Evidence of increased visceral obesity and reduced physical fitness in healthy insulin-resistant first-degree relatives of type 2 diabetic patients

OBJECTIVE: First-degree relatives (FDR) of type 2 diabetic patients are often insulin resistant. Visceral obesity is closely linked to both insulin resistance and type 2 diabetes. We therefore hypothesized that the inheritance of an increased tendency to store fat in visceral fat depots may be a characteristic phenotypic feature in FDR contributing to their insulin resistance. DESIGN AND METHODS: We measured fat distribution in 20 FDR and 14 age-, gender- and body mass index (BMI)-matched controls employing dual energy X-ray absorbtiometry (DEXA)- and computed tomography (CT)-scanning. Insulin-stimulated glucose uptake (ISGU) was determined by a hyperinsulinemic clamp and maximal aerobic work capacity (VO2 max) by a bicycle ergometer test. Baseline lipolysis was measured using [3H]palmitate. The activity level of the hypothalamic-pituitary-adrenal axis was assessed as the 24 h urinary (u)-cortisol/creatinine ratio. RESULTS: All subjects had a normal oral glucose tolerance test (OGTT), but FDR were insulin resistant (ISGU: 6.64+/-0.48 vs 9.12+/-0.98 mg/kg ffm/min, P=0.01). Despite similar BMI (25.2+/-0.5 vs 24.8+/-0.7 kg/m2, P=0.61) and overall fat mass (26.4+/-1.6 vs 24.2+/-2.1%, P=0.41) in FDR vs controls, the amount of visceral adipose tissue was substantially increased (65.9+/-10.0 vs 40.1+/-11.3 cm2, P<0.05) and VO2 max was reduced (52.2+/-3.1 vs 63.3+/-3.9 ml/kg ffm/min, P<0.05) in FDR. Visceral adiposity was inversely correlated with ISGU (FDR: r=-0.52, P<0.05; controls: r=-0.65, P<0.01) and in multiple regression analysis visceral adiposity (P<0.01), VO2 max (P<0.001) and a family history of type 2 diabetes (P<0.05) (r2=0.64) all significantly and independently contributed to the level of ISGU. Baseline palmitate appearance (145+/-10 vs 139+/-15 micromol/min, P=0.74) and the 24 h u-cortisol/creatinine ratio ((24.9+/-1.3 vs 27.4+/-2.0).10(-6), P=0.28) were both comparable in the two groups. CONCLUSION: Healthy but insulin-resistant FDR have enhanced visceral obesity and reduced VO2 max compared with people without a family history of diabetes, despite similar BMI and overall fat mass. Both the visceral adiposity and reduced aerobic fitness are strongly associated with and may contribute to their insulin resistance.

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Apelin and APJ regulation in adipose tissue and skeletal muscle of type 2 diabetic mice and humans

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00598.2009 ◽

2010 ◽

Vol 298 (6) ◽

pp. E1161-E1169 ◽

Cited By ~ 83

Author(s):

Cédric Dray ◽

Cyrille Debard ◽

Jennifer Jager ◽

Emmanuel Disse ◽

Danièle Daviaud ◽

...

Keyword(s):

Insulin Resistance ◽

Skeletal Muscle ◽

Adipose Tissue ◽

Receptor Expression ◽

Diabetic Patients ◽

Mrna Levels ◽

Type 2 Diabetic Patients ◽

Insulin Resistant ◽

Type 2 Diabetic

Apelin, an adipocyte-secreted factor upregulated by insulin, is increased in adipose tissue (AT) and plasma with obesity. Apelin was recently identified as a new player in the control of glucose homeostasis. However, the regulation of apelin and APJ (apelin receptor) expression in skeletal muscle in relation to insulin resistance or type 2 diabetes is not known. Thus we studied apelin and APJ expression in AT and muscle in different mice models of obesity and in type 2 diabetic patients. In insulin-resistant high-fat (HF)-fed mice, apelin and APJ expression were increased in AT compared with control. This was not the case in AT of highly insulin-resistant db/ db mice. In skeletal muscle, apelin expression was similar in control and HF-fed mice and decreased in db/ db mice. APJ expression was decreased in both HF-fed and db/ db mice. Control subjects and type 2 diabetic patients were subjected to a hyperinsulinemic-euglycemic clamp, and tissues biopsies were obtained before and at the end of the clamp. There was no significant difference in basal apelin and APJ expression in AT and muscle between control and diabetic patients. However, apelin plasma levels were significantly increased in diabetic patients. During the clamp, hyperinsulinemia increased apelin and APJ expression in AT of control but not in diabetic subjects. In muscle, only APJ mRNA levels were increased in control but also in diabetic patients. Taken together, these data show that apelin and APJ expression in mice and humans is regulated in a tissue-dependent manner and according to the severity of insulin resistance.

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Insulin-sensitive and insulin-resistant variants in nonobese Japanese type 2 diabetic patients. The role of triglycerides in insulin resistance

Diabetes Care ◽

10.2337/diacare.22.12.2100 ◽

1999 ◽

Vol 22 (12) ◽

pp. 2100-2101 ◽

Cited By ~ 14

Author(s):

A. Taniguchi ◽

M. Fukushima ◽

M. Sakai ◽

K. Kataoka ◽

K. Miwa ◽

...

Keyword(s):

Insulin Resistance ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Insulin Resistant ◽

Type 2 Diabetic

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Visceral adiposity index and atherogenic index of plasma: Simple markers of insulin resistance in type 2 diabetic patients

Endocrine Abstracts ◽

10.1530/endoabs.73.aep220 ◽

2021 ◽

Author(s):

Asma Kardi ◽

Ibtissem Oueslati ◽

Meriem Yazidi ◽

Bassem Hammami ◽

Fatma Boukhayatia ◽

...

Keyword(s):

Insulin Resistance ◽

Visceral Adiposity ◽

Atherogenic Index ◽

Diabetic Patients ◽

Visceral Adiposity Index ◽

Type 2 Diabetic Patients ◽

Atherogenic Index Of Plasma ◽

Adiposity Index ◽

Type 2 Diabetic

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Proteasome inhibition in skeletal muscle cells unmasks metabolic derangements in type 2 diabetes

AJP Cell Physiology ◽

10.1152/ajpcell.00110.2014 ◽

2014 ◽

Vol 307 (9) ◽

pp. C774-C787 ◽

Cited By ~ 20

Author(s):

Lubna Al-Khalili ◽

Thais de Castro Barbosa ◽

Jörgen Östling ◽

Julie Massart ◽

Pablo Garrido Cuesta ◽

...

Keyword(s):

Metabolic Disease ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Skeletal Muscle ◽

Proteome Analysis ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Insulin Resistant ◽

Type 2 Diabetic

Two-dimensional difference gel electrophoresis (2-D DIGE)-based proteome analysis has revealed intrinsic insulin resistance in myotubes derived from type 2 diabetic patients. Using 2-D DIGE-based proteome analysis, we identified a subset of insulin-resistant proteins involved in protein turnover in skeletal muscle of type 2 diabetic patients, suggesting aberrant regulation of the protein homeostasis maintenance system underlying metabolic disease. We then validated the role of the ubiquitin-proteasome system (UPS) in myotubes to investigate whether impaired proteasome function may lead to metabolic arrest or insulin resistance. Myotubes derived from muscle biopsies obtained from people with normal glucose tolerance (NGT) or type 2 diabetes were exposed to the proteasome inhibitor bortezomib (BZ; Velcade) without or with insulin. BZ exposure increased protein carbonylation and lactate production yet impaired protein synthesis and UPS function in myotubes from type 2 diabetic patients, marking the existence of an insulin-resistant signature that was retained in cultured myotubes. In conclusion, BZ treatment further exacerbates insulin resistance and unmasks intrinsic features of metabolic disease in myotubes derived from type 2 diabetic patients. Our results highlight the existence of a confounding inherent abnormality in cellular protein dynamics in metabolic disease, which is uncovered through concurrent inhibition of the proteasome system.

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p38 MAPK activation upregulates proinflammatory pathways in skeletal muscle cells from insulin-resistant type 2 diabetic patients

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00115.2014 ◽

2015 ◽

Vol 308 (1) ◽

pp. E63-E70 ◽

Cited By ~ 29

Author(s):

Audrey E. Brown ◽

Jane Palsgaard ◽

Rehannah Borup ◽

Peter Avery ◽

David A. Gunn ◽

...

Keyword(s):

Skeletal Muscle ◽

P38 Mapk ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Mapk Activation ◽

Insulin Resistant ◽

History Of ◽

Cultured Myotubes ◽

Type 2 Diabetic

Skeletal muscle is the key site of peripheral insulin resistance in type 2 diabetes. Insulin-stimulated glucose uptake is decreased in differentiated diabetic cultured myotubes, which is in keeping with a retained genetic/epigenetic defect of insulin action. We investigated differences in gene expression during differentiation between diabetic and control muscle cell cultures. Microarray analysis was performed using skeletal muscle cell cultures established from type 2 diabetic patients with a family history of type 2 diabetes and clinical evidence of marked insulin resistance and nondiabetic control subjects with no family history of diabetes. Genes and pathways upregulated with differentiation in the diabetic cultures, compared with controls, were identified using Gene Spring and Gene Set Enrichment Analysis. Gene sets upregulated in diabetic myotubes were associated predominantly with inflammation. p38 MAPK was identified as a key regulator of the expression of these proinflammatory gene sets, and p38 MAPK activation was found to be increased in the diabetic vs. control myotubes. Although inhibition of p38 MAPK activity decreased cytokine gene expression from the cultured diabetic myotubes significantly, it did not improve insulin-stimulated glucose uptake. Increased cytokine expression driven by increased p38 MAPK activation is a key feature of cultured myotubes derived from insulin-resistant type 2 diabetic patients. p38 MAPK inhibition decreased cytokine expression but did not affect the retained defect of impaired insulin action in the diabetic muscle cells.

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Abstract #381 The Relation of Obesity, Insulin Resistance and Cardiovascular Risk in Type 2 Diabetic Patients in Sudan

Endocrine Practice ◽

10.1016/s1530-891x(20)46725-4 ◽

2019 ◽

Vol 25 ◽

pp. 174-175

Author(s):

Sulaf Abdelaziz ◽

Eltohami Dafalla

Keyword(s):

Insulin Resistance ◽

Cardiovascular Risk ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic

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Objectivization of vacuum-compression therapy effects on micro- and macrovascular perfusion in type 2 diabetic patients

Biomedical Engineering / Biomedizinische Technik ◽

10.1515/bmt-2019-0066 ◽

2020 ◽

Vol 65 (4) ◽

pp. 469-476

Author(s):

Jaroslav Prucha ◽

Vladimir Socha ◽

Lenka Hanakova ◽

Andrej Lalis ◽

Karel Hana

Keyword(s):

Lower Limb ◽

Compression Therapy ◽

Neurological Complications ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Therapeutic Procedures ◽

History Of ◽

Injury Recovery ◽

Type 2 Diabetic

AbstractThe present study aimed to evaluate the characteristic influence of physical therapeutic procedures of vacuum-compression therapy (VCT) on microvascular perfusion (MiP) and macrovascular perfusion (MaP) of the lower limb in diabetic patients. A sample of nine patients with a medical history of type 2 diabetes was used for the purpose of this study. Most of the subjects’ medical conditions included venous and neurological complications of the lower limb, whereas the rest of the subjects entered the treatment due to injury recovery or their phlebological disease. The PeriFlux System 5000 (Perimed, Sweden) diagnostic device was used to measure MiP. The MaP was evaluated based on the perfusion index (PI) using the Extremiter monitoring device (Embitron, Czech Republic) designed to perform VCT procedures. The study found that MiP and MaP increase as an effect of VCT procedures and at the same time PI clearly reflects the effect of the applied vacuum and compression phases, verifying the method’s vital influence on peripheral perfusion disorders.

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