scholarly journals Declined Maternal GDCA is Correlated With Insulin Resistance and β-Cell Compensation in GDM: A Cross-Sectional Study in Chinese Pregnant Women

2020 ◽  
Author(s):  
Bo Zhu ◽  
Zhixin Ma ◽  
Yuning Zhu ◽  
Lei Fang ◽  
Hong Zhang ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Clinical Outcome ◽  
Glucose Tolerance ◽  
Pregnant Women ◽  
Bile Acids ◽  
Gestational Age ◽  
Metabolic Regulation ◽  
Resistance Index ◽  
Oral Glucose ◽  
Β Cell

Abstract BackgroundGestational diabetes mellitus (GDM) is characterized by glycemia and insulin disorders. Bile acids (Bas) have emerged as vital signaling molecules in glucose metabolic regulation. Bas change in GDM are still unclear, it exerts great significance to illustrate the change of Bas in GDM.MethodsWe organized GDM patient (n = 67) and normal pregnant women (n = 48) around the oral glucose tolerance test (OGTT) screening period, fasting serums were collected for the measurement of Bas. Clinical data were collected and Bas metabolism profiles were analyzed in the GDM and normal glucose tolerance (NGT). Delivery characteristics, delivery gestational age and infant birthweight were abstracted from medical record to illustrate the differences among the groups.ResultsGDM patients exert the distinctive features compared with NGT, including higher BMI, glucose, insulin (both fasting and OGTT) and HbA1c levels. GDM also gained higher insulin resistance index (HOMA-IR) and decreased β-cell compensation (DIo). Total bile acids (TBA) remained stable, but glycodeoxycholic acid (GDCA) and taurodeoxycholic acid (TDCA) declined significantly in GDM. GDCA was inversely correlated with HOMA-IR and positively correlated with DIo. There exists no obvious difference in clinical outcome between GDM and NGT. However, GDM patients with high HOMA-IR and low DIo are inclined to suffering higher cesarean delivery rate and earlier delivery gestational age. ConclusionsGDM with significantly increased insulin resistance and declined DIo elevated the worse clinical outcome, GDCA could be a valuable biomarker to evaluate insulin resistance and DIo in GDM.

scholarly journals Declined GDCA is Correlated With Adverse Clinical Outcome For Gestational Diabetes Mellitus

2020 ◽  
Author(s):  
Bo Zhu ◽  
Zhixin Ma ◽  
Yuning Zhu ◽  
Lei Fang ◽  
Hong Zhang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Clinical Outcome ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Bile Acids ◽  
Gestational Age ◽  
Resistance Index ◽  
Oral Glucose

Abstract BackgroundGestational diabetes mellitus (GDM) is characterized by glycemia and insulin disorders. Bile acids (Bas) have emerged as vital signaling molecules in glucose metabolic regulation. Bas change in GDM are still unclear, it exerts great significance to illustrate the change of Bas in GDM.MethodsWe organized GDM patient (n = 67) and normal pregnant women (n = 48) around the oral glucose tolerance test (OGTT) screening period, fasting serums were collected for the measurement of Bas. Clinical data were collected and Bas metabolism profiles were analyzed in GDM and normal glucose tolerance (NGT). Delivery characteristics, delivery gestational age and infant birthweight were abstracted from medical record.ResultsGDM patients exert the distinctive features compared with NGT, including higher BMI, glucose, insulin (both fasting and OGTT) and HbA1c levels. GDM also gained higher insulin resistance index (HOMA-IR) and decreased β-cell compensation (DIo). Total bile acids (TBA) remained stable, but glycodeoxycholic acid (GDCA) and taurodeoxycholic acid (TDCA) declined significantly in GDM. GDCA was inversely correlated with HOMA-IR and positively correlated with DIo. There exists no obvious difference in clinical outcome between GDM and NGT. However, GDM patients with high HOMA-IR and low DIo are inclined to suffering higher cesarean delivery rate and earlier delivery gestational age.ConclusionsGDCA could be a valuable biomarker to evaluate insulin resistance and DIo, decreased GDCA predicts worse clinical outcome of GDM.

Abstract P177: Effects of Gender, Race, and Glucose Tolerance on Lipoprotein Insulin Resistance Index Responses to Exercise Training

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Leanna M Ross ◽  
Cris A Slentz ◽  
Irina Shalaurova ◽  
Margery A Connelly ◽  
James D Otvos ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Exercise Training ◽  
Glucose Tolerance ◽  
Resistance Index ◽  
Analysis Of Covariance ◽  
Oral Glucose ◽  
Exercise Interventions ◽  
Insulin Resistance Index ◽  
Lower Baseline ◽  
Baseline Values

Introduction: Lipoprotein Insulin Resistance Index (LP-IR) is a novel spectroscopic multimarker linked to future diabetes risk. We recently assessed changes in LP-IR across the three STRRIDE trials, where on average, STRRIDE exercise interventions improved LP-IR. In the present study, we sought to determine if there were effects of gender, race, and glucose tolerance on LP-IR responses across the STRRIDE trials. Methods: A total of 461 adults with dyslipidemia (STRRIDE I and STRRIDE AT/RT) or prediabetes (STRRIDE-PD) were randomized to one of 7 exercise interventions, ranging from doses of 8-22 kcal/kg/week (KKW); intensities of 50-75% VO 2peak ; and durations of 6-9 months. Six groups included aerobic exercise, two groups included resistance training, and one group included dietary intervention (weight loss goal of 7%). Fasting blood samples were obtained at both baseline and 16-24 h after the final exercise bout. In STRRIDE-PD only (n=165), subjects completed oral glucose tolerance tests and were categorized into normal (NGT) and impaired glucose tolerance (IGT) groups at baseline. NMR spectroscopy was performed at LabCorp to determine LP-IR score (comprised of six lipoprotein subclass and size parameters). LP-IR score ranges from 0 (most insulin sensitive) to 100 (most insulin resistant). Irrespective of intervention group, we assessed change in LP-IR in three stratified analyses: by gender, race, and baseline glucose tolerance category. Paired t-tests determined whether the post- minus pre- intervention change scores within each group were significant (p<0.05). Analysis of covariance accounting for baseline values determined difference among groups. Results: At baseline, women had lower LP-IR scores compared to men (47.8 ± 22.3 vs 62.6 ± 21.5; p<0.0001). Both women and men significantly improved LP-IR following exercise training by -4.3 ± 15.0 and -8.0 ± 15.6 points, respectively. There were also significant baseline differences when stratified by race. Black subjects had lower baseline LP-IR scores compared to White subjects (43.2 ± 20.7 vs 56.3 ± 23.0; p<0.0001). After exercise training, Black subjects significantly improved their LP-IR score by -4.0 ± 14.6 points; White subjects significantly improved their LP-IR score by -6.2 ± 15.5 points. As expected, those with NGT had lower baseline LP-IR scores compared to those with IGT in STRRIDE-PD (49.0 ± 20.0 vs 64.4 ± 19.9; p<0.0001). Both NGT and IGT groups significantly improved LP-IR by -4.3 ± 14.6 and -7.6 ± 12.9 points, respectively. In all three stratified analyses, change in LP-IR was not significantly different among groups after controlling for baseline values. Conclusion: There were significant baseline differences in LP-IR among gender, racial, and glucose tolerance groups. However, after adjusting for these baseline differences, there were similar beneficial responses to exercise in this marker of insulin resistance.

scholarly journals Elevated Circulating Fetuin-B Levels Are Associated with Insulin Resistance and Reduced by GLP-1RA in Newly Diagnosed PCOS Women

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Mani Mokou ◽  
Shan Yang ◽  
Bin Zhan ◽  
Shan Geng ◽  
Kejia Li ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Glucose ◽  
Glucose Tolerance ◽  
Metabolic Diseases ◽  
Polycystic Ovary ◽  
Fasting Blood Glucose ◽  
Resistance Index ◽  
Oral Glucose ◽  
Healthy Women ◽  
Tnf Α

Background. Previous studies have suggested that Fetuin-B seems to be a secreted adipokine related to metabolic diseases. However, the results have been inconsistent. Here, our objective is to investigate the changes in circulating Fetuin-B levels in women with polycystic ovary syndrome (PCOS) and analyze the association of Fetuin-B and insulin resistance (IR). Methods. The current study is comprised of a cross-sectional study and a series of interventional studies. Oral glucose tolerance test (OGTT) and euglycemic-hyperinsulinemic clamp (EHC) were engaged to assess glucose tolerance and insulin sensitivity. Serum Fetuin-B levels were determined by ELISA. Results. Serum Fetuin-B and TNF-α levels were markedly increased in women with PCOS compared to healthy women. Circulating Fetuin-B was positively associated with body mass index, waist-to-hip ratio, the percentage of body fat (FAT%), systolic blood pressure, triglyceride, low-density lipoprotein cholesterol, fasting blood glucose, 2 h blood glucose after glucose overload, fasting insulin, 2 h insulin after glucose overload, HOMA-insulin resistance index (HOMA-IR), the area under the curve for insulin (AUCi), AUCg, and TNF-α, while negatively associated with M value and follicular stimulating hormone (FSH). During the EHC, Fetuin-B levels were found to be significantly increased in PCOS women. After a glucose challenge, serum Fetuin-B levels in healthy women were significantly increased. Lipid infusion reduced serum Fetuin-B levels in 30 healthy subjects. After six months of glucagon-like peptide-1 receptor agonist (GLP-1RA) intervention, serum Fetuin-B concentrations in PCOS women markedly decreased following ameliorated IR. Conclusion. Our results indicate that Fetuin-B may be a biomarker of IR in individuals with PCOS. This trial is registered with ChiCTR-IIR-16007901.

scholarly journals TNFα Dynamics During the Oral Glucose Tolerance Test Vary According to the Level of Insulin Resistance in Pregnant Women

2014 ◽  
Vol 99 (5) ◽  
pp. 1862-1869 ◽  
Author(s):  
Laetitia Guillemette ◽  
Marilyn Lacroix ◽  
Marie-Claude Battista ◽  
Myriam Doyon ◽  
Julie Moreau ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Pregnant Women ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance

scholarly journals Early Detection of Insulin Sensitivity and β-Cell Function with Simple Tests Indicates Future Derangements in Late Pregnancy

2008 ◽  
Vol 93 (3) ◽  
pp. 876-880 ◽  
Author(s):  
A. Lapolla ◽  
M. G. Dalfrà ◽  
G. Mello ◽  
E. Parretti ◽  
R. Cioni ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Insulin Sensitivity ◽  
Glucose Tolerance ◽  
Early Pregnancy ◽  
Cell Function ◽  
Late Pregnancy ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Β Cell ◽  
Β Cell Function

Abstract Objective: Insulin sensitivity and secretion during early and late pregnancy were assessed in women with normal glucose tolerance and gestational diabetes mellitus (GDM). Research Design and Methods: The oral glucose tolerance test (OGTT) was performed in 903 women at 16–20th gestational week, of whom 37 had GDM (GDM1 group), and 859 repeated the OGTT at wk 26–30. At the second test, 55 had GDM (GDM2 group); the others remained normotolerant (ND group). Insulin sensitivity from OGTT (as quantitative insulin sensitivity check index and OGTT insulin sensitivity) and β-cell function (as the ratio of the areas under the insulin and glucose concentration curves, adjusted for insulin sensitivity) were assessed in both tests. Results: In early pregnancy the quantitative insulin sensitivity check index was not different in the three groups, whereas OGTT insulin sensitivity was lowest in GDM2, intermediate in GDM1, and highest in ND. In late pregnancy both indices were reduced in GDM compared with ND and lower than in early pregnancy. In early pregnancy GDM1, but not GDM2, had lower β-cell function than ND. During the late visit, GDM2 also showed impaired β-cell function compared with ND; furthermore, the adaptation to the increase to insulin resistance from early to late pregnancy was defective in GDM2. Conclusions: In early pregnancy insulin sensitivity, as assessed from the OGTT but not from fasting measurements, is impaired in women who developed GDM. β-Cell function impairment is evident only when GDM is manifest and is characterized by inappropriate adaptation to the pregnancy induced increase in insulin resistance.

scholarly journals Prehepatic secretion and disposal of insulin in obese adolescents as estimated by three-hour, eight-sample oral glucose tolerance tests

2016 ◽  
Vol 311 (1) ◽  
pp. E82-E94 ◽  
Author(s):  
Josef A. Vogt ◽  
Christian Domzig ◽  
Martin Wabitsch ◽  
Christian Denzer
Keyword(s):  
Insulin Resistance ◽  
Insulin Secretion ◽  
Glucose Tolerance ◽  
Metabolic Regulation ◽  
The Body ◽  
Oral Glucose ◽  
Published Data ◽  
Oral Glucose Tolerance ◽  
Insulin Metabolism ◽  
Obese Adolescents

The body compensates for early-stage insulin resistance by increasing insulin secretion. A reliable and easy-to-use mathematical assessment of insulin secretion and disposal could be a valuable tool for identifying patients at risk for the development of type 2 diabetes. Because the pathophysiology of insulin resistance is incompletely understood, assessing insulin metabolism with minimal assumptions regarding its metabolic regulation is a major challenge. To assess insulin secretion and indexes of insulin disposal, our marginalized and regularized absorption approach (MRA) was applied to a sparse sampling oral glucose tolerance test (OGTT) protocol measuring the insulin and C-peptide concentrations. Identifiability and potential bias of metabolic parameters were estimated from published data with dense sampling. The MRA was applied to OGTT data from 135 obese adolescents to demonstrate its clinical applicability. Individual prehepatic basal and dynamic insulin secretion and clearance levels were determined with a precision and accuracy greater than 10% of the nominal value. The intersubject variability in these parameters was approximately four times higher than the intrasubject variability, and there was a strong negative correlation between prehepatic secretion and plasma clearance of insulin. MRA-based analysis provides reliable estimates of insulin secretion and clearance, thereby enabling detailed glucose homeostasis characterization based on restricted datasets that are obtainable during routine patient care.

scholarly journals Effects of the long-acting somatostatin analogue Lanreotide Autogel on glucose tolerance and insulin resistance in acromegaly

2006 ◽  
Vol 155 (1) ◽  
pp. 73-78 ◽  
Author(s):  
B Steffin ◽  
B Gutt ◽  
M Bidlingmaier ◽  
C Dieterle ◽  
F Oltmann ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Glucose ◽  
Glucose Tolerance ◽  
Cell Function ◽  
Oral Glucose ◽  
Model Assessment ◽  
Β Cell ◽  
Igf I ◽  
Β Cell Function ◽  
Lanreotide Autogel

Object: Treatment with somatostatin analogues (SA) not only inhibits GH secretion but may also impair insulin secretion. In order to evaluate the influence of SA on glucose metabolism, we investigated insulin resistance (IR) and β-cell function, using the recommended combination of homeostatic model assessment of IR (HOMA-IR) and β-cell function (HOMA-β). Design and methods: This is a prospective, cross-sectional study. We measured fasting insulin, blood glucose and IGF-I. Insulin and blood glucose measurements were taken 120 min after an oral glucose tolerance test with 75 g glucose. We studied 51 patients (27 female/24 male, age 54 years (20–75)). Eighteen patients were on Lanreotide Autogel (LA) treatment, 33 had no medical treatment. GH-levels of more than 2.5 ng/ml was reached by 59% of the patients, 74.5% had normal IGF-I levels. Results: We found no significant influence of disease activity on HOMA-IR and HOMA-β. In the 33 of 51 subjects without any drug treatment, median HOMA-β was 170.4% (36.0–624.0%). In contrast, in the 18 patients on LA treatment, median HOMA-β was found to be significantly lower (84.2% (36.5–346.2%); P = 0.001). Despite this, there was no difference in HOMA-IR in both groups (2.4 (0.7–8.4) vs 2.3 (0.7–6.1); P < 0.001) despite similar insulin values. Conclusion: In conclusion, we found that LA decreases β-cell function significantly without affecting IR. Therefore, we think that insulin secretagogues are probably more effective in the treatment of diabetes mellitus in acromegalic patients on LA therapy than insulin sensitizers.

Impaired β-cell compensation to dexamethasone-induced hyperglycemia in women with polycystic ovary syndrome

2004 ◽  
Vol 287 (2) ◽  
pp. E241-E246 ◽  
Author(s):  
David A. Ehrmann ◽  
Elena Breda ◽  
Matthew C. Corcoran ◽  
Melissa K. Cavaghan ◽  
Jacqueline Imperial ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Glucose Tolerance ◽  
Polycystic Ovary ◽  
Tolerance Test ◽  
Normal Glucose Tolerance ◽  
Oral Glucose ◽  
Β Cell ◽  
Glucose Levels ◽  
Control Subjects ◽  
And Control

Deterioration in glucose tolerance occurs rapidly in women with polycystic ovary syndrone (PCOS), suggesting that pancreatic β-cell dysfunction may supervene early. To determine whether the compensatory insulin secretory response to an increase in insulin resistance induced by the glucocorticoid dexamethasone differs in women with PCOS and control subjects, we studied 10 PCOS and 6 control subjects with normal glucose tolerance. An oral glucose tolerance test (OGTT) and a graded glucose infusion protocol were performed at baseline and after subjects took 2.0 mg of dexamethasone orally. Basal (Φb), static (Φs), dynamic (Φd), and global (Φ) indexes of β-cell sensitivity to glucose were derived. Insulin sensitivity (Si) was calculated using the minimal model; a disposition index (DI) was calculated as the product of Si and Φ. PCOS and control subjects had nearly identical fasting and 2-h glucose levels at baseline. Φb was higher, although not significantly so, in the PCOS subjects. The Φd, Φs, and Φ indexes were 28, 19, and 20% higher, respectively, in PCOS subjects. The DI was significantly lower in PCOS (30.01 ± 5.33 vs. 59.24 ± 7.59) at baseline. After dexamethasone, control subjects averaged a 9% increase (to 131 ± 12 mg/dl) in 2-h glucose levels; women with PCOS had a significantly greater 26% increase to 155 ± 6 mg/dl. The C-peptide-to-glucose ratios on OGTT increased by 44% in control subjects and by only 15% in PCOS subjects. The accelerated deterioration in glucose tolerance in PCOS may result, in part, from a relative attenuation in the response of the β-cell to the demand placed on it by factors exacerbating insulin resistance.

scholarly journals Pharmacological Treatment of Insulin Resistance at Two Different Stages in the Evolution of Type 2 Diabetes: Impact on Glucose Tolerance and β-Cell Function

2004 ◽  
Vol 89 (6) ◽  
pp. 2846-2851 ◽  
Author(s):  
Anny H. Xiang ◽  
Ruth K. Peters ◽  
Siri L. Kjos ◽  
Jose Goico ◽  
Cesar Ochoa ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Glucose Tolerance ◽  
Glucose Tolerance Test ◽  
Cell Function ◽  
Intervention Group ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Β Cell ◽  
Late Intervention ◽  
Β Cell Function

Abstract The purpose of this study was to compare the impact of treating insulin resistance with a thiazolidinedione drug before vs. at the onset of diabetes on glucose levels and β-cell function. Nondiabetic Hispanic women of Mexican or Central American descent with prior gestational diabetes mellitus (GDM) were randomized to troglitazone (early intervention), 400 mg/d, or placebo (later intervention). Women who developed diabetes were placed on open-label troglitazone. Glucose tolerance, insulin resistance, and β-cell function were measured at randomization, at the diagnosis of diabetes, and 8 months post trial to determine the long-term impact of the two treatment strategies on glucose levels and β-cell function. During a mean follow-up of 4.3 yr between baseline and posttrial tests, glucose tolerance (oral glucose tolerance test glucose area, P = 0.04) and insulin resistance (MINMOD SI, P = 0.02) worsened more in women randomized to late intervention (n = 69) than to early intervention (n = 57). Insulin secretion (acute insulin response in the iv glucose tolerance test, P = 0.09) and β-cell compensation for insulin resistance (disposition index, P = 0.07) also tended to worsen more in the late intervention group. Among women in the late intervention group who developed diabetes, oral glucose tolerance test glucose area (P = 0.0001) and β-cell function (P ≤ 0.04) deteriorated significantly during development of diabetes on placebo and then did not change significantly (P &gt; 0.50) during treatment with troglitazone and posttreatment washout. In high-risk Hispanic women, amelioration of insulin resistance can stabilize glycemia at the time diabetes develops. These findings highlight the role of insulin resistance in the genesis of progressive β-cell dysfunction during the evolution of type 2 diabetes.

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