Abstract P048: A Model Of Chronic Insufficient Sleep Increases Markers Of Insulin Resistance In Postmenopausal But Not Premenopausal Women

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Faris M Zuraikat ◽  
Samantha Scaccia ◽  
Ayanna Campbell ◽  
Bin Cheng ◽  
Marie-Pierre St-Onge

Introduction: Insufficient sleep is widely prevalent among US adults and is a risk factor for type 2 diabetes (T2D). Experimental studies show adverse effects of acute, severe short sleep on insulin sensitivity, but it is unclear whether these reflect risks associated with milder short sleep routinely observed in the general population. To date, no study has evaluated the impact of prolonged mild sleep curtailment on markers of insulin resistance in women or whether these effects differ by menopausal status, known to impact insulin sensitivity. Hypothesis: Glucose and insulin levels, as well as a measure of insulin resistance (HOMA-IR), will increase during 6 wk of sleep restriction (SR) relative to adequate sleep (AS). Adverse effects of prolonged short sleep will be exacerbated in postmenopausal women. Methods: Thirty-four women (age: 38±14 y; BMI: 25.6±3.6 kg/m2; n=10 postmenopausal) with adequate habitual total sleep time (TST) (453±33 min) took part in a randomized crossover study with two 6-wk phases: AS and SR. In AS, participants were asked to maintain stable nightly bed and wake times determined from 2 wk of screening with wrist actigraphy and sleep logs. In SR, bedtime was delayed to reduce TST by approximately 1.5 h/night. Sleep was measured continuously using actigraphy and verified weekly for compliance. At wk 0, 3, 4, and 6 fasting blood samples were collected. Outcomes included glucose and insulin levels as well as HOMA-IR scores, calculated from those values. Linear-mixed models tested interactions of sleep condition with week on outcome measures in the full sample and by menopausal status. Results: Sleep condition impacted the change in TST from baseline (P<0.0001), which was reduced in SR and unchanged in AS (-79±6 vs -4±6min). In the full sample, there was no sleep condition by week interactions for glucose (P=0.67), insulin (P=0.14), or HOMA-IR (P=0.16). Similar results were observed in premenopausal women (all P>0.50). However, in postmenopausal women, there was a significant effect of sleep condition on change in insulin (P=0.046) and HOMA-IR (P=0.039) over the 6 wk. In SR, insulin (slope: 0.26±0.28 μU/mL) and HOMA-IR (slope: 0.07±0.08) increased, while AS resulted in reductions in these outcomes (insulin slope: -0.56±0.29 μU/mL; HOMA-IR slope: -0.16±0.08). Conclusions: We provide the first evidence that chronic short sleep, even if mild, adversely affects insulin sensitivity in postmenopausal women. In contrast, maintenance of AS may improve glycemic regulation. Interestingly, prolonged short sleep did not impact markers of insulin resistance in premenopausal women; further investigation into these life-stage related differences, including underlying mechanisms, is warranted. Results suggest that, in postmenopausal women, a group at heightened risk of poor sleep and T2D, achieving adequate sleep may be an effective strategy to improve cardiometabolic health.

2018 ◽  
Vol 103 (9) ◽  
pp. 3394-3404 ◽  
Author(s):  
Julie Abildgaard ◽  
Else Rubaek Danielsen ◽  
Emma Dorph ◽  
Carsten Thomsen ◽  
Anders Juul ◽  
...  

Abstract Context Menopause is associated with an increased incidence of insulin resistance and diabetes. Objective The aim of this study was to explore the lipid deposition in liver and skeletal muscle and investigate the association with insulin sensitivity in postmenopausal and premenopausal women. Design and Setting Single-center cross-sectional study of 55 healthy women between 45 and 60 years of age. We measured lipid deposition in the liver with magnetic resonance spectroscopy, intramuscular and intra-abdominal lipid deposition with MRI, body composition with a dual-energy X-ray absorptiometry scan, and insulin sensitivity with the composite Matsuda Index. Outcome Measures We studied the association between fat distribution, ectopic lipid deposition, and insulin sensitivity in pre- and postmenopausal women. Results Postmenopausal women had an increased lipid deposition in the liver [0.68% (0.44 to 0.99) vs 0.49% (0.38 to 0.64), P = 0.01] and skeletal muscle [3% (2 to 4) vs 2% (1 to 3), P = 0.001] and had a 28% lower Matsuda insulin sensitivity index during an oral glucose tolerance test (6.31 ± 3.48 vs 8.78 ± 4.67, P = 0.05) compared with premenopausal women. Total fat mass and leg fat mass were stronger predictors of ectopic lipid deposition, and visceral fat mass was a stronger predictor of both ectopic lipid deposition and insulin resistance in postmenopausal women compared with premenopausal women. Conclusions For a given subcutaneous and visceral fat depot size, postmenopausal women show increased ectopic lipid deposition and insulin resistance compared with premenopausal women. It is suggested that lipid deposition in liver and skeletal muscle may represent important mechanistic links between the changes in fat depots and the increased incidence of insulin resistance seen after menopause.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041613
Author(s):  
Toshihide Izumida ◽  
Yosikazu Nakamura ◽  
Yukihiro Sato ◽  
Shizukiyo Ishikawa

ObjectivesSmall dense low-density lipoprotein cholesterol (sdLDL-C) might be a better cardiovascular disease (CVD) indicator than low-density lipoprotein cholesterol (LDL-C); however, details regarding its epidemiology remain elusive. The present study aimed at evaluating the association between the demographic factors, such as age, gender and menopausal status, and sdLDL-C levels and sdLDL-C/LDL-C ratio in the Japanese population.DesignThis was a cross-sectional study.Setting13 rural districts in Japan, 2010–2017.ParticipantsThis study included 5208 participants (2397 men and 2811 women), who underwent the health mass screening that was conducted in accordance with the medical care system for the elderly and obtained informed consent for this study.ResultsIn total, 517 premenopausal women (mean age ±SD, 45.1±4.2 years), 2294 postmenopausal women (66.5±8.8 years) and 2397 men (64.1±11.2 years) were analysed. In men, the sdLDL-C levels and sdLDL-C/LDL-C ratio increased during younger adulthood, peaked (36.4 mg/dL, 0.35) at 50–54 years, and then decreased. In women, relatively regular increasing trends of sdLDL-C level and sdLDL-C/LDL-C ratio until approximately 65 years (32.7 mg/dL, 0.28), followed by a downward or pleated trend. Given the beta value of age, body mass index, fasting glucose and smoking and drinking status by multiple linear regression analysis, standardised sdLDL-C levels and sdLDL-C/LDL-C ratio in 50-year-old men, premenopausal women and postmenopausal women were 26.6, 22.7 and 27.4 mg/dL and 0.24, 0.15 and 0.23, respectively. The differences between premenopausal and postmenopausal women were significant (p<0.001).ConclusionsSdLDL-C and sdLDL-C/LDL-C ratios showed different distributions by age, gender and menopausal status. A subgroup-specific approach would be necessary to implement sdLDL-C for CVD prevention strategies, fully considering age-related trends, gender differences and menopausal status.


Author(s):  
Kirstin A MacGregor ◽  
Iain J Gallagher ◽  
Colin N Moran

Abstract Context There is evidence demonstrating variation in insulin sensitivity across the menstrual cycle. However, to date, research has yielded inconsistent results. Objective This study investigated variation in insulin sensitivity across the menstrual cycle and associations with BMI, physical activity and cardiorespiratory fitness. Design Data from 1906 premenopausal women in NHANES cycles 1999-2006 were analysed. Main outcome measures Menstrual cycle day was assessed using questionnaire responses recording days since last period. Rhythmic variation of plasma glucose, triglyceride and insulin, homeostatic model of insulin resistance (HOMA-IR) and adipose tissue insulin resistance index (ADIPO-IR) across the menstrual cycle were analysed using cosinor rhythmometry. Participants were assigned low or high categories of BMI, physical activity and cardiorespiratory fitness and category membership included in cosinor models as covariates. Results Rhythmicity was demonstrated by a significant cosine fit for glucose (p= 0.014) but not triglyceride (p= 0.369), insulin (p= 0.470), HOMA-IR (p=0.461) and ADIPO-IR (p= 0.335). When covariates were included, rhythmicity was observed when adjusting for: 1. BMI: glucose (p&lt; 0.001), triglyceride (p&lt; 0.001), insulin (p&lt; 0.001), HOMA-IR (p&lt; 0.001) and ADIPO-IR (p&lt; 0.001); 2. Physical activity: glucose (p&lt; 0.001), triglyceride (p= 0.006) and ADIPO-IR (p= 0.038); 3. Cardiorespiratory fitness: triglyceride (p= 0.041), insulin (p= 0.002), HOMA-IR (p= 0.004) and ADIPO-IR (p= 0.004). Triglyceride amplitude, but not acrophase, was greater in the high physical activity category compared to low (p=0.018). Conclusions Rhythmicity in insulin sensitivity and associated metabolites across the menstrual cycle are modified by BMI, physical activity and cardiorespiratory fitness.


2019 ◽  
Vol 33 (8) ◽  
pp. 1107-1114 ◽  
Author(s):  
Shu Fang ◽  
Junmin Zhou

Purpose: To examine associations of daytime napping and diagnosed diabetes in middle-aged premenopausal, middle-aged postmenopausal, and older postmenopausal Chinese women. Design: Quantitative, cross-sectional. Setting: 2015 cross-sectional data from China Health and Retirement Longitudinal Study. Participants were recruited from 150 counties/districts and 450 villages/resident committees. Participants: Six thousand nine hundred and forty women aged 45 years and older (mean age = 61 years) stratified by age and menopausal status. Measures: The outcome was self-reported diagnosed diabetes. The exposure was self-reported daytime napping (0, >0-≤60, or >60 min/d). Participants were stratified to middle-aged premenopausal, middle-aged postmenopausal, and older postmenopausal women according to their age (≤60 or >60 years) and menopausal status. Analysis: One-way analysis of variance and χ2 tests were conducted to explore differences on characteristics of middle-aged premenopausal, middle-aged postmenopausal, and older postmenopausal women. Multiple logistic regressions were used to estimate adjusted odds ratios (ORs) for diagnosed diabetes according to daytime napping in the total sample, middle-aged premenopausal, middle-aged postmenopausal, and older postmenopausal Chinese women. Results: Participants’ mean self-reported daytime napping duration was 34 minutes. Women who napped more than 60 minutes were more likely to report diagnosed diabetes (OR = 1.39, 95% confidence interval (CI), 1.09-1.76) comparing to those who did not nap, after adjusting for potential confounders. No statistical significance of interaction term between daytime napping and age/menopausal status was detected ( P = .602 and P = .558) among total women. The stratified analysis revealed the significant association among middle-aged postmenopausal women napping more than 60 minutes (OR = 1.81, 95% CI, 1.18-2.77). The association, however, was found to be insignificant in middle-aged premenopausal women and older postmenopausal women. Conclusions: Long daytime nap (>60 min/d) was associated with diagnosed diabetes in middle-aged postmenopausal women in China.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Shatha Alharazy ◽  
Eman Alissa ◽  
Mohammed Ardawi ◽  
Susan Lanham-New ◽  
M. Denise Robertson

AbstractVitamin D (vitD) deficiency has been suspected as a risk factor for type 2 diabetes mellitus (T2DM). It has been reported that an inverse relationship exists between vitD status and risk of T2DM. The aim of this study was to investigate whether there is an association between vitD status and glycemic profile and other metabolic parameters among postmenopausal women with T2DM (living in Saudi Arabia). A cross-sectional study was conducted at King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia. One thirty six (n = 136) postmenopausal females (age ≥ 50 years) living in Jeddah city, Saudi Arabia, with T2DM were randomly recruited in this study. Anthropometric measures, blood pressure readings and fasting blood samples were obtained fro all study participants. Several biochemical parameters were estimated in fasting serum samples including total 25(OH)D, HbA1c, insulin, glucose, c-peptide and lipid profile. Surrogate markers for insulin resistance were calculated using Homeostasis Model Assessment for insulin resistance and beta cell activity (HOMA-IR, HOMA-β), Quantitative insulin sensitivity check index (QUICK-I) and McAuley's index. VitD deficiency was defined as serum total 25(OH)D level below 20 ng/ml.The Mean (± SD) serum levels of total 25(OH)D were 13.8 ± 8.6 ng/ml with 79% of the study cohort being vitD deficient. Furthermore, serum total 25(OH)D levels were found to be inversely correlated with fasting insulin (r = -0.24, p = 0.029), HOMA-IR (r = -0.24, p = 0.03), and positively correlated with McAuley's index (r = 0.22, p = 0.048) and QUICK-I (r = 0.25, p = 0.024). In conclusion, vitD deficiency is highly prevalent among postmenopausal women with T2DM living in Jeddah, Saudi Arabia. VitD was found to be associated with insulin resistance. Whether vitD supplements are able to improve insulin sensitivity and other parameters in T2DM postmenopausal women should be further investigated.


2008 ◽  
Vol 198 (1) ◽  
pp. 51-60 ◽  
Author(s):  
Julie Takada ◽  
Miriam Helena Fonseca-Alaniz ◽  
Tarcila Beatriz Ferraz de Campos ◽  
Sandra Andreotti ◽  
Amanda Baron Campana ◽  
...  

Obesity and insulin resistance are highly correlated with metabolic disturbances. Both the excess and lack of adipose tissue can lead to severe insulin resistance and diabetes. Adipose tissue plays an active role in energy homeostasis, hormone secretion, and other proteins that affect insulin sensitivity, appetite, energy balance, and lipid metabolism. Rats with streptozotocin-induced diabetes during the neonatal period develop the classic diabetic picture of hyperglycemia, hypoinsulinemia, and insulin resistance in adulthood. Low body weight and reduced epididymal (EP) fat mass were also seen in this model. The aim of this study was to investigate the glucose homeostasis and metabolic repercussions on the adipose tissue following chronic treatment with antidiabetic drugs in these animals. In the 4th week post birth, diabetic animals started an 8-week treatment with pioglitazone, metformin, or insulin. Animals were then killed, EP fat pads were excised, and blood samples were collected for biological and biochemical assays. Pioglitazone and insulin treatments, but not metformin, reduced hyperglycemia, polydipsia, and polyphagia. Although all antidiabetic therapies improved insulin sensitivity, this was particularly noteworthy in the pioglitazone-treated rats. Furthermore, a recovery of adipose mass and insulin levels were observed in pioglitazone- and insulin-, but not metformin-treated animals. Treatments with insulin or pioglitazone were able to correct significantly, but not completely, the metabolic abnormalities, parallel to full recovery of adipose mass, indicating that not only the low insulin levels but also the lack of adipose tissue might play a significant role on the pathophysiology of this particular diabetes model.


2020 ◽  
Author(s):  
Xing-Wang Wang ◽  
Hao Hu ◽  
Zhi-Yong Xu ◽  
Gong-Kai Zhang ◽  
Qing-Hua Yu ◽  
...  

Abstract Background: Despite the growing number of studies on the Coronavirus Disease-19 (COVID-19), little is known about the association of menopausal status with COVID-19 outcomes.Materials and methods: In this retrospective study, we included 336 COVID-19 in-patients between February 15, 2020 and April 30, 2020 at the Taikang Tongji Hospital (Wuhan), China. Electronic medical records, including patient demographics, laboratory results, and chest computed tomography (CT) images were reviewed. Results: In total, 300 patients with complete clinical outcomes were included for analysis. The mean age was 65.3 years and most patients were women (n=167, 55.7%). Over 50% of patients presented with comorbidities, with hypertension (63.5%) being the most common comorbidity. After propensity-score matching, results showed that men had significantly higher odds than premenopausal women for developing severe disease type (23.7% vs. 0%, OR 17.12, 95% CI 1.00–293.60; p=0.003) and bilateral lung infiltration (86.1% vs. 64.7%, OR 3.39, 95% CI 1.08–10.64; p= 0.04), but not for mortality (2.0% vs. 0%, OR 0.88, 95% CI 0.04–19.12, p=1.00). However, non-significant difference was observed among men and post-menopause women in the percentage of severe disease type (32.7% vs. 41.7%, OR 0.68, 95% CI 0.37–1.24, p=0.21) and bilateral lung infiltration (86.1% vs. 91.7%, OR 0.56, 95% CI 0.22–1.47, p=0.24), mortality (2.0% vs. 6.0%, OR 0.32, 95% CI 0.06–1.69, p=0.25).Conclusions: Men had higher disease severity than premenopausal women, while the differences disappeared between postmenopausal women and men. These findings support aggressive treatment for the poor-prognosis of postmenopausal women in clinical practice.


1993 ◽  
Vol 70 (04) ◽  
pp. 584-587 ◽  
Author(s):  
Pierre-Yves Scarabin ◽  
Geneviève Plu-Bureau ◽  
Lucienne Bara ◽  
Claire Bonithon-Kopp ◽  
Louis Guize ◽  
...  

SummaryLarge cohort studies have shown that postmenopausal estrogen use was associated with a reduction in the risk of coronary heart disease, This putative beneficial effect of hormone replacement therapy (HRT) may be partly mediated through changes in clotting factors and fibrinolytic system. We have measured haemostatic variables in 293 consecutive healthy women aged 45-54 years who attended a health check-up centre in Paris (IPC). Premenopausal women taking hormonal therapy were excluded (n = 34). Most women using HRT were given 17-β estradiol in combination with progestin. Mean levels (m ± sd) of plasma fibrinogen, factor VII coagulant activity and plasminogen activator inhibitor (PAI) were significantly higher in postmenopausal women not taking HRT (n = 99) than in premenopausal women (n = 139) within the same decade (319 ± 52 mg/dl vs 304 ± 60 mg/dl, 107 ± 17% vs 96 ± 16%, 9.73 ± 5.71 U/ml vs 7.61 ± 4.36 U/ml respectively). Allowance for main cardiovascular risk factors made no substantial differences to the results, although the effect of the menopause on fibrinogen was no longer significant. HRT (n = 21) significantly reversed the menopause-related changes in factor VII (94 ± 15%), even after adjustment for confounding factors. The same trend in both fibrinogen (294 ± 46 mg/dl) and PAI (8.22 ± 5.51 U/ml) was observed. Similar results were found in women using oral or percutaneous estrogen. Our findings suggest that 17-β estradiol in combination with progestins may protect against an increased thrombotic tendency in postmenopausal women. Randomized clinical trials are urgently needed for a better understanding of HRT effect on atherothrombotic process.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1633-1633
Author(s):  
Darius Fox ◽  
Ashley Toney ◽  
Mikyoung You ◽  
Hamid Band ◽  
Soonkyu Chung

Abstract Objectives Obesity induces adipocyte hypertrophy, which promotes metabolic dysfunction. The EPS15-Homology Domain-Containing (EHD) 2 is an endocytic traffic-regulatory protein regulating caveolae stability, thereby participating cell size expansion. Although EHD2 is abundantly expressed in adipocytes, very little information is available on its role on adipose metabolism. This study aimed to define the role of EHD2 on governing adipocyte size, lipid metabolism and insulin sensitivity. Methods To prepare the EHD2-deficient adipocytes, primary ear mesenchymal stem cells were isolate from wildtype (WT) and EHD2 KO mice and induced differentiation into adipocytes. To induce obesity and insulin resistance, EHD2 KO and WT male mice were fed a high-fat diet (50% calorie from lard) for 8 weeks. The changes in body weight was monitored weekly. Fasting plasma glucose and insulin levels were determined by glucometer and ELISA respectively. Glucose tolerance test (GTT) was conducted after HF diet feeding. To investigate insulin signaling, human recombinant insulin (1 U/kg BW) was injected peritoneally and epididymal fat was collected immediately for measuring the phosphorylation levels of AKT (p-AKT), a downstream target for insulin. To determine the lipogenic gene and protein expression, qPCR and Western blot analysis were conducted. Results Deletion of EHD2 markedly upregulated EHD1 expression in primary adipocytes. Also, deletion of EHD2 significantly attenuated adipocyte differentiation and maintained smaller lipid droplets. Consistently, absence of EHD2 was linked with reduced lipogenic gene expression. In vivo study, EHD2 KO mice exhibited slightly lower total body weight, but fat mass was markedly reduced. After 8 weeks of HF diet, EHD2 KO mice had lower levels of plasma glucose and insulin levels compared with WT. EHD2 KO mice were more glucose tolerant during GTT. Insulin signaling study revealed that EHD2 KO mice showed higher levels of insulin-stimulated p-AKT compared to WT mice, indicating EHD2 deletion promotes insulin sensitivity. Conclusions This study suggests that EHD2 is required for maximal adipocyte differentiation and hypertrophic expansion. The absence of EHD2 was linked with improved insulin and glucose sensitivity, presumably due to reduced adiposity and adipocyte size. Funding Sources Nebraska EPSCoR (Food for Health 2017) Seed Grant.


2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096122
Author(s):  
Jae-Min Park ◽  
Yong-Jae Lee

Objective Epidemiological studies on the association of serum oestradiol levels and inflammatory markers have reported inconsistent and conflicting results. Therefore, we investigated the association between serum oestradiol and high-sensitivity C-reactive protein (CRP) levels in women on the basis of their menopausal status. Methods This cross-sectional study examined the association between serum oestradiol and CRP levels on the basis of menopausal status in 151 premenopausal women aged 42.7 ± 6.7 years and 394 postmenopausal women aged 58.1 ± 6.7 years who participated in a health examination program. Multiple linear regression analysis was conducted using CRP levels as the dependent variable. Results Multiple linear regression analysis showed that serum oestradiol levels were inversely associated with CRP levels in premenopausal women (β coefficient = −0.298) after adjusting for age, body mass index, smoking, mean arterial pressure, and levels of fasting plasma glucose, triglycerides, high-density lipoprotein cholesterol, aspartate aminotransferase, and alanine aminotransferase. However, this association was not found in postmenopausal women after adjusting for the same confounding factors. Conclusions Serum oestradiol levels are inversely associated with CRP levels in premenopausal women, but not in postmenopausal women. Lower oestrogenic activity may at least partly contribute to the pathogenesis of chronic inflammation, particularly in premenopausal women.


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