scholarly journals Impact of Long-Term Dexamethasone Therapy on the Metabolic Profile of Patients With 21-Hydroxylase Deficiency

2019 ◽  
Vol 3 (8) ◽  
pp. 1574-1582 ◽  
Author(s):  
Carlos E Seraphim ◽  
Juliana S Frassei ◽  
Bruna S Pessoa ◽  
Renata C Scalco ◽  
Mirela C Miranda ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
The Body ◽  
Model Assessment ◽  
Hydroxylase Deficiency ◽  
Homeostatic Model Assessment ◽  
The Mean ◽  
Homeostatic Model ◽  
21 Hydroxylase Deficiency

Abstract Context No consensus has been reached regarding the glucocorticoid (GC) to use for congenital adrenal hyperplasia (CAH) during adulthood. Dexamethasone (DEX), because of its longer half-life, could improve compliance; however, no data are available regarding the long-term effects of DEX therapy. Objective To analyze the metabolic effect of DEX therapy for adults with CAH. Design Retrospective analysis of a CAH cohort receiving DEX therapy. Setting Medical School Hospital, São Paulo University, Brazil. Participants Sixty patients with well-controlled classic CAH (41 women; 30 with salt-wasting) receiving DEX after achievement of final height. Interventions None. Main Outcome Measures Clinical, laboratory, and metabolic data were compared immediately before DEX and at the last evaluation. Results The mean age at the last evaluation was 31.9 ± 9.6 years, and the duration of DEX therapy was 11.5 ± 4.9 years. The mean DEX dose was 0.18 ± 0.07 mg/m2/d. The body mass index SD score (1.6 ± 1.6 vs 1.5 ± 1.5 mg/m2; P = 0.65) and obesity prevalence (27% vs 27%) did not differ between evaluations. However, the waist/height ratio (WtHR) had increased from 0.54 ± 0.08 to 0.56 ± 0.1 (P = 0.001). An increase in the homeostatic model assessment for insulin resistance index (2.5 ± 1.3 vs 2.8 ± 1.7; P = 0.03) was observed and positively correlated with the WtHR (r = 0.54). The prevalence of metabolic syndrome (7% vs 10%; P = 0.7) and hypertension (15% vs 13.3%; P = 0.8) did not differ significantly between the two evaluations. Conclusions Long-term and low-dose DEX therapy did not lead to increases in obesity or metabolic syndrome, although it was associated with an increased WtHR and greater homeostatic model assessment for insulin resistance observed with chronic use of GCs. DEX appears to be an acceptable option to treat adult CAH.

scholarly journals Metabolic syndrome and insulin resistance in pre-pubertal children with psoriasis

2021 ◽  
Author(s):  
Francesca Caroppo ◽  
Alfonso Galderisi ◽  
Laura Ventura ◽  
Anna Belloni Fortina
Keyword(s):  
Metabolic Disease ◽  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Model Assessment ◽  
Limited Data ◽  
Single Center ◽  
Increased Risk ◽  
High Prevalence ◽  
Homeostatic Model Assessment ◽  
Homeostatic Model

AbstractPsoriasis in adults is associated with an increased risk of metabolic disease. Various cardiometabolic comorbidities have been reported in childhood psoriasis, but only a few studies have analyzed the prevalence of metabolic syndrome. We performed a single-center prospective study investigating the prevalence of metabolic syndrome and insulin resistance in children with psoriasis. The prevalence of metabolic syndrome was evaluated in 60 pre-pubertal children with psoriasis (age: 3–10 years), accordingly to recently established criteria for the diagnosis of metabolic syndrome in children. Insulin resistance was considered altered when the homeostatic model assessment (HOMA-IR) for insulin resistance was ≥ 90th sex- and age-specific percentile and HOMA 2-IR was > 1.8. Eighteen (30%) children with psoriasis were found to have metabolic syndrome. Sixteen (27%) children were found to have insulin resistance.Conclusion: Our data underline the importance of assessing metabolic syndrome not only in adults and adolescents but also in young children with psoriasis. What is Known:• Psoriasis in adults is strongly associated with metabolic disease and insulin resistance.• Very limited data are available on the prevalence of metabolic syndrome and insulin resistance in pre-pubertal children with psoriasis. What is New:• This study reports that in pre-pubertal children with psoriasis, there is a high prevalence of metabolic syndrome and insulin resistance.• In children with psoriasis metabolic syndrome risk factors should be assessed.

scholarly journals Association of vitamin D-binding protein and vitamin D3 with insulin and homeostatic model assessment (HOMA-IR) in overweight and obese females

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Leila Setayesh ◽  
Krista Casazza ◽  
Nariman Moradi ◽  
Sanaz Mehranfar ◽  
Habib Yarizadeh ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Vitamin D ◽  
Body Composition ◽  
Binding Protein ◽  
The Body ◽  
Enzyme Linked Immunosorbent Assay ◽  
Model Assessment ◽  
Vitamin D Binding Protein ◽  
Homeostatic Model Assessment ◽  
Homeostatic Model

Abstract Objective Equivocal association the contribution of 25-hydroxyvitamin D (25(OH)D) and the well-accepted role of vitamin D-binding protein (VDBP) on bioavailability of 25(OH)D or its independent roles, has led to possible association of the VDBP in glucose metabolism. This study was conducted to evaluate the relationships among 25(OH)D, VDBP, glucose/insulin metabolism and homeostatic model assessment (HOMA-IR). Blood samples were collected from 236 obese and overweight women. VDBP and 25(OH)D levels, and biochemical parameters were measured using an enzyme-linked immunosorbent assay (ELISA). An impedance fat analyzer was utilized to acquire the body composition. Results Using the multivariate linear regression, a reverse relationship was observed between VDBP and (HOMA-IR), such that women with higher VDBP displayed lower insulin resistance. The relationship was independent of age, body mass index, standardized energy intake and physical activity (p = 0.00). No significant relationship between 25(OH)D levels, FBS, body composition or insulin resistance were observed (p > 0.2). Current study observed that higher level of VDBP may be associated with lower levels of insulin and HOMA-IR, thus the evaluation of VDBP in diverse population groups seems to have significant clinical value in evaluating the prevalence of DM or early stage of glucose intolerance.

scholarly journals Elevated Retinol-Binding Protein 4 Levels Are Associated with Metabolic Syndrome in Chinese People

2007 ◽  
Vol 92 (12) ◽  
pp. 4827-4834 ◽  
Author(s):  
Qibin Qi ◽  
Zhijie Yu ◽  
Xingwang Ye ◽  
Feng Zhao ◽  
Ping Huang ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Odds Ratio ◽  
Large Scale ◽  
Density Lipoprotein ◽  
Retinol Binding Protein ◽  
Model Assessment ◽  
Retinol Binding Protein 4 ◽  
Homeostatic Model Assessment ◽  
Homeostatic Model

Abstract Context: High retinol-binding protein 4 (RBP4) is thought to be associated with insulin resistance in humans. However, evidence from large-scale populations about the relationship between RBP4 and metabolic diseases is scarce. Objective: We evaluated plasma RBP4 distribution and its association with metabolic syndrome (MetS) among middle-aged and older Chinese. Research Design and Methods: We evaluated plasma RBP4 in a cross-sectional sample of 3289 Chinese aged from 50 to 70 yr in Beijing and Shanghai by using an in-house developed and validated sandwich ELISA. MetS was defined according to the updated National Cholesterol Education Program Adult Treatment Panel III criteria for Asian-Americans. Results: RBP4 levels were higher in male and Beijing residents, compared with female and Shanghai participants (both P < 0.001). RBP4 levels were associated positively with body mass index, waist circumference, triglycerides, total and low-density lipoprotein cholesterol, blood pressure, fasting insulin, and homeostatic model assessment of insulin resistance and negatively with high-density lipoprotein cholesterol and adiponectin (all P < 0.001). In the highest RBP4 quartile, the MetS risk was significantly higher (odds ratio 2.58; 95% confidence interval 2.08–3.20) than in the lowest quartile after adjustment for potential confounders. This association remained strong (odds ratio 2.25; 95% confidence interval 1.72–2.94) after further controlling for C-reactive protein, adiponectin, homeostatic model assessment of insulin resistance, and body mass index. Conclusions: This first large-scale population study shows that elevated RBP4 levels are strongly and independently associated with MetS. Prospective studies are needed to establish the role of RBP4 in the development of MetS and related diseases.

scholarly journals Psoriasis Severity—A Risk Factor of Insulin Resistance Independent of Metabolic Syndrome

2018 ◽  
Vol 15 (7) ◽  
pp. 1486 ◽  
Author(s):  
Melita Polic ◽  
Maja Miskulin ◽  
Martina Smolic ◽  
Kristina Kralik ◽  
Ivan Miskulin ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Beta Cell Function ◽  
Cell Function ◽  
Model Assessment ◽  
Homeostatic Model Assessment ◽  
Homeostatic Model ◽  
Psoriasis Severity

Background: It is still debatable whether psoriasis increases cardiovascular risk indirectly since it is associated with metabolic syndrome or is an independent cardiovascular risk factor. The aim of this study was to evaluate psoriasis severity as an independent predictor of insulin resistance (IR) irrespective of the presence of metabolic syndrome (MetS). Methods: This was a case control study including 128 patients stratified into two groups: patients with psoriasis and metabolic syndrome vs. patients with psoriasis and no metabolic syndrome. MetS was diagnosed according to ATP III criteria with homeostatic model assessment of insulin resistance (HOMA-IR), as well as a homeostatic model assessment of beta cell function (HOMA-β) were calculated. Results: Compared to subjects without metabolic syndrome, patients with metabolic syndrome had a significantly higher Psoriasis Area Severity Index (PASI) values (p < 0.001). The strongest correlation was established for HOMA-IR and the PASI index (p < 0.001), even after adjustment for body mass index (BMI) in regression analysis model. In patients without MetS and severe forms of disease, the HOMA-IR and HOMA-β values were significantly higher compared to mild forms of disease (p < 0.001 for all) while in subjects with MetS no difference was established for HOMA-IR or HOMA-β based on disease severity. Conclusions: Psoriasis severity is an independent risk factor of HOMA-IR, the strongest association being present in the non-MetS group, who still had preserved beta cell function suggesting direct promotion of atherosclerosis via insulin resistance depending on the disease severity, but irrespective of the presence of metabolic syndrome.

scholarly journals TRI-PONDERAL MASS INDEX IS USEFUL FOR SCREENING CHILDREN AND ADOLESCENTS WITH INSULIN RESISTANCE

2020 ◽  
Vol 38 ◽  
Author(s):  
Felipe Silva Neves ◽  
Rafael de Oliveira Alvim ◽  
Divanei Zaniqueli ◽  
Virgilia Oliveira Pani ◽  
Caroline Resende Martins ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Mass Index ◽  
Public Schools ◽  
Children And Adolescents ◽  
Body Mass ◽  
The Body ◽  
Model Assessment ◽  
Homeostatic Model Assessment ◽  
Z Scores ◽  
Homeostatic Model

ABSTRACT Objective: To investigate whether tri-ponderal mass index and body mass index Z scores are equivalent for screening children and adolescents with insulin resistance. Methods: Cross-sectional study with 296 children and adolescents enrolled at public schools of Vitória, Espírito Santo, Brazil, aged eight to 14 years. The tri-ponderal mass index was calculated as the ratio between weight and height cubed. The body mass index was calculated as the ratio between weight and height squared. Insulin resistance was defined with the homeostatic model assessment (HOMA-IR). Results: The HOMA-IR was higher in the 4th quartile of body mass index Z scores and tri-ponderal mass index compared to 1st and 2nd quartiles for both girls and boys. The areas under the age-adjusted receiver operating characteristic curves were similar between the indices for girls (body mass index Z scores=0.756; tri-ponderal mass index=0.763) and boys (body mass index Z scores=0.831; tri-ponderal mass index=0.843). In addition, according to the simple linear regression analyses estimations, both body mass index Z scores and tri-ponderal mass index explained a significant fraction of the homeostatic model assessment variability for girls (body mass index Z scores: R2=0.269; tri-ponderal mass index: R2=0.289; p<0.001) and boys (body mass index Z scores: R2=0.175; tri-ponderal mass index: R2=0.210; p<0.001). Conclusions: The tri-ponderal mass index and body mass index Z scores were similar to discriminate children and adolescents with insulin resistance. It is noteworthy that the use of tri-ponderal mass index is clearly advantageous, because it can be calculated with no concerns on adjustments for the age, a fact that makes it very applicable in the clinical practice.

scholarly journals Thyroid hormone levels associate with insulin resistance in obese women with metabolic syndrome in Saudi Arabia: A cross-sectional study

2019 ◽  
Author(s):  
Manal Abdulaziz Binobead ◽  
Nawal Abdullah Al Badr ◽  
Wahidah Hazzaa Al-Qahtani ◽  
Sahar Abdulaziz AlSedairy ◽  
Tarfa Ibrahim Albrahim ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Body Mass Index ◽  
Waist Circumference ◽  
Model Assessment ◽  
Fasting Insulin ◽  
Obese Women ◽  
Free Triiodothyronine ◽  
Homeostatic Model Assessment ◽  
Homeostatic Model

AbstractBackgroundThe obesity epidemic is a pressing global health concern, as obesity rates continue to climb worldwide. The current study was aimed mainly to evaluate the correlation between thyroid hormones and homeostatic model assessment of insulin resistance in Saudi obese women with metabolic syndrome.Methods100 obese women aged 25 to 55 years were clinically evaluated, from which 72 women were diagnosed with the metabolic syndrome and 28 without metabolic syndrome. Insulin resistance was quantified using the homeostatic model assessment of insulin resistance method and the resulting values were analyzed for association with demographic, clinical, and metabolic parameters.ResultsThis analysis revealed that body mass index, systolic blood pressure, and biochemical parameters and fasting insulin showed statistically higher levels in the group with metabolic syndrome compared to the group without metabolic syndrome. Similarly, values of waist circumference, fat ratio, cholesterol, free thyroxine, free triiodothyronine and homeostatic model assessment of insulin resistance results were higher in the group with metabolic syndrome as compared to the group without metabolic syndrome. Correlation analysis revealed positive association of thyroid-stimulating hormone with waist circumference (P=0.01), total cholesterol (P=0.002), fasting insulin (P=0.03) and homeostatic model assessment of insulin resistance results (P<0.01), and negatively associated with diastolic blood pressure (P=0.013) and age (P=0.05). Free thyroxine was positively associated with triglyceride level (P=0.003) and negatively associated with homeostatic model assessment of insulin resistance values (P=0.035) and fasting insulin. Free triiodothyronine was positively associated with body mass index (P=0.032) and waist circumference (P= 0.006) and negatively with age (P=0.004) and total cholesterol (P=0.001).Homeostatic model assessment of insulin resistance test revealed elevated level with positive association of body mass index, waist circumference, biochemical parameters and thyroid-stimulating hormone in insulin resistant obese women. Higher level of free triiodothyronine was found to be associated with low insulin sensitivity.

scholarly journals Association Between First Episode Schizophrenia, Metabolic Syndrome and Insulin Resistance-Related Proteins in Female Balb/C Mice

2018 ◽  
Vol 7 ◽  
pp. e692
Author(s):  
Haseeb Sattar ◽  
Huqun Li ◽  
Yong Han ◽  
Hong Zhou ◽  
Sanaz Darbalaei ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Body Weight ◽  
Adipose Tissue ◽  
First Episode ◽  
Model Assessment ◽  
Homeostatic Model Assessment ◽  
Homeostatic Model ◽  
Ptp 1B ◽  
Related Proteins

Background: Metabolic syndrome is a group of different disorders mainly includes, insulin resistance, obesity, cerebrovascular disorders, dyslipidemia, which leads to increase mortality. Patients suffering from related psychotic disorders such as schizophrenia are at the higher risk of developing metabolic syndrome. The aim of this study was to evaluate the association between the first episode of schizophrenia, metabolic syndrome and insulin resistance-related proteins in blood and adipose tissue of mice.Materials and Methods: Twelve, female Balb/c mice were randomly divided into two groups; one group was injected intraperitoneal MK-801 (0.6mg/kg/d) to induce schizophrenia, and other group received the 0.9% normal saline for two weeks. Body weight, fasting blood glucose (FBG), oral glucose tolerance (OGT), and Homeostatic model assessment (HOMA), were observed. Blood and adipose tissue were collected and Western blotting was done to evaluate the insulin resistance related proteins (GGPPS, FAT, PTP-1B, GRK2, ATGL, FGF21, and PGC-1α) by using GAPDH as an internal standard. Results: There was a significant increase in mean body weight in schizophrenic group (21.76 vs 22.81, P=004). On day 14, the FBG, insulin concentrations and Homeostatic model assessment and insulin resistance (HOME-IR) were high in schizhphrenic group vs control group, e.g. 5.3±0.6 vs 3.47±0.2 (P=0.0001), 28.9±2.2 vs 23.3±0.6 (P<0.005) and 9.2±1.3 vs 3.9±0.2 (P=0.0001) . Impaired glucose tolerance deranged from 4.8mmol/L to 6.4mmol/L. Western blotting showed a marked increase in the expression of GGPPS, FAT, ATGL, and FGF21 proteins in monocytes and PTP-1B, GRK2, and PGC-1α ratios in adipose tissues.Conclusion: There was a positive relation between schizophrenia and metabolic syndrome e.g. insulin resistance and obesity. Certain proteins in adipocytes and blood were responsible for causing insulin resistance. [GMJ.2018;7:e692]

scholarly journals Unique Metabolic Features of Adults Discordant for Indices of Insulin Resistance

2020 ◽  
Vol 105 (8) ◽  
pp. e2753-e2763
Author(s):  
Yilin Song ◽  
Esben Søndergaard ◽  
Michael D Jensen
Keyword(s):  
Insulin Resistance ◽  
Visceral Fat ◽  
Plasma Lipids ◽  
Resistance Index ◽  
Defined Medium ◽  
The Body ◽  
Model Assessment ◽  
Insulin Resistance Index ◽  
Homeostatic Model Assessment ◽  
Homeostatic Model

Abstract Purpose Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and Adipose Insulin Resistance index (ADIPO-IR) values are often concordant. In this study we evaluated whether there are groups discordant for HOMA-IR and ADIPOpalmitate-IR and, if so, what are their defining characteristics. Methods The body composition, basal metabolic rate (BMR), fasting plasma lipids, insulin, glucose, and free fatty acid (FFA) palmitate concentrations data of 466 volunteers from previous research studies were abstracted and analyzed. The middle 2 population quartiles for HOMA-IR and Adipose Insulin Resistance index palmitate concentration (ADIPOpalmitate-IR) defined medium HOMA-IR and ADIPOpalmitate-IR (MH and MA), the top and bottom quartiles were defined as high/low HOMA (HH/LH), and high/low ADIPOpalmitate as HA/LA. Because ADIPOpalmitate-IR was significantly greater in women than in men, we established sex-specific quartiles for each index. We identified groups discordant for HOMA-IR and ADIPO-IR (HHMA, LHMA, MHHA, and MHLA). Results Body fat and fasting triglycerides (TGs) were significantly greater with higher indices in the concordant groups (HHHA &gt; MHMA &gt; LHLA). MHHA differed from MHLA by visceral fat (P &lt; .01) and fasting TGs (P &lt; .05), whereas HHMA differed (P &lt; .01) from LHMA by BMR. By multivariate regression, the group factor contributed to BMR (P &lt; .01) and visceral fat (P &lt; .05). Conclusions Adults discordant for HOMA-IR and ADIPO-IR have unique features including differences in visceral fat, TGs, and BMR. This suggests different forms of insulin resistance are present, which should be considered when studying insulin resistance in the future.

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