scholarly journals O Papel da Hemoglobina A1c no Rastreio de Intolerância à Glicose e da Diabetes Tipo 2 em Crianças e Adolescentes Obesos

2015 ◽  
Vol 28 (3) ◽  
pp. 307 ◽  
Author(s):  
Júlia Galhardo ◽  
Julian Shield
Keyword(s):  
Insulin Resistance ◽  
Screening Tool ◽  
Area Under The Curve ◽  
Glycated Haemoglobin ◽  
Tolerance Test ◽  
Receiver Operator Characteristic ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Characteristic Analysis ◽  
Receiver Operator Characteristic Analysis

<strong>Introduction:</strong> In 2012, an international expert committee in diabetes wrote in favor of screening adult and paediatric patients for glucose intolerance and type 2 diabetes using glycated haemoglobin. The aim of this study was to evaluate glycated haemoglobin utility as a screening tool in a young obese mainly Caucasian population.<br /><strong>Material and Methods:</strong> Children [(n = 266), body mass index z-score 3.35 ± 0.59, 90% Caucasian 90%, 55% female, median age 12.3 (range: 8.9 - 17.6) years old] recently referred to a tertiary hospital-based obesity clinic underwent a routine oral glicose tolerance test and glycated haemoglobin measurement. Exclusion criteria: abnormal forms of haemoglobin and conditions linked to increased erythrocyte turnover.<br /><strong>Results:</strong> The oral glicose tolerance test diagnosed 13 (4.9%) subjects as prediabetic but none as diabetic. According to glycated haemoglobin, 32 would be prediabetic (29 false positives) and one would be diabetic (when he was only glucose intolerant). On the other hand, 10 prediabetic patients would not have been identified (false negatives). Glycated haemoglobin receiver operator characteristic analysis area under the curve was 0.59 (CI 95% 0.40 - 0.78), confirming its reduced capacity to identify prediabetes. Better results were achieved when calculating receiver operator characteristic analysis area under the curve for fasting glucose (0.76;<br />CI 95% 0.66 - 0.87), homeostasis model assessment for insulin resistance (0.77; CI 95% 0.64 - 0.90) and triglycerides:HDL cholesterol ratio (0.81; CI 95% 0.66 - 0.96).<br /><strong>Discussion:</strong> In Paediatric populations, especially when mainly Caucasian, glycated haemoglobin does not seem to be a useful<br />screening tool for prediabetes.<br /><strong>Conclusion:</strong> For this reason, it would appear premature to advise it as a diagnostic tool until significantly more data is available. Homeostasis model assessment for insulin resistance and triglycerides: HDL cholesterol have higher precision and can be calculated using a fasting blood sample.

scholarly journals Use of Blood Lipid Indicators as a Screening Tool of Insulin Resistance among Individuals in Low-Income Country Sides of China: A Multiethnic Region Study

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Yi-Zhong Yan ◽  
Jia-Ning Fan ◽  
Jia-Ming Liu ◽  
Yun-hua Hu ◽  
Jiao-Long Ma ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Low Income ◽  
Rural Areas ◽  
Screening Tool ◽  
Metabolic Diseases ◽  
Area Under The Curve ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Diagnostic Value ◽  
Model Assessment

Objective. This study is aimed at evaluating the diagnostic value of blood lipid indicators (BLIs) for insulin resistance (IR) among major ethnic groups in Xinjiang, China, to identify the most valuable indicators and appropriate cut-off points for each ethnic group and to lay the foundation for the early detection, diagnosis, and treatment of metabolic diseases in remote rural areas. Methods. Overall, 418 Uygurs, 331 Kazakhs, and 220 Hans were randomly included in our study. The homeostasis model assessment was the gold standard for identifying IR. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value, and the nomogram was utilized to analyze the predictive value. The size of the area under the curve (AUC) reflected the accuracy of screening and prediction. Results. Differences in races were observed in terms of IR and BLIs, and the Kazakhs had the highest IR level at 5.27 mmol/L. The correlation between IR and BLIs differed among the three races. For the Kazakhs and Hans, all BLIs, except total cholesterol (TC), were correlated to IR. However, for the Uygurs, only the triglyceride (TG) level, TG/high-density lipoprotein cholesterol (HDL-C) ratio, and TC/HDL-C ratio were associated with IR. After further adjustment of confounding factors, these indicators were still correlated to IR. BLIs that independently correlated to IR in the three nationalities had a certain diagnostic value for IR. In terms of the AUC size, the TG level was the highest in Uygurs, the TG/HDL-C ratio was the highest for Kazakhs and Hans, and the corresponding best cut-off points for IR were 1.515, 1.230, and 1.495 mmol/L, respectively. In addition, for each race, when the indicators with a certain diagnostic value were combined, the diagnostic value for IR was higher. Conclusion. BLIs had a certain diagnostic value for IR and could be used as a screening tool for IR among Uygurs, Kazakhs, and Hans in Xinjiang. These findings are extremely important for the prevention and treatment of IR and metabolic diseases in remote rural areas.

scholarly journals Rumex japonicus Houtt. Ethanol Extract and Its Active Component on Prevention of Dyslipidemia and Hyperglycemia in Diet-Induced C57BL/6J Obese Mice

2018 ◽  
Vol 8 (11) ◽  
pp. 2247
Author(s):  
Eun-Young Kwon ◽  
Mi Yu ◽  
Je Woo ◽  
Su-Jung Cho ◽  
Aki Yamano ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Active Component ◽  
Plasma Lipid ◽  
Area Under The Curve ◽  
Ethanol Extract ◽  
Plasma Free Fatty Acid ◽  
Tolerance Test ◽  
Model Assessment ◽  
Obese Mice ◽  
Rumex Japonicus

Obesity is a continuous chronic metabolic disorder and has adverse effects on health, such as dyslipidemia, hyperglycemia, and insulin resistance. This study evaluated whether Rumex japonicus Houtt. ethanol extract (RU) and its active component nepodin (NE) affect obesity and its related complications, such as dyslipidemia and hyperglycemia in high-fat diet (HFD)-fed obese mice. The NE and RU supplements did not produce significant differences in body weight and adipose tissue weight compared to HFD group, while plasma lipid profiles were only improved by the RU supplement. However, both the NE and RU supplement had beneficial effects on glucose homeostasis and insulin resistance through reduction of plasma free fatty acid (FFA) (p < 0.05), insulin (p < 0.05), homeostatic model assessment for insulin resistance (p < 0.05), and C-peptide (p < 0.05) levels. In particular, the RU supplement decreased the area under the curve (AUC) of intraperitoneal glucose tolerance test (IPGTT) (p < 0.05), and improved glucose intolerance. Taken together, NE and RU supplements can contribute to improvements in HFD-induced hyperglycemia, while dyslipidemia was only improved by the RU supplement.

scholarly journals Triglyceride Glucose-Waist Circumference Better Predicts Coronary Calcium Progression Compared with Other Indices of Insulin Resistance: A Longitudinal Observational Study

2020 ◽  
Vol 10 (1) ◽  
pp. 92
Author(s):  
Yun Kyung Cho ◽  
Jiwoo Lee ◽  
Hwi Seung Kim ◽  
Eun Hee Kim ◽  
Min Jung Lee ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Waist Circumference ◽  
Area Under The Curve ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Tyg Index ◽  
Longitudinal Observational Study ◽  
Potential Marker ◽  
Reliable Marker ◽  
Better Than

The triglyceride glucose (TyG) index, a product of triglyceride and fasting glucose, is a reliable marker for insulin resistance. We aimed to investigate the association between the TyG-related markers and coronary artery calcification (CAC) progression. We enrolled 1145 asymptomatic participants who underwent repeated CAC score measurements during routine health examinations. Homeostasis model assessment of insulin resistance (HOMA-IR), TyG index, TyG-BMI (body mass index), and TyG-WC (waist circumference) were calculated. Progression of CAC was defined as (1) incident CAC in a CAC-free population, or an (2) increase of ≥2.5 units between the baseline and final square root of the CAC scores in participants with detectable CAC. According to the quartiles of parameters, we stratified the subjects into four groups. The prevalence of progression increased with the TyG-WC quartile (15.0%, 24.1%, 31.0%, and 32.2% for each of the groups; p < 0.001). The multivariate-adjusted odds ratio (95% confidence interval) for CAC score progression was 1.66 (1.01–2.77) when the highest and lowest TyG-WC index quartiles were compared. Furthermore, the predictability of TyG-WC for CAC progression was better than the other indices in terms of the area under the curve. The TyG-WC index predicted CAC progression better than other indices and could be a potential marker of future coronary atherosclerosis.

scholarly journals Studies of insulin resistance in patients with clinical and subclinical hyperthyroidism

2010 ◽  
Vol 163 (4) ◽  
pp. 625-630 ◽  
Author(s):  
Eirini Maratou ◽  
Dimitrios J Hadjidakis ◽  
Melpomeni Peppa ◽  
Maria Alevizaki ◽  
Katerina Tsegka ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Glucose Transport ◽  
Area Under The Curve ◽  
Postprandial Glucose ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Model Assessment ◽  
Subclinical Hyperthyroidism

ObjectiveAlthough clinical hyperthyroidism (HR) is associated with insulin resistance, the information on insulin action in subclinical hyperthyroidism (SHR) is limited.Design and methodsTo investigate this, we assessed the sensitivity of glucose metabolism to insulinin vivo(by an oral glucose tolerance test) andin vitro(by measuring insulin-stimulated rates of glucose transport in isolated monocytes) in 12 euthyroid subjects (EU), 16 patients with HR, and 10 patients with SHR.ResultsHR and SHR patients displayed higher postprandial glucose levels (area under the curve, AUC0–30032 190±1067 and 31 497±716 mg/dl min respectively) versus EU (27 119±1156 mg/dl min,P<0.05). HR but not SHR patients displayed higher postprandial insulin levels (AUC0–30011 020±985 and 9565±904 mU/l min respectively) compared with EU subjects (AUC0–3007588±743 mU/l min,P<0.05). Homeostasis model assessment index was increased in HR and SHR patients (2.81±0.3 and 2.43±0.38 respectively) compared with EU subjects (1.27±0.16,P<0.05), while Matsuda and Belfiore indices were decreased in HR (4.21±0.41 and 0.77±0.05 respectively,P<0.001) and SHR patients (4.47±0.33 and 0.85±0.05 respectively,P<0.05 versus EU (7.76±0.87 and 1 respectively). At 100 μU/ml insulin, i) GLUT3 levels on the monocyte plasma membrane were increased in HR (468.8±7 mean fluorescence intensity (MFI)) and SHR patients (522.2±25 MFI) compared with EU subjects (407±18 MFI,P<0.01 andP<0.05 respectively), ii) glucose transport rates in monocytes (increases from baseline) were decreased in HR patients (37.8±5%) versus EU subjects (61.26±10%,P<0.05).ConclusionsInsulin-stimulated glucose transport in isolated monocytes of patients with HR was decreased compared with EU subjects. Insulin resistance was comparable in patients with both HR and SHR.

scholarly journals Hepatic insulin clearance is increased in patients with high HbA1c type 2 diabetes: a preliminary report

2020 ◽  
Vol 8 (1) ◽  
pp. e001149 ◽  
Author(s):  
Tsuyoshi Okura ◽  
Yohei Fujioka ◽  
Risa Nakamura ◽  
Mari Anno ◽  
Yuichi Ito ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Gene Polymorphism ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Insulin Clearance ◽  
Model Assessment ◽  
High Hba1c ◽  
Hepatic Insulin Clearance

IntroductionHepatic insulin clearance (HIC) is an important pathophysiology of type 2 diabetes. HIC was reported to decrease in patients with type 2 diabetes and metabolic syndrome. However, hyperglycemia was suggested to enhance HIC, and it is not known whether poorly controlled diabetes increases HIC in patients with type 2 diabetes. We investigated whether HIC was increased in patients with poorly controlled diabetes, and whether HIC was associated with insulin resistance and incretins.Research design and methodsWe performed a meal tolerance test and the hyperinsulinemic–euglycemic clamp in 21 patients with type 2 diabetes. We calculated the postprandial C-peptide area under the curve (AUC)-to-insulin AUC ratio as the HIC; measured fasting and postprandial glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and glucagon levels and analyzed serum adiponectin and zinc transporter-8 (ZnT8) gene polymorphism.ResultsThe HIC significantly correlated with glycated hemoglobin (HbA1c) (r_S=0.58, p<0.01). In patients with high HIC above the median of 6.5, the mean HbA1c was significantly higher compared with low HIC below the median. Homeostatic model assessment (HOMA)-beta (r_S=−0.77, p<0.01) and HOMA-IR (r_S=−0.66, p<0.005) were correlated with HIC. The M/I value in the clamp study was correlated with HIC. GLP-1-AUC and GIP-AUC were not correlated with HIC. Glucagon-AUC was negatively correlated with HIC, but there were no significant differences between the high and low HIC groups. Adiponectin was positively correlated with HIC. The ZnT8 gene polymorphism did not affect HIC.ConclusionsThese results suggest that HIC was increased in patients with high HbA1c type 2 diabetes, low insulin secretion, low insulin resistance and high adiponectin conditions.

scholarly journals Epidemiologic Behavior and Estimation of an Optimal Cut-Off Point for Homeostasis Model Assessment-2 Insulin Resistance: A Report from a Venezuelan Population

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Valmore Bermúdez ◽  
Joselyn Rojas ◽  
María Sofía Martínez ◽  
Vanessa Apruzzese ◽  
Mervin Chávez-Castillo ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Sensitivity And Specificity ◽  
Adult Population ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Reference Population ◽  
Point Estimation ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Cross Sectional

Background. Mathematical models such as Homeostasis Model Assessment have gained popularity in the evaluation of insulin resistance (IR). The purpose of this study was to estimate the optimal cut-off point for Homeostasis Model Assessment-2 Insulin Resistance (HOMA2-IR) in an adult population of Maracaibo, Venezuela. Methods. Descriptive, cross-sectional study with randomized, multistaged sampling included 2,026 adult individuals. IR was evaluated through HOMA2-IR calculation in 602 metabolically healthy individuals. For cut-off point estimation, two approaches were applied: HOMA2-IR percentile distribution and construction of ROC curves using sensitivity and specificity for selection. Results. HOMA2-IR arithmetic mean for the general population was 2.21±1.42, with 2.18±1.37 for women and 2.23±1.47 for men (P=0.466). When calculating HOMA2-IR for the healthy reference population, the resulting p75 was 2.00. Using ROC curves, the selected cut-off point was 1.95, with an area under the curve of 0.801, sensibility of 75.3%, and specificity of 72.8%. Conclusions. We propose an optimal cut-off point of 2.00 for HOMA2-IR, offering high sensitivity and specificity, sufficient for proper assessment of IR in the adult population of our city, Maracaibo. The determination of population-specific cut-off points is needed to evaluate risk for public health problems, such as obesity and metabolic syndrome.

Early Renal Dysfunction in Obese Patients with Insulin Resistance

2019 ◽  
Vol 26 (3) ◽  
pp. 261-265
Author(s):  
Natalia Pertseva ◽  
Mariia Rokutova
Keyword(s):  
Insulin Resistance ◽  
Renal Function ◽  
Renal Dysfunction ◽  
Filtration Rate ◽  
Diagnostic Value ◽  
Glomerular Hyperfiltration ◽  
Model Assessment ◽  
Homa Index ◽  
Obese Patients ◽  
Homeostasis Model Assessment

Abstract Background and aims. Obese individuals have insulin resistance status assessed in the present study by the HOMA index (“Homeostasis model assessment”). This prospective study assessed renal disorders in the insulin resistance in obese patients. Material and Methods. The study included 73 young obese patients. The assessment included the HOMA index before meal and parameters of renal function (glomerular filtration rate, albuminuria, β2-microglobulinuria). Results. In young obese, insulin-resistance patients, glomerular hyperfiltration and β2-microglobulinuria are found in 77.0 and 93.4% of cases respectively. The albuminuria is noted in some cases, which reduces diagnostic value. Conclusions. In young obese patients with insulin resistance, glomerular hyperfiltration and β2-microglobulinuria are main diagnostic markers of renal dysfunction.

Magnesium intake, insulin resistance and markers of endothelial function among women

2021 ◽  
pp. 1-9
Author(s):  
Narges Ghorbani Bavani ◽  
Parvane Saneei ◽  
Ammar Hassanzadeh Keshteli ◽  
Ahmadreza Yazdannik ◽  
Ebrahim Falahi ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Insulin Sensitivity ◽  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Adhesion Molecule ◽  
Cell Function ◽  
Intercellular Adhesion Molecule ◽  
Model Assessment ◽  
Serum Concentrations ◽  
Homeostasis Model Assessment

Abstract Objective: We investigated the association of dietary Mg intake with insulin resistance and markers of endothelial function among Iranian women. Design: A cross-sectional study. Setting: Usual dietary intakes were assessed using a validated FFQ. Dietary Mg intake was calculated by summing up the amount of Mg in all foods. A fasting blood sample was taken to measure serum concentrations of glycemic indices (fasting plasma glucose and insulin) and endothelial function markers (E-selectin, soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1). Insulin resistance and sensitivity were estimated using the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR), Homeostasis Model Assessment β-cell function (HOMA-β) and quantitative insulin sensitivity check index (QUICKI). Participants: Iranian female nurses (n 345) selected by a multistage cluster random sampling method. Results: The Mg intake across energy-adjusted quartiles was 205 (se 7), 221·4 (se 8), 254·3 (se 7) and 355·2 (se 9) mg/d, respectively. After adjustments for potential confounders, QUICKI level was significantly different across quartiles of Mg intake (Q1: 0·34 (se 0·02), Q2: 0·36 (se 0·01), Q3: 0·40 (se 0·01), and Q4: 0·39 (se 0·02), P = 0·02); however, this association disappeared after considering markers of endothelial function, indicating that this relation might be mediated through endothelial dysfunction. After controlling for all potential confounders, Mg intake was inversely, but not significantly, associated with serum concentrations of sICAM (Q1: 239 (se 17), Q2: 214 (se 12), Q3: 196 (se 12), and Q4: 195 (se 17), P = 0·29). There was no other significant association between dietary Mg intake and other indicators of glucose homoeostasis or endothelial markers. Conclusions: Higher dietary Mg intake was associated with better insulin sensitivity in Iranian females. This linkage was mediated through reduced endothelial dysfunction.

scholarly journals Surrogate Indexes of Insulin Resistance in Dairy Goats: Transitional Variation in Subclinical Hyperketonemia

2021 ◽  
Vol 8 (6) ◽  
pp. 102
Author(s):  
Siqi Liu ◽  
Yezi Kong ◽  
Jing Wen ◽  
Yan Huang ◽  
Yaoquan Liu ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Transition Period ◽  
Jugular Vein ◽  
Metabolic Parameters ◽  
Model Assessment ◽  
Early Lactation ◽  
Homeostasis Model Assessment ◽  
Dairy Goats ◽  
Blood Samples ◽  
Normal Glucose

Background: Dairy goats are highly susceptible to subclinical hyperketonemia (SCHK) during the transition period. This study aimed to compare the variation in metabolic parameters and surrogate indexes of insulin resistance (sIR) between goats with SCHK and clinically healthy (HEAL) goats during the transition period. Methods: Twenty Guanzhong dairy goats were assorted to HEAL (n = 10) and SCHK (n = 10) groups according to the blood β-hydroxybutyrate (BHBA) concentrations. The blood samples were taken from the jugular vein of each goat at −3, −2, −1, 0 (partum), +1, +2, and +3 weeks relative to kidding to analyses GLU and INS. The sIR was calculated from blood metabolic parameters. Results: Compared with the HEAL goats, the insulin concentrations were significantly higher in SCHK goats during the first three weeks postpartum. The QUICKI, revised QUICKI (RQUICKI), and RQUICKIBHBA were significantly lower in goats with SCHK at 1 week postpartum, while the homeostasis model assessment-IR (HOMA-IR) was significantly higher. Conclusion: Goats with SCHK made more efforts through elevated insulin levels at early lactation than HEAL goats, thereby maintaining the normal glucose concentrations.

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