scholarly journals Association of uric acid and glucose disposal rate value in euglycemic Chinese subjects

2020 ◽  
Author(s):  
Tao Yuan ◽  
Shixuan Liu ◽  
Yingyue Dong ◽  
Yong Fu ◽  
Yan Tang ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Uric Acid ◽  
Waist Circumference ◽  
Density Lipoprotein ◽  
Stepwise Multiple Regression ◽  
Glucose Disposal ◽  
Oral Glucose ◽  
Visceral Adiposity Index ◽  
Glucose Disposal Rate ◽  
Chinese Subjects

Abstract Background: We aimed to examine the relationship between serum uric acid (SUA) levels and glucose disposal rate value (M value) evaluated by hyperinsulinemic euglycemic clamp technique in euglycemic Chinese subjects.Methods: There were 19 non-diabetic Chinese subjects included in this study. The participants accepted physical examination, laboratory examination and standardized questionnaire. Insulin resistance was evaluated by M value. Some other indices were also calculated by data obtained from 3-hour oral glucose tolerance test (OGTT).
Subjects were divided into two groups based on the median of SUA levels.Results: The level of systolic blood pressure (SBP) (P=0.035), waist circumference (P=0.009), waist-to-hip ratio (P=0.004), Chinese visceral adiposity index (CAVI) (P=0.028), weight (P=0.01), serum creatinine (Cr) (P=0.05) and the percentage of drinking habits (P=0.03) were all significantly increased in high SUA group. The level of M value and high-density lipoprotein cholesterol (HDL-c) were significantly decreased in high SUA group (P=0.041 for M value and P=0.09 for HDL-c). There were no significant differences between those indirect insulin resistance indices and SUA. In addition, the SUA levels were inversely correlated with M value (r=-0.666, P=0.002) and HDL-c (r=-0.619, P=0.005), positively correlated with waist circumference (r=0.615, P=0.005), CVAI (r=0.630, P=0.004), SBP (r=0.521, P=0.022) and Cr (r-0.550, P=0.015) levels. Analysis of stepwise multiple regression showed the independent association between SUA and M value in both male and female euglycemic subjects.Conclusions: There is a significant correlation between SUA levels and glucose disposal rate value in euglycemic Chinese subjects, which suggested that UA played an important role on insulin resistance even in those non-diabetic subjects

scholarly journals Metabolically healthy obesity: predictors of transformation to unhealthy phenotype in St Petersburg population (according to the ESSE-RF study)

2021 ◽  
Vol 27 (3) ◽  
pp. 279-290
Author(s):  
M. A. Boyarinova ◽  
O. P. Rotar ◽  
A. M. Erina ◽  
N. A. Paskar ◽  
A. S. Alieva ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Uric Acid ◽  
Waist Circumference ◽  
Low Density Lipoprotein ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Metabolically Healthy Obesity ◽  
Metabolically Healthy ◽  
Over Time

Objective. The purpose of the study was to determine the dynamics of the metabolically healthy obesity (MHO) status according to the Meigs criteria, and to establish the predictors of the transformation of healthy obesity phenotype into an unhealthy (MUHO) one in the population of residents of St Petersburg (Russia) at 6,5-year follow-up. Design and methods. Within the epidemiology study ESSE-RF a random sample of 1600 St Petersburg inhabitants stratified according to gender and age was formed. Examination of participants included anthropometry with measurement of waist circumference and calculation of body mass index (BMI), measurement of blood pressure (BP), fasting blood glucose, insulin (index of insulin resistance was calculated), creatinine, cortisol, lipid spectrum, C-reactive protein, adiponectin, leptin, and uric acid. Meigs MHO criteria (2006) were used in obese subjects (BMI > 30 kg/m²). Obese patients, who were identified as metabolically healthy in 2012–2013, were invited for follow-up in 2018–2019. Results. At the first stage obesity was diagnosed in 430 (26,9 %) participants, according to the BMI, 116 (27,0 %) of them were metabolically healthy according to the Meigs criteria. At follow-up, 44,4% individuals with the MHO phenotype transformed to the MUHO category on average after 6,5 years. Individuals who retained the MHO phenotype over time had significantly lower baseline systolic BP and diastolic BP levels, more favorable lipid levels and lower levels of uric acid, insulin, and index of insulin resistance. Glucose increase by every 0,5 mmol/l and higher was associated with elevated probability of transformation MHO to MUHO phenotype by 10,9 times (adjusted for sex and age). Conclusions. Significantly higher levels of BP, insulin resistance, low density lipoprotein and uric acid at baseline, as well as an increase in glucose levels over time, were associated with the transformation of the metabolically healthy to the unhealthy phenotype in obese individuals at 6,5-year follow-up. In all individuals with the MHO phenotype, there was a significant increase in waist circumference over time, accompanied by an increase in BMI only in those who transformed into the MUHO status.

scholarly journals Uric acid as a future biomarker in diagnosing metabolic syndrome patients.

2019 ◽  
Vol 26 (11) ◽  
pp. 1911-1915
Author(s):  
Shameela Majeed ◽  
Brig. Rizwan Hashim
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Uric Acid ◽  
Waist Circumference ◽  
Serum Uric Acid ◽  
Serum Triglyceride ◽  
Military Hospital ◽  
P Value ◽  
Model Assessment ◽  
R Value

Objectives: To determine the possible correlation between raised serum uric acid and various components of metabolic syndrome (Waist circumference, serum triglyceride, plasma HDL-C). Study Design: Descriptive case control. Setting: Army Medical College laboratory, Military Hospital, Rawalpindi. Period: One year (November 2014 to October 2015). Material and Methods: Total of 100 subjects were enrolled in this study. WHO criteria were applied for identifying the patients of metabolic syndrome. Fasting plasma glucose, lipid profile and serum uric acid levels were measured by using colorimetric enzymatic method. The formula of Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) was applied to calculate Insulin resistance. Collected data was analyzed by using SPSS- Window version-17 for statistical analysis. Results: Serum uric acid levels were turned out to be high in metabolic syndrome patients (cases= 6.1±1.3mg/dL) when compared with controls (having no symptoms of MetS=3.6±1.2; p<0.001). Uric acid showed a statistically significant positive association with waist circumference (WC=r-value:0.250; p-value:0.000) and serum triglyceride (TG=r-value:0.341; p-value:0.000). Negative correlation had been found between plasma high-density lipoprotein-cholesterol (HDL-C=r-value: -0.173; p-value:<0.01) with uric acid levels. Conclusion: Serum uric acid levels show a significant association with components of metabolic syndrome making it a powerful biomarker of metabolic syndrome and its various cardiometabolic complications.

scholarly journals Differences in Cardiometabolic Risk Profiles Between Chinese and Finnish Older Adults with Glucose Impairment and Central Obesity

2021 ◽  
Author(s):  
Shenglong Le ◽  
Yinan Zhang ◽  
Ari Voutilainen ◽  
Xiao Tan ◽  
Jari Laukkanen ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Older Adults ◽  
Central Obesity ◽  
Cardiometabolic Risk ◽  
Cell Function ◽  
Density Lipoprotein ◽  
Β Cell ◽  
Β Cell Function ◽  
Chinese Subjects

Abstract Background Obesity and ethnicity play important roles in cardiovascular complications in patients with T2DM. This study aimed to compare cardiometabolic risk profiles between Chinese and Finnish older adults with prediabetes or type 2 diabetes mellitus (T2DM) and central obesity. Methods Study subjects were 60-74 years old and originated from two population samples. The Finnish subjects came from the Kuopio Ischemic Heart Disease (KIHD) study (n = 1089), and the Chinese subjects came from the Shanghai High-risk Diabetic Screen (SHiDS) study (n = 818). The KIHD and SHiDS studies used similar questionnaires to determine participants’ baseline characteristics regarding the history of medication use and diseases and lifestyle factors. All study subjects participated in glucose tolerance tests and anthropometry assessments, including waist circumference measurements. Results Among study subjects with prediabetes and central obesity (n = 298), fasting glucose, 2-h glucose, fasting insulin, insulin resistance, and triglyceride (TG) levels were significantly higher while the low-density lipoprotein cholesterol (LDL) and LDL to high-density lipoprotein cholesterol (HDL) ratio were lower in Chinese individuals than Finnish individuals (p <0.0001-0.003). Among subjects with T2DM and central obesity (n = 251), Chinese subjects had significantly less proportions of antihypertensive, glycaemic control medication, and statin users as well as lower level of physical activity (p < 0.0001 for all), while higher blood pressure (p = 0.002 for systolic blood pressure and p < 0.0001 for diastolic blood pressure), TG levels (p < 0.05) and HDL (p = 0.002) than the Finnish counterparts. There were no differences in β-cell function (HOMA-β) between Chinese and Finnish both in prediabetes and T2DM. Conclusions Our results indicated that Chinese and Finnish older adults with prediabetes and T2DM had similar β-cell function. However, Chinese individuals with prediabetes are prone to lipid metabolism dysfunction and insulin resistance. Strategies for preventing prediabetes from developing into diabetes in Chinese individuals should be focused on interventions such as exercise to increase insulin sensitivity and prevent insulin resistance. For Finnish individuals with prediabetes, more attention should be given to weight control.

scholarly journals Estimated glucose disposal rate and risk of stroke and mortality in type 2 diabetes: a nationwide cohort study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Alexander Zabala ◽  
Vladimer Darsalia ◽  
Marcus Lind ◽  
Ann-Marie Svensson ◽  
Stefan Franzén ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Cox Regression ◽  
Glucose Disposal ◽  
Risk Of Death ◽  
Increased Risk ◽  
Estimated Glucose Disposal Rate ◽  
Glucose Disposal Rate

Abstract Background and aims Insulin resistance contributes to the development of type 2 diabetes (T2D) and is also a cardiovascular risk factor. The aim of this study was to investigate the potential association between insulin resistance measured by estimated glucose disposal rate (eGDR) and risk of stroke and mortality thereof in people with T2D. Materials and methods Nationwide population based observational cohort study that included all T2D patients from the Swedish national diabetes registry between 2004 and 2016 with full data on eGDR and categorised as following: < 4, 4–6, 6–8, and ≥ 8 mg/kg/min. We calculated crude incidence rates and 95% confidence intervals (CIs) and used multiple Cox regression to estimate hazard ratios (HRs) to assess the association between the risk of stroke and death, according to the eGDR categories in which the lowest category < 4 (i.e., highest grade of insulin resistance), served as a reference. The relative importance attributed of each factor in the eGDR formula was measured by the R2 (± SE) values calculating the explainable log-likelihoods in the Cox regression. Results A total of 104 697 T2D individuals, 44.5% women, mean age of 63 years, were included. During a median follow up-time of 5.6 years, 4201 strokes occurred (4.0%). After multivariate adjustment the HRs (95% CI) for stroke in patients with eGDR categories between 4–6, 6–8 and > 8 were: 0.77 (0.69–0.87), 0.68 (0.58–0.80) and 0.60 (0.48–0.76), compared to the reference < 4. Corresponding numbers for the risk of death were: 0.82 (0.70–0.94), 0.75 (0.64–0.88) and 0.68 (0.53–0.89). The attributed relative risk R2 (± SE) for each variable in the eGDR formula and stroke was for: hypertension (0.045 ± 0.0024), HbA1c (0.013 ± 0.0014), and waist (0.006 ± 0.0009), respectively. Conclusion A low eGDR (a measure of insulin resistance) is associated with an increased risk of stroke and death in individuals with T2D. The relative attributed risk was most important for hypertension.

scholarly journals Relationships With Type 2 Diabetes Mellitus of the Basic Parameters of Urine Acid Metabolism With Indicators of Insulin Resistance

2020 ◽  
Vol 6 (1) ◽  
pp. 122-128
Author(s):  
I. Madyanov
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Uric Acid ◽  
Acid Metabolism ◽  
Density Lipoprotein ◽  
Tyg Index ◽  
Insulin Dependent

Hyperuricemia (HU) occurs in one third of patients with type 2 diabetes mellitus (DM 2). The formation of HU in DM 2 is due to metabolic factors and impaired renal function. At the stage of prediabetes, GU reveals a connection with insulin resistance (IR), it is not clear to what extent this phenomenon is associated with an increase in uricemia in DM 2. Direct assessment of IR in patients with DM 2 is difficult. There are methods for indirect estimation of IR based on the calculation of indices using the results of simple laboratory tests. These indices are based on the determination of fasting plasma levels of triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) — TG/HDL-C, TG and glucose — TyG index, as well as TG, HDL-C and glucose — MI (metabolic index). The aim of the study was to study the relationship in patients DM 2 between the main indicators of uric acid metabolism and the TG/HDL-C index, TyG index, and MI. 368 patients with DM 2 an average age of 55.8 years, and an average disease duration of 7.2 years were examined. There were 147 men, 221 women. The connection of uricemia with TG/HDL-C was established (Rs=0.2, p=0.03). In the non-insulin-dependent course of DM 2, uricemia was positively correlated with TG/HDL-C (Rs=0.21, p=0.03), negative relations of renal clearance of urates with TG/HDL-C (Rs=0.34, p=0.007) and fractional clearance of urates with TyG (Rs =−0.27, p=0.007) were recorded. In the insulin-dependent course of DM 2, a positive association of TyG with uricuria (Rs=0.44, p=0.03) and a negative correlation with GGFRT, the main enzyme for purine reuse (Rs=−0.44, p=0.03), were revealed. The results obtained do not contradict the previously established patterns of uric acid metabolism in DM 2. The conclusion is made on the feasibility of using the TG/HDL-C index as an indicator of metabolic disorders of uric acid and IR in DM 2. In the insulin-dependent course of DM2, TyG index becomes important, an increase in which is associated with increased catabolism of purines and their insufficient reutilization.

scholarly journals Small intestinal metabolism is central to whole-body insulin resistance

Gut ◽  
2020 ◽  
pp. gutjnl-2020-322073
Author(s):  
Giulia Angelini ◽  
Serenella Salinari ◽  
Lidia Castagneto-Gissey ◽  
Alessandro Bertuzzi ◽  
James Casella-Mariolo ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Insulin Sensitivity ◽  
Glucose Uptake ◽  
Insulin Signalling ◽  
Whole Body ◽  
Glucose Disposal ◽  
Jejunal Loop ◽  
Oral Glucose ◽  
Metabolic Signature ◽  
Jejunal Bypass

ObjectiveTo assess the role of jejunum in insulin resistance in humans and in experimental animals.DesignTwenty-four subjects undergoing biliopancreatic diversion (BPD) or Roux-en-Y gastric bypass (RYGB) were enrolled. Insulin sensitivity was measured at baseline and at 1 week after surgery using oral glucose minimal model.We excluded the jejunum from intestinal continuity in pigs and created a jejunal loop with its vascular and nerve supply intact accessible from two cutaneous stomas, and reconnected the bowel with an end-to-end anastomosis. Glucose stable isotopes were given in the stomach or in the jejunal loop.In vitro studies using primary porcine and human hepatocytes or myoblasts tested the effects of plasma on gluconeogenesis or glucose uptake and insulin signalling.ResultsWhole-body insulin sensitivity (SI∙104: 0.54±0.12 before vs 0.82±0.11 after BPD, p=0.024 and 0.41±0.09 before vs 0.65±0.09/pM/min after RYGB, p=not significant) and Glucose Disposition Index increased only after BPD. In pigs, insulin sensitivity was significantly lower when glucose was administered in the jejunal loop than in the stomach (glucose rate of disappearance (Rd) area under the curve (AUC)/insulin AUC∙10: 1.82±0.31 vs 2.96±0.33 mmol/pM/min, p=0.0017).Metabolomics showed a similar pattern before surgery and during jejunal-loop stimulation, pointing to a higher expression of gluconeogenetic substrates, a metabolic signature of impaired insulin sensitivity.A greater hepatocyte phosphoenolpyruvate-carboxykinase and glucose-6-phosphatase gene expression was elicited with plasma from porcine jejunal loop or before surgery compared with plasma from jejunectomy in pigs or jejunal bypass in humans.Stimulation of myoblasts with plasma from porcine jejunal loop or before surgery reduced glucose uptake, Ser473-Akt phosphorylation and GLUT4 expression compared with plasma obtained during gastric glucose administration after jejunectomy in pigs or after jejunal bypass in humans.ConclusionProximal gut plays a crucial role in controlling insulin sensitivity through a distinctive metabolic signature involving hepatic gluconeogenesis and muscle insulin resistance. Bypassing the jejunum is beneficial in terms of insulin-mediated glucose disposal in obesity.Trial registration numberNCT03111953.

scholarly journals Fasting insulin reflects heterogeneous physiological processes: role of insulin clearance

2011 ◽  
Vol 301 (2) ◽  
pp. E402-E408 ◽  
Author(s):  
Mark O. Goodarzi ◽  
Jinrui Cui ◽  
Yii-Der I. Chen ◽  
Willa A. Hsueh ◽  
Xiuqing Guo ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Insulin Secretion ◽  
Waist Circumference ◽  
Mexican Americans ◽  
Fasting Glucose ◽  
Insulin Clearance ◽  
Oral Glucose ◽  
Metabolic Clearance ◽  
Insulinogenic Index ◽  
Fasting Insulin

Several processes contribute to variation in fasting insulin concentration, including fasting glucose, insulin resistance, insulin secretion, and insulin clearance. Our goal was to determine the relative contribution of each of these insulin-related traits, plus anthropometric parameters, to fasting insulin among 470 Mexican Americans. The euglycemic hyperinsulinemic clamp yielded insulin sensitivity (M value) and metabolic clearance rate of insulin (MCRI). Acute insulin secretion was estimated by the insulinogenic index (IGI30) from the oral glucose tolerance test. Regression (univariate) and generalized estimating equations (multivariate) were used to describe the relationship of insulin-related traits to fasting insulin. Univarate analyses were used to select which traits to include in the multivariate model. In multivariate analysis, MCRI, M, BMI, waist circumference, and fasting glucose were independently associated with fasting insulin. Decreasing M and MCRI were associated with increasing fasting insulin, whereas increasing BMI, waist circumference, and fasting glucose were associated with increasing fasting insulin. Standardized coefficients allowed determination of the relative strength of each trait's association with fasting insulin in the entire cohort (strongest to weakest): MCRI (−0.35, P < 0.0001), M (−0.24, P < 0.0001), BMI (0.20, P = 0.0011), waist circumference (0.16, P = 0.021), and fasting glucose (0.11, P = 0.014). Fasting insulin is a complex phenotype influenced by several independent processes, each of which might have its own environmental and genetic determinants. One of the most associated traits was insulin clearance, which has implications for studies that have used fasting insulin as a surrogate for insulin resistance.

Abdominal adiposity and insulin resistance in obese men

2002 ◽  
Vol 282 (3) ◽  
pp. E657-E663 ◽  
Author(s):  
Robert Ross ◽  
James Aru ◽  
Jennifer Freeman ◽  
Robert Hudson ◽  
Ian Janssen
Keyword(s):  
Insulin Resistance ◽  
Glucose Tolerance ◽  
Tolerance Test ◽  
Cardiovascular Fitness ◽  
Glucose Disposal ◽  
Oral Glucose ◽  
Lower Glucose ◽  
Strong Correlate ◽  
Metabolic Variable ◽  
Magnetic Resonance Imaging Mri

We examined the independent relationships among various visceral and abdominal subcutaneous adipose tissue (AT) depots, glucose tolerance, and insulin sensitivity in 89 obese men. Measurements included an oral glucose tolerance test (OGTT), glucose disposal by euglycemic clamp, and abdominal and nonabdominal (e.g., peripheral) AT by magnetic resonance imaging (MRI). OGTT glucose and glucose disposal rates were related ( P < 0.05) to visceral AT ( r = 0.50 and −0.41, respectively). These observations remained significant ( P < 0.05) after control for nonabdominal and abdominal subcutaneous AT, and maximal O2 consumption (V˙o 2 max). Abdominal subcutaneous AT was not a significant correlate ( P > 0.05) of any metabolic variable after control for nonabdominal and visceral AT andV˙o 2 max. Division of abdominal subcutaneous AT into deep and superficial depots and visceral AT into intra- and extraperitoneal AT depots did not alter the observed relationships. Further analysis matched two groups of men for abdominal subcutaneous AT but also for low and high visceral AT. Men with high visceral AT had higher OGTT glucose values and lower glucose disposal rates compared with those with low visceral AT values ( P < 0.05). A similar analysis performed on two groups of men matched for visceral AT but also for high and low abdominal subcutaneous AT revealed no statistically different values for any metabolic variable ( P > 0.10). In conclusion, visceral AT alone is a strong correlate of insulin resistance independent of nonabdominal and abdominal subcutaneous AT and cardiovascular fitness. Subdivision of visceral and abdominal subcutaneous AT by MRI did not provide additional insight into the relationship between abdominal obesity and metabolic risk in obese men.

Contributions of total and regional fat mass to risk for cardiovascular disease in older women

2002 ◽  
Vol 282 (5) ◽  
pp. E1023-E1028 ◽  
Author(s):  
R. E. Van Pelt ◽  
E. M. Evans ◽  
K. B. Schechtman ◽  
A. A. Ehsani ◽  
W. M. Kohrt
Keyword(s):  
Insulin Resistance ◽  
Postmenopausal Women ◽  
Fat Mass ◽  
Independent Predictor ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Oral Glucose ◽  
Protective Effects ◽  
Serum Triglycerides ◽  
Regional Body Composition

The aim of this study was to determine whether trunk fat mass, measured by dual-energy X-ray absorptiometry (DEXA), is predictive of insulin resistance and dyslipidemia, independently of arm and leg fat mass, in postmenopausal women. Total and regional body composition was measured by DEXA in 166 healthy, postmenopausal women (66 ± 4 yr). Four primary markers of insulin resistance and dyslipidemia were assessed: 1) area under the curve for the insulin (INSAUC) response to an oral glucose tolerance test (OGTT), 2) product of the OGTT glucose and insulin areas (INSAUC×GLUAUC), 3) serum triglycerides (TG), and 4) high-density lipoprotein (HDL)-cholesterol. Trunk fat mass was the strongest independent predictor of each of the primary dependent variables. In multivariate regression models, trunk fat mass was associated with unfavorable levels of INSAUC, INSAUC×GLUAUC, TG, and HDL-C, whereas leg fat mass was favorably associated with each of these variables. Thus trunk fat is a strong independent predictor of insulin resistance and dyslipidemia in postmenopausal women, whereas leg fat appears to confer protective effects against metabolic dysfunction.

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