scholarly journals The immune-opioid axis in prediabetes: prediction of prediabetes with insulin resistance by plasma interleukin-10 and Endomorphin-2 to kappa-opioid receptors ratio

2020 ◽  
Author(s):  
Shatha Rouf Moustafa

AbstractBackgroundPrediabetes is characterized by a hemoglobin A1c of 5.7%–6.4% and fasting blood glucose of 100–125 mg/dl. A high percentage of prediabetes subjects develops into type 2 diabetes mellitus in the following years. The effect of opioid peptides and their receptors, in addition to immunological cytokines on prediabetes, is not well understood.ObjectiveWe hypothesize that opioid peptides and their receptors affect the insulin and the insulin resistance (IR) in patients with prediabetes and that the immune cytokines, IL-6 (inflammatory factor) and IL-10 (anti-inflammatory factor), influence the opioid system.MethodsA total of 60 patients with prediabetes and IR (prediabetes+IR), 60 patients with prediabetes without IR (prediabetes-IR), and 60 controls participated in the study. The IR state was HOMAIR > 2.5. The enzyme linked immunosorbent assay was used to measure interleukin (IL)-6, IL-10, μ- and κ-opioid receptors (MOR and KOR), endomorphin-2 (EM2), and β- endorphin (βEP).ResultsThe subjects with prediabetes had dyslipidemia, and not all of them underwent the IR state. The IL-6, IL-10, β-endorphin, MOR, and endomorphin-2 were higher in the prediabetes subgroups compared with the control group. MOR was correlated with IL-10 and KOR. Prediabetes+IR can be predicted by the increased levels of the combination of IL-10, βEP, and EM2 and by the combination of IL-10 and endomorphin-2/KOR with good sensitivity and specificity.ConclusionOpioid peptides and their receptors were upregulated in patients with prediabetes depending on the significance of IR. These changes in the opioid system depend on the immune cytokines. Both systems need to be normalized to prevent further development into diabetes mellitus.

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Shatha Rouf Moustafa

Abstract Background Prediabetes is characterized by a hemoglobin A1c of 5.7–6.4% and fasting blood glucose of 100–125 mg/dl. A high percentage of prediabetes subjects develop type 2 diabetes mellitus in the next years. The effects of opioid peptides and their receptors, in addition to immunological cytokines, on prediabetes are not well understood. Therefore, molecular, physiological, and clinical studies are required to link the opioid system, immune system, and insulin resistance (IR) in prediabetes. We hypothesize that opioid peptides (endomorphin-2 (EM2), and β-endorphin (βEP)), and their receptors (µ-opioid receptors (MOR) and κ-opioid receptors (KOR)), in addition to the inflammatory cytokines (IL-6) and anti-inflammatory cytokine (IL-10), affect IR parameters in patients with prediabetes. Methods Sixty prediabetes patients with IR (prediabetes+IR) and sixty prediabetes patients without IR (prediabetes-IR), in addition to 58 controls, have participated in the study. IL-6, IL-10, EM2, βEP, MOR, and KOR were measured by the ELISA technique. Results In general, most prediabetes subjects have dyslipidemia. The IL-6, IL-10, β-endorphin, MOR, and endomorphin-2 were higher in the prediabetes subgroups than the control group. The immune system was activated in the prediabetes in an IR-dependent manner. Prediabetes+IR can be predicted by the increased levels of IL-10, βEP, and EM2 and by the combination of IL-10 and EM2/KOR with good sensitivity and specificity. Conclusion Opioid peptides and their receptors were upregulated in patients with prediabetes, depending on the significance of IR and the immune cytokines. The intercorrelation between the immune system, EOS, and insulin in prediabetes was confirmed.


2020 ◽  
Author(s):  
Shakiba Naiemian ◽  
Mohsen naeemipour ◽  
Mehdi Zarei ◽  
Ali Gohari ◽  
Mohammad Reza Behroozikhah ◽  
...  

Abstract Background: Asprosin, a newly identified adipokine, is pathologically increased in individuals with insulin resistance. However, the available evidence on the association of asprosin and type 2 diabetes mellitus (T2DM) status is still scarce. Therefore, this study aimed to determine the relationship between serum concentrations of asprosin and T2DM status . Methods: This observational study was performed based on 194 adults (97 newly diagnosed T2DM and 97 healthy individuals). Anthropometric and biochemical variables were determined in all participants . Serum concentrations of asprosin were measured using enzyme-linked immunosorbent assay (ELISA). Results: In patients with T2DM, the serum concentrations of asprosin were significantly higher than the healthy controls (4.18 [IQR: 4.4] vs. 3.5 [IQR: 1.85], P< 0.001). The concentrations of asprosin were significantly correlated with body mass index (BMI) and fasting blood glucose (FBG) in healthy subjects and with BMI, FBG, hemoglobin A1c (HbA1c), homeostatic model assessment of insulin resistance (HOMA-IR), and quantitative insulin check index (QUICKI), triacylglycerol (TAG) and total cholesterol/ high-density lipoprotein cholesterol (TC/HDL-C) ratio in the T2DM group. In fully adjusted model, the odds ratio (OR) of T2DM with serum concentrations of asprosin was approximately 1.547 (95% CI 1.293-1.850, P< 0.001) compared to the control group . Multiple stepwise regression analysis indicated that FBG and HOMA-IR were independently associated with asprosin in T2DM. Conclusion : Our findings indicated that serum concentrations of asprosin are increased in patients with T2DM. Also, asprosin is correlated with insulin resistance and TC/HDL-C ratio (atherosclerotic risk factor of cardiovascular diseases) in patients with T2DM.


2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Ilkin Zindancı ◽  
Ozlem Albayrak ◽  
Mukaddes Kavala ◽  
Emek Kocaturk ◽  
Burce Can ◽  
...  

Background. Psoriasis is a chronic inflammatory skin disorder in which proinflammatory cytokines including IL-6 and TNF-αincrease both locally and systematically. It is thought that chronic inflammation results in metabolic diseases and proinflammatory cytokines give rise to the development of atherogenesis, peripheral insulin resistance, hypertension, and type 2 diabetes. Our aim was to investigate the prevalence of metabolic syndrome in patients with psoriasis vulgaris.Methods. Study consisted of 115 plaque-type psoriasis patients and 140 healthy individuals. Data including body weight, height, waist circumference, body-mass index, and arterial blood pressure were collected. Fasting blood glucose, triglyceride, and HDL levels were determined. International Diabetes Federation Criteria for Metabolic Syndrome and Insulin Resistance were used for evaluating patients with metabolic syndrome and diabetes.Results. Compared to the control group, metabolic syndrome, diabetes mellitus, and hypertension were found to be higher in psoriasis patients. Metabolic syndrome was increased by 3-folds in psoriasis patients and was more prevalent in women than in men. It was determined that the prevalence of metabolic syndrome was higher in psoriasis patients after the age of 40. Metabolic syndrome was not related to smoking, severity of psoriasis, and duration of disease.Conclusions. Our findings suggest that psoriasis preconditions occurrence of a group of diseases such as diabetes mellitus, hypertension, and metabolic syndrome. For this reason, patients with psoriasis should be treated early and they should be followed with respect to metabolic diseases.


2021 ◽  
pp. 21-27
Author(s):  
T. S. Vatseba

Abstract. The aim of the study was to investigate insulin resistance in patients with pancreatic and colorectal cancer diagnosed in people with type 2 diabetes. Materials and methods. 64 patients were examined. They were divided into the following groups: group I – healthy people (control group) (n = 16); group II – patients with type 2 diabetes without cancer (n = 28); group IIIa – patients with type 2 diabetes with pancreatic cancer (n = 10), group IIIb – patients with type 2 diabetes with colorectal cancer (n = 10). The study involved patients from specialized departments of the Ivano-Frankivsk Regional Hospital and the Precarpathian Clinical Oncology Center. Blood insulin levels were determined by enzyme-linked immunosorbent assay, using Insulin ELISA diagnostic kits, EIA-2935. Fasting blood glucose was determined by glucose oxidase method. Compensation for diabetes was assessed by the level of glycated hemoglobin (HbA1c) and determined by ion exchange chromatography. Data analysis was performed using Statistica 12.0 (StatSoft Inc., USA). Differences between the values in the comparison groups were determined by Student’s t-test and were considered significant at P < 0.05. Results. Patients with type 2 diabetes who were diagnosed with pancreatic cancer or colorectal cancer were older, compared with patients with type 2 diabetes without cancer (P < 0.05). Obesity was diagnosed in patients with colorectal cancer of group IIIb, their BMI was higher in comparison with patients of group IIIa who suffered from pancreatic cancer (P < 0.05). BMI in patients of group IIIa was lower than in control group (P < 0.05), in patients of group II (P < 0.05) and in patients of group IIIb with colorectal cancer (P < 0.05). Compared with patients of group II, patients with pancreatic and colorectal cancer had significantly lower insulin levels (P < 0.05), but significantly higher fasting blood glucose levels (P < 0.05). Insulin resistance according to the HOMA-IR index (> 3.0) was detected in both types of cancer. The HOMA-IR index in patients with pancreatic cancer was significantly lower than in patients of group II (P < 0.05). The level of HbA1c in patients with type 2 diabetes without cancer and in patients with cancer diagnosed on the background of diabetes did not differ significantly (P > 0.05). Prior to cancer detection, the same number of patients (50.0%) received metformin-free therapy in both the pancreatic cancer group and the colorectal cancer group. However, the duration of diabetes in patients with pancreatic cancer was 2.90 ± 2.60 years and was significantly shorter than in patients with colorectal cancer 9.70 ± 5.66 (P < 0.05). 80.0% of patients in group IIIa had a history of diabetes less than 5 years, and 80.0% of patients in group IIIb – more than 5 years. Conclusions: 1.In patients with type 2 diabetes mellitus with pancreatic cancer, as well as in patients with colorectal cancer, insulin resistance was detected by the HOMA-IR index, which depended on the combined effect of insulin and hyperglycemia in patients with colorectal cancer and on the fasting blood glucose in patients with pancreatic cancer. 2. The absence of hyperinsulinemia, the short duration of type 2 diabetes in patients with pancreatic cancer may be indirect evidence of cancer induced pancreatogenic diabetes (T3cDM) in the majority of patients of this group. For elderly patients with newly diagnosed diabetes mellitus without obesity, without hyperinsulinemia, screening for pancreatic cancer is recommended.


2022 ◽  
Vol 28 (1) ◽  
pp. 59-61
Author(s):  
Bin Zhang

ABSTRACT Introduction: Type 2 diabetes mellitus (T2DM), also known as non-insulin-dependent diabetes mellitus (NIDDM), accounts for more than 90% of the total number of diabetes mellitus cases and often occurs in middle-aged and elderly people. Objective: To investigate the effect of exercise intervention on insulin resistance in obese type 2 diabetes patients. Methods: Eighty-six obese diabetic patients were screened as experimental subjects in physical examinations and randomly divided into observation and control groups. Visceral fat volume, fasting blood glucose, and fasting insulin of all subjects were measured before and after completion of the 6-month experimental implementation. The insulin resistance was calculated for both groups and the values for each indicator were compared statistically between groups. Results: Control of body weight, body mass index, blood glucose, blood lipids and insulin resistance index were better in the observation group than in the control group, and the difference was statistically significant (P < 0.05). Conclusions: Basal intervention with quantitative exercise can significantly improve insulin resistance in obese type 2 diabetes patients and the effect is better than treatment with diet and conventional exercise. Level of evidence II; Therapeutic studies - investigation of treatment results.


2020 ◽  
Author(s):  
Shakiba Naiemian ◽  
Mohsen naeemipour ◽  
Mehdi Zarei ◽  
Moslem Lari Najafi ◽  
Ali Gohari ◽  
...  

Abstract Background: Asprosin, a newly identified adipokine, is pathologically increased in individuals with insulin resistance. However, the available evidence on the association of asprosin and type 2 diabetes mellitus (T2DM) status is still scarce. Therefore, this study aimed to determine the relationship between serum concentrations of asprosin and T2DM status. Methods: This observational study was performed based on 194 adults (97 newly diagnosed T2DM and 97 healthy individuals). Anthropometric and biochemical variables were determined in all participants. Serum concentrations of asprosin were measured using enzyme-linked immunosorbent assay (ELISA). Results: In patients with T2DM, the serum concentrations of asprosin were significantly higher than the healthy controls (4.18 [IQR: 4.4] vs. 3.5 [IQR: 1.85], P< 0.001). The concentrations of asprosin were significantly correlated with body mass index (BMI) and fasting blood glucose (FBG) in healthy subjects and with BMI, FBG, hemoglobin A1c (HbA1c), homeostatic model assessment of insulin resistance (HOMA-IR), and quantitative insulin check index (QUICKI), triacylglycerol (TAG) and total cholesterol/ high-density lipoprotein cholesterol (TC/HDL-C) ratio in the T2DM group. In fully adjusted model, the odds ratio (OR) of T2DM with serum concentrations of asprosin was approximately 1.547 (95% CI 1.293-1.850, P< 0.001) compared to the control group. Multiple stepwise regression analysis indicated that FBG and HOMA-IR were independently associated with asprosin in T2DM. Conclusion: Our findings indicated that serum concentrations of asprosin are increased in patients with T2DM. Also, asprosin is correlated with insulin resistance and TC/HDL-C ratio (atherosclerotic risk factor of cardiovascular diseases) in patients with T2DM.


2021 ◽  
pp. 779-786
Author(s):  
Chinar Hameed Sadiq ◽  
Ridha H. Hussein ◽  
Ismail M. Maulood

Background: Orexin-A is an orexigenic hormone that plays an important role in the metabolism of blood glucose, insulin, and insulin resistance (IR). The pathogenesis of type 2 diabetes mellitus (T2DM) is related to the abnormality in insulin and IR. However, no sufficient studies to date have clearly shown the association of orexin-A with biochemical parameters related to T2DM. Objectives: The aim of this study was to determine the relation of orexin-A with IR and how they associate with physiological changes in T2DM patients. Understanding this relation will offer some pharmacological tools to reduce some complications in diabetes. Materials and Methods: A total of 41 T2DM and 43 non-DM subjects, aged between 40-60 years with body mass index (BMI) ≤25 kg/m2, participated in the present study. Fasting serum orexin-A, IR, fasting blood glucose (FBG), glycated hemoglobin (HbA1C), lipid profile, liver enzymes (alanine aminotransferase (ALT) and aspartate transaminase (AST)), nitric oxide (NO), and malondialdehyde (MDA) parameters were evaluated. Orexin-A was evaluated by using enzyme-linked immunosorbent assay (ELISA). For statistical analysis, GraphPad Prism 7.0 and SPSS version 24.0 programs were used. Results: Orexin-A was positively correlated with blood pressure, FBG, HbA1c, insulin, and IR but inversely related to insulin sensitivity (IS), leptin, and gender. Stepwise multiple regression presented HOMA-IR, diastolic blood pressure, and very-low-density lipoprotein-cholesterol as predictors for orexin-A. The area under control value showed orexin-A, FBG, HbA1c, HOMA-IR, IS, ALT, AST, NO and MDA as biomarkers for T2DM disease. Conclusion: Orexin-A has a predictive ability to diagnose T2DM, as it is significantly associated with hyperglycemia, IR, and IS.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Karol Graňák ◽  
Vnucak Matej ◽  
Petra Skálová ◽  
Margaréta Pytliaková ◽  
Ľudovít Laca ◽  
...  

Abstract Background and Aims The incidence of post-transplant diabetes mellitus (PTDM) after kidney transplantation (KT) is high and ranges from 15-30%. Insulin resistance (IR) at the time of KT is the most significant risk factor for the development of PTDM in patients after KT, as demonstrated by several analyzes. It is possible to reduce the high incidence of PTDM by influencing just modifiable risk factors, including obesity and the associated IR. The aim of this work is to determine the effect of precisely determined physical activity and lifestyle changes on IR and other risk factors for PTDM in patients after KT. Method This is a prospective controlled analysis, which included 44 patients after primary KT in the Martin Transplant Center. Half consisted of a study group (n = 22) whose patients were assigned to perform regular physical activity. The primary goal was to complete at least 150 minutes of moderate intensity physical exertion per week. They performed an aerobic or combined (aerobic + anaerobic) type of sports activity. Monitoring was provided by a sports tracker (Xiaomi Mi Band 3 compatible with Mi Fit mobile application). The other half was made up of a control group. The exclusion criterion at that time was already diagnosed with diabetes mellitus or a pre-diabetic condition. IR was assessed using the HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) index from fasting blood glucose and insulinemia values. Each patient underwent an oral glucose tolerance test (oGTT) at the end of follow-up. Patients in both groups have the same immunosuppressive protocol. The duration of follow-up was 6 months. Results In the observed group we univariately found in the 3rd and 6th month of monitoring significantly lower waist circumference (P = 0.0437, P = 0.0372), better graft function (P = 0.0036, P = 0.0137), lower value glycemia (P = 0.0016, P = 0.0003), C-peptide (P = 0.0447, P = 0014) and lower low-density lipoprotein (LDL) at 6 months (P = 0.0444) compared to the control group. We confirmed a statistically significantly lower IR at 6 months (P = 0.0202) and fasting blood glucose at 3 and 6 months (P = 0.0227) by multivariate analysis in the observed group. After the end of the follow-up, we identified statistically significantly fewer patients with a negative oGTT result in the control group (P &lt; 0.0001), significantly more patients with impaired glucose tolerance, fasting hyperglycemia (P = 0.0078) and diagnosed with PTDM (P = 0.0212). In the control group, we found a statistically significant increase in glycemia at 30 (P = 0.0034) as well as at 120 minutes (P = 0.0011) during oGTT compared to the observed group. Conclusion In our study, we confirmed a significant effect of regular physical activity in preventing the development of IR and associated pre-diabetic conditions and PTDM.


2020 ◽  
Author(s):  
Shakiba Naiemian ◽  
Mohsen naeemipour ◽  
Mehdi Zarei ◽  
Ali Gohari ◽  
Mohammad Reza Behroozikhah ◽  
...  

Abstract Background: Asprosin, a newly identified adipokine, is pathologically increased in individuals with insulin resistance. However, the available evidence on the association of asprosin and type 2 diabetes mellitus (T2DM) status is still scarce. Therefore, this study aimed to determine the relationship between serum concentrations of asprosin and T2DM status. Methods: This observational study was performed based on 194 adults (97 newly diagnosed T2DM and 97 healthy individuals). Anthropometric and biochemical variables were determined in all participants. Serum concentrations of asprosin were measured using enzyme-linked immunosorbent assay (ELISA). Results: In patients with T2DM, the serum concentrations of asprosin were significantly higher than the healthy controls (4.18 [IQR: 4.4] vs. 3.5 [IQR: 1.85], P< 0.001). The concentrations of asprosin were significantly correlated with body mass index (BMI) and fasting blood glucose (FBG) in healthy subjects and with BMI, FBG, hemoglobin A1c (HbA1c), homeostatic model assessment of insulin resistance (HOMA-IR), and quantitative insulin check index (QUICKI), triacylglycerol (TAG) and total cholesterol/ high-density lipoprotein cholesterol (TC/HDL-C) ratio in the T2DM group. In fully adjusted model, the odds ratio (OR) of T2DM with serum concentrations of asprosin was approximately 1.547 (95% CI 1.293-1.850, P< 0.001) compared to the control group. Multiple stepwise regression analysis indicated that FBG and HOMA-IR were independently associated with asprosin in T2DM. Conclusion: Our findings indicated that serum concentrations of asprosin are increased in patients with T2DM. Also, asprosin is correlated with insulin resistance and TC/HDL-C ratio (atherosclerotic risk factor of cardiovascular diseases) in patients with T2DM.


2021 ◽  
pp. 16-18
Author(s):  
Nishanth Kumar ◽  
Malathi R D ◽  
Ramadevi M

Background: Diabetes mellitus is a metabolic disorder of multifactorial origin characterized by hyperglycemia and disturbances of glucose , fat and protein metabolism. Hypomagnesemia is been associated with chronic and uncontrolled diabetes mellitus. Magnesium deciency in diabetes is known to be associated with increased risk of microvascular and macrovascular complications. The aim of this study is to estimate fasting plasma glucose and serum magnesium levels and to assess the correlation of hypomagnesemia with abnormal fasting plasma glucose values. Material and Methods: The study was done at Government Medical College, Nizamabad. 80 subjects were recruited out of whom 40 apparently normal persons were taken as control group and the second group of 40 patients with known history of diabetes. The fasting plasma glucose(FPG) was estimated by GOD-POD method and serum Magnesium(Mg) levels were estimated using the Chemchek Mg kit which is based on Xylidyl Blue with ACTS method. Results :The mean values of fasting plasma glucose was 87.1 mg/dL in non diabetics when compared to 159.4 mg/dL in diabetics while Serum magnesium levels in control subjects had a mean value of 2.19mg/dLand 1.8mg/dLin diabetics. The data was analysed and found to be statistically signicant with a negative correlation between plasma magnesium and fasting blood glucose. Conclusion: There is signicant hypomagnesaemia which correlates increased fasting plasma glucose values in diabetics when compared to non diabetics and therefore assessing the serum magnesium levels may help in reducing risk of complications.


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