Association of periodontitis with insulin resistance, &beta;-cell function, and impaired fasting glucose before onset of diabetes

Abstract BACKGROUND: Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant syndrome characterized by hyperparathyroidism, pituitary adenomas, and gastro-entero-pancreatic neuroendocrine tumors. Patients with MEN1 mutations have impaired glucose homeostasis, but the role of insulin resistance and beta-cell function is unclear. METHODS: Using a case-control study design, a retrospective analysis of germline mutation-positive MEN 1 patients (n=289) seen at our institution between 1991-2019 was performed. Patients with diabetes and/or insulinoma were excluded. Subjects were age, BMI, sex and race matched 1:1 to unrelated, healthy controls. Fasting glucose, insulin, c-peptide, calcium, PTH, 25-OH vitamin D, cholesterol, LDL, HDL and triglycerides (TG) were compared between two groups. Homeostasis model assessment (HOMA-IR) and HOMA-beta cell function (HOMA-b) were used as surrogate measures of insulin resistance and beta-cell function, respectively. Data is presented as mean ± SD. RESULTS: MEN1 subjects (n=40; age 41±11 years; BMI 29.2±7.2 kg/m2) were matched to healthy controls (age 41±11 years; BMI 29.1±7.5 kg/m2). Only 3 MEN1 patients had no evidence of pancreatic neuroendocrine tumors. Impaired fasting glucose was more prevalent in MEN1 compared with controls (53% vs 10%, p<0.0001). HOMA-IR was positively associated with BMI, but not age, sex, calcium or vitamin D levels in either cohort. HOMA-IR adjusted for age, BMI, and sex was higher in patients with MEN1 compared with controls (4.01 vs. 2.44, adjusted ratio of means 1.54, 95% CI [1.14, 2.07], p=0.005). HOMA-b was not significantly different between the groups (177 vs. 129, adjusted ratio of means 1.17, 95% CI [0.86, 1.58], p=0.23). There were no significant differences in total cholesterol, LDL, HDL, and TG between the groups. CONCLUSION: Lower insulin sensitivity, but not impaired beta cell function may contribute to the higher prevalence of impaired fasting glucose in MEN1 patients compared with controls. Mechanistic studies into the role of menin loss in glucose homeostasis are warranted.

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Comprehensive Biomarker Testing of Glycemia, Insulin Resistance, and Beta Cell Function Has Greater Sensitivity to Detect Diabetes Risk Than Fasting Glucose and HbA1c and Is Associated with Improved Glycemic Control in Clinical Practice

Journal of Cardiovascular Translational Research ◽

10.1007/s12265-014-9577-1 ◽

2014 ◽

Vol 7 (6) ◽

pp. 597-606 ◽

Cited By ~ 13

Author(s):

Stephen A. Varvel ◽

Szilard Voros ◽

Dawn L. Thiselton ◽

James V. Pottala ◽

Tara Dall ◽

...

Keyword(s):

Insulin Resistance ◽

Clinical Practice ◽

Glycemic Control ◽

Beta Cell ◽

Beta Cell Function ◽

Cell Function ◽

Fasting Glucose ◽

Diabetes Risk ◽

Biomarker Testing

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Beta Cell Function: A Useful Measure of Insulin Resistance in Adolescent with Polycystic Ovarian Disease

Annals of King Edward Medical University ◽

10.21649/akemu.v22i3.1402 ◽

2016 ◽

Vol 22 (3) ◽

Author(s):

Reema Irum ◽

Ghazala Qureshi ◽

Alia Dilawar ◽

Rukhshan Khurshid ◽

Shirin Khawar

Keyword(s):

Insulin Resistance ◽

Beta Cell ◽

Beta Cell Function ◽

Polycystic Ovarian Syndrome ◽

Cell Function ◽

Fasting Glucose ◽

Serum Insulin ◽

Premenopausal Women ◽

And Control ◽

Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is the universal endocrine disarray in premenopausal women, These women are prone to insulin resistance as well as altered beta cell function. Study was designed to find out the relationship of insulin resistance and betacell function in adolescent with PCOS.Material and Methods:Â Â Study included 50 female patients, aged range 16-20 years from Obstetrics and Gynaecology department in Lahore. All subjects were already diagnosed and documented as patients of polycystic ovarian syndrome on the basis of pelvic ultrasonic findings. Level of serum insulin was estimated by ELISA technique using standard kit. Level of fasting glucose was estimated by glucose oxidase method. The value of insulin resistance, glucose: insulin ratio and Beta cell function were calculated.Results:Â Â Mean age of subjects with PCOS and control was 18.9 and 18.6 year respectively. Fasting glucose of PCOS subject was non-significantly decreased when compared to their controls. Serum level of insulin was significantly (P < 0.001) increased in patients compared to their controls. Glucose insulin (GIR) ratio was significantly decreased (P < 0.001) when compared to their controls. Insulin resistance was non-significantly increased in subjects as compared to their controls. Increased function of beta cell was found in PCOS subjects as compared to their controls. The Pearsonâ€™s correlation showed a positive significant correlation between HOMA-IR and fasting insulin. A significant correlation was observed between level of insulin and insulin resistance. Weak correlation was observed between level of insulin and beta cell function.Conclusion:Â Â It is the concluded that function of beta cell failure to compensate insulin resistance increases the risk of diabetes in adolescent with PCOS. More research is needed to define the degree of beta cell effect.

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One-Hour Postload Hyperglycemia Is a Stronger Predictor of Type 2 Diabetes Than Impaired Fasting Glucose

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2015-2573 ◽

2015 ◽

Vol 100 (10) ◽

pp. 3744-3751 ◽

Cited By ~ 63

Author(s):

Teresa Vanessa Fiorentino ◽

Maria Adelaide Marini ◽

Francesco Andreozzi ◽

Franco Arturi ◽

Elena Succurro ◽

...

Keyword(s):

Type 2 Diabetes ◽

Insulin Sensitivity ◽

Glucose Tolerance ◽

Beta Cell ◽

Impaired Fasting Glucose ◽

Longitudinal Analysis ◽

Beta Cell Function ◽

Cell Function ◽

Fasting Glucose

Context: Subjects with normal glucose tolerance (NGT) but 1-h postload glucose ≥ 155 mg/dL (NGT-1h-high) exhibit an intermediate cardiometabolic risk profile between individuals with NGT and impaired glucose tolerance (IGT). Objective: This study aimed to evaluate whether NGT-1h-high subjects have different cardiometabolic characteristics and an increased risk of type 2 diabetes compared with individuals with isolated impaired fasting glucose (IFG). Setting, Design, and Patients: A cross-sectional analysis was performed on 595 nondiabetic subjects who underwent an oral glucose tolerance test and an euglycemic hyperinsulinemic clamp in an ambulatory care setting. In addition, a longitudinal analysis was performed on 392 individuals, who were reexamined after a followup of 5.2 ± 0.9 y. Main Outcome Measures: Insulin sensitivity, beta-cell function, and risk of developing diabetes were measured. Results: Subjects with NGT-1h-high have a significant reduction of peripheral insulin sensitivity and beta-cell function, assessed by the disposition index, compared with either 1-h postload glucose < 155 mg/dL (NGT-1h-low) or IFG individuals, but not compared with IGT. Among the 392 subjects studied in the longitudinal analysis the incidence rate of type 2 diabetes over the follow-up period was 2.9, 16.7, 12.5, and 31.4% for subjects with NGT-1h-low, NGT-1h-high, IFG, and IGT, respectively. In a Cox proportional hazard regression analysis the risk of developing diabetes for NGT-1h-high subjects was 4.02 (95% confidence interval [CI] 1.06–15.26); an even higher risk (6.67; 95% CI, 2.09–21.24) was observed in subjects with IGT, but not in the isolated IFG group (1.91; 95% CI, 0.44–8.29). Conclusions: NGT-1h-high subjects exhibit a higher risk of developing diabetes than those with IFG or NGT-1h-low, likely due to decreased insulin sensitivity and beta-cell function.

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