scholarly journals The effect of obesity and Insulin Resistance on Liver Enzymes in Type2 Diabetes Mellitus

2015 ◽  
Vol 12 (3) ◽  
pp. 536-545
Author(s):  
Baghdad Science Journal

Diabetes mellitus (DM) has been defined as a clinical syndrome that is characterized by abnormal carbohydrate metabolism. The chronic hyperglycemia of diabetes is associated with long term damage, dysfunction, and failure of different organs, especially the liver .This study was conducted to assess the effect obesity and insulin resistance on liver enzymes in diabetic Iraqi patients.A comparative study of (90) Iraqi adults divided to three subgroup(30) obese ,(30) nonobese diabetic patients and(30)person had used as control. The analysis included Liver enzyme ALP,ALT,AST,GGT ,Fasting Plasma Glucose (FBG) , Lipid Profile , Hemoglobin A1C , insulin and homeostasis model assessment of insulin resistance (HOMA IR) were measured. Subjects were excluded from this study if they had liver disease, alcohol intake, medications for lowering lipid, insulin treatment, pregnant women and women taking contraceptive pills . The study shows significantly higher of liver enzymes level ( gamma glutamyl transpeptidase (GGT), alkaline phosphatase, Aspartate Amino Transferase , Alanine Transaminase) in obese diabetic patients compared with non-obese diabetic patients and control subject and HOMA IR showed significantly higher in obese diabetic patients compared with non-obese with diabetic patients and control (P < 0.05). The lipids level showed significantly higher in obese diabetic patients compared with non-obese diabetic patients and control.The HbA1c level showed higher significantly in obese diabetic patients compared with control and ther is a posative correlation between insulin and HOMA IR , ALP in obeses diabetic patients while there was negative correlation between ALT and cholesterol in obese group and with HbA1c in control group. The liver enzymes level of(alkaline phosphatase, alanine transaminase, aspartate transaminase gama glutaminase transferase ) is significantly higher in obese diabetic patients than non –obese diabetic patients and control group , also There was posative correlation between ALP and HOMA IR while there was negative correlation between ALT and cholesterol in obese group and with HbA1c in control group .

2017 ◽  
Vol 14 (2) ◽  
pp. 116-121 ◽  
Author(s):  
Wen-Jia Chen ◽  
Yue Liu ◽  
Yu-Bin Sui ◽  
Bo Zhang ◽  
Xiao-Hui Zhang ◽  
...  

Background: Musclin is a newly identified skeletal muscle–derived secretory factor, which has been recently characterized as a stimulator that induces insulin resistance in mice. However, the pathophysiological role of musclin in humans remains poorly understood. The aim of this study was to explore the potential correlations between musclin plasma levels and various metabolic parameters in patients with type 2 diabetes mellitus. Materials and methods: In this hospital-based study, plasma samples were collected from the enrolled individuals, including 38 newly diagnosed, treatment-naive type 2 diabetes mellitus patients and 41 age- and gender-matched control subjects. Plasma musclin levels were examined by radioimmunoassay. Results: Compared with the control group, musclin plasma levels were significantly higher in untreated type 2 diabetes mellitus patients. Musclin levels in the plasma of newly diagnosed type 2 diabetes mellitus patients were positively correlated with fasting plasma glucose, haemoglobin A1c, serum insulin, triglycerides and homeostasis model assessment of insulin resistance. Furthermore, multivariate logistic regression analysis showed that the level of musclin was associated with the presence of type 2 diabetes mellitus. Receiver operating characteristic curve analysis yielded an area under the curve for musclin of 0.718 in type 2 diabetes mellitus. Conclusion: The circulating concentration of musclin was significantly increased in type 2 diabetes mellitus patients. Our results suggest that musclin has a strong relationship with insulin resistance in type 2 diabetes mellitus.


Author(s):  
Aarti Sati ◽  
Amit Varma ◽  
Neeraj Kumar ◽  
Tariq Masood

Type II diabetes (T2DM) is caused by environmental, genetic, metabolic, and unknown variables. In diabetics, insulin resistance is the most of prolonged hyperglycemia. T2DM is induced by insulin resistance and cell dysfunction. The interaction of genetics and environment further complicates T2DM development. Insulin resistance and beta cell dysfunction are two of the most common Type 2 Diabetes Mellitus symptoms. A vicious triangle of cell failure (80% cell function) and insulin resistance in the muscles and liver causes major physiological issues. A group of diabetes patients (Group I), non-diabetic first-degree relatives of diabetic patients (Group II), and a non-diabetic healthy control group (Group III) were studied. The diabetes patients had the greatest systolic and diastolic blood pressures, followed by first degree relatives and healthy controls. We found that people with diabetes had higher fasting (FBS) and postprandial sugar, glycated haemoglobin (HbA1c) than diabetic offsprings and control group. Moreover, fasting insulin levels are higher in first degree relatives than in diabetes patients in the control group. The HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) levels of diabetics and their progeny do not differ much. The HOMA-IR measures insulin resistance severity. Common reference levels for HOMA-IR insulin resistance range from 0.7 - 2. Insulin resistance in diabetics and their first-degree relatives is evident from the results.


2004 ◽  
Vol 287 (3) ◽  
pp. H1225-H1231 ◽  
Author(s):  
Lucilla D. Monti ◽  
Claudio Landoni ◽  
Emanuela Setola ◽  
Elena Galluccio ◽  
Pietro Lucotti ◽  
...  

We evaluated the influence of chronic hypertriglyceridemia and endothelial dysfunction on myocardial glucose uptake (MGU) in Type 2 diabetic patients without coronary heart disease. Patients were divided into two groups according to fasting triglyceride (TG) levels: 5.4 ± 1.1 and 1.5 ± 0.3 mmol/l for high- and normal-TG groups, respectively. Five subjects were assigned to the high-TG group and 11 to the normal-TG group. Age, gender, body mass index, systolic and diastolic blood pressure, glucose, insulin, HbA1c, cholesterol, and HDL cholesterol were similar in the two groups, whereas free fatty acid (FFA) levels were higher in the high-TG group basally and at the end of the clamp. Furthermore, five healthy subjects were subjected to the same protocol and used as the control group. MGU was assessed by using 18F-labeled 2-fluoro-2-deoxy-d-glucose under hyperglycemic-hyperinsulinemic conditions. Basal endothelin-1 and nitric oxide levels were significantly higher in the high-TG group than in the normal-TG and control groups, and cGMP and maximal postischemic vasodilation were significantly decreased in the high-TG group compared with the normal-TG and control groups. However, significant alterations were found in the same parameters in the normal-TG group compared with the control group. By the end of the hyperglycemic clamp, in the high-TG group, MGU was ∼40 and 65% of that in the normal-TG and control groups. MGU negatively correlated with TG, FFA, and endothelin-1, whereas a positive correlation was found with cGMP and maximal postischemic vasodilation. In conclusion, increased TG and FFA levels are risks, in addition to Type 2 diabetes mellitus, for myocardial insulin resistance, endothelial dysfunction, and alteration of nitric oxide/cGMP levels.


2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Juan Pablo Aitken ◽  
Carolina Ortiz ◽  
Irene Morales-Bozo ◽  
Gonzalo Rojas-Alcayaga ◽  
Mauricio Baeza ◽  
...  

Background. Subjects with type 2 diabetes mellitus (DM2) require an adequate glycemic control to avoid diabetic complications. Currently, saliva biomarkers are used as a diagnostic tool and can be indicative of the degree of progression and control of various diseases. Several studies indicate thatα-2-macroglobulin levels are elevated in diabetic patients.Methods. 120 subjects with DM2 were enrolled and classified into two groups according to their glycemic control (percentage of glycated hemoglobin-A1c (HbA1c), <7% adequate glycemic control group; >7% inadequate glycemic control group). The relationship betweenα-2-macroglobulin levels from saliva samples and HbA1c was subsequently evaluated.Results. We found a positive correlation betweenα-2-macroglobulin and HbA1c (r=0.778andP<0.0001). Area under the receivers operating characteristic (ROC) curve ofα-2-macroglobulin indicated a positive discrimination threshold ofα-2-macroglobulin (AUC = 0.903, CI 95%: 0.847–0.959,P<0.0001) to diagnose glycemic control.Conclusions. Our data strongly suggest that the level of salivaα-2-macroglobulin is an indicator for the degree of glycemic control in diabetic patients and represents a promising alternative method to evaluate this parameter.


2020 ◽  
Vol 33 (6) ◽  
pp. 761-765
Author(s):  
Fariba Tarhani ◽  
Ghobad Heidari ◽  
Alireza Nezami

AbstractObjectivesReduced levels of α-Klotho is associated with the pathogenesis of various diseases including diabetes. In type I diabetes, decrease in Klotho leads to apoptosis of β-cells of pancreases. The aim of this study was to evaluate the levels of α-Klotho in type I diabetic pediatric patients.MethodsIn this cross-sectional single centered study, 46 patients presenting type I diabetes mellitus (case group) and 78 control group under the age of 12, referred to our clinic were included in our study. Serum levels of soluble Klotho were measured by sandwich ELISA in case and control groups. Statistical analysis was conducted for the data recorded via questionnaire.ResultsMean age of the patients in the case and control group was 7.65 ± 3.09 and 7 ± 2.37, respectively. Type I diabetes patients had a significant reduction in the levels of serum Klotho, as compared to controls (p<0.001). However, gender and age-based comparison between patient and control group was not significant.ConclusionsThis study reports a significant decrease in the serum levels of α-Klotho in type 1 diabetic patients. Low levels of Klotho can be associated with diabetic nephropathy and other comorbidities in these patients.


2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Hamid Ali-Bahar ◽  
Maysam Mard-Soltani ◽  
Yousef Paridar ◽  
Zahra Nasirbaghban ◽  
Zahra Sadat Hashemi ◽  
...  

Background: One of the major microvascular complications of diabetes mellitus (DM) is diabetic retinopathy (DR). Studies have shown that angiotensin-converting enzyme (ACE) gene polymorphisms are correlated with DR progression. Accordingly, the elucidation of the association between ACE gene polymorphism and the risk of DR development seems to be highly crucial. Methods: In this study, 195 individuals with type 2 diabetes mellitus (T2DM) were classified as the case group with retinopathy (99 people) and control group without retinopathy (96 people). Screening for DR was performed by ophthalmologists using clinical examination and fluorescein angiography. Different ACE genotypes (II, ID, and DD) were identified by the collection of blood samples, extraction of DNA, and PCR amplification using specific primers. Results: The frequency distribution of genotypes was significantly different between the case and control groups (P = 0.009). Interestingly, possessing a DD genotype made diabetic patients approximately 2.5 folds (95% CI = 1.271 - 4.840, P = 0.007) and 3.25 folds (95% CI = 1.312 - 8.051, P = 0.01) more susceptible to DR when compared to having DI and II genotypes, respectively. Moreover, having a D allele made diabetic individuals nearly 1.75 folds (95% CI = 1.167 - 2.623, P = 0.007) more susceptible to DR than possessing an I allele. Conclusions: Our results potentiate the hypothesis that the DD genotype and D allele of the ACE gene might play a role in the pathogenesis of DR.


2022 ◽  
Vol 28 (1) ◽  
pp. 59-61
Author(s):  
Bin Zhang

ABSTRACT Introduction: Type 2 diabetes mellitus (T2DM), also known as non-insulin-dependent diabetes mellitus (NIDDM), accounts for more than 90% of the total number of diabetes mellitus cases and often occurs in middle-aged and elderly people. Objective: To investigate the effect of exercise intervention on insulin resistance in obese type 2 diabetes patients. Methods: Eighty-six obese diabetic patients were screened as experimental subjects in physical examinations and randomly divided into observation and control groups. Visceral fat volume, fasting blood glucose, and fasting insulin of all subjects were measured before and after completion of the 6-month experimental implementation. The insulin resistance was calculated for both groups and the values for each indicator were compared statistically between groups. Results: Control of body weight, body mass index, blood glucose, blood lipids and insulin resistance index were better in the observation group than in the control group, and the difference was statistically significant (P < 0.05). Conclusions: Basal intervention with quantitative exercise can significantly improve insulin resistance in obese type 2 diabetes patients and the effect is better than treatment with diet and conventional exercise. Level of evidence II; Therapeutic studies - investigation of treatment results.


Webology ◽  
2021 ◽  
Vol 18 (1) ◽  
pp. 179-191
Author(s):  
Heru Supriyatno ◽  
Dwi Ari Murti Widigdo ◽  
Wiwin Renny Rahmawati

Android Based Diabetic Manager (ABDM) is an application used for diabetic patients to control their diet. This application is an easy way to remind them in consuming foods and giving them alert when its necessary calories have been achieved. This study was conducted in response to technological developments in the Era 4.0 to help people with Type 2 Diabetes Mellitus through diet control that can be done independently. This study was conducted in the city of Magelang aimed to evaluate whether using ABMD was effective to improve patients adherence in their diet and to control their blood glucose levels. This experimental study was using pre test and post test with control group design. By using simple random sampling, 52 people suffering from Type 2 Diabetes Mellitus recruited in this study devided into two groups, ABDM group and control group. The Pearson Chi-Square test result showed that there was significantly different between ABDM group and control group in the status of blood glucose control and patient adherence with p value was 0.048and 0.000 respectively (p value <0.05). This result indicated that H0 was rejected and H1 was accepted, which could be interpreted that Android based Diabetic Managerapplication influenced the status of blood sugar control and improved the patient adherence in managing their diet. Android based Diabetic Managerapplication influenced the status of blood sugar control and improved the patient adherence in managing their diet. Recomendation was made to conduct future study in the wider Diabetes community by adding more complete types of menu list and its variations in the Android based Diabetic Manager.


Author(s):  
Qingju WANG ◽  
Juan DU ◽  
Fenglian LIU

Background: We aimed to investigate the changes of serum adiponectin and glycated albumin (GA) levels in gestational diabetes mellitus patients and their relationship with insulin resistance. Methods: Overall, 137 pregnant women were enrolled from Jinan City People's Hospital, Laiwu District, China from Jan 2015 to Jun 2018. Among them, 71 pregnant women with gestational diabetes mellitus were examined as diabetes group, and 66 normal pregnant women as normal pregnant women group. In addition, 58 normal non-pregnant women of childbearing age who were examined in our hospital during the same period were selected as a control group. The serum adiponectin and GA levels of the three groups were compared, and the relationship between serum adiponectin, GA levels and insulin resistance was analyzed. Results: The serum adiponectin level of pregnant women in gestational diabetes mellitus (GDM) group was significantly lower than that of normal pregnant women and control group (P=0.031, P=0.027). The serum GA level of pregnant women in GDM group was significantly higher than that of normal pregnant women and control group (P<0.001). Pearson correlation analysis showed that GA was positively correlated with Fasting plasma glucose (FPG), Fasting insulin (FINS) and Insulin resistance index(HOMA-IR) levels (P<0.001), while adiponectin was negatively correlated with FPG FINS and HOMA-IR levels (P<0.001). Conclusion: Abnormal levels of serum GA and adiponectin are closely related to insulin resistance in patients with gestational diabetes mellitus. Detection of serum GA and adiponectin levels can diagnose gestational diabetes mellitus quickly and effectively.


2021 ◽  
Author(s):  
Effatul Afifah ◽  
Detty Siti Nurdiati ◽  
Hamam Hadi ◽  
Zainal Muttaqien Sofro ◽  
Ahmad Hamim Sadewa ◽  
...  

Abstract Background Gestational diabetes mellitus (GDM) is a carbohydrate intolerance condition that is diagnosed for the first-time during pregnancy and is associated with various adverse pregnancy outcomes for both mother and child, such as increased rates of perinatal complications and long-term morbidity. Exercise is a strategy to reduce hyperglycemia experienced during gestational diabetes mellitus. One type of exercise that can be done is a social nervous exercise (SaSo). SaSo can stimulate the parasympathetic or myelinated vagus nerves and control blood glucose by stimulating autonomic nerves system so that nerve homeostasis and glucose homeostasis occur. This study aimed to determine the impact of a SaSo program consisting of warm-up, core (prayer movements) and cool-down exercises on glucose homeostasis (HOMA-IR) parameters in women with GDM. Methods The study used a quasi-experimental design. Thirty-seven women with GDM at 24-28 weeks gestation were divided into an experimental group (n=19) with a regularly supervised SaSo program (n=18). The control group received only standard antenatal care for GDM. The exercise program started from the time of diagnosis of diabetes to six weeks of intervention conducted twice per week with sessions lasting 40-45 minutes. Bivariate analysis was used to test the difference in means with pretest and posttest results. Results Majority of pregnant women were in the not at-risk age category for control and intervention groups (79% and 83%, respectively). The baseline data results for the experimental and control groups were homogeneous, with no difference in baseline variables (P>0.05). The social nervous exercise experimental group had lower mean difference (MD±SD) levels of insulin resistence in late pregnancy compared to the control group (-9.15±10.06 vs 3.42 ±14.84) (P=0.004). Conclusions A social nervous exercise program has a beneficial effect on insulin resistance (HOMA-IR) levels in late pregnancy. Further research needs to be done with larger studies to confirm the findings of this study. Trial registration: Ethical approval was obtained from the Medical and Health Research Ethics Committee of the Faculty of Medicine, Universitas Gadjah Mada Yogyakarta (KE/0978/08/2019).


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