scholarly journals Pregnancy Outcomes and Maternal Insulin Sensitivity: Design and Rationale of a Multi-Center Longitudinal Study in Mother and Offspring (PROMIS)

2021 ◽  
Vol 10 (5) ◽  
pp. 976
Author(s):  
Anoush Kdekian ◽  
Maaike Sietzema ◽  
Sicco A. Scherjon ◽  
Helen Lutgers ◽  
Eline M. van der Beek
Keyword(s):  
Body Composition ◽  
Insulin Sensitivity ◽  
Eating Behavior ◽  
Pregnancy Outcomes ◽  
Tolerance Test ◽  
Overweight And Obesity ◽  
Adverse Outcomes ◽  
Oral Glucose ◽  
Mother And Child ◽  
Body Circumferences

The worldwide prevalence of overweight and obesity in women of reproductive age is rapidly increasing and a risk factor for the development of gestational diabetes (GDM). Excess adipose tissue reduces insulin sensitivity and may underlie adverse outcomes in both mother and child. The present paper describes the rationale and design of the PRegnancy Outcomes and Maternal Insulin Sensitivity (PROMIS) study, an exploratory cohort study to obtain detailed insights in insulin sensitivity and glucose metabolism during pregnancy and its relation to pregnancy outcomes including early infancy growth. We aim to recruit healthy pregnant women with a body mass index (BMI) ≥ 25 kg/m2 before 12 weeks of gestation in Northern Netherlands. A total of 130 woman will be checked on fasted (≤7.0 mmol/L) or random (≤11.0 mmol/L) blood glucose to exclude pregestational diabetes at inclusion. Subjects will be followed up to six months after giving birth, with a total of nine contact moments for data collection. Maternal data include postprandial measures following an oral meal tolerance test (MTT), conducted before 16 weeks and repeated around 24 weeks of gestation, followed by a standard oral glucose tolerance test before 28 weeks of gestation. The MTT is again performed around three months postpartum. Blood analysis is done for baseline and postprandial glucose and insulin, baseline lipid profile and several biomarkers of placental function. In addition, specific body circumferences, skinfold measures, and questionnaires about food intake, eating behavior, physical activity, meal test preference, mental health, and pregnancy complications will be obtained. Fetal data include assessment of growth, examined by sonography at week 28 and 32 of gestation. Neonatal and infant data consist of specific body circumferences, skinfolds, and body composition measurements, as well as questionnaires about eating behavior and complications up to 6 months after birth. The design of the PROMIS study will allow for detailed insights in the metabolic changes in the mother and their possible association with fetal and postnatal infant growth and body composition. We anticipate that the data from this cohort women with an elevated risk for the development of GDM may provide new insights to detect metabolic deviations already in early pregnancy. These data could inspire the development of new interventions that may improve the management of maternal, as well as offsrping complications from already early on in pregnancy with the aim to prevent adverse outcomes for mother and child.

scholarly journals Ethnic Differences in Insulin Action in Obese African-American and Latino Adolescents

2010 ◽  
Vol 95 (8) ◽  
pp. 4048-4051 ◽  
Author(s):  
Rebecca E. Hasson ◽  
Tanja C. Adam ◽  
Jaimie N. Davis ◽  
Marc J. Weigensberg ◽  
Emily E. Ventura ◽  
...  
Keyword(s):  
Body Composition ◽  
African American ◽  
Insulin Sensitivity ◽  
African Americans ◽  
Glucose Tolerance Test ◽  
Insulin Response ◽  
Tolerance Test ◽  
Latino Adolescents ◽  
Oral Glucose ◽  
Glucose Effectiveness

Introduction: African-American children have a greater acute insulin response to iv glucose (AIR) compared with Latino children despite a similar degree of insulin resistance and body composition. It is unclear whether African-Americans demonstrate an exaggerated insulin response to an oral glucose challenge and whether any differences are seen in more obese children in advanced pubertal development. Purpose: Our objective was to compare glucose and insulin indices derived from an oral glucose tolerance test (OGTT) and iv glucose tolerance test (IVGTT) in sedentary, obese African-American (n = 59) and Latino (n = 83) adolescents. Methods: Glucose and insulin incremental area under the curve was measured during an OGTT, and AIR, insulin sensitivity, disposition index, and glucose effectiveness were assessed during an IVGTT. Body composition was assessed via dual-energy x-ray absorptiometry and magnetic resonance imaging. Results: From the OGTT, glucose and insulin IAUC were 29.1 and 22.5% lower (P = 0.01) in African-Americans compared with Latino adolescents. From the IVGTT, insulin sensitivity and glucose effectiveness were 41.7% (P < 0.01) and 50.0% (P = 0.02) lower in African-Americans compared to Latinos. AIR (P = 0.001) and disposition index (P = 0.02) were 63.0 and 48.8% higher in African-Americans, respectively, compared with Latinos. These findings persisted after controlling for body composition and fat distribution. Conclusions: There were marked differences in glucose and insulin indices derived from the OGTT and IVGTT. African-Americans were more insulin resistant as measured by the IVGTT compared with the Latino adolescents. However, the well-described hyperinsulinemia in response to iv glucose was not observed after oral glucose in African-American adolescents.

Changes in insulin sensitivity precede changes in body composition during 14 days of step reduction combined with overfeeding in healthy young men

2012 ◽  
Vol 113 (1) ◽  
pp. 7-15 ◽  
Author(s):  
Sine Haugaard Knudsen ◽  
Louise Seier Hansen ◽  
Maria Pedersen ◽  
Thomas Dejgaard ◽  
Jakob Hansen ◽  
...  
Keyword(s):  
Body Composition ◽  
Body Weight ◽  
Insulin Sensitivity ◽  
Insulin Response ◽  
Tolerance Test ◽  
Whole Body ◽  
Calorie Intake ◽  
Oral Glucose ◽  
Glucose Response ◽  
High Calorie

A lifestyle characterized by inactivity and a high-calorie diet is a known risk factor for impaired insulin sensitivity and development of Type 2 diabetes mellitus. To investigate possible links, nine young healthy men (24 ± 3 yr; body mass index of 21.6 ± 2.5 kg/m2) completed 14 days of step reduction (10,000 to 1,500 steps/day) and overfeeding (+50% kcal). Body composition (dual X-ray absorptiometry, MRI), aerobic fitness (maximal O2 consumption), systemic inflammation and insulin sensitivity [oral glucose tolerance test (OGTT), hyperinsulinemic euglycemic clamp] were assessed before ( day 0), during ( days 3 and 7), and immediately after the intervention ( day 14), with follow-up tests ( day 30). Body weight had increased at days 7 and 14 ( P < 0.05). The amount of visceral fat had increased at day 14 compared with day 0 ( P < 0.05). The insulin response to the OGTT had increased at days 7 and 14 ( P < 0.05). Insulin sensitivity, estimated using the Matsuda index, had decreased at days 3 and 7 ( P < 0.01). At day 14, glucose infusion rates had decreased by ∼44% during the euglycemic clamps ( P < 0.05). Also, plasma levels of leptin and adiponectin had increased ( P < 0.05), whereas no changes were seen in inflammatory markers. At day 30, body weight and whole body adiposity were still elevated compared with day 0 ( P < 0.05), whereas the insulin sensitivity as well as the insulin response to the OGTT did not differ from baseline. The glucose response to the OGTT was only affected at day 30, with a decrease compared with day 0. Our data show that insulin sensitivity was impaired after 3 days of inactivity and overfeeding. Impairments in insulin sensitivity occurred before changes in body composition, supporting the notion that the initial steps in impairment of insulin sensitivity may be linked directly to the effects of inactivity and a high calorie intake.

scholarly journals QOL-43. ENDOCRINE AND METABOLIC CHANGES IN CHILDREN TREATED FOR MEDULLOBLASTOMA

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii439-iii439
Author(s):  
Alexey Kalinin ◽  
Natalia Strebkova ◽  
Olga Zheludkova
Keyword(s):  
Insulin Resistance ◽  
Body Composition ◽  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Impaired Glucose Tolerance ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Hormone Deficiency ◽  
Oral Glucose ◽  
Oral Glucose Tolerance

Abstract We examined 63 patients (40 males/23 females) after complex treatment of medulloblastoma. Patients had a median age (range) of 11.3 (5.5 ÷ 17.9) years. The median time after the end of treatment was 3.7 (1.5 ÷ 11.6) years. Endocrine disorders were detected with the following frequency: growth hormone deficiency - 98.41% (62 of 63 patients), thyroid hormone deficiency – 69.8% (44/63), adrenal hormone deficiency - 17.4% (11/63). Three cases (4.7%) of premature sexual development were also detected. Lipids levels, beta-cell function and insulin resistance (IR) during 2-h oral glucose tolerance test were evaluated. A mono frequent bioelectrical impedanciometer was used to measure body composition. Overweight (SDS BMI&gt; 1) was observed only in 16 patients (3 girls and 13 boys), obesity (SDS BMI&gt; 2) in 1 boy. Dyslipidemia was found in 34 patients (54%). All patients underwent oral glucose tolerance test. Insulin resistance (ISI Matsuda &lt;2.5 and/or HOMA-IR&gt; 3.2) was detected in 7 patients (11/1%), impaired glucose tolerance (120 min glucose ≥7.8 mmol / l) was observed in 2 patients with IR and in 2 patients without IR. At the same time, IR and impaired glucose tolerance were encountered in only 5 children with overweight and no one with obesity. All patients with impaired glucose tolerance had normal values of fasting glucose (4.3 ÷ 5.04 mmol / l) and HbA1c (4.8 ÷ 5.8%). A bioelectrical impedanciometer was used to measure body composition in 49 cases, the percentage of adipose tissue was increased in 14 patients (28%) with normal BMI.

HDL Containing Apolipoprotein C-III is Associated with Insulin Sensitivity: a Multi-Center Cohort Study

2021 ◽  
Author(s):  
Rain Yamamoto ◽  
Majken K Jensen ◽  
Sarah Aroner ◽  
Jeremy D Furtado ◽  
Bernard Rosner ◽  
...  
Keyword(s):  
Cohort Study ◽  
Insulin Sensitivity ◽  
Clinical Investigation ◽  
Biological Effects ◽  
Sandwich Elisa ◽  
Insulin Response ◽  
Protein Composition ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Euglycemic Hyperinsulinemic Clamp

Abstract Context HDL in humans is composed of a heterogeneous group of particles varying in protein composition as well as biological effects. Objective We investigated the prospective associations between HDL subspecies containing and lacking apoC-III at baseline and insulin sensitivity at year 3. Design, Setting, and Participants A prospective cohort study of 864 healthy volunteers drawn from the RISC study, a multi-center European clinical investigation, whose recruitment initiated in 2002 with a follow-up of 3 years. Main Measures Insulin sensitivity was estimated from an oral glucose tolerance test (OGTT) at baseline and year 3, and by euglycemic-hyperinsulinemic clamp at baseline only. The apolipoprotein concentrations were measured at baseline by a sandwich ELISA-based method. Results The two HDL subspecies demonstrated significantly opposite associations with insulin sensitivity at year 3 (p-heterogeneity=0.004). The highest quintile of HDL containing apoC-III was associated with a 1.2% reduction in insulin sensitivity (p-trend=0.02), while the highest quintile of HDL lacking apoC-III was associated with a 1.3% increase (p-trend=0.01), compared to the lowest quintile. No significant association was observed for total HDL, and VLDL and LDL containing apoC-III. ApoC-III contained in HDL was associated with a decrease in insulin sensitivity even more strongly than plasma total apoC-III. Conclusion Both HDL containing apoC-III and apoC-III in HDL adversely affect the beneficial properties of HDL on insulin response to glucose. Our results support the potential of HDL-associated apoC-III as a promising target for diabetes prevention and treatment.

scholarly journals Insulin sensitivity obtained from the oral glucose tolerance test and its relationship with birthweight

2007 ◽  
Vol 27 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Yıldız Dallar ◽  
Dilek Dilli ◽  
Ilknur Bostancı ◽  
Elmas Öğüş ◽  
Şeyda Doğankoç ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance

Prevalence of Hypoglycemia Following Pre-exercise Carbohydrate Ingestion Is Not Accompanied by Higher Insulin Sensitivity

2002 ◽  
Vol 12 (4) ◽  
pp. 398-413 ◽  
Author(s):  
Roy L.P.G. Jentjens ◽  
Asker E. Jeukendrup
Keyword(s):  
Insulin Sensitivity ◽  
Plasma Glucose ◽  
Glucose Tolerance Test ◽  
Time Trial ◽  
Tolerance Test ◽  
Cycle Ergometer ◽  
Submaximal Exercise ◽  
Oral Glucose ◽  
Carbohydrate Ingestion ◽  
Carbohydrate Feeding

Pre-exercise carbohydrate feeding may result in rebound hypoglycemia in some but not all athletes. The aim of the present study was to examine whether insulin sensitivity in athletes who develop rebound hypoglycemia is higher compared with those who do not show rebound hypoglycemia. Twenty trained athletes (V̇O2max of 61.8 ± 1.4 ml · kg−1 · min−1) performed an exercise trial on a cycle ergometer. Forty-five minutes before the start of exercise, subjects consumed 500 ml of a beverage containing 75 g of glucose. The exercise trial consisted of · 20 min of submaximal exercise at 74 ± 1% V̇O2max immediately followed by a time trial. Based upon the plasma glucose nadir reached during submaximal exercise, subjects were assigned to a Hypo group (<3.5 mmol/L) and a Non-hypo group (≥3.5 mmol/L). An oral glucose tolerance test was performed to obtain an index of insulin sensitivity (ISI). The plasma glucose nadir during submaximal exercise was significantly lower (p < .01) in the Hypo-group (n = 10) compared with the Non-hypo group (n = 10) (2.7 ± 0.1 vs. 4.1 ± 0.2 mmol/L, respectively). No difference was found in ISI between the Hypo and the Non-hypo group (3.7 ± 0.4 vs. 3.8 ± 0.5, respectively). The present results suggest that insulin sensitivity does not play an important role in the occurrence of rebound hypoglycemia.

Comparison of insulin sensitivity indices properties calculated from OGTT

Open Medicine ◽  
2011 ◽  
Vol 6 (5) ◽  
pp. 567-574 ◽  
Author(s):  
Jana Chrenova ◽  
Zuzana Rausova ◽  
Adela Penesova ◽  
Ladislav Dedik
Keyword(s):  
Insulin Sensitivity ◽  
Glucose Tolerance Test ◽  
Statistical Significance ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Individual Subject ◽  
Sensitivity Indices ◽  
Continuous Scale ◽  
Selection Of

AbstractThe aim of this study was to present the properties of insulin sensitivity indices formulas to justify selection of formulas to evaluate of insulin sensitivity for calculation from an oral glucose tolerance test (OGTT) data. Twelve of the most applicable formulae for ISI calculation were analyzed in the view of two sets of results: 1) point contrasts, calculated as the ratio of average ISI values in lean and obese groups of patients; and 2) interval contrasts, calculated as ratios of T from the two-sided t-test, evaluated as dimensionless, mutually comparable contrasts within a continuous scale. Statistical significance of individual ISIs in terms of their contrasts was evaluated by two-sided t-tests. P<0.001 was a considered statistically significance between a group of 59 healthy volunteers with BMI<25 kg/m2 and a group of 63 volunteers with BMI≥25 kg/m2 who underwent frequent OGTT sampling. To compare data of an individual subject with the standard, we recommend selecting the formulas with a high point contrast. To compare of data of several subject groups, we recommend using the formulas with a high interval contrast.

Effect of Iron Chelation Therapy on Glucose Metabolism in Non-Transfusion-Dependent Thalassaemia

2016 ◽  
Vol 137 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Ampaiwan Chuansumrit ◽  
Pimprae Pengpis ◽  
Pat Mahachoklertwattana ◽  
Nongnuch Sirachainan ◽  
Preamrudee Poomthavorn ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Serum Ferritin ◽  
Cell Function ◽  
Iron Status ◽  
Iron Chelation ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Β Cell ◽  
Iron Load ◽  
Β Cell Function

Aims: To compare insulin sensitivity, β-cell function and iron status biomarkers in non-transfusion-dependent thalassaemia (NTDT) with iron excess during pre- and post-iron chelation. Methods: Subjects with NTDT, aged older than 10 years, with serum ferritin >300 ng/ml, were included. Iron chelation with deferasirox (10 mg/kg/day) was prescribed daily for 6 months. Results: Ten patients with a median age of 17.4 years were enrolled. The comparison between pre- and post-chelation demonstrated significantly lower iron load: median serum ferritin (551.4 vs. 486.2 ng/ml, p = 0.047), median TIBC (211.5 vs. 233.5 µg/dl, p = 0.009) and median non-transferrin binding iron (5.5 vs. 1.4 µM, p = 0.005). All patients had a normal oral glucose tolerance test (OGTT) both pre- and post-chelation. However, fasting plasma glucose was significantly reduced after iron chelation (85.0 vs.79.5 mg/dl, p = 0.047). MRI revealed no significant changes of iron accumulation in the heart and liver after chelation, but there was a significantly lower iron load in the pancreas, assessed by higher T2* at post-chelation compared with pre-chelation (41.9 vs. 36.7 ms, p = 0.047). No adverse events were detected. Conclusions: A trend towards improving insulin sensitivity and β-cell function as well as a reduced pancreatic iron load was observed following 6 months of iron chelation (TCTR20160523003).

scholarly journals Association between Timing of Energy Intake and Insulin Sensitivity: A Cross-Sectional Study

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 503
Author(s):  
Vittobai Rashika Rangaraj ◽  
Alankrita Siddula ◽  
Helen J. Burgess ◽  
Silvana Pannain ◽  
Kristen L. Knutson
Keyword(s):  
Insulin Sensitivity ◽  
Total Energy ◽  
Energy Intake ◽  
Tolerance Test ◽  
Cross Sectional Study ◽  
Oral Glucose ◽  
Food Diary ◽  
Cross Sectional ◽  
Carbohydrate Consumption ◽  
Matsuda Index

In addition to the caloric and macronutrient composition of meals, timing of energy consumption may be important for optimal glucose metabolism. Our goal was to examine whether the habitual timing of energy intake was associated with insulin sensitivity in healthy volunteers. Volunteers without diabetes aged 21–50 years completed a 3-day food diary and underwent an oral glucose tolerance test to estimate insulin sensitivity (n = 44). From the food diary, we calculated the proportions of the total energy and macronutrients consumed in the morning and evening, and the clock time at which 25%, 50% and 75% of total energy was consumed. A greater proportion of energy intake in the morning was significantly associated with higher insulin sensitivity estimated by Matsuda Index (B = 2.8 per 10%; 95%CI: 0.3, 5.2). The time at which 25% of energy was consumed was associated with insulin sensitivity estimated by Matsuda Index (B = −1.6 per hour; 95%CI: −3.0, −0.3) and QUICKI (B = −1.4 per hour, 95%CI: −2.8, −0.1). The timing of carbohydrate consumption demonstrated similar associations. Greater energy intake earlier in the day was associated with higher insulin sensitivity in individuals without diabetes.

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