to severity level (p

To verify the accuracy of different indices of glucose homeostasis in recognizing the metabolic syndrome in a group of adult patients with Prader–Willi syndrome (PWS), 102 PWS patients (53 females/49 males), age ±SD 26.9 ± 7.6 yrs, Body Mass Index (BMI) 35.7 ± 10.7, were studied. The following indices were assessed in each subject during an oral glucose tolerance test (OGTT): 1 h (>155 mg/dL) and 2 h (140–199 mg/dL) glucose levels, the oral disposition index (ODI), the insulinogenic index (IGI), the insulin resistance (HOMA-IR) were evaluated at baseline, 1 h and 2 h. Although minor differences among indices were found, according to the ROC analysis, no index performed better in recognizing MetS. Furthermore, the diagnostic threshold levels changed over the years and therefore the age-related thresholds were calculated. The easily calculated HOMA-IR at baseline may be used to accurately diagnose MetS, thus avoiding more complicated procedures.

Resistensi insulin sangat penting pada diabetes melitus sebagai prediktor yang kuat terhadap perkembangan diabetes melitus dan target terapi saat hiperglikemia sudah terjadi. HOMA-IR merupakan suatu metode yang telah tervalidasi dalam menilai resistensi insulin pada pasien diabetes melitus. Puguntano suatu tanaman budidaya yang terdapat di Sumatra Utara diketahui memiliki efek antidiabetes. Sampel diambil dari tahun 2015-2016 di Rumah Sakit Haji Adam Malik Medan. Studi ini mencoba menilai pengaruh puguntano sebagai tanaman budidaya di Sumatera Utara terhadap resistensi insulin pada pasien Diabetes Melitus tipe 2. Untuk mengetahui pengaruh pemberian serbuk puguntano terhadap HOMA-IR pada pasien DM tipe 2 yang baru didiagnosis. Dilakukan uji klinis terbuka dengan desain paralel selama 12 minggu pada 24 pasien (12 pasien dan 12 kontrol) Diabetes Mellitus tipe 2 yang baru terdiagnosa yang dibagi dalam 2 grup masing-masing diberikan puguntano dan metformin selama 12 minggu. HOMA-IR dan HbA1c diperiksa pada awal dan akhir pengobatan (minggu ke 12). Didapatkan penurunan HOMA-IR rata-rata pada grup puguntano 1,71 (±2,29) (p=0,034). Tidak didapatkan perbedaan penurunan HOMA-IR rata-rata antara kedua grup puguntano vs metformin 1.71 (±2,29) vs 0,80 (±1,47) (p=0,402). Didapatkan penurunan nilai HOMA-IR dengan pemberian puguntano pada penderita Diabetes Mellitus tipe 2 yang baru didiagnosis. Simpulan, efek puguntano dalam mengontrol gula darah terutama dalam perannya memperbaiki sensitifitas insulin tidak jauh berbeda dengan metformin yang telah menjadi obat standar dalam pengobatan lini pertama diabetes melitus tipe 2.

Self surrender practice (latihanpasrahdiri/LPD) is a form of relaxation therapy that has been increasingly used, not only in the treatment of psychosomatic diseases, but also of other non-psychosomatic diseases. Previous studies reported thatSSP shows modest improvement on clinical parameters of type 2diabetes mellitus(T2DM) patients,not onlydepression symptoms improvement, but also glycemic control.However, the effect of LPD on insulin resistance has not been investigated. The study aimed to investigate the effect of LPD on insulin resistance in T2DM patients without depression. This was a single-blinded, randomized, controlledtrial conducted in outpatient unit of the Department of Internal Medicine, Dr. Soeradji Tirtonegoro General Hospital, Klaten, Central Java.The subjects of the study were T2DM patients aged over 30 yearsand had no depression.Fourthy-four T2DM patients were randomized into two groups as the controlgroup and the treatment group who underwent SSP group for eight weeks. The data of insulin resistancemeasured by HOMA-IR, perceived stress scale (PSS), fasting plasma glucose (FBG), HbA1c, and two hour plasma glucose (PPG)levels of both groups werecollected and statistically analysed.No significantly different in the patient’scharacteristics of both groups was observed.At the end of the study period, the LPD group showed reduction of HOMA-IR and HbA1c but not statistically significant, (ΔHOMA-IR = -0.39±1.52; p = 0.976; HbA1c=-0.55±0.85%; p = 0.189). The FBG and PPGincreased in the LPD group compared to control but also not statistically significant (ΔFBG=10.16±50.33; p=0.294; PPG=40.74±69.35; p=0.062). We also observed the decrease of stress level in LPD group compared to control groupbut it was no statistical significance (ΔPSS=-5.09±6.47; p=0.655).Self surrender practice (LPD) decreasesHOMA-IR, improves glycemic control (HbA1c) and reduces stress levels in T2DM patients without depressionAlthough the theyarenot statisticallysignificant, however they may be clinically significant.