Insulin resistance in prostate cancer patients and predisposing them to acute ischemic heart disease

Lack of insulin or insulin resistance (IR) plays a central role in diabetes mellitus and makes diabetics prone to acute ischemic heart disease (AIHD). It has likewise been found that many cancer patients, including prostate cancer patients die of AIHD. Previously it has been delineated from our laboratory that dermcidin could induce anomalous platelet aggregation in AIHD and also impaired nitric oxide and insulin activity and furthermore dermcidin was also found in a few types of cancer patients. To determine the role of this protein in prostatic malignancy, a retrospective case–control study was conducted and blood was collected from prostate cancer patients and healthy normal volunteers. So, we measured the level of dermcidin protein and analyzed the IR by Homeostasis Model Assessment (HOMA) score calculation. Nitric oxide was measured by methemoglobin method. HDL, glycated hemoglobin (HbA1c), BMI, hs-cTroponin-T were measured for the validation of the patients’ status in the presence of Dermcidin isoform-2 (DCN-2). Multiple logistic regression model adjusted for age and BMI identified that the HOMA score was significantly elevated in prostate cancer patients (OR = 7.19, P<0.001). Prostate cancer patients are associated with lower level of NO and higher level of both proteins dermcidin (OR = 1.12, P<0.001) and hs-TroponinT (OR = 1.76, P<0.001). From the results, it can be interpreted that IR plays a key role in the pathophysiology of prostate cancer where dermcidin was the cause of IR through NO inhibition leading to AIHD was also explained by high-sensitive fifth generation cTroponin-T (hs-cTroponinT) and HbA1c level which are associated with endothelial dysfunction.

Outcome Melatonin Supplementation on Insulin Resistance in a Sample of Iraqi Acromegalic Patients with Sleep Apnea

Sleep apnea, a common respiratory complication of acromegaly is accountable for 25% of deaths in acromegalic patients. It contributes to increasing cardiovascular diseases and raising mortality rate in acromegalic patients and still persists after control of acromegaly. Raised insulin resistance that was noticed in some acromegalic patients are believed to be caused by acromegaly itself, weight gain, octreotide therapy or the deleterious effect of sleep apnea itself. It was found that both acromegaly and sleep apnea share a disordered melatonin secretion. Numerous clinical and experimental studies have shown a promising role of melatonin as an antidiabetic agent. Nevertheless, no other study had examined the effect of melatonin supplementation on insulin resistance level in acromegalic patients receiving their standard treatment and experiencing some sleep difficulties. The study was designed to scrutinize the effect of melatonin supplementation on insulin resistance in controlled acromegalic patients who had been receiving their standard treatment. It was a prospective randomised controlled open labelled study included 27 Iraqi acromegalic patients. Their age ranged (29-57).The patients were receiving their usual octreotide monthly dose determined by the physician to control their disease and they had moderate to severe sleep apnea (Epworth sleepiness scale and STOP-BANG score were used to include them in the study ,they were enrolled if the summation of their ESS points ≥10 or of their STOP-BANG points ≥3).The patients were divided into two groups, group 1 included 15 patients taking their usual octreotide dose once monthly plus 5 mg of melatonin at night, group 2 included 12 patients taking their usual octreotide dose only. Blood samples were taken at fasting state at baseline and after 2 months to estimate serum growth hormone (GH), insulin like growth factor-1 (IGF-1), insulin and blood glucose. The homeostatic model assessment for insulin resistance (HOMA) result was calculated for each subject. At the end of the study period, melatonin treated group showed no significant change in GH, IGF-1, a highly significant decrease in glucose level (p<0.001), a highly significant decrease in insulin (p<0.001) and a highly significant decrease in HOMA score (p<0.001).Standard treatment group showed no significant difference in GH, IGF-1, insulin level and HOMA score at the end of the two months study period and a highly significant increase in glucose level. In conclusion, our study has confirmed the existing evidence of that melatonin supplementation improves glucose homeostasis and offers promising tool for future studies in acromegalic patients and larger trials.

Acculturation and Insulin Resistance Among US Chinese Immigrant Women

<p class="Pa7"><strong>Objective: </strong>Chinese immigrants in the Unit­ed States undergo a transition to increased chronic disease risk commonly attributed to acculturative changes. Longitudinal data to confirm this are lacking. We examined acculturation in relation to insulin resistance in a sample of Chinese immigrant women to determine differences by level of education and possible mediation by anthropometry and diet.</p><p class="Pa7"><strong>Design: </strong>Longitudinal study.</p><p class="Pa7"><strong>Setting</strong><em>: </em>Philadelphia, Pennsylvania.</p><p class="Pa7"><strong>Participants: </strong>305 Chinese immigrant women recruited October 2005 to April 2008 and followed until April 2010.</p><p class="Pa7"><strong>Main Outcome Measures</strong><em>: </em>Association of acculturation, measured using the General Ethnicity Questionnaire – American version (GEQA), with homeostasis model assess­ment (HOMA) score as an indicator of insulin resistance, modeled using general­ized estimating equations to account for repeated measures over time.</p><p class="Pa7"><strong>Results: </strong>GEQA was associated with log HOMA score, but only in women with &lt;9 years of education (beta [SE] = .09 [.04], <em>P</em>=.02; interaction <em>P</em>=.02). The association persisted with adjustment for body mass index, waist circumference, and dietary variables.</p><p><strong>Conclusions: </strong>These findings provide longitudinal evidence that insulin resistance increases with acculturation. However, the association was apparent only in less-edu­cated immigrants and may be mediated by a pathway other than changes in anthropom­etry and diet. <em>Ethn Dis. </em>2015;25(4):443-450; doi:10.18865/ed.25.4.443</p>

Two Valid Measures of Self-rated Physical Activity and Capacity

Objectives: Questionnaires on physical activity (PA) and physical capacity (PC) are valuable tools, as they are cost beneficial, and have high response rates. The validity of short versions of such questionnaires has not been examined satisfactorily. Therefore, we aimed at examining the validity of a set of questions coding for PA and PC. Design: The questions were administered to 217 men and women attending a cardiac rehabilitation program. Participants also gave blood samples, measuring HDL cholesterol, triglycerides (TG), insulin, glucose, and microCRP. The relations between PA and PC and biological markers were examined by linear regression analyses. Results: Measures for PC and for PA were identified by factor analysis, which proved internally consistent. TG, homeostatic model assessment (HOMA) score, and mCRP were all significantly associated with the measures of PC and PA. Conclusions: The measures of PA and PC are valid compared with biological markers, allowing cost-beneficial and time-efficient evaluation of important measures for cardiovascular health.

The hepatic response to FGF19 is impaired in patients with nonalcoholic fatty liver disease and insulin resistance

Intestinal FGF19 has emerged as a novel endocrine regulator of hepatic bile salt and lipid metabolism. In patients with nonalcoholic fatty liver disease (NAFLD) hepatic lipid metabolism is deranged. A possible role of FGF19 in NAFLD has not been reported yet. In this study, we assessed intestinal FGF19 production and the hepatic response to FGF19 in NAFLD patients with and without insulin resistance [homeostasis model of assessment (HOMA) score ≥2.5 ( n = 12) and HOMA score <2.5 ( n = 8), respectively]. To this end, NAFLD patients received a standardized oral fat challenge. Postprandial excursions of triglycerides, bile salts, and FGF19 were monitored, and plasma levels of a marker for bile salt synthesis (7α-hydroxy-4-cholesten-3-one) were determined. Fasted FGF19 levels were comparable in a control group of healthy volunteers ( n = 15) and in NAFLD patients (0.26 ± 0.28 vs. 0.18 ± 0.09 ng/ml, respectively, P = 0.94). Postprandial FGF19 levels in both controls and NAFLD patients peaked between 3–4 h and were three times higher than baseline levels. The areas under the postprandial FGF19 curve were similar in controls and in the HOMA score-based NAFLD subgroups. In NAFLD patients with HOMA score <2.5, the postprandial increase in plasma FGF19 was accompanied by a lowering of plasma levels of 7α-hydroxy-4-cholesten-3-one (−30%, P = 0.015). This anticipated decline was not observed in insulin-resistant NAFLD patients (+10%, P = 0.22). In conclusion, patients with NAFLD show an unimpaired intestinal FGF19 production. However, the hepatic response to FGF19 is impaired in NAFLD patients with insulin resistance (HOMA score ≥2.5). This impaired hepatic response to FGF19 may contribute to the dysregulation of lipid homeostasis in NAFLD.

Plasma Resistin, Insulin Concentration in Non-Diabetic and Diabetic, Overweight/Obese Thai

This study investigated levels of fasting plasma glucose (FBS), homeostasis model of the assessment of the insulin resistance (HOMA), lipid profile, insulin, and resistin hormones in 202 individuals, divided into four groups. Two groups had type II diabetes mellitus (DM): one group had been overnourished (DM/OB) (body mass index: BMI equal or above 25) and the other had not (DM/nOB). Two additional groups not suffering from diabetes were either overnourished (nDM/OB) or of normal nutritional status (nDM/nOB). Only the DM/OB group had insulin levels elevated above the other three groups. Resistin levels had been lowest in the nDM/nOB group. When participants of the two nOB groups were pooled into one group and the subjects of the two OB groups were combined into another group, the median plasma resistin levels of the OB groups were significantly higher compared with the nOB groups. Likewise the DM groups had higher resistin levels than the nDM groups. A significant correlation of plasma resistin with BMI, waist circumference, waist-to-hip ratio, FBS, and HOMA score had been observed. The result suggests that plasma resistin has a role in linking central obesity and obesity-related insulin resistance to type II diabetes mellitus.