EFFECT OF EXERCISE ON INSULIN RESISTANCE IN OBESE TYPE 2 DIABETES PATIENTS

ABSTRACT Introduction: Type 2 diabetes mellitus (T2DM), also known as non-insulin-dependent diabetes mellitus (NIDDM), accounts for more than 90% of the total number of diabetes mellitus cases and often occurs in middle-aged and elderly people. Objective: To investigate the effect of exercise intervention on insulin resistance in obese type 2 diabetes patients. Methods: Eighty-six obese diabetic patients were screened as experimental subjects in physical examinations and randomly divided into observation and control groups. Visceral fat volume, fasting blood glucose, and fasting insulin of all subjects were measured before and after completion of the 6-month experimental implementation. The insulin resistance was calculated for both groups and the values for each indicator were compared statistically between groups. Results: Control of body weight, body mass index, blood glucose, blood lipids and insulin resistance index were better in the observation group than in the control group, and the difference was statistically significant (P < 0.05). Conclusions: Basal intervention with quantitative exercise can significantly improve insulin resistance in obese type 2 diabetes patients and the effect is better than treatment with diet and conventional exercise. Level of evidence II; Therapeutic studies - investigation of treatment results.

Importance of Doppler study of Umbilical Artery and FoetalMiddle Cerebral Artery in PIH and IUGR

Background: PIH is associated with increased vascular resistance and decreased utero -placental perfusion resulting in an increased incidence of foetal hypoxia and impaired foetalgrowth.The objective of this study was to assess the diagnostic performance of S/D ratio, resistance index(RI), pulsatility index (PI) and cerebro-placental ratio (CPR) in the prediction of adverse perinatal outcome in PIH and IUGR. Objective: is to determine S/D ratio, RI, PI, CPR and asses their diagnostic values in the prediction of adverse perinatal outcome.Material& Methods:50 pregnant patients with PIH and IUGR, beyond 28 weeks of gestation, were prospectively studied at P k das institute of medical college,vaniyamkulamand subjected for Doppler study of the umbilical artery and foetal middle cerebral artery. The abnormality of above parameters was correlated with the major adverse perinatal outcome.Results:Patients with abnormal Doppler parameters had a poor perinatal outcome, compared to those who had normal Doppler study. The cerebro-placental ratios(CPR) had the sensitivity and specificity, positive and negative predictive values of 95%,76%,73%,95% respectively with Kappa value of o .68(good agreement) and p value of .000 which was statistically significant, for the prediction of major adverse perinatal outcome.Conclusions:This study shows that Doppler study of umbilical and foetal middle cerebral artery can reliably predict the neonatal morbidity and helpful in determining the optimal time of delivery in complicated pregnancies. The CPR is more accurate than the independent evaluation of S/D, RI, PI, in identifying foetus with adverse perinatal outcome.

Experimental Study of the Dynamic Characteristics of a New Antidrainage Subgrade Structure for High-Speed Railways in Diatomaceous Earth Areas

The experience needed to carry out engineering and construction in diatomaceous earth areas is currently lacking. This project studies the new Hang Shaotai high-speed railway passing through a diatomaceous earth area in Shengzhou, Zhejiang Province, and analyzes the hydrological and mechanical properties of diatomaceous earth on the basis of a field survey and laboratory. Moreover, a new antidrainage subgrade structure was proposed to address the rainy local environment, and field excitation tests were performed to verify the antidrainage performance and stability of the new subgrade structure. Finally, the dynamic characteristics and deformation of the diatomaceous earth roadbed were examined. The hydrophysical properties of diatomaceous earth in the area are extremely poor, and the disintegration resistance index ranges from 3.1% to 9.0%. The antidrainage subgrade structure has good water resistance and stability under dynamic loading while submerged in water. After 700,000 loading cycles, the dynamic stress and vibration acceleration of the surface of the subgrade bed stabilized at approximately 6.37 kPa and 0.94 m/s2, respectively. When the number of excitations reached 2 million, the settlement of the diatomaceous earth foundation was 0.08 mm, and there was basically negligible postwork settlement of the diatomaceous earth foundation. These results provide new insights for engineering construction in diatomaceous earth areas.

Effect of Hyperinsulinemia and Insulin Resistance on Endocrine, Metabolic, and Reproductive Outcomes in Non-PCOS Women Undergoing Assisted Reproduction: A Retrospective Cohort Study

Objective: To evaluate the effect of hyperinsulinemia (HI) and insulin resistance (IR) on endocrine, metabolic, and reproductive outcomes in women without polycystic ovary syndrome (PCOS) undergoing assisted reproduction.Materials and Methods: The study included 1,104 non-PCOS women undergoing in vitro fertilization/intracytoplasmic sperm injection-fresh embryo transfer. HI was evaluated by serum fasting insulin (FIN), and IR was evaluated by homeostatic model assessment of insulin resistance index (HOMA-IR). In addition, biometric, sex hormone, and metabolic parameters were measured. Independent t-test, linear, and logistic regression examined associations between HI, IR, and endocrine, metabolic, ovarian stimulation characteristics, and reproductive outcomes.Results: Women with HI and IR had lower levels of progesterone, luteinizing hormone, follicle-stimulating hormone, estradiol, high-density lipoproteins, and increased levels of triglycerides low-density lipoproteins. For ovarian stimulation characteristics, those with HI and IR had a longer duration of stimulation, a higher total gonadotropin dose, and a lower peak estradiol level. Linear regression confirmed these associations. For reproductive outcomes, HI and IR were not associated with clinical pregnancy, live birth, and miscarriage.Conclusions: HI and IR did not impair reproductive outcomes in non-PCOS women undergoing assisted reproduction.

Alleviation of Dyslipidemia via a Traditional Balanced Korean Diet Represented by a Low Glycemic and Low Cholesterol Diet in Obese Women in a Randomized Controlled Trial

A traditional balanced Korean diet (K-diet) may improve energy, glucose, and lipid metabolism. To evaluate this, we conducted a randomized crossover clinical trial, involving participants aged 30–40 years, who were randomly assigned to two groups—a K-diet or westernized Korean control diet daily, with an estimated energy requirement (EER) of 1900 kcal. After a 4-week washout period, they switched the diet and followed it for 4 weeks. The carbohydrate, protein, and fat ratios based on energy intake were close to the target values for the K-diet (65:15:20) and control diet (60:15:25). The glycemic index of the control diet and the K-diet was 50.3 ± 3.6 and 68.1 ± 2.9, respectively, and daily cholesterol contents in the control diet and K-diet were 280 and 150 mg, respectively. Anthropometric and biochemical parameters involved in energy, glucose, and lipid metabolism were measured while plasma metabolites were determined using UPLC-QTOF-MS before and after the 4-week intervention. After the four-week intervention, both diets improved anthropometric and biochemical variables, but the K-diet significantly reduced them compared to the control diet. Serum total cholesterol, non-high-density lipoprotein cholesterol, and triglyceride concentrations were significantly lower in the K-diet group than in the control diet group. The waist circumference (p = 0.108) and insulin resistance index (QUICKI, p = 0.089) tended to be lower in the K-diet group than in the control diet group. Plasma metabolites indicated that participants in the K-diet group tended to reduce insulin resistance compared to those in the control diet group. Amino acids, especially branched-chain amino acids, tyrosine, tryptophan, and glutamate, and L-homocysteine concentrations were considerably lower in the K-diet group than in the control diet group (p < 0.05). Plasma glutathione concentrations, an index of antioxidant status, and 3-hydroxybutyric acid concentrations, were higher in the K-diet group than in the control diet group. In conclusion, a K-diet with adequate calories to meet EER alleviated dyslipidemia by decreasing insulin resistance-related amino acids and increasing ketones in the circulation of obese women.

Role of portal color Doppler ultrasonography as noninvasive predictive tool for esophageal varices in cirrhotic patients

Background Esophageal varices (EV) is the most common apprehensive complication of portal hypertension in patients with cirrhotic liver. Guidelines recommend Upper gastro-intestinal endoscopic screening for EV in patients with newly diagnosed chronic cirrhosis (Imperiale et al. in Hepatology 45(4):870–878, 2007). Yet, it is invasive, time consuming and costly. To avoid unnecessary endoscopy, some studies have suggested Doppler ultrasound examination as simple, and noninvasive tool in prediction and assessment of severity of EV (Agha et al. in Dig Dis Sci 54(3):654–660, 2009). Our study was to assess the role of different Doppler indices of portal vein, hepatic and splenic arteries as a noninvasive tool for prediction of esophageal varices in cirrhotic patients. Results This prospective case control study was conducted on 100 cirrhotic liver patients and 100 of healthy volunteers as control group. Patients were subjected to clinical examination, upper gastrointestinal tract endoscopy, abdominal ultrasonography with duplex Doppler evaluation of different portal Doppler hemodynamic indices were done for each patient. The results revealed that portal vein diameter, hepatic artery pulsatility index, portal hypertensive index, portal vein flow velocity, portal congestion index have high sensitivity for prediction of EV. However, Splenic artery resistance index, hepatic artery resistance index HARI, liver vascular index and platelet count/spleen diameter have less sensitivity for prediction of EV. Conclusion Measuring the portal hemodynamic indices can help physicians as noninvasive predictors of EV in cirrhotic patients to restrict the need for unnecessary endoscopic screening especially when endoscopic facilities are limited.

Ad-VT enhances the sensitivity of chemotherapy-resistant lung adenocarcinoma cells to gemcitabine and paclitaxel in vitro and in vivo

SummaryBackground One of the main challenges in the clinical treatment of lung cancer is resistance to chemotherapeutic drugs. P-glycoprotein (P-gp)-mediated drug resistance is the main obstacle to successfully implementing microtubule-targeted tumor chemotherapy. Purpose In this study, we explored the effect of Ad-hTERTp-E1a-Apoptin (Ad-VT) on drug-resistant cell lines and the molecular mechanism by which Ad-VT combined with chemotherapy affects drug-resistant cells and parental cells. Methods In vitro, cell proliferation, colony formation, resistance index (RI), apoptosis and autophagy assays were performed. Protein expression was analyzed by Western blotting. Finally, a xenograft tumor model in nude mice was used to detect tumor growth and evaluate histological characteristics. Results Our results showed that Ad-VT had an obvious killing effect on A549, A549/GEM and A549/Paclitaxel cancer cells, and the sensitivity of drug-resistant cell lines to Ad-VT was significantly higher than that of parental A549 cells. Compared with A549 cells, A549/GEM and A549/Paclitaxel cells had higher autophagy levels and higher viral replication ability. Ad-VT decreased the levels of p-PI3k, p-Akt and p-mTOR and the expression of P-gp. In vivo, Ad-VT combined with chemotherapy can effectively inhibit the growth of chemotherapy-resistant tumors and prolong the survival of mice. Conclusions Thus, the combination of Ad-VT and chemotherapeutic drugs will be a promising strategy to overcome chemoresistance.

STATISTICAL ASSESSMENT OF THE ECONOMIC RESILIENCE OF THE REGIONS OF THE REPUBLIC OF BELARUS

The article discusses the main approaches to the definition of a relatively new term for economic science - economic resilience of territories. The author made an attempt to assess the level of economic resilience of the regions of Belarus on the basis of the 2015-2016 recession resistance index. and the index of recovery of economic dynamics in the post-recession period (2017-2019). This is the first time an analytical work of this level has been carried out in Belarus. It has been established that the central regions of the country - Minsk and the Minsk region - have high economic resilience. The author outlines the prospects for the use and methodological problems of assessing the economic resilience of regions in statistical science.

Lipid ratios and obesity indices are effective predictors of metabolic syndrome in women with polycystic ovary syndrome

Background: Insulin resistance (IR) is common in women with polycystic ovary syndrome (PCOS). Metabolic syndrome (MS) involves IR, arterial hypertension, dyslipidemia, and visceral fat accumulation. Therefore, fatness indices and blood lipid ratios can be considered as screening markers for MS. Our study aimed to evaluate the predictive potential of selected indirect metabolic risk parameters to identify MS in PCOS. Methods: This cross-sectional study involved 596 women aged 18–40 years, including 404 PCOS patients diagnosed according to the Rotterdam criteria and 192 eumenorrheic controls (CON). Anthropometric and blood pressure measurements were taken, and blood samples were collected to assess glucose metabolism, lipid parameters, and selected hormone levels. Body mass index (BMI), waist-to-height ratio (WHtR), homeostasis model assessment for insulin resistance index (HOMA-IR), visceral adiposity index (VAI), lipid accumulation product (LAP), non-high-density lipoprotein cholesterol (non-HDL-C), and triglycerides-to-HDL cholesterol ratio (TG/HDL-C) were calculated. MS was assessed using the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) criteria. Results: MS prevalence was significantly higher in PCOS versus CON. Patients with both MS and PCOS had more unfavorable anthropometric, hormonal, and metabolic profiles versus those with neither MS nor PCOS and versus CON with MS. LAP, TG/HDL-C, VAI, and WHtR were the best markers and strongest indicators of MS in PCOS, and their cut-off values could be useful for early MS detection. MS risk in PCOS increased with elevated levels of these markers and was the highest when TG/HDL-C was used. Conclusions: LAP, TG/HDL-C, VAI, and WHtR are representative markers for MS assessment in PCOS. Their predictive power makes them excellent screening tools for internists and enables acquiring accurate diagnoses using fewer MS markers.