ABSTRACT
Introducción: El sustrato del receptor de insulina 1 (IRS1) es un componente importante de la cascada de transducción de señales de la insulina y podría estar relacionado con los trastornos metabólicos asociados al síndrome metabólico. Objetivo: Evaluar el papel del polimorfismo Gly972Arg del gen IRS1 con factores de riesgo cardiometabólicos en niños pre-púberes. Metodología: Se estudiaron 279 niños con edades comprendidas entre 2-12 años, clasificados según los parámetros antropométricos y bioquímicos en: a) niños obesos sin RI (n=135), b) niños obesos con RI (n=80) y c) niños controles sanos (n=64). A cada niño se le realizó una extracción de sangre en ayunas y una postprandial, para determinar glicemia e insulina basal y postprandial, triglicéridos, colesterol total y fraccionado y la frecuencia genotípica del SNP Gly972Arg. Resultados: Se observó que 37,5% de los niños presentó RI; 9,6% hiperglicemia en ayunas; 27,3% hipertrigliceridemia y 50,46% bajos niveles de HDL-c. La frecuencia genotípica fue 89% genotipo Gly/Gly y 11% genotipo Gly/Arg. Se encontró diferencia significativa en la distribución de los diferentes genotipos del gen de IRS1 en los niños con sobrepeso/obesidad sin RI y niños con sobrepeso/obesidad con RI con respecto al grupo control (OR= 4,47; IC 95%=0,96-16,92; p < 0,05) y (OR= 4,43; IC 95%=0,93-21,00; p < 0,05) respectivamente. Conclusión: Se observó una asociación entre la presencia del genotipo Gly/Arg del gen IRS1 con sobrepeso/obesidad (factor de riesgo cardiometabólico) en los niños del estudio, presentando estos niños 4 veces más riesgos a presentar sobrepeso/obesidad que los niños con el genotipo Gly/Gly.
Introduction: Insulin receptor substrate 1 (IRS-1) is an important component of the insulin signal transduction cascade and could be related with metabolic disorders associated with metabolic syndrome (MS). Aim: Evaluate the role of the Gly972Arg polymorphism in the IRS1 gene in prepubertal children with cardiometabolic risk factors. Methods: We studied 279 children between 2-12 years of age, divided in groups 3 groups: a) obese children without insulin resistance (IR) (n=135), b) obese children with IR (n=80) and c) healthy children as controls (n=64). Basal and postprandial glucose, insulin, triglycerides, total and fractionated cholesterol and genotype frequency of the Gly972Arg SNP were determined in fasting and postprandial samples in each child. Results: 37.5% of the children had IR; in the fasting state, 9.6% had hyperglycemia, 27.3% hypertriglyceridemia and 50.46 % low HDL-C. The genotypic frequency was 89% for the Gly / Gly genotype and 11% Gly / Arg genotype. Significant difference was found in the distribution of the different genotypes of the IRS1 gene in children with overweight/obesity without IR and children with overweight/obesity with IR compared to the control group (OR = 4.47;CI 95% = 0.96-16.92; p <0.05) and (OR = 4.43; CI 95%= 0.93 - 21.00, p <0.05) respectively. Conclusion: Association between the presence of Gly/Arg genotype of the IRS1 gene with overweight/obesity (cardiometabolic risk factor) was observed in the studied children. These children were four times more likely to be overweight/obese than children with Gly / Gly genotype.
ABSTRACT
Objective To investigate the relationship of serum level of 25 hydroxyl vitamin D3 [25(OH)D3 ] with insulin resistance (IR) and bone metabolism in diabetic patients with chronic kidney disease (CKD) . Methods From April 2012 to February 2014 ,200 diabetic patients with CKD were selected ,and they were divided into three groups according to eGFR:60 subjects in eGFR> 45 ~ 59 ml/(min?1.73 m2 ) group ,60 subjects in eGFR 30~44 ml/(min?1.73 m2 ) group and 80 subjects in eGFR 15~29 ml/(min?1.73 m2 ) group .Clinical features ,IR and indexes of bone metabolism among different groups were compared .Indexes of bone metabolism between two groups with different HOMA‐IR level were also compared . Results The difference of age ,gender ,BMI ,blood pressure and FPG among three groups had no statistical significance (P> 0 .05) .The difference of duration of diabetes mellitus ,duration of CKD ,urine protein ,blood lipid ,eGFR ,HbA1c ,FIns ,HOMA‐IR and indexes of bone metabolism had statistical significance (P< 0.05) .In 200 patients ,there were 129 patients (IR) with HOMA‐IR≥3.28 ,and 71 patients (non‐insulin resistance) with HOMA‐IR<3.28 .The difference of bone metabolism indexes between two groups had statistical significance (P<0.05) .The serum level of 25(OH)D3 was positively related to HOMA‐IR ,bone mineral density (BMD) at left proximal femur , BMD at lumbar ,P ,Ca and BSAP (P<0.05);while it was negatively related to osteoprotegerin and PTH (P<0 .05) . Conclusion The serum level of 25 (OH )D3 has relevance to IR and bone metabolism in diabetic patients with CKD .
ABSTRACT
Objective To explore the relationship between insulin resistance (IR) and benign prostatic hyperplasia (BPH) in elderly men of different ages.Methods Totally 100 elderly outpatients with BPH in our hospital from January 2012 to June 2012 were recruited in this study.All patients were divided into 2 groups according to age:60-75 years(n =52) and 76-93 years (n=48).Fasting plasma glucose,fasting insulin (FINS) and prostate specific antigen (PSA) were assayed.Insulin resistance index (IRI) was calculated by using the homeostasis model assessment-insulin resistance (HOMA2-IR) software.The body height,body weight,waist circumference were measured and the body mass index (BMI) was calculated.Prostate volume (PV) was measured by abdominal ultrasound.Clinical data were compared between the two groups.Based on HOMA2-IR,patients were divided into insulin resistant group (IR＞ 1.7) and non insulin resistant group (IR＜ 1.7).Serum PSA,PV and waist circumference were compared between the two groups.Results The waist circumference and PV were significantly larger in insulin resistant group than in non-insulin resistant group [(96.6± 7.2) cm vs.(93.1±8.9) cm,(50.0±9.0) ml vs.(46.1±7.8) ml,respectively,P＜0.01,0.05].However,the PSA level was lower in insulin resistant group than in non-insulin resistant group [(1.44±1.08) μg/L vs.(2.1 ±2.0)μg/L,P＜0.05],and no correlation was found between HOMA-IR and PV.There was no correlation between serum PSA levels and PV in patients aged 76-93 years.In patients aged 60-75 years,PSA level was positively correlated with PV (r =0.52,P＜0.05) and negatively correlated with HOMA-IR (r=0.38,P＜0.05).Conclusions Serum PSA level is positively correlated with PV and negatively correlated with HOMA IR in BPH patients under 75 years old.
ABSTRACT
Se destaca al sobrepeso y obesidad como el principal condicionante actual de patología crónica no transmisible. Se identifican y discuten las principales comorbilidades asociadas al sobrepeso y obesidad, analizando las evidencias que las apoyan. Se destaca el rol de la adiposidad en la etiopatogenia del síndrome metabólico y en forma muy especial de la DM. Se analiza la asociación entre indicadores de masa corporal y tejido adiposo y tasas de mortalidad, destacando un significativo incremento de la mortalidad a medida que la masa corporal o grasa se incrementa. Se destacan los rangos asociados a la menor mortalidad, nadires que fundamentan los rangos de peso normal. Se discute en forma separada la asociación entre sobrepeso yobesidad en la infancia y adolescencia y salud, en especial su posible rol en la incidencia de patologías crónicas al alcanzar la adultez.
The article highlights overweight and obesity as the main factor in some current chronic diseases. Also it identifies and discusses major co-morbidities associated with overweight and obesity, analyzing the evidence that support them. The role of adiposity in the pathogenesis of metabolic syndrome especially in the development of mellitus diabetes 2 is discussed. We analyze the association between indicators of body mass and adipose tissue and mortality, highlighting a significant increase in mortality as the fat body mass increases and shows the range associated with lower mortality, basing the normal weight ranges. Will be discussing separately the association between overweight and obesity in childhood and adolescence health, especially its possible role in the incidence of chronic diseases that will develop at adulthood.
Subject(s)
Humans , Adipose Tissue , Adipocytes/physiology , Overweight , Obesity/epidemiology , Comorbidity , Metabolic Diseases , Risk FactorsABSTRACT
With consideration of optimizing treatment of type 2 diabetes,early combination therapy has been deeply explored, with fixed-doses combination therapy as a available preparation for easier administration. Avandamet ( rosiglitazone maleate and metformin HC1) is widely used in clinical treatment, providing comprehensive and sustained long-term efficacy and confirmed safety with lower hypoglycemia risk, and also high convenience and compliance. Combination of rosiglitazone and metformin improves the dual core defects of type 2 diabetes, targeting FPG and PPG reduction through decreasing hepatic glucose output, and improving peripheral insulin resistance, especially increasing skeletal muscle's utilization of glucose respectively. Large-scale clinical trials gave more confidence to Avandamet. Recently, RECORD study indicated that rosiglitazone in combination with metformin achieved long-term antihyperglycemic efficacy in 5 years period, superior to sulphanylureas plus metformin. Additionally, lower risk of hypoglycemia is another benefit of Avandamet. In conclusion,early use of Avandamet can yield much more benefits than monotherapy and late administration, in consistent with implication of evidence-based trial, guideline, and clinical experiences.
ABSTRACT
Lipocalin-2 is an adipocytokine secreted mainly by adipose tissue. Increasing lines of evidence suggest that lipocalin-2 is an inflammatory factor associated with insulin resistence, obesity and its complications. The precise mechanism of the development of obesity-related disorders induced by lipocalin-2 is not very clear, however, it may be a useful target in drug therapy for obesity-related metabolic and cardiovascular diseases.
ABSTRACT
Objective To establish the technique of hyperinsulinemic euglycemic clamp and to study the reference value of insulin sensitivity index in healthy Chinese. Methods According to the feedback mathematical model developed by DeFronzo, the technique of hyperinsulinemic euglycemic clamp was used in 90 healthy Chi- nese [ male:female =71 = 19; age; (28. 3±6. 1) years; body mass index (20. 9±1.5) kg/m2 ] to study die glu-cose metabolized rate. Blood samples were obtained at timed intervals in the fasting state and during the clamp for the measurement of glucose, insulin and C peptide. Results During the clamp tests, the blood glucose levels were con-trolled within 10% of target value. The coefficient of variation of glucose levels was 3. 8% 0.1%. In the steady state, the insulin sensitivity index (glucose metabolized rate, M value ) was (7.78±2.30) mg· kg-1 min-1, which was distributed normally. The lowest quartile of M value was 6. 286 mg·kg -1 min-1'. The coefficient of variation of M value was 9.4%±2.8%. Conclusion The technique of hyperinsulinemic euglycemic clamp and the reference value of insulin sensitivity index in healthy Chinese are successfully established in our center.
ABSTRACT
Objective To investigate the effect of rosiglitazone on non-alcoholic fatty liver (NA and to explore the relationship between insulin resistance and NAFL. Methods Animal model of NAFL was established by feeding Sprague-Dawley rats a high-fat diet for 8 weeks. The model rats were then randomized into rosiglitazone-treated and untreated groups. The animals were sacrificed after being treated with rosiglitazone or vehicle for 4 weeks. The histological changes of liver were examined, and liver function, fasting plasma glucose, fasting serum insulin, serum lipid profile, leptin, and adiponectin were measured. Results As compared with untreated group, hepatic steatosis and liver function were significantly improved in rosiglitazone-treated group. Alanine aminotransferase (ALT) was 54±19 U/L vs 101±24 U/L, aspartic acid aminotransferase (AST) 151±37 U/L vs 198±48 U/L, and alkaline phosphatase (ALP) 87±16 U/L vs 115±39 U/L, respectively (P<0.01). Serum adiponectin level was higher, and serum leptin level and insulin resistance index (HOMA-IR) were lower in rosiglitazone-treated group than in untreated group. HOMA-IR was 6.9±1.8 vs 12.0±1.2 (P<0.01). Serum triglyceride, total cholesterol and low density lipoprotein-cholesterol level were significantly decreased in rosiglitazone-treated group as compared with untreated group (P<0.01). Conclusions Insulin resistance might play important role in the pathogenesis of NAFL. Rosiglitazone effectively reverses NAFL in animal model.
ABSTRACT
Objective To explore the pathogenic mechanism associated with insulin resistance(IR) and adiponetin(APN) abnormality in carotid atherosclerosis(CAS) patients complicated with nonalcoholic fatty liver disease(NAFLD),and to study their relationships with traditional Chinese medical(TCM) syndrome types.Methods Seventy-four CAS patients complicated with NAFLD(group A) and 25 CAS patients(group B) were enrolled into the study.Fasting blood glucose(FBG),fasting serum insulin(FI),and serum APN levels were measured.IR and APN were evaluated by the homeostasis assessment(HOMA) method.HOMA-IR and APN in group A were compared with those in group B,and bivariate correlation analysis was made between the two indexes in group A.The relationship of HOMA-IR and APN with TCM syndrome types was analyzed in group A.Results (1) HOMA-IR was obviously increased,and APN was obviously decreased in group A(P
ABSTRACT
Objective To investigate the effects of Irbesartan on endothelial function and autonomic nervous system activity of patients with essential hypertension. Methods The endothelium dependent flow mediated dilatation (F-MD) and the endothelium independent nitroglycerin mediated dilatation (NTG-MD) were evaluated by the brachial ultrasound examination. Time-domain indices of heart rate variability (HRV) were measured by 24 h ambulatory electrocardiogram. The changes of blood lipoproteins, blood glucose, insulin levels, endothelial function and heart rate variability in 60 patients with mild-moderate essential hypertension and 20 healthy controls were compared, and the effects of different antihypertensive agents (AT1 receptor blocker and diuretic) for 8-week treatment were observed. Results Endothelial dysfunction and abnormal autonomic nervous activity were observed in patients with mild-moderate essential hypertension as follow: mildly decreased total HRV and mildly increased 24-hour average heart rate, significantly decreased parasympathetic tone-rMSSD and PNN50, obviously lowered endothelium dependent F-MD. The postprandial insulin level and insulin/glucose ratio of patients with hypertension was significantly higher than that of healthy controls. The decreased blood pressure level caused by AT1 receptor blocker (Irbesartan) and diuretic (Indapamide) was similar. Irbesartan for 8-week therapy resulted in a significant improvement of the endothelium dependent F-MD and insulin resistence, the increase of vagal nervous activity and the decrease of 24-hour average heart rate, but Indapamide presented no such effects. Conclusion This study suggested that patients with mild-moderate essential hypertension have significantly abnormal endothelial function and autonomic nervous activity, and the beneficial effect of Irbesartan is associated with an improvement of insulin resistence and heart rate variability, not with the decrease of blood pressure level.
ABSTRACT
Objective To investigate the role of insulin resistance index (HOMA-IR) in premonishing hepatogenous diabetes subsequent to chronic liver disease related to hepatitis B virus. Methods Fasting plasma glucose (FPG) and fasting serum insulin (FINS) were measured in 176 patients, including 80 patients with chronic hepatitis B (CHB), 66 patients with liver cirrhosis (LC) and 30 patients with chronic severe hepatitis B (CSHB). In addition 30 healthy subjects served as control (group HC). None of the subjects in the study had a history of diabetes. FPG and FINS were measured in all the subjects to exclude impaired glucose tolerance and diabetes. Then HOMA-IR was calculated. Results Among the HC and CHB, LC and CSHB patients, both FINS and HOMA-IR levels gradually elevated. FINS and HOMA-IR in CHB patients (10.58?6.48, 2.35?1.55) were significantly higher than those in group HC (8.06?2.14,1.68?1.53), while lower than those in LC (12.73?5.88, 2.91?1.41) and CSHB (18.30?14.17, 4.35?3.17) patients (P0.05), while the values of FINS and HOMA-IR were significantly higher in severe patients than those in moderate patients (P0.05), while the values of FPG were significantly higher in LC and CSHB patients than those in group HC (P