scholarly journals Fasting insulin-lipid index - A novel insulin resistance index with better cardiovascular risk predictability in type 2 diabetes mellitus

2021 ◽  
Vol 14 (4) ◽  
pp. 184
Author(s):  
TaoreedAdegoke Azeez
2020 ◽  
Vol 9 (2) ◽  
pp. 321 ◽  
Author(s):  
Erwin Garcia ◽  
Irina Shalaurova ◽  
Steven P. Matyus ◽  
David N. Oskardmay ◽  
James D. Otvos ◽  
...  

Background: Quantifying mildly elevated ketone bodies is clinically and pathophysiologically relevant, especially in the context of disease states as well as for monitoring of various diets and exercise regimens. As an alternative assay for measuring ketone bodies in the clinical laboratory, a nuclear magnetic resonance (NMR) spectroscopy-based test was developed for quantification of β-hydroxybutyrate (β-HB), acetoacetate (AcAc) and acetone. Methods: The ketone body assay was evaluated for precision, linearity and stability and method comparisons were performed. In addition, plasma ketone bodies were measured in the Insulin Resistance Atherosclerosis Study (IRAS, n = 1198; 373 type 2 diabetes mellitus (T2DM) subjects). Results: β-HB and AcAc quantified using NMR and mass spectrometry and acetone quantified using NMR and gas chromatography/mass spectrometry were highly correlated (R2 = 0.996, 0.994, and 0.994 for β-HB, AcAc, acetone, respectively). Coefficients of variation (%CVs) for intra- and inter-assay precision ranged from 1.3% to 9.3%, 3.1% to 7.7%, and 3.8% to 9.1%, for β-HB, AcAc and acetone, respectively. In the IRAS, ketone bodies were elevated in subjects with T2DM versus non-diabetic individuals (p = 0.011 to ≤0.001). Age- and sex-adjusted multivariable linear regression analysis revealed that total ketone bodies and β-HB were associated directly with free fatty acids (FFAs) and T2DM and inversely with triglycerides and insulin resistance as measured by the Lipoprotein Insulin Resistance Index. Conclusions: Concentrations of the three main ketone bodies can be determined by NMR with good clinical performance, are elevated in T2DM and are inversely associated with triglycerides and insulin resistance.


2018 ◽  
Vol 15 (2) ◽  
pp. 7-15
Author(s):  
Vesa Cosmin Mihai ◽  
Popa Loredana ◽  
Daina Lucia ◽  
Moisi Mădălina ◽  
Popescu Mircea ◽  
...  

AbstractInsulin resistance is a determinant factor for the increased prevalence of hypertension and dyslipidemia in type 2 diabetes patients. In this study we determined those modifications of clinical and biochemical parameters associated with insulin resistance in the diabetic patient, these alterations can offer us indications concerning the pathophysiological mechanisms that lead to the diabetes development in the case of most patients. Also we determined a correlation between insulin resistance and cardiovascular risk, through the combined effect of age and insulin resistance on this risk.


Author(s):  
Sandinti Deepa ◽  
V Lakshmaiah ◽  
K Prabhakar ◽  
A Raveesha ◽  
CR Vidyasagar ◽  
...  

Introduction: Insulin Resistance (IR) can develop into type 2 diabetes mellitus and is closely associated with obesity. However, the non-obese population has also shown a predisposition to the risk of IR due to genetics. Aim: To assess the relationship between IR and obesity in Type 2 Diabetes Mellitus (T2DM) by comparing the proportion of subjects with IR in lean and obese T2DM and to identify the factors predicting IR in T2DM. Materials and Methods: A cross-sectional, hospital-based study was done at Department of Medicine of RL Jalappa hospital, Kolar, Karnataka on 106 T2DM patients aged >18 years. The study population was grouped into lean (BMI <19 kg/m2) and obese adults (BMI >30 kg/m2). IR was calculated using Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) and was considered as primary outcome variable. Obesity was considered as primary explanatory variable. Age, Gender, fasting insulin, C-peptide, Fasting Blood Sugar, Glycated haemoglobin (GHB or HbA1c) were the other explanatory variables. Descriptive analysis was carried out using mean and standard deviation for quantitative variables, frequency and proportion for categorical variables. Chi-square test was used to test statistical significance between the groups. Univariate logistic regression analysis was done to identify the predictors of IR. IBM Statistical Package for Social Sciences (SPSS) version 22 was used for statistical analysis. The p-value <0.05 was considered to be statistically significant. Results: The 106 subjects involved in the study had a mean age of 53.88±9.21 years. 44 subjects (41.5%) had IR. Obese to lean diabetic patients were in the ratio of 1:4. The proportion of obese diabetic subjects was (n=84, 79.2%) whereas lean diabetics were (n=22, 20.8%). The proportion of obese diabetic subjects with IR was 38.1% while the proportion of lean diabetic subjects with IR was 54.55%, but this difference was statistically not significant (p=0.163). On univariate logistic regression analysis, fasting insulin (odds ratio of 2.442 with 95% CI of 1.665 to 3.851, p<0.001**) and C-peptide (odds ratio of 1.446 with 95% CI of 1.123, p=0.004) were statistically significant factors attributing to IR. Conclusion: There was no significant relationship between IR and obesity. IR was independently associated with Fasting insulin levels and C-peptide levels.


2022 ◽  
Vol 11 (1) ◽  
Author(s):  
Jorge Alberto Tapia-Martínez ◽  
Margarita Franco-Colín ◽  
Vanessa Blas-Valdivia ◽  
Edgar Cano-Europa

Introduction Congenital hypothyroidism affects metabolic and thyroid programming, having a deleterious effect on bodyweight regulation promoting metabolic diseases. This work aimed to demonstrate the development of type 2 diabetes mellitus (T2D) in animals with congenital hypothyroidism, only by the consumption of a mild hypercaloric diet in the extrauterine stage. Methods Two groups of female Wistar rats (n  = 9): euthyroid and hypothyroid were used. Hypothyroidism was induced by a thyroidectomy with parathyroid reimplantation. Male offsprings post-weaning were divided into four groups (n  = 10): euthyroid, hypothyroid, euthyroid + hypercaloric diet, and hypothyroid + hypercaloric diet. The hypercaloric diet consisted of ground commercial feed plus 20% lard and was administered until postnatal week 40. Bodyweight and energy intake were monitored weekly. Also, metabolic and hormonal markers related to cardiovascular risk, insulin resistance, and glucose tolerance were analyzed at week 40. Then, animals were sacrificed to perform the morphometric analysis of the pancreas and adipose tissue. Results T2D was developed in animals fed a hypercaloric diet denoted by the presence of central obesity, hyperphagia, hyperglycemia, dyslipidemia, glucose tolerance, insulin resistance and hypertension, as well as changes in the cytoarchitecture of the pancreas and adipose tissue related to T2D. The results show that congenital hypothyroid animals had an increase in metabolic markers and an elevated cardiovascular risk. Conclusions Congenital hypothyroid animals develop T2D, having the highest metabolic disturbances and a worsened clinical prognosis than euthyroid animals.


2021 ◽  
Author(s):  
Taoreed Adegoke Azeez

Abstract BackgroundThis study was aimed at determining the correlation between insulin resistance indices and atherogenic index as well as determining the ability of the indices to discriminate between low and high cardiovascular risk in diabetic individuals. The study involved 70 participants. Ethical approval was granted by the institution review board. Fasting plasma glucose, insulin and lipid profile were analyzed for each participant. Atherogenic index of plasma (AIP), homeostatic mode assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), fasting glucose insulin ratio (FGIR), fasting insulin resistance index (FIRI), McAuley’s index and Raynauld’s index were calculated using the appropriate formulae. Pearson’s correlation and receiver operating characteristic (ROC) analysis were done.ResultsThe mean age of the participants was 53.34 ± 9.57 years. Males were 50%. The mean duration of type 2 diabetes in the participants was 6.29 ± 2.78 years. Each index had a strong and significant correlation with fasting plasma insulin (p<0.001). Using AIP as a marker of cardiovascular risk, 14.3% had intermediate/high risk. Among the indices, only McAuley’s index showed a statistically significant negative correlation with AIP (r= -0.453;p<0.001). None of the indices could reliably discriminate between low and intermediate/high cardiovascular risk.ConclusionThe studied indices could not predict cardiovascular risk despite their usefulness as insulin resistance markers. Further studies are needed to identify an ideal insulin resistance index that can also predict cardiovascular risk.


Author(s):  
Navneet Kaur ◽  
Gitanjali Gitanjali ◽  
Ravinder Garg ◽  
Chaitanya Tapasvi ◽  
Sonia Chawla ◽  
...  

Abstract Context Insulin resistance (IR) and abnormal insulin secretion play a key role for the development of type 2 diabetes mellitus (DM). Aims We investigated the surrogate markers of IR, i.e., Homeostasis Model Assessment (HOMA), Quantitative Insulin Sensitivity Check Index (QUICKI), McAuley, and Fasting Insulin Resistance Index (FIRI) in type 2 DM patients. Also, fasting insulin (FI) levels were estimated in type 2 diabetics. Further, the correlation of FI with other surrogate markers of IR in type 2 DM was done. Settings and Design A hundred newly diagnosed patients with type 2 DM from Malwa population, Punjab, were considered for evaluation. Another 100 healthy individuals (age and sex-matched) were examined as controls. Methods and Material Fasting blood glucose, FI, and lipid profile were estimated, and IR was calculated using McAuley index (McA), HOMA, QUICKI, and FIRI. Statistical Analysis Used The statistical analysis was performed on the above-mentioned clinical interpretations. The Cohen’s kappa test was used to affirm the agreement. Results FI levels in patients with type 2 diabetes were significantly higher (20.8 ± 9.05 µIU/L) than controls (7.93 ± 1.01 µIU/L). IR by surrogate markers was found significant in the study group. The 76% patients with type 2 diabetes ended up as resistant to insulin by FI measurement, almost equivalent to McA, 80%; HOMA, 88%; FIRI, 88%; and QUICKI, 90%. A notable correlation was highlighted between FI and McA manifesting IR (p < 0.01, r = −0.85). We calculated the statistical correlation of FI with HOMA, QUICKI, and FIRI indices (p < 0.01, r = 0.93; p < 0.01 r = −0.92; and p < 0.01, r = +0.93, respectively). The agreement visible from Cohen’s kappa test also affirms the same (k = 0.9 for McA). Conclusion We concluded that all the surrogate markers for IR were specific when compared with FI, but in terms of sensitivity McA was found to be more sensitive as it includes markers of dyslipidemia, which is the precipitating factor of metabolic derangements so as the IR in type 2 DM.


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