Serum lipoprotein ratios as markers of insulin resistance: A study among non-diabetic acute coronary syndrome patients with impaired fasting glucose.

Background & objectives: Recent data suggest that insulin resistance can predict cardiovascular disease independently of the other risk factors, such as hypertension, visceral obesity or dyslipidaemia. However, the majority of available methods to evaluate insulin resistance are complicated to operate, expensive, and time consuming. This study was undertaken to assess whether serum lipoprotein ratios could predict insulin resistance in non-diabetic acute coronary syndrome (ACS) patients. Methods: Ninety non-diabetic patients with impaired fasting glucose admitted with a diagnosis of ACS were included in the study. At the time of admission fasting glucose and insulin concentrations were measured. The homeostatic model assessment-insulin resistance (HOMA-IR) was used for insulin resistance. The fasting serum total cholesterol (TC), triglycerides (TG) and high density lipoprotein cholesterol (HDL-C) levels were checked, and then TC/HDL-C and TG/HDL-C ratios were calculated. The areas under the curves (AUC) of the receiver operating characteristic (ROC) curves were used to compare the power of these serum lipoprotein ratios as markers. Results: Lipoprotein ratios were significantly higher in patients with HOMA-IR index > 2.5 as compared to patients with index <2.5 (P < 0.05). Both TG/HDL-C and TC/HDL-C ratios were significantly correlated with HOMA-IR (P<0.05). The area under the ROC curve of the TG/HDL-C and TC/HDL-C ratio for predicting insulin resistance was 0.80 (95% CI, 0.67 to 0.93), 0.78 (95% CI, 0.65 to 0.91), respectively. Interpretation & conclusions: The findings of this study demonstrate that serum lipoprotein ratios can provide a simple means of identifying insulin resistance and can be used as markers of insulin resistance and cardiovascular diseases risk in adult non-diabetic patients.

Electrolyte Imbalance in Cataract Patients.

100 cataract patients of IGGMC attending Biochemistry OPD for routine Blood sugar, were estimated for serum electrolyte level i.e. Sodium, Potassium level and compared with normal healthy age related ( 50-70 yrs) control by t test. Plasma Glucose level (to rule out Diabetes) and serum Creatinine (to rule out renal disorder) in both cases and control were also studied. Result of our study shows Elevation in serum Na level in cataract pts mean 148.52 + /-4.13 meq/lt compared to control mean 139.26 +/-3.08 meq/lt (p value 0.001) which is significantly high. Normal Serum Na level is required to maintain proper water electrolyte balance across lens membrane that in turn is also responsible for maintaining lens membrane permeability. Elevation in serum Na level in cataract pts may result into its further increase in aqueous humor of lens which may lead to osmotic imbalance across lens membrane and aggravate, progression of disease. We conclude that salt restricted Diet must be advised in Cataract patients so as to maintain normal electrolyte balance which may prevent further progression of disease.

Polyherbal preparation for anti-diabetic activity: A screening study.

Objective: To screen the Polyherbal preparation for anti-diabetic activity in rats. Materials and Methods: The blood glucose lowering activity of the Polyherbal preparation-I (1:1:1 of Wheat germ oil, Coriandrum sativum and Aloe vera) was studied in normal rats after oral administration at doses of 1.0 and 2.0 ml/kg and Polyherbal preparation-I, II (Wheat germ oil, fresh juice of C. sativum and Aloe vera in the ratio of 2:2:1), and III (Wheat germ oil, fresh juice of C. sativum and Aloe vera in the ratio of 1:2:2) on alloxan-induced diabetic rats, after oral administration at doses of 1.0 and 2.0 ml/kg. Blood samples were collected from the tail vein method at 0, 0.5, 1, 2, 4, 8, 12, and 24 h in normal rats and in diabetic rats at 0, 1, 3, 7, 15, and 30 days. Blood plasma glucose was estimated by the GOD/POD (glucose oxidase and peroxidase) method. The data was compared statistically using the one-way ANOVA method followed by the Dunnett multiple component test. Statistical significance was set at P<0.05. Results: The Polyherbal preparation-I produced significant (P<0.05) reduction in the blood glucose level of normal rats and Polyherbal preparation-I, II, and III produced significant (P<0.01) reduction in the blood glucose level of diabetic rats during 30 days study and compared with that of control and Glibenclamide. Conclusion: The Polyherbal preparation-I showed a significant glucose lowering effect in normal rats and Polyherbal preparation-I, II, and III in diabetic rats. This preparation is going to be promising anti-diabetic preparation for masses; however, it requires further extensive studies in human beings.

Association between thyroid hormones, insulin resistance, and metabolic syndrome

To determine the association between thyroid hormones, insulin resistance, and metabolic syndrome in euthyroid women. Forty-five women with no past medical history were studied in this cross-sectional study at the Department of Endocrinology, Medwin Hospitals, Hyderabad, India, from August 2008 to September 2008. The body fat was estimated using bio-impedance method, and fasting blood sample was analyzed for total triiodothyronine [T3], total thyroxine [T4], thyroid-stimulating hormone [TSH], free triiodothyronine [FT3], lipid profile, insulin, and glucose. The mean age of the participants was 32.6 +/- 9.6 years with a body mass index [BMI] of 29.9 +/- 3.8 kg/m[2]. Evidence of homeostasis model assessment index for insulin resistance [HOMA-IR] more than 3 was seen in 34 [75%] and metabolic syndrome in 29 [64%] participants. Total T3 showed a positive correlation with triglycerides, low density lipoproteincholesterol [LDL-C], total cholesterol, insulin, HOMA-IR and negatively with body fat. Thyroid-stimulating hormone correlated positively with BMI, insulin, HOMA-IR, LDL-C and negatively with HDL-cholesterol [p<0.05]. Free triiodothyronine correlated positively with waist circumference and T4 did not correlate with metabolic syndrome parameters. Our preliminary data show an association between thyroid hormones and some components specific of the metabolic syndrome in euthyroid women. Total triiodothyronine and TSH correlated more with variables of metabolic syndrome than FT3 and T4

Metabolic syndrome among adults attending obesity clinics in Kuwait

Was to determine the main characteristics of adults attending obesity clinics in Kuwait and the prevalence of the metabolic syndrome [MS] among them. The study design is cross sectional one using data collected from 617 adults aged 15 years and over attending two obesity clinics in primary health care centers during April - May 2007 in Kuwait. The metabolic variables analyzed were fasting blood glucose [FBS], high density lipoprotein cholesterol [HDL], and triglycerides [TG]. In addition, measurements of obesity such as body mass index [BMI], and waist circumference [WC] as well as blood pressure were taken. Six hundred seventeen apparently healthy men arid women were recruited for participation in this study. Weight, height, waist girth, and blood pressure were recorded using standard procedures. Blood samples were taken after an overnight fasting and analyzed. The study revealed that the majority of adults attending the selected clinics were suffering from obesity [74.2%]. Abnormal physical and biochemical measurement were encountered among 86.5% of the participants for WC, 34.0% for diabetes, 63.5% for HDL, 25.6 for TG and 45.9% for high blood pressure. The prevalence of the metabolic syndrome was 46.8%. Comparing the main characteristics of the MS and non-MS subjects showed significant differences in almost all the variables except for nationality and smoking. Female gender, increased age, obesity and sedentary life style were significantly associated with MS. Metabolic syndrome is present in 46.8% patients aged 15 years and over. Low HDL, hypertriglyceridemia, obesity, increasead waist circumference, and high blood pressure were the most prevalent associated factors in this study

Effect of chromium deficiency and supplementation on some aspects of carbohydrate and lipid metabolism in male albino rats

In this work, thirty adult male albino rats were used to study the effect of chromium deficiency and supplementation on carbohydrates and lipid metabolism. Rats were divided into three equal groups control, chromium deficient and chromium supplemented. Rats of the first group were fed on normal diet, rats of the second group were fed on a chromium deficient diet. Rats of the third group were fed on the same chromium deficient diet but were supplemented with oral chromium picolinate [90 |-l micro gm / kg body weight] daily for forty five days. At the end of the experimental period [45 days] plasma glucose, insulin serum triglycerides, cholesterol, LDL and HDL were determined. The study showed that chromium deficiency led to a significant increase in plasma glucose level, and insulin with insignificant changes in serum triglycerides, cholesterol, HDL and LDL as compared to control group. The study showed also that chromium supplementation led to an insignificant increase in serum glucose and insulin with significant decrease in serum triglycerides, cholesterol, LDL and a significant increase in serum HDL

Predictors of cardiovascular risk factors in Tehranian adults: diet and lifestyle

We carried out a dietary intake assessment in 486 adults 20 from the Tehran Lipid and Glucose Study. There was a strong positive association between body mass index [BMI] and serum triglycerides [beta = 1.6, P < 0.05] and carbohydrate intake and triglycerides [beta = 2.4, P < 0.05]. There was also an association between low-density lipoprotein cholesterol and weight [beta = 1.1, P < 0.05], age [beta = 1.6, P < 0.05] and cholesterol intake [beta = 0.7, P < 0.01]. For 1 unit increase in either BMI, waist to hip ratio or saturated fatty acid intake, diastolic blood pressure increased 0.6, 0.9 and 0.1 mmHg, respectively [P < 0.05]. Dietary and non-dietary factors have an association with, and play a role as predictors of, CVD risk factors

Role of dyslipidemia in old age of both sexes

To observe the risk of dyslipidemia and variation in other biochemical parameters in old age subjects of both sexes and to observe the relationship of biochemical parameters with the dietary pattern. Seventy males and 30 females, with age ranging from 40-60 years were included in the study. Levels of serum triglyceride, cholesterol, uric acid, blood sugar, blood urea and serum creatinine were estimated. The levels of serum triglyceride and uric acid were significantly increased in both sexes. Other biochemical parameters showed no significant difference. The dietary pattern and life style showed a direct relation with the level of triglyceride as compared to that of serum cholesterol. Levels of triglycerides were found to be elevated in older patients. An education program is needed for the dietary modifications and morning walk that may lead to the lowering of serum triglyceride level

role of endogenous oestrogen and androgen on cardiovascular risk factors in rats

Ischemic heart disease is an important cause of death for both sexes. Risk factors include dyslipidemia, glucose intolerance and hyperinsulinemia [Graunberry and Fonesca, 1999]. The incidence of ischemic heart disease is more in male than female in the reproductive period of life due to the well known protective mechanism of estrogen. The androgen role is still controversial. This study was designed to investigate the role of endogenous estrogen and androgen on cardiovascular risk factors in rats. Three groups of albino rats were used in this study. Each group is subdivided into subgroup A [males] and subgroup B [females]. Group I: is served as a control group. Group II were injected IP by anti-estrogen at a dose 1 mg/ Kg/ day. Group III were given anti-androgen orally at a dose 67.5 mg/kg/ day. Blood samples were collected by decapitation after 12 weeks of experiment and the following were estimated in animal sera: Fasting blood sugar, fasting insulin, cholesterol, triglycerides, LDL and HDL. Cardiovascular risk factors changes indicate that both endogenous estrogen and androgen have a protective role against ischemic heart disease, but estrogen is more protective in females and androgen is more protective in males. We conclude that both endogenous estrogen and androgen have an important protective role in ischemic heart disease in both males and females. A balance between estrogen and androgen in men and women is essential for this protective role. Any defect in estrogen / androgen balance increase cardiovascular risk factors

Honey: is it a safe sweetner for diabetics

The objective of this study was to determine whether or not honey could be used as a sweetening agent for non insulin dependent diabetics instead of sucrose. The work included 11 non-insulin dependent diabetic patients for whom an oral glucose tolerance test was performed on 2 alternative days. A carbohydrate load composed of 3 tea spoonfuls of honey together with a mixed flour bread [160 gm] was given on one occasion and 3 tea spoonfuls of sucrose with mixed flour bread [160 gm] on another. Blood glucose was determined in the fasting state and at 30, 60, 90, 120 and 180 minutes after the carbohydrate load. Serum samples were stored for insulin estimation by radio-immunoassay. Results showed that the values of the percent increment rise of blood glucose or serum insulin after sucrose were not significantly different from those after honey. It can be concluded that honey is not suitable to be used as a sweetening agent for non-insulin dependent diabetics in amounts higher than any other absorbable sugar allowance

effect of comparison of complex carbohydrates and high fibre preparations on post-prandial blood glucose and insulin levels in non-insulin dependent diabetics

Since the last decade, the physiological effects of dietary fibres and their possible role in prevention and management of many diseases have been emphasized. The aim of the present work has been to study the possible effects of supplementary different complex carbohydrates, consumed by the Egyptian population, with high fibre preparation, on the post-prandial blood glucose and insulin levels- in non-insulin dependent diabetics. This work has been carried out on 30 NIDD, who have been subjected to oral carbohydrate tolerance tests using boiled rice, boiled potatoes or bread [equivalent to 75 g glucose] at different occasions. Then the same patients have been subjected to the same tests after supplementing each carbohydrate load with high fibre preparation in the form of ceral bran and citrus fruit fibres. Blood glucose and insulin levels have been estimated using RIA technique for the latter. The maximum increment rise of glucose occurred at 90 minutes post-prandial and rice elecited the lowest glucose response, while potatoes elecited the highest one. Similarly rice elecited the lowest plasma insulin response. Supplementation of fibres led to marked and significant reduction of blood glucose level at 60 and 90 minutes in cases of rice and bread [P < 0.05] while the reduction is not significant in cases of potatoes [P > 0.05]. On the other hand addition of high fibre preparation did not affect siguificantly insulin resnonse

Actividad hipoglucemiante en ratas machos de derivados del ácido biciclo (3,1,0) hexano-6-carboxílico / Hypoglycemic activity in male rats of bicyclo (3,1,0) hexane-6-carboxylic acid derivatives

Se determinó la glucemia después de la administración subcutánea de glucosa a ratas machos adultas en varios tiempos. Se evaluó el efecto hipoglucemiante conocido del clorhidrato de feniletilbiguanida (FEB) después de su administración oral, y este compuesto sirvió como referencia. Se probaron seis nuevos compuestos sintetizados por los autores, relacionados con el ácido biciclo (3, 1, 0) hexano-6-hexo-carboxílico (ABCH). Se comprobó la actividad hipoglicemiante conocida del ABCH). Los seis nuevos compuestos conservaron la configuración exo y todos mostraron actividad hipoglucemiante oral en tiempos variables