scholarly journals Prevalence of Insulin Resistance in the Hungarian General and Roma Populations as Defined by Using Data Generated in a Complex Health (Interview and Examination) Survey

Author(s):  
Róza Ádány ◽  
Péter Pikó ◽  
Szilvia Fiatal ◽  
Zsigmond Kósa ◽  
János Sándor ◽  
...  

Data mainly from one-off surveys clearly show that the health of Roma, the largest ethnic minority of Europe, is much worse than that of the general population. However, results from comprehensive exploratory studies are missing. The aim of our study was to create a complex database for comparative and association studies to better understand the background of the very unfavourable health of Roma, especially the high burden of cardiometabolic diseases. A three-pillar (questionnaire-based, physical and laboratory examinations) health survey was carried out on randomly selected samples of the Hungarian general (HG, n = 417) and Roma (HR, n = 415) populations, and a database consisting of more than half a million datapoints was created. Using selected data, the prevalence rates of metabolic syndrome (MetS) and of its components were determined, and to estimate the risk of insulin resistance (IR), surrogate measures (the homeostasis model assessment of insulin resistance index, quantitative insulin sensitivity check index, McAuley and TyG indices and the TG/HDL-C ratio) were calculated. Receiver operating characteristic curve analysis and Youden’s method were used to define the optimal cut-off values of each IR index. The prevalence of MetS was very high in both study populations (HG: 39.8%, HR: 44.0%) with no statistically significant difference between the two groups in females or males. The prevalence of MetS showed a very marked increase in the HR 35–49 years age group. Among surrogate measures, the TyG index showed the greatest power for predicting IR/MetS at a cut-off value of 4.69 (77% sensitivity, 84% specificity) and indicated a 42.3% (HG) and 40.5% (HR) prevalence of IR. The prevalence of MetS and IR is almost equally very unfavourable in both groups; thus, the factors underlying the high premature mortality burden of Roma should be further clarified by investigating the full spectrum of risk factors available in the database, with a special focus on the access of Roma people to preventive and curative health services.

2021 ◽  
Vol 12 ◽  
pp. 204201882110496
Author(s):  
Gurhan Guney ◽  
Mine Islimye Taskin ◽  
Ozgur Baykan ◽  
Ertan Adali ◽  
Selin Gul Tezcan ◽  
...  

Background: Polycystic ovary syndrome is known to be the most common hormonal disorder in women of reproductive age. Current evidence shows that regulatory proteins secreted from the adipose tissue called adipokines may have a role in polycystic ovary syndrome. We planned to investigate the role of endotrophin that has never been researched in polycystic ovary syndrome before and its correlation with other metabolic parameters and adipokines such as adiponectin and ghrelin in patients with polycystic ovary syndrome. Methods: Forty-three women ( n: 43) with polycystic ovary syndrome and 43 ( n: 43) women as a control group were enrolled in this cross-sectional study. Serum levels of endotrophin, adiponectin, and ghrelin levels were measured with the enzyme-linked immunosorbent assay method. High-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol levels, luteinizing hormone/follicle-stimulating hormone ratio, total testosterone, and triglyceride levels were measured. Homeostasis model assessment for insulin resistance index, body mass index, Ferriman Gallwey Score, and waist-to-hip ratio were also evaluated. Results: Total testosterone, homeostasis model assessment for insulin resistance, C-reactive protein, luteinizing hormone/follicle-stimulating hormone ratio, and triglyceride levels were higher in patients with polycystic ovary syndrome ( p < 0.01). No difference was detected between the groups in terms of body mass index, Ferriman Gallwey Score, waist-to-hip ratio, total cholesterol, low-density lipoprotein, and high-density lipoprotein levels ( p > 0.05). We did not observe any significant difference in adiponectin and ghrelin levels between the groups ( p > 0.05). Patients with polycystic ovary syndrome had significantly higher endotrophin levels ( p < 0.01). According to our regression analyses [area under the curve: 0.973 (0.935–1.000), 95% confidence interval, 95.2% sensitivity, and 100% specificity], it was shown that endotrophin greater than 92 ng/ml and homeostasis model assessment for insulin resistance greater than 2.5 might be good predictors for polycystic ovary syndrome diagnosis. Conclusion: We demonstrated that endotrophin level is higher in patients with polycystic ovary syndrome and may have predicted polycystic ovary syndrome with increased homeostasis model assessment for insulin resistance index. There was no significant difference in adiponectin and ghrelin levels in the polycystic ovary syndrome group. Endotrophin may have a role in polycystic ovary syndrome etiology rather than other adipokines.


2011 ◽  
Vol 165 (4) ◽  
pp. 563-569 ◽  
Author(s):  
Neşe Çinar ◽  
Neşe Ersöz Gülçelik ◽  
Kadriye Aydín ◽  
Şafak Akín ◽  
Aydan Usman ◽  
...  

ObjectiveTo elucidate the link between TSH and obesity, the relationship between TSH and adipocytokines were previously studied. Animal studies demonstrated a possible relationship between vaspin levels and thyroid functions. In this study, we aimed to investigate vaspin levels in hypothyroid states and its relationship with insulin resistance parameters in humans.DesignProspective observational study.MethodsWe enrolled 27 overt hypothyroid, 33 subclinical hypothyroid and 41 euthyroid patients. We measured the body mass index (BMI), fasting glucose, fasting insulin, homeostasis model assessment of insulin resistance index (HOMA-IR), lipid profile, TSH, free triiodothyronine, free thyroxine and vaspin levels. The change in vaspin levels in 12 overt hypothyroid patients after establishment of euthyroidism was analysed.ResultsAll groups were age-matched. Overt hypothyroid group had higher BMI values (P<0.05) than other groups. No significant difference was observed in insulin levels and HOMA-IR among the groups (P>0.05). Adjusted vaspin levels for BMI and age were similar among the groups. Mean vaspin levels in overt, subclinical and euthyroid patients were 1.20±1.17, 1.48±0.93 and 0.95±0.75 ng/ml respectively (P>0.05). There was no significant association between vaspin levels and BMI, fasting glucose, insulin and HOMA-IR (P>0.05). Establishing euthyroidism in hypothyroid patients did not result in a significant change in vaspin levels (before and after treatment, 1.35±1.06 and 1.25±0.68 ng/ml, respectively; P>0.05).ConclusionWe herein present novel data indicating vaspin levels are neither altered in overt and subclinical hypothyroidism nor have a relationship with features of insulin resistance in hypothyroid patients.


2007 ◽  
Vol 99 (1) ◽  
pp. 44-48 ◽  
Author(s):  
F. J. Tinahones ◽  
F. Cardona ◽  
G. Rojo-Martínez ◽  
M. C. Almaraz ◽  
I. Cardona ◽  
...  

Hyperuricaemia is one of the components of metabolic syndrome. Both oxidative stress and hyperinsulinism are important variables in the genesis of this syndrome and have a close association with uric acid (UA). We evaluated the effect of an oral glucose challenge on UA concentrations. The study included 656 persons aged 18 to 65 years. Glycaemia, insulin, UA and plasma proteins were measured at baseline and 120 min after an oral glucose tolerance test (OGTT). The baseline sample also included measurements of total cholesterol, triacylglycerol (TAG) and HDL-cholesterol. Insulin resistance was calculated with the homeostasis model assessment. UA levels were significantly lower after the OGTT (281·93 (sd92·19)v. 267·48 (sd90·40) μmol/l;P < 0·0001). Subjects with a drop in UA concentrations >40·86 μmol/l (>75th percentile) had higher plasma TAG levels (P = 0·0001), baseline insulin (P = 0·02) and greater insulin resistance (P = 0·034). Women with a difference in plasma concentrations of UA above the 75th percentile had higher baseline insulin levels (P = 0·019), concentration of plasma TAG (P = 0·0001) and a greater insulin resistance index (P = 0·029), whereas the only significant difference in men was the level of TAG. Multiple regression analysis showed that the basal TAG levels, insulin at 120 min, glycaemia at 120 min and waist:hip ratio significantly predicted the variance in the UA difference (r20·077). Levels of UA were significantly lower after the OGTT and the individuals with the greatest decrease in UA levels are those who have greater insulin resistance and higher TAG levels.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Pikó ◽  
S z Fiatal ◽  
Z s Kósa ◽  
J Sándor ◽  
R Ádány

Abstract Background The metabolic syndrome (MS) based on insulin resistance (IR) is a cluster of conditions indicating an increased risk of cardiometabolic diseases. This study aimed to define valid cut-off values for surrogate measures for IR to predicting the risk for the development of MS in the Hungarian general (HG) and Roma (HR) populations. Methods This study included 397 HG and 368 HR subjects aged 20-64 years from a complex health survey in 2018/2019. Four surrogate measures, namely the homeostasis model assessment-IR (HOMA-IR), McAuley index (McA), TG to HDL-cholesterol ratio (TG/HDL-C) and TG and glucose index (TyG) were calculated for all participants. The cut-off values were determined as the value with the highest Youden index (YI) on the basis of results obtained by receiver operating characteristic (ROC) curve analysis for the development of MS on separate and combined populations. Results Since no significant difference could be detected between the results obtained on separate populations, cut-off values defined on the combined one are proposed to use for risk prediction. The area under the ROC curve was 0.753 (95%CI: 0.718-0.787) for HOMA-IR, 0.827 (95%CI: 0.797-0.856) for McA, 0.843 (95%CI: 0.814-0.872) for TG/HDL-C ratio and 0.862 (95%CI: 0.835-0.889) for TyG. The cut-off value was 2.32 (sensitivity (sens.) 70.9%; specificity (spec.) 69.0%; YI: 0.399) for HOMA-IR, 5.989 (sens. 69.7%; spec. 82.7%; YI: 0.524) for McA, 1.274 (sens. 73.4; spec. 84.3%; YI: 0.574) for TG/HDL-C ratio and 4.694 (sens. 77.2%; spec. 84.3%; YI: 0.615) for TyG. Concerning the fact, that the TyG has the best indicative power for predicting IR to the estimation of MS risk in both populations the IR/MS prevalence was defined by using TyG and found to be as high as 42.3% and 40.5% in the HG and HR populations, respectively. Conclusions Based on our results the TyG index could be a useful supplementary method for identifying individuals at risk for MS. Key messages The optimal cut-off points’ four surrogate indices of insulin resistance for the prediction of metabolic syndrome did not differ significantly between the Hungarian general and Roma populations. The triglyceride and glucose index proved to be the strongest predictor for the risk of metabolic syndrome in the Hungarian general and Roma populations.


2012 ◽  
Vol 16 (3) ◽  
pp. 479-486 ◽  
Author(s):  
Katerina Kondaki ◽  
Evangelia Grammatikaki ◽  
David Jiménez-Pavón ◽  
Stefaan De Henauw ◽  
Marcela González-Gross ◽  
...  

AbstractObjectiveThe present study aimed to evaluate the relationship between the consumption of selected food groups and insulin resistance, with an emphasis on sugar-sweetened beverages (SSB).DesignThe present research is a large multicentre European study in adolescents, the HELENA-CSS (Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study).SettingHomeostasis model assessment–insulin resistance index (HOMA-IR) was calculated. Several anthropometric and lifestyle characteristics were recorded. Dietary assessment was conducted by using a short FFQ.SubjectsThe participants were a subset of the original sample (n 546) with complete data on glucose, insulin and FFQ. All participants were recruited at schools.ResultsMedian (25th, 75th percentile) HOMA-IR was 0·62 (0·44, 0·87). Mean HOMA-IR was significantly higher among adolescents consuming brown bread ≤1 time/week than among those consuming 2–6 times/week (P = 0·011). Mean values of HOMA-IR were also higher in adolescents consuming SSB >5 times/week compared with those consuming less frequently, although a statistically significant difference was detected between those consuming SSB 5–6 times/week and 2–4 times/week (P = 0·049). Multiple linear regression analysis showed that only the frequency of SSB consumption was significantly associated with HOMA-IR after controlling for potential confounders. In particular, it was found that HOMA-IR levels were higher among adolescents consuming SSB 5–6 times/week and ≥1 time/d compared with those consuming ≤1 time/week by 0·281 and 0·191 units, respectively (P = 0·009 and 0·046, respectively).ConclusionsThe present study revealed that daily consumption of SSB was related with increased HOMA-IR in adolescents.


2014 ◽  
Vol 112 (10) ◽  
pp. 1724-1734 ◽  
Author(s):  
Eirini C. Spyridaki ◽  
Panagiotis Simos ◽  
Pavlina D. Avgoustinaki ◽  
Eirini Dermitzaki ◽  
Maria Venihaki ◽  
...  

Published evidence suggests that obesity impairs cognition. Development of chronic low-grade inflammation (CLGI) represents the earliest consequence of obesity. The present study investigated the association between obesity and fluid intelligence impairment and assessed the potential mediating role of CLGI and psychological (depression/anxiety symptoms), lifestyle (exercise) and physiological (metabolic dysfunction indices) factors in this association. Clinically healthy participants (n 188), grouped as per BMI, underwent cognitive (General Ability Measure for Adults), psychological (Beck Depression Inventory-II and State-Trait Anxiety Inventory) and activity (Godin leisure-time physical activity) measurements. Biochemical parameters included the following: (a) indices of CLGI (high-sensitivity C-reactive protein, erythrocyte sedimentation rate and fibrinogen); (b) insulin resistance (Homeostasis Model Assessment of Insulin Resistance index); (c) adiposity (plasma adiponectin). An inverse association between elevated BMI and fluid intelligence was observed, with obese participants displaying significantly poorer performance compared with age-matched normal-weight peers. Structural equation modelling results were consistent with a negative impact of obesity on cognition that was mediated by CLGI. The results of the present study support the hypothesis that reduced general cognitive ability is associated with obesity, an adverse effect mainly mediated by obesity-associated activation of innate immunity.


Author(s):  
Chaitali Maitra ◽  
Ramesh Chandra Gupta ◽  
Rishika Raj

Introduction: Polycystic Ovarian Syndrome (PCOS) is a common endocrine disorder in the women of reproductive age. Studies show that there is an intensive relationship between insulin and gonadal function. As per Rotterdam Criteria, there are four major phenotypes of PCOS with different presentation. Early detection of Insulin Resistance (IR) and consequential prevention of Metabolic Syndrome (MS) associated with PCOS may lead to better prospect for the disease. Aim: To find the pattern of IR in all the phenotypes of PCOS in relation to Waist Hip Ratio (WHR), Body Mass Index (BMI) and Testosterone and thereby, providing data for designing phenotype specific treatment of the disease. Materials and Methods: In this cross-sectional observational study, fasting insulin and fasting glucose were analysed to calculate Homeostasis Model Assessment (HOMA-IR) and Testosterone for total 144 female subjects of reproductive age group (18-40 years). Subjects were classified in to four groups as per Rotterdam Criteria. Complete PCOS (PCO-COM), PCO with Oligo/Anovulation (PCO-O), Anovulation with Hyperandrogenism (O-HA), and PCO with Hyperandrogenism (PCO-HA). Regression analysis was done to find the relation among the study variables. Analysis of Variance (ANOVA) was used to analyse the significant variance among the groups. Results: IR was found to be maximum among O-HA phenotype (2.4±0.37) and lowest among PCO-HA phenotypes (1.3±0.22). Regression analysis shows that there exist significant associations between IR and BMI (t=4.96, p=0.001) as well as between IR and WHR (t=2.97, p=0.003). No independent association between testosterone and IR was observed. Conclusion: Significant difference of IR, WHR, and BMI was observed among the four phenotypes of PCOS. Due to increased IR, O-HA and PCO-COM phenotypes are more predisposed to Cardiometabolic consequences of PCOS.


2018 ◽  
Vol 33 (2) ◽  
pp. 99-103 ◽  
Author(s):  
Branko Srećković ◽  
Ivan Soldatovic ◽  
Emina Colak ◽  
Igor Mrdovic ◽  
Mirjana Sumarac-Dumanovic ◽  
...  

Abstract Background: Abdominal adiposity has a central role in developing insulin resistance (IR) by releasing pro-inflammatory cytokines. Patients with metabolic syndrome (MS) have higher values of homocysteine. Hyperhomocysteinemia correlates with IR, increasing the oxidative stress. Oxidative stress causes endothelial dysfunction, hypertension and atherosclerosis. The objective of the study was to examine the correlation of homocysteine with siMS score and siMS risk score and with other MS co-founding factors. Methods: The study included 69 obese individuals (age over 30, body mass index [BMI] >25 kg/m2), classified into two groups: I-with MS (33 patients); II-without MS (36 patients). Measurements included: anthropometric parameters, lipids, glucose regulation parameters and inflammation parameters. IR was determined by homeostatic model assessment for insulin resistance (HOMA-IR). ATP III classification was applied for diagnosing MS. SiMS score was used as continuous measure of metabolic syndrome. Results: A significant difference between groups was found for C-reactive protein (CRP) (p<0.01) apolipoprotein (Apo) B, HOMA-IR and acidum uricum (p<0.05). siMS risk score showed a positive correlation with homocysteine (p=0.023), while siMS score correlated positively with fibrinogen (p=0.013), CRP and acidum uricum (p=0.000) and homocysteine (p=0.08). Homocysteine correlated positively with ApoB (p=0.036), HbA1c (p=0.047), HOMA-IR (p=0.008) and negatively with ApoE (p=0.042). Conclusions: Correlation of siMS score with homocysteine, fibrinogen, CRP and acidum uricum indicates that they are co-founding factors of MS. siMS risk score correlation with homocysteine indicates that hyperhomocysteinemia increases with age. Hyperhomocysteinemia is linked with genetic factors and family nutritional scheme, increasing the risk for atherosclerosis.


Author(s):  
Bassel Matli ◽  
Andreas Schulz ◽  
Thomas Koeck ◽  
Tanja Falter ◽  
Johannes Lotz ◽  
...  

Abstract Objectives Insulin resistance (IR) is a hallmark of type 2 diabetes mellitus (DM). The homeostatic model assessment of insulin resistance (HOMA-IR) provides an estimate for IR from fasting glucose and insulin serum concentrations. The aim of this study was to obtain a reference interval for HOMA-IR for a specific insulin immunoassay. Methods The Gutenberg Health Study (GHS) is a population-based, prospective, single-center cohort study in Germany with 15,030 participants aged 35–74 years. Fasting glucose, insulin, and C-peptide were available in 10,340 participants. HOMA-IR was calculated in this group and three reference subgroups with increasingly more stringent inclusion criteria. Age- and sex-dependent distributions of HOMA-IR and reference intervals were obtained. In a substudy three insulin assays were compared and HOMA-IR estimated for each assay. Results Among the 10,340 participants analyzed there were 6,590 non-diabetic, 2,901 prediabetic, and 849 diabetic individuals. Median (interquartile range [IQR]) HOMA-IR was 1.54 (1.13/2.19), 2.00 (1.39/2.99), and 4.00 (2.52/6.51), respectively. The most stringently selected reference group consisted of 1,065 persons. Median (IQR) HOMA-IR was 1.09 (0.85/1.42) with no significant difference between men and women. The 97.5th percentile was 2.35. There was a non-significant trend towards higher values with older age. Comparison of three immunoassays for insulin showed an unsatisfactory correlation among the assays and systematic differences in calculated HOMA-IR. Conclusions We present HOMA-IR reference intervals for adults derived by more or less stringent selection criteria for the reference cohort. In addition we show that assay specific reference intervals for HOMA-IR are required.


Sign in / Sign up

Export Citation Format

Share Document