Glucose Homeostasis in Obese Women Is Not Associated to Unacylated Ghrelin Plasma Levels

Introduction: Unacylated ghrelin (UAG) is the major form of circulating ghrelin. Initially considered as a nonfunctional peptide, soon after, UAG has been associated to an insulin sensitizing action and to a negative action on energy balance. The aim of this study was to analyze the association between the serum levels of UAG and glucose metabolism parameters in obese women, independently from eventual influence of anthropometrics. Methods: One hundred lean and 254 obese Caucasian women were studied. Each woman was characterized for anthropometrics, fasting glucose, insulin, HbA1c, and UAG. In addition, obese women were subjected to a classic oral glucose tolerance test (oGTT) to assess glucose and insulin at 120 minutes. Insulin resistance was assessed by the homeostasis model assessment (HOMA-IR). Obese women were classified in 3 glycemic status subgroups (normoglycemia, prediabetes, and diabetes) according to HbA1c and to fasting and oGTT glucose values. Results: In comparison with the lean group, significantly lower levels of UAG were observed in obese women. However, no significant difference was observed through obesity classes I to III. UAG levels were not significantly different among glycemic status subgroups and did not show any association with glucose, insulin, HOMA-IR, or HbA1c. Conclusions: Although anthropometry can influence the level of the unacylated form of ghrelin, UAG plasma levels do not associate to glucose homeostasis parameters.

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The effects of natural nano-sized clinoptilolite and Nigella sativa supplementation on serum bone markers in diabetic rats

Bioimpacts ◽

10.15171/bi.2019.21 ◽

2019 ◽

Vol 9 (3) ◽

pp. 173-178

Author(s):

Yalda Salari Lak ◽

Sirous Khorram ◽

Mehran Mesgari Abbasi ◽

Mohammad Asghari-Jafarabadi ◽

Ali Tarighat-Esfanjani ◽

...

Keyword(s):

Bone Markers ◽

Nigella Sativa ◽

Bone Mineralization ◽

Serum Levels ◽

Study Groups ◽

Tolerance Test ◽

Diabetic Rats ◽

Oral Glucose ◽

Model Assessment ◽

Beneficial Effects

Introduction: Many studies confirm that diabetes mellitus is associated with higher risks of bone fracture. The beneficial effects of Nigella sativa (NS) and clinoptilolite in preventing/reducing some diabetes-related disorders have been shown. This study was conducted to examine the effects of separate and concurrent supplementation of natural nano-sized clinoptilolite (NCLN) and NS on serum bone markers in rats with type 2 diabetes. Methods: A total of 42 (case=36 and control=6) adult male Wistar rats were divided into 2 groups: diabetic and non-diabetic. An oral glucose tolerance test and a homeostatic model assessment of insulin resistance (HOMA-IR) test were conducted to confirm diabetes. Then, the diabetic group was divided into 4 subgroups: [1] control (n=9), [2] NS 1%/food (n=9), [3] NCLN 2%/food (n=9), [4] NS 1%/food + NCLN 2%/food (n=9). After 7 weeks, serum levels of bone markers were determined using ELISA kits. Results: Analysis showed that serum levels of alkaline phosphatase (ALP) in the NCLN group (1318.6 ± 217.5 U/L) was significantly (P<0.05) higher than other intervented groups. On the other hand, serum levels of calcium in NCLN+NS group (10.8 ± 2.6 mg/dL) were higher (P=0.027) compared to all other study groups. However, rats in the NS group had higher (535.8 ± 49.3 pg/mL) PTH (P<0.0001) compared to other supplementation groups. There were no significant differences in vitamin D and osteoprotegerin. Conclusion: The results of the current study suggest that bone mineralization may be affected by concurrent use of NS and NCLN through influencing calcium circulation. Moreover, dietary NS administration is strongly related to an augmented level of PTH.

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Plasma but not serum brain-derived neurotrophic factor concentration is decreased by oral glucose tolerance test-induced hyperglycemia in children

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2016-0344 ◽

2017 ◽

Vol 30 (5) ◽

Cited By ~ 2

Author(s):

Shunsuke Araki ◽

Yukiyo Yamamoto ◽

Reiko Saito ◽

Aoi Kawakita ◽

Mami Eguchi ◽

...

Keyword(s):

Glucose Tolerance ◽

Oral Glucose Tolerance Test ◽

Neurotrophic Factor ◽

Plasma Levels ◽

Glucose Tolerance Test ◽

Serum Levels ◽

Brain Derived Neurotrophic Factor ◽

Tolerance Test ◽

Oral Glucose ◽

Oral Glucose Tolerance

AbstractBackground:Little is known regarding the relationships among circulating brain-derived neurotrophic factor (BDNF) levels and glucose or insulin in children and adolescents. The objective of this study was to investigate whether circulating BDNF levels would change during the oral glucose tolerance test (OGTT).Methods:We performed the OGTT and measured the serial changes in BDNF levels in both plasma and serum.Results:There were 22 subjects in the normal type (N) group and 20 in the borderline/diabetic type (B/D) group, defined by the results of the OGTT. Serum levels of BDNF were almost five times higher and plasma levels gradually decreased during the OGTT, whereas serum levels showed no significant change. The reduction of plasma BDNF level changes from baseline to 120 min were significantly different between the N and B/D groups (36.3% vs. 20.8%, p=0.023).Conclusions:Our results showed that plasma levels of BDNF are more sensitive to acute changes in glucose or insulin levels than serum.

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Circulating obestatin levels and the ghrelin/obestatin ratio in obese women

Acta Endocrinologica ◽

10.1530/eje-07-0059 ◽

2007 ◽

Vol 157 (3) ◽

pp. 295-301 ◽

Cited By ~ 46

Author(s):

Valentina Vicennati ◽

Silvia Genghini ◽

Rosaria De Iasio ◽

Francesca Pasqui ◽

Uberto Pagotto ◽

...

Keyword(s):

Insulin Resistance ◽

Tolerance Test ◽

Normal Weight ◽

Metabolic Parameters ◽

Blood Levels ◽

Oral Glucose ◽

Sensitivity Index ◽

Model Assessment ◽

Obese Women ◽

Glucose Levels

Objective: We measured blood levels of obestatin, total ghrelin, and the ghrelin/obestatin ratio and their relationship with anthropometric and metabolic parameters, adiponectin and insulin resistance, in overweight/obese and normal-weight women. Design: Outpatients Unit of Endocrinology of the S Orsola-Malpighi Hospital of Bologna, Italy. Methods: Fasting obestatin, ghrelin, adiponectin and lipid levels, fasting and glucose-stimulated oral glucose tolerance test insulin, and glucose levels were measured in 20 overweight/obese and 12 controls. The fasting ghrelin/obestatin ratio was calculated; the homeostasis model assessment-IR (HOMA-IR) and insulin sensitivity index (ISIcomposite) were calculated as indices of insulin resistance. Results: Obese women had higher obestatin and lower ghrelin blood levels, and a lower ghrelin/obestatin ratio compared with controls. In all subjects, obestatin was significantly and positively correlated with total cholesterol and triglycerides, but not with ghrelin, anthropometric, and metabolic parameters. In the obese women, however, obestatin and ghrelin concentrations were positively correlated. By contrast, the ghrelin/obestatin ratio was significantly and negatively correlated with body mass index, waist, waist-to-hip ratio, fasting insulin, and HOMA-IR, and positively with ISIcomposite but not with adiponectin. None of these parameters were correlated with the ghrelin/obestatin ratio in the obese. Conclusions: Increased obestatin, decreased ghrelin levels, and a decreased ghrelin/obestatin ratio characterize obesity in women. This supports the hypothesis that the imbalance of ghrelin and obestatin may have a role in the pathophysiology of obesity. On the other hand, some relevant differences between our data on circulating levels of obestatin and the ghrelin/obestatin ratio in obese subjects and those reported in the few studies published so far imply that further research is needed.

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Biochemical predictors of metabolically unhealthy obesity in children and adolescents

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2021-0542 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Ah Young Cho ◽

Jung Gi Roh ◽

Young Suk Shim ◽

Hae Sang Lee ◽

Jin Soon Hwang

Keyword(s):

Insulin Resistance ◽

Uric Acid ◽

Children And Adolescents ◽

Resistance Index ◽

Serum Levels ◽

Tolerance Test ◽

Binary Logistic Regression Analysis ◽

Oral Glucose ◽

Model Assessment ◽

Metabolically Unhealthy Obesity

Abstract Background Children and adolescents with obesity can now be classified according to metabolic profile, as those with metabolically healthy obesity (MHO) and those with metabolically unhealthy obesity (MUO). We aimed to determine the prevalence of MUO and identify its biochemical predictors in pediatric patients with obesity. Methods We evaluated the medical records of 187 boys and girls with obesity. The children were divided into MHO and MUO groups, and anthropometric and biochemical parameters were assessed. Oral glucose tolerance test (OGTT) was used to identify impaired glucose regulation and hyperinsulinism, and binary logistic regression analysis was used to determine predictors of MUO in children with obesity. Results Of the 187 children, MUO was found in 71.7% (n=134) and MHO in 28.3% (n=53); those in the MHO group were younger than those in the MUO group. Blood pressure, triglyceride, total cholesterol, and uric acid levels were significantly higher in the MUO group than in the MHO group. Further, the MUO group exhibited a significantly higher level of insulin resistance (p<0.05) than the MHO group. Serum levels of uric acid and homeostasis model assessment of insulin resistance index (HOMA-IR) were confirmed as biochemical predictors of the MUO phenotype in children with obesity. Conclusions The ratio of MUO in children with obesity was relatively high; further, serum levels of uric acid and HOMA-IR can be used as biochemical predictors of MUO.

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Improving Glucose Homeostasis after Parathyroidectomy for Normocalcemic Primary Hyperparathyroidism with Co-Existing Prediabetes

Nutrients ◽

10.3390/nu12113522 ◽

2020 ◽

Vol 12 (11) ◽

pp. 3522

Author(s):

Spyridon Karras ◽

Cedric Annweiler ◽

Dimitris Kiortsis ◽

Ioannis Koutelidakis ◽

Kalliopi Kotsa

Keyword(s):

Primary Hyperparathyroidism ◽

Glucose Homeostasis ◽

Glycosylated Hemoglobin ◽

Tolerance Test ◽

Oral Glucose ◽

Model Assessment ◽

Glucose Levels ◽

Group A ◽

Group B

We have previously described increased fasting plasma glucose levels in patients with normocalcemic primary hyperparathyroidism (NPHPT) and co-existing prediabetes, compared to prediabetes per se. This study evaluated the effect of parathyroidectomy (PTx) (Group A), versus conservative follow-up (Group B), in a small cohort of patients with co-existing NPHPT and prediabetes. Sixteen patients were categorized in each group. Glycemic parameters (levels of fasting glucose (fGlu), glycosylated hemoglobin (HbA1c), and fasting insulin (fIns)), the homeostasis model assessment for estimating insulin secretion (HOMA-B) and resistance (HOMA-IR), and a 75-g oral glucose tolerance test were evaluated at baseline and after 32 weeks for both groups. Measurements at baseline were not significantly different between Groups A and B, respectively: fGlu (119.4 ± 2.8 vs. 118.2 ± 1.8 mg/dL, p = 0.451), HbA1c (5.84 ± 0.3 %vs. 5.86 ± 0.4%, p = 0.411), HOMA-IR (3.1 ± 1.2 vs. 2.9 ± 0.2, p = 0.213), HOMA-B (112.9 ± 31.8 vs. 116.9 ± 21.0%, p = 0.312), fIns (11.0 ± 2.3 vs. 12.8 ± 1.4 μIU/mL, p = 0.731), and 2-h post-load glucose concentrations (163.2 ± 3.2 vs. 167.2 ± 3.2 mg/dL, p = 0.371). fGlu levels demonstrated a positive correlation with PTH concentrations for both groups (Group A, rho = 0.374, p = 0.005, and Group B, rho = 0.359, p = 0.008). At the end of follow-up, Group A demonstrated significant improvements after PTx compared to the baseline: fGlu ((119.4 ± 2.8 vs. 111.2 ± 1.9 mg/dL, p = 0.021) (−8.2 ± 0.6 mg/dL)), and 2-h post-load glucose concentrations ((163.2 ± 3.2 vs. 144.4 ± 3.2 mg/dL, p = 0.041), (−18.8 ± 0.3 mg/dL)). For Group B, results demonstrated non-significant differences: fGlu ((118.2 ± 1.8 vs. 117.6 ± 2.3 mg/dL, p = 0.031), (−0.6 ± 0.2 mg/dL)), and 2-h post-load glucose concentrations ((167.2 ± 2.7 vs. 176.2 ± 3.2 mg/dL, p = 0.781), (+9.0 ± 0.8 mg/dL)). We conclude that PTx for individuals with NPHPT and prediabetes may improve their glucose homeostasis when compared with conservative follow-up, after 8 months of follow-up.

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THE ICET-A RECOMMENDATIONS FOR THE DIAGNOSIS AND MANAGEMENT OF DISTURBANCES OF GLUCOSE HOMEOSTASIS IN THALASSEMIA MAJOR PATIENTS

Mediterranean Journal of Hematology and Infectious Diseases ◽

10.4084/mjhid.2016.058 ◽

2016 ◽

Vol 8 ◽

pp. 2016058 ◽

Cited By ~ 2

Author(s):

Vincenzo De Sanctis

Keyword(s):

Glucose Tolerance ◽

Glucose Homeostasis ◽

Glucose Tolerance Test ◽

Laboratory Data ◽

Thalassemia Major ◽

Tolerance Test ◽

Oral Glucose ◽

Model Assessment ◽

Intravenous Glucose ◽

Diagnosis And Management

Iron overload in patients with thalassemia major (TM) affects glucose regulation, and is mediated by several mechanisms. These include the oxidative damage inflicted by iron on the pancreatic ß -cells and liver cells leading to pancreatic and hepatic dysfunction and insulin resistance. These disturbances have been identified by oral glucose tolerance test (OGTT), euglycemic insulin clamp, homeostatic model assessment (HOMA), intravenous glucose tolerance test (IVGT) and continuous glucose monitoring system (CGMS). A group of endocrinologists, hematologists and paediatricians, members of the International Network of Clinicians for Endocrinopathies in Thalassemia and Adolescence Medicine (ICET-A) convened to formulate recommendations for the diagnosis and management of abnormalities of glucose homeostasis in thalassemia major patients on the basis of available evidence from clinical and laboratory data and consensus practice. The results of their work and discussions are described in this article.Key words: Thalassemia major; Glucose homeostasis; Diagnosis; Management; Guidelines

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Effects of Different Methods Used to Take Blood Samples on Blood Glucose Measurements

Clinical Nursing Research ◽

10.1177/10547738211024782 ◽

2021 ◽

pp. 105477382110247

Author(s):

Eda Ergin ◽

Ayten Zaybak

Keyword(s):

Blood Glucose ◽

Glucose Tolerance Test ◽

Venous Blood ◽

Tolerance Test ◽

Capillary Blood ◽

Oral Glucose ◽

Blood Samples ◽

Significant Difference ◽

Measurement Results ◽

Quasi Experimental

The purpose of this study is to compare whether or not there is a difference between venous and capillary blood samples in blood glucose measurements and investigate the effects of different aseptic methods used in skin cleaning before collecting blood samples on measurement results. This quasi-experimental study was conducted with 109 patients. The capillary first and second blood drop values taken from the patients after fasting and at 2 hours following 75 g oral glucose tolerance test (OGTT) and capillary and venous blood glucose values were compared. There was no significant difference between the median venous blood glucose value and the capillary second blood drop value taken after wiping the finger with alcohol. There was no significant difference between the first and second blood drop values of capillary blood glucose 2 hours after OGTT.

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Studies of insulin resistance in patients with clinical and subclinical hypothyroidism

Acta Endocrinologica ◽

10.1530/eje-08-0797 ◽

2009 ◽

Vol 160 (5) ◽

pp. 785-790 ◽

Cited By ~ 165

Author(s):

Eirini Maratou ◽

Dimitrios J Hadjidakis ◽

Anastasios Kollias ◽

Katerina Tsegka ◽

Melpomeni Peppa ◽

...

Keyword(s):

Insulin Resistance ◽

Plasma Membrane ◽

Glucose Transport ◽

Subclinical Hypothyroidism ◽

Tolerance Test ◽

Oral Glucose ◽

Model Assessment ◽

Increased Risk

ObjectiveAlthough clinical hypothyroidism (HO) is associated with insulin resistance, there is no information on insulin action in subclinical hypothyroidism (SHO).Design and methodsTo investigate this, we assessed the sensitivity of glucose metabolism to insulin both in vivo (by an oral glucose tolerance test) and in vitro (by measuring insulin-stimulated rates of glucose transport in isolated monocytes with flow cytometry) in 21 euthyroid subjects (EU), 12 patients with HO, and 13 patients with SHO.ResultsAll three groups had comparable plasma glucose levels, with the HO and SHO having higher plasma insulin than the EU (P<0.05). Homeostasis model assessment index was increased in HO (1.97±0.22) and SHO (1.99±0.13) versus EU (1.27±0.16, P<0.05), while Matsuda index was decreased in HO (3.89±0.36) and SHO (4.26±0.48) versus EU (7.76±0.87, P<0.001), suggesting insulin resistance in both fasting and post-glucose state. At 100 μU/ml insulin: i) GLUT4 levels on the monocyte plasma membrane were decreased in both HO (215±19 mean fluorescence intensity, MFI) and SHO (218±24 MFI) versus EU (270±25 MFI, P=0.03 and 0.04 respectively), and ii) glucose transport rates in monocytes from HO (481±30 MFI) and SHO (462±19 MFI) were decreased versus EU (571±15 MFI, P=0.04 and 0.004 respectively).ConclusionsIn patients with HO and SHO: i) insulin resistance was comparable; ii) insulin-stimulated rates of glucose transport in isolated monocytes were decreased due to impaired translocation of GLUT4 glucose transporters on the plasma membrane; iii) these findings could justify the increased risk for insulin resistance-associated disorders, such as cardiovascular disease, observed in patients with HO or SHO.

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Importance of Intestinal Environment and Cellular Plasticity of Islets in the Development of Postpancreatectomy Diabetes

10.2337/figshare.13626788 ◽

2021 ◽

Author(s):

Tatsuya Fukuda ◽

Ryotaro Bouchi ◽

Takato Takeuchi ◽

Kikuko Amo-Shiinoki ◽

Atsushi Kudo ◽

...

Keyword(s):

Insulin Resistance ◽

Short Chain Fatty Acids ◽

Tolerance Test ◽

Oral Glucose ◽

Cellular Plasticity ◽

Β Cell ◽

Microbiome Composition ◽

Significant Difference ◽

Histological Characteristics ◽

Design And Methods

OBJECTIVE To elucidate the pathogenesis of post-pancreatectomy diabetes (PPDM). RESEARCH DESIGN AND METHODS Forty-eight patients without diabetes undergoing either pancreatoduodenectomy (PD) (n = 20) or distal pancreatectomy (DP) (n = 28) were included. 75-g oral glucose tolerance test was performed every 6 months. Microbiome composition and short-chain fatty acids in feces were examined before and 6 months after surgery. The association of histological characteristics of the resected pancreas with PPDM were examined. RESULTS During follow-up (median, 3.19 years), 2 out of 20 PD patients and 16 out of 28 DP patients developed PPDM. Proteobacteria relative abundance, plasma GLP-1, and fecal butyrate levels increased only after PD. Postsurgical butyrate levels were correlated with postsurgical GLP-1 levels. With no significant difference in the volume of the resected pancreas between the surgical procedures, both β-cell and α-cell areas in the resected pancreas were significantly higher in DP patients than in PD patients. In DP patients, the progressors to diabetes showed pre-existing insulin resistance compared with non-progressors, and both increased α- and β-cell areas were predictors of PPDM. Furthermore, in DP patients, α-cell and β-cell areas were associated with ALDH1A3 expression in islets. CONCLUSIONS We postulate that a greater removal of β-cells contributes to the development of PPDM after DP. Islet expansion along with pre-existing insulin resistance is associated with high cellular-plasticity, which may predict the development of PPDM after DP. In contrast, PD is associated with alterations of gut microbiome and increases in SCFA production and GLP-1 secretion, possibly protecting against PPDM development.

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Parameters of Glucose Homeostasis in the Recognition of the Metabolic Syndrome in Young Adults with Prader–Willi Syndrome

Journal of Clinical Medicine ◽

10.3390/jcm10235635 ◽

2021 ◽

Vol 10 (23) ◽

pp. 5635

Author(s):

Graziano Grugni ◽

Antonio Fanolla ◽

Fiorenzo Lupi ◽

Silvia Longhi ◽

Antonella Saezza ◽

...

Keyword(s):

Metabolic Syndrome ◽

Glucose Homeostasis ◽

Tolerance Test ◽

Oral Glucose ◽

Prader Willi Syndrome ◽

Insulinogenic Index ◽

Glucose Levels ◽

The Metabolic Syndrome ◽

Diagnostic Threshold ◽

Age Related

To verify the accuracy of different indices of glucose homeostasis in recognizing the metabolic syndrome in a group of adult patients with Prader–Willi syndrome (PWS), 102 PWS patients (53 females/49 males), age ±SD 26.9 ± 7.6 yrs, Body Mass Index (BMI) 35.7 ± 10.7, were studied. The following indices were assessed in each subject during an oral glucose tolerance test (OGTT): 1 h (>155 mg/dL) and 2 h (140–199 mg/dL) glucose levels, the oral disposition index (ODI), the insulinogenic index (IGI), the insulin resistance (HOMA-IR) were evaluated at baseline, 1 h and 2 h. Although minor differences among indices were found, according to the ROC analysis, no index performed better in recognizing MetS. Furthermore, the diagnostic threshold levels changed over the years and therefore the age-related thresholds were calculated. The easily calculated HOMA-IR at baseline may be used to accurately diagnose MetS, thus avoiding more complicated procedures.

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