scholarly journals Can neck circumference predict insulin resistance in older people? A cross-sectional study at primary care in Brazil

2017 ◽  
Vol 33 (8) ◽  
Author(s):  
Maria Auxiliadora Nogueira Saad ◽  
Maria Luiza Garcia Rosa ◽  
Giovanna Balarini Lima ◽  
Rubens Antunes da Cruz Filho

Abstract: This study focused on the correlation between neck circumference and other anthropometric measurements and cardiovascular risk factors and insulin resistance in the elderly in Niterói, Rio de Janeiro State, Brazil. This was a cross-sectional study in 411 patients seen in primary care. Anthropometric measurements including neck circumference, body mass index (BMI), waist circumference (WC), and waist-hip ratio (WHR) were recorded. Bioelectrical impedance analysis (BIA) estimated the percentage of total body fat (%TBF). Insulin resistance was estimated by HOMA-IR (homeostasis model assessment IR index). The data were analyzed by the Mann-Whitney test and the correlation between numerical variables by Spearman’s test. Receiver operating characteristic (ROC) was used to assess the anthropometric measurements’ predictive capacity to diagnosis insulin resistance. Neck circumference was positively correlated with WC, BMI, WHR, %TBF, and HOMA-IR in both sexes. In women, neck circumference showed higher AUC (area under the curve) for insulin resistance. In men, WC showed higher AUC, followed by BMI and neck circumference. The current study in Southeast Brazil suggests that neck circumference can predict insulin resistance, an important marker of cardiovascular risk in the elderly population treated in primary care.

2020 ◽  
pp. 1-3
Author(s):  
Prabir Kumar Ganguly ◽  
Niladri Das

ABSTRACT HAART (Highly active antiretroviral therapy) has transformed a fatal disease to a chronic, manageable disease. But long term toxicities are emerging after prolonged exposure to antiretroviral therapy(ART). Adverse metabolic effects like dyslipidemia, increased blood pressure, and insulin resistance(IR) have been attributed to HAART. Therefore, the use of HAART raises concerns regarding metabolic disorders and cardiovascular risk in HIV(Human immunodeficiency virus) infected patients. Objective: To determine the prevalence of insulin resistance in a cohort of HIV infected patients on HAART as compared to HAART naïve PLHIV(People living with HIV) Methods: A cross sectional study includes 53 subjects, out of which 26 were PLHIV on ART –Group I, 27 were ART naïve PLHIV-Group II was conducted. Insulin resistance was determined by homeostasis model assessment (HOMA-IR) mathematical model. Statistical analysis was performed to assess the association between demographic, clinical characteristics, laboratory results and insulin resistance. Results: 69.5 % PLHIV on HAART showed IR, as compared to 37 % of ART naïve PLHIV (p= 0.01). MetS(Metabolic Syndrome) was found in 53.8% among PLHIV on ART , compared to 11.1% among ART naïve PLHIV(p= 0.001) .In the multivariate analysis, presence of metabolic syndrome was found to be directly associated with insulin resistance.


BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016835 ◽  
Author(s):  
Steve Raoul Noumegni ◽  
Jean Joel Bigna ◽  
Vicky Jocelyne Ama Moor epse Nkegoum ◽  
Jobert Richie Nansseu ◽  
Felix K Assah ◽  
...  

ObjectivesCardiovascular disease (CVD) and metabolic diseases are growing concerns among patients with HIV infection as a consequence of the improving survival of this population. We aimed to assess the relationship between CVD risk and insulin resistance in a group of black African individuals with HIV infection.MethodsThis cross-sectional study involved patients with HIV infection aged 30–74 years and followed up at the Yaoundé Central Hospital, Cameroon. Absolute CVD risk was calculated using the Framingham and the DAD CVD risk equations while the HOMA-IR index was used to assess insulin resistance (index ≥2.1).ResultsA total of 452 patients (361 women; 80%) were screened. The mean age was 44.4 years and most of the respondents were on antiretroviral therapy (88.5%). The median 5-year cardiovascular risk was 0.7% (25th−75th percentiles: 0.2–2.0) and 0.6% (0.3–1.3) according to the Framingham and DAD equations respectively. Of all participants, 47.3% were insulin resistant. The Framingham equation derived absolute CVD risk was significantly associated with insulin resistance; while no linear association was found using the DAD equation.ConclusionThe relationship between cardiovascular risk and insulin resistance in black African patients with HIV infection seems to depend on the cardiovascular risk equation used.


2015 ◽  
Vol 65 (636) ◽  
pp. e454-e459 ◽  
Author(s):  
Damian RJ Martínez-St John ◽  
Antonio Palazón-Bru ◽  
Vicente F Gil-Guillén ◽  
Armina Sepehri ◽  
Felipe Navarro-Cremades ◽  
...  

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044749
Author(s):  
Sara Manrique-Arija ◽  
Natalia Mena-Vazquez ◽  
Inmaculada Ureña ◽  
José Rioja ◽  
Pedro Valdivielso ◽  
...  

ObjectivesTo describe the prevalence of insulin resistance (IR) in patients with established rheumatoid arthritis (RA) and to analyse the contribution of cumulative inflammatory burden and other factors to its development.DesignObservational cross-sectional study.ParticipantsPatients with RA and controls matched for age, sex and Body Mass Index. We excluded patients with diabetes.SettingsPatients from an RA inception cohort at Hospital Regional Universitario de Málaga, Spain, were recruited between September 2016 and May 2018.Primary and secondary outcome measuresIR was evaluated using the homeostasis model assessment for IR and beta-cell function and the quantitative insulin sensitivity check index. Other variables included the cumulative 28-Joint Disease Activity Score (DAS28) with C reactive protein (CRP) body composition and cytokines. Two logistic regression models were constructed to identify factors associated with IR in patients with RA.ResultsEighty-nine patients with RA and 80 controls were included. The prevalence of IR was similar in both cases and controls. Inflammatory activity was controlled appropriately in patients during follow-up (mean DAS28 3.1 (0.8)). The presence of IR in patients with RA was associated with obesity (OR 6.01, 95% CI 1.9 to 8.7), higher cumulative DAS28-CRP values during follow-up (OR 2.8, 95% CI 1.3 to 6.0), and higher interleukin-1β levels (OR 1.6, 95% CI 1.1 to 2.4). The second model showed that the risk of IR increased by 10% for each kilogram of excess body fat.ConclusionIn patients with well-controlled, established RA, IR is associated mainly with poorer control of inflammation from diagnosis and with obesity, specifically total fat mass.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Kunrong Wu ◽  
Xiaoli Li ◽  
Yuedong Xu ◽  
Xiaoqian Zhang ◽  
Ziwan Guan ◽  
...  

Background. Metformin is the most widely used oral antidiabetic agent and can reduce insulin resistance (IR) effectively. Organic cation transporter 1 (encoded by SLC22A1) is responsible for the transport of metformin, and ataxia-telangiectasia-mutated (ATM) is a gene relating to the DNA repair and cell cycle control. The aim of this study was to evaluate if the genetic variants in SLC22A1 rs622342 and ATM rs11212617 could be effective predictors of islet function improvement in patients with type 2 diabetes mellitus (T2DM) on metformin treatment. Methods. This cross-sectional study included 111 patients with T2DM treated with metformin. Genotyping was performed by the dideoxy chain-termination method. The homeostatic indexes of IR (HOMA-IR) and beta-cell function (HOMA-BCF) were determined according to the homeostasis model assessment. Results. Fasting plasma glucose (FPG) levels, HbA1c levels, and HOMA-IR were significantly higher in patients with the rs622342 AA genotype than in those with C allele (P<0.05). However, these significant differences were not observed between rs11212617 genotype groups. Further data analysis revealed that the association between the rs622342 polymorphism and HOMA-IR was gender related, and so was rs11212617 polymorphism and HOMA-BCF. HOMA-IR was significantly higher in males with rs622342 AA genotype than in those with C allele (P=0.021), and HOMA-BCF value was significantly higher in females carrying rs11212617 CC genotype than in those with A allele (P=0.038). The common logarithm (Lg10) of HOMA-BCF was positively correlated with the reciprocal of HbA1c (r = 0.629, P<0.001) and negatively associated with Lg10 FPG (r = −0.708, P<0.001). Conclusions. The variant of rs622342 could be a predictor of insulin sensitivity in patients with T2DM treated with metformin. The association between the rs622342 polymorphism and HOMA-IR and the association between the rs11212617 polymorphism and HOMA-BCF were both gender related.


2021 ◽  
pp. 175-184

BACKGROUND: Insulin resistance (IR) is a pathological condition in which cells fail to respond normally to insulin. IR has been associated with multiple conditions, including chronic pain. Fibromyalgia (FM) is one of the common generalized chronic painful conditions with an incidence rate affecting 3% to 6% of the population. Substantial interest and investigation into FM continue to generate many hypotheses. The relationship between IR and FM has not been explored. IR is known to cause abnormalities in the cerebral microvasculature, leading to focal hypoperfusion. IR also has been shown to cause cognitive impairment in FM patients, as in parkinsonism. As demonstrated by advanced imaging methods, similar brain perfusion abnormalities occur in the brain of patients with FM as with IR. OBJECTIVES: To determine the potential association between FM and IR. SETTING: Subspecialty pain medicine clinics. STUDY DESIGN: Observational cross-sectional study. METHODS: Laboratory data was extracted through a retrospective review of medical records from patients who had met the American College of Rheumatology (ACR) criteria for FM. The Hemoglobin A1c (HbA1c) values from 33 patients with FM were compared with the means of the glycated HbA1c levels of 2 control populations. In addition, established indices of IR [Quantitative Insulin Sensitivity Check Index (QUICKI) and the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)] were calculated in a subgroup of patients in whom the analytes necessary for these calculations were available. To assess for confounding factors, the associations between HbA1c, QUICKI, HOMA-IR, fasting insulin levels, and glucose, after controlling for age, were explored by multiple analyses of variance with relation to gender and ethnicity. RESULTS: We found an association between IR and FM that was independent of age, gender, and ethnicity. We found that patients with FM belong to a distinct population that can be segregated from the control groups by their HbA1c levels, a surrogate marker of IR. This was demonstrated by analyzing the data after introducing an age correction into a linear regression model. This strategy showed significant differences between patients with FM and control subjects (P < 0.0001 and P = 0.0002, for 2 separate control populations, respectively). A subgroup analysis using the QUICKI and HOMA-IR showed that all patients with FM in this subgroup (100%) exhibited laboratory abnormalities pointing to IR. LIMITATIONS: Small observational cross-sectional study. There are also intrinsic limitations that are attributed to cross-sectional studies. CONCLUSION: The association demonstrated in this study warrant further investigation, including the pursuit of randomized, double-blind clinical trials to determine the effect of improving insulin sensitivity in FM related pain scores. Such studies could unveil a potential pathogenetic relationship between FM, central pain, and IR. Based on these initial findings, we present the hypothesis that IR may underlie pathological mechanisms leading to central pain. If confirmed, this may lead to a paradigm shift in the management of central pain. KEY WORDS: Fibromyalgia, insulin resistance, chronic widespread pain, hemoglobin A1c


2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Qing Gu ◽  
Jian Meng ◽  
Xue Hu ◽  
Jun Ge ◽  
Sui Jun Wang ◽  
...  

AbstractThe vital role of insulin resistance (IR) in the pathogenesis of isolated systolic hypertension (ISH) has been expounded at the theoretical level. However, research on the correlation between some specific IR indicators and ISH is still rare, especially at different glycemic statuses. We conducted this study to explore the association between three IR indicators and ISH among young and middle-aged adults with normal fasting plasma glucose (NFG). This large cross-sectional study included 8246 young and middle-aged men with NFG and diastolic blood pressure < 90 mmHg. The homeostasis model assessment for IR (HOMA-IR) index, triglyceride glucose (TyG) index, and the metabolic score for IR (METS-IR) were calculated with the corresponding formula. The proportions of ISH among young and middle-aged men were 6.7% and 4.4%, respectively. After fully adjusting, only HOMA-IR rather than TyG and METS-IR was significantly associated with ISH. Moreover, fully adjusted smooth curve fitting showed that the association between HOMA-IR and ISH were approximately linear in both two age groups (P for non-linearity were 0.047 and 0.430 in young and middle-aged men, respectively). Among young and middle-aged men with NFG, using HOMA-IR instead of noninsulin-dependent IR indicators may have advantages in the hierarchical management of ISH. Further longitudinal research may be needed to determine their potential causal relationship.


2022 ◽  
Vol 12 ◽  
Author(s):  
Jun Muratsu ◽  
Kei Kamide ◽  
Takashi Fujimoto ◽  
Yasushi Takeya ◽  
Ken Sugimoto ◽  
...  

BackgroundAdipokine dysregulation is a key feature of insulin resistance and a metabolic syndrome associated with obesity. Low adiponectin levels are associated with higher risks of cardiovascular diseases (CVD). However, high adiponectin levels have also been associated with increased all-cause and cardiovascular mortality in the elderly. This adiponectin paradox has yet to be clarified, which has hindered our understanding of the biological role of adiponectin. Adipokine dysregulation and insulin resistance are also associated with energy-deprivation conditions, such as frailty in old age. The objective of this study was to investigate the association between plasma adiponectin and insulin resistance using the homeostasis model assessment for insulin resistance (HOMA-IR) classified by age. In particular, we sought to determine the factors of the subjects associated with both high adiponectin levels and HOMA-IR (H-adiponectin/H-HOMA) and high adiponectin levels and low HOMA-IR (H-adiponectin/L-HOMA).MethodsThe eligible subjects in this cross-sectional study were 33,216 individuals who had undergone health checkups at the Physical Checkup Center of Sumitomo Hospital between April 2008 and December 2018. After excluding 26,371 individuals who were under 60 years old, 529 who had been taking medications for diabetes mellitus, and 690 with missing data, the present study included 5,673 (3,467 males, 2,206 females) subjects with no missing data. The relationship between serum adiponectin levels and HOMA-IR was assessed using logistic regression models adjusted by clinically relevant factors.ResultsIn the multivariable logistic regression analysis, age and low BMI were shown to positively correlate with the characteristics of H-adiponectin/H-HOMA. In females, systolic blood pressure was also shown to be an associated factor.ConclusionIn conclusion, this study showed that aging or a low BMI may contribute to high adiponectin levels and insulin resistance.


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