scholarly journals The Association of Cortisol Excretion with Weight and Metabolic Parameters in Nondiabetic Patients with Morbid Obesity

Obesity Facts ◽  
2021 ◽  
pp. 1-10
Author(s):  
Johanna Maria Brix ◽  
Andrea Tura ◽  
Carsten Thilo Herz ◽  
Astrid Feder ◽  
Eva-Christina Krzizek ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Glucose Tolerance ◽  
Multivariable Analysis ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Metabolic Parameters ◽  
Oral Glucose ◽  
Urinary Cortisol ◽  
Urinary Cortisol Excretion ◽  
Cortisol Excretion

<b><i>Introduction:</i></b> Cortisol is involved in the regulation of gluconeogenesis and glucose utilization. In morbid obesity (MO), the association of cortisol excretion with metabolic parameters is not well-characterized. In our study, we evaluated cortisol excretion in nondiabetic subjects with MO and its effect on glucose metabolism. <b><i>Methods:</i></b> We included 1,249 nondiabetic patients with MO (79.8% females, mean BMI 44.9 ± 6.5 kg/m<sup>2</sup>, mean age 38 ± 11 years). Anthropometric data and cardiovascular risk factors were assessed, and an oral glucose tolerance test for calculation of insulin resistance was performed. Cortisol excretion was assessed on 2 consecutive days (24 h urine specimens). <b><i>Results:</i></b> Regarding cortisol excretion, patients were divided into 3 tertiles (urinary cortisol ≤51.6, &#x3e;51.6 and &#x3c;117.6, and ≥117.6 μg/24 h, respectively). Patients in the highest tertile were younger (<i>p</i> = 0.003), more obese (BMI: <i>p</i> = 0.040), had lower diastolic blood pressure ([DBP]; <i>p</i> = 0.012), lower total (<i>p</i> = 0.032) and LDL cholesterol (<i>p</i> = 0.021), fasting (<i>p</i> = 0.049) and 2-h glycemia (<i>p</i> = 0.028), 2-h insulinemia (<i>p</i> = 0.020), and HbA1c (<i>p</i> &#x3c; 0.001), and a higher estimated glomerular filtration rate (eGFR) (<i>p</i> &#x3c; 0.001). The glucose (<i>p</i> &#x3c; 0.001) and insulin (<i>p</i> = 0.011) area under the curve (AUC) were also lower. Urinary cortisol excretion adjusted for age, sex, and eGFR was positively correlated with body weight (BW, beta = 0.076, <i>p</i> = 0.004) and overall glucose tolerance (oral disposition index, beta = 0.090, <i>p</i> = 0.011), and negatively with HbA1c (beta = −0.179, <i>p</i> &#x3c; 0.001), 2-h glycemia (beta = −0.075, <i>p</i> = 0.032), AUC glucose (beta = −0.103, <i>p</i> = 0.002), and DBP (beta = −0.139, <i>p</i> &#x3c; 0.001). HbA1c, BW, and DBP remained significant after multivariable analysis. <b><i>Discussion/Conclusion:</i></b> Despite being more obese, patients with higher cortisol excretion have a more favorable metabolic profile. These results deserve further attention regarding the respective mechanisms.

scholarly journals Glucose area under the curve during oral glucose tolerance test as an index of glucose intolerance

2015 ◽  
Vol 7 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Kazuhiko Sakaguchi ◽  
Kazuo Takeda ◽  
Mitsuo Maeda ◽  
Wataru Ogawa ◽  
Toshiyuki Sato ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Glucose Intolerance ◽  
Glucose Tolerance Test ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance

scholarly journals Influence of Cinnamon on Glycemic Control in Individuals With Prediabetes: A Randomized Controlled Trial

2020 ◽  
Vol 4 (11) ◽  
Author(s):  
Giulio R Romeo ◽  
Junhee Lee ◽  
Christopher M Mulla ◽  
Youngmin Noh ◽  
Casey Holden ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Controlled Trial ◽  
Area Under The Curve ◽  
Cost Effective ◽  
Tolerance Test ◽  
Controlled Clinical Trial ◽  
Oral Glucose ◽  
Serious Adverse Events ◽  
Double Blind ◽  
Favorable Safety

Abstract Context The identification of adjunct safe, durable, and cost-effective approaches to reduce the progression from prediabetes to type 2 diabetes (T2D) is a clinically relevant, unmet goal. It is unknown whether cinnamon’s glucose-lowering properties can be leveraged in individuals with prediabetes. Objective The objective of this work is to investigate the effects of cinnamon on measures of glucose homeostasis in prediabetes. Design, Setting, Participants, and Intervention This double-blind, placebo-controlled, clinical trial randomly assigned adult individuals meeting any criteria for prediabetes to receive cinnamon 500 mg or placebo thrice daily (n = 27/group). Participants were enrolled and followed at 2 academic centers for 12 weeks. Main Outcome Measures Primary outcome was the between-group difference in fasting plasma glucose (FPG) at 12 weeks from baseline. Secondary end points included the change in 2-hour PG of the oral glucose tolerance test (OGTT), and the change in the PG area under the curve (AUC) derived from the OGTT. Results From a similar baseline, FPG rose after 12 weeks with placebo but remained stable with cinnamon, leading to a mean between-group difference of 5 mg/dL (P &lt; .05). When compared to the respective baseline, cinnamon, but not placebo, resulted in a significant decrease of the AUC PG (P &lt; .001) and of the 2-hour PG of the OGTT (P &lt; .05). There were no serious adverse events in either study group. Conclusions In individuals with prediabetes, 12 weeks of cinnamon supplementation improved FPG and glucose tolerance, with a favorable safety profile. Longer and larger studies should address cinnamon’s effects on the rate of progression from prediabetes to T2D.

scholarly journals Plasma Metabolomics to Identify and Stratify Patients With Impaired Glucose Tolerance

2019 ◽  
Vol 104 (12) ◽  
pp. 6357-6370 ◽  
Author(s):  
Charlotte Wildberg ◽  
Annette Masuch ◽  
Kathrin Budde ◽  
Gabi Kastenmüller ◽  
Anna Artati ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Proton Nuclear Magnetic Resonance ◽  
Oral Glucose ◽  
Resonance Spectroscopy ◽  
Insulin Levels ◽  
Model Combining ◽  
Branched Chain

Abstract Objective Impaired glucose tolerance (IGT) is one of the presymptomatic states of type 2 diabetes mellitus and requires an oral glucose tolerance test (OGTT) for diagnosis. Our aims were twofold: (i) characterize signatures of small molecules predicting the OGTT response and (ii) identify metabolic subgroups of participants with IGT. Methods Plasma samples from 827 participants of the Study of Health in Pomerania free of diabetes were measured using mass spectrometry and proton-nuclear magnetic resonance spectroscopy. Linear regression analyses were used to screen for metabolites significantly associated with the OGTT response after 2 hours, adjusting for baseline glucose and insulin levels as well as important confounders. A signature predictive for IGT was established using regularized logistic regression. All cases with IGT (N = 159) were selected and subjected to unsupervised clustering using a k-means approach. Results and Conclusion In total, 99 metabolites and 22 lipoprotein measures were significantly associated with either 2-hour glucose or 2-hour insulin levels. Those comprised variations in baseline concentrations of branched-chain amino ketoacids, acylcarnitines, lysophospholipids, or phosphatidylcholines, largely confirming previous studies. By the use of these metabolites, subjects with IGT segregated into two distinct groups. Our IGT prediction model combining both clinical and metabolomics traits achieved an area under the curve of 0.84, slightly improving the prediction based on established clinical measures. The present metabolomics approach revealed molecular signatures associated directly to the response of the OGTT and to IGT in line with previous studies. However, clustering of subjects with IGT revealed distinct metabolic signatures of otherwise similar individuals, pointing toward the possibility of metabolomics for patient stratification.

scholarly journals Serum angiopoietin-like 3 levels are elevated in obese non diabetic men but are unaffected during an oral glucose tolerance test

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Maria Fernanda Garcés ◽  
Julieth Daniela Buell-Acosta ◽  
Haiver Antonio Rodríguez-Navarro ◽  
Estefania Pulido-Sánchez ◽  
Juan José Rincon-Ramírez ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Glucose Tolerance Test ◽  
Area Under The Curve ◽  
Serum Levels ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Matsuda Index ◽  
Obese Subjects

AbstractThis study aimed to determine ANGPTL3 serum levels in healthy young lean and obese non-diabetic men during an oral glucose tolerance test (OGTT) and correlate them with anthropometric, biochemical and hormonal parameters. A case–control study was carried out and 30 young obese non-diabetic (23.90 ± 3.84 years and BMI 37.92 ± 4.85 kg/m2) and 28 age-matched healthy lean (24.56 ± 3.50 years and BMI of 22.10 ± 1.72 kg/m2) men were included in this study. The primary outcome measures were serum basal ANGPTL3 and ANGPTL3–area under the curve (AUC) levels. The percentage of body fat was measured by dual-energy X-ray absorptiometry and biochemical, hormonal and insulin resistance indices were determined. Basal ANGPTL3 and ANGPTL3–AUC levels were significantly elevated (p < 0.05) in young obese subjects compared with lean subjects and were positively and significantly associated with different anthropometric measurements. Fasting ANGPTL3 serum levels were positively correlated with fasting insulin, leptin, Leptin/Adiponectin index and triglyceride—glucose index. Moreover, ANGPTL3–AUC was negatively correlated with Matsuda index. In this regard, chronically high ANGPTL3 levels in young obese subjects might favor triglyceride-rich lipoprotein clearance to replenish triglyceride stores by white adipose tissue rather than oxidative tissues.

Glucose Tolerance Is Improved After Low- and High-Intensity Exercise in Middle-Age Men and Women

1998 ◽  
Vol 23 (6) ◽  
pp. 583-593 ◽  
Author(s):  
Arend Bonen ◽  
Margaret Ball-Burnett ◽  
Caryl Russel
Keyword(s):  
Glucose Tolerance ◽  
High Intensity ◽  
Area Under The Curve ◽  
Exercise Bout ◽  
Tolerance Test ◽  
High Intensity Exercise ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Beneficial Effects ◽  
Low Intensity Exercise

We compared the effects of low- and high-intensity exercise on oral glucose tolerance immediately and 24 hr after each exercise bout. Participants were 5 male and 5 female individuals (age 40-48). A fasted, oral glucose tolerance test (OGTT) was conducted several days before the first exercise bout. Glucose and insulin concentrations were determined every 15 min throughout a 2 hr, 75 g OGTT. Immediately after low-intensity exercise, the incremental glucose area under the curve was reduced by 16%, compared to the fasting OGTT (p < .05). This was reduced further (−30%) 24 hr postexercise (p < .05). After high-intensity exercise, similar results were observed, with the incremental glucose area reduced by 14 and 35% immediately and 24 hr postexercise, respectively (p < .05). In conclusion, exercise improves glucose tolerance, this effect is more pronounced 24 hr postexercise, and low-and high-intensity exercise provide similar beneficial effects on glucose tolerance. Key words: cycle ergometry, insulin

scholarly journals Lifetime congenital isolated GH deficiency does not protect from the development of diabetes

2013 ◽  
Vol 2 (2) ◽  
pp. 112-117 ◽  
Author(s):  
Taísa A R Vicente ◽  
Ívina E S Rocha ◽  
Roberto Salvatori ◽  
Carla R P Oliveira ◽  
Rossana M C Pereira ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Cell Function ◽  
Gh Deficiency ◽  
Receptor Gene ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Insulinogenic Index ◽  
Model Assessment ◽  
Cross Sectional

ObjectivesAdult subjects with untreated, lifetime, isolated GH deficiency (IGHD) due to a homozygous GHRH receptor gene mutation (MUT/MUT) residing in Itabaianinha, Brazil, present with lower BMI, higher prevalence of impaired glucose tolerance (IGT), increased insulin sensitivity (IS), and reduced β-cell function (βCF) when compared with non-BMI-matched homozygous normal controls. However, the prevalence of diabetes mellitus (DM) in this cohort is unknown. Comparing their IS and βCF with BMI-matched individuals heterozygous for the same mutation (MUT/N) may be useful to elucidate the role of the GH–IGF1 axis in IS and βCF. The purposes of this work were to verify the prevalence of IGT and DM in adult MUT/MUT subjects from this kindred and to compare IS and βCF in MUT/MUT and MUT/N.DesignCross-sectional study.MethodsWe studied most (51) of the living IGHD adults of this kindred who are GH naive. The oral glucose tolerance test (OGTT) could be performed in 34 subjects, fasting glucose was measured in 15, while two had a previous diagnosis of DM. The OGTT results of 24 MUT/MUT subjects were compared with those of 25 BMI-matched MUT/N subjects. IS was assessed by homeostatic model assessment of insulin resistance (HOMA–IR), quantitative IS check index, and oral glucose IS index for 2 and 3 h. βCF was assayed by HOMA-β, insulinogenic index, and the area under the curve of insulin:glucose ratio.ResultsThe prevalence of DM and IGT in IGHD was 15.68 and 38.23% respectively. IS was increased and βCF was reduced in MUT/MUT in comparison with MUT/N.ConclusionsLifetime, untreated IGHD increases IS, impairs βCF, and does not provide protection from diabetes.

scholarly journals No difference in exogenous carbohydrate oxidation during exercise in children with and without impaired glucose tolerance

2016 ◽  
Vol 121 (3) ◽  
pp. 724-729 ◽  
Author(s):  
Lisa Chu ◽  
Katherine M. Morrison ◽  
Michael C. Riddell ◽  
Sandeep Raha ◽  
Brian W. Timmons
Keyword(s):  
Insulin Sensitivity ◽  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Normal Glucose Tolerance ◽  
Whole Body ◽  
Oral Glucose ◽  
Insulin Resistant ◽  
Glucose Levels

The capacity to match carbohydrate (CHO) utilization with availability is impaired in insulin-resistant, obese adults at rest. Understanding exogenous carbohydrate (CHOexo) oxidation during exercise and its association to insulin resistance (IR) is important, especially in children at risk for type 2 diabetes. Our objective was to examine the oxidative efficiency of CHOexo during exercise in obese children with normal glucose tolerance (NGT) or impaired glucose tolerance (IGT). Children attended two visits and were identified as NGT ( n = 22) or IGT ( n = 12) based on 2-h oral glucose tolerance test (OGTT) glucose levels of <7.8 mmol/l or ≥7.8 mmol/l, respectively. Anthropometry, body composition, and aerobic fitness (V̇o2max) were assessed. Insulin and glucose at baseline, 30, 60, 90, and 120 min during the OGTT were used to calculate measures of insulin sensitivity. On a separate day, a 13C-enriched CHO drink was ingested before exercise (3 × 20 min bouts) at 45% V̇o2max. Breath measurements were collected to calculate CHOexo oxidative efficiency. CHOexo oxidative efficiency during exercise was similar in IGT (17.0 ± 3.6%) compared with NGT (17.1 ± 4.4%) ( P = 0.90) despite lower whole body insulin sensitivity in IGT at rest ( P = 0.02). Area under the curve for insulin (AUCins) measured at rest during the OGTT was greater in IGT compared with NGT ( P = 0.04). The ability of skeletal muscle to utilize CHOexo was not impaired during exercise in children with IGT.

scholarly journals Acute Postexercise Effects of Concentric and Eccentric Exercise on Glucose Tolerance

2015 ◽  
Vol 25 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Matthew David Cook ◽  
Stephen David Myers ◽  
John Stephen Michael Kelly ◽  
Mark Elisabeth Theodorus Willems
Keyword(s):  
Glucose Tolerance ◽  
Eccentric Exercise ◽  
Glucose Control ◽  
Isometric Force ◽  
Insulin Response ◽  
Area Under The Curve ◽  
Acute Effect ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Downhill Running

Impaired glucose tolerance was shown to be present 48 hr following muscle-damaging eccentric exercise. We examined the acute effect of concentric and muscle-damaging eccentric exercise, matched for intensity, on the responses to a 2-hr 75-g oral glucose tolerance test (OGTT). Ten men (27 ± 9 years, 178 ± 7 cm, 75 ± 11 kg, VO2max: 52.3 ± 7.3 ml·kg-1·min-1) underwent three OGTTs after an overnight 12 hr fast: rest (control), 40-min (5 × 8-min with 2-min interbout rest) of concentric (level running, 0%, CON) or eccentric exercise (downhill running, –12%, ECC). Running intensity was matched at 60% of maximal metabolic equivalent. Maximal isometric force of m. quadriceps femoris of both legs was measured before and after the running protocols. Downhill running speed was higher (level: 9.7 ± 2.1, downhill: 13.8 ± 3.2 km·hr-1, p < .01). Running protocols had similar VO2max (p = .59), heart rates (p = .20) and respiratory exchange ratio values (p = .74) indicating matched intensity and metabolic demands. Downhill running resulted in higher isometric force deficits (level: 3.0 ± 6.7, downhill: 17.1 ± 7.3%, p < .01). During OGTTs, area-under-the-curve for plasma glucose (control: 724 ± 97, CON: 710 ± 77, ECC: 726 ± 72 mmol·L-1·120 min, p = .86) and insulin (control: 24995 ± 11229, CON: 23319 ± 10417, ECC: 21842 ± 10171 pmol·L-1·120 min, p = .48), peak glucose (control: 8.1 ± 1.3, CON: 7.7 ± 1.2, ECC: 7.7 ± 1.1 mmol·L-1, p = .63) and peak insulin levels (control: 361 ± 188, CON: 322 ± 179, ECC: 299 ± 152 pmol·L-1, p = .30) were similar. It was concluded that glucose tolerance and the insulin response to an OGTT were not changed immediately by muscle-damaging eccentric exercise.

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