Angiotensin Receptor Blocker Telmisartan Improves Insulin Sensitivity in Peritoneal Dialysis Patients

2010 ◽  
Vol 30 (1) ◽  
pp. 66-71 ◽  
Author(s):  
Antonio Cioni ◽  
Caterina Sordini ◽  
Ivo Cavallini ◽  
Roberto Bigazzi ◽  
Vito M. Campese
Keyword(s):  
Peritoneal Dialysis ◽  
Insulin Sensitivity ◽  
Antihypertensive Drugs ◽  
Serum Insulin ◽  
Assessment Method ◽  
Model Assessment ◽  
Angiotensin Receptor ◽  
Improve Insulin Sensitivity ◽  
Insulin Levels

BackgroundInsulin resistance (IR) is common among patients on dialysis and is worse among patients on peritoneal dialysis (PD) than among patients on hemodialysis. In this study we tested the hypothesis that administration of telmisartan, an angiotensin II type 1 receptor antagonist, might improve insulin sensitivity in patients on PD.MethodThis was a crossover study of 30 nondiabetic patients with end-stage renal disease being treated with PD. Group A patients ( n = 15) received telmisartan and other antihypertensive drugs for 4 months, followed by 4 months without telmisartan. Group B patients ( n = 15) received their usual treatment for 4 months, followed by 4 months of treatment with telmisartan. Blood glucose and serum insulin levels were monitored and homeostasis model assessment method for IR (HOMA-IR) was calculated.ResultsTreatment with telmisartan had no significant impact on serum glucose, potassium, and bicarbonate levels. However, telmisartan significantly reduced serum insulin levels and the HOMA index in groups A and B.ConclusionThis study demonstrated that telmisartan, an angiotensin receptor type 1 antagonist, may effectively improve insulin sensitivity as measured by HOMA in patients treated with PD.

scholarly journals Insulin Resistance Induced by Maximal Exercise Correlates With a Post-Exercise Increase in Uridine Concentration in the Blood of Healthy Young Men

2013 ◽  
pp. 163-170 ◽  
Author(s):  
W. DUDZINSKA ◽  
A. LUBKOWSKA ◽  
K. JAKUBOWSKA ◽  
M. SUSKA ◽  
E. SKOTNICKA
Keyword(s):  
Insulin Resistance ◽  
Insulin Sensitivity ◽  
Healthy Subjects ◽  
Maximal Exercise ◽  
Serum Insulin ◽  
Model Assessment ◽  
Post Exercise ◽  
Insulin Levels ◽  
Exercise Induced ◽  
The Impact

Uridine is postulated to participate in the development of insulin resistance. Since exercise is an effective tool in the treatment of insulin resistance it appeared justified to assess the impact of maximal exercise on plasma uridine and insulin sensitivity indices (e.g. insulin and HOMA-IR) in healthy subjects. The study included forty-four healthy males (18.5±2.92 years, VO2max 50.2±6.26 ml kg-1 min-1). Subjects performed a single maximal exercise on a bicycle ergometer. Blood samples were taken three times: immediately before exercise, immediately after exercise and at the 30th min of rest. Uridine concentrations were determined in the whole blood using high-performance liquid chromatography. Serum insulin levels were measured by a specific ELISA method. Insulin sensitivity was assessed by homeostasis model assessment method (HOMA-IR). A maximal exercise-induced increase in the concentration of uridine correlated with post-exercise increases in insulin levels and HOMA-IR. Our results indicate a relationship between the concentration of uridine in the blood and indicators of insulin sensitivity in healthy subjects. We are the first to demonstrate that a maximal exercise-induced increase in the concentration of uridine is correlated with post-exercise increases in insulin levels and HOMA-IR in healthy subjects. It appears that uridine may be an indicator of insulin resistance.

scholarly journals Leptin Levels, β-Cell Function, and Insulin Sensitivity in Families with Congenital and Acquired Generalized Lipoatropic Diabetes1

1998 ◽  
Vol 83 (2) ◽  
pp. 503-508
Author(s):  
Victor C. Pardini ◽  
Ivana M. N. Victória ◽  
Selma M. V. Rocha ◽  
Danielle G. Andrade ◽  
Aline M. Rocha ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Temporal Relationship ◽  
Cell Function ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Β Cell ◽  
Insulin Levels ◽  
Β Cell Function ◽  
Plasma Leptin ◽  
Specific Insulin

Lipoatropic diabetes (LD) designates a group of syndromes characterized by diabetes mellitus with marked insulin resistance and either a localized or generalized absence of adipose tissue. In this study, we evaluated plasma leptin levels in subjects with congenital generalized lipoatropic diabetes (CGLD, n = 11) or acquired generalized lipoatropic diabetes (AGLD, n = 11), and assessed correlations between leptin levels and estimations of insulin secretion and insulin sensitivity using homeostasis model assessment (HOMA). Leptin levels were 0.86 ± 0.32, 1.76 ± 0.78, and 6.9 ± 4.4 ng/mL in subjects with CGLD, AGLD, and controls (n = 19), respectively (ANOVA P < 0.0001). Specific insulin levels were 154 ± 172, 177 ± 137 and 43 ± 22 pmol/L, respectively (P < 0.0001). Insulin sensitivity was significantly decreased in both groups with LD (P< 0.0001), whereas HOMA β-cell function was not significantly different when compared with controls. Leptin levels were significantly correlated with body mass index, insulin levels, and HOMA β-cell function, and inversely correlated with insulin sensitivity in control subjects but not in subjects with generalized LD. In conclusion, decreased leptin levels were observed in subjects with generalized LD, with a trend towards lower levels in the acquired than in the congenital form (P = 0.06). The temporal relationship between the decrease in leptin levels and the development of lipoatrophy should be investigated in at-risk young relatives of subjects with the acquired forms to assess the usefulness of leptin levels as a marker of lipoatrophy.

Influence of assay-dependent variability of serum insulin levels on insulin sensitivity indices

2008 ◽  
Vol 46 (11) ◽  
Author(s):  
Dana Borza ◽  
Rafik Karmali ◽  
Stéphanie André ◽  
Joseph Valsamis ◽  
Ephraim Cytryn ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Serum Insulin ◽  
Insulin Levels ◽  
Sensitivity Indices

scholarly journals Serum Insulin Bioassay Reflects Insulin Sensitivity and Requirements in Type 1 Diabetes

2017 ◽  
Vol 102 (10) ◽  
pp. 3814-3821 ◽  
Author(s):  
Joseph A M J L Janssen ◽  
Gemma Llauradó ◽  
Aimee J Varewijck ◽  
Per-Henrik Groop ◽  
Carol Forsblom ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 1 Diabetes ◽  
Insulin Sensitivity ◽  
Serum Insulin ◽  
Glycosylated Hemoglobin ◽  
Insulin Dose ◽  
Biologically Active ◽  
Insulin Analogs ◽  
Insulin Requirements

Abstract Context Insulin resistance could increase insulin requirements in type 1 diabetes (T1D). Current insulin immunoassays do not detect insulin analogs. Kinase insulin receptor (IR) activation (KIRA) bioassays specific for human IR isoforms A (IR-A) and B (IR-B) permit assessment of all circulating insulin bioactivity. We studied whether IR-A and IR-B KIRA assays are related to direct measures of insulin sensitivity or insulin doses in T1D. Design We evaluated 31 adult patients with T1D (age 45.7 ± 1.6 years, body mass index 28.8 ± 0.7 kg/m2). Serum IR-A and IR-B bioactivities were measured by KIRA bioassays. Insulin sensitivity of glucose production (Ra) was measured by the euglycemic hyperinsulinemic clamp technique in which a low insulin dose (0.4 mU/kg/min for 240 minutes) was combined with D-[3-3H] glucose infusion to measure rates of Ra and utilization and insulin action on antilipolysis from suppression of serum free fatty acids. Results Baseline circulating IR-A bioactivity was 53 ± 7 pmol/L, and IR-B bioactivity was 81 ± 11 pmol/L. Compared with baseline, insulin infusion significantly increased IR-A (P < 0.001) and IR-B (P < 0.001) bioactivities. Fasting IR-A and IR-B bioactivities were positively related to endogenous Ra (r = 0.44, P = 0.01 and r = 0.38, P < 0.05). Fasting IR-A (r = 0.43, P = 0.02) and IR-B (r = 0.47, P = 0.01) bioactivities were significantly correlated with insulin requirements and glycosylated hemoglobin (IR-A: r = 0.52, P = 0.002; IR-B: r = 0.48, P = 0.006). Conclusions Circulating IR-A and IR-B bioactivities are associated with insulin resistance, high insulin requirements, and poor glycemic control in T1D. Measurement of IR bioactivity by KIRA assays provides a tool to assess the amount of biologically active insulin in groups of T1D patients treated with insulin analogs.

Angiotensin II type 1 receptor blockers improve insulin sensitivity in patients with schizophrenia being treated with olanzapine

2010 ◽  
Vol 213 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Hakuei Yamashita ◽  
Hiroo Yoda ◽  
Noriomi Kuroki ◽  
Michiko Kuwabara ◽  
Yuji Odagaki ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Angiotensin Ii ◽  
Improve Insulin Sensitivity ◽  
Receptor Blockers

scholarly journals 24-h severe energy restriction impairs postprandial glycaemic control in young, lean males

2018 ◽  
Vol 120 (10) ◽  
pp. 1107-1116 ◽  
Author(s):  
David J. Clayton ◽  
Jack Biddle ◽  
Tyler Maher ◽  
Mark P. Funnell ◽  
Jack A. Sargeant ◽  
...  
Keyword(s):  
Weight Loss ◽  
Insulin Sensitivity ◽  
Glycaemic Control ◽  
Dietary Intervention ◽  
Serum Insulin ◽  
Serum Glucose ◽  
Energy Restriction ◽  
Fibroblast Growth Factor 21 ◽  
Oral Glucose ◽  
Model Assessment

AbstractIntermittent energy restriction (IER) involves short periods of severe energy restriction interspersed with periods of adequate energy intake, and can induce weight loss. Insulin sensitivity is impaired by short-term, complete energy restriction, but the effects of IER are not well known. In randomised order, fourteen lean men (age: 25 (sd 4) years; BMI: 24 (sd 2) kg/m2; body fat: 17 (4) %) consumed 24-h diets providing 100 % (10 441 (sd 812) kJ; energy balance (EB)) or 25 % (2622 (sd 204) kJ; energy restriction (ER)) of estimated energy requirements, followed by an oral glucose tolerance test (OGTT; 75 g of glucose drink) after fasting overnight. Plasma/serum glucose, insulin, NEFA, glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP) and fibroblast growth factor 21 (FGF21) were assessed before and after (0 h) each 24-h dietary intervention, and throughout the 2-h OGTT. Homoeostatic model assessment of insulin resistance (HOMA2-IR) assessed the fasted response and incremental AUC (iAUC) or total AUC (tAUC) were calculated during the OGTT. At 0 h, HOMA2-IR was 23 % lower after ER compared with EB (P<0·05). During the OGTT, serum glucose iAUC (P<0·001), serum insulin iAUC (P<0·05) and plasma NEFA tAUC (P<0·01) were greater during ER, but GLP-1 (P=0·161), GIP (P=0·473) and FGF21 (P=0·497) tAUC were similar between trials. These results demonstrate that severe energy restriction acutely impairs postprandial glycaemic control in lean men, despite reducing HOMA2-IR. Chronic intervention studies are required to elucidate the long-term effects of IER on indices of insulin sensitivity, particularly in the absence of weight loss.

scholarly journals Evaluation of insulin resistance in a cohort of HIV-infected youth

2007 ◽  
Vol 157 (5) ◽  
pp. 655-659 ◽  
Author(s):  
Raffaella Rosso ◽  
Arianna Parodi ◽  
Giuseppe d'Annunzio ◽  
Francesca Ginocchio ◽  
Laura Nicolini ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Young Adults ◽  
Antiretroviral Therapy ◽  
Serum Insulin ◽  
Targeted Prevention ◽  
Healthy Children ◽  
Model Assessment ◽  
Insulin Levels ◽  
Children And Young Adults

AbstractObjectiveMetabolic abnormalities, including impairment of glucose homeostasis, have been well characterized in HIV-infected patients. In contrast to adults, insulin resistance and diabetes mellitus appear to be relatively uncommon finding in youth.DesignWe assessed insulin resistance, and associated risk factors, in a population of vertically HIV-infected children and young adults, when compared with a control population of healthy children.MethodsAt the time of enrolment, weeks of pregnancy, birth weight, sex, age, weight, height, body mass index (BMI), pubertal stages, CDC classification, blood pressure, clinical lipodystrophy, hepatitis B or C co-infection, antiretroviral therapy, CD4 T lymphocyte counts, and HIV-RNA levels were recorded. Fasting plasma glucose and insulin levels and homeostatic model assessment-insulin resistance (HOMA-IR) were determined. These parameters were compared between HIV patients and healthy controls with multivariate analyses.ResultsFasting insulin levels (OR=1.21, P<0.001) and glycemia (OR=0.89, P<0.001) were significantly different between HIV-infected patients and controls. Antiretroviral therapy duration (r=0.281, P<0.05), triglyceride levels (r=0.286, P<0.05), age (r=0.299, P<0.05), and BMI SDS (r=0.485, P<0.001) were significant predictor variables of insulin resistance, expressed as HOMA-IR. Moreover, clinical lipodystrophy seems to be strongly correlated to glycemia (P<0.05), triglyceride levels (P<0.05), serum insulin levels (P<0.001), HOMA-IR (P<0.05), and also with therapy duration (P<0.05).ConclusionsBoth HIV infection and antiretroviral therapy demonstrate differential effects on glucose metabolism in HIV-infected children. Targeted prevention of insulin resistance and diabetes mellitus in HIV-infected children and young adults is needed in order to avoid the associated long-term complications that would otherwise occur, given the improvement in life expectancy of HIV-infected individuals.

Taiwanese vegetarians have higher insulin sensitivity than omnivores

2006 ◽  
Vol 95 (1) ◽  
pp. 129-135 ◽  
Author(s):  
Chien-Jung Hung ◽  
Po-Chao Huang ◽  
Yi-Hwei Li ◽  
Shao-Chun Lu ◽  
Low-Tone Ho ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Insulin Sensitivity ◽  
Cell Function ◽  
Assessment Method ◽  
Thyroid Stimulating Hormone ◽  
Blood Levels ◽  
Model Assessment ◽  
Dietary Intakes ◽  
Β Cell Function ◽  
High Insulin

The present study was designed to examine the effects of habitual consumption of Taiwanese vegetarian diets on hormonal secretion, and on lipid and glycaemic control. Of the ninety-eight healthy female adults recruited from Hualien, Taiwan (aged 31–45 years), forty-nine were Buddhist lactovegetarians and forty-nine were omnivores. Dietary intakes were measured, and blood levels of nutrients and hormones were analysed. Vegetarians consumed less energy, fat and protein, but more fibre than the omnivores. Compared with the omnivores, the vegetarians had, on average, lower BMI and smaller waist circumference. Except for slightly lower levels of thyroxine (T4) in vegetarians, vegetarians and omnivores both showed similar levels of triiodothyronine (T3), free T4, thyroid-stimulating hormone, T3:T4 ratio and cortisol. Compared with the omnivores, the vegetarians had significantly lower levels of fasting insulin (median: 35·3 v. 50·6pmol/l) and plasma glucose (mean: 4·7 (se 0·05) v. 4·9 (se 0·05) mmol/l). Insulin resistance, as calculated by the homeostasis model assessment method, was significantly lower in the vegetarians than in the omnivores (median: 1·10 v. 1·56), while β-cell function was not different between the two groups. BMI and diet were both independent predictors for insulin resistance, and contributed 18 and 15% of the variation in insulin resistance, respectively. In conclusion, Taiwanese vegetarians had lower glucose and insulin levels and higher insulin sensitivity than did the omnivores. Diet and lower BMI were partially responsible for the high insulin sensitivity observed in young Taiwanese vegetarians.

scholarly journals Relationship Between Serum Testosterone, Leptin,Interleukin-6 (il-6) Level and Insulin Sensitivity in Non-obese and Obese Male Subjects in Magway Region, Myanmar

2021 ◽  
Vol 2 (2) ◽  
pp. 9
Author(s):  
Mya Thanda Sein ◽  
Zarchi Theint-Theint Hlaing ◽  
Thurein - Zaw ◽  
Yin Thu Theint ◽  
Soe Minn Htway
Keyword(s):  
Insulin Sensitivity ◽  
Serum Insulin ◽  
Serum Testosterone ◽  
Obese Group ◽  
Serum Testosterone Level ◽  
Model Assessment ◽  
Serum Leptin ◽  
Homeostatic Model Assessment ◽  
The Relationship ◽  
Male Subjects

Objective: To determine the relationship between insulin resistance and related variables (serum testosterone, interleukin (IL-6) and leptin level) in obese and non-obese healthy subjects. Methods: Community-based crosssectional, analytic study was undertaken in 60 subjects for each obese group (BMI ≥ 30.0 kg/m2) and non-obese group (BMI 18.5 to 24.9 kg/m2) (age;18-45 years) residing in Magway Township from December 2016 to December 2017. Serum insulin, testosterone, IL-6 and leptin levels were measured by enzyme linked immunoassay, and serum fasting glucose was measured by glucose oxidase method. Insulin sensitivity was calculated by HOMA formula (Homeostatic Model Assessment). Results:HOMA-IR, serum leptin and IL-6 level were significantly higher in obese group while serum testosterone level was significantly lower in obese group. There was a significantly correlation between HOMA-IR with leptin (r=0.306, p=0.001), IL-6 (r=0.237, p=0.009) and testosterone (r=-0.209,p=0.02). Moreover, serum leptin was significantly and positively correlated with IL-6 (r=0.391, p<0.001) while serum testosterone was significantly and negatively correlated with leptin (r=-0.408, p<0.001), and IL-6 (r=-0.34, p<0.001).Conclusions:Obese men are more likely to have low testosterone, high inflammatory markers leptin and Il-6, which were associated with decreased insulin sensitivity. 

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