IMPORTANCE OF FASTING INSULIN LEVELS IN INSULIN RESISTANCE AND DIABETES MELLITUS (HOMEOSTATIC MODEL ASSESSMENT)

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.

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Sarkopenie im Kontext von Insulinresistenz und Diabetes mellitus im Alter – Daten aus der Berliner Altersstudie II

Diabetologie und Stoffwechsel ◽

10.1055/a-1223-1888 ◽

2020 ◽

Vol 15 (05) ◽

pp. 400-408

Author(s):

Dominik Spira ◽

Nikolaus Buchmann ◽

Knut Mai ◽

Thomas Bobbert ◽

Joachim Spranger ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Body Mass Index ◽

Body Mass ◽

Diabetes Mellitus Typ 2 ◽

Körperliches Training ◽

Model Assessment ◽

Homeostatic Model Assessment ◽

Homeostatic Model ◽

Negative Effekte

Zusammenfassung Hintergrund Diabetes mellitus Typ 2 (T2DM) und Sarkopenie nehmen mit steigendem Alter in ihrer Prävalenz zu und können langfristig betrachtet jeweils zu erheblichen gesundheitlichen und funktionellen Einschränkungen führen. Während eine zunehmende Insulinresistenz bei abnehmender Muskelmasse plausibel erscheint, sind umgekehrt auch glukotoxische negative Effekte auf die Skelettmuskulatur im Sinne einer sekundären Sarkopenie denkbar. Ziel dieser Arbeit war es, den Zusammenhang zwischen Sarkopenie, Insulinresistenz und T2DM bei älteren Menschen zu untersuchen. Methoden Untersucht wurden 1555 Probanden der Berliner Altersstudie II (BASE-II) mit einem durchschnittlichen Alter von 68 ± 4 Jahren. Die Diagnose T2DM wurde basierend auf der Anamnese sowie oralem Glukosetoleranztest und HbA1c-Wert nach ADA-Kriterien gestellt und die Insulinresistenz wurde via Homeostatic Model Assessment for Insulin resistance (HOMA-IR) und Insulinsensitivitätsindex nach Matsuda (ISI) eingeschätzt. Die appendikuläre Skelettmuskelmasse (ALM) wurde mittels Dual-Röntgen-Absorptiometrie (DXA) und eine Sarkopenie mithilfe der anhand des Body-Mass-Index (BMI) korrigierten Muskelmasse (ALM/BMI) nach den Cut-off-Werten des FNIH Sarcopenia Project bestimmt. Gruppenvergleiche wurden mittels Kruskal-Wallis-Test berechnet, und der Zusammenhang zwischen Diabetes mellitus und Sarkopenie bzw. ALM und Insulinresistenz wurde mittels geeigneter Regressionsmodelle überprüft. Ergebnisse 25,2 % der insgesamt 160 Probanden mit T2DM hatten bereits eine Sarkopenie. Sarkopenisch-adipöse Probanden wiesen im Vergleich zu nur adipösen, nur sarkopenen oder weder adipösen noch sarkopenen Probanden im Median einen niedrigeren ISI und einen höheren HOMA-IR auf (jeweils p < 0,001). T2DM zeigte sich unabhängig assoziiert mit Sarkopenie (OR 3,293, 95 %-KI 1,984–5,466, p < 0,001), während nach Ausschluss bekannter Diabetiker eine höhere ALM mit einem höheren ISI (B 0,229, 95 %-KI 0,119–0,338; p < 0,001), nicht jedoch niedrigerem HOMA-IR (B –0,017, 95 %-KI –0,089–0,055; p = 0,640) einherging. Diskussion Sarkopenie ist sowohl mit Insulinresistenz als auch T2DM assoziiert. Die Frage bzgl. der Kausalität ist aufgrund des querschnittlichen Designs der Studie nicht zu beantworten, jedoch sollte eine mögliche Rolle des T2DM als sekundäre Sarkopenieursache berücksichtigt und weiter untersucht werden. Im Hinblick auf mögliche Folgen erscheinen die Identifizierung von Risikopatienten mit kombiniertem Auftreten von Sarkopenie und Insulinresistenz und die Evaluation basaler präventiver Maßnahmen wie gezieltes körperliches Training und angepasste Ernährung ein weiterführendes sinnvolles Ziel.

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Serum Interleukin 2 Levels in Patients with Rheumatoid Arthritis and Correlation with Insulin Sensitivity

Journal of International Medical Research ◽

10.1177/147323000203000404 ◽

2002 ◽

Vol 30 (4) ◽

pp. 386-390 ◽

Cited By ~ 10

Author(s):

O Öncül ◽

C Top ◽

S Özkan ◽

Ş Çavuşlu ◽

M Danaci

Keyword(s):

Rheumatoid Arthritis ◽

Insulin Resistance ◽

Insulin Sensitivity ◽

Interleukin 2 ◽

Model Assessment ◽

Fasting Insulin ◽

Peripheral Insulin Resistance ◽

Homeostatic Model Assessment ◽

Homeostatic Model

Interleukin 2 (IL-2), a Th1 lymphocyte-derived cytokine, is thought to play an important role in the pathogenesis of type 2 diabetes and rheumatoid arthritis (RA). The aim of our study was to evaluate changes in serum IL-2 levels and their correlation with glucose metabolism abnormalities, such as insulin resistance, in patients with RA. Thirty-six subjects with varying degrees of disease activity and 20 healthy age-, sex- and body mass index-matched control individuals were evaluated. Patients with any causes of peripheral insulin resistance were excluded. After a 12-h overnight fast, fasting insulin levels, homeostatic model assessment-insulin resistance (HOMA-IR) estimated insulin sensitivity, and serum IL-2 levels were significantly higher in all patients with RA than in the control individuals. Fasting insulin, HOMA-IR scores and IL-2 levels were correlated in the RA group. This study showed that patients with RA have altered IL-2 regulation, and that there was a significant correlation between serum IL-2 levels and insulin sensitivity.

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

European Journal of Pediatrics ◽

10.1007/s00431-020-03924-w ◽

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.

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The Relationship between Insulin Resistance and the Cardiovascular Biomarker Growth Differentiation Factor-15 in Obese Patients

Clinical Chemistry ◽

10.1373/clinchem.2010.153726 ◽

2011 ◽

Vol 57 (2) ◽

pp. 309-316 ◽

Cited By ~ 73

Author(s):

Greisa Vila ◽

Michaela Riedl ◽

Christian Anderwald ◽

Michael Resl ◽

Ammon Handisurya ◽

...

Keyword(s):

Insulin Resistance ◽

Gastric Bypass ◽

Insulin Sensitivity ◽

Oral Glucose ◽

Model Assessment ◽

Obese Patients ◽

Growth Differentiation Factor 15 ◽

Homeostatic Model Assessment ◽

Homeostatic Model ◽

The Relationship

BACKGROUND Growth differentiation factor-15 (GDF-15) is a stress-responsive cytokine linked to obesity comorbidities such as cardiovascular disease, inflammation, and cancer. GDF-15 also has adipokine properties and recently emerged as a prognostic biomarker for cardiovascular events. METHODS We evaluated the relationship of plasma GDF-15 concentrations with parameters of obesity, inflammation, and glucose and lipid metabolism in a cohort of 118 morbidly obese patients [mean (SD) age 37.2 (12) years, 89 females, 29 males] and 30 age- and sex-matched healthy lean individuals. All study participants underwent a 75-g oral glucose tolerance test; 28 patients were studied before and 1 year after Roux-en-Y gastric bypass surgery. RESULTS Obese individuals displayed increased plasma GDF-15 concentrations (P < 0.001), with highest concentrations observed in patients with type 2 diabetes. GDF-15 was positively correlated with age, waist-to-height ratio, mean arterial blood pressure, triglycerides, creatinine, glucose, insulin, C-peptide, hemoglobin A1c, and homeostatic model assessment insulin resistance index and negatively correlated with oral glucose insulin sensitivity. Age, homeostatic model assessment index, oral glucose insulin sensitivity, and creatinine were independent predictors of GDF-15 concentrations. Roux-en-Y gastric bypass led to a significant reduction in weight, leptin, insulin, and insulin resistance, but further increased GDF-15 concentrations (P < 0.001). CONCLUSIONS The associations between circulating GDF-15 concentrations and age, insulin resistance, and creatinine might account for the additional cardiovascular predictive information of GDF-15 compared to traditional risk factors. Nevertheless, GDF-15 changes following bariatric surgery suggest an indirect relationship between GDF-15 and insulin resistance. The clinical utility of GDF-15 as a biomarker might be limited until the pathways directly controlling GDF-15 concentrations are better understood.

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