The Role of Metabolic Factors in Renal Cancers

An increasing number of evidence indicates that metabolic factors may play an important role in the development and progression of certain types of cancers, including renal cell carcinoma (RCC). This tumour is the most common kidney cancer which accounts for approximately 3–5% of malignant tumours in adults. Numerous studies indicated that concomitant diseases, including diabetes mellitus (DM) and hypertension, as well as obesity, insulin resistance, and lipid disorders, may also influence the prognosis and cancer-specific overall survival. However, the results of studies concerning the impact of metabolic factors on RCC are controversial. It appears that obesity increases the risk of RCC development; however, it may be a favourable factor in terms of prognosis. Obesity is closely related to insulin resistance and the development of diabetes mellitus type 2 (DM2T) since the adipocytes in visceral tissue secrete substances responsible for insulin resistance, e.g., free fatty acids. Interactions between insulin and insulin-like growth factor (IGF) system appear to be of key importance in the development and progression of RCC; however, the exact role of insulin and IGFs in RCC pathophysiology remains elusive. Studies indicated that diabetes increased the risk of RCC, but it might not alter cancer-related survival. The risk associated with a lipid profile is most mysterious, as numerous studies provided conflicting results. Even though large studies unravelling pathomechanisms involved in cancer growth are required to finally establish the impact of metabolic factors on the development, progression, and prognosis of renal cancers, it seems that the monitoring of health conditions, such as diabetes, low body mass index (BMI), and lipid disorders is of high importance in clear-cell RCC.

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Insulin resistance and chronic hepatitis C

Terapevticheskii arkhiv ◽

10.17116/terarkh2016881129-36 ◽

2016 ◽

Vol 88 (11) ◽

pp. 29-36

Author(s):

L I Tkachenko ◽

V V Maleev

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Comparison Group ◽

The Impact

Aim. To estimate the spread of insulin resistance (IR) in patients with chronic hepatitis C (CHC) and to define the role of IR in the development of hepatic steatosis (HS) and in the progression of liver fibrosis (LF), as well as the impact of IR on the results of antiviral therapy (AVT). Subjects and methods. A total of 211 patients with CHC were examined. A comparison group consisted of 75 patients with chronic hepatitis B (CHB). The patients were divided according to the presence and absence of IR and type 2 diabetes mellitus (DM). IR was analyzed in patients with CHC with a body mass index (BMI) of

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Magnesium, Little Known But Possibly Relevant: A Link between NASH and Related Comorbidities

Biomedicines ◽

10.3390/biomedicines9020125 ◽

2021 ◽

Vol 9 (2) ◽

pp. 125

Author(s):

Jorge Simón ◽

Teresa Cardoso Delgado ◽

Luis Alfonso Martinez-Cruz ◽

Maria Luz Martínez-Chantar

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Inflammatory Process ◽

Fibrotic Response ◽

Hepatic Lipid Accumulation ◽

Root Cause ◽

Worldwide Population ◽

Global Health Problem

Non-alcoholic steatohepatitis (NASH) is characterized by an abnormal hepatic lipid accumulation accompanied by a necro-inflammatory process and a fibrotic response. It comprises from 10% to 30% of cases of patients with non-alcoholic liver disease, which is a global health problem affecting around a quarter of the worldwide population. Nevertheless, the development of NASH is often surrounded by a pathological context with other comorbidities, such as cardiovascular diseases, obesity, insulin resistance or type 2 diabetes mellitus. Dietary imbalances are increasingly recognized as the root cause of these NASH-related comorbidities. In this context, a growing concern exists about whether magnesium consumption in the general population is sufficient. Hypomagnesemia is a hallmark of the aforementioned NASH comorbidities, and deficiencies in magnesium are also widely related to the triggering of complications that aggravate NASH or derived pathologies. Moreover, the supplementation of this cation has proved to reduce mortality from hepatic complications. In the present review, the role of magnesium in NASH and related comorbidities has been characterized, unraveling the relevance of maintaining the homeostasis of this cation for the correct functioning of the organism.

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The evaluation of the role of BMI and insulin resistance on inflammatory markers, PAI-1 levels and arterial stiffness in newly diagnosed type 2 diabetes mellitus patients

Minerva Endocrinology ◽

10.23736/s2724-6507.20.03158-2 ◽

2021 ◽

Vol 46 (1) ◽

Author(s):

Nizameddin KOCA ◽

Koray AYAR ◽

Öznur BAL ◽

Canan ERSOY

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Arterial Stiffness ◽

Inflammatory Markers ◽

Newly Diagnosed ◽

Pai 1

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Predictors of Insulin Resistance in Obesity and Type 2 Diabetes Mellitus - The Role of Magnesium

Journal of Metabolic Syndrome ◽

10.4172/2167-0943.1000235 ◽

2017 ◽

Vol 06 (04) ◽

Cited By ~ 1

Author(s):

Soetkin Milbouw ◽

Julie Verhaegen ◽

An Verrijken ◽

Benedicte Y De Winter ◽

Luc F Van Gaal ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus

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Insulin Resistance and Atherosclerosis: Implications for Insulin-Sensitizing Agents

Endocrine Reviews ◽

10.1210/er.2018-00141 ◽

2019 ◽

Vol 40 (6) ◽

pp. 1447-1467 ◽

Cited By ~ 19

Author(s):

Antonino Di Pino ◽

Ralph A DeFronzo

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Insulin Resistance ◽

High Risk ◽

Cardiometabolic Risk ◽

Considerable Evidence ◽

Risk Patients ◽

Cv Disease ◽

The Impact

Abstract Patients with type 2 diabetes mellitus (T2DM) are at high risk for macrovascular complications, which represent the major cause of mortality. Despite effective treatment of established cardiovascular (CV) risk factors (dyslipidemia, hypertension, procoagulant state), there remains a significant amount of unexplained CV risk. Insulin resistance is associated with a cluster of cardiometabolic risk factors known collectively as the insulin resistance (metabolic) syndrome (IRS). Considerable evidence, reviewed herein, suggests that insulin resistance and the IRS contribute to this unexplained CV risk in patients with T2DM. Accordingly, CV outcome trials with pioglitazone have demonstrated that this insulin-sensitizing thiazolidinedione reduces CV events in high-risk patients with T2DM. In this review the roles of insulin resistance and the IRS in the development of atherosclerotic CV disease and the impact of the insulin-sensitizing agents and of other antihyperglycemic medications on CV outcomes are discussed.

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Dysmetabolic Syndrome in a Man with a Novel Mutation of the Aromatase Gene: Effects of Testosterone, Alendronate, and Estradiol Treatment

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2003-030313 ◽

2004 ◽

Vol 89 (1) ◽

pp. 61-70 ◽

Cited By ~ 227

Author(s):

Laura Maffei ◽

Yoko Murata ◽

Vincenzo Rochira ◽

Gloria Tubert ◽

Claudio Aranda ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Diabetes Mellitus Type 2 ◽

Acanthosis Nigricans ◽

Diabetes Mellitus Type ◽

Bone Maturation ◽

Bilateral Cryptorchidism ◽

High Doses

We present the fourth case of an adult man (29 yr old) affected by aromatase deficiency resulting from a novel homozygous inactivating mutation of the CYP19 (P450arom) gene. At first observation, continuing linear growth, eunuchoid body proportions, diffuse bone pain, and bilateral cryptorchidism were observed. The patient presented also a complex dysmetabolic syndrome characterized by insulin resistance, diabetes mellitus type 2, acanthosis nigricans, liver steatohepatitis, and signs of precocious atherogenesis. The analysis of the effects induced by the successive treatment with high doses of testosterone, alendronate, and estradiol allows further insight into the roles of androgens and estrogens on several metabolic functions. High doses of testosterone treatment resulted in a severe imbalance in the estradiol to testosterone ratio together with the occurrence of insulin resistance and diabetes mellitus type 2. Estrogen treatment resulted in an improvement of acanthosis nigricans, insulin resistance, and liver steatohepatitis, coupled with a better glycemic control and the disappearance of two carotid plaques. Furthermore, the study confirms previous data concerning the key role of estrogens on male bone maturation, at least in part, and regulation of gonadotropin secretion. The biopsy of the testis showed a pattern of total germ cell depletion that might be due to the concomitant presence of bilateral cryptorchidism. Thus, a possible role of estrogen in male reproductive function is suggested but without revealing a direct cause-effect relationship. Data from this case provide new insights into the role of estrogens in glucose, lipid, and liver metabolism in men. This new case of aromatase deficiency confirms previous data on bone maturation and mineralization, and it reveals a high risk for the precocious development of cardiovascular disease in young aromatase-deficient men.

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