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INTRODUCTION: Polycystic ovarian syndrome (PCOS) is the utmost prevailing, complex endocrinopathy of reproductive-aged women and one of the fundamental reasons for female infertility. It has been acclaimed as a metabolic syndrome variant in women and comprises a crucial segment of the female population at risk of cardiovascular diseases and type 2 diabetes mellitus. Vitamin D deficiency is connected with deleterious metabolic outcomes in PCOS and may be responsible for exacerbating PCOS symptoms. This hormonal deficiency is linked with insulin resistance (IR), adiposity, impaired glucose and lipid metabolism, and systemic pro-inflammatory milieu in PCOS women. Ferritin, a regulator of iron homeostasis, is linked with IR and obesity. There is an absolute interrelation of even slightly raised body iron stores with aggravated risk of IR, diabetes, cardiovascular events, and metabolic syndrome in PCOS. AIMS: This study was designed to assess and compare Vitamin D and ferritin status in PCOS and control group women. We also aimed to analyze the association of Vitamin D and body iron stores with IR and adiposity in PCOS women. MATERIAL AND METHODS: Women with a diagnosis of PCOS, between 18 and 40 years of age, were recruited and compared with healthy controls. Baseline information was obtained from all the participants, and biochemical parameters such as Vitamin D and ferritin were analyzed. RESULTS: This study demonstrated that women with PCOS have significantly decreased Vitamin D levels compared to controls. A compromised Vitamin D status in PCOS women is associated with higher IR, body mass index (BMI), waist/hip ratio, and lipid accumulation product (LAP). PCOS women showed increased serum ferritin concentration that correlated with IR and BMI. CONCLUSION: An inadequate Vitamin D and raised ferritin status in PCOS women are associated with IR and adiposity. These biochemical markers might be the hallmark of metabolic aberrations in PCOS and their assessment would be worthwhile for evaluating cardiovascular and diabetes risks in these women. Furthermore, the correlation of the LAP index with the IR index suggests that obesity has a strong impact on IR.

IntroductionHIV infection is associated with insulin resistance and dyslipidaemia driven by HIV-associated immune dysregulation and antiretroviral therapy (ART). Children living with perinatally acquired HIV (CHIV) face many decades of exposure to these factors. We evaluated the longitudinal trajectory of insulin resistance and dyslipidaemia in CHIV and HIV-exposed uninfected children (CHEU), compared with children HIV-unexposed (CHU).MethodsFour hundred and eighty-five children (141 CHIV, 169 CHEU, 175 CHU) aged 5-16 years, previously part of CHER and P1060 trials, were followed annually at Tygerberg Children's Hospital, South Africa. The primary outcome was Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). Secondary outcomes included low-density lipoprotein (LDL) cholesterol, triglyceride-to-HDL ratio, android fat mass and SBP. Outcomes were evaluated using linear mixed effects models, adjusting for potential confounders.ResultsCHIV had 73% greater HOMA-IR than CHU in ages 6-8 years (95% CI 15.9-158.2%, P

BackgroundObesity and cardiometabolic dysfunction have been associated with cancer risk and severity. Underlying mechanisms remain unclear.ObjectivesThe aim of this study was to examine associations of obesity and related cardiometabolic traits with incident cancer.MethodsFHS (Framingham Heart Study) and PREVEND (Prevention of Renal and Vascular End-Stage Disease) study participants without prevalent cancer were studied, examining associations of obesity, body mass index (BMI), waist circumference, visceral adipose tissue (VAT) and subcutaneous adipose tissue depots, and C-reactive protein (CRP) with future cancer in Cox models.ResultsAmong 20,667 participants (mean age 50 years, 53% women), 2,619 cancer events were observed over a median follow-up duration of 15 years. Obesity was associated with increased risk for future gastrointestinal (HR: 1.30; 95% CI: 1.05-1.60), gynecologic (HR: 1.62; 95% CI: 1.08-2.45), and breast (HR: 1.32; 95% CI: 1.05-1.66) cancer and lower risk for lung cancer (HR: 0.62; 95% CI: 0.44-0.87). Similarly, waist circumference was associated with increased risk for overall, gastrointestinal, and gynecologic but not lung cancer. VAT but not subcutaneous adipose tissue was associated with risk for overall cancer (HR: 1.22; 95% CI: 1.05-1.43), lung cancer (HR: 1.92; 95% CI: 1.01-3.66), and melanoma (HR: 1.56; 95% CI: 1.02-2.38) independent of BMI. Last, higher CRP levels were associated with higher risk for overall, colorectal, and lung cancer (P < 0.05 for all).ConclusionsObesity and abdominal adiposity are associated with future risk for specific cancers (eg, gastrointestinal, gynecologic). Although obesity was associated with lower risk for lung cancer, greater VAT and CRP were associated with higher lung cancer risk after adjusting for BMI.

INTRODUCTION: Obesity, which is defined as excessive and abnormal accumulation of adipose tissue, can lead to various systemic diseases beyond the deterioration of the quality of life of individuals. In this study, we aimed to compare the biochemical parameters, the presence of hepatosteatosis, non-invasive liver fibrous scores (NAFLD), and common carotid artery (CCA) media thickness in metabolically healthy obese (MHO) and metabolically unhealthy obese (MUHO). METHODS: Charts of patients who were admitted to the internal medicine outpatient clinic between June 2018 and June 2019 were retrospectively evaluated. Patients with body mass index ≥30 kg/m2 were evaluated for inclusion in the study. Participants were divided into two groups as MHO and MUHO, according to the Third National Health and Nutrition Examination Survey III criteria. The presence of liver fibrosis was calculated using NAFLD fibrosis score (NFS) and Fib-4 score. Patients categorized as MHO and MUHO were compared according to demographic characteristics, biochemical parameters, and radiological findings. RESULTS: Totally, 123 obese patients were enrolled into the study, and 95 patients were classified as MUHO. CCA was measured as 0.6 mm in MHO and 0.7 mm in MHUO, and the difference was statically significant in favor of MHO (p

Introduction: Obesity is one of the leading causes of morbidity and mortality due to associated risk factors, including Type 2 Diabetes Mellitus (T2DM). Obese and diabetic patients have lower amounts of adiponectin. Leptin, a hormone released by adipocytes that controls hunger, is crucial in the emergence of obesity. Furthermore, it has been claimed that the Adiponectin/ Leptin Ratio (ALR) correlates with Insulin Resistance (IR) better than adiponectin or leptin alone. Aim: To evaluate adiponectin, leptin, and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) in obese subjects with and without T2DM and compare the variations, if any, from the normal subjects. Materials and Methods: This hospital-based, cross-sectional study was carried out at Sri Guru Ram Das (SGRD) University of Health Sciences, Amritsar, and Punjab Institute of Medical Sciences (PIMS), Jalandhar from January 2020 to December 2022. A total of 125 subjects of either gender aged above 18 years, visiting the medicine Outpatient Department (OPD) of PIMS, Jalandhar, were included in the study. Among them, 25 healthy volunteers served as controls. Serum levels of Adiponectin, Leptin, and Insulin were estimated using the Enzyme-Linked Immunosorbent Assay (ELISA) method. The data obtained were statistically analysed using one-way Analysis of Variance (ANOVA) test (with Bonferroni post-hoc). Results: A total of 125 participants were analysed in the present study, with 50 being obese with T2DM (mean age: 50.22±8.6 years), 50 being obese without T2DM (mean age: 46.9±9.8 years), and 25 being non obese non diabetic individuals (controls) (mean age: 42.8±9.09 years). A higher number of females 78 (62.4%) reported to the OPD compared to males 47 (37.6%). Although no statistical significance was found, there was a considerable decrease in adiponectin levels in obese and obese with T2DM subjects. Moreover, the leptin levels and HOMA-IR were increased in obese and obese with T2DM subjects compared to the control subjects. Conclusion: ALR may be used as a clinical marker for assessing the morbidity due to obesity and in T2DM subjects. Moreover, lifestyle modifications can be targeted to prevent IR.

Abstract Background The triglyceride glucose (TyG) index, a metric for estimating insulin resistance (IR), is linked with cardiovascular disease (CVD) morbidity and mortality among the population regardless of diabetic status. However, IR prevalence and the association between the TyG index and heart failure (HF) in Americans is unclear. Methods The Nation Health and Nutrition Examination Survey (NHANES) (2009–2018) dataset was used. IR was defined by homeostatic model assessment of insulin resistance (HOMA-IR) > 2.0 and 1.5. The TyG index was calculated as Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. A weighted logistic regression was applied to evaluate the association between the TyG index and the prevalence of HF. Results This study comprised 12,388 people, including 322 (2.6%) individuals with HF. The average prevalence of IR was found to be 13.9% and 22.7% for cutoff values greater than 2.0 and 1.5, respectively. HOMA-IR and the TyG index showed a moderate correlation (r = 0.30). There is a significant positive association between the TyG index and HF prevalence (per 1-unit increment; adjusted OR [aOR]: 1.34; 95% confidence interval [CI]: 1.02–1.76). Patients with higher TyG values were associated with a prevalence of HF (OR:1.41; 95% CI: 1.01,1.95) (quartiles 4 vs 1–3). The TyG index is associated with a higher prevalence of dyslipidemia, coronary heart disease, and hypertension but not a stroke (cerebrovascular disease). Conclusions Our results show that IR does not considerably increase from 2008 to 2018 in American adults. A moderate correlation is noted between HOMA-IR and the TyG index. TyG index is associated with the prevalence of HF, as were other cardiovascular diseases.

Background: Unexplained recurrent pregnancy loss (RPL) accounts for >50% of the patients with RPL. Insulin resistance (IR) is a potential cause of unexplained RPL. Objectives: To evaluate the relationship between insulin resistance (IR) and unexplained RPL among Saudi women. Methods: This is a single-center, case–control study conducted at a tertiary hospital in the Eastern Province of Saudi Arabia. The study group comprised Saudi women with unexplained RPL, while the control group had Saudi women with at least one live birth and no RPL. Blood samples were taken to determine the fasting glucose (FG) and fasting insulin (FI) levels. Women with diabetes mellitus and polycystic ovarian syndrome were excluded. A homeostatic model assessment of insulin resistance index (HOMA-IR) value ≥3 was considered as IR. Results: The study and control groups comprised 43 and 56 women, respectively. Between the groups, there was a significant difference in the mean age (case: 37.9 ± 5.4 years; control: 32.2 ± 5.9 years; P ˂ 0.0001) and the mean BMI (case: 31.5 ± 6.0; control: 26.1 ± 2.8; P ˂ 0.0001). FG level was slightly higher in the control group (90.9 mg/dL vs 88.7 mg/dL; P = 0.068). FI level was significantly higher in the study group (16.33 μU/mL vs. 6.17 μU/mL; P ˂ 0.0001). HOMA-IR of ≥3 was significantly more common in the study group (n = 22; 51.2%) than the control group (4; 7.1%) (P < 0.0001). After adjusting for age and BMI, IR ≥3 was found to be independently associated with unexplained RPL (aOR: 13.2; 95% CI: 3.77–46.36). Conclusions: This study showed that Saudi women with unexplained RPL had significantly higher levels of fasting insulin and insulin resistance than those without a history of RPL. Therefore, it is recommended to assess IR in women with RPL. [ABSTRACT FROM AUTHOR]

Introduction: Obesity is one of the leading causes of morbidity and mortality due to associated risk factors, including Type 2 Diabetes Mellitus (T2DM). Obese and diabetic patients have lower amounts of adiponectin. Leptin, a hormone released by adipocytes that controls hunger, is crucial in the emergence of obesity. Furthermore, it has been claimed that the Adiponectin/ Leptin Ratio (ALR) correlates with Insulin Resistance (IR) better than adiponectin or leptin alone. Aim: To evaluate adiponectin, leptin, and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) in obese subjects with and without T2DM and compare the variations, if any, from the normal subjects. Materials and Methods: This hospital-based, cross-sectional study was carried out at Sri Guru Ram Das (SGRD) University of Health Sciences, Amritsar, and Punjab Institute of Medical Sciences (PIMS), Jalandhar from January 2020 to December 2022. A total of 125 subjects of either gender aged above 18 years, visiting the medicine Outpatient Department (OPD) of PIMS, Jalandhar, were included in the study. Among them, 25 healthy volunteers served as controls. Serum levels of Adiponectin, Leptin, and Insulin were estimated using the Enzyme-Linked Immunosorbent Assay (ELISA) method. The data obtained were statistically analysed using one-way Analysis of Variance (ANOVA) test (with Bonferroni post-hoc). Results: A total of 125 participants were analysed in the present study, with 50 being obese with T2DM (mean age: 50.22±8.6 years), 50 being obese without T2DM (mean age: 46.9±9.8 years), and 25 being non obese non diabetic individuals (controls) (mean age: 42.8±9.09 years). A higher number of females 78 (62.4%) reported to the OPD compared to males 47 (37.6%). Although no statistical significance was found, there was a considerable decrease in adiponectin levels in obese and obese with T2DM subjects. Moreover, the leptin levels and HOMA-IR were increased in obese and obese with T2DM subjects compared to the control subjects. Conclusion: ALR may be used as a clinical marker for assessing the morbidity due to obesity and in T2DM subjects. Moreover, lifestyle modifications can be targeted to prevent IR. [ABSTRACT FROM AUTHOR]

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Background: The triglyceride glucose (TyG) index, a metric for estimating insulin resistance (IR), is linked with cardiovascular disease (CVD) morbidity and mortality among the population regardless of diabetic status. However, IR prevalence and the association between the TyG index and heart failure (HF) in Americans is unclear. Methods: The Nation Health and Nutrition Examination Survey (NHANES) (2009–2018) dataset was used. IR was defined by homeostatic model assessment of insulin resistance (HOMA-IR) > 2.0 and 1.5. The TyG index was calculated as Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. A weighted logistic regression was applied to evaluate the association between the TyG index and the prevalence of HF. Results: This study comprised 12,388 people, including 322 (2.6%) individuals with HF. The average prevalence of IR was found to be 13.9% and 22.7% for cutoff values greater than 2.0 and 1.5, respectively. HOMA-IR and the TyG index showed a moderate correlation (r = 0.30). There is a significant positive association between the TyG index and HF prevalence (per 1-unit increment; adjusted OR [aOR]: 1.34; 95% confidence interval [CI]: 1.02–1.76). Patients with higher TyG values were associated with a prevalence of HF (OR:1.41; 95% CI: 1.01,1.95) (quartiles 4 vs 1–3). The TyG index is associated with a higher prevalence of dyslipidemia, coronary heart disease, and hypertension but not a stroke (cerebrovascular disease). Conclusions: Our results show that IR does not considerably increase from 2008 to 2018 in American adults. A moderate correlation is noted between HOMA-IR and the TyG index. TyG index is associated with the prevalence of HF, as were other cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Background: Unexplained recurrent pregnancy loss (RPL) accounts for >50% of the patients with RPL. Insulin resistance (IR) is a potential cause of unexplained RPL. Objectives: To evaluate the relationship between insulin resistance (IR) and unexplained RPL among Saudi women. Methods: This is a single-center, case–control study conducted at a tertiary hospital in the Eastern Province of Saudi Arabia. The study group comprised Saudi women with unexplained RPL, while the control group had Saudi women with at least one live birth and no RPL. Blood samples were taken to determine the fasting glucose (FG) and fasting insulin (FI) levels. Women with diabetes mellitus and polycystic ovarian syndrome were excluded. A homeostatic model assessment of insulin resistance index (HOMA-IR) value ≥3 was considered as IR. Results: The study and control groups comprised 43 and 56 women, respectively. Between the groups, there was a significant difference in the mean age (case: 37.9 ± 5.4 years; control: 32.2 ± 5.9 years; P ˂ 0.0001) and the mean BMI (case: 31.5 ± 6.0; control: 26.1 ± 2.8; P ˂ 0.0001). FG level was slightly higher in the control group (90.9 mg/dL vs 88.7 mg/dL; P = 0.068). FI level was significantly higher in the study group (16.33 μU/mL vs. 6.17 μU/mL; P ˂ 0.0001). HOMA-IR of ≥3 was significantly more common in the study group (n = 22; 51.2%) than the control group (4; 7.1%) (P < 0.0001). After adjusting for age and BMI, IR ≥3 was found to be independently associated with unexplained RPL (aOR: 13.2; 95% CI: 3.77–46.36). Conclusions: This study showed that Saudi women with unexplained RPL had significantly higher levels of fasting insulin and insulin resistance than those without a history of RPL. Therefore, it is recommended to assess IR in women with RPL.

Introduction: H.pylori is the most common infection leading to gastrointestinal and extra-gastrointestinal lesions. Few studies had studied about H.pylori's effect on glucose metabolism and insulin resistance and found that H.pylori is associated with increase in mean Glycated Haemoglobin (HbA1c) levels and insulin resistance. But few studies have found no association between H.pylori and glucose metabolism. Aim: To determine the relationship between H.pylori infection and glucose metabolism profiles in dyspeptic patients, based on the histopathological examination. Materials and Methods: This prospective case-control study was carried out in the Department of Pathology at SRM Medical College Hospital and Research Centre from April 2021 to September 2021 on 70 dyspeptic patients. They were split into two groups: H.pylori positive (Group-I, n=35) and H.pylori negative (Group-II, n=35) groups. The age and gender of Group-I were matched with Group-II. Endoscopic gastric biopsy was taken and tissue sections were stained with Haematoxylin and Eosin (H&E), and Immunohistochemical (IHC) stain using H.pylori (Clone: EP279) rabbit monoclonal antibody. Blood samples were collected to test Fasting Blood Glucose (FBG) and insulin. Insulin resistance was calculated using Homeostatic Model Assessment of Insulin Resistance (HOMAIR). Histomorphological changes and H.pylori colonisation were graded according to Updated Sydney System and correlated with HOMA-IR levels. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) software version 22.0. Results: There was no significant variation between H.pylori positive and negative groups in demographic variables such as age (p-value=0.45) and gender (p-value=0.23). Body Mass Index (BMI) and H.pylori infection showed statistically significant association (p-value=0.04). Increase in mean values of FBG, insulin and HOMA-IR were statistically associated with H.pylori positive (p-value<0.05). Degree of H.pylori bacterial density (rs=0.2992), chronic inflammation (rs=0.3193), activity (rs=0.4576) and atrophy (rs=0.2542) were positively correlated with HOMA-IR. Conclusion: This study showed that chronic active gastritis with atrophic related changes and H.pylori colonisation were significantly correlated with HOMA-IR. Patients with H.pylori induced gastritis should be followed with regular monitoring of HOMA-IR; as early diagnosis and eradication of H.pylori might reduce the risk of insulin resistance and glucose metabolism dysregulation. [ABSTRACT FROM AUTHOR]

Background: Studies found a link between visceral obesity and insulin resistance (IR). Numerous attempts made to discover a link between fat lipotoxicity and IR by measuring waist circumference (WC) or body mass index (BMI). This study investigates the relationship between body adiposity index [BAI], a body shape index [ABSI], BMI, waist-to-hip ratio [WHR], TGI-WC = Triglyceride glucose index-× WC, and TGI-BMI = Triglyceride glucose index-BMI. Homeostatic model assessment of IR (HOMA-IR) is utilized to examine the significance of those indices in the target population with obesity-linked IR in Iraq. Objective: The aim is to identify the most relevant obesity index by examining the relationship between multiple obesity indices and IR in obese healthy individuals. Design and Methods: 100 obese and nonobese patients' height, weight, and hip circumference were taken. Triglycerides (TGs), glycated hemoglobin (HbA1c), serum insulin, and fasting plasma glucose were obtained to calculate HOMA-IR, TGI-WC, and TGI-BMI. Results: Healthy adults 18-50 years were divided (obese and not-obese), clinical features were averaged, and standard errors of the mean calculated. Results for the first obese group were blood pressure [BP] = 114 ± 2/75 ± 9, HbA1c=5.76 ± 0.09, TG = 175.26 ± 3.66, fasting blood glucose [FBG] = 111.84 ± 1.57, WC = 106.62 ± 1.68, BMI = 32.02 ± 0.69, while those for the second group were BP = 111 ± 8/70 ± 6, HbA1c = 4.41 ± 0.06, TG = 96.36 ± 2.02, FBG = 82.40 ± 1.48, WC = 83.76 ± 0.85, and BMI = 22.84 ± 0.22. The relationships between obesity indices were analyzed with HOMA-IR being judged to be IR when it acquired a score value of = 2. The Pearson's correlation coefficient® used to represent was WHR: r = 0.58, P = 0.0001, ABSI: r = 0.44, P = 0.04, BAI: r = 0.50, P = 0.02, TGI-WC: r = 0.89, P = 0.0001, and TGI-BMI: r = 0.74, P = 0.74. Conclusion: All of the obesity and lipid-related indices investigated were positively correlated with IR. The use of TGI-WC is recommended since it is straightforward to calculate using accessible laboratory tests; it showed the highest (Pearson's) coefficient (r = 0.89; P = 0.0001). [ABSTRACT FROM AUTHOR]

Objective: To assess correlation between serum adiponectin levels and insulin resistance in patients with Polycystic ovary syndrome. Study Design: Comparative Cross-Sectional study. Place and Duration of Study: PNS Hafeez Hospital, Islamabad Pakistan, and Multidisciplinary Lab-I, Department of Biochemistry, Army Medical College Rawalpindi, Pakistan from Feb 2018 to Jan 2019. Methodology: Three groups (35 females each) were formed from selected one hundred and five females (puberty till 25 years) who had Polycystic ovary syndrome. After overnight fast, blood samples were collected to measure serum levels of insulin and adiponectin. Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was used to calculate insulin resistance. Results: The over-weight PCOS subgroup displayed lowest serum adiponectin level (8.73±2.13 mg/L; 13.87±3.60 mg/L in normal weight PCOS and 15.09±3.07 mg/L in controls). There was statistical significance of serum Fasting Blood Glucose (mmol/L, p=0.002), serum Insulin (mIU/L; p=0.003) andserum Adiponectin levels (mg/L; p<0.001) and HOMA-IR (p<0.001) among three groups. The over-weight PCOS subgroup presented with highest HOMA-IR (1.71±0.19; 1.35±0.25 in normal weight PCOS subgroup and 1.12±0.26 in controls). There is negative correlation between serum adiponectin and HOMA-IR with r=-0.46. Conclusion: In PCOS-affected females, HOMA-IR correlates inversely with serum adiponectin levels, signifying that abdominal adiposity indirectly favors insulin resistance in PCOS through decrease in adiponectin secretion. Serum adiponectin level is negatively associated with severity of IR in PCOS. [ABSTRACT FROM AUTHOR]

Introduction: H.pylori is the most common infection leading to gastrointestinal and extra-gastrointestinal lesions. Few studies had studied about H.pylori’s effect on glucose metabolism and insulin resistance and found that H.pylori is associated with increase in mean Glycated Haemoglobin (HbA1c) levels and insulin resistance. But few studies have found no association between H.pylori and glucose metabolism. Aim: To determine the relationship between H.pylori infection and glucose metabolism profiles in dyspeptic patients, based on the histopathological examination. Materials and Methods: This prospective case-control study was carried out in the Department of Pathology at SRM Medical College Hospital and Research Centre from April 2021 to September 2021 on 70 dyspeptic patients. They were split into two groups: H.pylori positive (Group-I, n=35) and H.pylori negative (Group-II, n=35) groups. The age and gender of Group-I were matched with Group-II. Endoscopic gastric biopsy was taken and tissue sections were stained with Haematoxylin and Eosin (H&E), and Immunohistochemical (IHC) stain using H.pylori (Clone: EP279) rabbit monoclonal antibody. Blood samples were collected to test Fasting Blood Glucose (FBG) and insulin. Insulin resistance was calculated using Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). Histomorphological changes and H.pylori colonisation were graded according to Updated Sydney System and correlated with HOMA-IR levels. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) software version 22.0. Results: There was no significant variation between H.pylori positive and negative groups in demographic variables such as age (p-value=0.45) and gender (p-value=0.23). Body Mass Index (BMI) and H.pylori infection showed statistically significant association (p-value=0.04). Increase in mean values of FBG, insulin and HOMA-IR were statistically associated with H.pylori positive (p-value

Aim: The present investigation was designed to test the association between leukocyte telomere length (LTL) and two simple markers of insulin resistance, that is, homeostatic model assessment of insulin resistance (HOMA-IR) and triglyceride-glucose (TyG) index in U.S. adults without metabolic diseases. Methods: A total of 6489 U.S. adults without diabetes from NHANES 1999–2002 were analyzed. TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. HOMA-Index was calculated as fasting plasma glucose (mmol/L) × fasting serum insulin (mU/mL)/22.5. LTL was obtained using the quantitative polymerase chain reaction method. Multivariate linear regression analysis was assessed to evaluate the association of TyG index HOMA-IR with LTL. We further conducted a generalized additive model (GAM) and a fitted smoothing curve with penalized spline method. Results: It was found that the mean LTL was 5796.1 bp in the measured healthy adults. Overall, TyG index was significantly associated with LTL, while HOMA-IR was not. Compared with participants in tertile 1 of the TyG index, the β (95% CI) for those in the second (8.27 to 8.77) and third (≥ 8.77) were -4.31 (95% CI: -48.12~39.49) and -95.98 (95% CI: -145.08~-46.89), respectively. Subjects with TyG index ≥ 8.77 had statistically significant shorter LTL (β = -93.33, 95%CI: -134.33~-52.32), compared with TyG index < 8.77. We further explored a dose-response relation between TyG index by a decile approach [≤ 7.81 (reference), 7.81-8.04, 8.04-8.21, 8.21-8.37, 8.37-8.52, 8.52-8.68, 8.68-8.83, 8.83-9.03, 9.03-9.33, and >9.33] and LTL. Five subgroups (TyG index 7.81-8.04, 8.04-8.21, 8.21-8.37, 8.37-8.52, and 8.52-8.68) did not show significant effect on LTL; while there was a significantly shorter LTL for participants with the TyG index > 8.68, supporting a threshold effect of TyG index on LTL. Conclusions: The results suggested that higher TyG index (> 8.68) was closely related to shorter LTL and the TyG index was better associated with LTL than HOMA-IR. [ABSTRACT FROM AUTHOR]

AimThe present investigation was designed to test the association between leukocyte telomere length (LTL) and two simple markers of insulin resistance, that is, homeostatic model assessment of insulin resistance (HOMA-IR) and triglyceride-glucose (TyG) index in U.S. adults without metabolic diseases.MethodsA total of 6489 U.S. adults without diabetes from NHANES 1999–2002 were analyzed. TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. HOMA-Index was calculated as fasting plasma glucose (mmol/L) × fasting serum insulin (mU/mL)/22.5. LTL was obtained using the quantitative polymerase chain reaction method. Multivariate linear regression analysis was assessed to evaluate the association of TyG index HOMA-IR with LTL. We further conducted a generalized additive model (GAM) and a fitted smoothing curve with penalized spline method.ResultsIt was found that the mean LTL was 5796.1 bp in the measured healthy adults. Overall, TyG index was significantly associated with LTL, while HOMA-IR was not. Compared with participants in tertile 1 of the TyG index, the β (95% CI) for those in the second (8.27 to 8.77) and third (≥ 8.77) were -4.31 (95% CI: -48.12~39.49) and -95.98 (95% CI: -145.08~-46.89), respectively. Subjects with TyG index ≥ 8.77 had statistically significant shorter LTL (β = -93.33, 95%CI: -134.33~-52.32), compared with TyG index < 8.77. We further explored a dose-response relation between TyG index by a decile approach [≤ 7.81 (reference), 7.81-8.04, 8.04-8.21, 8.21-8.37, 8.37-8.52, 8.52-8.68, 8.68-8.83, 8.83-9.03, 9.03-9.33, and >9.33] and LTL. Five subgroups (TyG index 7.81-8.04, 8.04-8.21, 8.21-8.37, 8.37-8.52, and 8.52-8.68) did not show significant effect on LTL; while there was a significantly shorter LTL for participants with the TyG index > 8.68, supporting a threshold effect of TyG index on LTL.ConclusionsThe results suggested that higher TyG index (> 8.68) was closely related to shorter LTL and the TyG index was better associated with LTL than HOMA-IR.

Background: Acne is usually recognized as an adolescent skin disorder, but recently prevalence among adults is increasing. There are not many studies on adult acne in Indian population. Objectives: To study the various clinico-epidemiological factors and assess laboratory investigations for underlying hormonal imbalance in patients with adult acne. Objectives: To study the impact of adult acne on psychological stress and patients quality of life. Materials and Methods: In our prospective observational study, female patients over the age of 25 years presenting with acne in a tertiary care hospital were included. All patients were assessed for hormonal imbalances both clinically and with laboratory investigations. Patients were asked to fill questionnaires to assess stress and impairment in quality of life. Statistical analysis used: Descriptive statistics like percentage ,mean, range were used. Inferential statistics like chi square test was used. The statistical significance was evaluated at 95% confidence level (P

Background : Insulin resistance (IR) is a collective clinical entity that exacerbates metabolic syndrome (MetS). As the gold-standard test to quantify IR involves intravenous insulin loading and repeated blood glucose monitoring, many indices have been developed for IR assessment for convenience. This study tested the ideal cut-off values and clinical utility of IR indices in identifying MetS. Methods : We recruited 150 subjects, 75 MetS patients and 75 healthy controls, then obtained written informed consent to participate in this study. We collected fasting blood samples for glucose and lipid profiles and calculated nineteen indices of IR and insulin secretion using validated formulae. We determined the precision of these IR indices using the area under the curve (AUC) in a receiver operating characteristic analysis. Results : Subjects with MetS have significantly higher IR coupled with lower insulin sensitivity and beta-cell function than controls. Among the surrogate markers of IR tested, the homeostatic model assessment of insulin resistance (HOMA-IR), HOMA-adiponectin (HOMA-AD), triglyceride-glucose (TyG) index, HOMA-1%S (insulin sensitivity), quantitative insulin sensitivity check index (QUICKI), McAuley index, single-point insulin sensitivity estimator (SPISE), and HOMA-2%B (beta-cell function) showed the highest AUC values for detecting MetS. Conclusion : Our study results suggest that the ideal cut-off and AUC values identified for HOMA-IR, HOMA-AD, the TyG index, HOMA-1%S, QUICKI, the McAuley index, SPISE, and HOMA-2%B offer a clinical approach to the early detection and risk stratification for MetS among people in southern India.

The present meta-analysis was conducted to investigate the association between circulating chemerin levels and polycystic ovary syndrome (PCOS) in women. Relevant studies published up to May 2020 were searched from PubMed, Ovid, the Cochrane Library, and Clinical Trial Database. A random effects model was used to measure the strength of association between PCOS and chemerin by using the standardized mean difference (SMD) and 95% confidence interval (CI). All data were analyzed using Stata 12.0 (version 12; Stata-Corp, College Station, TX). The final meta-analysis included eight studies with 15 results including a total of 897 participants (524 patients with PCOS and 373 controls). The circulating chemerin levels were higher in patients with PCOS (random effects SMD = 1.07; 95% CI: 0.55–1.59; p <.001) than in controls. However, considerable heterogeneity across studies was not eliminated in subgroup analyses. The meta-regression analysis further suggested that region is the main source of heterogeneity (p =.001). Our meta-analysis indicated that women with PCOS have significantly higher circulating chemerin levels than in healthy women, indicating that chemerin may be involved in the pathogenesis of PCOS. [ABSTRACT FROM AUTHOR]

Abstract Background Prior studies have shown insulin resistance is associated with reduced cardiac autonomic function measured at rest, but few studies have determined whether insulin resistance is associated with reduced cardiac autonomic function measured during daily activities. Methods We examined older adults without diabetes with 48-h ambulatory electrocardiography (n = 759) in an ancillary study of the Atherosclerosis Risk in Communities Study. Insulin resistance, the exposure, was defined by quartiles for three indexes: 1) the homeostatic model assessment of insulin resistance (HOMA-IR), 2) the triglyceride and glucose index (TyG), and 3) the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C). Low heart rate variability, the outcome, was defined by

Abstract Background Insulin resistance may contribute to aortic stiffening that leads to end-organ damage. We examined the cross-sectional association and prospective association of insulin resistance and aortic stiffness in older adults without diabetes. Methods We analyzed 2571 men and women at Visit 5 (in 2011–2013), and 2350 men and women at repeat examinations from baseline at Visit 1 (in 1987–1989) to Visit 5 (in 2011–2013). Linear regression was used to estimate the difference in aortic stiffness per standard unit of HOMA-IR, TG/HDL-C, and TyG at Visit 5. Linear mixed effects were used to assess if high, as opposed to non-high, aortic stiffness (> 75th percentile) was preceded by a faster annual rate of change in log-HOMA-IR, log-TG/HDL-C, and log-TyG from Visit 1 to Visit 5. Results The mean age of participants was 75 years, 37% (n = 957) were men, and 17% (n = 433) were African American. At Visit 5, higher HOMA-IR, higher TG/HDL-C, and higher TyG were associated with higher aortic stiffness (16 cm/s per SD (95% CI 6, 27), 29 cm/s per SD (95% CI 18, 40), and 32 cm/s per SD (95% CI 22, 42), respectively). From Visit 1 to Visit 5, high aortic stiffness, compared to non-high aortic stiffness, was not preceded by a faster annual rate of change in log-HOMA-IR from baseline to 9 years (0.030 (95% CI 0.024, 0.035) vs. 0.025 (95% CI 0.021, 0.028); p = 0.15) or 9 years onward (0.011 (95% CI 0.007, 0.015) vs. 0.011 (95% CI 0.009, 0.013); p = 0.31); in log-TG/HDL-C from baseline to 9 years (0.019 (95% CI 0.015, 0.024) vs. 0.024 (95% CI 0.022, 0.026); p = 0.06) or 9 years onward (− 0.007 (95% CI − 0.010, − 0.005) vs. − 0.009 (95% CI − 0.010, − 0.007); p = 0.08); or in log-TyG from baseline to 9 years (0.002 (95% CI 0.002, 0.003) vs. 0.003 (95% CI 0.003, 0.003); p = 0.03) or 9 years onward (0 (95% CI 0, 0) vs. 0 (95% CI 0, 0); p = 0.08). Conclusions Among older adults without diabetes, insulin resistance was associated with aortic stiffness, but the putative role of insulin resistance in aortic stiffness over the life course requires further study.

Introduction: Hepatitis C, in addition to liver disease, also causes extrahepatic manifestations in almost 35% of patients, resulting in a spectrum of autoimmune conditions. The prevalence of type 2 diabetes has been reported to be more in these patients. There is a compelling reason to believe this because studies have shown an increased prevalence of hepatitis C virus (HCV) in type 2 diabetes mellitus (DM). The study was conceived to find the prevalence of type 2 DM in HCV-positive patients and its relation to genotype. Materials and Methods: This was a hospital-based case-control study, conducted in the Department of Gastroenterology, Government Medical College Srinagar, Jammu and Kashmir, India. All patients with hepatitis C were enrolled and investigated as per the study design. According to the standard protocol already in vogue, the cases were thoroughly investigated which included all base line investigations, GTT, HbA1c and HOMA-IR. However, majority of the controls were subjected to GTT, HbA1c and homeostatic model assessment of insulin resistance (HOMA-IR) only. Results: Among the cases, the mean age was 45.97 ± 11.982 years; 67.14% had genotype 3 and 32.85% had genotype 1. Cases and controls were compared on the basis of fasting blood sugar levels in three different ranges (≤100 mg%, 101–125 mg%, and ≥126 mg%) and a 2-h GTT at three different levels (

Background: Insulin resistance (IR) is a pre-diabetic condition and has been reported in patients with acanthosis nigricans (AN) and acrochordon. AN and acrochordon are claimed to be cutaneous markers of IR. Aim: The purpose of this paper was to study the association of AN and acrochordon with IR. Methods: It was a cross-sectional hospital-based study. Both groups were assessed for IR by using homeostatic model assessment of insulin resistance (HOMA-IR) formula. Results: A total of 70 cases and an equal number of controls were studied. IR was observed more in cases (41.4%) compared to controls (17.1%) (P < 0.01). Mean HOMA-IR value was also significantly higher in cases (4.32 ± 4.44) compared to controls (2.27 ± 0.90) (P < 0.05). Limitations: Low number of cases and controls were taken in the study. Association with hyperlipidemia and metabolic syndrome was not elicited. Conclusions: AN and acrochordons were found to be associated with IR.

Background: Reduced levels of estrogen have been associated with metabolic alterations and increased insulin resistance (IR) in postmenopausal women, thus predisposing them to cardiometabolic risks. The aim of this study was to assess alterations in parameters of cardiometabolic risk in apparently healthy pre- and post-menopausal women and to study the effect of IR on these metabolic parameters. Methods: A cross-sectional study was conducted on randomly selected apparently healthy women (n = 262). These women were categorized as premenopausal (n = 184) and postmenopausal (n = 78). Anthropometric measurements, blood pressure, lipid profile, fasting glucose, and insulin concentrations were estimated on all the participants using standard protocols. Homeostatic model assessment of IR was computed to estimate the level of IR. Results: Most lipid parameters, blood pressure, waist circumference, and fat percentage were significantly higher (P < 0.05) in postmenopausal women than premenopausal women. On subcategorizing women with respect to IR (3), metabolic parameters (e.g., triglyceride – 104.7 ±53.2 mg/dl, Blood Sugar Level Fasting (BSLF) – 103.3 ± 40.1 mg/dl, and fasting serum insulin – 23 ± 12.3 mIU/L) were also higher (P < 0.001) in premenopausal women having IR >3. Significantly higher low-density lipoprotein (132.7 ± 38.7 mg/dl vs. 114.4 ± 25 mg/dl) and total cholesterol (211.3 ± 40.5 vs. 184.8 ± 29.4 mg/dl) were observed in postmenopausal women with IR >3 (P < 0.05) along with higher BSLF (126.6±54.3 mg/dl**) and fasting insulin levels (22.3 ± 12.1 mIU/L) (P < 0.001). Conclusion: This study reveals that IR may predispose women to increased cardiometabolic risk. Urgent attention needs to be focused toward metabolic health of women.

BACKGROUND: Obesity has been an increasing problem globally, and attempts have been made to identify the best anthropometric predictor of chronic diseases in various populations. Owing to increased cost and methodological complexities, imaging diagnostics has been a challenge in resource constraint settings. Thus, anthropometric markers have been assumed to be a better predictor in this regard. Addressing the dearth of research in this arena from this part of the country, the present study was conducted in regular footballers who were assessed for their anthropometric parameters as a probable risk indicator for type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: This cross-sectional study involved 136 athletes, who were screened for risk factors and assessed for their measures such as height, weight, body circumferences, fat level, skeletal muscle, and skinfold thickness. Baseline laboratory investigations of serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase, fasting glucose, and insulin were done. Homeostatic model assessment of insulin resistance (HOMA-IR) was assessed for all the participants. A 3-day dietary recall history was obtained from all respondents for calculation of total nutrient intake. RESULTS: The mean age of respondents was 13.96 ± 1.91 years. While body mass index was recorded in normal range for 41 participants, 94 were in the "under" range and 1 was overweight. The mean waist, hip, and mid-thigh circumferences were 65.8 cm, 72.15 cm, and 43.86 cm, respectively. HOMA-IR derangement was noted in 11 participants. Increased fasting glucose and SGOT levels were noted in 9 participants, respectively. CONCLUSION: Anthropometric measures may serve as an easy and inexpensive marker for T2DM prediction. However, assessment of its utility across genders and various subgroup populations mandates further research. [ABSTRACT FROM AUTHOR]

Background: Insulin resistance (IR) is a collective clinical entity that exacerbates metabolic syndrome (MetS). As the gold-standard test to quantify IR involves intravenous insulin loading and repeated blood glucose monitoring, many indices have been developed for IR assessment for convenience. This study tested the ideal cut-off values and clinical utility of IR indices in identifying MetS. Methods: We recruited 150 subjects, 75 MetS patients and 75 healthy controls, then obtained written informed consent to participate in this study. We collected fasting blood samples for glucose and lipid profiles and calculated nineteen indices of IR and insulin secretion using validated formulae. We determined the precision of these IR indices using the area under the curve (AUC) in a receiver operating characteristic analysis. Results: Subjects with MetS have significantly higher IR coupled with lower insulin sensitivity and beta-cell function than controls. Among the surrogate markers of IR tested, the homeostatic model assessment of insulin resistance (HOMA-IR), HOMA-adiponectin (HOMA-AD), triglyceride-glucose (TyG) index, HOMA-1%S (insulin sensitivity), quantitative insulin sensitivity check index (QUICKI), McAuley index, single-point insulin sensitivity estimator (SPISE), and HOMA-2%B (beta-cell function) showed the highest AUC values for detecting MetS. Conclusion: Our study results suggest that the ideal cut-off and AUC values identified for HOMA-IR, HOMA-AD, the TyG index, HOMA-1%S, QUICKI, the McAuley index, SPISE, and HOMA-2%B offer a clinical approach to the early detection and risk stratification for MetS among people in southern India. [ABSTRACT FROM AUTHOR]

The study was conducted to comprehensively assess the association of the concentration of vitamin D in the blood and insulin resistance in non-diabetic subjects. The objective was to pool the results from all observational studies from the beginning of 1980 to August 2021. PubMed, Medline and Embase were systematically searched for the observational studies. Filters were used for more focused results. A total of 2248 articles were found after raw search which were narrowed down to 32 articles by the systematic selection of related articles. Homeostatic Model Assessment of Insulin Resistance (HOMAIR) was used as the measure of insulin resistance and correlation coefficient was used as a measure of the relationship between vitamin D levels and the insulin resistance. Risk of bias tables and summary plots were built using Revman software version 5.3 while Comprehensive meta-analysis version 3 was used for the construction of forest plot. The results showed an inverse association between the status of vitamin D and insulin resistance (r = −0.217; 95% CI = −0.161 to −0.272; p = 0.000). A supplement of vitamin D can help reduce the risk of insulin resistance; however further studies, like randomized controlled trials are needed to confirm the results.

Patients with polycystic ovarian syndrome showed hormonal imbalance and hyperandrogenemia because of higher secretion of androgen from theca cells of ovaries and adrenal gland due to excess LH or hyperinsulinemia. Obesity and increase fat mass aid the pathophysiology of PCOS, therefore, Different studies try to find the relationship of PCOS with Vaspin protein, which expressed in visceral adipose tissue resulting in increased insulin sensitivity by different mechanisms. This study is designed to show the effect of metformin treatment on Vaspin levels in newly diagnosed PCOS patients treated by this drug and the association of PCOS hormonal changes with Vaspin level Forty three patients of newly diagnosed PCOS patients are included in the study with no abnormal thyroid or adrenal function, they do not use oral contraceptive or other treatment to treat their PCOS before the study, they agree to start metformin 850 mg twice daily for three months and provide fasting blood sample with measuring BMI, at the second day of menstruation before starting treatment and after completing three months of treatment. FSH, LH, SHBG, total testosterone, insulin, glucose, estradiol are determined by cobas technique, while Vaspin and free testosterone are determined by ELISA technique. Homeostatic model assessment is used to measure insulin resistance (HOMA-IR) is determined according to the following formula: HOMA-IR=(Fasting Insulin multiplied by Fasting glucose)divided by 22.5 It was found that there were no significant changes in BMI, FSH,LH, SHBG, total testosterone, estradiol and vaspin after end of treatment for all patients, but free testosterone and HOMA-IR showed significant decrease at p-value 0.02 and 0.03 respectively. The study reveals that metformin can induce decrease in free testosterone and insulin resistance but cannot produce sever weight loss or changes in hormones regulating menstrual cycle, SHBG or Vaspin. The study suggested that there are different factors can affect Vaspin level in PCOS patients other than insulin resistance as its level failed to decrease after intake of insulin sensitizing drug, metformin. [ABSTRACT FROM AUTHOR]

Background: Prior studies have shown insulin resistance is associated with reduced cardiac autonomic function measured at rest, but few studies have determined whether insulin resistance is associated with reduced cardiac autonomic function measured during daily activities.Methods: We examined older adults without diabetes with 48-h ambulatory electrocardiography (n = 759) in an ancillary study of the Atherosclerosis Risk in Communities Study. Insulin resistance, the exposure, was defined by quartiles for three indexes: 1) the homeostatic model assessment of insulin resistance (HOMA-IR), 2) the triglyceride and glucose index (TyG), and 3) the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C). Low heart rate variability, the outcome, was defined by <25th percentile for four measures: 1) standard deviation of normal-to-normal R-R intervals (SDNN), a measure of total variability; 2) root mean square of successive differences in normal-to-normal R-R intervals (RMSSD), a measure of vagal activity; 3) low frequency spectral component (LF), a measure of sympathetic and vagal activity; and 4) high frequency spectral component (HF), a measure of vagal activity. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals weighted for sampling/non-response, adjusted for age at ancillary visit, sex, and race/study-site. Insulin resistance quartiles 4, 3, and 2 were compared to quartile 1; high indexes refer to quartile 4 versus quartile 1.Results: The average age was 78 years, 66% (n = 497) were women, and 58% (n = 438) were African American. Estimates of association were not robust at all levels of HOMA-IR, TyG, and TG/HDL-C, but suggest that high indexes were associated consistently with indicators of vagal activity. High HOMA-IR, high TyG, and high TG/HDL-C were consistently associated with low RMSSD (OR: 1.68 (1.00, 2.81), OR: 2.03 (1.21, 3.39), and OR: 1.73 (1.01, 2.91), respectively). High HOMA-IR, high TyG, and high TG/HDL-C were consistently associated with low HF (OR: 1.90 (1.14, 3.18), OR: 1.98 (1.21, 3.25), and OR: 1.76 (1.07, 2.90), respectively).Conclusions: In older adults without diabetes, insulin resistance was associated with reduced cardiac autonomic function - specifically and consistently for indicators of vagal activity - measured during daily activities. Primary prevention of insulin resistance may reduce the related risk of cardiac autonomic dysfunction. [ABSTRACT FROM AUTHOR]

Background: Insulin resistance (IR) is a pre-diabetic condition and has been reported in patients with acanthosis nigricans (AN) and acrochordon. AN and acrochordon are claimed to be cutaneous markers of IR. Aim: The purpose of this paper was to study the association of AN and acrochordon with IR. Methods: It was a cross-sectional hospital-based study. Both groups were assessed for IR by using homeostatic model assessment of insulin resistance (HOMA-IR) formula. Results: A total of 70 cases and an equal number of controls were studied. IR was observed more in cases (41.4%) compared to controls (17.1%) (P < 0.01). Mean HOMA-IR value was also significantly higher in cases (4.32 ± 4.44) compared to controls (2.27 ± 0.90) (P < 0.05). Limitations: Low number of cases and controls were taken in the study. Association with hyperlipidemia and metabolic syndrome was not elicited. Conclusions: AN and acrochordons were found to be associated with IR. [ABSTRACT FROM AUTHOR]

Background: Insulin resistance may contribute to aortic stiffening that leads to end-organ damage. We examined the cross-sectional association and prospective association of insulin resistance and aortic stiffness in older adults without diabetes. Methods: We analyzed 2571 men and women at Visit 5 (in 2011–2013), and 2350 men and women at repeat examinations from baseline at Visit 1 (in 1987–1989) to Visit 5 (in 2011–2013). Linear regression was used to estimate the difference in aortic stiffness per standard unit of HOMA-IR, TG/HDL-C, and TyG at Visit 5. Linear mixed effects were used to assess if high, as opposed to non-high, aortic stiffness (> 75th percentile) was preceded by a faster annual rate of change in log-HOMA-IR, log-TG/HDL-C, and log-TyG from Visit 1 to Visit 5. Results: The mean age of participants was 75 years, 37% (n = 957) were men, and 17% (n = 433) were African American. At Visit 5, higher HOMA-IR, higher TG/HDL-C, and higher TyG were associated with higher aortic stiffness (16 cm/s per SD (95% CI 6, 27), 29 cm/s per SD (95% CI 18, 40), and 32 cm/s per SD (95% CI 22, 42), respectively). From Visit 1 to Visit 5, high aortic stiffness, compared to non-high aortic stiffness, was not preceded by a faster annual rate of change in log-HOMA-IR from baseline to 9 years (0.030 (95% CI 0.024, 0.035) vs. 0.025 (95% CI 0.021, 0.028); p = 0.15) or 9 years onward (0.011 (95% CI 0.007, 0.015) vs. 0.011 (95% CI 0.009, 0.013); p = 0.31); in log-TG/HDL-C from baseline to 9 years (0.019 (95% CI 0.015, 0.024) vs. 0.024 (95% CI 0.022, 0.026); p = 0.06) or 9 years onward (− 0.007 (95% CI − 0.010, − 0.005) vs. − 0.009 (95% CI − 0.010, − 0.007); p = 0.08); or in log-TyG from baseline to 9 years (0.002 (95% CI 0.002, 0.003) vs. 0.003 (95% CI 0.003, 0.003); p = 0.03) or 9 years onward (0 (95% CI 0, 0) vs. 0 (95% CI 0, 0); p = 0.08). Conclusions: Among older adults without diabetes, insulin resistance was associated with aortic stiffness, but the putative role of insulin resistance in aortic stiffness over the life course requires further study. [ABSTRACT FROM AUTHOR]

Background: Reduced levels of estrogen have been associated with metabolic alterations and increased insulin resistance (IR) in postmenopausal women, thus predisposing them to cardiometabolic risks. The aim of this study was to assess alterations in parameters of cardiometabolic risk in apparently healthy pre- and post-menopausal women and to study the effect of IR on these metabolic parameters. Methods: A cross-sectional study was conducted on randomly selected apparently healthy women (n = 262). These women were categorized as premenopausal (n = 184) and postmenopausal (n = 78). Anthropometric measurements, blood pressure, lipid profile, fasting glucose, and insulin concentrations were estimated on all the participants using standard protocols. Homeostatic model assessment of IR was computed to estimate the level of IR. Results: Most lipid parameters, blood pressure, waist circumference, and fat percentage were significantly higher (P < 0.05) in postmenopausal women than premenopausal women. On subcategorizing women with respect to IR (<3, >3), metabolic parameters (e.g., triglyceride – 104.7 ±53.2 mg/dl, Blood Sugar Level Fasting (BSLF) – 103.3 ± 40.1 mg/dl, and fasting serum insulin – 23 ± 12.3 mIU/L) were also higher (P < 0.001) in premenopausal women having IR >3. Significantly higher low-density lipoprotein (132.7 ± 38.7 mg/dl vs. 114.4 ± 25 mg/dl) and total cholesterol (211.3 ± 40.5 vs. 184.8 ± 29.4 mg/dl) were observed in postmenopausal women with IR >3 (P < 0.05) along with higher BSLF (126.6±54.3 mg/dl**) and fasting insulin levels (22.3 ± 12.1 mIU/L) (P < 0.001). Conclusion: This study reveals that IR may predispose women to increased cardiometabolic risk. Urgent attention needs to be focused toward metabolic health of women. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate the sensitivity and specificity of total bilirubin (serum) in determining thyroid status in clinically euthyroid non-obese, overweight, and obese type 2 diabetics Subjects and Methods: Three anthropometry specific groups of clinically euthyroid type 2 diabetics were enabled, following enrolment: 153 non-obese (body mass index [BMI] = 18.5-24.99), 291 overweight (BMI = 25-29.99), and 126 obese type 2 diabetes mellitus (BMI ≥30). Total bilirubin (serum), glycemic status, insulin resistance (IR), and thyroid hormones, besides routine biochemistry, were estimated, as per International Federation of Clinical Chemistry approved procedures. Results: Receiver operating characteristic curves for non-obese, overweight, and obese were plotted to assess the role of total bilirubin (serum) in determining thyroid status in clinically euthyroid type 2 diabetics. In overweight, the area under curve (AUC) for FT3 and postprandial sugar showed 0.621 and 0.531 with cutoff values of 2.02 pg/ml and 147.5 mg/dl, respectively, whereas for aspartate aminotransferase/ alanine aminotransferase (De Ritis ratio), the AUC was 0.583. As regards, obese diabetics and the AUC for insulin and homeostatic model assessment IR were 0.657 and 0.709, respectively, with cutoff values of 16.06 mIU/L and 7.274, respectively, and for postprandial sugar 0.727, in the same group (obese) with cutoff value of 208.5 mg/dl. Conclusion: Total bilirubin could predict thyroid status and IR in anthropometry specific clinically euthyroid type 2 diabetics. [ABSTRACT FROM AUTHOR]

Introduction: Various metabolic changes in obesity may increase oxidative stress, which if persists continuously may predispose to insulin resistance and diabetes mellitus. Oxidative stress will generate Reactive Oxygen species (ROS) which affects proteins, lipids, carbohydrates and cell membrane. Malon-Di-Aldehyde (MDA) is a lipid peroxidation product found to be elevated in diabetes. Measurement and reduction of oxidative stress in prediabetes may prevent the grave consequences of diabetes. Aim: The present study was aimed at evaluating MDA levels in prediabetics and diabetics and correlating it with Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) of the same subjects. Materials and Methods: Plasma MDA and serum insulin were measured in 96 prediabetics and 101 diabetics selected for study and their Body Mass Index (BMI) was calculated. Prediabetic and diabetic patients were divided into two groups, one with BMI>25 kg/m2, and other with BMI25 kg/m2 . Statistically significant positive correlation was observed between MDA and insulin resistance in prediabetic group (p

The aim of the present study was to confirm the effects of a commercially available mung bean protein isolate (GLUCODIA™) on glucose and lipid metabolism. The main component of GLUCODIA™ is 8S globulin, which constitutes 80 % of the total protein. The overall structure of this protein closely resembles soyabean β-conglycinin, which accounts for 20 % of total soya protein (soya protein isolate; SPI). Many physiological beneficial effects of β-conglycinin have been reported. GLUCODIA™ is expected to produce beneficial effects with fewer intakes than SPI. We conducted two independent double-blind, placebo-controlled clinical studies. In the first (preliminary dose decision trial) study, mung bean protein was shown to exert physiological beneficial effects when 3·0 g were ingested per d. In the second (main clinical trial) study, mung bean protein isolate did not lower plasma glucose levels, although the mean insulin level decreased with consumption of mung bean protein. The homeostatic model assessment of insulin resistance (HOMA-IR) values significantly decreased with mung bean protein. The mean TAG level significantly decreased with consumption of mung bean protein isolate. A significant increase in serum adiponectin levels and improvement in liver function enzymes were observed. These findings suggest that GLUCODIA™ could be useful in the prevention of insulin resistance and visceral fat accumulation, which are known to trigger the metabolic syndrome, and in the prevention of liver function decline.

Background: A large proportion of adults in North America are not meeting recommended intakes for magnesium (Mg). Women and people of South Asian race may be at higher risk for Mg deficiency because of lower Mg intakes relative to requirements and increased susceptibility to diabetes, respectively. Objective: This study compared serum Mg concentrations in South Asian (n=276) and white (n=315) Canadian women and men aged 20–79 years living in Canada's Capital Region and examined the relationship with diabetes, glucose control, insulin resistance, and body mass index. Results: Serum Mg concentration was lower in women of both races and South Asians of both genders. Racial differences in serum Mg were not significant after controlling for use of diabetes medication. A substantial proportion of South Asian (18%) and white (9%) women had serum Mg

Background: Cichorium intybus has a wide range of therapeutic applications in Indian traditional systems of medicine, especially in metabolic disorders. Objective: To evaluate the toxicity profile and to investigate the antidiabetic, antihyperlipidemic, and antioxidative efficacy of C. intybus seeds in Wistar rats. Materials and Methods: The aqueous extract of seeds was prepared by decoction, and its quality control analysis was carried out by thin-layer chromatography and ultra-performance liquid chromatography-mass spectrometry (UPLC-MS) fingerprinting. Wistar rats were fed with high-fat diet for 5 weeks followed by a single dose of streptozotocin intraperitoneally to induce diabetes. The protective group of rats was given aqueous extract during and after the induction of type 2 diabetes mellitus. Further, repeated dose 28-day (subacute) and repeated dose 90-day (chronic) toxicity studies were conducted as per the OECD guidelines. Results: A total of 18 metabolites have been tentatively identified by UPLC-MS profiling in aqueous extract of C. intybus seeds. No significant changes in mortality and biochemical parameters have been observed during toxicity studies. Moreover, administration of the extract to a protective group of diabetic rats attenuated serum glucose and triglyceride levels by 52.7% and 65.3%, respectively, supported by similar results for parameters related to insulin resistance and oxidative stress. The beneficial effect of extract has also been confirmed through in silico screening. Conclusion: C. intybus can be used as a natural dietary supplement for the prevention and management of diabetes and can be explored to develop a potent phytopharmaceutical for diabetes. Abbreviations used: AECIS: Aqueous extract of Cichorium intybus seeds; HOMA-IR: Homeostatic model assessment of insulin resistance; OGTT: Oral glucose tolerance test; TLC: Thin-layer chromatography; UPLC-MS: Ultra-performance liquid chromatography-mass spectrometry. [ABSTRACT FROM AUTHOR]

Background: While there is currently much emphasis on the developmental origins of diseases associated with deranged metabolism in developed societies, there is a paucity of data on this subject in developing countries. Insulin resistance (IR) at birth is known to be the earliest detectable abnormality in the natural history of diabetes. It is also a precursor of obesity and cardiovascular diseases. Objective: The objective of the study was to determine IR profile in apparently healthy term neonates. Methods: The cross-sectional study involved 33 small for gestational age (SGA), 29 appropriate for gestational age (AGA), and 38 large for gestational age (LGA) healthy neonates <48 h of age. Glucose and insulin samples taken after a shortened fasting time were measured with glucose oxidase and Enzyme-linked immunosorbent assay methods, respectively. Homeostatic model assessment of IR (HOMA-IR) was calculated. Results: The mean fasting glucose, fasting insulin, and HOMA-IR were 2.66 ± 0.7 mmol/L, 8.68 ± 3.63 μU/mL, and 1.01 ± 0.46, respectively. Fasting glucose levels in LGA, AGA, and SGA neonates were 2.92 ± 0.76 mmol/L, 2.58 ± 0.53 mmol/L, and 2.45 ± 0.68 mmol/L, respectively (p = 0.012). Insulin levels of LGA, AGA, and SGA were 9.47 ± 4.77 μU/mL, 8.44 ± 2.03 μU/mL, and 7.98 ± 3.08 μU/mL, respectively (p = 0.207). HOMA-IR of LGA, AGA, and SGA was 1.18 ± 0.54, 0.97 ± 0.32, and 0.86 ± 0.40, respectively (p = 0.01). The correlation coefficient, r, between HOMA-IR and birth weight was 0.72 (p < 0.001) and the correlation coefficient between HOMA-IR of neonates and maternal body mass index (BMI) was 0.51 (p = 0.001). Conclusions: LGA and infants delivered to mothers with higher BMI are at a higher risk of IR and should be screened at birth. [ABSTRACT FROM AUTHOR]

Studies on the effects of consuming 100 % fruit juice on measures of glycaemic control are conflicting. The purpose of the present study was to systematically review and quantitatively summarise results from randomised controlled trials (RCT) examining effects of 100 % fruit juice on glucose–insulin homeostasis. Eligible studies were identified from a systematic review of PubMed and EMBASE and hand searches of reference lists from reviews and relevant papers. Using data from eighteen RCT, meta-analyses evaluated the mean difference in fasting blood glucose (sixteen studies), fasting blood insulin (eleven studies), the homeostatic model assessment of insulin resistance (HOMA-IR; seven studies) and glycosylated Hb (HbA1c; three studies) between the 100 % fruit juice intervention and control groups using a random-effects model. Compared with the control group, 100 % fruit juice had no significant effect on fasting blood glucose (−0·13 (95 % CI −0·28, 0·01) mmol/l; P = 0·07), fasting blood insulin (−0·24 (95 % CI −3·54, 3·05) pmol/l; P = 0·89), HOMA-IR (−0·22 (95 % CI −0·50, 0·06); P = 0·13) or HbA1c (−0·001 (95 % CI −0·38, 0·38) %; P = 0·28). Results from stratified analyses and univariate meta-regressions also largely showed no significant associations between 100 % fruit juice and the measures of glucose control. Overall, findings from this meta-analysis of RCT suggest a neutral effect of 100 % fruit juice on glycaemic control. These findings are consistent with findings from some observational studies suggesting that consumption of 100 % fruit juice is not associated with increased risk of diabetes.

Purpose: The purpose of this study is to investigate the association of the serum 25-hydroxyvitamin D (25-OHD) level with markers of insulin resistance (IR) in postmenopausal Indian women. Materials and Methods: This was a cross-sectional study, conducted at a Tertiary Care Hospital in New Delhi, India. Seventy one postmenopausal women (mean age 56.3 ± 7.6 years) were enrolled. Exclusion criteria were known or newly detected diabetics, subjects with chronic renal failure, chronic liver disease or any other chronic inflammatory condition, chronic smokers and chronic alcoholics. Serum calcium (and albumin for calculating corrected calcium), phosphorus, alkaline phosphatase and 25-OHD were measured as parameters of calcium homeostasis. Fasting blood glucose (FBG), systolic and diastolic blood pressures, body mass index (BMI), fasting serum insulin, calculated glucose insulin ratio (GIR), and homeostatic model assessment of insulin resistance (HOMA-IR) were studied as parameters of IR. Data was then analyzed for statistical significance. Results: The mean serum 25-OHD level was 12.73 ± 7.63 ng/ml. The mean BMI was 27.78 ± 5.37 kg/m 2 . The mean calculated GIR was 13.14 ± 9.39 and HOMA-IR was 2.31 ± 1.70. Serum 25-OHD was inversely correlated with BMI (correlation coefficient −0.234, P value 0.050) and with HOMA-IR (correlation coefficient −0.237, P value 0.047). However, when 25-OHD was adjusted for BMI the correlation between 25-OHD and HOMA-IR lost its significance. No correlation was found between serum 25-OHD and any other parameters of IR studied. Conclusions: There is a significant negative linear correlation between 25-OHD and BMI. The significant negative linear correlation between 25-OHD and HOMA-IR was confounded by BMI. There is no correlation between 25-OHD and parameters of IR.

Introduction: Regular physical activity (PA) can reduce the risk of developing type 2 diabetes, but adherence to time-orientated (150 min week-1 or more) PA guidelines is very poor. A practical and time-efficient PA regime that was equally efficacious at controlling risk factors for cardio-metabolic disease is one solution to this problem. Herein, we evaluate a new time-efficient and genuinely practical high-intensity interval training (HIT) protocol in men and women with pre-existing risk factors for type 2 diabetes. Materials and methods: One hundred eighty-nine sedentary women (n=101) and men (n=88) with impaired glucose tolerance and/or a body mass index>27 kg m-2 [mean (range) age: 36 (18-53) years] participated in this multi-center study. Each completed a fully supervised 6-week HIT protocol at work-loads equivalent to ∼100 or ∼125% VO2max . Change in V&O2max was used to monitor protocol efficacy, while Actiheart™ monitors were used to determine PA during four, weeklong, periods. Mean arterial (blood) pressure (MAP) and fasting insulin resistance [homeostatic model assessment (HOMA)-IR] represent key health biomarker outcomes. Results: The higher intensity bouts (∼125% VO2max ) used during a 5-by-1 min HIT protocol resulted in a robust increase in VO2max (136 participants, +10.0%, p<0.001; large size effect). 5-by-1 HIT reduced MAP (∼3%; p<0.001) and HOMA-IR (∼16%; p<0.01). Physiological responses were similar in men and women while a sizeable proportion of the training-induced changes in VO2max, MAP and HOMA-IR was retained 3 weeks after cessation of training. The supervised HIT sessions accounted for the entire quantifiable increase in PA and this equated to 400 metabolic equivalent (MET) min week-1. Meta-analysis indicated that 5-by-1 HIT matched the efficacy and variability of a time-consuming 30-week PA program on VO2max, MAP and HOMA-IR. Conclusion: With a total time-commitment of<15 min per session and reliance on a practical ergometer protocol, 5-by-1 HIT offers a new solution to modulate cardio-metabolic risk factors in adults with pre-existing risk factors for type 2 diabetes while approximately meeting the MET min week-1 PA guidelines. Long-term randomized controlled studies will be required to quantify the ability for 5-by-1 HIT to reduce the incidence of type 2 diabetes, while strategies are required to harmonize the adaptations to exercise across individuals. [ABSTRACT FROM AUTHOR]

Total serum magnesium (Mg) concentration (SMC) is commonly used to assess Mg status. This study reports current SMCs of Canadians and their associations with demographic factors, diabetes, and measures of glycemic control and insulin resistance using results from the Canadian Health Measures Survey cycle 3 (2012-2013). Associations were examined in adults aged 20-79 years using linear mixed models. Mean SMCs and percentile distributions for 11 sex-age groups between and 79 years (n = 5561) are reported. SMCs were normally distributed and differences (p < 0.05) among sex and age groups were small. Between 9.5% and 16.6% of adult sex-age groups had a SMC below the lower cut-off of a population-based reference interval (0.75-0.955 mmol⋅L-1) established in the United States population as part of the NHANESI conducted in 1971-1974. Having diabetes was associated with 0.04 to 0.07 mmol⋅L-1 lower SMC compared to not having diabetes in the various models. Body mass index, glycated hemoglobin, serum glucose and insulin concentrations, and homeostatic model assessment of insulin resistance were negatively associated with SMC. This is the first study to report SMCs in a nationally representative sample of the Canadian population. A substantial proportion of Canadians are hypomagnesaemic in relation to a population-based reference interval, and SMC was negatively associated with diabetes and indices of glycemic control and insulin resistance. [ABSTRACT FROM AUTHOR]

Studies on the effects of consuming 100% fruit juice on measures of glycaemic control are conflicting. The purpose of the present study was to systematically review and quantitatively summarise results from randomised controlled trials (RCT) examining effects of 100% fruit juice on glucose-insulin homeostasis. Eligible studies were identified from a systematic review of PubMed and EMBASE and hand searches of reference lists from reviews and relevant papers. Using data from eighteen RCT, meta-analyses evaluated the mean difference in fasting blood glucose (sixteen studies), fasting blood insulin (eleven studies), the homeostatic model assessment of insulin resistance (HOMA-IR; seven studies) and glycosylated Hb (HbA1c; three studies) between the 100% fruit juice intervention and control groups using a random-effects model. Compared with the control group, 100% fruit juice had no significant effect on fasting blood glucose (-0·13 (95% CI -0·28, 0·01) mmol/l; P =0·07), fasting blood insulin (-0·24 (95% CI -3·54, 3·05) pmol/l; P = 0·89), HOMA-IR (-0·22 (95% CI -0·50, 0·06); P = 0·13) or HbA1c (-0·001 (95% CI -0·38, 0·38) %; P = 0·28). Results from stratified analyses and univariate meta-regressions also largely showed no significant associations between 100% fruit juice and the measures of glucose control. Overall, findings from this meta-analysis of RCT suggest a neutral effect of 100% fruit juice on glycaemic control. These findings are consistent with findings from some observational studies suggesting that consumption of 100% fruit juice is not associated with increased risk of diabetes. [ABSTRACT FROM AUTHOR]