Insulin Resistance in Patients with Essential Hypertension Using Homeostatic Model Assessment

Introduction: Insulin resistance has a strong relationship with the incidence of type II diabetes. It also has a direct relationship with other risk factors of diabetes, which together are known as metabolic syndrome. The aim of this study was to investigate the relationship between insulin resistance and hypertension.Materials and Methods: In this historical cohort study, 90 patients were divided into three different groups: those without hypertension, those with controlled hypertension, and those with uncontrolled hypertension. Systolic and diastolic blood pressure, body mass index, and laboratory test results such as cholesterol, triglycerides, low- density lipoprotein, high-density lipoprotein, fasting plasma glucose, and fasting plasma insulin were compared among the three groups. Data were analyzed with t-tests and the analysis of variance test, which were performed using statistical package for the social sciences version 20 software.Results: Age and sex were the same among the three groups; however, BMI, systolic blood pressure, and diastolic blood pressure in the uncontrolled-hypertension group were higher than in the controlled-hypertension and without-hypertension groups (P<0.05). Lipid profile (P<0.05), creatinine (P=0.77), and uric acid (P=0.233) were not significantly different among the groups, although fasting plasma insulin (P=0.012) and homeostatic model assessment of insulin resistance (P=0.038) were significantly higher in the uncontrolled-hypertension group than in the other groups.Conclusion: Homeostasis model assessment of insulin resistance in patients with uncontrolled hypertension was higher than in patients with controlled hypertension and those without hypertension. Therefore, homeostatic model assessment of insulin resistance can be used as a predictive clinical test for the early diagnosis of diabetes in patients with uncontrolled hypertension.

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Elevated Retinol-Binding Protein 4 Levels Are Associated with Metabolic Syndrome in Chinese People

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2007-1219 ◽

2007 ◽

Vol 92 (12) ◽

pp. 4827-4834 ◽

Cited By ~ 145

Author(s):

Qibin Qi ◽

Zhijie Yu ◽

Xingwang Ye ◽

Feng Zhao ◽

Ping Huang ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Odds Ratio ◽

Large Scale ◽

Density Lipoprotein ◽

Retinol Binding Protein ◽

Model Assessment ◽

Retinol Binding Protein 4 ◽

Homeostatic Model Assessment ◽

Homeostatic Model

Abstract Context: High retinol-binding protein 4 (RBP4) is thought to be associated with insulin resistance in humans. However, evidence from large-scale populations about the relationship between RBP4 and metabolic diseases is scarce. Objective: We evaluated plasma RBP4 distribution and its association with metabolic syndrome (MetS) among middle-aged and older Chinese. Research Design and Methods: We evaluated plasma RBP4 in a cross-sectional sample of 3289 Chinese aged from 50 to 70 yr in Beijing and Shanghai by using an in-house developed and validated sandwich ELISA. MetS was defined according to the updated National Cholesterol Education Program Adult Treatment Panel III criteria for Asian-Americans. Results: RBP4 levels were higher in male and Beijing residents, compared with female and Shanghai participants (both P < 0.001). RBP4 levels were associated positively with body mass index, waist circumference, triglycerides, total and low-density lipoprotein cholesterol, blood pressure, fasting insulin, and homeostatic model assessment of insulin resistance and negatively with high-density lipoprotein cholesterol and adiponectin (all P < 0.001). In the highest RBP4 quartile, the MetS risk was significantly higher (odds ratio 2.58; 95% confidence interval 2.08–3.20) than in the lowest quartile after adjustment for potential confounders. This association remained strong (odds ratio 2.25; 95% confidence interval 1.72–2.94) after further controlling for C-reactive protein, adiponectin, homeostatic model assessment of insulin resistance, and body mass index. Conclusions: This first large-scale population study shows that elevated RBP4 levels are strongly and independently associated with MetS. Prospective studies are needed to establish the role of RBP4 in the development of MetS and related diseases.

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Somatostatin Analogs and Glucose Metabolism in Acromegaly: A Meta-Analysis of Prospective Interventional Studies

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2017-02566 ◽

2018 ◽

Vol 103 (6) ◽

pp. 2089-2099 ◽

Cited By ~ 16

Author(s):

Alessia Cozzolino ◽

Tiziana Feola ◽

Ilaria Simonelli ◽

Giulia Puliani ◽

Carlotta Pozza ◽

...

Keyword(s):

Meta Analysis ◽

Somatostatin Analogs ◽

Tolerance Test ◽

Oral Glucose ◽

Model Assessment ◽

Glucose Levels ◽

Fasting Plasma ◽

Homeostatic Model Assessment ◽

Fasting Plasma Insulin ◽

Homeostatic Model

Abstract Context Somatostatin analogs (SSAs) effectively control growth hormone secretion in first- and second-line treatment of acromegaly. Their effect on glucose metabolism is still debated. Objective To address the following questions: (1) Do SSAs affect fasting plasma glucose (FPG), fasting plasma insulin, glycosylated hemoglobin (HbA1c), glucose load (glucose levels after 2-hour oral glucose tolerance test), homeostatic model assessment of insulin resistance (HOMA-I), homeostatic model assessment of pancreatic β-cell function (HOMA-β), triglycerides, weight, or body mass index? (2) Do lanreotide and octreotide affect metabolism differently? (3) Does their effect depend on disease control? Design We performed a meta-analysis of prospective interventional trials treating acromegaly with SSAs. Inclusion criteria: all studies reporting glycometabolic outcomes before and after SSAs with a minimum 6-month follow-up. Results The inclusion criteria were met by 47 studies treating 1297 subjects (631 females). SSA treatment effectively lowered fasting plasma insulin [effect size (ES), −6.67 mU/L; 95% confidence interval (CI), −8.38 to −4.95 mU/L; P < 0.001], HOMA-I (ES, −1.57; CI, −2.42 to −0.72; P < 0.001), HOMA-β (ES, −47.45; CI, −73.15 to −21.76; P < 0.001), and triglycerides (ES, −0.37 mmol/L; CI, −0.47 to −0.27 mmol/L; P < 0.001). SSAs worsened glucose levels after a 2-hour oral glucose tolerance test (ES, 0.59 mmol/L; CI, 0.05 to 1.13 mmol/L; P = 0.032), but not FPG. A mild but significant increase in HbA1c (ES, 0.12%; CI, 0.00% to 0.25%; P = 0.044) was found in subjects treated with octreotide. Conclusions SSA treatment in acromegaly patients, while improving disease control, reduces insulin levels, increases after-load glucose, and, ultimately, increases HbA1c levels without affecting FPG. The findings suggest that clinicians treating acromegaly with SSAs should consider targeting postprandial glucose.

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Potential triggers of atrial fibrillation in type 2 diabetes mellitus

10.21203/rs.3.rs-408113/v1 ◽

2021 ◽

Author(s):

Zulfiya Mirzarakhimova ◽

Bakhodir Narziev ◽

Akmal Yakubov ◽

Oybek Salaev ◽

Ramesh Hamraev ◽

...

Keyword(s):

Diabetes Mellitus ◽

Atrial Fibrillation ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Plasma Insulin ◽

Model Assessment ◽

Fasting Plasma ◽

Fasting Plasma Insulin

Abstract Introduction. Atrial fibrillation is an irregular heartbeat that accelerates to form blood clots in the chambers of the heart and leads to stroke, heart failure, and other cardiovascular complications. Diabetes mellitus itself has been identified as a risk factor for atrial fibrillation, but the association between them is unclear. Material and methods. We analyzed 70 patients with type 2 insulin non-dependent diabetes mellitus. All patients were examined in parallel continuous glucose (CGM) and ECG for 14 days. The study population divided into documented atrial fibrillation (AF group, n = 16) and without atrial fibrillation (non-AF group, n = 54) groups. We assessed the relationship between hypoglycemia, fasting plasma insulin, insulin resistance using the homeostatic model assessment (HOMA-IR) equation, and the incidence of atrial fibrillation. Results. We found a total of 46 episodes of documented atrial fibrillation (AF be defined as an arrhythmia lasting ≥ 30 seconds) lasted on the whole 596.9 minute, which was the most significant by the number (2.87 ± 2.05 per patient, p < 0.0001) or the time (31.31 ± 16.57 min per patient, p < 0.0001). We also compared the incident rate of different types of atrial premature complexes between two groups. We found a maximum of 642.6 ± 567.2 single PACs per patient in the AF group, compared to 84.6 ± 87.9, p = 0.002. Despite this, there were significant differences by the following parameters: couplet PACs (p = 0.0015) and triplet or > 3 PACs (p = 0.0007). Over 14 days, a total of 263 hypoglycemic episodes or 5135 min hypoglycemic time were detected, the average number and time of hypoglycemic episodes were 8.0 ± 4.94 per person and 137.0 ± 63.17 min in AF group, and 2.5 ± 4.64 per person (p = 0.0001), 54.5 ± 67.3 min (p = 0.004) in the non-AF group. There was a statistically significant (p < 0.0001) association between FPI and incident AF, more exactly, the mean level of FPI was 31 ± 6.1 mlU/L in the AF group, whereas was 11.3 ± 4.07 in the non-AF group. When we measured the HOMA-IR index by using the homeostasis model, we found significant differences between AF and non-AF groups (11.2 ± 3.88 mmol/l vs. 4.3 ± 1.66 mmol/l, p < 0.0001). Conclusion. The parallel recording of continuous glucose and ECG are necessary to evaluate hypoglycemia-related atrial fibrillation in type 2 diabetes mellitus. Elevated fasting plasma insulin, as well as insulin resistance, are important predictors of atrial fibrillation development, but it needs further studies.

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Evaluation of fasting plasma insulin concentration as an estimate of insulin action in nondiabetic individuals: comparison with the homeostasis model assessment of insulin resistance (HOMA-IR)

Acta Diabetologica ◽

10.1007/s00592-013-0461-2 ◽

2013 ◽

Vol 51 (2) ◽

pp. 193-197 ◽

Cited By ~ 25

Author(s):

Fahim Abbasi ◽

QueenDenise Okeke ◽

Gerald M. Reaven

Keyword(s):

Insulin Resistance ◽

Insulin Action ◽

Plasma Insulin ◽

Insulin Concentration ◽

Model Assessment ◽

Homeostasis Model Assessment ◽

Plasma Insulin Concentration ◽

Fasting Plasma ◽

Fasting Plasma Insulin

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Distribution of Fasting Plasma Insulin, Free Fatty Acids, and Glucose Concentrations and of Homeostasis Model Assessment of Insulin Resistance in a Representative Sample of Quebec Children and Adolescents

Clinical Chemistry ◽

10.1373/49.4.644 ◽

2003 ◽

Vol 49 (4) ◽

pp. 644-649 ◽

Cited By ~ 127

Author(s):

Pierre Allard ◽

Edgard E Delvin ◽

Gilles Paradis ◽

James A Hanley ◽

Jennifer O’Loughlin ◽

...

Keyword(s):

Insulin Resistance ◽

Fatty Acids ◽

Free Fatty Acids ◽

Representative Sample ◽

Plasma Insulin ◽

Model Assessment ◽

Fasting Insulin ◽

Homeostasis Model Assessment ◽

Fasting Plasma ◽

Fasting Plasma Insulin

Abstract Background: Plasma fasting insulin and the homeostasis model assessment of insulin resistance (HOMA-IR) are markers of IR, which, at least in part, mediates the relation of obesity to increased cardiovascular risk. Increased free fatty acids (FFAs) may be involved in the pathogenesis of IR. Our objectives were to describe the distributions of fasting plasma insulin, glucose, and FFAs and HOMA-IR in youth and to assess the relationship between FFAs and markers of IR. Methods: Fasting plasma insulin, glucose, and FFAs were measured in a representative sample of Quebec youth comprising 2244 individuals 9, 13, and 16 years of age. Results: In all age and sex groups, glucose exhibited remarkably tight distributions (median CV, 7.1%) in contrast to insulin, HOMA-IR, and FFAs (median CVs, 52%, 54% and 45%, respectively). For every percentile examined, 9-year-olds had lower insulin concentrations and HOMA-IR values than 13- and 16-year-olds. We observed strong correlations between insulin concentrations and HOMA-IR values, as well as close similarity in their rankings of individuals. The mean concentrations of glucose were higher in our population than in other Caucasian pediatric populations. No positive correlations were detected between FFAs and markers of IR. Conclusions: We report some of the first data on the distributions of fasting plasma insulin, HOMA-IR, and FFAs from a representative sample of youth. HOMA-IR does not appear more informative than fasting insulin as a marker of IR. Our findings on higher mean glucose concentrations in this population require confirmation in other representative samples of youth to assess whether the North American distribution of glucose concentrations is shifting positively.

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Metabolic syndrome and insulin resistance in pre-pubertal children with psoriasis

European Journal of Pediatrics ◽

10.1007/s00431-020-03924-w ◽

2021 ◽

Author(s):

Francesca Caroppo ◽

Alfonso Galderisi ◽

Laura Ventura ◽

Anna Belloni Fortina

Keyword(s):

Metabolic Disease ◽

Insulin Resistance ◽

Metabolic Syndrome ◽

Model Assessment ◽

Limited Data ◽

Single Center ◽

Increased Risk ◽

High Prevalence ◽

Homeostatic Model Assessment ◽

Homeostatic Model

AbstractPsoriasis in adults is associated with an increased risk of metabolic disease. Various cardiometabolic comorbidities have been reported in childhood psoriasis, but only a few studies have analyzed the prevalence of metabolic syndrome. We performed a single-center prospective study investigating the prevalence of metabolic syndrome and insulin resistance in children with psoriasis. The prevalence of metabolic syndrome was evaluated in 60 pre-pubertal children with psoriasis (age: 3–10 years), accordingly to recently established criteria for the diagnosis of metabolic syndrome in children. Insulin resistance was considered altered when the homeostatic model assessment (HOMA-IR) for insulin resistance was ≥ 90th sex- and age-specific percentile and HOMA 2-IR was > 1.8. Eighteen (30%) children with psoriasis were found to have metabolic syndrome. Sixteen (27%) children were found to have insulin resistance.Conclusion: Our data underline the importance of assessing metabolic syndrome not only in adults and adolescents but also in young children with psoriasis. What is Known:• Psoriasis in adults is strongly associated with metabolic disease and insulin resistance.• Very limited data are available on the prevalence of metabolic syndrome and insulin resistance in pre-pubertal children with psoriasis. What is New:• This study reports that in pre-pubertal children with psoriasis, there is a high prevalence of metabolic syndrome and insulin resistance.• In children with psoriasis metabolic syndrome risk factors should be assessed.

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The Relationship between Insulin Resistance and the Cardiovascular Biomarker Growth Differentiation Factor-15 in Obese Patients

Clinical Chemistry ◽

10.1373/clinchem.2010.153726 ◽

2011 ◽

Vol 57 (2) ◽

pp. 309-316 ◽

Cited By ~ 73

Author(s):

Greisa Vila ◽

Michaela Riedl ◽

Christian Anderwald ◽

Michael Resl ◽

Ammon Handisurya ◽

...

Keyword(s):

Insulin Resistance ◽

Gastric Bypass ◽

Insulin Sensitivity ◽

Oral Glucose ◽

Model Assessment ◽

Obese Patients ◽

Growth Differentiation Factor 15 ◽

Homeostatic Model Assessment ◽

Homeostatic Model ◽

The Relationship

BACKGROUND Growth differentiation factor-15 (GDF-15) is a stress-responsive cytokine linked to obesity comorbidities such as cardiovascular disease, inflammation, and cancer. GDF-15 also has adipokine properties and recently emerged as a prognostic biomarker for cardiovascular events. METHODS We evaluated the relationship of plasma GDF-15 concentrations with parameters of obesity, inflammation, and glucose and lipid metabolism in a cohort of 118 morbidly obese patients [mean (SD) age 37.2 (12) years, 89 females, 29 males] and 30 age- and sex-matched healthy lean individuals. All study participants underwent a 75-g oral glucose tolerance test; 28 patients were studied before and 1 year after Roux-en-Y gastric bypass surgery. RESULTS Obese individuals displayed increased plasma GDF-15 concentrations (P < 0.001), with highest concentrations observed in patients with type 2 diabetes. GDF-15 was positively correlated with age, waist-to-height ratio, mean arterial blood pressure, triglycerides, creatinine, glucose, insulin, C-peptide, hemoglobin A1c, and homeostatic model assessment insulin resistance index and negatively correlated with oral glucose insulin sensitivity. Age, homeostatic model assessment index, oral glucose insulin sensitivity, and creatinine were independent predictors of GDF-15 concentrations. Roux-en-Y gastric bypass led to a significant reduction in weight, leptin, insulin, and insulin resistance, but further increased GDF-15 concentrations (P < 0.001). CONCLUSIONS The associations between circulating GDF-15 concentrations and age, insulin resistance, and creatinine might account for the additional cardiovascular predictive information of GDF-15 compared to traditional risk factors. Nevertheless, GDF-15 changes following bariatric surgery suggest an indirect relationship between GDF-15 and insulin resistance. The clinical utility of GDF-15 as a biomarker might be limited until the pathways directly controlling GDF-15 concentrations are better understood.

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