scholarly journals Optimal Waist Circumference Cutoff Value Based on Insulin Resistance and Visceral Obesity in Koreans with Type 2 Diabetes

2015 ◽  
Vol 39 (3) ◽  
pp. 253 ◽  
Author(s):  
Jung Soo Lim ◽  
Young Ju Choi ◽  
Soo-Kyung Kim ◽  
Byoung Wook Huh ◽  
Eun Jig Lee ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Waist Circumference ◽  
Visceral Obesity ◽  
Cutoff Value

scholarly journals The effects of metformin plus sulfonylurea therapy on clinical features of the metabolic syndrome

2010 ◽  
Vol 63 (9-10) ◽  
pp. 611-615 ◽  
Author(s):  
Branka Koprivica ◽  
Teodora Beljic-Zivkovic ◽  
Tatjana Ille
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Body Mass Index ◽  
Waist Circumference ◽  
Glycemic Control ◽  
Body Mass ◽  
Combined Therapy

Introduction. Insulin resistance is a well-known leading factor in the development of metabolic syndrome. The aim of this study was to evaluate metabolic effects of metformin added to sulfonylurea in unsuccessfully treated type 2 diabetic patients with metabolic syndrome. Material and methods. A group of thirty subjects, with type 2 diabetes, secondary sulfonylurea failure and metabolic syndrome were administered the combined therapy of sulfonylurea plus metformin for six months. Metformin 2000 mg/d was added to previously used sulfonylurea agent in maximum daily dose. Antihypertensive and hypolipemic therapy was not changed. The following parameters were assessed at the beginning and after six months of therapy: glycemic control, body mass index, waist circumference, blood pressure, triglycerides, total cholesterol and its fractions, homeostatic models for evaluation of insulin resistance and secretion (HOMA R, HOMA B) and C- peptide. Results. Glycemic control was significantly improved after six months of the combined therapy: (fasting 7.89 vs. 10.61 mmol/l. p<0.01; postprandial 11.12 vs. 12.61 mmol/l. p<0.01, p<0.01; glycosylated hemoglobin 6.81 vs. 8.83%. p<0.01). the body mass index and waist circumference were significantly lower (26.7 vs. 27.8 kg/m2, p<0.01 and 99.7 vs. 101.4 cm for men, p<0.01; 87.2 vs. 88.5 for women, p<0.01). Fasting plasma triglycerides decreased from 3.37 to 2.45 mmol/l (p<0.001) and HOMA R from 7.04 to 5.23 (p<0.001). No treatment effects were observed on blood pressure, cholesterol, and residual insulin secretion. Conclusion. Administration of metformin in type 2 diabetes with metabolic syndrome decreased cardiovascular risk factors by reducing glycemia, triglycerides, BMI, central obesity and insulin resistance.

scholarly journals Proinsulin to insulin ratio is associated with incident type 2 diabetes but not with vascular complications in the KORA F4/FF4 study

2020 ◽  
Vol 8 (1) ◽  
pp. e001425
Author(s):  
Cornelia Then ◽  
Christina Gar ◽  
Barbara Thorand ◽  
Cornelia Huth ◽  
Holger Then ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Vascular Complications ◽  
Model Assessment ◽  
Incident Type ◽  
The Metabolic Syndrome ◽  
Incident Type 2 Diabetes

IntroductionWe investigated the association of the proinsulin to insulin ratio (PIR) with prevalent and incident type 2 diabetes (T2D), components of the metabolic syndrome, and renal and cardiovascular outcomes in the population-based Cooperative Health Research in the Region of Augsburg (KORA) F4 study (2006–2008)/FF4 study (2013–2014).Research design and methodsThe analyses included 1514 participants of the KORA F4 study at baseline and 1132 participants of the KORA FF4 study after a median follow-up time of 6.6 years. All-cause and cardiovascular mortality as well as cardiovascular events were analyzed after a median time of 9.1 and 8.6 years, respectively. The association of PIR with T2D, renal and cardiovascular characteristics and mortality were assessed using logistic regression models. Linear regression analyses were used to assess the association of PIR with components of the metabolic syndrome.ResultsAfter adjustment for sex, age, body mass index (BMI), and physical activity, PIR was associated with prevalent (OR: 2.24; 95% CI 1.81 to 2.77; p<0.001) and incident T2D (OR: 1.66; 95% CI 1.26 to 2.17; p<0.001). PIR was associated with fasting glucose (β per SD: 0.11±0.02; p<0.001) and HbA1c (β: 0.21±0.02; p<0.001). However, PIR was not positively associated with other components of the metabolic syndrome and was even inversely associated with waist circumference (β: −0.22±0.03; p<0.001), BMI (β: −0.11±0.03; p<0.001) and homeostatic model assessment of insulin resistance (β: −0.22±0.02; p<0.001). PIR was not significantly associated with the intima-media thickness (IMT), decline of kidney function, incident albuminuria, myocardial infarction, stroke, cardiovascular or all-cause mortality.ConclusionsIn the KORA F4/FF4 cohort, PIR was positively associated with prevalent and incident T2D, but inversely associated with waist circumference, BMI and insulin resistance, suggesting that PIR might serve as a biomarker for T2D risk independently of the metabolic syndrome, but not for microvascular or macrovascular complications.

P5299Epicardial obesity as a significant predictor of leptino and insulin resistance

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Ott ◽  
G A Chumakova
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Linear Regression Analysis ◽  
Clinical Manifestations ◽  
Visceral Obesity ◽  
Soluble Receptors ◽  
Correlation Relationship ◽  
Group 2 ◽  
The Right

Abstract Leptino (LR) and insulin resistance (IR) are significant predictors of atherosclerosis, thrombosis, type 2 diabetes. The effect of epicardial obesity (EO) (as a type of visceral obesity) on the formation of LR and IR is studied. Objective To study the effect of EO on the formation of LR and IR among men with arterial hypertension (AH). Materials and methods The study included 130 men 49.5±4.3 years old, with AH of 1–3 degrees and the absence of clinical manifestations of coronary heart disease and atherosclerosis of other localizations, type 2 diabetes with a BMI of 20–35 kg /m2 and abdominal obesity according to WC ≥94 cm. Patients were divided into two groups depending on the thickness of epicardial adipose tissue (EAT), measured behind the free wall of the right ventricle by echocardiography. Group 1 consisted of 60 patients with epicardial obesity (EAT ≥7 mm), group 2 included 70 patients without epicardial obesity (EAT <7 mm). All subjects assessed indicators of LR and IR: measured levels of serum leptin (SL), soluble receptors for leptin (SLR), free leptin index (FLI), calculated as the ratio SL/SLR (as the only currently existing marker LR); IR was estimated by calculating the HOMA-IR index. IR was diagnosed with the generally accepted HOMA-IR index >2.7. Results When comparing LR indices in the studied groups, higher average values of SL, FLI were observed in the group with EO (EAT ≥7 mm) than in the group without EO (EAT <7 mm): (SL = 32.16 ng/ml (26.7; 37.62) versus SL = 14.92 ng/ml (11.62; 18.22), p=0.01, respectively); (FLI = 1.67 (0.47; 2.87) versus FLI = 0.37 (0.28; 0.46), p=0.01, respectively). Also in the EO group, higher indices of the HOMA-IR index were observed compared with the group without EO: (2.16 (1.62; 2.66) versus 1.35 (1.06; 1.64), p=0,01, respectively). When conducting the correlation analysis between FLI (as a marker of LR) and various obesity indicators (BMI, WC, EO) in the studied groups, a significant positive correlation relationship between FLI and EO was found in both the first and second groups (r=0.67, p=0.01; r=0.62, p=0.01, respectively). The IR index HOMA-IR also significantly positively correlated with EO in the group with a EAT ≥7 mm (r=0.68, p=0.01). BMI and WC did not correlate with FLI, IR in both groups 1 and 2 (p>0.05). In the EO group, 11 patients had IR with a HOMA-IR index >2.7. Using the linear regression analysis, the regression equation was obtained and the value of EO was calculated, from which the IR with HOMA-IR >2.7 started to be determined. This figure was 9.5 mm. Conclusions EO (EAT ≥7 mm) is a significant predictor of LR and IR, unlike the generally accepted criteria for obesity (BMI, WC). A EAT ≥9.5 mm can be a significant predictor of the development of type 2 diabetes, so these patients need additional examinations.

scholarly journals Clinical Measures of Physical Fitness Predict Insulin Resistance in People at Risk for Diabetes

2008 ◽  
Vol 88 (11) ◽  
pp. 1355-1364 ◽  
Author(s):  
Chiao-Nan Chen ◽  
Lee-Ming Chuang ◽  
Ying-Tai Wu
Keyword(s):  
Physical Activity ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Body Mass Index ◽  
At Risk ◽  
Risk Factor ◽  
Waist Circumference ◽  
Physical Fitness ◽  
Clinical Measures

Background and Purpose Physical inactivity has been well documented as a risk factor for type 2 diabetes. Previous studies measured the level of physical activity either with questionnaires or with direct measurements of maximum oxygen uptake. However, questionnaires are patient-report measures, and methods for obtaining direct maximum oxygen uptake measurements often are not available clinically. The purpose of this study was to investigate whether clinical measurement of health-related physical fitness with a simple test battery can predict insulin resistance, a precursor of type 2 diabetes, in people at risk for diabetes. Subjects and Methods A total of 151 volunteers with at least one diabetes risk factor (overweight, hypertension, dyslipidemia, family history, impaired glucose tolerance, gestational diabetes, or delivering a baby weighing more than 4.0 kg) were recruited. Insulin resistance (as determined with the homeostasis model assessment of insulin resistance [HOMA-IR]), physical fitness (including body composition, as determined with the body mass index and waist circumference), muscle strength (handgrip strength [force-generating capacity]), muscle endurance (sit-up test), flexibility (sit-and-reach test), and cardiorespiratory endurance (step test) were measured, and a physical activity questionnaire was administered. Backward regression analysis was used to build the prediction models for insulin resistance from components of physical fitness and physical activity. Results Body mass index, muscle strength, and cardiorespiratory fitness predicted HOMA-IR in men (adjusted R2=.264). In women, age, waist circumference, and cardiorespiratory fitness were the predictors of HOMA-IR (adjusted R2=.438). Discussion and Conclusion Clinical measures of physical fitness can predict insulin resistance in people at risk for diabetes. The findings support the validity of clinical measures of physical fitness for predicting insulin resistance in people at risk for diabetes.

scholarly journals РОЛЬ МАРКЕРА КОСТНОГО РЕМОДЕЛИРОВАНИЯ ОСТЕОКАЛЬЦИНА В РЕГУЛЯЦИИ ЭНЕРГЕТИЧЕСКОГО ГОМЕОСТАЗА ПРИ САХАРНОМ ДИАБЕТЕ 2 ТИПА

World Science ◽  
2020 ◽  
Vol 2 (5(57)) ◽  
pp. 20-29
Author(s):  
Ковальчук А. В. ◽  
Зиныч О. В. ◽  
Корпачев В. В. ◽  
Кушнарева Н. Н. ◽  
Прибила О. В.
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Adipose Tissue ◽  
Energy Homeostasis ◽  
Visceral Obesity ◽  
Mineral Density ◽  
General Group ◽  
Men And Women ◽  
Visceral Adipose

Osteocalcin (OK) is actively involved in the humoral regulation of energy homeostasis. However, the relationship between the level of OK as a modulator of metabolic processes and constitutional and metabolic features in patients with type 2 diabetes mellitus (DM) of a different gender remains not thoroughly studied.The study included 127 patients with type 2 diabetes ≥ 50 years of age. Of these, 70 were postmenopausal women and 57 men.It was found that in the general group of women, the concentration of OK in the blood serum was significantly higher than in men. The observed difference is due to significantly higher levels of OK in women of the older age group (≥ 60 years) in comparison with men. At the same time, a decrease in bone mineral density (BMD) in the femoral neck was observed in subgroups of men and women aged ≥ 60 years and older, while in the younger subgroups of patients, the BMD of lumbar and femoral zones were close to each other.The relationships between OK levels and adipose tissue parameters, evaluated by calculating the morphological and functional index of visceral obesity (IVO), were investigated. An increase in the OK level in the groups of men and women was accompanied by a decrease in the IVO values. The highest degree of insulin resistance was determined in groups of patients with minimal levels of OK and high IVO, and the lowest values were recorded in patients with high levels of OK and low IVO.The decrease of the blood OK level in patients with type 2 diabetes occurs in parallel with an increase in the degree of insulin resistance and dysfunction of visceral adipose tissue. In this case, IVO is a more accurate parameter reflecting the constitutional and metabolic phenotypic changes, compared with the index of the waist circumference. The decrease in BMD in patients with type 2 diabetes is the result of predominantly involutive processes that are noticeable at the age of ≥ 60 years and occur against the background of a decrease in the content of OK with age.

scholarly journals The effect of combination therapy of insulin glargine, metformin, and sitagliptin on insulin secretion, insulin resistance, and metabolic parameters in obese subjects with type 2 diabetes

2016 ◽  
Vol 144 (9-10) ◽  
pp. 497-502
Author(s):  
Teodora Beljic-Zivkovic ◽  
Milica Marjanovic-Petkovic ◽  
Miljanka Vuksanovic ◽  
Ivan Soldatovic ◽  
Dobrila Kanlic ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Waist Circumference ◽  
Insulin Glargine ◽  
Body Mass ◽  
Fasting Glucose ◽  
C Peptide ◽  
Obese Subjects

Introduction. A combination of drugs is required for treatment of obese subjects with diabetes, due to multiple pathogenic mechanisms implicated in the development of both diabetes and obesity. Objective. Assessment of the effect of sitagliptin added to insulin glargine and metformin, in obese subjects with type 2 diabetes. Methods. A total of 23 obese subjects on metformin and insulin glargine participated in the study. Titration of insulin glargine during a one-month period preceded the addition of 100 mg of sitagliptin daily. Body mass index, waist circumference, fasting, and prandial glucose were measured monthly, lipids and hemoglobin A1c (HbA1c) every three months, insulin, c-peptide and glucagon at the start and after six months of treatment. Homeostatic models for insulin secretion (HOMA B) and insulin resistance (HOMA IR) were calculated. Results. Participants were 58.65 ?} 7.62 years of age with a body mass index of 35.06 ?} 5.15 kg/m2, waist circumference of 115.04 ?} 15.5 cm, and the duration of diabetes of 4.11 ?} 2.57 years. With the titration of insulin glargine, target fasting glucose levels were not achieved. Waist circumference and body mass index decreased during three months of sitagliptin treatment, thereafter remaining stable. HbA1c decreased significantly after three and six months of therapy. C-peptide increased significantly, while glucagon level fell. HOMA indexes were unchanged. Conclusion. Sitagliptin can improve diabetes control and induce modest weight loss in obese subjects poorly controlled on insulin glargine and metformin. Titration of insulin glargine to optimal fasting glucose values is a prerequisite of success of this combination therapy.

scholarly journals The Effect of Sodium Channel Blocker, Mexiletine, on Body Weight in Type 2 Diabetes Patients with Visceral Obesity

2019 ◽  
Vol 12 ◽  
pp. 117955141882504
Author(s):  
Naohiko Ueno
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Uric Acid ◽  
Waist Circumference ◽  
Diabetic Neuropathy ◽  
Serum Uric Acid ◽  
Visceral Obesity ◽  
Control Group ◽  
Diabetes Patients

Objective: Mexiletine is an anti-arrhythmic agent also used for the treatment of painful diabetic neuropathy. In this study, the effect of mexiletine on body weight was evaluated in type 2 diabetes patients with diabetic neuropathy exhibiting visceral obesity. Methods: Type 2 diabetes patients with neuropathy exhibiting visceral obesity (n = 21) treated by mexiletine (300 mg/day) and a control group of type 2 diabetes patients with the same condition who received vitamin B12 (n = 12) were retrospectively evaluated. Body weight, waist circumference, hemoglobin A1c (HbA1c), blood pressure, liver function, serum lipids, and serum uric acid were assessed before and 6 months after the treatment. Results: Mexiletine significantly decreased body weight and waist circumference. The changes in body weight and waist circumference in 6 months in the mexiletine group were greater than in the control group. In metabolic parameters, there were significant decreases in triglyceride (TG) and serum uric acid. There were positive relationships between the change in body weight and the changes in TG, uric acid, alanine aminotransferase (ALT), and HbA1c. Conclusions: Mexiletine may affect body weight regulation. It ameliorated the metabolic parameters possibly by decreasing visceral fat. Further study should be performed to clarify the mechanism of the effect.

Resistin is Associated with Inflammation and Renal Function, but not with Insulin Resistance in Type 2 Diabetes

2021 ◽  
Author(s):  
Łukasz Rzepa ◽  
Michał Peller ◽  
Ceren Eyileten ◽  
Marek Rosiak ◽  
Agnieszka Kondracka ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Waist Circumference ◽  
High Sensitivity ◽  
Model Assessment ◽  
Tnf Α ◽  
Lower Egfr ◽  
Homeostatic Model Assessment ◽  
Factor Α

AbstractThe aim of the study was to investigate the association of adipokines (resistin, leptin and adiponectin) with obesity, insulin resistance (IR) and inflammation in type 2 diabetes mellitus (T2DM). A total of 284 patients with T2DM were included. Concentrations of resistin, leptin, adiponectin, and inflammatory markers [high sensitivity C-reactive protein (hsCRP), tumor necrosis factor α (TNF-α), and interleukin 6 (IL-6)] were measured and homeostatic model assessment for IR (HOMA-IR) index was calculated. Resistin correlated negatively with estimated glomerular filtration rate (eGFR) and positively with hsCRP, TNF-α, IL-6, and white blood cell count (WBC). Leptin correlated positively with HOMA-IR, whereas adiponectin correlated negatively. Leptin also correlated positively with body mass index (BMI), waist circumference, IL-6, WBC and negatively with eGFR. Adiponectin correlated negatively with waist circumference, WBC, and eGFR. Multivariate logistic regression indicated lower eGFR and higher WBC and IL-6 as independent predictive factors of resistin concentration above the upper quartile (CAQ3), whereas female sex and higher BMI and HOMA-IR of leptin CAQ3, and lower HOMA-IR and older age of adiponectin CAQ3. In conclusion, in contrast to leptin and adiponectin, in T2DM patients, resistin is not associated with BMI and IR, but with inflammation and worse kidney function.

scholarly journals Predictors of Insulin Resistance in Children versus Adolescents with Obesity

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Yvette E. Lentferink ◽  
Marieke A. J. Elst ◽  
Catherijne A. J. Knibbe ◽  
Marja M. J. van der Vorst
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Waist Circumference ◽  
Major Part ◽  
Tanner Stage ◽  
Multivariable Regression Model ◽  
Multivariable Regression ◽  
Pediatric Populations

Introduction. Obesity is a risk factor to develop metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM). Insulin resistance (IR) plays a major part in both. With increasing incidence of childhood obesity, this retrospective study aimed to identify predictors of IR in children/adolescents with obesity to optimize screening for IR. Method. Patients aged ≥ 2–≤ 18 years with obesity (BMI-SDS > 2.3) were included. IR was defined as HOMA-IR ≥ 3.4, and MetS if ≥3 of the following criteria were present: waist circumference and blood pressure ≥ 95th age percentile, triglycerides ≥ 1.7 mmol/l, HDL < 1.03 mmol/l, and fasting plasma glucose ≥ 5.6 mmol/l. Results. In total, 777 patients were included. Of the 306 children, 51, 38, and 0 were diagnosed with IR, MetS, and T2DM, respectively. Of the 471 adolescents, 223, 95, and 0 were diagnosed with IR, MetS, and T2DM, respectively. In the multivariable regression model, BMI-SDS, preterm birth, and Tanner stage were associated with IR in children (6.3 (95% CI 1.3–31.1), 5.4 (95% CI 1.4–20.5), 2.2 (95% CI 1.0–4.8)), and BMI-SDS and waist circumference in adolescents (4.0 (95% CI 1.7–9.2), 3.7 (95% CI 1.5–9.4)). Conclusion. Different IR predictors were observed in children/adolescents with obesity. These predictors can be used to optimize screening for IR in pediatric populations.

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