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Wu T, Liu Y, Kong F, Hu J, Liu Y, Yang J, Chen J. Improvement of endocrine and metabolic conditions in patients with polycystic ovary syndrome through acupuncture and its combined therapies: a systematic review and meta-analysis. Ann Med 2025; 57:2477295. [PMID: 40091529 PMCID: PMC11915742 DOI: 10.1080/07853890.2025.2477295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Revised: 01/07/2025] [Accepted: 01/20/2025] [Indexed: 03/19/2025] Open
Abstract
BACKGROUND Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder among women of reproductive age that significantly impacts their reproductive health. Acupuncture and its combined therapies may have beneficial effects on the endocrine and metabolic states of women with PCOS. This systematic review and meta-analysis evaluated the treatment effects and potential mechanisms of acupuncture and its combined therapies compared to oral metformin in treating PCOS patients. METHODS The evaluation focused on three sets of outcomes: hormonal indicators, metabolic indicators, and body weight indicators. Studies that involved additional therapies beyond the specified interventions or included patients with other diseases were excluded. Additionally, data mining methods were used, including frequency statistics to analyze the frequency of acupuncture points and the meridians involved, and the Apriori algorithm to perform association rule analysis for the most effective interventions. RESULTS The study included 46 articles (51 studies) involving six interventions: acupuncture combined with metformin, acupuncture treatment, acupuncture with Chinese herbal medicine and metformin, acupuncture with Chinese herbal medicine, acupuncture combined with cupping, and auricular acupuncture combined with metformin showed significant improvements in all evaluated indicators. Data mining revealed the Stomach meridian of foot yangming was the most frequently used, and the most commonly used combination of points included CV4, SP6, and ST36. CONCLUSIONS This study suggests that acupuncture and its combined therapies may benefit PCOS. However, risk of bias and heterogeneity observed were noted. Future high-quality, rigorously designed randomized controlled trials are needed to confirm these findings and provide stronger clinical recommendations for acupuncture in PCOS treatment.
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Affiliation(s)
- Tianyu Wu
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yiwei Liu
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Fanjing Kong
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jinqun Hu
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yu Liu
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jie Yang
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiao Chen
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Chen IW, Wang WT, Wu JY, Yu CH, Chang YJ, Hung KC. Diagnostic performance of the triglyceride-glucose index in predicting occurrence of cancer: a meta-analysis. Front Oncol 2025; 15:1532253. [PMID: 40416870 PMCID: PMC12098037 DOI: 10.3389/fonc.2025.1532253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2025] [Accepted: 04/16/2025] [Indexed: 05/27/2025] Open
Abstract
Objective This meta-analysis aimed to evaluate the diagnostic performance of the triglyceride-glucose (TyG) index in predicting cancer occurrence. Method A comprehensive literature search was conducted in Embase, Medline, Cochrane Library, and Google Scholar from inception to July 2024. Observational studies reporting the diagnostic efficacy of the TyG index in predicting cancer occurrence using ROC curve analysis were included. Pooled sensitivity, specificity, and area under the summary receiver operating characteristic (SROC) curve were calculated using a bivariate random-effects model. Results Eleven studies with 46,658 participants were included. Patients with cancer had a significantly higher TyG index than those without cancer (mean difference: 0.34, 95% CI: 0.23-0.45). The pooled sensitivity and specificity of the TyG index for predicting cancer occurrence were 0.68 (95% CI: 0.62-0.74) and 0.65 (95% CI: 0.54-0.74), respectively. The area under the SROC curve was 0.72 (95% CI: 0.68-0.75), indicating good discriminatory ability. Subgroup analysis of female participants yielded similar results, with an AUC of 0.73 (95% CI: 0.69-0.77). Conclusion The TyG index demonstrates good discriminatory ability and may have potential as an adjunct screening tool to help identify individuals at a higher risk of developing cancer. However, this should be interpreted alongside other established risk factors, as many confounding factors (including cancer type, genetic predisposition, and other malignancy risk factors) must be considered. Further research is needed to establish optimal cut-off values, which likely vary across different cancer types, and to investigate their diagnostic accuracy in diverse populations. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42024573712.
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Affiliation(s)
- I-Wen Chen
- Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Wei-Ting Wang
- Department of Anesthesiology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Jheng-Yan Wu
- Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan
| | - Chia-Hung Yu
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
| | - Ying-Jen Chang
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
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Hong D, Li X, Sheng G, Yang H, Wang W, Zou Y. Comparing the impact of cumulative insulin resistance surrogates exposure on stroke: optimizing prevention strategies. Lipids Health Dis 2025; 24:158. [PMID: 40281515 PMCID: PMC12023373 DOI: 10.1186/s12944-025-02579-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2025] [Accepted: 04/21/2025] [Indexed: 04/29/2025] Open
Abstract
BACKGROUND Insulin resistance (IR) plays a major role in increasing the risk of stroke. The objective of this research is to systematically evaluate and compare the impact of cumulative exposure over time to four commonly used IR surrogates-triglyceride-glucose (CumTyG) index, metabolic score for IR (CumMetS-IR), estimated glucose disposal rate (CumeGDR) and triglyceride to high-density lipoprotein cholesterol (CumTG/HDL-C) ratio-on stroke risk, providing insights for optimizing monitoring strategies for primary stroke prevention. METHODS The study population was sourced from the China Health and Retirement Longitudinal Study (CHARLS2011-2018). Cumulative exposure to IR (CumIR) surrogates was calculated as the mean value of IR surrogates measured in the first and third waves of CHARLS, multiplied by the total exposure duration. The primary endpoint was incident stroke, determined through questionnaires in the third and fourth waves of CHARLS. Multivariable Cox regression models were applied to estimate and compare HRs and 95% CIs for stroke across quartiles of CumIR surrogates. RESULTS A total of 4,669 participants with no history of stroke at baseline were included. During a median follow-up of 6 years, 347 new stroke events (7.43%) were recorded. The incidence rates of stroke in the highest quartiles of CumTyG index, CumTG/HDL-C ratio, and CumMetS-IR, as well as the lowest quartile of CumeGDR, were 9.67%, 9.93%, 10.45%, and 13.02%, respectively. In terms of risk assessment, the multivariable Cox regression analysis showed that the highest quartiles of CumTyG index, CumTG/HDL-C ratio, and CumMetS-IR and the lowest quartile of CumeGDR were associated with stroke risk, with corresponding HR (95% CI) of 1.48(1.05-2.10), 1.61(1.15-2.24), 1.72(1.21-2.43), and 3.57(2.25-5.68), respectively. In terms of event prediction, receiver operating characteristic analysis revealed that CumeGDR had the highest predictive accuracy for incident stroke compared with other common IR surrogates. CONCLUSIONS In assessing stroke risk and predicting events in middle-aged and elderly populations, cumulative exposure to eGDR demonstrates significant advantages over other common IR surrogates. Incorporating eGDR as an IR monitoring marker is recommended for primary stroke prevention.
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Affiliation(s)
- Dezhi Hong
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Xiaohui Li
- Department of Cardiology, Chongren County People's Hospital, Fuzhou, Jiangxi, China
| | - Guotai Sheng
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Hongyi Yang
- Discipline Construction Office, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Wei Wang
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China.
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China.
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Jamil F, Mir U, Niazi AG, Kifayat S, Kifayat S, Shafiq S, Wali Z, Khan MAJ, Wali B, Kobra KT, Khan MS. A multi-level approach to reduce exploding type 2 diabetes in Pakistan. Front Public Health 2025; 13:1514090. [PMID: 40190761 PMCID: PMC11968735 DOI: 10.3389/fpubh.2025.1514090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2024] [Accepted: 03/03/2025] [Indexed: 04/09/2025] Open
Abstract
Pakistan has the third-highest rate of type 2 diabetes globally, following China and India, making this a significant public health crisis. Despite the severity of the issue, efforts from health and policy practitioners to address it remain limited. With millions already diagnosed as pre-diabetic, the rising incidence of diabetes is rapidly becoming a public health emergency that demands immediate attention. This policy brief provides an accessible overview of diabetes, focusing on its types, mechanisms, and preventive measures. It also identifies key contributing factors, such as dietary habits, obesity, physical inactivity, and the influence of modern dietary trends, while proposing strategies for individuals, communities, and policymakers to combat this growing epidemic in Pakistan. The brief emphasizes the need for a multi-level approach that includes public awareness, education, behavioral and dietary changes, and policy interventions to reverse the trend. Strategies discussed include promoting healthy eating, increasing physical activity, managing obesity, and enhancing access to affordable, healthy food. Additionally, the brief highlights the importance of community and government support, such as public health campaigns, infrastructure improvements, and legislative efforts. By adopting this comprehensive approach, Pakistan can take meaningful steps to address the diabetes epidemic and improve public health outcomes.
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Affiliation(s)
- Fazal Jamil
- St. Elizabeth Youngstown Hospital, Youngstown, OH, United States
| | - Umaima Mir
- Lady Reading Hospital, Peshawar, Pakistan
| | - Anum G. Niazi
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Shandana Kifayat
- Khyber Teaching Hospital, Khyber Medical University, Peshawar, Pakistan
| | | | | | | | - Muhammad Ali Jan Khan
- College of Physical Medicine and Rehabilitation Paraplegic Center, Khyber Medical University, Peshawar, Pakistan
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Ryu HE, Lee YJ, Park B, Jung DH. Comparisons of three novel markers for insulin resistance to predict incident cardiovascular disease: a Korean cohort study from three different regions. Eur J Med Res 2025; 30:188. [PMID: 40114229 PMCID: PMC11924704 DOI: 10.1186/s40001-025-02374-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 02/10/2025] [Indexed: 03/22/2025] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is a crucial human health challenge. Previous studies have shown an association between CVD and the triglyceride-glucose (TyG) index, atherogenic index of plasma (AIP), and metabolic score for insulin resistance (METS-IR). However, a comparison of these novel markers for predicting CVD is not well known. Therefore, we aimed to assess the value of TyG, AIP, and METS-IR in predicting the incidence of CVD in three large cohorts of Korean adults. METHODS Data from 28 437 participants in the Korean Genome and Epidemiology Study (KoGES) and Korea Health Insurance Review and Assessment (HERAS-HIRA) were assessed. The participants were divided into four groups according to the quartiles of TyG index: ln ([triglyceride × fasting plasma glucose]/2), AIP calculated as log (triglyceride/high-density lipoprotein cholesterol), and METS-IR index: (ln ([2 × fasting plasma glucose] + triglyceride) × body mass index)/(ln [high-density lipoprotein cholesterol-cholesterol]). We prospectively assessed the hazard ratios (HRs) with 95% confidence intervals (CIs) for CVD using multivariate Cox proportional hazard regression models after adjusting for potential confounding variables. RESULTS During the follow-up period, 987 participants (3.5%) developed CVD. Compared with the referent first quartiles, the highest TyG index, AIP, and METS-IR quartiles, with HRs of 1.73 (95% CI 1.41-2.12), 1.47 (95% CI 1.19-1.80), and 2.61 (95% CI 1.83-3.72), respectively, significantly predicted future CVD, after adjusting for age, sex, and body mass index. When comparing the three biomarkers for insulin resistance, the TyG index and METS-IR showed similar predictive values, whereas AIP had a lower significance in predicting CVD. CONCLUSIONS Based on the current findings, novel surrogate markers of insulin resistance, particularly METS-IR and TyG index, may help predict the risk of CVD in Koreans.
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Affiliation(s)
- Ha Eun Ryu
- Department of Family Medicine, Yongin Severance Hospital, 363 Dongbaekjukjeondae-Ro, Giheung-Gu, Yongin-Si, Gyeonggi-Do, 16995, Republic of Korea
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Yong Jae Lee
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
- 3Department of Family Medicine, Gangnam Severance Hospital, Seoul, 06273, Republic of Korea
| | - Byoungjin Park
- Department of Family Medicine, Yongin Severance Hospital, 363 Dongbaekjukjeondae-Ro, Giheung-Gu, Yongin-Si, Gyeonggi-Do, 16995, Republic of Korea.
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
| | - Dong Hyuk Jung
- Department of Family Medicine, Yongin Severance Hospital, 363 Dongbaekjukjeondae-Ro, Giheung-Gu, Yongin-Si, Gyeonggi-Do, 16995, Republic of Korea.
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
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Hirose T, Takagi H, Kuno M, Sasaki T, Taki K, Ito Y, Miyata T, Kobayashi T, Sugiyama M, Onoue T, Hagiwara D, Iwama S, Suga H, Banno R, Arima H. Dapagliflozin increased pancreatic beta cell proliferation and insulinogenic index in mice fed a high-fat and high-sodium chloride diet. Biochem Biophys Res Commun 2025; 749:151364. [PMID: 39855047 DOI: 10.1016/j.bbrc.2025.151364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2024] [Revised: 01/17/2025] [Accepted: 01/19/2025] [Indexed: 01/27/2025]
Abstract
People in Eastern Asia, including Japan, traditionally consume higher amounts of sodium chloride than in the United States and Western Europe, and it is common knowledge that impaired insulin secretion-rather than insulin resistance-is highly prevalent in Asian people who have diabetes mellitus. We previously reported that mice fed a high-fat and high-sodium chloride (HFHS) diet had a relatively lower degree of obesity than mice fed a high-fat diet, but had a comparatively impaired insulin secretion. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have been shown to dampen down the sympathetic nervous system, which reportedly is activated by a high-sodium chloride diet. In this study, we examined the effects of dapagliflozin, a SGLT2 inhibitor, on glucose metabolism and insulin secretion in mice fed a HFHS diet. C57BL6/J mice were fed a HFHS diet for 6 weeks and subsequently divided into two treatment groups fed: (1) a HFHS diet mixed with dapagliflozin for up to 3 weeks (HFHS + Da) and (2) a HFHS diet without dapagliflozin (HFHS). Dapagliflozin improved glucose tolerance and the insulinogenic index accompanied by increased pancreatic beta cell proliferation. Furthermore, dapagliflozin decreased both the tyrosine hydroxylase-positive area in pancreatic islets and catecholamine excretion in urine. Our results suggest that dapagliflozin improved insulin secretion by suppressing sympathetic nerve activation in mice fed a HFHS diet.
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Affiliation(s)
- Tomonori Hirose
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Hiroshi Takagi
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan; Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8602, Japan.
| | - Mitsuhiro Kuno
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Tomoyuki Sasaki
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Keigo Taki
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Yoshihiro Ito
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Takashi Miyata
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Tomoko Kobayashi
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Mariko Sugiyama
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Takeshi Onoue
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Daisuke Hagiwara
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Shintaro Iwama
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Hidetaka Suga
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Ryoichi Banno
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan; Research Center of Health, Physical Fitness and Sports, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601, Japan
| | - Hiroshi Arima
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
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Massa J, Sapp C, Janisch K, Adeyemo MA, McClure A, Heredia NI, Hoelscher DM, Moin T, Malik S, Slusser W, Eisenberg DM. Improving Cooking Skills, Lifestyle Behaviors, and Clinical Outcomes for Adults at Risk for Cardiometabolic Disease: Protocol for a Randomized Teaching Kitchen Multisite Trial (TK-MT). Nutrients 2025; 17:314. [PMID: 39861444 PMCID: PMC11768256 DOI: 10.3390/nu17020314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2024] [Revised: 01/07/2025] [Accepted: 01/09/2025] [Indexed: 01/27/2025] Open
Abstract
BACKGROUND/OBJECTIVES This protocol describes a study to investigate the feasibility and preliminary efficacy of a novel Teaching Kitchen Multisite Trial (TK-MT) for adults with cardiometabolic abnormalities. The TK-MT protocol describes a hybrid lifestyle intervention combining in-person and virtual instruction in culinary skills, nutrition education, movement, and mindfulness with community support and behavior change strategies. This 18-month-long randomized controlled trial aims to evaluate the feasibility of implementing a 12-month, 24 class program, assess preliminary study efficacy, and identify barriers and facilitators to implementation. METHODS The intervention program includes 16 weeks of intensive hands-on culinary and lifestyle education classes followed by eight monthly virtual classes. Psychometric assessments and biometric data will be collected at baseline, 4, 12, and 18 months. Semi-structured interviews and open-ended surveys will be conducted during the 12-month follow-up assessment. RESULTS Feasibility will be assessed through recruitment, attendance, and fidelity data. Secondary outcomes will analyze changes in health behaviors, biometric data, and anthropometric measures using mixed-effects regression models. Qualitative data will undergo thematic analysis. CONCLUSIONS As envisioned and described in detail in this manuscript, this study will inform the development and implementation of reproducible, scalable teaching kitchen interventions. The protocol described here is intended to set the stage for future investigations to evaluate evidence for the impact of teaching kitchen interventions on dietary habits, physical activity, and overall health and well-being.
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Affiliation(s)
- Jennifer Massa
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (K.J.); (D.M.E.)
| | - Candace Sapp
- Department of Nutrition, University of Tennessee, Knoxville, TN 37996, USA;
- Department of Behavioral, Social and Health Education Sciences, School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Kate Janisch
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (K.J.); (D.M.E.)
| | - Mopelola A. Adeyemo
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA; (M.A.A.); (T.M.)
| | - Auden McClure
- Section of Obesity Medicine, Center for Digestive Health, Dartmouth Health, Lebanon, NH 03756, USA;
- Department of Pediatrics and Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
| | - Natalia I. Heredia
- Department of Health Promotion & Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth Houston), Houston, TX 77030, USA; (N.I.H.); (D.M.H.)
| | - Deanna M. Hoelscher
- Department of Health Promotion & Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth Houston), Houston, TX 77030, USA; (N.I.H.); (D.M.H.)
- Michael and Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin, TX 78701, USA
| | - Tannaz Moin
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA; (M.A.A.); (T.M.)
- Health Services Research, Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA
| | - Shaista Malik
- Susan Samueli Integrative Health Institute, Mary and Steve Wen Cardiovascular Division, Department of Medicine, University of California-Irvine, Irvine, CA 92697, USA;
| | - Wendelin Slusser
- Semel Healthy Campus Initiative Center, Chancellor’s Office, University of California at Los Angeles, Los Angeles, CA 90024, USA;
- Department of Pediatrics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90024, USA
- Department of Community Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA 90024, USA
| | - David M. Eisenberg
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (K.J.); (D.M.E.)
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Lai J, Li XQ, Zheng Y, Liu Z, Wu Q, Cao Y. Age-dependent interaction between serum zinc and triglyceride-glucose index among American adults: National Health and Nutrition Examination Survey. Front Nutr 2025; 11:1475204. [PMID: 39872136 PMCID: PMC11769825 DOI: 10.3389/fnut.2024.1475204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Accepted: 12/12/2024] [Indexed: 01/29/2025] Open
Abstract
Introduction Zinc plays a crucial role in glucose metabolism. The association between serum zinc and insulin resistance has recently been investigated as well, but the findings are inconsistent. The triglyceride-glucose index (TyG) is frequently utilized in epidemiological research to assess insulin resistance. The association between serum zinc levels and TyG has not yet been explored. Therefore, we designed this cross-sectional study to assess the relationship between serum zinc and TyG in adults using data from the National Health and Nutrition Examination Survey (NHANES). Methods A cross-sectional analysis was performed on 1,610 adults aged ≥20 years who participated in the National Health and Nutrition Examination Survey (NHANES) 2011-2016. The participants were stratified by age, and the differences in log-transformed serum zinc quartiles and TyG were further evaluated in age groups <60 years and ≥60 years using multivariable linear regression with an interaction test. Additionally, a restricted cubic spline (RCS) model was employed to examine the dose-response relationships between log-transformed serum zinc and TyG. Results In this cross-sectional study, a significant interaction was observed between log-transformed serum zinc and TyG in individuals aged <60 years and those aged ≥60 years when log-transformed serum zinc was transformed into a categorical variable (P-value for the likelihood ratio test for the interaction was P = 0.017). Additionally, in the fully adjusted analyses, the association between log-transformed serum zinc and TyG in the age <60 years group demonstrated a J-shaped nonlinear pattern (P for nonlinearity = 0.014), with an inflection point at ~1.94 μg/dL. While in the age ≥60 years group, it exhibited an inverted-L shaped nonlinear pattern (P for nonlinearity < 0.001***). Conclusion There is a significant relationship between log-transformed serum zinc and TyG in adults in the United States, with age potentially influencing this association. Further prospective studies are needed to offer additional evidence and insights into these findings.
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Affiliation(s)
- Jun Lai
- Department of Pharmacology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, Shanxi, China
- Department of Pharmacy, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, Jiangxi, China
| | - Xin-Qing Li
- Department of Pharmacy, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, Jiangxi, China
| | - Yinglin Zheng
- Department of Endocrinology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, Jiangxi, China
| | - Zongyan Liu
- Department of Pharmacy, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, Jiangxi, China
| | - Qiquan Wu
- Department of Pharmacy, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, Jiangxi, China
| | - Yongxiao Cao
- Department of Pharmacology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, Shanxi, China
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Pucci G, Alcidi R, Curcio R. The triglyceride-glucose index: A valuable tool for uncovering the hidden connection between metabolic diseases and arterial ageing. Nutr Metab Cardiovasc Dis 2025; 35:103766. [PMID: 39571326 DOI: 10.1016/j.numecd.2024.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Revised: 10/01/2024] [Accepted: 10/04/2024] [Indexed: 12/16/2024]
Affiliation(s)
- Giacomo Pucci
- Unit of Internal and Translational Medicine, Azienda Ospedaliera "Santa Maria", Terni, Italy; Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
| | - Riccardo Alcidi
- Unit of Internal and Translational Medicine, Azienda Ospedaliera "Santa Maria", Terni, Italy
| | - Rosa Curcio
- Unit of Internal and Vascular Medicine, Azienda Ospedaliera "Santa Maria", Terni, Italy
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10
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Qiu J, He S, Yu C, Yang R, Kuang M, Sheng G, Zou Y. Assessing the validity of METS-IR for predicting the future onset of diabetes: an analysis using time-dependent receiver operating characteristics. BMC Endocr Disord 2024; 24:238. [PMID: 39508243 PMCID: PMC11542444 DOI: 10.1186/s12902-024-01769-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 10/29/2024] [Indexed: 11/08/2024] Open
Abstract
BACKGROUND The Metabolic Insulin Resistance Score (METS-IR) is a non-invasive proxy for insulin resistance (IR) that has been newly developed in recent years and has been shown to be associated with diabetes risk. Our aim was to assess the predictive value of METS-IR for the future development of diabetes and its temporal differences in people of different sex, age, and body mass index (BMI). METHODS The current study included 15,453 baseline non-diabetic subjects in the NAGALA cohort and then grouped according to the World Health Organization's (WHO) recommended criteria for age and BMI. Multivariate Cox regression and time-dependent receiver operator characteristics (ROC) curves were used to analyze the value of METS-IR in assessing and predicting the risk of diabetes in people of different sexes, ages, and BMIs. RESULTS 373 individuals developed diabetes during the observation period. By multivariate COX regression analysis, the development of future diabetes was significantly associated with increased METS-IR, and this positive association was stronger in women than in men and in individuals < 45 years than in individuals ≥ 45 years; while no significant differences were observed between non-obese and overweight/obesity individuals. Using time-dependent ROC analysis we also assessed the predictive value of METS-IR for future diabetes at a total of 11-time points between 2 and 12 years. The results showed that METS-IR had a higher predictive value for the future development of diabetes in women or individuals < 45 years of age compared to men or individuals ≥ 45 years of age for almost the entire follow-up period. Furthermore, across different BMI categories, we also found that in the short term (3-5 years), METS-IR had a higher predictive value for the development of diabetes in individuals with overweight/obesity, while in the medium to long term (6-12 years), METS-IR was more accurate in predicting the development of diabetes in non-obese individuals. CONCLUSIONS Our study showed that METS-IR was independently associated with the development of future diabetes in a non-diabetic population. METS-IR was a good predictor of diabetes, especially for women and individuals < 45 years old for predicting the future risk of developing diabetes at all times.
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Affiliation(s)
- Jiajun Qiu
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
| | - Shiming He
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi Provincial, China
| | - Changhui Yu
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi Provincial, China
| | - Ruijuan Yang
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
- Department of Endocrinology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi Provincial, China
| | - Maobin Kuang
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi Provincial, China
| | - Guotai Sheng
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi Provincial, China.
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi Provincial, China.
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11
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Dogan R, Kucuk RB, Tugrul S, Yenigun A, Calim OF, Dogan EE, Polat E, Ozturan O. Evaluation of Triglyceride-Glucose Index Elevation as a Biomarker and Risk Factor in Laryngeal Squamous Cell Carcinoma. Clin Otolaryngol 2024; 49:742-747. [PMID: 38982800 DOI: 10.1111/coa.14197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/24/2024] [Accepted: 06/25/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVES Insulin resistance is associated with increased levels of IGF-1. IGF-1 has been shown to increase the risk of laryngeal squamous cell carcinoma. The Triglyceride-glucose index (TyG index) is a marker of insulin resistance. Our study aimed to investigate the relationship between the TyG index and laryngeal squamous cell carcinoma. DESIGN Retrospective cohort study. SETTING Two tertiary care academic hospitals. METHODS The study included 53 patients with laryngeal squamous cell carcinoma (Group 1) and 48 healthy volunteers (Group 2). Laryngeal cancer patients were divided into two groups according to their stage. Stages I and II were named Group 1A, and Stages III and IV were called Group 1B. The TyG index was calculated as ln [fasting Triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. The effect of the TyG index on laryngeal cancer was investigated on the parameters of sex, age, body mass index, and stage of the disease. RESULTS There were no significant differences in age, sex, and BMI between the groups. The TyG index of group 1 (4.75 ± 0.33) was significantly higher than that of group 2 (4.59 ± 0.15). The TyG index value of group 1B (4.84 ± 0.31) was significantly higher than both group 1A (4.61 ± 0.32) and group 2 (4.59 ± 0.15). There was no significant difference between the TyG index values of group 1A (4.61 ± 0.32) and group 2 (4.59 ± 0.15). CONCLUSION The TyG index may be a promising laryngeal squamous cell carcinoma biomarker. People with a higher TyG index may have a higher incidence of laryngeal squamous cell carcinoma and a higher risk of progression.
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Affiliation(s)
- Remzi Dogan
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Ramazan Bahadir Kucuk
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Selahattin Tugrul
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Alper Yenigun
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Omer Faruk Calim
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Elif Ece Dogan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Emre Polat
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Orhan Ozturan
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
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12
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Lai X, Chen T. Association between the triglyceride-glucose index and serum soluble Klotho in middle-aged and older adults from NHANES 2007-2016. Sci Rep 2024; 14:18408. [PMID: 39117772 PMCID: PMC11310314 DOI: 10.1038/s41598-024-69226-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Accepted: 08/01/2024] [Indexed: 08/10/2024] Open
Abstract
Klotho, an anti-aging protein, is believed to participate in metabolic diseases and play a potential protective role by regulating insulin sensitivity. This study aimed to explore the relationship between the triglyceride-glucose (TyG) index (a simple marker of insulin resistance) and serum soluble Klotho (S-Klotho) levels. The cross-sectional study comprised 5237 adults aged 40-79 years who participated in the National Health and Nutrition Examination Surveys (NHANES) 2007-2016. The TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. The serum levels of S-Klotho were measured by enzyme-linked immunosorbent assay. The association between the TyG index and S-Klotho levels was investigated by multiple linear regression models, smoothed curve fitting, segmented linear regression models, subgroup analyses, and interaction tests. The TyG index was inversely associated with serum S-Klotho level after full adjustment (β = - 45.11, 95% CI (- 79.53, - 10.69), P = 0.011). Furthermore, we also found a non-linear correlation and saturation phenomenon between the TyG index and serum S-Klotho levels, with a turning point of 9.56. In addition, a significant interaction effect of sex was found between the two (P for interaction < 0.001), with a more pronounced association observed in females. Further studies are required to explore the mechanisms and verify the correlation.
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Affiliation(s)
- Xiaoli Lai
- Department of Endocrinology and Metabolism, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
- The Third Clinical Medical College of Fujian Medical University, Fujian Medical University, Longyan, 364000, China
| | - Tao Chen
- Department of Endocrinology and Metabolism, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.
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13
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Wang G, Zhu Z, Wang Y, Zhang Q, Sun Y, Pang G, Ge W, Ma Z, Ma H, Gong L, Ma H, Shao F, Zhu M. The association between METS-IR, an indirect index for insulin resistance, and lung cancer risk. Eur J Public Health 2024; 34:800-805. [PMID: 38300233 PMCID: PMC11293818 DOI: 10.1093/eurpub/ckad234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Insulin resistance has been reported to increase the risk of breast, prostate and colorectal cancer. However, the role of insulin resistance and its interaction with genetic risk in the development of lung cancer remains controversial. Therefore, we aimed to explore the association between a novel metabolic score for insulin resistance (METS-IR) and lung cancer risk. METHODS A total of 395 304 participants without previous cancer at baseline were included. The Cox proportional hazards regression model was performed to investigate the association between METS-IR and lung cancer risk. In addition, a Mendelian randomization analysis was also performed to explore the causal relationship. The joint effects and additive interactions between METS-IR and polygenetic risk score (PRS) of lung cancer were also investigated. RESULTS During a median follow-up of 11.03 years (Inter-quartile range (IQR): 10.30-11.73), a total of 3161 incident lung cancer cases were diagnosed in 395 304 participants. There was a significant association between METS-IR and lung cancer risk, with an HR of 1.28 (95% CI: 1.17-1.41). Based on the Mendelian randomization analysis, however, no causal associations were observed. We observed a joint effect but no interaction between METS-IR and genetic risk. The lung cancer incidence was estimated to be 100.42 (95% CI: 91.45-109.38) per 100 000 person-year for participants with a high METS-IR and PRS, while only 42.76 (95% CI: 36.94-48.59) with low METS-IR and PRS. CONCLUSIONS High METS-IR was significantly associated with an increased risk of lung cancer. Keeping a low level of METS-IR might help reduce the long-term incident risk of lung cancer.
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Affiliation(s)
- Guoqing Wang
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Zhaopeng Zhu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yi Wang
- Department of Respiratory Disease, Nanjing Chest Hospital, Nanjing Medical University, Nanjing, China
| | - Qiang Zhang
- Department of Thoracic Surgery, Nanjing Chest Hospital, Nanjing Medical University, Nanjing, China
| | - Yungang Sun
- Department of Thoracic Surgery, Nanjing Chest Hospital, Nanjing Medical University, Nanjing, China
| | - Guanlian Pang
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Wenjing Ge
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Zhimin Ma
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Huimin Ma
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Linnan Gong
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Hongxia Ma
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Feng Shao
- Department of Thoracic Surgery, Nanjing Chest Hospital, Nanjing Medical University, Nanjing, China
| | - Meng Zhu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Epidemiology, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
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14
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Wang J, Li H, Hu J, Shi R, Qin C, Chen X, Chen S, Zeng X, Luo H, Luo H, Zhou Y, Yang P, Wang D. Relationship of triglyceride-glucose index to gallstone prevalence and age at first gallstone surgery in American adults. Sci Rep 2024; 14:16749. [PMID: 39033195 PMCID: PMC11271289 DOI: 10.1038/s41598-024-67883-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 07/17/2024] [Indexed: 07/23/2024] Open
Abstract
The triglyceride-glucose (TyG) index is a novel marker of insulin resistance that has been strongly associated with many diseases related to metabolic disorders, such as diabetes, coronary heart disease, myocardial infarction, obesity, nonalcoholic fatty liver disease, and stroke. However, whether the TyG index is associated with the prevalence of gallstones has not been determined. Therefore, the purpose of this study was to evaluate the relationship between the TyG index and the prevalence of gallstones in American adults, as well as the age at which adults in America undergo their first gallstone surgery. We selected individuals from the National Health and Nutrition Examination Survey (NHANES) database from 2017 to March 2020. Based on the goal of our study, comprehensive inclusion and exclusion criteria were created. A logistic regression analysis, dose-response curve, and subgroup analysis were computed to assess the relationship between the TyG index and gallstone prevalence and age at first surgery for gallstone. A total of 3905 participants aged > 20 years were included in our study, of whom 421 had a self-reported history of gallstones. A total of 1884 (48.2%) males and 2021 (51.8%) females were included. After confounders adjustment, it was found single-unit increases in the TyG index were linked with a 25.0% increase in gallstone prevalence (odds ratio [OR] = 1.25, 95% confidence interval [95%CI]: 1.04, 1.51). After conversion of the TyG index values from continuous to categorical variables with tertiles, a marked 48% increase in gallstone incidence was found in tertile 3 relative to tertile 1 (OR = 1.48, 95% CI: 1.09, 1.99). The dose-response curve results indicated positive associations between gallstone prevalence and the TyG index, while the latter was negatively associated with age at first gallstone surgery. Based on subgroup analysis, the positive association between TyG index and high-incidence of gallstones was more significant in females (OR = 1.39, 95% CI: 1.09, 1.77), age < 40 years (OR = 2.02, 95% CI: 1.23, 3.29), and other race (OR = 1.46, 95% CI: 1.06, 2.02). A higher TyG index is associated with a higher incidence of gallstones and may lead to an earlier age of first gallstone surgery. However, a causal relationship between TyG and gallstones cannot be established.
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Affiliation(s)
- Jianjun Wang
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
- NHC Key Laboratory of Nuclear Technology Medical Transformation, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Han Li
- Department of Cardiology, The Fifth Hospital of Wuhan, Wuhan, 430050, China
| | - Junchao Hu
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Ruizi Shi
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Chuan Qin
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Xi Chen
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Sirui Chen
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Xintao Zeng
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Hua Luo
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Huiwen Luo
- NHC Key Laboratory of Nuclear Technology Medical Transformation, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Yulong Zhou
- Department of General Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China
| | - Pei Yang
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China.
| | - Decai Wang
- NHC Key Laboratory of Nuclear Technology Medical Transformation, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China.
- Department of Urology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, 621000, China.
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15
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Zhou X, Xu J, Dai H. The ratio of alanine aminotransferase to high-density lipoprotein cholesterol is positively correlated with the insulin resistance in American adults: a population-based cohort study. Front Med (Lausanne) 2024; 11:1418364. [PMID: 38962742 PMCID: PMC11220187 DOI: 10.3389/fmed.2024.1418364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/05/2024] [Indexed: 07/05/2024] Open
Abstract
Introduction Previous studies have demonstrated a correlation between the ratio of alanine aminotransferase to high-density lipoprotein cholesterol (ALT/HDL-C) in the serum and the risk of diabetes. However, no existing study has investigated the association between insulin resistance (IR) and ALT/HDL-C. Therefore, this study aims to explore the association between ALT/HDL-C and IR in American adults. Methods A total of 7,599 adults selected from the National Health and Nutrition Examination Survey (NHANES) in 2013 to 2020 were studied. IR was assessed based on the homeostatic model assessment of insulin resistance (HOMA-IR). And the association between IR and ALT/HDL-C was assessed through multiple logistic regression, generalized smooth curve fitting and subgroup analyses. Results Multiple logistic regression analysis indicated a significant correlation between IR and ALT/HDL-C, with odds ratios (OR) of 1.04 (95% CI = 1.02-1.05) in males and 1.04 (95% CI = 1.02-1.07) in females. A non-linear association and saturation effect between ALT/HDL-C and IR risk were identified, with an inverted L shaped curve and an inflection point at 33.62. The area under the ROC curve (AUC) of ALT/HDL-C was significantly larger (AUC = 0.725 for males and 0.696 for females, all p < 0.01) compared with the use of ALT, HDL-C, AST and AST/ALT. Subgroup analysis showed a significantly higher independent association in obese individuals and individuals aged ≥50 years (All P interaction <0.05). Conclusion Elevated ALT/HDL-C demonstrates a significant correlation with IR, which can be used as a potential indicator of IR in American adults.
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Affiliation(s)
| | | | - Huifang Dai
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
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16
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Cheng H, Jia Z, Li YT, Yu X, Wang JJ, Xie YJ, Hernandez J, Wang HHX. Metabolic Score for Insulin Resistance and New-Onset Type 2 Diabetes in a Middle-Aged and Older Adult Population: Nationwide Prospective Cohort Study and Implications for Primary Care. JMIR Public Health Surveill 2024; 10:e49617. [PMID: 38569189 PMCID: PMC11184265 DOI: 10.2196/49617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 02/29/2024] [Accepted: 03/29/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND The metabolic score for insulin resistance (METS-IR) has emerged as a noninsulin-based index for the approximation of insulin resistance (IR), yet longitudinal evidence supporting the utility of METS-IR in the primary prevention of type 2 diabetes mellitus (T2DM) remains limited. OBJECTIVE We aimed to investigate the longitudinal association between METS-IR, which combines fasting plasma glucose (FPG), lipid profiles, and anthropometrics that can be routinely obtained in resource-limited primary care settings, and the incidence of new-onset T2DM. METHODS We conducted a closed-cohort analysis of a nationwide, prospective cohort of 7583 Chinese middle-aged and older adults who were free of T2DM at baseline, sampled from 28 out of 31 provinces in China. We examined the characteristics of participants stratified by elevated blood pressure (BP) at baseline and new-onset T2DM at follow-up. We performed Cox proportional hazard regression analysis to explore associations of baseline METS-IR with incident T2DM in participants overall and in participants stratified by baseline BP. We also applied net reclassification improvement and integrated discrimination improvement to examine the incremental value of METS-IR. RESULTS During a mean follow-up period of 6.3 years, T2DM occurred in 527 participants, among which two-thirds (332/527, 62.9%; 95% CI 58.7%-67.1%) had baseline FPG<110 mg/dL. A SD unit increase in baseline METS-IR was associated with the first incidence of T2DM (adjusted hazard ratio [aHR] 1.33, 95% CI 1.22-1.45; P<.001) in all participants. We obtained similar results in participants with normal baseline BP (aHR 1.41, 95% CI 1.22-1.62; P<.001) and elevated baseline BP (aHR 1.29, 95% CI 1.16-1.44; P<.001). The predictive capability for incident T2DM was improved by adding METS-IR to FPG. In study participants with new-onset T2DM whose baseline FPG was <126 mg/dL and <110 mg/dL, 62.9% (332/527; 95% CI 60%-65.9%) and 58.1% (193/332; 95% CI 54.3%-61.9%) of participants had baseline METS-IR above the cutoff values, respectively. CONCLUSIONS METS-IR was significantly associated with new-onset T2DM, regardless of baseline BP level. Regular monitoring of METS-IR on top of routine blood glucose in clinical practice may add to the ability to enhance the early identification of primary care populations at risk for T2DM.
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Affiliation(s)
- Hui Cheng
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Zhihui Jia
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Yu Ting Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Xiao Yu
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Jia Ji Wang
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Yao Jie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, China (Hong Kong)
| | - Jose Hernandez
- Faculty of Medicine and Health, EDU, Digital Education Holdings Ltd, Kalkara, Malta
- Green Templeton College, University of Oxford, Oxford, United Kingdom
| | - Harry H X Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, China (Hong Kong)
- Usher Institute, Deanery of Molecular, Genetic & Population Health Sciences, The University of Edinburgh, Edinburgh, United Kingdom
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17
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Zhou X, Xu J. Association between serum uric acid-to-high-density lipoprotein cholesterol ratio and insulin resistance in an American population: A population-based analysis. J Diabetes Investig 2024; 15:762-771. [PMID: 38407574 PMCID: PMC11143423 DOI: 10.1111/jdi.14170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 01/31/2024] [Accepted: 02/13/2024] [Indexed: 02/27/2024] Open
Abstract
INTRODUCTION Previous studies have demonstrated a correlation between the serum uric acid-to-high-density lipoprotein cholesterol ratio (UHR) and insulin resistance (IR) in individuals with type 2 diabetes mellitus. However, no existing studies have investigated the relationship between IR and UHR in the general population. Therefore, the primary objective of this study was to investigate the correlation between UHR and IR in the general American population. METHODS A sample of 8,817 participants was selected from the 2013 to 2020 National Health and Nutrition Examination Survey (NHANES). Homeostatic model assessment of insulin resistance (HOMA-IR) was used to assess insulin resistance. Multiple logistic regression, generalized smooth curve fitting, and subgroup analysis were used to assess the association between IR and UHR. RESULTS Multiple logistic regression analysis indicated a significant correlation between insulin resistance and UHR, with odds ratios (OR) of 1.07 (95% CI = 1.03-1.11) in males and 1.18 (95% CI = 1.13-1.25) in females. A non-linear relationship and saturation effect between IR risk and UHR were observed, characterized by an inverted L-shaped curve and a critical inflection point at 8.82. It was found that the area under the ROC curve (AUC) of UHR was significantly larger (AUC = 0.703 for males and 0.747 for females, all P < 0.01) compared with the use of UA or HDL-C alone. Subgroup analysis showed that this independent association remain consistent regardless of race, age, BMI, diabetes, moderate activities, education level, alcohol drinking, and gender. CONCLUSION Elevated UHR demonstrates a significant correlation with insulin resistance, so it can be used as a potential indicator of insulin resistance within the American population.
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Affiliation(s)
- Xiaohai Zhou
- Department of Hematology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jing Xu
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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18
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Łupińska A, Aszkiełowicz S, Kowalik D, Jeziorny K, Kolasa-Kicińska M, Smalczewska P, Zygmunt A, Lewiński A, Stawerska R. Comparison of the Clinical Utility of Two Insulin Resistance Indices: IRI-HOMA and IRI-Belfiore in Diagnosing Insulin Resistance and Metabolic Complications in Children Based on the Results Obtained for the Polish Population. J Clin Med 2024; 13:2865. [PMID: 38792408 PMCID: PMC11122103 DOI: 10.3390/jcm13102865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/06/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Recognizing insulin resistance (IR) in children remains challenging due to uncertain IRI-HOMA cut-offs and unclear recommendations for evaluating IR based on OGTT. In our study, we compare the effectiveness of IRI-HOMA and IRI-Belfiore (OGTT-based) in detecting IR and its metabolic complications in children. Methods: The analysis included 553 children who were hospitalized at the Department of Endocrinology and Metabolic Diseases of the Polish Mother's Memorial Hospital Research Institute (PMMH-RI) in Lodz, Poland, between 2002 and 2018 due to various reasons-of these, 67.5% were girls. All underwent OGTT for glucose and insulin assessment. IR diagnosis relied on IRI-HOMA and IRI-Belfiore. IR based on IRI-HOMA was evaluated using three criteria: (A) >2.5; (B) >2.67 in boys and >2.22 in girls before puberty and >5.22 and >3.82 during puberty, respectively; (C) >95th percentile according to charts for IRI-HOMA in children. Results: Prepubertal children exhibited significantly lower IRI-HOMA and IRI-Belfiore than their pubertal counterparts (p < 0.00005). IRI-HOMA and IRI-Belfiore values positively correlated with age and BMI SDS value (p < 0.000001 for all calculations). As many as 26% to 46.9% of children with normal IRI-HOMA showed elevated IRI-Belfiore, with notably higher levels of triglycerides, a lower HDL cholesterol fraction, and a lower HDL/total cholesterol ratio in this subgroup. Conclusions: A notable proportion of children exhibited elevated IRI-Belfiore levels despite having normal IRI-HOMA values. This suggests the possibility of peripheral IR preceding hepatic IR in children-omitting an OGTT may therefore lead to overlooking cases of IR. Children diagnosed with IR via OGTT displayed significantly poorer lipid profiles compared to those without IR (characterized by normal values in both IRI-HOMA and IRI-Belfiore). This underscores the ability of OGTT-derived IR indices to identify individuals at risk of developing complications associated with obesity and IR before the onset of metabolic syndrome (MS) symptoms. If IR is already detected in children based on fasting glucose and insulin levels (IRI-HOMA), further evaluation may not be warranted, as OGTT results often simply confirm the diagnosis.
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Affiliation(s)
- Anna Łupińska
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
- Department of Pediatric Endocrinology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Sara Aszkiełowicz
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
| | - Dorota Kowalik
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
| | - Krzysztof Jeziorny
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
- Department of Pediatric Endocrinology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Marzena Kolasa-Kicińska
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
| | - Paula Smalczewska
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
| | - Arkadiusz Zygmunt
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, 90-419 Lodz, Poland
| | - Andrzej Lewiński
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
- Department of Pediatric Endocrinology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Renata Stawerska
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
- Department of Pediatric Endocrinology, Medical University of Lodz, 90-419 Lodz, Poland
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Seckiner S, Bas M, Simsir IY, Ozgur S, Akcay Y, Aslan CG, Kucukerdonmez O, Cetinkalp S. Effects of Dietary Carbohydrate Concentration and Glycemic Index on Blood Glucose Variability and Free Fatty Acids in Individuals with Type 1 Diabetes. Nutrients 2024; 16:1383. [PMID: 38732629 PMCID: PMC11085728 DOI: 10.3390/nu16091383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/08/2024] [Accepted: 04/08/2024] [Indexed: 05/13/2024] Open
Abstract
Monitoring glycemic control status is the cornerstone of diabetes management. This study aimed to reveal whether moderate-carbohydrate (CHO) diets increase the risk of free fatty acid (FFA) levels, and it presents the short-term effects of four different diet models on blood sugar, glycemic variability (GV), and FFA levels. This crossover study included 17 patients with type 1 diabetes mellitus to identify the effects of four diets with different CHO contents and glycemic index (GI) on GV and plasma FFA levels. Diet 1 (D1) contained 40% CHO with a low GI, diet 2 (D2) contained 40% CHO with a high GI, diet 3 (D3) contained 60% CHO with a low GI, and diet 4 (D4) contained 60% CHO with a high GI. Interventions were performed with sensor monitoring in four-day periods and completed in four weeks. No statistical difference was observed among the groups in terms of blood glucose area under the curve (p = 0.78), mean blood glucose levels (p = 0.28), GV (p = 0.59), and time in range (p = 0.567). FFA and total triglyceride levels were higher in the D1 group (p < 0.014 and p = 0.002, respectively). Different diets may increase the risk of cardiovascular diseases by affecting GI, FFA, and blood glucose levels.
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Affiliation(s)
- Selda Seckiner
- Department of Nutrition and Dietetics, Faculty of Health Sciences, İstanbul Beykent University, Istanbul 34520, Turkey
- Institute of Health Sciences, Acibadem Mehmet Ali Aydınlar University, Istanbul 34450, Turkey
| | - Murat Bas
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Acibadem Mehmet Ali Aydınlar University, Istanbul 34450, Turkey;
| | - Ilgin Yildirim Simsir
- Division of Endocrinology and Metabolism Disorders, Department of Internal Medicine, Faculty of Medicine, Ege University, Izmir 35100, Turkey; (I.Y.S.); (S.C.)
| | - Su Ozgur
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ege University, Izmir 35100, Turkey;
| | - Yasemin Akcay
- Department of Medical Biochemistry, Faculty of Medicine, Ege University, Izmir 35100, Turkey;
| | - Cigdem Gozde Aslan
- Department of Medical Biochemistry, Faculty of Medicine, Biruni University, Istanbul 34010, Turkey;
| | - Ozge Kucukerdonmez
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ege University, Izmir 35100, Turkey;
| | - Sevki Cetinkalp
- Division of Endocrinology and Metabolism Disorders, Department of Internal Medicine, Faculty of Medicine, Ege University, Izmir 35100, Turkey; (I.Y.S.); (S.C.)
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Zeng J, Zhang T, Yang Y, Wang J, Zheng D, Hou Y, Tong Y, Fan X, Wang X, Fang Y. Association between a metabolic score for insulin resistance and hypertension: results from National Health and Nutrition Examination Survey 2007-2016 analyses. Front Endocrinol (Lausanne) 2024; 15:1369600. [PMID: 38711979 PMCID: PMC11070536 DOI: 10.3389/fendo.2024.1369600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/08/2024] [Indexed: 05/08/2024] Open
Abstract
Background The Metabolic Score for Insulin Resistance (METS-IR) offers a promising and reliable non-insulin-based approach to assess insulin resistance and evaluate cardiometabolic risk. However, evidence for the association between METS-IR and hypertension was still limited. Methods Participants from the National Health and Nutrition Examination Survey (NHANES) database from 2007-2016 were selected for weighted multivariable regression analyses, subgroup analyses and restricted cubic spline (RCS) modeling to assess the association between the METS-IR and hypertension, as well as systolic blood pressure (SBP) and diastolic blood pressure (DBP). Results This study enrolled 7,721 adults aged ≥20 years, 2,926 (34.03%) of whom was diagnosed as hypertension. After adjusting for all potential covariates, an increased METS-IR (log2 conversion, denoted as log2METS-IR) was independently associated with a higher prevalence of hypertension (odd ratio [OR] 3.99, 95% confidence interval [CI] 3.19~5.01). The OR for hypertension in subjects with the highest quartile of METS-IR was 3.89-fold (OR 3.89, 95% CI 3.06~4.94) higher than that in those with the lowest quartile of METS-IR. This positive correlation became more significant as METS-IR increased (p for trend < 0.001). Log2METS-IR was significantly correlated with increase in SBP (β 6.75, 95% CI 5.65~7.85) and DBP (β 5.59, 95% CI 4.75~6.43) in a fully adjusted model. Consistent results were obtained in subgroup analyses. Hypertension, SBP and DBP all exhibited a non-linear increase with the rise in METS-IR. The minimal threshold for the beneficial association of METS-IR with hypertension, SBP and DBP were all identified to be 46.88. Conclusion The findings of this study revealed a significant positive association between METS-IR and hypertension among US adults, suggesting METS-IR as a potential tool for assessing hypertension risk.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Xuan Wang
- Department of Endocrinology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yi Fang
- Department of Endocrinology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
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21
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Shangguan Q, Liu Q, Yang R, Zhang S, Sheng G, Kuang M, Zou Y. Predictive value of insulin resistance surrogates for the development of diabetes in individuals with baseline normoglycemia: findings from two independent cohort studies in China and Japan. Diabetol Metab Syndr 2024; 16:68. [PMID: 38491516 PMCID: PMC10943817 DOI: 10.1186/s13098-024-01307-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 03/05/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Insulin resistance (IR) plays a crucial role in the occurrence and progression of diabetes. This study aimed to evaluate and compare the predictive value of four IR surrogates, including the triglycerides glucose (TyG) index, TyG and body mass index (TyG-BMI), triglycerides/high-density lipoprotein cholesterol (TG/HDL-C) ratio, and the metabolic score for IR (MetS-IR) for diabetes in two large cohorts. METHODS A total of 116,661 adult participants from the China Rich Healthcare Group and 15,464 adult participants from the Japanese NAGALA cohort were included in the study. Multivariable Cox proportional hazards models were used to assess the standardized hazard ratio (HR) of the TyG index, TyG-BMI, TG/HDL-C ratio, and MetS-IR directly associated with diabetes. Receiver operating characteristic (ROC) curve and time-dependent ROC curve analysis were performed to evaluate and compare the predictive value of the four IR surrogates for diabetes. RESULTS In the two independent cohorts, the average follow-up time was 3.1 years in the China cohort, with 2681(2.30%) incident cases of diabetes recorded, and 6.13 years in the Japan cohort, with 373 incident cases (2.41%) of diabetes recorded. After adjusting for potential confounding factors, we found that among the four IR surrogates, TyG-BMI and MetS-IR showed stronger associations with diabetes. The stronger associations persisted even after further stratification by age, sex, hypertension, and obese subgroups. In terms of diabetes prediction, based on ROC analysis, TyG-BMI demonstrated the highest predictive accuracy for diabetes in the Chinese population, while both TyG-BMI and MetS-IR showed the highest predictive accuracy in the Japanese population. The results of further subgroup ROC analysis confirmed the robustness of these findings. Furthermore, the time-dependent ROC results indicated that among the four IR surrogates, MetS-IR exhibited the highest accuracy in predicting future diabetes at various time intervals in the Japanese population. CONCLUSION Our findings suggest that evaluating TyG-BMI and MetS-IR as IR surrogates may be the most useful for predicting diabetes events and assessing the risk of developing diabetes in East Asian populations.
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Affiliation(s)
- Qing Shangguan
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
| | - Qiuling Liu
- Cardiovascular Research Institute of Jiangxi Province, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
| | - Ruijuan Yang
- Jiangxi Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China
- Department of Endocrinology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
| | - Shuhua Zhang
- Cardiovascular Research Institute of Jiangxi Province, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
| | - Guotai Sheng
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China
| | - Maobin Kuang
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China.
- Cardiovascular Research Institute of Jiangxi Province, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China.
- Jiangxi Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China.
| | - Yang Zou
- Cardiovascular Research Institute of Jiangxi Province, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China.
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22
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Yu C, Shi Y, Wang T, Zhu L, Zhou W, Bao H, Cheng X. Triglyceride-glucose index change and chronic kidney disease progression in a Chinese hypertensive population. Front Endocrinol (Lausanne) 2024; 15:1342408. [PMID: 38405159 PMCID: PMC10893760 DOI: 10.3389/fendo.2024.1342408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/25/2024] [Indexed: 02/27/2024] Open
Abstract
Background The impact of triglyceride-glucose (TyG) index variations on chronic kidney disease (CKD) progression remains unexplored. To investigate the effects of the TyG index and its dynamic changes on CKD progression. Method This prospective cohort study included data from 8,418 hypertensive participants. The exposure variable in this study was defined as the difference between the TyG index at the last visit from that at baseline. The study's outcome variable was the progression of CKD, defined as follows: for subjects with an estimated glomerular filtration rate (eGFR) ≥60 mL/min, a ≥30% decrease in eGFR with a final follow-up value <60 mL/min; for those with an eGFR <60 mL/min, a ≥50% decrease in eGFR; or terminal renal failure requiring dialysis. Results During a median follow-up period of 48 months, 1077 patients were diagnosed with CKD progression. In the fully adjusted Model 3, patients with a change in the TyG index <0 exhibited a significantly decreased 13% risk of CKD progression (HR: 0.87, 95% CI: 0.76-0.98) compared to those with a change in the TyG index≥0 group. Subgroup analyses showed that changes in the TyG index significantly increased the risk of CKD progression only in patients with diastolic blood pressure (DBP) <90mmHg. In the path analysis, baseline TyG was associated with follow-up eGFR (the standard regression coefficient was 1.26 [95% CI, 0.45-2.06]). Conclusions Our findings suggest that TyG variability may serve as a useful tool for identifying individuals at risk of CKD progression, particularly hypertensive patients with normal DBP levels.
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Affiliation(s)
- Chao Yu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-Center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Yumeng Shi
- Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-Center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Tao Wang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-Center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Lingjuan Zhu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-Center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Wei Zhou
- Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-Center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-Center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-Center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
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Wu L, Xu J. Relationship Between Cardiometabolic Index and Insulin Resistance in Patients with Type 2 Diabetes. Diabetes Metab Syndr Obes 2024; 17:305-315. [PMID: 38283637 PMCID: PMC10821666 DOI: 10.2147/dmso.s449374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/13/2024] [Indexed: 01/30/2024] Open
Abstract
Purpose Cardiometabolic index (CMI) has been suggested as innovative measures for assessing the cardiometabolic status. However, there is a lack of relevant studies on exploring the relationship between CMI and insulin resistance (IR). Consequently, this study aims to examine the relationship between CMI and IR in subjects with type 2 diabetes mellitus (T2DM). Patients and Methods A cross-sectional study was performed on 2493 patients with T2DM (including 1505 males and 988 females). IR was measured through the homeostatic model assessment of insulin resistance (HOMA-IR), which was defined as HOMI-IR≥2.69. The relationship between CMI and IR was evaluated with Spearman's correlation, ROC analysis, multiple logistic regression, generalized smooth curve fitting and subgroup analysis. Results CMI was correlated with HOMA-IR in patients with T2DM (Spearman correlation coefficient = 0.391 in females and 0.346 in males, P<0.001). Through the multiple logistic regression analysis, CMI was significantly correlated with IR (OR=1.30, 95% CI=1.15-1.47 in males and OR=1.62, 95% CI=1.32-1.99 in females). In addition, a non-linear correlation between CMI and IR risk was identified. The AUC of CMI (AUC = 0.702 for males and 0.733 for females, all p < 0.01) was the largest compared with traditional indexes of adiposity and blood lipids. According to the subgroup analysis, the two had a more significantly positive correlation in females, the elderly and subjects with HbA1c < 7%. Conclusion In patients with T2DM, elevated CMI is significantly correlated with IR, as a useful index of IR.
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Affiliation(s)
- Limin Wu
- Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Lucheng District, Wenzhou, Zhejiang Province, People’s Republic of China
| | - Jing Xu
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Lucheng District, Wenzhou, Zhejiang Province, People’s Republic of China
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Zhou X, Xu J. Association between serum uric acid-to-high-density lipoprotein cholesterol ratio and insulin resistance in patients with type 2 diabetes mellitus. J Diabetes Investig 2024; 15:113-120. [PMID: 37737515 PMCID: PMC10759725 DOI: 10.1111/jdi.14086] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/28/2023] [Accepted: 09/01/2023] [Indexed: 09/23/2023] Open
Abstract
INTRODUCTION Previous studies have shown that the serum uric acid-to-high-density lipoprotein cholesterol ratio (UHR) is related to metabolic syndrome. However, no existing study has examined the relationship between UHR and insulin resistance (IR). Therefore, this study aims to explore the association between the UHR and IR in patients with type 2 diabetes mellitus (T2DM). METHODS Patients with type 2 diabetes mellitus (1,532 males and 1,013 females) were enrolled. Insulin resistance was measured by homeostatic model assessment of insulin resistance (HOMA-IR) and was defined as HOMI-IR ≥ 2.69. Pearson correlation, multiple logistic regression, ROC analysis, and subgroup analysis were used to evaluate the association between UHR and IR. RESULTS UHR was associated with HOMA-IR in patients with type 2 diabetes mellitus (pearson's correlation coefficient = 0.274 in males and 0.337 in females, P < 0.001). Multiple logistic regression analysis showed that UHR was significantly correlated with insulin resistance (OR = 1.06, 95%CI = 1.03-1.08 in males and OR = 1.11, 95%CI = 1.08-1.15 in females). The area under the ROC curve (AUC) of UHR (AUC = 0.665 for males and 0.717 for females, all P < 0.01) was the largest compared with that of UA and HDL-C in insulin resistance. Subgroup analysis showed that there was a more significantly positive correlation among subjects with BMI ≥ 24 kg/m2 , age < 60 years old, HbA1c < 7%, non-hypertension, or in female subjects. CONCLUSION Elevated UHR is significantly correlated with insulin resistance, which can be used as an indicator of insulin resistance in patients with type 2 diabetes mellitus.
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Affiliation(s)
- Xinhe Zhou
- Department of EndocrinologyThe Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Jing Xu
- Department of EndocrinologyThe Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
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25
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Cao S, Meng L, Lin L, Hu X, Li X. The association between the metabolic score for insulin resistance (METS-IR) index and urinary incontinence in the United States: results from the National Health and Nutrition Examination Survey (NHANES) 2001-2018. Diabetol Metab Syndr 2023; 15:248. [PMID: 38041100 PMCID: PMC10693039 DOI: 10.1186/s13098-023-01226-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/20/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND The association between insulin resistance and urinary incontinence (UI) has not been investigated widely. The purpose of this study is to assess the relationship between a novel indicator for assessing insulin resistance the metabolic score for insulin resistance (METS-IR) index and urinary incontinence (UI). METHODS This study utilized data from National Health and Nutrition Examination Survey (NHANES) 2001-2018. Weighted multivariable logistic regression models were conducted to explore the association of METS-IR index with three types of UI [stress UI (SUI), urgency UI (UUI), and mixed UI (MUI)]. Smooth curve fitting was utilized to investigate the linear relationship. Subgroup analysis was used to examine the stability of the connection between METS-IR index and UI in different stratifications. RESULTS A total of 17,474 participants were included in this study, of whom 23.76% had SUI, 20.05% had UUI, and 9.59% had MUI. METS-IR index was positively associated with three types of UI with full adjustment [SUI: odds ratio (OR) = 1.023, 95% confidence interval (CI) 1.019-1.027; UUI: OR = 1.015, 95% CI 1.011-1.019; MUI: OR = 1.020, 95% CI 1.016-1.025, all p < 0.001]. After transferring METS-IR index into a categorical variable by quartiles, the positive connection between METS-IR index and UI was still observed in the highest METS-IR group compared to the lowest METS-IR interval (SUI: OR = 2.266, 95% CI 1.947-2.637, p < 0.001; UUI: OR = 1.534, 95% CI 1.344-1.750, p < 0.001; MUI: OR = 2.044, 95% CI 1.707-2.448, p < 0.001). The analysis of smooth curves fitting showed that METS-IR index was positively linearly related to three types of UI. Moreover, the association between METS-IR index and SUI was more significant in females compared to males (p for interaction < 0.05). CONCLUSION An elevated METS-IR index was related to increased risks of three types of UI (SUI, UUI, and MUI) in the United States population. METS-IR index was more significantly connected to SUI in females than males. The association between insulin resistance and UI needs to be explored with more studies.
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Affiliation(s)
- Shangqi Cao
- Institute of Urology, Department of Urology, West China Medical School, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, China
| | - Linghao Meng
- Institute of Urology, Department of Urology, West China Medical School, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, China
| | - Lede Lin
- Institute of Urology, Department of Urology, West China Medical School, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, China
| | - Xu Hu
- Institute of Urology, Department of Urology, West China Medical School, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, China.
| | - Xiang Li
- Institute of Urology, Department of Urology, West China Medical School, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, China.
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Gong S, Gan S, Zhang Y, Zhou H, Zhou Q. Gamma-glutamyl transferase to high-density lipoprotein cholesterol ratio is a more powerful marker than TyG index for predicting metabolic syndrome in patients with type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2023; 14:1248614. [PMID: 37854188 PMCID: PMC10579940 DOI: 10.3389/fendo.2023.1248614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/13/2023] [Indexed: 10/20/2023] Open
Abstract
Purpose The prevalence of metabolic syndrome (MetS) is increasing globally and has become a global and national public health problem that cannot be ignored as an independent predictor of cardiovascular events, cancer and all-cause mortality. γ-glutamyl transferase (GGT) and high-density lipoprotein cholesterol (HDL-C) are associated with insulin resistance, dyslipidemia and oxidative stress. This study was designed to explore the relationship and predictive performance between γ-glutamyl transferase high-density lipoprotein cholesterol ratio (GGT/HDL-C) and MetS. Methods This was a cross-sectional study. MetS was diagnosed from biochemical and anthropometric data in subjects with T2DM. Multivariate logistic regression was used to analyses the relationship between GGT/HDL-C ratio, TyG index and HOMA-IR and MetS in subjects with T2DM. Receiver operating characteristic (ROC) curve was drawn and the areas under the curve (AUC) were used to assess the ability of these indexes in screening MetS in subjects with T2DM. Statistical differences between the AUC values of these indexes were compared. In addition, we performed subgroup analyses and interactions. Results 769 (70.55%) patients with T2DM were defined as having MetS. patients with MetS had higher anthropometric values and biochemical indicators compared to those without MetS. Multivariate logistic regression analysis of GGT/HDL-C ratio was an independent risk factor for MetS (Per 1 SD increase, OR = 2.49, 95% CI: 1.51, 4.10). According to ROC curve analysis, the value of GGT/HDL-C ratio in predicting MetS in subjects with T2DM was superior to that of TyG index and HOMA-IR. The best cut-off value for GGT/HDL-C prediction was 19.94. Conclusions GGT/HDL-C ratio may be an important predictor of MetS in subjects with T2DM, and its predictive power is stronger than that of TyG index and HOMA-IR. The risk of MetS in subjects with T2DM is increased in the presence of a higher GGT/HDL-C ratio.
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Affiliation(s)
- Shijun Gong
- Department of Medicine, Jishou University, Jishou, China
| | - Shenglian Gan
- Department of Endocrinology, The First People’s Hospital of Changde City, Changde, China
| | - YuHua Zhang
- Department of Medicine, Jishou University, Jishou, China
| | - HaiFeng Zhou
- Department of Endocrinology, The First People’s Hospital of Changde City, Changde, China
| | - Quan Zhou
- Department of Science and Education, The First People’s Hospital of Changde City, Changde, China
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Dikker O, Aktaş A, Şahin M, Doğan M, Dağ H. The Association of Serum Uric Acid Levels and Various Uric Acid-Related Ratios with Insulin Resistance and Obesity: A Preliminary Study in Adolescents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1493. [PMID: 37761454 PMCID: PMC10528166 DOI: 10.3390/children10091493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Studies have shown that serum uric acid levels and uric acid-related ratios, such as uric acid-to-albumin ratio (UAR), uric acid-to-creatinine ratio (UCR), uric acid-to-high-density lipoprotein cholesterol (HDL cholesterol) ratio (UHR), and uric acid-to-lymphocyte ratio (ULR), are associated with various diseases and their complications, and that these ratios can be used as biomarkers. In the current study, we aimed to investigate uric acid levels in obese adolescents and the relationship of uric acid-related ratios with insulin resistance and obesity for the first time in the literature. METHODS A total of 100 adolescents (60 obese and 40 healthy) aged 10-17 years were retrospectively included. Participants were assigned to two groups: the obese group and the healthy control group. Obesity was defined as a body mass index (BMI) >the 95th percentile for age and gender. Demographic and laboratory data (serum glucose, urea, creatinine, uric acid, albumin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), C-reactive protein (CRP), total cholesterol, triglyceride, HDL cholesterol, thyroid-stimulating hormone (TSH), free T4 (fT4), insulin levels, and complete blood count) were obtained from the laboratory information management system. A homeostatic model of assessment for insulin resistance (HOMA-IR), low-density lipoprotein cholesterol (LDL cholesterol), and uric acid-related ratios were calculated. RESULTS Uric acid, UAR, UCR, and UHR levels of obese adolescents were significantly higher than the healthy group (p < 0.05). We found that HOMA-IR was positively correlated with uric acid, UAR, and UHR. No correlation was found between BMI and uric acid or uric acid-related ratios. We did not find any difference between the two groups in terms of ULR levels, and we did not find any correlation between BMI and HOMA-IR. CONCLUSION High levels of serum uric acid, UAR, UCR, and UHR were associated with obesity. Furthermore, we found that uric acid, UAR, and UHR were positively correlated with insulin resistance.
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Affiliation(s)
- Okan Dikker
- Department of Medical Biochemistry, Istanbul Prof. Dr. Cemil Taşcıoğlu City Hospital, University of Health Sciences, Istanbul 34384, Turkey;
| | - Ayşe Aktaş
- Department of Medical Biochemistry, Istanbul Prof. Dr. Cemil Taşcıoğlu City Hospital, University of Health Sciences, Istanbul 34384, Turkey;
| | - Mustafa Şahin
- Department of Medical Biochemistry, Hitit University Faculty of Medicine, Çorum 19030, Turkey;
| | - Murat Doğan
- Department of Pediatrics, Istanbul Prof. Dr. Cemil Taşcıoğlu City Hospital, University of Health Sciences, Istanbul 34384, Turkey; (M.D.); (H.D.)
| | - Hüseyin Dağ
- Department of Pediatrics, Istanbul Prof. Dr. Cemil Taşcıoğlu City Hospital, University of Health Sciences, Istanbul 34384, Turkey; (M.D.); (H.D.)
- Department of Pediatric Basic Sciences, Institute of Child Health, Adolesance Health, Istanbul University, Istanbul 34093, Turkey
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Gu P, Pu B, Xin Q, Yue D, Luo L, Tao J, Li H, Chen M, Hu M, Hu X, Zheng X, Zeng Z. The metabolic score of insulin resistance is positively correlated with bone mineral density in postmenopausal patients with type 2 diabetes mellitus. Sci Rep 2023; 13:8796. [PMID: 37258550 DOI: 10.1038/s41598-023-32931-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/04/2023] [Indexed: 06/02/2023] Open
Abstract
The prevalence of type 2 diabetes mellitus (T2DM) complicated with osteoporosis (OP) is increasing yearly. Early prevention, detection and treatment of OP are important in postmenopausal patients with T2DM. This study aimed to explore the correlation between insulin resistance and bone mineral density (BMD), and OP in postmenopausal patients with T2DM. In this study, postmenopausal patients with T2DM who visited our hospital from January 2021 to March 2022 were divided into the OP group (n = 91) and non-OP group (n = 119) according to whether they were complicated with OP or not. The general data of patients, BMD, blood routine, glucose metabolism, lipid metabolism, liver and kidney function indexes were collected, and the homeostatic model assessment for IR (HOMA-IR), the triglyceride-glucose (TyG) index and the metabolic score for IR (METS-IR) were calculated. A weighted multivariate linear regression model assessed the correlation between insulin resistance (IR) related indexes and lumbar spine, femoral neck, and hip BMD. A weighted logistic regression model assessed the odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between the IR-related indexes and OP risk. The nonlinear relationship was also evaluated by smooth curve fitting (SCF) and a weighted generalized additive model (GAM). Moreover, the Receiver-operating characteristics (ROC) curve was used to analyze the predictive efficiency of METS-IR in postmenopausal patients with T2DM with OP. HOMA-IR, TyG, and METS-IR in the OP group were lower than those in the non-OP group (all P < 0.05). Weighted multiple linear regression after adjusting covariates showed that METS-IR was positively correlated with the lumbar spine, femoral neck, and hip BMD (βMETS-IR = 0.006,0.005,0.005, all P < 0.001). The results of weighted Logistic regression and GAM showed that when METS-IR < 44.5, each unit of increased METS-IR value was associated with a decreased OP risk of 12% (P = 0.002). When METS-IR ≥ 44.5, there was no significant correlation between METS-IR and the risk of OP (OR = 1.00, P = 0.934). Similar trends were not observed in HOMA-IR and TyG. The ROC suggested helpful discriminative power of the METS-IR index for T2DM. We confirmed that METS-IR, as a novel alternative marker of IR, had a positive association with BMD in postmenopausal patients with T2DM, and METS-IR was a protective factor for OP in a specific range.
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Affiliation(s)
- Peng Gu
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Bin Pu
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Qiao Xin
- Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
| | - Dan Yue
- Southwest Medical University, Luzhou, Sichuan, China
| | - LieLiang Luo
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - JiaSheng Tao
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - HaiShan Li
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Ming Chen
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - MingHua Hu
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - XiaoRong Hu
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - XiaoHui Zheng
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - ZhanPeng Zeng
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.
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Duan S, Zhou M, Lu F, Chen C, Chen S, Geng L, Zhang C, Guo H, Zeng M, Sun B, Mao H, Zhang B, Xing C, Yuan Y. Triglyceride-glucose index is associated with the risk of chronic kidney disease progression in type 2 diabetes. Endocrine 2023:10.1007/s12020-023-03357-z. [PMID: 37004636 DOI: 10.1007/s12020-023-03357-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 03/17/2023] [Indexed: 04/04/2023]
Abstract
OBJECTIVE The study aimed to investigate the association of TyG index with chronic kidney disease (CKD) progression in type 2 diabetes mellitus (T2DM). METHODS A total of 179 T2DM patients with CKD were retrospectively included. CKD progression was defined as a doubling of baseline serum creatinine or onset of end-stage kidney disease (ESKD). Internal validation was performed by the Kidney Failure Risk Equation (KFRE) model and Net reclassification improvement (NRI). RESULTS The optimal cut-off value of the TyG index was 9.17. The cumulative incidence of kidney outcomes was significantly higher in the high-TyG group (v.s low-TyG group, P = 0.019). In addition, the high-TyG index was associated with a greater risk of CKD progression (HR 1.794, 95% CI 1.026-3.137, P = 0.040). And reclassification analyses confirmed the final adjusted model improved NRI (61.90% v.s model 2, 43.80% v.s model 1). The further RCS curves presented an inverted S-shaped relationship between the TyG index and the risk of CKD progression. Internal validation verified that a higher TyG index was associated with 2.10-fold increased odds of 2-year ESKD risk >10% (95% CI 1.82-8.21). Moreover, subgroup analysis suggested that the association was more pronounced in those at relatively early CKD stages (higher than stage 2) and with no medication history of oral hypoglycemic agents. CONCLUSION An elevated TyG index was associated with a higher risk of CKD progression in T2DM patients. Our findings suggested that timely targeting insulin sensitivity at the early stages of T2DM might be associated with declined future risk of CKD development.
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Affiliation(s)
- Suyan Duan
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Meng Zhou
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Fang Lu
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Chen Chen
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Si Chen
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Luhan Geng
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Chengning Zhang
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Honglei Guo
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Ming Zeng
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Bin Sun
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Huijuan Mao
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Bo Zhang
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China.
| | - Changying Xing
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China.
| | - Yanggang Yuan
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China.
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Cheng H, Yu X, Li YT, Jia Z, Wang JJ, Xie YJ, Hernandez J, Wang HHX, Wu HF. Association between METS-IR and Prediabetes or Type 2 Diabetes Mellitus among Elderly Subjects in China: A Large-Scale Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1053. [PMID: 36673809 PMCID: PMC9859146 DOI: 10.3390/ijerph20021053] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
The metabolic score for insulin resistance (METS-IR) was recently proposed as a non-insulin-based, novel index for assessing insulin resistance (IR) in the Western population. However, evidence for the link between METS-IR and prediabetes or type 2 diabetes mellitus (T2DM) among the elderly Chinese population was still limited. We aimed to investigate the associations between METS-IR and prediabetes or T2DM based on large-scale, cross-sectional, routine physical examination data. In a total of 18,112 primary care service users, an increased METS-IR was independently associated with a higher prevalence of prediabetes (adjusted odds ratio [aOR] = 1.457, 95% confidence interval [CI]: 1.343 to 1.581, p < 0.001) and T2DM (aOR = 1.804, 95%CI: 1.720 to 1.891, p < 0.001), respectively. The aOR for prediabetes in subjects with the highest quartile of METS-IR was 3.060-fold higher than that in those with the lowest quartile of METS-IR. The aOR for T2DM in subjects with the highest quartile of METS-IR was 6.226-fold higher than that in those with the lowest quartile of METS-IR. Consistent results were obtained in subgroup analyses. Our results suggested that METS-IR was significantly associated with both prediabetes and T2DM. The monitoring of METS-IR may add value to early identification of individuals at risk for glucose metabolism disorders in primary care.
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Affiliation(s)
- Hui Cheng
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiao Yu
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yu-Ting Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Zhihui Jia
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Jia-Ji Wang
- Centre for General Practice, The Seventh Affiliated Hospital, Southern Medical University, Foshan 528244, China
- School of Public Health, Guangzhou Medical University, Guangzhou 510182, China
| | - Yao-Jie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon 852, Hong Kong, China
| | - Jose Hernandez
- Medicine and Health, EDU Institute of Higher Education, 1320 Kalkara, Malta
- Green Templeton College, University of Oxford, Oxford OX2 6HG, UK
| | - Harry H. X. Wang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Hua-Feng Wu
- Shishan Community Health Centre of Nanhai, Foshan 528234, China
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Đukić-Ćosić D, Baralić K, Javorac D, Bulat Z, Ćurčić M, Antonijević B, Đorđević V, Repić A, Buha Djordjevic A. Exploring the relationship between blood toxic metal(oid)s and serum insulin levels through benchmark modelling of human data: Possible role of arsenic as a metabolic disruptor. ENVIRONMENTAL RESEARCH 2022; 215:114283. [PMID: 36088992 DOI: 10.1016/j.envres.2022.114283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 09/01/2022] [Accepted: 09/03/2022] [Indexed: 06/15/2023]
Abstract
The major goal of this study was to estimate the correlations and dose-response pattern between the measured blood toxic metals (cadmium (Cd), mercury (Hg), chromium (Cr), nickel (Ni))/metalloid (arsenic (As)) and serum insulin level by conducting Benchmark dose (BMD) analysis of human data. The study involved 435 non-occupationally exposed individuals (217 men and 218 women). The samples were collected at health care institutions in Belgrade, Serbia, from January 2019 to May 2021. Blood sample preparation was conducted by microwave digestion. Cd was measured by graphite furnace atomic absorption spectrophotometry (GF-AAS), while inductively coupled plasma-mass spectrometry (ICP-MS) was used to measure Hg, Ni, Cr and As. BMD analysis of insulin levels represented as quantal data was done using the PROAST software version 70.1 (model averaging methodology, BMD response: 10%). In the male population, there was no correlation between toxic metal/metalloid concentrations and insulin level. However, in the female population/whole population, a high positive correlation for As and Hg, and a strong negative correlation for Ni and measured serum insulin level was established. BMD modelling revealed quantitative associations between blood toxic metal/metalloid concentrations and serum insulin levels. All the estimated BMD intervals were wide except the one for As, reflecting a high degree of confidence in the estimations and possible role of As as a metabolic disruptor. These results indicate that, in the case of As blood concentrations, even values higher than BMD (BMDL): 3.27 (1.26) (male population), 2.79 (0.771) (female population), or 1.18 (2.96) μg/L (whole population) might contribute to a 10% higher risk of insulin level alterations, meaning 10% higher risk of blood insulin increasing from within reference range to above reference range. The obtained results contribute to the current body of knowledge on the use of BMD modelling for analysing human data.
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Affiliation(s)
- Danijela Đukić-Ćosić
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, Vojvode Stepe 450, 11221, Belgrade, Serbia
| | - Katarina Baralić
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, Vojvode Stepe 450, 11221, Belgrade, Serbia.
| | - Dragana Javorac
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, Vojvode Stepe 450, 11221, Belgrade, Serbia
| | - Zorica Bulat
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, Vojvode Stepe 450, 11221, Belgrade, Serbia
| | - Marijana Ćurčić
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, Vojvode Stepe 450, 11221, Belgrade, Serbia
| | - Biljana Antonijević
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, Vojvode Stepe 450, 11221, Belgrade, Serbia
| | - Vladimir Đorđević
- First Surgical Clinic, Clinical Center of Serbia, Koste Todorovića 5, 11000, Belgrade, Serbia
| | - Aleksandra Repić
- Institute of Forensic Medicine, Faculty of Medicine University of Belgrade, 11000, Belgrade, Serbia
| | - Aleksandra Buha Djordjevic
- Department of Toxicology "Akademik Danilo Soldatović", University of Belgrade - Faculty of Pharmacy, Vojvode Stepe 450, 11221, Belgrade, Serbia
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Lee YC, Lee JW, Kwon YJ. Comparison of the triglyceride glucose (TyG) index, triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, and metabolic score for insulin resistance (METS-IR) associated with periodontitis in Korean adults. Ther Adv Chronic Dis 2022; 13:20406223221122671. [PMID: 36120508 PMCID: PMC9478708 DOI: 10.1177/20406223221122671] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/10/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Periodontitis is one of the most common diseases associated with the oral
cavity. Previous studies have suggested that there is an association between
periodontitis and metabolic dysfunction. Recently, the triglyceride glucose
(TyG) index, high-density lipoprotein cholesterol (TG/HDL-C) ratio, and
metabolic score for insulin resistance (METS-IR) index have been identified
as useful markers for assessing insulin resistance. Objective: This study aimed to evaluate the relationship between periodontitis and
non-insulin-based insulin resistance (IR) indices and compare the predictive
values of these indices in the Korean population. Design: This is a cross-sectional study. Methods: A total of 13,584 participants were included in the 2013–2015 Korean National
Health and Nutrition Examination Survey data. A community periodontal index
score⩾3 was used to define periodontitis. Participants were divided into
quartiles according to each index. Odds ratios (ORs) and 95% confidence
intervals (CIs) for the prevalence of periodontitis and the TyG index,
TG/HDL-C ratio, and METS-IR index quartiles were calculated using multiple
logistic regression analysis. We estimated the areas under the receiver
operating characteristic curves (AUCs) of the indices to compare the
predictive values of the three indices. Results: Compared with quartile 1, the fourth quartile ORs (95% CIs) for periodontitis
were 1.23 (1.01–1.49) for the TyG index, 1.23 (1.02–1.48) for the TG/HDL-C
ratio, and 1.53 (1.25–1.88) for the METS-IR index after adjustment for
confounders. The AUC (95% CIs) was 0.608 (0.598–0.618) for the TyG index,
0.600 (0.590–0.610) for the TG/HDL-C ratio, and 0.617 (0.608–0.627) for the
METS-IR index to identify periodontitis. The predictive power of METS-IR was
significantly higher than that of the TyG index and TG/HDL-C. Conclusion: Higher TG/HDL-C ratio, TyG, and METS-IR indices are associated with a higher
prevalence of periodontitis. The METS-IR index is a more powerful predictor
of periodontitis prevalence than the TyG index and TG/HDL-C ratio.
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Affiliation(s)
- Yea-Chan Lee
- Department of Medicine, Graduate School of Medicine, Yonsei University, Seoul, Republic of Korea.,The 3rd Air and Missile Defense Brigade, Air & Missile Defense Command, Republic of Korea Air Force, Seoul, Republic of Korea
| | - Ji-Won Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yu-Jin Kwon
- Professor, Department of Family Medicine, Yonsei University College of Medicine, Yongin Severance Hospital, 363, Dongbaekjukjeon-daero, Giheung-gu, Yongin-si 16995, Gyeonggi-do, Republic of Korea
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Lyu Y, Li D, Yuan X, Li Z, Zhang J, Ming X, Shaw PC, Zhang C, Kong APS, Zuo Z. Effects of combination treatment with metformin and berberine on hypoglycemic activity and gut microbiota modulation in db/db mice. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 101:154099. [PMID: 35489323 DOI: 10.1016/j.phymed.2022.154099] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/30/2022] [Accepted: 04/14/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Gut microbiota alterations could influence the metabolism of administered drugs, leading to their altered pharmacokinetics and pharmacodynamics. Despite that metformin and berberine has individually demonstrated their impacts on hypoglycemic activities and gut microbiota alterations in diabetic mice, investigation regarding the impact of their combination treatment in diabetic treatment has never been conducted. PURPOSE Our current study was proposed aiming to investigate the effect of combination use of metformin with berberine on hypoglycemic activity and identify the possible intestinal bacteria involved in their microbiota-medicated drug-drug interactions in db/db mice. STUDY DESIGN Pharmacodynamics interactions between metformin and berberine were evaluated in six groups of db/db mice (db, M250, B250, B125, B250+M250, and B125+M250) with its wild type (WT) as control to receive 14 days treatment of vehicle, metformin at 250 mg/kg, berberine at 250/125 mg/kg, and metformin (250 mg/kg) 2 h after dosing berberine (250/125 mg/kg). METHODS On day 13, insulin tolerance test (ITT) was conducted. On day 15, fasting serum samples were obtained for insulin concentration determination followed by intraperitoneal glucose tolerance test (ipGTT), homeostatic model assessment for insulin resistance (HOMA-IR) calculation, and feces collection for microbial 16S rRNA sequencing analyses. In addition, metformin steady state plasma concentrations on day 15 were measured by validated LC-MS/MS method. RESULTS Combination treatment of metformin with berberine could further reduce in blood glucose in comparison to that of db/db diabetic control. Further microbial 16S rRNA sequencing analyses revealed that gut microbiota compositions were significantly changed with the abundance of Proteobacteria and Verrucomicrobia altered the most after metformin and berberine co-treatment compared to their monotherapy. In addition, steady state metformin concentrations in their combination treatment were significantly higher than that from metformin monotherapy. CONCLUSION Co-administration of metformin (250 mg/kg) with berberine (125 mg/kg) could not only further improve insulin sensitivity, but also demonstrate different alterations on gut microbial communities than that of their individual treatment in db/db mice.
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Affiliation(s)
- Yuanfeng Lyu
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, PR China
| | - Dan Li
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, PR China
| | - Xiaopeng Yuan
- School of Pharmacy, Nanchang University, Nanchang, Jiangxi Province, PR China
| | - Ziwei Li
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, PR China
| | - Jun Zhang
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, PR China
| | - Xing Ming
- Division of Endocrinology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, PR China
| | - Pang Chui Shaw
- School of Life Sciences and Li Dak Sum Yip Yio Chin R&D Centre for Chinese Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, PR China
| | - Chunbo Zhang
- School of Pharmacy, Nanchang University, Nanchang, Jiangxi Province, PR China
| | - Alice Pik Shan Kong
- Division of Endocrinology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, PR China
| | - Zhong Zuo
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, PR China.
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The role of pancreas to improve hyperglycemia in STZ-induced diabetic rats by thiamine disulfide. Nutr Diabetes 2022; 12:32. [PMID: 35725834 PMCID: PMC9209469 DOI: 10.1038/s41387-022-00211-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/04/2022] [Accepted: 06/06/2022] [Indexed: 12/04/2022] Open
Abstract
Background The present study investigated the effect of thiamine disulfide (TD) on the pancreas in terms of hyperglycemia improvement and insulin sensitivity increase in diabetic male rats. We also aimed to study the function of Pdx1 (pancreatic and duodenal homeobox 1) and Glut2 (glucose transporter 2) genes in pancreatic tissue. Methods Type 1 diabetes was induced through injection of 60 mg/kg streptozotocin (STZ). The diabetic rats were divided into four groups, namely diabetic control (DC), diabetic treated with thiamine disulfide (D-TD), diabetic treated with insulin (D-insulin), and diabetic treated with TD and insulin (D-insulin+TD). The non-diabetic (NDC) and diabetic groups received a normal diet (14 weeks). Blood glucose level and body weight were measured weekly; insulin tolerance test (ITT) and glucagon tolerance test (GTT) were performed in the last month of the study. The level of serum insulin and glucagon were measured monthly and a hyperglycemic clamp (Insulin Infusion rate (IIR)) was done for all the groups. Pancreas tissue was isolated so that Pdx1and Glut2 genes expression could be measured. Results We observed that TD therapy decreased blood glucose level, ITT, and serum glucagon levels in comparison with those of the DC group; it also increased serum insulin levels, IIR, and expression of Pdx1 and Glut2 genes in comparison with those of the DC group. Conclusion Administration of TD could improve hyperglycemia in type 1 diabetic animals through improved pancreas function. Therefore, not only does TD have a significant effect on controlling and reducing hyperglycemia in diabetes, but it also has the potential to decrease the dose of insulin administration.
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Amisi CA. Markers of insulin resistance in Polycystic ovary syndrome women: An update. World J Diabetes 2022; 13:129-149. [PMID: 35432749 PMCID: PMC8984569 DOI: 10.4239/wjd.v13.i3.129] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 09/14/2021] [Accepted: 02/22/2022] [Indexed: 02/06/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders, affecting 5%-10% of women of reproductive age. The importance of this syndrome lies in the magnitude of associated comorbidities: infertility, metabolic dysfunction, cardiovascular disease (CVD), plus psychological and oncological complications. Insulin resistance (IR) is a prominent feature of PCOS with a prevalence of 35%-80%. Without adequate management, IR with compensatory hyperinsulinemia contributes directly to reproductive dysfunction in women with PCOS. Furthermore, epidemiological data shows compelling evidence that PCOS is associated with an increased risk of impaired glucose tolerance, gestational diabetes mellitus and type 2 diabetes. In addition, metabolic dysfunction leads to a risk for CVD that increases with aging in women with PCOS. Indeed, the severity of IR in women with PCOS is associated with the amount of abdominal obesity, even in lean women with PCOS. Given these drastic implications, it is important to diagnose and treat insulin resistance as early as possible. Many markers have been proposed. However, quantitative assessment of IR in clinical practice remains a major challenge. The gold standard method for assessing insulin sensitivity is the hyperinsulinemic euglycemic glucose clamp. However, it is not used routinely because of the complexity of its procedure. Consequently, there has been an urgent need for surrogate markers of IR that are more applicable in large population-based epidemiological investigations. Despite this, many of them are either difficult to apply in routine clinical practice or useless for women with PCOS. Considering this difficulty, there is still a need for an accurate marker for easy, early detection and assessment of IR in women with PCOS. This review highlights markers of IR already used in women with PCOS, including new markers recently reported in literature, and it establishes a new classification for these markers.
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Affiliation(s)
- Chantal Anifa Amisi
- Endocrinology and Diabetes Unit, Department of Medicine, Universita Campus Bio-medico di Rome, Rome 00128, Italy
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The effects of spasticity on glucose metabolism and soft tissue body composition in patients with spinal cord injury. Turk J Phys Med Rehabil 2022; 68:46-54. [PMID: 35949969 PMCID: PMC9305643 DOI: 10.5606/tftrd.2022.6310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 09/29/2020] [Indexed: 11/21/2022] Open
Abstract
Objectives
The aim of this study was to assess the effects of spasticity on glucose metabolism and percentage of fat-free mass (FFM%) in patients with spinal cord injury (SCI).
Patients and methods
A total of 33 patients (22 males, 11 females; mean age: 38.6±12.5 years; range, 20 to 64 years) with SCI defined by the American Spinal Injury Association Impairment Scale Grades A to D were included between September 2014 and May 2018. We assessed spasticity with the Modified Ashworth Scale (MAS) and evaluated spasms with the Penn Spasm Frequency Scale (PSFS). We assessed the glucose metabolism by calculating the Matsuda and HOMA-IR index, and measured FFM% by dual-energy X-ray absorptiometry.
Results
Fourteen patients had motor complete, and 19 had motor incomplete SCI. The neurological injury levels of the patients were C4-T12. There was a positive correlation between hip adductor muscle MAS and trunk, android, and gynoid FFM% and between hip extensor muscle MAS and android FFM% in patients with motor complete SCI. Hip extensor and knee flexor muscle MAS showed a negative correlation with the HOMA-IR. Hip adductor and extensor muscle MAS, as well as knee flexor and extensor muscle MAS, had a positive correlation with the Matsuda index in these patients. There was a positive correlation between knee extensor muscle MAS and gynoid FFM% and between PSFS and arms, trunk, gynoid, and total FFM% in patients with motor incomplete SCI. There was a negative correlation between hip adductor and extensor muscle MAS, PSFS, and level of fasting glucose in these patients.
Conclusion
This study supports the notion that spasticity has positive effects on the FFM% and glucose metabolism in patients with motor complete and incomplete SCI.
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Su W, Wang J, Yu S, Chen K, Gao Z, Tang X, Wan Q, Luo Z, Ning G, Mu Y. METS‐IR, a novel score to evaluate insulin sensitivity, is associated with the urinary albumin–creatinine ratio in Chinese adults: A cross‐sectional REACTION study. J Diabetes Investig 2022; 13:1222-1234. [PMID: 35220678 PMCID: PMC9248423 DOI: 10.1111/jdi.13782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/11/2022] [Accepted: 02/24/2022] [Indexed: 11/27/2022] Open
Affiliation(s)
- Wanlu Su
- School of Medicine Nankai University No. 94 Weijin Road Tianjin 300071 China
- Department of Endocrinology Chinese People’s Liberation Army General Hospital No. 28 Fuxing Road Beijing 100853 China
| | - Jie Wang
- Department of Endocrinology Beijing Chao‐Yang Hospital Capital Medical University, 8 Gongren Tiyuchang Nanlu Chaoyang District Beijing 100020 P. R. China
| | - Songyan Yu
- Department of Endocrinology Beijing Tiantan Hospital Capital Medical University Beijing 100070 China
| | - Kang Chen
- Department of Endocrinology Chinese People’s Liberation Army General Hospital No. 28 Fuxing Road Beijing 100853 China
| | - Zhengnan Gao
- Department of Endocrinology Dalian Municipal Central Hospital No. 826 Southwest Shahekou District Road Dalian 116033 China
| | - Xuelei Tang
- Department of Endocrinology The First Hospital of Lanzhou University Lanzhou, Gansu China
| | - Qin Wan
- Department of Endocrinology Affiliated Hospital of Luzhou Medical College No. 25 Taiping Road Luzhou 646000 China
| | - Zuojie Luo
- Department of Endocrinology The First Affiliated Hospital of Guangxi Medical University Nanning Guangxi China
| | - Guang Ning
- Department of Endocrinology Shanghai National Research Center for Endocrine and Metabolic Disease State Key Laboratory of Medical Genomics Shanghai Institute for Endocrine and Metabolic Disease Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai China
| | - Yiming Mu
- School of Medicine Nankai University No. 94 Weijin Road Tianjin 300071 China
- Department of Endocrinology Chinese People’s Liberation Army General Hospital No. 28 Fuxing Road Beijing 100853 China
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Tsaban G, Yaskolka Meir A, Zelicha H, Rinott E, Kaplan A, Shalev A, Katz A, Brikner D, Blüher M, Ceglarek U, Stumvoll M, Stampfer MJ, Shai I. Diet-induced Fasting Ghrelin Elevation Reflects the Recovery of Insulin Sensitivity and Visceral Adiposity Regression. J Clin Endocrinol Metab 2022; 107:336-345. [PMID: 34643713 DOI: 10.1210/clinem/dgab681] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Indexed: 01/15/2023]
Abstract
CONTEXT Lower fasting ghrelin levels (FGL) are associated with obesity and metabolic syndrome. OBJECTIVE We aimed to explore the dynamics of FGL during weight loss and its metabolic and adiposity-related manifestations beyond weight loss. METHODS This was a secondary analysis of a clinical trial that randomized participants with abdominal obesity/dyslipidemia to 1 of 3 diets: healthy dietary guidelines (HDG), Mediterranean diet (MED), or green-MED diet, all combined with physical activity (PA). Both MED diets were similarly hypocaloric and included 28 g/day walnuts. The green-MED group further consumed green tea (3-4 cups/day) and a Wolffia globosa (Mankai) plant green shake. We measured FGL and quantified body fat depots by magnetic resonance imaging at baseline and after 18 months. RESULTS Among 294 participants (body mass index = 31.3 kg/m2; FGL = 504 ± 208 pg/mL; retention rate = 89.8%), lower FGL was associated with unfavorable cardiometabolic parameters such as higher visceral adipose tissue (VAT), intrahepatic fat, leptin, and blood pressure (P < 0.05 for all; multivariate models). The ∆FGL18-month differed between men (+7.3 ± 26.6%) and women (-9.2% ± 21.3%; P = 0.001). After 18 months of moderate and similar weight loss among the MED groups, FGL increased by 1.3%, 5.4%, and 10.5% in HDG, MED, and green-MED groups, respectively (P = 0.03 for green-MED vs HDG); sex-stratified analysis revealed similar changes in men only. Among men, FGL18-month elevation was associated with favorable changes in insulin resistance profile and VAT regression, after adjusting for relative weight loss (HbA1c: r = -0.216; homeostatic model of insulin resistance: r = -0.154; HDL-c: r = 0.147; VAT: r = -0.221; P < 0.05 for all). Insulin resistance and VAT remained inversely related with FGL elevation beyond that explained by weight loss (residual regression analyses; P < 0.05). CONCLUSION Diet-induced FGL elevation may reflect insulin sensitivity recovery and VAT regression beyond weight loss, specifically among men. Green-MED diet is associated with greater FGL elevation.
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Affiliation(s)
- Gal Tsaban
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Soroka University Medical Center, Beer-Sheva, Israel
| | - Anat Yaskolka Meir
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Hila Zelicha
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ehud Rinott
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Alon Kaplan
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Aryeh Shalev
- Soroka University Medical Center, Beer-Sheva, Israel
| | - Amos Katz
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Dov Brikner
- Nuclear Research Center Negev, Department of Medicine, Dimona, Israel
| | - Matthias Blüher
- Department of Medicine, University of Leipzig, Leipzig, Germany
| | - Uta Ceglarek
- Department of Medicine, University of Leipzig, Leipzig, Germany
| | | | - Meir J Stampfer
- Harvard T.H. Chan School of Public Health and Channing Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Iris Shai
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Harvard T.H. Chan School of Public Health and Channing Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
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Low-Grade Systemic Inflammation Interferes with Anabolic and Catabolic Characteristics of the Aged Human Skeletal Muscle. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:8376915. [PMID: 34917235 PMCID: PMC8670932 DOI: 10.1155/2021/8376915] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/17/2021] [Indexed: 12/20/2022]
Abstract
Aging is associated with the development of chronic low-grade systemic inflammation (LGSI) characterized by increased circulating levels of proinflammatory cytokines and acute phase proteins such as C-reactive protein (CRP). Collective evidence suggests that elevated levels of inflammatory mediators such as CRP, interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α) are correlated with deteriorated skeletal muscle mass and function, though the molecular footprint of this observation in the aged human skeletal muscle remains obscure. Based on animal models showing impaired protein synthesis and enhanced degradation in response to LGSI, we compared here the response of proteolysis- and protein synthesis-related signaling proteins as well as the satellite cell and amino acid transporter protein content between healthy older adults with increased versus physiological blood hs-CRP levels in the fasted (basal) state and after an anabolic stimulus comprised of acute resistance exercise (RE) and protein feeding. Our main findings indicate that older adults with increased hs-CRP levels demonstrate (i) increased proteasome activity, accompanied by increased protein carbonylation and IKKα/β phosphorylation; (ii) reduced Pax7+ satellite cells; (iii) increased insulin resistance, at the basal state; and (iv) impaired S6 ribosomal protein phosphorylation accompanied by hyperinsulinemia following an acute RE bout combined with protein ingestion. Collectively, these data provide support to the concept that age-related chronic LGSI may upregulate proteasome activity via induction of the NF-κB signaling and protein oxidation and impair the insulin-dependent anabolic potential of human skeletal muscle.
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Yoon JS, Shim YS, Lee HS, Hwang IT, Hwang JS. A population-based study of TyG index distribution and its relationship to cardiometabolic risk factors in children and adolescents. Sci Rep 2021; 11:23660. [PMID: 34880367 PMCID: PMC8654923 DOI: 10.1038/s41598-021-03138-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/22/2021] [Indexed: 11/09/2022] Open
Abstract
The purpose of this study was to present age- and sex-specific distributions of the triglyceride-glucose (TyG) index and to evaluate their relationship with cardiometabolic risk factors in children and adolescents. A total of 7404 participants aged 10-18 years from the Korean National Health and Nutrition Survey were included as the reference population. The TyG index was calculated as ln(fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The percentile of the TyG index exhibited a steady linear relationship with age for both sexes. TyG index significantly correlated with waist circumference (WC) standard deviation score (SDS; r = 0.110, p < 0.001), systolic blood pressure (SBP; r = 0.104, p < 0.001), diastolic blood pressure (DBP; r = 0.083, p < 0.001), glucose (r = 0.220, p < 0.001), high-density lipoprotein cholesterol (HDL-C; r = - 0.325, p < 0.001), and triglycerides (TG; r = 0.926, p < 0.001). Multiple linear regression analysis revealed that the TyG index was significantly associated with WC SDS (β = 0.116, p < 0.001), SBP (β = 2.009, p < 0.001), DBP (β = 1.464, p < 0.001), glucose (β = 3.376, p < 0.001), HDL-C (β = - 6.431, p < 0.001), and TG (β = 85.518, p < 0.001). Our results suggest that the TyG index has a steady linear distribution for sex and age in children and adolescents and constitutes an indicator for predicting metabolic disorders that could lead to cardiovascular disease later in life.
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Affiliation(s)
- Jong Seo Yoon
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Young Suk Shim
- Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, San 5, Wonchon-dong, Yeongtong-gu, Suwon, 443-721, Korea.
| | - Hae Sang Lee
- Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, San 5, Wonchon-dong, Yeongtong-gu, Suwon, 443-721, Korea
| | - Il Tae Hwang
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Jin Soon Hwang
- Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, San 5, Wonchon-dong, Yeongtong-gu, Suwon, 443-721, Korea
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Investigation of d-allulose effects on high-sucrose diet-induced insulin resistance via hyperinsulinemic-euglycemic clamps in rats. Heliyon 2021; 7:e08013. [PMID: 34589631 PMCID: PMC8461346 DOI: 10.1016/j.heliyon.2021.e08013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/09/2021] [Accepted: 09/14/2021] [Indexed: 02/06/2023] Open
Abstract
d-Allulose, a C-3 epimer of d-fructose, is a rare sugar that has no calories. Although d-allulose has been reported to have several health benefits, such as anti-obesity and anti-diabetic effects, there have been no reports evaluating the effects of d-allulose on insulin resistance using a hyperinsulinemic-euglycemic clamp (HE-clamp). Therefore, we investigated the effects of d-allulose on a high-sucrose diet (HSD)-induced insulin resistance model. Wistar rats were randomly divided into three dietary groups: HSD containing 5% cellulose (HSC), 5% d-allulose (HSA), and a commercial diet. The insulin tolerance test (ITT) and HE-clamp were performed after administration of the diets for 4 and 7 weeks. After 7 weeks, the muscle and adipose tissues of rats were obtained to analyze Akt signaling via western blotting, and plasma adipocytokine levels were measured. ITT revealed that d-allulose ameliorated systemic insulin resistance. Furthermore, the results of the 2-step HE-clamp procedure indicated that d-allulose reversed systemic and muscular insulin resistance. d-Allulose reversed the insulin-induced suppression of Akt phosphorylation in the soleus muscle and epididymal fat tissues and reduced plasma TNF-α levels. This study is the first to show that d-allulose improves systemic and muscle insulin sensitivity in conscious rats.
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Lyu Y, Lin L, Xie Y, Li D, Xiao M, Zhang Y, Cheung SCK, Shaw PC, Yang X, Chan PKS, Kong APS, Zuo Z. Blood-Glucose-Lowering Effect of Coptidis Rhizoma Extracts From Different Origins via Gut Microbiota Modulation in db/db Mice. Front Pharmacol 2021; 12:684358. [PMID: 34211397 PMCID: PMC8239385 DOI: 10.3389/fphar.2021.684358] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/27/2021] [Indexed: 01/14/2023] Open
Abstract
Background:Coptidis rhizoma extracts (CREs) have been used widely for their anti-diabetic and anti-microbial activities, and berberine/jatrorrhizine/coptisine/palmatine are the primary bioactive components. Although guidelines have adopted content analyses of these components as a quality control method for CREs, it is difficult to differentiate the CREs from different sources using this method because of the lack of indications for their related pharmacological activities. Purpose: To explore the effect of CREs (CREA/CREB/CREC) with different compositions of major components on the gut microbiota and blood glucose levels in db/db mice. Methods: Degradation of berberine/jatrorrhizine/coptisine/palmatine from CREA/CREB/CREC in rat/mouse intestinal contents and their impact on nine common gastrointestinal bacteria were investigated. In addition, the effects of oral administration of CREA/CREB/CREC for 2 weeks on the gut microbiota and blood glucose levels in db/db mice were monitored via insulin/glucose tolerance test (ITT/GTT), insulin concentration, homeostatic model assessment of insulin resistance and fecal 16S rRNA sequencing. Results and Conclusion: The total amount of berberine/jatrorrhizine/coptisine/palmatine was highest in CREA. Clostridium perfringens was strongly inhibited by all three CREs, with CREA demonstrating the most significant inhibitory effects on minimum inhibitory concentration, time-kill kinetics, and ATP production. In db/db mice, CREA resulted in the most significant decrease in ITT/GTT and depicted different changes in the microbiota from CREB/CREC. Thus, CREs with different compositions of berberine/jatrorrhizine/coptisine/palmatine differed in terms of time-kill kinetics and ATP production assays on C. perfringens. CREA revealed the potent bacterial inhibitory effects and glucose-lowering activity.
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Affiliation(s)
- Yuanfeng Lyu
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China
| | - Lin Lin
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China
| | - Yuning Xie
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China
| | - Dan Li
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China
| | - Min Xiao
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China
| | - Yufeng Zhang
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China
| | - Stanley Chun Kai Cheung
- School of Life Sciences and Li Dak Sum Yip Yio Chin R&D Centre for Chinese Medicine, The Chinese University of Hong Kong, Shatin, China
| | - Pang Chui Shaw
- School of Life Sciences and Li Dak Sum Yip Yio Chin R&D Centre for Chinese Medicine, The Chinese University of Hong Kong, Shatin, China
| | - Xiao Yang
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China
| | - Paul Kay Sheung Chan
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China
| | - Alice Pik Shan Kong
- Division of Endocrinology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China
| | - Zhong Zuo
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China
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Sharma VR, Matta ST, Haymond MW, Chung ST. Measuring Insulin Resistance in Humans. Horm Res Paediatr 2021; 93:577-588. [PMID: 33934092 PMCID: PMC8162778 DOI: 10.1159/000515462] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/25/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Insulin resistance is a pathophysiological condition associated with diabetes and cardiometabolic diseases that is characterized by a diminished tissue response to insulin action. Our understanding of this complex phenomenon and its role in the pathogenesis of cardiometabolic diseases is rooted in the discovery of insulin, its isolation and purification, and the challenges encountered with its therapeutic use. SUMMARY In this historical perspective, we explore the evolution of the term "insulin resistance" and demonstrate how advances in insulin and glucose analytics contributed to the recognition and validation of this metabolic entity. We identify primary discoveries which were pivotal in expanding our knowledge of insulin resistance, the challenges in measurement and interpretation, contemporary techniques, and areas of future exploration. Key Message: Measurements of insulin resistance are important tools for defining and treating cardiometabolic diseases. Accurate quantification of this pathophysiological entity requires careful consideration of the assumptions and pitfalls of the methodological techniques and the historical and clinical context when interpreting and applying the results.
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Affiliation(s)
- Vandhna R. Sharma
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Samantha T. Matta
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Stephanie T. Chung
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA,*Stephanie T. Chung,
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Moriyama K, Kishimoto N, Shiina Y, Urata N, Masuda Y, Oda K, Yamada C, Takashimizu S, Kubo A, Nishizaki Y. Oleic acid to stearic acid ratio might be a potential marker for insulin resistance in non-obese Japanese. J Clin Biochem Nutr 2021; 68:164-168. [PMID: 33879968 PMCID: PMC8045998 DOI: 10.3164/jcbn.20-95] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/17/2020] [Indexed: 11/22/2022] Open
Abstract
Results from a recent study indicate that a higher level of oleic acid/stearic acid ratio was associated with metabolically unhealthy obesity. This was further validated in cross-sectional and interventional studies; however, this was not extensively studied in a non-obese population. We recruited 260 Japanese subjects with serum free fatty acid profiles undergoing anti-aging health examinations. The determinants for oleic acid/stearic acid ratio were investigated using multiple regression analyses. To compare different markers, the subjects were classified based on oleic acid/stearic acid ratio and the combination of oleic acid/stearic acid ratio and triglyceride levels. The oleic acid/stearic acid ratio exhibited a positive correlation with the logmatic transformed triglyceride/high-density lipoprotein cholesterol ratio and the fasting triglycerides-glucose index, both of which were used as markers for insulin resistance. Multiple regression analyses revealed that the triglyceride/high-density lipoprotein cholesterol ratio and fasting triglyceride-glucose index were positively associated with the oleic acid/stearic acid ratio. Most markers were the worst in the highest triglyceride group in both oleic acid/stearic acid groups. In addition, most markers were worse in high oleic acid/stearic acid ratio group than low group. In conclusion, oleic acid/stearic acid ratio might be a useful marker for insulin resistance in non-obese Japanese subjects.
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Affiliation(s)
- Kengo Moriyama
- Department of Clinical Health Science, Tokai University School of Medicine, Tokai University Hachioji Hospital, 1838 Ishikawa-machi, Hachioji, Tokyo 192-0032, Japan
| | - Noriaki Kishimoto
- Department of Clinical Health Science, Tokai University School of Medicine, 1-2-5 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan
- Tokai University Tokyo Hospital, 1-2-5 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan
| | - Yutaka Shiina
- Department of Clinical Health Science, Tokai University School of Medicine, Tokai University Hospital, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Nana Urata
- Department of Clinical Health Science, Tokai University School of Medicine, 1-2-5 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan
- Tokai University Tokyo Hospital, 1-2-5 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan
| | - Yumi Masuda
- Department of Clinical Health Science, Tokai University School of Medicine, 1-2-5 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan
| | - Kanae Oda
- Department of Clinical Health Science, Tokai University School of Medicine, 1-2-5 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan
- Tokai University Tokyo Hospital, 1-2-5 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan
| | - Chizumi Yamada
- Department of Clinical Health Science, Tokai University School of Medicine, 1-2-5 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan
- Tokai University Tokyo Hospital, 1-2-5 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan
| | - Shinji Takashimizu
- Department of Clinical Health Science, Tokai University School of Medicine, Tokai University Hospital, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Akira Kubo
- Department of Clinical Health Science, Tokai University School of Medicine, 1-2-5 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan
- Tokai University Tokyo Hospital, 1-2-5 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan
| | - Yasuhiro Nishizaki
- Department of Clinical Health Science, Tokai University School of Medicine, 1-2-5 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan
- Tokai University Tokyo Hospital, 1-2-5 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan
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Müllner E, Röhnisch HE, von Brömssen C, Moazzami AA. Metabolomics analysis reveals altered metabolites in lean compared with obese adolescents and additional metabolic shifts associated with hyperinsulinaemia and insulin resistance in obese adolescents: a cross-sectional study. Metabolomics 2021; 17:11. [PMID: 33438144 PMCID: PMC7803706 DOI: 10.1007/s11306-020-01759-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 12/09/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Hyperinsulinaemia and insulin resistance (IR) are strongly associated with obesity and are forerunners of type 2 diabetes. Little is known about metabolic alterations separately associated with obesity, hyperinsulinaemia/IR and impaired glucose tolerance (IGT) in adolescents. OBJECTIVES To identify metabolic alterations associated with obesity, hyperinsulinaemia/IR and hyperinsulinaemia/IR combined with IGT in obese adolescents. METHODS 81 adolescents were stratified into four groups based on body mass index (lean vs. obese), insulin responses (normal insulin (NI) vs. high insulin (HI)) and glucose responses (normal glucose tolerance (NGT) vs. IGT) after an oral glucose tolerance test (OGTT). The groups comprised: (1) healthy lean with NI and NGT, (2) obese with NI and NGT, (3) obese with HI and NGT, and (4) obese with HI and IGT. Targeted nuclear magnetic resonance-based metabolomics analysis was performed on fasting and seven post-OGTT plasma samples, followed by univariate and multivariate statistical analyses. RESULTS Two groups of metabolites were identified: (1) Metabolites associated with insulin response level: adolescents with HI (groups 3-4) had higher concentrations of branched-chain amino acids and tyrosine, and lower concentrations of serine, glycine, myo-inositol and dimethylsulfone, than adolescents with NI (groups 1-2). (2) Metabolites associated with obesity status: obese adolescents (groups 2-4) had higher concentrations of acetylcarnitine, alanine, pyruvate and glutamate, and lower concentrations of acetate, than lean adolescents (group 1). CONCLUSIONS Obesity is associated with shifts in fat and energy metabolism. Hyperinsulinaemia/IR in obese adolescents is also associated with increased branched-chain and aromatic amino acids.
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Affiliation(s)
- Elisabeth Müllner
- Department of Molecular Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Hanna E Röhnisch
- Department of Molecular Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Claudia von Brömssen
- Department of Energy and Technology, Unit of Applied Statistics and Mathematics, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Ali A Moazzami
- Department of Molecular Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.
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Liu X, Liu Y, Liu H, Li H, Yang J, Hu P, Xiao X, Liu D. Dipeptidyl-Peptidase-IV Inhibitors, Imigliptin and Alogliptin, Improve Beta-Cell Function in Type 2 Diabetes. Front Endocrinol (Lausanne) 2021; 12:694390. [PMID: 34616361 PMCID: PMC8488395 DOI: 10.3389/fendo.2021.694390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTS Imigliptin is a novel dipeptidyl peptidase-4 inhibitor. In the present study, we aimed to evaluate the effects of imigliptin and alogliptin on insulin resistance and beta-cell function in Chinese patients with type-2 diabetes mellitus (T2DM). METHODS A total of 37 Chinese T2DM patients were randomized to receive 25 mg imigliptin, 50 mg imigliptin, placebo, and 25 mg alogliptin (positive drug) for 13 days. Oral glucose tolerance tests were conducted at baseline and on day 13, followed by the oral minimal model (OMM). RESULTS Imigliptin or alogliptin treatment, compared with their baseline or placebo, was associated with higher beta-cell function parameters (φs and φtot) and lower glucose area under the curve (AUC) and postprandial glucose levels. The changes in the AUC for the glucose appearance rate between 0 and 120 min also showed a decrease in imigliptin or alogliptin groups. However, the insulin resistance parameter, fasting glucose, was not changed. For the homeostatic model assessment (HOMA-β and HOMA-IR) parameters or secretory units of islets in transplantation index (SUIT), no statistically significant changes were found both within treatments and between treatments. CONCLUSIONS After 13 days of treatment, imigliptin and alogliptin could decrease glycemic levels by improving beta-cell function. By comparing OMM with HOMA or SUIT results, glucose stimulation might be more sensitive for detecting changes in beta-cell function.
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Affiliation(s)
- Xu Liu
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China
- Drug Clinical Trial Center, Peking University Third Hospital, Beijing, China
| | - Yang Liu
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital and Chinese Academy of Medical Sciences, Beijing, China
- Department of Pharmacology, College of Pharmacy, Inner Mongolia Medical University, Hohhot, China
| | - Hongzhong Liu
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital and Chinese Academy of Medical Sciences, Beijing, China
| | - Haiyan Li
- Drug Clinical Trial Center, Peking University Third Hospital, Beijing, China
- Center of Clinical Medical Research, Institute of Medical Innovation and Research, Peking University Third Hospital, Beijing, China
| | - Jianhong Yang
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China
| | - Pei Hu
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital and Chinese Academy of Medical Sciences, Beijing, China
| | - Xinhua Xiao
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital and Chinese Academy of Medical Sciences, Beijing, China
| | - Dongyang Liu
- Drug Clinical Trial Center, Peking University Third Hospital, Beijing, China
- Center of Clinical Medical Research, Institute of Medical Innovation and Research, Peking University Third Hospital, Beijing, China
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Pan Y, Zhong S, Zhou K, Tian Z, Chen F, Liu Z, Geng Z, Li S, Huang R, Wang H, Zou W, Hu J. Association between Diabetes Complications and the Triglyceride-Glucose Index in Hospitalized Patients with Type 2 Diabetes. J Diabetes Res 2021; 2021:8757996. [PMID: 34671683 PMCID: PMC8523276 DOI: 10.1155/2021/8757996] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/17/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Triglyceride-glucose (TyG) index is a convenient indicator of insulin resistance. It has been shown to be associated with macrovascular and microvascular complications in nonhospitalized diabetic patients. However, whether TyG index is a risk factor of diabetes vascular complications in hospitalized type 2 diabetic patients is unclear. We sought to explore the association between TyG index and the risk of macrovascular and microvascular complications in a large Chinese cohort of hospitalized patients. METHOD A total of 4,721 patients with type 2 diabetes (T2D) who were hospitalized in the Department of Endocrinology, Kunshan Hospital Affiliated to Jiangsu University were enrolled between January 2015 and November 2020. TyG index was calculated as ln[fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Measures of macrovascular complications included brachial-ankle pulse wave velocity (ba-PWV) and ankle-brachial index (ABI), whilst urine microalbumin (MAU), chronic kidney disease (CKD), and diabetic retinopathy (DR) were evaluated for microvascular complications. Logistic regressions were used to examine the association between TyG index and diabetes complications. RESULTS In univariate logistic regressions, higher TyG index was significantly (p < 0.002) associated with increased odds of MAU (OR = 1.39, 95% CI: [1.22~1.59]) and ABI (OR = 1.31, 95% CI: [1.10-1.57]) but not CKD, DR, or ba-PWV. After controlling for confounders such as age, sex, and body mass index (BMI), TyG index remained strongly (p < 0.002) associated with MAU and ABI. These associations were more pronounced (p < 0.001) in patients with poor glycemic control or in the elderly. CONCLUSION Hospitalized patients with an elevated TyG index were at a higher risk of lower limb vascular stenosis and nephric microvascular damage. Close monitoring of TyG index in patients with younger age or poor glycemic control could potentially reduce the burden of diabetes complications and prevent readmission.
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Affiliation(s)
- Ying Pan
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Department of Endocrinology, Kunshan Hospital Affiliated to Jiangsu University, Kunshan, Jiangsu, China
| | - Shao Zhong
- Department of Endocrinology, Kunshan Hospital Affiliated to Jiangsu University, Kunshan, Jiangsu, China
| | - Kaixin Zhou
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Zijian Tian
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Fei Chen
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Ziqing Liu
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Zhaoxu Geng
- Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Shaoyun Li
- Big Data Laboratory, Renji Hospital, University of Chinese Academy of Sciences, Chongqing, China
| | - Rong Huang
- Bioland Laboratory (Guangzhou Regenerative Medicine and Health Guangdong Laboratory), Guangzhou, China
| | - Heyou Wang
- Penglang Community Health Service Center, Kunshan, Jiangsu, China
| | - Weiqing Zou
- Penglang Community Health Service Center, Kunshan, Jiangsu, China
| | - Ji Hu
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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Herrod PJJ, Gharahdaghi N, Rudrappa SS, Phillips HG, Ranat RA, Hardy EJO, Rathmacher JA, Atherton PJ, Phillips BE. The impact of acute beta-hydroxy-beta-methylbutyrate (HMB) ingestion on glucose and insulin kinetics in young and older men. J Funct Foods 2020; 73:104163. [PMID: 33101462 PMCID: PMC7573812 DOI: 10.1016/j.jff.2020.104163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Insulin resistance (IR) is a key feature in the development of numerous metabolic diseases. The cornerstone for treatment for IR remains diet and exercise, however these have poor rates of adherence. Beta-hydroxy-beta-methylbutyrate (HMB) is a nutraceutical with contentious effects on IR in animal models. The aim of this study was to evaluate the impact of acute HMB on IR in humans during an oral glucose tolerance test (OGTT). Young and older male volunteers underwent two 75 g OGTT with or without 3 g HMB. In young men, HMB significantly reduced the insulin area-under-the-curve (AUC), with no difference in glucose AUC, resulting in a numerical increase in the Cederholm index of insulin sensitivity. In older men, HMB had no effect on insulin or glucose responses. In conclusion, acute HMB may improve IR following a glucose load in young men; however, this does not appear to be sustained into older age.
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Affiliation(s)
- Philip J J Herrod
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, School of Medicine, Royal Derby Hospital Centre, Derby, UK.,Department of Surgery and Anaesthetics, Royal Derby Hospital, Derby, UK
| | - Nima Gharahdaghi
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, School of Medicine, Royal Derby Hospital Centre, Derby, UK
| | - Supreeth S Rudrappa
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, School of Medicine, Royal Derby Hospital Centre, Derby, UK
| | - Hannah G Phillips
- Department of Surgery and Anaesthetics, Royal Derby Hospital, Derby, UK
| | - Reesha A Ranat
- Department of Surgery and Anaesthetics, Royal Derby Hospital, Derby, UK
| | - Edward J O Hardy
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, School of Medicine, Royal Derby Hospital Centre, Derby, UK.,Department of Surgery and Anaesthetics, Royal Derby Hospital, Derby, UK
| | - John A Rathmacher
- Metabolic Technologies Inc., Iowa State University Research Park, Iowa, USA
| | - Philip J Atherton
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, School of Medicine, Royal Derby Hospital Centre, Derby, UK
| | - Bethan E Phillips
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, School of Medicine, Royal Derby Hospital Centre, Derby, UK
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Wilkinson D, Szekely S, Gue B, Tam CS, Chapman I, Heilbronn LK. Assessment of insulin sensitivity during hyperbaric oxygen treatment. Diving Hyperb Med 2020; 50:238-243. [PMID: 32957125 DOI: 10.28920/dhm50.3.238-243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/18/2020] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Previous studies using a hyperinsulinaemic, euglycaemic glucose clamp have demonstrated an increase in peripheral insulin sensitivity in men with and without Type-2 diabetes mellitus on the third and thirtieth hyperbaric oxygen treatment (HBOT) session. In two studies using different techniques for assessment of insulin sensitivity, we investigated the onset and duration of this insulin-sensitising effect of HBOT. METHODS Men who were obese or overweight but without diabetes were recruited. One study performed a hyperinsulinaemic euglycaemic glucose clamp (80 mU.m-2.min-1) at baseline and during the first HBOT exposure (n = 9) at a pressure of 203 kPa. Data were analysed by paired t-test. The other study assessed insulin sensitivity by a frequently sampled intravenous glucose tolerance test (FSIGT) at three time points: baseline, during the third HBOT and 24-hours post-HBOT (n = 9). Results were analysed by repeated-measures ANOVA. RESULTS There was a significant 23% increase in insulin sensitivity by clamp measured during the first HBOT exposure. The FSIGT showed no significant changes in insulin sensitivity. CONCLUSIONS The hyperinsulinaemic, euglycaemic glucose clamp demonstrated a significant increase in peripheral insulin sensitivity during a single, 2-hour HBOT session in a group of men who were obese or overweight but without diabetes. As an alternate technique for assessing insulin sensitivity during HBOT, the FSIGT failed to show any changes during the third HBOT and 24-hours later, however modification of the study protocol should be considered.
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Affiliation(s)
- David Wilkinson
- Hyperbaric Medicine Unit, Royal Adelaide Hospital, Adelaide, Australia.,Adelaide Medical School, The University of Adelaide, Adelaide, Australia.,Corresponding author: Dr David Wilkinson, Hyperbaric Medicine Unit, Royal Adelaide Hospital, Port Road, Adelaide, SA 5000, Australia,
| | - Suzy Szekely
- Hyperbaric Medicine Unit, Royal Adelaide Hospital, Adelaide, Australia
| | - Brian Gue
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Charmaine S Tam
- Centre for Translational Data Science and Northern Clinical School, Sydney, Australia
| | - Ian Chapman
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Leonie K Heilbronn
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
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Stefanovski D, Moate PJ, Frank N, Ward GM, Localio AR, Punjabi NM, Boston RC. Metabolic modeling using statistical and spreadsheet software: Application to the glucose minimal model. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 191:105353. [PMID: 32113102 DOI: 10.1016/j.cmpb.2020.105353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 01/14/2020] [Accepted: 01/21/2020] [Indexed: 06/10/2023]
Abstract
Kinetic non-linear metabolic models are used extensively in medical research and increasingly for clinical diagnostic purposes. An example of such a model is the Glucose Minimal Model by Bergman and colleagues [1]. This model is similar to pharmacokinetic/pharmacodynamic models in that like pharmacokinetic/pharmacodynamic models, it is based on a small number of fairly simple ordinary differential equations and it aims to determine how the changing concentration of one blood constituent influences the concentration of another constituent. Although such models may appear prima facie, to be relatively simple, they have gained a reputation of being difficult to fit to data, especially in a consistent and repeatable fashion. Consequently, researchers and clinicians have generally relied on dedicated software packages to do this type of modeling. This article describes the use of statistical and spreadsheet software for fitting the Glucose Minimal Model to data from an insulin modified intravenous glucose tolerance test (IM-IVGTT). A novel aspect of the modeling is that the differential equations that are normally used to describe insulin action and the disposition of plasma glucose are first solved and expressed in their explicit forms so as to facilitate the estimation of Glucose Minimal Model parameters using the nonlinear (nl) optimization procedure within statistical and spreadsheet software. The most important clinical parameter obtained from the Glucose Minimal Model is insulin sensitivity (SI). Using IM-IVGTT data from 42 horses in one experiment and 48 horses in a second experiment, we demonstrate that estimates of SI derived from the Glucose Minimal Model fitted to data using STATA and Excel, are highly concordant with SI estimates obtained using the industry standard software, MinMod Millennium. This work demonstrates that there is potential for statistical and spreadsheet software to be applied to a wide range of kinetic non-linear modeling problems.
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Affiliation(s)
- D Stefanovski
- Department of Clinical Studies - New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, United States.
| | - P J Moate
- Agriculture Research Division, Department of Economic Development Jobs Transport and Resources, Ellinbank Centre, Ellinbank, VIC 3821, Australia
| | - N Frank
- Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA, United States
| | - G M Ward
- Department of Endocrinology and Diabetes, St. Vincent's Hospital Melbourne, Melbourne, Australia
| | - A R Localio
- Division of Biostatistics, Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA, United States
| | - N M Punjabi
- Division of Pulmonary and Critical Care Medicine (N.M.P.), Johns Hopkins University, Baltimore, MD, United States
| | - R C Boston
- Department of Clinical Studies - New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, United States
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