High-Circulating Leptin Levels Are Associated with Greater Risk of Hypertension in Men Independently of Body Mass and Insulin Resistance: Results of an Eight-Year Follow-Up Study

Background: We previously reported a significant association between plasma leptin (LPT) concentration and blood pressure (BP), which was partly independent of serum insulin levels and insulin resistance. The aims of this study were to detect whether serum LPT levels predict the development of hypertension (HPT) in the 8-yr follow-up investigation of a sample of an adult male population (the Olivetti Heart Study), and to evaluate the role of body mass index (BMI) and insulin resistance in this putative association. Patients and Methods: The study population was made up of 489 untreated normotensive subjects examined in 1994–1995 (age: 50.1 ± 6.7 yr; BMI: 26.3 ± 2.8 kg/m2; BP: 120 ± 10/78 ± 6 mm Hg; and homeostatic model assessment index: 2.1 ± 1.6). Results: The HPT incidence over 8 yr was 35%. The participants with incident HPT had similar age but higher BMI (P < 0.001), serum LPT (P < 0.001), and BP (P < 0.01) at baseline. One sd positive difference in baseline serum LPT log was associated at univariate analysis with a 49% higher rate of HPT [95% confidence interval (CI) 22–83; P < 0.001]). In three different models of multivariable logistical regression analysis, LPT was respectively associated with a 41% greater risk to develop HPT (95% CI 15–74; P < 0.001) upon adjustment for age and baseline BP, with a 48% (95% CI 20–81) greater risk when adding the homeostatic assessment model index to the model, and with 33% greater risk (95% CI 6–67; P < 0.02) upon adjustment for BMI. Conclusions: In this sample of originally normotensive men, circulating LPT level was a significant predictor of the risk to develop HPT over 8 yr, independently of BMI and insulin resistance.

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Circulating Irisin in Relation to Insulin Resistance and the Metabolic Syndrome

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2013-2373 ◽

2013 ◽

Vol 98 (12) ◽

pp. 4899-4907 ◽

Cited By ~ 235

Author(s):

Kyung Hee Park ◽

Lesya Zaichenko ◽

Mary Brinkoetter ◽

Bindiya Thakkar ◽

Ayse Sahin-Efe ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Body Mass Index ◽

Body Mass ◽

Model Assessment ◽

Homeostasis Model Assessment ◽

Cvd Risk ◽

Baseline Serum ◽

The Metabolic Syndrome ◽

Increased Risk

Context: Irisin, a recently identified hormone, has been proposed to regulate energy homeostasis and obesity in mice. Whether irisin levels are associated with risk of the metabolic syndrome (MetS), cardiometabolic variables, and cardiovascular disease (CVD) risk in humans remains unknown. Objective: Our objective was to assess the associations between baseline serum irisin levels and MetS, cardiometabolic variables, and CVD risk. Design, Setting, and Subjects: We conducted a comparative cross-sectional evaluation of baseline circulating levels of the novel hormone irisin and the established adipokine adiponectin with MetS, cardiometabolic variables, and CVD risk in a sample of 151 subjects. Results: Baseline irisin levels were significantly higher in subjects with MetS than in subjects without MetS. Irisin was associated negatively with adiponectin (r = −0.4, P < .001) and positively with body mass index (r = 0.22, P = .008), systolic (r = 0.17, P = .04) and diastolic (r = 0.27, P = .001) blood pressure, fasting glucose (r = 0.25, P = .002), triglycerides (r = 0.25, P = .003), and homeostasis model assessment for insulin resistance (r = 0.33, P < .001). After adjustment for potential confounders, including body mass index, subjects in the highest tertile of irisin levels were more likely to have MetS (odds ratio [OR] = 9.44, 95% confidence interval [CI] = 2.66–33.44), elevated fasting blood glucose (OR = 5.80, 95% CI = 1.72–19.60), high triglycerides (OR = 3.89, 95% CI = 1.16–13.03), and low high-density lipoprotein cholesterol (OR = 3.30, 95% CI = 1.18–9.20). Irisin was independently associated with homeostasis model assessment for insulin resistance and general Framingham risk profile in multiple linear regression analyses after adjustment for confounders. Adiponectin demonstrated the expected associations with outcomes. Conclusions: Irisin is associated with increased risk of MetS, cardiometabolic variables, and CVD in humans, indicating either increased secretion by adipose/muscle tissue and/or a compensatory increase of irisin to overcome an underlying irisin resistance in these subjects.

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Associations between maternal anthropometric characteristics and infant birth weight in Iranian population

SAGE Open Medicine ◽

10.1177/2050312116646691 ◽

2016 ◽

Vol 4 ◽

pp. 205031211664669 ◽

Cited By ~ 2

Author(s):

Sormeh Nourbakhsh ◽

Sepideh Ashrafzadeh ◽

Ali Hafizi ◽

Ali Naseh

Keyword(s):

Insulin Resistance ◽

Body Mass Index ◽

Birth Weight ◽

Body Mass ◽

Gestational Age ◽

Serum Insulin ◽

Maternal Body Mass Index ◽

Model Assessment ◽

Homeostatic Model Assessment ◽

Homeostatic Model

Objective: To examine the (1) normal ranges of anthropometric and insulin resistance/sensitivity indices (homeostatic model assessment for insulin resistance, homeostatic model assessment for insulin sensitivity, and quantitative insulin sensitivity check index) for Iranian pregnant women and their newborns and (2) associations between maternal anthropometric and metabolic values and infants’ birth weights among Iranian women. Methods: Anthropometric and metabolic values of 163 singleton non-diabetic pregnant women in Tehran, Iran (2014) were collected before and during pregnancy and at delivery. Linear regression, multivariable regression, and Student t tests were used to evaluate correlations between birth weight and maternal variables. Results: Linear regression modeling suggested that maternal serum glucose ( p = 0.2777) and age ( p = 0.6752) were not associated with birth weight. Meanwhile, maternal weight and body mass index before pregnancy ( p = 0.0006 and 0.0204, respectively), weight at delivery ( p = 0.0036), maternal height ( p = 0.0118), and gestational age ( p = 0.0016) were positively associated with birth weight, while serum insulin ( p = 0.0300) and homeostatic model assessment for insulin resistance ( p = 0.0334) were negatively associated with infant’s birth weight. Using multivariate modeling, we identified severalconfounders: parity (multipara mothers delivered heavier babies compared to first-time mothers) explained as much as 24% of variation in birth weight ( p = 0.005), maternal height explained 20.7% ( p = 0.014), gestational age accounted for 19.7% ( p = 0.027), and maternal body mass index explained 19.1% ( p = 0.023) of the variation in the infant’s birth weight. Maternal serum insulin and infant’s sex were not observed to be associated with birth weight ( p = 0.342 and 0.669, respectively) in the overall model. Conclusion: Overweight/obese women may experience higher incidence of delivering larger babies. Multivariable regression analyses showed that maternal body mass index and height, parity, and gestational age are associated with newborn’s birth weight.

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Acanthosis nigricans: a clinical marker of insulin resistance

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20171497 ◽

2017 ◽

Vol 3 (2) ◽

pp. 161

Author(s):

Sanjiv V. Choudhary ◽

Vikrant Saoji ◽

Adarshlata Singh ◽

Shivani Mane

Keyword(s):

Insulin Resistance ◽

Blood Sugar ◽

Acanthosis Nigricans ◽

Serum Insulin ◽

Univariate Analysis ◽

Fasting Blood Sugar ◽

P Value ◽

Model Assessment ◽

Fasting Insulin ◽

Positive Correlation

Background: Very little information is available regarding the association of acanthosis nigricans with insulin resistance from rural areas of India. Therefore this study was carried out with the aim and objectives to study the association between acanthosis nigricans and insulin resistance and to evaluate correlation of acanthosis nigricans severity, neck severity and neck texture severity with fasting blood sugar & serum insulin especially in this rural part of central India.Methods: In this cross sectional study with comparative group, total 162 age and sex matched subjects were divided into two groups of cases (81) with acanthosis nigricans and comparative subjects (81) without acanthosis nigricans. The severity acanthosis nigricans was assessed using the Burke’s quantitative scale. Fasting blood sugar and fasting insulin levels were estimated to know the Homeostasis model assessment of insulin resistance (HOMA-IR) values. Data was analyzed by using appropriate statistical tests.Results: The age range was 20 to 55 years with the mean of 32.82 ± 10.19 years for cases and 33.67 ± 8.09 for comparative subjects. Univariate analysis which showed significant association of acanthosis nigricans with fasting insulin and HOMA-IR with significant odds ratios and p value (p =0.0001) respectively. Fasting blood sugar showed greater risk of association in cases but it was statistically insignificant with p-value of (p =0.32). Spearman rank coefficient correlation showed weak correlation of HOMA-IR with acanthosis nigricans severity, neck severity and neck texture severity, but showed positive correlation of fasting insulin with acanthosis nigricans severity, neck severity and neck texture severity, with statistically significant P-value (p <0.05).Conclusions: Acanthosis nigricans was strongly associated with insulin resistance with significant odds ratio and statistical significant p value (P < 0.05). Acanthosis nigricans severity, neck severity and neck texture severity showed positive correlation with fasting serum insulin with statistically significant p value (P <0.05).

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Effects of probiotic and synbiotic supplementation on insulin resistance in women with polycystic ovary syndrome: a meta-analysis

Journal of International Medical Research ◽

10.1177/03000605211031758 ◽

2021 ◽

Vol 49 (7) ◽

pp. 030006052110317

Author(s):

Chenyun Miao ◽

Qingge Guo ◽

Xiaojie Fang ◽

Yun Chen ◽

Ying Zhao ◽

...

Keyword(s):

Insulin Resistance ◽

Polycystic Ovary Syndrome ◽

Confidence Interval ◽

Polycystic Ovary ◽

Serum Insulin ◽

Meta Analysis ◽

Mean Difference ◽

Model Assessment ◽

Ovary Syndrome ◽

Synbiotic Supplementation

Objective This meta-analysis evaluated the effect of probiotics and synbiotics on insulin resistance in patients with polycystic ovary syndrome (PCOS). Methods A systematic search was performed to identify all relevant publications listed on the electronic databases (PubMed®, Web of Science, Embase® and China National Knowledge Infrastructure) between inception and 30 October 2020. All statistical analyses were performed on randomized controlled trials (RCTs) using RevMan version 5.3 software provided by the Cochrane Collaboration. Results A total of 486 patients from seven RCTs were included in the meta-analysis. Probiotic and synbiotic supplementation appeared to improve levels of homeostatic model assessment of insulin resistance (mean difference = –0.37; 95% confidence interval –0.69, –0.05) and serum insulin (standardized mean difference = –0.66; 95% confidence interval –1.19, –0.12). The results failed to show any influence of probiotic and synbiotic supplementation on body mass index, waist circumference, hip circumference and fasting blood sugar. Conclusions Probiotics and synbiotics appear to have a partially beneficial effect on indices of insulin resistance in patients with PCOS.

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Visfatin levels in non-obese, obese, and insulin resistant adolescents

Paediatrica Indonesiana ◽

10.14238/pi56.5.2016.291-6 ◽

2017 ◽

Vol 56 (5) ◽

pp. 291

Author(s):

Indra Ihsan ◽

Eka Agustia Rini ◽

Rismawati Yaswir

Keyword(s):

Insulin Resistance ◽

Adipose Tissue ◽

Serum Insulin ◽

Enzyme Linked Immunosorbent Assay ◽

Model Assessment ◽

Fasting Serum ◽

Obese Adolescents ◽

Insulin Resistant ◽

Resistant Group ◽

Visfatin Level

Background Adipose tissue is not merely a site for energy storage, but is also the largest endocrine organ, secreting various adipocytokines. Plasma visfatin, an adipocytokine predominantly secreted from visceral adipose tissue, has insulin-mimetic effects, and has been closely linked to insulin resistance.Objective To compare plasma visfatin levels between obese and non-obese adolescents, as well as between obese adolecents with and without insulin resistance.Methods This cross-sectional study was conducted in students who attended three senior high schools in Padang. Subjects comprised 28 obese and 28 non-obese adolescents. The age of the subjects ranged from 14-18 years. Obesity criteria were based on body mass index (BMI) measurements. Fasting serum glucose level was measured by glucose hexokinase photometry and serum insulin was measured by chemiluminesence immunoassay. Plasma visfatin was measured by enzyme-linked immunosorbent assay (ELISA). The insulin resistance index was estimated from fasting serum insulin and glucose levels using the homeostatic model assessment for insulin resistance (HOMA-IR). Differences in the variables were tested using independent T-test and Mann-Whitney test, depending on the distribution of the variables.Results The mean plasma visfatin level was significantly higher in the obese than in the control group [2.55 (SD 1.54) vs. 1.61 (SD 0.64) ng/mL, respectively; (P=0.005)]. The insulin resistant group had significantly higher mean plasma visfatin level than the non-resistant group [3.61 (SD 1.59) vs. 1.96 (SD 1.18) ng/mL, respectively; (P=0.004)].Conclusion Obese adolescents with insulin resistance have signifcantly higher plasma visfatin levels compared to those without insulin resistance.

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Serum levels of the myokine irisin in relation to metabolic and renal function

Acta Endocrinologica ◽

10.1530/eje-13-1053 ◽

2014 ◽

Vol 170 (4) ◽

pp. 501-506 ◽

Cited By ~ 73

Author(s):

Thomas Ebert ◽

Denise Focke ◽

David Petroff ◽

Ulrike Wurst ◽

Judit Richter ◽

...

Keyword(s):

Insulin Resistance ◽

Renal Function ◽

Univariate Analysis ◽

Visceral Obesity ◽

Serum Levels ◽

Model Assessment ◽

Glucose And Lipid Metabolism ◽

The Metabolic Syndrome ◽

Physiological Relevance ◽

Ckd Stage

ObjectiveIrisin has recently been introduced as a novel myokine which reverses visceral obesity and improves glucose metabolism in mice. However, regulation of irisin in humans in relation to renal and metabolic disease has not been comprehensively studied.Design and methodsSerum irisin levels were quantified by ELISA and correlated with anthropometric and biochemical parameters of renal function, glucose and lipid metabolism, as well as inflammation, in 532 patients with stages 1–5 of chronic kidney disease (CKD).ResultsMedian serum irisin levels adjusted for age, gender, and BMI significantly decreased with increasing CKD stage and lowest concentrations were seen in patients with CKD stage 5. Furthermore, irisin concentrations were associated with facets of the metabolic syndrome including diastolic blood pressure, markers of impaired glucose tolerance, and dyslipidemia in univariate analysis. Moreover, markers of renal function, e.g. glomerular filtration rate, and insulin resistance, e.g. homeostasis model assessment of insulin resistance, remained independently associated with circulating irisin levels in robust multivariate analysis.ConclusionsWe show that irisin serum concentrations decrease with increasing CKD stage and are independently and positively predicted by renal function and insulin resistance. The physiological relevance of our findings, as well as the factors contributing to irisin regulation in humans, needs to be further defined in future experiments.

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Depression and cardiovascular risk—association among Beck Depression Inventory, PCSK9 levels and insulin resistance

Cardiovascular Diabetology ◽

10.1186/s12933-020-01158-6 ◽

2020 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

C. Macchi ◽

C. Favero ◽

A. Ceresa ◽

L. Vigna ◽

D. M. Conti ◽

...

Keyword(s):

Insulin Resistance ◽

Risk Factor ◽

Beck Depression Inventory ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Model Assessment ◽

Cvd Risk ◽

Assessment Index ◽

Increased Risk ◽

Homeostatic Model Assessment

Abstract Background Depression and cardiovascular disease (CVD) are among the most common causes of disability in high-income countries, depression being associated with a 30% increased risk of future CV events. Depression is twice as common in people with diabetes and is associated with a 60% rise in the incidence of type 2 diabetes, an independent CVD risk factor. Proprotein convertase subtilisin/kexin type 9 (PCSK9), a key regulator of low-density lipoprotein cholesterol, has been related to a large number of CV risk factors, including insulin resistance. Aim of this study was to investigate whether the presence of depression could affect PCSK9 levels in a population of obese subjects susceptible to depressive symptoms and how these changes may mediate a pre-diabetic risk. Results In 389 obese individuals, the Beck Depression Inventory (BDI-II) was significantly associated with PCSK9 levels. For every one-unit increment in BDI-II score, PCSK9 rose by 1.85 ng/mL. Depression was associated also with the HOMA-IR (homeostatic model assessment index of insulin resistance), 11% of this effect operating indirectly via PCSK9. Conclusions This study indicates a possible mechanism linking depression and insulin resistance, a well-known CV risk factor, providing evidence for a significant role of PCSK9.

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P2541Plasma levels of amyloid beta 1-40 are associated with the rate of progression of carotid subclinical atherosclerosis in postmenopausal women

European Heart Journal ◽

10.1093/eurheartj/ehz748.0869 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

D Delialis ◽

G Georgiopoulos ◽

K Sopova ◽

I Kanakakis ◽

C Kontogiannis ◽

...

Keyword(s):

Insulin Resistance ◽

Postmenopausal Women ◽

Amyloid Beta ◽

Linear Mixed Model ◽

Subclinical Atherosclerosis ◽

Repeated Measurements ◽

Model Assessment ◽

Clinical Value ◽

Rate Of Progression

Abstract Background There is increasingly recognized undetected residual cardiovascular (CV) risk in postmenopausal women, suggesting the need for new risk biomarkers in this population. We have previously shown that amyloid-beta (1–40) (Aβ1–40), a proinflammatory and pro-atherosclerotic peptide, is associated with concurrent subclinical cardiovascular disease (CVD) in the general population and with major adverse cardiac events in patients with established cardiac disease. However, the clinical value of Aβ1–40 in menopause or whether this peptide is linked with an increased rate of progression of atherosclerotic disease is unknown. Purpose To examine the association of Aβ1–40 levels with the rate of progression of carotid intima-media thickness (IMT) in postmenopausal women. Methods In the settings of a Menopause Clinic, postmenopausal women (n=140) without clinically overt CVD or diabetes were consecutively recruited and re-evaluated after a median follow-up period of 24 months. IMT in the carotid arteries was measured by ultrasonography. The average of maximal IMT (mean cIMT) measured at both left and right common carotid, carotid bulb (cb)and internal carotid (ic) artery were used as the main end-point of the analysis. Aβ1–40 was measured in plasma samples at baseline and follow up. Fasting insulin resistance was assessed using the homeostasis model assessment of insulin resistance (HOMA-IR). Results Women with increased plasma levels Aβ1–40 in the highest tertile presented the highest probability to have increased mean cIMT (adjusted OR=2.97, 95% CI 1.18–7.52, p=0.021) independently of age, smoke, hypertension, and hyperlipidemia. After adjustment for HOMA-IR, this association remained significant. Similarly, Aβ1–40 levels were associated with increased mean cb and icIMT (adjusted OR=3.34 for highest versus lower tertile, 95% CI 1.27–8.81, p=0.015). Mean cIMT significantly increased across the follow up period (0.73mm (0.065–0.08) to 0.77mm (0.07–0.089), median increase rate per year 0.024mm, p<0.001). By multi-level linear mixed model analysis, changes in Aβ1–40 levels were associated with increased rate of progression of mean cIMT (4.1% increase per 1-SD increase, p<0.001) after adjustment for differences in follow-up duration and age, hypertension, hyperlipidemia, and smoking. When repeated measurements of HOMA-IR were also considered, this association did not materially change (p=0.021). Similarly, longitudinal changes in Aβ1–40 correlated with the progression of mean cb and icIMT (3.9% increase per 1-SD increase, p=0.001), independently of time to re-evaluation and cardiovascular risk factors. Conclusion Aβ1–40 is an independent predictor of the rate of progression of subclinical carotid atherosclerosis in menopausal women. This finding supports the clinical value of Aβ1–40 in menopause and warrants further investigation for its prognostic role in this population.

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Glycolysis/gluconeogenesis- and tricarboxylic acid cycle–related metabolites, Mediterranean diet, and type 2 diabetes

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqaa016 ◽

2020 ◽

Vol 111 (4) ◽

pp. 835-844 ◽

Cited By ~ 3

Author(s):

Marta Guasch-Ferré ◽

José L Santos ◽

Miguel A Martínez-González ◽

Clary B Clish ◽

Cristina Razquin ◽

...

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Relative Risk ◽

Mediterranean Diet ◽

Tca Cycle ◽

Tricarboxylic Acid ◽

Model Assessment ◽

Weighted Score

ABSTRACT Background Glycolysis/gluconeogenesis and tricarboxylic acid (TCA) cycle metabolites have been associated with type 2 diabetes (T2D). However, the associations of these metabolites with T2D incidence and the potential effect of dietary interventions remain unclear. Objectives We aimed to evaluate the association of baseline and 1-y changes in glycolysis/gluconeogenesis and TCA cycle metabolites with insulin resistance and T2D incidence, and the potential modifying effect of Mediterranean diet (MedDiet) interventions. Methods We included 251 incident T2D cases and 638 noncases in a nested case-cohort study within the PREDIMED Study during median follow-up of 3.8 y. Participants were allocated to MedDiet + extra-virgin olive oil, MedDiet + nuts, or control diet. Plasma metabolites were measured using a targeted approach by LC–tandem MS. We tested the associations of baseline and 1-y changes in glycolysis/gluconeogenesis and TCA cycle metabolites with subsequent T2D risk using weighted Cox regression models and adjusting for potential confounders. We designed a weighted score combining all these metabolites and applying the leave-one-out cross-validation approach. Results Baseline circulating concentrations of hexose monophosphate, pyruvate, lactate, alanine, glycerol-3 phosphate, and isocitrate were significantly associated with higher T2D risk (17–44% higher risk for each 1-SD increment). The weighted score including all metabolites was associated with a 30% (95% CI: 1.12, 1.51) higher relative risk of T2D for each 1-SD increment. Baseline lactate and alanine were associated with baseline and 1-y changes of homeostasis model assessment of insulin resistance. One-year increases in most metabolites and in the weighted score were associated with higher relative risk of T2D after 1 y of follow-up. Lower risks were observed in the MedDiet groups than in the control group although no significant interactions were found after adjusting for multiple comparisons. Conclusions We identified a panel of glycolysis/gluconeogenesis-related metabolites that was significantly associated with T2D risk in a Mediterranean population at high cardiovascular disease risk. A MedDiet could counteract the detrimental effects of these metabolites. This trial was registered at controlled-trials.com as ISRCTN35739639.

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Analysis of candidate genes in Polish families with obesity

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm.2004.083 ◽

2004 ◽

Vol 42 (5) ◽

Cited By ~ 6

Author(s):

Malgorzata Malczewska-Malec ◽

Iwona Wybranska ◽

Iwona Leszczynska-Golabek ◽

Lukasz Partyka ◽

Jadwiga Hartwich ◽

...

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Insulin Sensitivity ◽

Body Mass ◽

Tolerance Test ◽

Whole Body ◽

Oral Glucose ◽

Sensitivity Index ◽

Model Assessment ◽

The Metabolic Syndrome

AbstractThis study analyzes the relationship between risk factors related to overweight/obesity, insulin resistance, lipid tolerance, hypertension, endothelial function and genetic polymorphisms associated with: i) appetite regulation (leptin, melanocortin-3-receptor (MCR-3), dopamine receptor 2 (D2R)); ii) adipocyte differentiation and insulin sensitivity (peroxisome proliferator-activated receptor-γThe 122 members of 40 obese Caucasian families from southern Poland participated in the study. The genotypes were analyzed by restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR) or by direct sequencing. Phenotypes related to obesity (body mass index (BMI), fat/lean body mass composition, waist-to-hip ratio (WHR)), fasting lipids, glucose, leptin and insulin, as well as insulin during oral glucose tolerance test (OGTT) (4 points within 2 hours) and during oral lipid tolerance test (OLTT) (5 points within 8 hours) were assessed. The insulin sensitivity indexes: homeostasis model assessment of insulin resistance, whole body insulin sensitivity index, hepatic insulin sensitivity and early secretory response to an oral glucose load (HOMA-IR, ISI-COMP, ISI-HOMA and DELTA) were calculated.The single gene mutations such as CWe conclude that the polymorphisms we investigated were weakly correlated with obesity but significantly modified the risk factors of the metabolic syndrome.

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