HOMA-Adiponectin Closely Associates with Cardiometabolic Risk Markers in Middle-Aged Indians with Metabolic Syndrome

2020 ◽  
Author(s):  
Joyita Banerjee ◽  
Yogita Dhas ◽  
Neetu Mishra
Keyword(s):  
Insulin Resistance ◽  
Cardiometabolic Risk ◽  
Risk Indicators ◽  
Atherogenic Index ◽  
Model Assessment ◽  
Risk Markers ◽  
Middle Aged ◽  
Homeostatic Model Assessment ◽  
Hs Crp ◽  
Cardiometabolic Risk Markers

Abstract Background Unhealthy dietary habits and sedentary lifestyles have raised alarming concerns for the rising prevalence of metabolic syndrome (MetS) and associated cardiometabolic risk among Indians at an early age. Insulin resistance and adiposity are the important risk factors associated with MetS. The present study aimed to investigate the relationship between a modified marker of insulin resistance (homeostatic model assessment-adiponectin (HOMA-AD)) and cardiometabolic risk among middle-aged Indians. Methods The study comprised of 144 subjects of age-group 31–50 years, where 83 subjects were diagnosed for MetS according to the guidelines given by the International Diabetes Federation. We measured cardiometabolic risk indicators such as fasting blood glucose (FPG), fasting plasma insulin (FPI), homeostatic model assessment- insulin resistance (HOMA-IR), adiponectin, high sensitivity C-reactive protein (hs-CRP), oxidized LDL (oxLDL), monocyte chemoattractant protein-1 (MCP-1), and atherogenic index, among others. We calculated HOMA-AD by the formula: [FPG (mmol/l) × FPI (µIU/ml)] / [22.5 × Adiponectin (µg/ml)]. Results HOMA-IR and HOMA-AD were highly increased (p<0.001) in the MetS subjects than controls. Adiponectin was significantly (p<0.01) lower whereas cardiac risk markers such as atherogenic index, hs-CRP, oxLDL, and MCP-1 were significantly (p<0.01) elevated in MetS group than controls. Linear regression showed positive and significant associations (p<0.01) of HOMA-AD with all the cardiometabolic risk markers except MCP-1. HOMA-AD showed higher AUC (0.806) than HOMA-IR (0.791) for predicting MetS. Conclusion HOMA-AD could be a surrogate adipokine-based marker correlated significantly with components of MetS and cardiometabolic risk indicators. It appeared to be a better predictor of MetS among middle-aged Indians than HOMA-IR.

scholarly journals Interplay of Glycemic Index, Glycemic Load, and Dietary Antioxidant Capacity with Insulin Resistance in Subjects with a Cardiometabolic Risk Profile

2018 ◽  
Vol 19 (11) ◽  
pp. 3662 ◽  
Author(s):  
Cristina Galarregui ◽  
María Zulet ◽  
Irene Cantero ◽  
Bertha Marín-Alejandre ◽  
José Monreal ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Antioxidant Capacity ◽  
Diet Quality ◽  
Glycemic Index ◽  
Cardiometabolic Risk ◽  
Glycemic Load ◽  
Risk Profile ◽  
Model Assessment ◽  
Susceptible Population ◽  
Homeostatic Model Assessment

Background: Dietary total antioxidant capacity (TAC), glycemic index (GI), and glycemic load (GL) are accepted indicators of diet quality, which have an effect on diet–disease relationships. The aim of this study was to evaluate potential associations of dietary TAC, GI, and GL with variables related to nutritive status and insulin resistance (IR) risk in cardiometabolic subjects. Methods: A total of 112 overweight or obese adults (age: 50.8 ± 9 years old) were included in the trial. Dietary intake was assessed by a validated 137-item food frequency questionnaire (FFQ), which was also used to calculate the dietary TAC, GI, and GL. Anthropometrics, blood pressure, body composition by dual-energy X-ray absorptiometry (DXA), glycemic and lipid profiles, C-reactive protein (CRP), as well as fatty liver quantification by magnetic resonance imaging (MRI) were assessed. Results: Subjects with higher values of TAC had significantly lower circulating insulin concentration and homeostatic model assessment of insulin resistance (HOMA-IR). Participants with higher values of HOMA-IR showed significantly higher GI and GL. Correlation analyses showed relevant inverse associations of GI and GL with TAC. A regression model evidenced a relationship of HOMA-IR with TAC, GI, and GL. Conclusion: This data reinforces the concept that dietary TAC, GI, and GL are potential markers of diet quality, which have an impact on the susceptible population with a cardiometabolic risk profile.

scholarly journals Nuclear Magnetic Resonance Derived Biomarkers for Evaluating Cardiometabolic Risk in Youth and Young Adults Across the Spectrum of Glucose Tolerance

2021 ◽  
Vol 12 ◽  
Author(s):  
Stephanie T. Chung ◽  
Samantha T. Matta ◽  
Abby G. Meyers ◽  
Celeste K. Cravalho ◽  
Alfredo Villalobos-Perez ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Cardiometabolic Risk ◽  
Resistance Index ◽  
Model Assessment ◽  
Predictive Tool ◽  
Clinical Trial Registration ◽  
Increased Risk ◽  
Homeostatic Model Assessment ◽  
Normal Glucose ◽  
Lipid Testing

Youth with obesity have an increased risk for cardiometabolic disease, but identifying those at highest risk remains a challenge. Four biomarkers that might serve this purpose are “by products” of clinical NMR LipoProfile® lipid testing: LPIR (Lipoprotein Insulin Resistance Index), GlycA (inflammation marker), BCAA (total branched-chain amino acids), and glycine. All are strongly related to insulin resistance and type 2 diabetes (T2DM) in adults (glycine inversely) and are independent of biological and methodological variations in insulin assays. However, their clinical utility in youth is unclear. We compared fasting levels of these biomarkers in 186 youth (42 lean normal glucose tolerant (NGT), 88 obese NGT, 23 with prediabetes (PreDM), and 33 with T2DM. All four biomarkers were associated with obesity and glycemia in youth. LPIR and GlycA were highest in youth with PreDM and T2DM, whereas glycine was lowest in youth with T2DM. While all four were correlated with HOMA-IR (Homeostatic Model Assessment for Insulin Resistance), LPIR had the strongest correlation (LPIR: r = 0.6; GlycA: r = 0.4, glycine: r = −0.4, BCAA: r = 0.2, all P &lt; 0.01). All four markers correlated with HbA1c (LPIR, GlycA, BCAA: r ≥ 0.3 and glycine: r = −0.3, all P &lt; 0.001). In multi-variable regression models, LPIR, GlycA, and glycine were independently associated with HOMA-IR (Adjusted R2 = 0.473, P &lt; 0.001) and LPIR, glycine, and BCAA were independently associated with HbA1c (Adjusted R2 = 0.33, P &lt; 0.001). An LPIR index of &gt;44 was associated with elevated blood pressure, BMI, and dyslipidemia. Plasma NMR-derived markers were related to adverse markers of cardiometabolic risk in youth. LPIR, either alone or in combination with GlycA, should be explored as a non-insulin dependent predictive tool for development of insulin resistance and diabetes in youth.Clinical Trial RegistrationClinicaltrials.gov, identifier NCT:02960659

scholarly journals The effect of a low carbohydrate high fat diet on emerging biochemical markers of cardiometabolic risk

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Deaglan McCullough ◽  
Tanja Harrison ◽  
Katie Lane ◽  
Lynne Boddy ◽  
Farzad Amirabdollahian ◽  
...  
Keyword(s):  
Cardiometabolic Risk ◽  
Metabolic Adaptation ◽  
Model Assessment ◽  
High Fat ◽  
Low Carbohydrate ◽  
Homeostatic Model Assessment ◽  
Ad Libitum ◽  
Cardiometabolic Risk Markers ◽  
The Uk ◽  
The Impact

AbstractWorldwide, cardiovascular disease (CVD) is the number 1 cause of mortality and is associated with insulin resistance (IR). Emerging biomarkers such as FGF21 and adiponectin are associated with cardiometabolic risk. Low carbohydrate, high fat (LCHF) diets have been reported to reduce cardiometabolic risk markers; however, few studies have compared a LCHF diet vs. a high carbohydrate (HC), lower fat diet under ad libitum conditions on adiponectin and FGF21. The purpose of this study was to investigate the effects of an ad libitum LCHF vs. HC diet on IR, FGF21 and adiponectin in 16 healthy adults. Ethical approval: Liverpool John Moores University Research Ethics Committee (16/ELS/029); registered with ClinicalTrials.gov (Ref. NCT03257085). Participants were randomly assigned to a HC diet (n = 8, the UK Eatwell guidelines; ≥ 50% of energy from carbohydrates) or a LCHF diet (n = 8, consume < 50 g/day of carbohydrates). All provided plasma samples at 0, 4 and 8 weeks. FGF21 (R&D Systems) was analysed via ELISA and adiponectin, insulin and glucose were analysed via immunoassay technology (Randox Evidence Investigator™ Metabolic Syndrome Arrays I & II). Mann Whitney, Friedmans, Wilcoxon tests and 2×3 ANOVA (IBM SPSS 25®) were undertaken to investigate significant differences between and within groups. The homeostatic model assessment (HOMA) was used to calculate IR. FGF21 significantly (P = 0.04) decreased (Mdn, IQR:148.16, 78.51–282.02 to 99.4, 39.87–132.29 pg/ml) after 4 weeks and significantly (P = 0.02) increased (Mdn, IQR:167.38, 80.82–232.89 pg/ml) by 8 weeks vs. baseline with LCHF. No significant differences (P > 0.05) were observed between groups. Adiponectin was significantly (P = 0.03) different at week 4 only between groups. Adiponectin increased after 4 weeks (Mdn, IQR:13.44, 9.12–25.47 to 16.64, 11.96–21.51 ng/ml) but was only significantly (P = 0.03) different by 8 weeks vs. baseline in the HC group (Mdn, IQR:16, 10.8–27.43 ng/ml). Adiponectin remained unchanged (P = 0.96) in the LCHF group. HOMA significantly decreased with both diets after 8 weeks only (mean ± SD, LCHF: 2.9 ± 1.3 to 1.8 ± 0.8, HC: 2.5 ± 0.6 to 1.9 ± 0.6, P = 0.008) but was not significantly (P = 0.60) different between groups. These preliminary data reveal that while both diets improved insulin sensitivity, they may do so by different mechanisms. Future studies are warranted to investigate further, how a LCHF vs. HC diet affects FGF21 and adiponectin, and the subsequent regulation of IR. Furthermore, studies that extend these findings by determining the impact of LCHF vs. HC on peripheral metabolism to determine potential nutrition-mediated mechanisms of metabolic adaptation are warranted.

scholarly journals Plasma vitamin D is associated with fasting insulin and homeostatic model assessment of insulin resistance in young adult males, but not females, of the Jerusalem Perinatal Study

2014 ◽  
Vol 18 (7) ◽  
pp. 1324-1331 ◽  
Author(s):  
Amy Moore ◽  
Hagit Hochner ◽  
Colleen M Sitlani ◽  
Michelle A Williams ◽  
Andrew N Hoofnagle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Vitamin D ◽  
Young Adult ◽  
Cardiometabolic Risk ◽  
Cardiometabolic Risk Factors ◽  
Plasma Vitamin ◽  
Model Assessment ◽  
Homeostatic Model Assessment ◽  
Homeostatic Model

AbstractObjectiveTo examine cross-sectional relationships between plasma vitamin D and cardiometabolic risk factors in young adults.DesignData were collected from interviews, physical examinations and biomarker measurements. Total plasma 25-hydroxyvitamin D (25(OH)D) was measured using LC–tandem MS. Associations between 25(OH)D and cardiometabolic risk factors were modelled using weighted linear regression with robust estimates of standard errors.SettingIndividuals born in Jerusalem during 1974–1976.SubjectsParticipants of the Jerusalem Perinatal Study (n 1204) interviewed and examined at age 32 years. Participants were oversampled for low and high birth weight and for maternal pre-pregnancy obesity.ResultsMean total 25(OH)D concentration among participants was 21·7 (sd 8·9) ng/ml. Among males, 25(OH)D was associated with homeostatic model assessment of insulin resistance (natural log-transformed, β=−0·011, P=0·004) after adjustment for BMI. However, these associations were not present among females (P for sex interaction=0·005).ConclusionsWe found evidence for inverse associations of 25(OH)D with markers of insulin resistance among males, but not females, in a healthy, young adult Caucasian population. Prospective studies and studies conducted on other populations investigating sex-specific effects of vitamin D on cardiometabolic risk factors are warranted.

Abstract 13507: The Role of Weight Loss in Mediating the Effects of a 2-year Caloric Restriction Regimen on Cardiometabolic Risk Markers in Individuals Without Obesity

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
James L Dorling ◽  
Leanne Redman ◽  
Eric Ravussin ◽  
Kim Huffman ◽  
Susan B RACETTE ◽  
...  
Keyword(s):  
Weight Loss ◽  
Caloric Restriction ◽  
Cardiometabolic Risk ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Model Assessment ◽  
Risk Markers ◽  
Mediation Analyses ◽  
Cardiometabolic Risk Markers ◽  
The Impact

Introduction: Caloric restriction (CR) improves cardiometabolic risk, even among individuals without obesity. However, it is unclear whether these aging-related benefits are mediated by weight loss. Mediation analyses inform mechanisms underlying relationships between an exposure and outcome. Using mediation analyses, our aim was to test if 2-year weight loss mediates the beneficial effects of CR on cardiometabolic risk markers in individuals without obesity. Methods: Participants without obesity were randomized 2:1 to CR or ad libitum (AL) as part of the 2-year trial, Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE). The CR group aimed to enact 25% CR for 2 years, while AL maintained habitual energy intake. Baseline and year 2 assessments included weight and cardiometabolic risk markers. Using the approaches of Valeri and VanderWeele, mediation was quantified as the natural indirect effect (NIE), defined as the impact of an exposure on an outcome through a mediator. Here, the NIE was the effect of CR (exposure) on cardiometabolic risk markers (outcome) that was accounted for by weight change (mediator). Results: In total, 117 and 71 participants in the CR and AL groups, respectively, completed the trial. The CR group achieved 11.9 (± 0.7)% CR and 7.6 (± 0.3) kg of weight loss ( P < 0.01 versus AL). Weight loss significantly mediated the CR-induced improvements in total cholesterol (NIE = -10.4 ± 3.5 mg/dL), low-density lipoprotein cholesterol (NIE = -8.5 ± 2.8 mg/dL), high-density lipoprotein cholesterol (NIE = 2.9 ± 1.3 mg/dL), triglycerides (NIE = -0.20 ± 0.05 log mg/dL), the homeostatic model assessment of insulin resistance (NIE = -0.22 ± 0.06), and C-reactive protein (NIE = -0.39 ± 0.15 log ug/mL) ( P ≤ 0.02). Weight loss did not mediate CR-induced reductions in systolic (NIE = -0.9 ± 1.4 mmHg) and diastolic (NIE = -1.0 ± 1.1 mmHg) blood pressure ( P ≥ 0.37). Conclusion: In individuals without obesity, CR-induced improvements in multiple cardiometabolic risk markers are driven by weight loss after 2 years. These findings emphasize that, even in individuals without obesity, weight loss after prolonged CR plays a role in improving cardiometabolic disease risk; however, some CR benefits still occur independent of weight loss.

scholarly journals Urbanisation, nutrition transition and cardiometabolic risk: the Benin study

2011 ◽  
Vol 107 (10) ◽  
pp. 1534-1544 ◽  
Author(s):  
Hélène Delisle ◽  
Gervais Ntandou-Bouzitou ◽  
Victoire Agueh ◽  
Roger Sodjinou ◽  
Benjamin Fayomi
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Diet Quality ◽  
Cardiometabolic Risk ◽  
Nutrition Transition ◽  
Large City ◽  
Sub Saharan Africa ◽  
Model Assessment ◽  
Risk Markers ◽  
Cardiometabolic Risk Markers

A rising prevalence of CVD and diabetes has been observed in sub-Saharan Africa, particularly in cities. The aim of the present study conducted in Benin was to examine the mediating role of nutrition transition in the relationship of urbanisation level and socio-economic status (SES) to cardiometabolic risk markers. A total of 541 subjects in apparent good health were randomly selected from the main city of Cotonou, a small town and its surrounding rural areas. SES was assessed based on a proxy for income and on education. Dietary intake and physical activity were assessed with at least two non-consecutive 24 h recalls. Scores for micronutrient adequacy and preventive diet were used as indicators of diet quality. Cardiometabolic risk markers were BMI, waist circumference (WC), blood pressure, serum cholesterol and insulin resistance according to homeostasis model assessment. A more advanced stage of nutrition transition, which correlated with lower diet quality scores and less physical activity, was observed in the large city compared with less urbanised locations. More obesity and more adverse cholesterol profiles, but also lower blood pressure, were present in the large city. Urbanisation, income, sedentary lifestyle and alcohol consumption, but not diet quality, independently contributed to higher BMI and WC. Higher micronutrient adequacy was independently associated with a better cholesterol profile. The study confirmed the positive rural–urban gradient in nutrition transition and cardiometabolic risk, except for blood pressure. This risk could be mitigated by a more adequate diet, particularly micronutrient intake, and a more active lifestyle.

scholarly journals Association of Serum Levels of Zinc, Copper, and Iron with Risk of Metabolic Syndrome

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 548
Author(s):  
Chia-Wen Lu ◽  
Yi-Chen Lee ◽  
Chia-Sheng Kuo ◽  
Chien-Hsieh Chiang ◽  
Hao-Hsiang Chang ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Linear Models ◽  
Serum Zinc ◽  
Serum Levels ◽  
Least Square ◽  
Model Assessment ◽  
Serum Concentrations ◽  
Metabolic Factors ◽  
Homeostatic Model Assessment

The association between serum concentrations of zinc, copper, or iron and the risk of metabolic syndrome are inconclusive. Therefore, we conduct a case-control study to explore the relationship between serum levels of zinc, copper, or iron and metabolic syndrome as well as each metabolic factor and insulin resistance. We enrolled 1165 adults, aged ≥ 40 (65.8 ± 10) years in a hospital-based population to compare the serum levels of zinc, copper, and iron between subjects with and without metabolic syndrome by using multivariate logistic regression analyses. The least square means were computed by general linear models to compare serum concentrations of zinc, copper, and iron in relation to the number of metabolic factors. The mean serum concentrations of zinc, copper, and iron were 941.91 ± 333.63 μg/L, 1043.45 ± 306.36 μg/L, and 1246.83 ± 538.13 μg/L, respectively. The odds ratios (ORs) of metabolic syndrome for the highest versus the lowest quartile were 5.83 (95% CI: 3.35–10.12; p for trend < 0.001) for zinc, 2.02 (95% CI: 1.25–3.25; p for trend: 0.013) for copper, and 2.11 (95% CI: 1.24–3.62; p for trend: 0.021) for iron after adjusting for age, sex, personal habits, body mass index, and homeostatic model assessment insulin resistance. Additionally, the serum zinc, copper, and iron concentrations increased as the number of metabolic factors rose (p for trend < 0.001). This was the first study to clearly demonstrate that higher serum levels of zinc, copper, and iron were associated with the risk of metabolic syndrome and the number of metabolic factors independent of BMI and insulin resistance.

scholarly journals Metabolic syndrome and insulin resistance in pre-pubertal children with psoriasis

2021 ◽  
Author(s):  
Francesca Caroppo ◽  
Alfonso Galderisi ◽  
Laura Ventura ◽  
Anna Belloni Fortina
Keyword(s):  
Metabolic Disease ◽  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Model Assessment ◽  
Limited Data ◽  
Single Center ◽  
Increased Risk ◽  
High Prevalence ◽  
Homeostatic Model Assessment ◽  
Homeostatic Model

AbstractPsoriasis in adults is associated with an increased risk of metabolic disease. Various cardiometabolic comorbidities have been reported in childhood psoriasis, but only a few studies have analyzed the prevalence of metabolic syndrome. We performed a single-center prospective study investigating the prevalence of metabolic syndrome and insulin resistance in children with psoriasis. The prevalence of metabolic syndrome was evaluated in 60 pre-pubertal children with psoriasis (age: 3–10 years), accordingly to recently established criteria for the diagnosis of metabolic syndrome in children. Insulin resistance was considered altered when the homeostatic model assessment (HOMA-IR) for insulin resistance was ≥ 90th sex- and age-specific percentile and HOMA 2-IR was > 1.8. Eighteen (30%) children with psoriasis were found to have metabolic syndrome. Sixteen (27%) children were found to have insulin resistance.Conclusion: Our data underline the importance of assessing metabolic syndrome not only in adults and adolescents but also in young children with psoriasis. What is Known:• Psoriasis in adults is strongly associated with metabolic disease and insulin resistance.• Very limited data are available on the prevalence of metabolic syndrome and insulin resistance in pre-pubertal children with psoriasis. What is New:• This study reports that in pre-pubertal children with psoriasis, there is a high prevalence of metabolic syndrome and insulin resistance.• In children with psoriasis metabolic syndrome risk factors should be assessed.

Pro- and anti-inflammatory adipokines are associated with cardiometabolic risk markers in Brazilian schoolchildren

2021 ◽  
Author(s):  
Mariana De Santis Filgueiras ◽  
Milene Cristine Pessoa ◽  
Josefina Bressan ◽  
Fernanda Martins de Albuquerque ◽  
Lara Gomes Suhett ◽  
...  
Keyword(s):  
Cardiometabolic Risk ◽  
Risk Markers ◽  
Anti Inflammatory ◽  
Cardiometabolic Risk Markers

P1279INSULIN RESISTANCE IN HEMODIALYSIS PATIENS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Pavel Filinyuk ◽  
Aleksander Rumyantsev
Keyword(s):  
Insulin Resistance ◽  
Systemic Inflammation ◽  
Clinical Manifestations ◽  
Biological Response ◽  
Fold Increase ◽  
Atherogenic Dyslipidemia ◽  
Model Assessment ◽  
Peripheral Tissues ◽  
Reactive Protein ◽  
Homeostatic Model Assessment

Abstract Background and Aims insulin resistance (IR) is a decrease in the biological response of sensitive tissues to insulin. IR is known as an adverse risk factor in cardiovascular disease, which largely determines the prognosis of patients receiving hemodialysis (HD). But this issue is not well understood. For the screening of IR, special indices have been developed that characterize the sensitivity of tissues to insulin. The aim of the study was to compare the methods of screening for IR in patients receiving HD in relation to the markers of systemic inflammation and atherogenic dyslipidemia (AtD). Method 124 patients receiving HD for 75.4 ± 44.5 months were examined including 66 men and 58 women aged 57.6 ± 13.6 years. For IR screening, the Homeostatic Model Assessment-1 and 2 indices (HOMA-1 and HOMA-2), the Quantitative Insulin Sensitivity Check Index (QUICKI) and triglycerides / glucose (Tri/G) were used. Patients were examined in accordance with the recommendations of KDIGO. Data analysis was carried out using “STATISTICA 10.0”. Results fasting insulin levels were elevated in 19% of patients. But, the calculated indices were consistent with the idea that IR is much more common. So, the IR index in the HOMA -1 model was increased in 47%, in the HOMA -2 model - in 33%, in the QUICKI model - in 36%, the TriH indicator - in 91%. The sensitivity of peripheral tissues in the HOMA-1 and HOMA-2 models was equally reduced by 35-40%. The results of the correlation analysis between indicators of IR and plasma concentration of C-reactive protein and lipid profile are presented in table 1. Informativeness of IR indicators depending on the presence of obesity is presented in table 2 We were also interested in whether insulin resistance affects the development of clinical manifestations of atherosclerosis, cardiac arrhythmias, and heart failure. An analysis of this relationship did not reveal. Only the IR index in the HOMA-1 model with a value of more than 2.7 units was associated with a 4.5-fold increase in the risk of developing clinical manifestations of atherosclerotic lesions (χ2 = 4.582 p = 0.032). Statistically significant it was only in men. Given our data, perhaps IR is one of the reasons for the higher morbidity and mortality of men at HD. Conclusion a comparison of IR models allows us to distinguish HOMA-2 as the most accurate index. The highest correlation with systemic inflammation and AtD was in the HOMA-1 and HOMA-2 indices.

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