Clinical characteristics of gestational diabetes mellitus / 中国医师进修杂志

Objective To compare the clinical characteristics of pregnant women with gestational diabetes mellitus (GDM) and normal gestational glucose metabolism at the 25th weeks of pregnant. Methods Sixty-eighty patients with GDM (GDM group) and 68 patients with normal blood glucose(control group) were enrolled in this study. During 25 weeks of pregnancy, oral glucose tolerance test (OGTT), blood pressure, fasting insulin, glycosylated hemoglobin, uric acid, triglyceride, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol were measured and body mass index (BMI), homeostasis model of assessment for insulin resistence index (HOMA-IR), insulin sensitivity index (ISI) were computed. The results were compared between two groups. Results The age in GDM group was significantly higher than that in control group: (31.38 ± 0.54) years vs. (29.50 ± 0.56) years, P0.05), but diastolic blood pressure in GDM group was significantly higher than that in control group:(73.2 ± 0.8) mmHg vs. (70.9 ± 0.8) mmHg, 1 mmHg=0.133 kPa, P0.05). Conclusions Compared to those with normal blood glucose, the patients with GDM have the characteristics of higher age, higher body weight, higher BMI, higher diastolic blood pressure , higher level of insulin, insulin resistance and decreased insulin sensitivity.

Effects of Wuling Powder on Insulin Resistance of Mice Induced by High Lipid Diet / 中国中医药信息杂志

Objective To investigate the effects of Wuling Powder on insulin resistance of C57BL/6J mice induced by high lipid diet, and discuss the mechanism. Methods C57BL/6J mice were randomly divided into six groups:normal group, model group, rosiglitazone group, Wuling Powder in low, middle, and high dose groups, 10 mice per group. Besides the normal group, other five groups were fed with high fat and sugar diet, with a purpose to establish insulin resistance model. Normal group and model group were given pure water. Rosiglitazone group received a gavage with rosiglitazone of 0.75 mg/kg. Wuling Power low, middle, and high groups received gavage with Wuling Power of 1.23, 3.69, 11.07 g/kg, respectively, the does volume was 0.2 mL/10 g, once a day. The weight and abdominal girth were detected every week. At the end of the sixth week, mice were given 12-hour fasting, and their eyeball were taken for blood. The body weight, length, and fat in abdomen and both kidneys were detected. Paraffin section was made with HE staining. FPG and FINS of each group were detected. ISI and IRI were calculated, and TC and TG were detected. Results Compared with the model group, Wuling Powder can significantly reduce the body weight and abdominal girth of mice (P<0.01, P<0.001), improve liver fatty degeneration, lower the FPG, FINS, TCH, TG, IRI, and increase the ISI in mice (P<0.05, P<0.01). Conclusions Wuling Powder has the effect of preventing insulin resistance of C57BL/6J mice induced by high lipid diet.

A simple index derived from triglycerides and blood glucose for identifying insulin resistance / 中华内分泌代谢杂志

ObjectiveTo compare the sensitivity and specificity of a new index of insulin resistance (IR) derived from plasma triglyceride and glucose with homeostasis model assessment for insulin resistance index ( HOMA-IR) and insulin sensitivity index from frequent sampling intravenous glucose tolerance test (FSIGT-ISI).Methods A total of 1024 subjects (240 normal control,335 with obesity,312 impaired glucose regulation,and 137 type 2 diabetes mellitus) were included in the present study.Standard oral glucose tolerance test,insulin release test,lipid profiles,and other biochemical markers were measured. Among them 540 subjects were selected to undertake FSIGT.TyG index is derived from plasma triglyceride and fasting glucose.TyG2 index is derived from plasma triglyceride and postprandial 2 plasma glucose.ResultsPearson correlation coefficient between TyG and HOMA-IR or FSIGT-ISI was 0.427 ( P＜0.01 ) and -0.100 ( P=0.024 ),respectively,and that between TyG2 and HOMA-IR or FSIGT-ISI was 0.455 ( P＜0.01 ) and - 0.162 ( P＜0.01 ),respectively.The sensitivity and specificity of TyG index for diagnosis of IR was 68.5％ and 63.5％ compared with HOMA-IR,and 68.5％ and49.5％ compared with FSIGT-ISI.For TyG2 index,the slightly higher sensitivity ( 81.7％ with HOMA-IR,75.7％ with FSIGT-ISI),but lower specificity (51.5％ with HOMA-IR,48.2％ with FSIGT-ISI) were found.ConclusionsBothTyGandTyG2 indices could be used as a surrogate for assessing IR in Chinese subjects.However,considering its moderately high sensitivity but low specificity,these two indices are limited in the use of large-scale epidemiological screening.

Usefulness of Oral Glucose Insulin Sensitivity Index in Women with Polycystic Ovary Syndrome / 이화의대지

OBJECTIVES: Insulin resistance is a major pathophysiology in polycystic ovary syndrome (PCOS), and assessment of insulin sensitivity is important. Various insulin sensitivity indices from fasting state or oral glucose tolerance test (OGTT) have been compared with euglycemic hyperinsulinemic clamp. We aimed to evaluate the usefulness of these indices in young Korean women with PCOS. METHODS: Euglycemic hyperinsulinemic clamp test and 75 g OGTT were performed in 290 women with PCOS. Insulin mediated glucose uptake (IMGU), the insulin sensitivity index from clamp, was compared with various insulin sensitivity indices such as composite insulin sensitivity index (ISIcomp), estimated metabolic clearance rate (MCRest) of glucose and estimated insulin sensitivity index (ISIest), area under the curve of glucose and insulin ratio (AUC-GIR), OGTT-derived Belfiore index, and oral glucose insulin sensitivity index (OGSI) by Kazama. Fasting state indices such as glucose insulin ratio (GIR), homeostasis model assessment for insulin resistance (HOMA-IR), fasting Belfiore index, and quantitative insulin sensitivity check index (QUICKI) were also compared with IMGU. RESULTS: The correlation coefficients of ISIcomp, MCRest, ISIest, AUC-GIR, OGTT-Belfiore index, and OGSI with IMGU were all about 0.5 (Ps'<0.001) in PCOS women as a whole. The MCRest and ISIest were significantly correlated with IMGU in both obese (r=0.58 and 0.58, P<0.0001) and non-obese subjects (r=0.33 and 0.32, P<0.001). Fasting glucose and insulin-derived indices showed worse correlation with IMGU than OGTT-derived ones. CONCLUSION: The MCRest and ISIest from OGTT might be the best replacement for the insulin sensitivity index from hyperinsulinemic euglycemic clamp independent of obesity.

Assessing new homeostasis model assessment by Botnia clamp / 中华内分泌代谢杂志

objective To investigate the ability of insulin sensitivity index HOMA2-%S and secretion function index HOMA2-%B calculated by HOMA2,the new homeostasis model assessment,in clinical application. Methods Eighty female volunteers with polycystic ovary syndrome in Chongqing area [50 subjects with normal glucose tolerance(NGT group)and 30 subjects with impaired glucose regulation(IGR group)]were involved in this study.Thev underwent a 75 g oral glucose tolerance test(OGTF)and the Botnia clamp test. From the data of faming blood samples in OGTF,insulin sensitivity index HOMAI-ISI,secretion function index HOMAl-β and disposal index DI-HOMA1 were calculated by the old homeostasis model assessment(HOMA I),meanwhile insulin sensitivity index HOMA2-%S,secretion function index HOMA2-%B and disposal index(DI-HOMA2) were caleulated by the new homeostasis model assessment (HOMA2).Correlation coefficients between insulin sensitivity index and GIR (the glucose infusion rate at steady state of Botnia clamp test),and between insulin secretion function index and AIR(the acute insulin response in Botnia clamp test),were studied.Results The Pearson's linear correlation coefficient between HOMA2-%S and GIR(r=0.503),HOMA1-ISI and HOMA2-%S (r= 0.990).HOMA2-%B and AIR(r=0.382),HOMA1-B and HOMA2-%B(r=0.976) were all statistically significant(a11 P<0.01).The glucose disposal indexes calculated from the HOMA2 and HOMA1 of 1GR group were significantly lower than those from the NGT group(t=2.825,P<0.Ol;t=2.222,P<0.05). Conclusion The HOMA2 is a better model in evaluating the insulin sensitivity and secretion function and is recommended to be widely used in clinical evaluation.

Metabolic Characteristics of Insulin Secretion and Insulin Sensitivity in Isolated Postchallenge Hyperglycemia / 上海第二医科大学学报

Objective To evaluate the metabolic characteristics of insulin secretion and insulin sensitivity in isolated postchallenge hyperglycemia(IPH) and to clarify the factors responsible for the development of IPH. Methods(Eight hundred) and fifty subjects were classified into the following three groups based on the results of a 75-g oral glucose tolerance test(OGTT): normal glucose tolerance(NGT),n=557;isolated impaired glucose tolerance(iIGT),n=146;and IPH,n=147.Insulin secretion(insulinogenic index) and insulin sensitivity(insulin sensitivity index) were identified in the three groups. Results From NGT to iIGT and IPH in these subjects,the insulinogenic index and insulin sensitivity index were gradually decreased(P

Utilidad de la prueba de tolerancia oral a la glucosa para el cálculo de los índices de sensibilidad a la insulina y su importancia diagnóstica en el síndrome de ovarios poliquísticos

Objetivos: Evaluar y comparar algunos índices de sensibilidad a la insulina a partir de los valores de glucemia e insulinemia obtenidos durante la prueba de tolerancia oral a la glucosa (PTGO) en mujeres con sindrome de ovario poliquístico (SOPQ) categorizadas de acuerdo al índice de masa corporal (IMC). Métodos: Treinta y cinco mujeres con diagnóstico de SOPQ y 45 controles sanas, en edad comprendida entre 18-35 años, fueron estudiadas. De acuerdo al IMC se categorizaron en normopeso, sobrepeso y obesa. Se calcularon los índices HOMAIR, QUICKI e ISI-MF. Resultados: La glucemia en ayunas y 30 minutos post carga fue significativamente más alta en la categoría SOPQ-Normo peso (NP) comparado con su control (p>0.001). El área bajo la curva de glucosa (AUC-G), no mostró diferencias significativas entre las 3 categorías. Comparado con sus controles, la insulinemia en ayunas fue significativamente más alta solo en la categoría SOPQ-Np (p<0.01). El área bajo la curva de insulina (AUCI) aumentó significativamente en función del aumento del IMC tanto en el grupo control como en el grupo SOPQ, con valores significativamente más altos (p<0,001) en todas las categorías de este grupo. El HOMAIR, aumentó en relación con el incremento del IMC, sin embargo, el grupo SOPQ-Np mostró un valor significativamente más alto que su C-Np. (p<0,05). El índice QUICKI disminuyó en relación al incremento del IMC en ambos grupos, sin embargo, las mujeres con SOPQ-Np mostraron un valor significativamente más bajo comparado con su control (p<0,01). El índice ISI-MF disminuyó en función del IMC en ambos grupos; valores más bajos se obtuvieron en las 3 categorías de SOPQ. En el grupo control el HOMAIR se relacionó positivamente con el IMC, ICC y la CC mientras que el QUICKI e ISI-MF se relacionaron inversamente con las mismas variables; estas correlaciones no se obtuvieron en las mujeres con SOPQ. Conclusiones: los índices de resistencia a la insulina, permiten demostrar tempranamente la presencia de resistencia a la insulina en las mujeres con SOPQ tanto obesas como no obesas.

Objective: To compare the insulin indexes obtained from oral glucose tolerance (OGTT) in polycystic ovary syndrome (PCOS). Methods: Thirty-five PCOS women aged 18-35 years and 45 healthy control women were studied. Body mass index (BMI), waist circumference (WC), and waist-to-hip ratio were registered. According to BMI, women were categorized as lean (L:19-24.9), overweight (Ow:25-29.9) and obese (Ob:>30). Plasma glucose and insulin were measured at baseline and 30, 60 and 120 minutes after oral glucose load (75g). Homeostasis model assessment (HOMAIR), quantitative insulin sensitivity check index (QUICKI) and insulin sensitivity index (ISI-MF) were calculated. Results: Both fasting glucose and 30 minutes post glucose were significantly higher in lean PCOS women as compared with controls (p<0.001). AUC-G did not show any significant difference between patients and controls. Fasting insulin was significantly higher only in lean PCOS women (p<0.01). AUC-I, increased significantly as a function of BMI increment in both study groups, although higher values were observed in PCOS women (p<0,001). HOMAIR value increased concomitantly with BMI increase, however, lean PCOS showed a significant higher value than control group (p<0,05). Both patients and controls showed lower values of QUICKI and ISI-MF index related to increments of BMI, however, lean PCOS women had a significant lower value than lean controls. Regression analysis in control group showed that HOMAIR was positively correlated with BMI, waist-to-hip ratio and waist circumference, while QUICKI e ISI-MF were inversely correlated with these variables. These correlations were not observed when analysis was performed in PCOS group. Conclusions: insulin sensitivity indexes appear to be useful for early detection of insulin resistance in both lean and overweight women with PCOS.

Effects of Insulin Aspart 30 versus Glimepiride on B Islet Cell Function in Patients with Newly Diagnosed Type 2 Diabetes / 中国药房

OBJECTIVE:To discuss the effects of different intensive treatment on B islet cell function in patients with newly diagnosed type 2 diabetes. METHODS: 54 patients who had been newly diagnosed as having type 2 diabetes were randomly assigned to receive Insulin aspart 30 or Glimepiride combined with Metformin (oral hypoglycemic agent). The blood glucose, glycosylated hemoglobin (HbA1c), and B islet cell function in two groups before and after treatment were followed. RESULTS: After treatment, blood glucose and glycosylated hemoglobin (HbA1c) in both group lowered significantly (P

Insulin Resistance, Body Fat Distribution, and Sex Hormones in Healthy Men and Premenopausal Women / 대한내분비학회지

It is well known that obesity central obesity is associated with insulin resistance and some studies reported that sex hormones were associated with insulin resistance. Recently, low levels of sex-hormone binding globulin(SHBG), an indirect index of androgenicity, have been observed to predict the development of non-insulin dependent diabetes mellitus(NIDDM) in women and SHBG has been proposed as a marker for insulin resistance. In contrast to findings in women, decreased SHBG did not predict the occurrence of NIDDM in men, so it is suggested that sex hormones may have a different role for insulin resistance between men and women. To investigate the difference of the associations among the body fat distribution, sex hormone and insulin sensitivity index in men and women, we measured body-mass index(BMI) and waist to hip circumference ratio(WHR) and concentrations serum SHBG, total testosterone, free testosterone, and dehydroepiandrosterone sulfate(DHEA-S) concentrations in 29 healthy adults(men:19, women:10) who showed normal glucose tolerance. Insulin sensitivity index(M/I) was measured by euglycemic hyperinsulinemic clamp. There were no differences in age, BMI, fasting plasma glucose, insulin and free fatty acid levels between men and women. WHR of men is higher than that of women(0.82+-0.01 vs. 0.73+-0.01, p=0.002). Insulin sensitivity index(M/I) is similar in men and women(7.80+-0.71 mg/kg/min/uU/ml X 100 vs. 9.74+-0.89 mg/kg/min/uU/ml X 100, p=0.196).In Pearson's correlation, M/I was significantly correlated with BMI(r=-0.69, p<0.01) and WHR(r=-0.68, p<0.01) in men and DHEA-S(r=-0.68, p<0.05) and SHBG(r=0.61, p=0.056) concentrations in women.In multiple regression analysis, M/I had the most significant association with BMI(R

The change and its clinical significance of plasma insulin sensitivity and leptin level in the patients with ischemic stroke / 临床神经病学杂志

Objective To investigate the change and its clinical significance of plasma insulin and leptin level in the patients with cerebral infarction.Methods The plasma leptin, insulin, glucose levels and insulin sensitivity index(ISI) of 31 patients with atherothrombotic cerebral infarction (ACI), 30 patients with lacunar infarction (LI) and 21 cases of healthy controls were determined. Results Compared with those in the controls, there were elevation of plasma insulin level (6.17 ? 4.33 ?IU/ml, P

HOMA2-IR is a good basal insulin resistance index / 中华内分泌代谢杂志

The application of HOMA2-IR is reviewed. HOMA2-IR is a good basal insulin resistance index for the use in epidemiological studies.

Relationship among serum leptin, free fatty acid and adiponectin levels in obesity / 中华内分泌代谢杂志

25 kg/m2] and 20 normal lean controls all took oral 75 g glucose tolerance test and frequently sampled intravenous glucose tolerance test ( FSIVGTT). According to their plasma glucose level, the obese subjects were divided into simple obesity group (n=38) and diabetic obesity group (n= 25). Fasting leptin, FFA and adiponectin concentrations were measured at the same time in all subjects. The relationships among these factors were analyzed by SPSS 10.0 software. Results The serum leptin and FFA levels in obese subjects were significantly higher than those of normal controls, while serum adiponectin level was significantly lower in obese subjects than that of normal controls. (Leptin: simple obesity (15.55?1.87)?g/L, diabetic obesity (13.41?5.07)?g/L vs' normal control ( 2.83?0.70)?g/L, both P

Study of correlation between serum adiponectin level and insulin sensitivity in patients with insulin resistance syndrome / 中华内分泌代谢杂志

Objective To assay the serum adiponectin levels in normal subjects and patients with insulin resistance syndrome, and to explore the correlation between adiponectin and insulin sensitivity, blood glucose, insulin, lipids etc. Methods Insulin sensitivity index (SI) was assessed by the reduced sample number of Bergman's minimal model method with intravenous glucose tolerance test in subjects of normal controls, obesity, impaired glucose tolerance (ICT) and type 2 diabetes mellitus (DM). Meanwhile the anthropometrical parameters such as body mass index (BMI) and waist hip ratio (WHR) were evaluated and the serum lipids, fasting and postprandial 2 h plasma glucose and insulin levels were also measured. Results Compared with normal control group, the SI in obesity, IGT and type 2 DM groups was significantly decreased (P