c-peptide and Metabolic-Syndrome

Insulin resistance is common among obese adolescents; however, the extent of this problem is not clear. We conducted a systematic review of PubMed-Medline, CINAHL, The Web of Science, EMBASE and Scopus for observational studies evaluating components defining insulin resistance (insulin, C-peptide and homeostatic model assessment-insulin resistance [HOMA-IR]) in obese adolescents (12-18 years) versus non-obese adolescents. Our systematic review and meta-analysis followed the PRISMA guidelines. Data were combined using a random-effects model and summary statistics were calculated using the mean differences (MDs). 31 studies were included (n = 8655). In 26 studies, fasting insulin levels were higher in obese adolescents when compared to non-obese adolescents (MD = 64.11 pmol/L, 95%CI 49.48-78.75, p < 0.00001). In three studies, fasting C-peptide levels were higher in obese adolescents when compared to non-obese adolescents (MD = 0.29 nmol/L, 95%CI 0.22-0.36, p < 0.00001). In 24 studies, HOMA-IR values were higher in obese adolescents when compared to non-obese adolescents (MD = 2.22, 95%CI 1.78-2.67, p < 0.00001). Heterogeneity of effects among studies was moderate to high. Subgroup analyses showed similar results to the main analyses. Circulating insulin and C-peptide levels and HOMA-IR values were significantly higher in obese adolescents compared to those non-obese.

Topics: Adolescent; Adolescent Nutritional Physiological Phenomena; Biomarkers; C-Peptide; Humans; Hyperinsulinism; Insulin; Insulin Resistance; Metabolic Syndrome; Observational Studies as Topic; Pediatric Obesity; Reproducibility of Results

Topics: Albuminuria; Animals; Biomarkers; C-Peptide; Calmodulin; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Glomerular Filtration Rate; Humans; Insulin; Insulin-Secreting Cells; Metabolic Syndrome; Receptors, G-Protein-Coupled; Sodium-Potassium-Exchanging ATPase

To evaluate the lipoprotein profiles, triglycerides and glycemia along with the abdominal fat to explore the risk factors associated with non-diabetic state to IGF, IGT and Type-2 diabetes in Canadian population.. We examined 780 subjects using the ADA and WHO criteria to classify them into groups based on (1) normal glucose tolerance with FBS <6.0 and 2hBS <7.0 mmol/l), (2) IFG; FPG > or =6.1 mmol/l but 2hBS >7.8-11.1 mmol/l; (3) combined IFG/IGT (FPG > or =7.0 mmol/l and 2hBS >11.1 mmol/l). We compared the three groups for glycemia, insulin secretion and insulin sensitivity based on their WHR, abdominal and visceral fat measurements.. The subjects with higher 2 hrs glucose levels 5.2 for NGT vs. 9.1 for IGT and 13.4 mmol/l for NIDDM, p<0.001, apo C-III level (12.8 (DM) vs. 8.9 mg/dl (normal), p<0.001), waist to hip ratio (0.91 (IGT) vs. 0.89 (Normal), p<0.01) and abdominal fat and were found to be highly insulin resistant.. The higher apolipoproteins levels, BMI and abdominal and visceral fat accompanied by poor glycemia were shown to be associated strongly with the metabolic abnormalities. These factors led to the worsening of insulin secretory dysfunction and insulin resistance and were strong predictors of diabetes.

Topics: Adipose Tissue; Atherosclerosis; Biomarkers; Blood Glucose; C-Peptide; Cholesterol, HDL; Cholesterol, LDL; Diabetes Mellitus; Diabetic Angiopathies; Fatty Acids, Nonesterified; Glycated Hemoglobin; Humans; Insulin; Insulin Secretion; Metabolic Syndrome; Risk Factors; Triglycerides

Several biological markers have been identified as risk factors for cardiovascular disease and are associated with increased risk of metabolic syndrome (MetS). This study provides a factual information on promising biomarkers that are associated with MetS and can aid in early detection and management of MetS in young adults of Western Algeria. We studied a total of one hundred subjects aged between thirty and forty years with MetS, in which anthropometric measurements, insulin resistance, C peptide and HbA1c, lipid profile, circulating adipokines and glucagon-like peptide-1 were measured by suitable methods, in comparison to two groups of control. MetS is closely linked to altered glucose homeostasis, the plasma insulin/glucose ratio; i.e., the insulinogenic index helps to estimate the level of insulin secretion and also for assessing β-cell function. The correlation between homeostasis model assessment insulin resistance index (HOMA-IR) and HbA1c, body mass index or plasma triglycerides yielded positive and significant values. Biomarkers with a known and predictable association with MetS can provide a means to detect those at risk and intervene as needed. This could significantly decrease the burden complications impose on patients and the healthcare system.

Topics: Adipokines; Adult; Algeria; Biomarkers; C-Peptide; Female; Glucagon-Like Peptide 1; Glycated Hemoglobin; Humans; Insulin Secretion; Male; Metabolic Syndrome; Models, Biological

This study aimed to determine whether L-arginine supplementation lasting for 18 months maintained long-lasting effects on diabetes incidence, insulin secretion and sensitivity, oxidative stress, and endothelial function during 108 months among subjects at high risk of developing type 2 diabetes.. One hundred and forty-four middle-aged subjects with impaired glucose tolerance and metabolic syndrome were randomized in 2006 to an L-arginine supplementation (6.4 g orally/day) or placebo therapy lasting 18 months. This period was followed by a 90-month follow-up. The primary outcome was a diagnosis of diabetes during the 108 month study period. Secondary outcomes included changes in insulin secretion (proinsulin/c-peptide ratio), insulin sensitivity (IGI/HOMA-IR), oxidative stress (AOPPs), and vascular function. After the 18 month participation, subjects that were still free of diabetes and willing to continue their participation (104 subjects) were further followed until diabetes diagnosis, with a time span of about 9 years from baseline.. Although results derived from the 18 month of the intervention study demonstrated no differences in the probability of becoming diabetics, at the end of the study, the cumulative incidence of diabetes was of 40.6% in the L-arginine group and of 57.4% in the placebo group. The adjusted HR for diabetes (L-arginine vs. placebo) was 0.66; 95% CI 0.48, 0.91; p < 0.02). Proinsulin/c-peptide ratio (p < 0.001), IGI/HOMA-IR (p < 0.01), and AOPP (p < 0.05) levels were ameliorated in L-arginine compared to placebo.. These results may suggest that the administration of L-arginine could delay the development of T2DM for a long period. This effect could be mediated, in some extent, by L-arginine-induced reduction in oxidative stress.

Topics: Administration, Oral; Arginine; Blood Glucose; C-Peptide; Diabetes Mellitus, Type 2; Diet; Endothelial Cells; Exercise; Follow-Up Studies; Glucose Intolerance; Humans; Insulin; Insulin Resistance; Metabolic Syndrome; Middle Aged; Oxidative Stress; Sample Size; Surveys and Questionnaires; Treatment Outcome

Limited clinical evidence is available on the effects of amount and types of dietary fats on postprandial insulinemic and gastrointestinal peptide responses in metabolic syndrome subjects. We hypothesized that meals enriched with designated: (1) amount of fats (50 vs 20 g), (2) fats with differing fatty acid composition (saturated, SFA; monounsaturated, MUFA or n-6 polyunsaturated fatty acids, PUFA) would affect insulinemic and gastrointestinal peptide releases in metabolic syndrome subjects.. Using a randomized, crossover and double-blinded design, 15 men and 15 women with metabolic syndrome consumed high-fat meals enriched with SFA, MUFA or n-6 PUFA, or a low-fat/high-sucrose (SUCR) meal. C-peptide, insulin, glucose, gastrointestinal peptides and satiety were measured up to 6 h.. As expected, SUCR meal induced higher C-peptide (45 %), insulin (45 %) and glucose (49 %) responses compared with high-fat meals regardless of types of fatty acids (P < 0.001). Interestingly, incremental area under the curve (AUC. The amount of fat regardless of the types of fatty acids affects insulin and glycemic responses. Both the amount and types of fatty acids acutely affect the gastrointestinal peptide release in metabolic syndrome subjects, but not satiety.

Topics: Adult; Blood Glucose; C-Peptide; Cross-Over Studies; Diet, High-Fat; Dietary Fats; Dietary Sucrose; Double-Blind Method; Fatty Acids; Fatty Acids, Monounsaturated; Fatty Acids, Omega-6; Female; Gastric Inhibitory Polypeptide; Ghrelin; Humans; Insulin; Male; Meals; Metabolic Syndrome; Postprandial Period; Satiation

The diabetogenic action of statins remains a concern, particularly in patients at high risk for diabetes receiving intensive statin therapy. Despite the risk of diabetes with statin use being considered a potential class effect, recent studies have suggested that pitavastatin exerts neutral or favorable effects on diabetogenicity. However, no randomized trial has compared the long-term effects of pitavastatin with those of other statins on glycemic control in populations at high risk for diabetes. Hence, we aim to assess the long-term effects of pitavastatin in comparison with atorvastatin on glucose metabolism in patients with metabolic syndrome (MetS).. The Long-term Effects of high-doSe pitavaStatin on Diabetogenicity in comparison with atorvastatin in patients with Metabolic syndrome (LESS-DM) trial is a prospective, randomized, open-label, active control clinical trial of patients with MetS. We plan to randomize 500 patients with MetS (1:1) to receive high-dose pitavastatin (4 mg) or atorvastatin (20 mg) daily for 24 months. The primary endpoint will be the change in hemoglobin A1c after statin treatment. Secondary endpoints will include the following: (1) changes in biochemical markers, including insulin, C-peptide, homeostasis model assessment of insulin resistance and insulin secretion, and adiponectin; (2) changes in imaging parameters, including carotid elasticity metrics and indices of cardiac function; and (3) the incidence of clinical events, including new-onset diabetes and cardiovascular disease.. In this trial, we will explore whether pitavastatin 4 mg does not disturb glucose metabolism in patients with MetS. It will also provide mechanistic information on statin type-dependent diabetogenic effects and surrogate data regarding vascular and cardiac changes achieved by intensive statin therapy.. ClinicalTrials.gov, NCT02940366 . Registered on 19 October 2016.

Topics: Atorvastatin; Biomarkers; Blood Glucose; C-Peptide; Cardiovascular Diseases; Clinical Protocols; Diabetes Mellitus; Glycated Hemoglobin; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Insulin; Metabolic Syndrome; Prospective Studies; Quinolines; Republic of Korea; Research Design; Risk Factors; Time Factors; Treatment Outcome

To examine the lipid and glycaemic effects of 52 weeks of treatment with evolocumab.. The Durable Effect of PCSK9 Antibody Compared with Placebo Study (DESCARTES) was a 52-week placebo-controlled trial of evolocumab that randomized 905 patients from 88 study centres in 9 countries, with 901 receiving at least one dose of study drug. For this post-hoc analysis, DESCARTES patients were categorized by baseline glycaemic status: type 2 diabetes, impaired fasting glucose (IFG), metabolic syndrome (MetS) or none of these. Monthly subcutaneous evolocumab (420 mg) or placebo was administered. The main outcomes measured were percentage change in LDL-cholesterol (LDL-C) at week 52 and safety.. A total of 413 patients had dysglycaemia (120, type 2 diabetes; 293, IFG), 289 had MetS (194 also had IFG) and 393 had none of these conditions. At week 52, evolocumab reduced LDL-C by >50% in all subgroups, with favourable effects on other lipids. No significant differences in fasting plasma glucose, HbA1c, insulin, C-peptide or HOMA indices were seen in any subgroup between evolocumab and placebo at week 52. The overall incidence of new-onset diabetes mellitus did not differ between placebo (6.6%) and evolocumab (5.6%); in those with baseline normoglycaemia, the incidences were 1.9% and 2.7%, respectively. Incidences of AEs were similar in evolocumab- and placebo-treated patients.. Evolocumab showed encouraging safety and efficacy at 52 weeks in patients with or without dysglycaemia or MetS. Changes in glycaemic parameters did not differ between evolocumab- and placebo-treated patients within the glycaemic subgroups examined.

Topics: Adult; Aged; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Anticholesteremic Agents; Blood Glucose; C-Peptide; Case-Control Studies; Cholesterol, HDL; Cholesterol, LDL; Diabetes Mellitus, Type 2; Female; Glucose Intolerance; Glycated Hemoglobin; Humans; Hypercholesterolemia; Insulin; Insulin Resistance; Male; Metabolic Syndrome; Middle Aged; Treatment Outcome; Triglycerides

Evidence shows that tocotrienols potentially reverse various chronic disease progressions caused by the metabolic syndrome. We aimed to investigate the acute effects of a single-dose supplementation of gamma and delta tocotrienols (γδ-T3, 1:4 ratio) compared with those in placebo on the insulinemic, anti-inflammatory and anti-thrombogenic responses in metabolic syndrome subjects.. Thirty metabolic syndrome subjects (15 men and 15 women) were recruited to a randomized, double-blinded and crossover study. The subjects were administered a single dose of 200 mg or 400 mg γδ-T3 emulsions or placebo incorporated into a glass of strawberry-flavored milkshake, consumed together with a high-fat muffin. Blood samples were collected at 0, 5, 15, 30, 60, 90, 120, 180, 240, 300 and 360 min after meal intake.. Plasma vitamin E levels reflected the absorption of γδ-T3 after treatments. Postprandial changes in serum C-peptide, serum insulin, plasma glucose, triacylglycerol, non-esterified fatty acid and adiponectin did not differ between treatments, with women displaying delayed increase in the aforementioned markers. No significant difference between treatments was observed for plasma cytokines (interleukin-1 beta, interleukin-6 and tumor necrosis factor alpha) and thrombogenic markers (plasminogen activator inhibitor type 1 and D-dimer).. Supplementation of a single dose of γδ-T3 did not change the insulinemic, anti-inflammatory and anti-thrombogenic responses in metabolic syndrome subjects.

Topics: Adiponectin; Adult; Anti-Inflammatory Agents; Blood Glucose; C-Peptide; Cross-Over Studies; Diet, High-Fat; Dietary Supplements; Double-Blind Method; Fatty Acids, Nonesterified; Female; Fibrinolytic Agents; Humans; Insulin; Male; Metabolic Syndrome; Middle Aged; Postprandial Period; Tocotrienols; Triglycerides; Vitamin E; Vitamins; Young Adult

Gestational Diabetes Mellitus (GDM) and vitamin D deficiency are related to insulin resistance and impaired beta cell function, with heightened risk for future development of diabetes. We evaluated the impact of vitamin D supplementation on markers of glucose metabolism and cardio metabolic risk in Asian women with former GDM and hypovitaminosis D. In this double blind, randomized controlled trial, 26 participants were randomized to receive either daily 4000 IU vitamin D3 or placebo capsules. 75 g Oral Glucose Tolerance Test (OGTT) and biochemistry profiles were performed at baseline and 6 month visits. Mathematical models, using serial glucose, insulin and C peptide measurements from OGTT, were employed to calculate insulin sensitivity and beta cell function. Thirty three (76%) women with former GDM screened had vitamin D level of <50 nmol/L at baseline. Supplementation, when compared with placebo, resulted in increased vitamin D level (+51.1 nmol/L vs 0.2 nmol/L, p<0.001) and increased fasting insulin (+20% vs 18%, p = 0.034). The vitamin D group also demonstrated a 30% improvement in disposition index and an absolute 0.2% (2 mmol/mol) reduction in HbA1c. There was no clear change in insulin sensitivity or markers of cardio metabolic risk. This study highlighted high prevalence of vitamin D deficiency among Asian women with former GDM. Six months supplementation with 4000 IU of vitamin D3 safely restored the vitamin D level, improved basal pancreatic beta-cell function and ameliorated the metabolic state. There was no effect on markers of cardio metabolic risk. Further mechanistic studies exploring the role of vitamin D supplementation on glucose homeostasis among different ethnicities may be needed to better inform future recommendations for these women with former GDM at high risk of both hypovitaminosis D and future diabetes.

Topics: Adult; Asian People; Biomarkers; Blood Glucose; C-Peptide; Diabetes, Gestational; Female; Humans; Insulin; Metabolic Syndrome; Pregnancy; Vitamin D; Vitamin D Deficiency; Vitamins

Plasma calprotectin is a potential biomarker of cardiovascular disease (CVD), insulin resistance (IR), and obesity. We examined the relationship between plasma calprotectin concentrations, CVD manifestations and the metabolic syndrome (MetS) in patients with type 2 diabetes mellitus (T2DM) in order to evaluate plasma calprotectin as a risk assessor of CVD in diabetic patients without known CVD.. An automated immunoassay for determination of plasma calprotectin was developed based on a fecal Calprotectin ELIA, and a reference range was established from 120 healthy adults. Plasma calprotectin concentrations were measured in 305 T2DM patients without known CVD. They were screened for carotid arterial disease, peripheral arterial disease (PAD), and myocardial ischemia (MI) by means of carotid artery ultrasonography, peripheral ankle and toe systolic blood pressure measurements, and myocardial perfusion scintigraphy.. The reference population had a median plasma calprotectin concentration of 2437 ng/mL (2.5-97.5% reference range: 1040-4262 ng/mL). The T2DM patients had significantly higher concentrations (3754 ng/mL, p < 0.0001), and within this group plasma calprotectin was significantly higher in patients with MetS (p < 0.0001) and also in patients with autonomic neuropathy, PAD, and MI compared with patients without (p < 0.001, p = 0.021 and p = 0.043, respectively). Plasma calprotectin was by linear regression analysis found independently associated with BMI, C-reactive protein, and HDL cholesterol. However, plasma calprotectin did not predict autonomic neuropathy, PAD, MI or CVD when these variables entered the multivariable regression analysis as separate outcome variables.. T2DM patients had higher concentrations of plasma calprotectin, which were associated with obesity, MetS status, autonomic neuropathy, PAD, and MI. However, plasma calprotectin was not an independent predictor of CVD, MI, autonomic neuropathy or PAD.. NCT00298844.

Topics: Adult; Aged; Biomarkers; Body Mass Index; C-Peptide; Cardiovascular Diseases; Cholesterol, HDL; Diabetes Mellitus, Type 2; Diabetic Neuropathies; Female; Homeostasis; Humans; Insulin; Insulin Resistance; Leukocyte L1 Antigen Complex; Male; Metabolic Syndrome; Middle Aged; Obesity; Reference Values; Young Adult

This study investigated if additional non-starch polysaccharide (NSP) or resistant starch (RS), above that currently recommended, leads to better improvement in insulin sensitivity (IS) than observed with modest weight loss (WL). Obese male volunteers (n = 14) were given an energy-maintenance (M) diet containing 27 g NSP and 5 g RS daily for one week. They then received, in a cross-over design, energy-maintenance intakes of either an NSP-enriched diet (42 g NSP, 2.5 g RS) or an RS-enriched diet (16 g NSP, 25 g RS), each for three weeks. Finally, a high protein (30% calories) WL diet was provided at 8 MJ/day for three weeks. During each dietary intervention, endogenous glucose production (EGP) and IS were assessed. Fasting glycaemia was unaltered by diet, but plasma insulin and C-peptide both decreased with the WL diet (p < 0.001), as did EGP (-11%, p = 0.006). Homeostatis model assessment of insulin resistance improved following both WL (p < 0.001) and RS (p < 0.05) diets. Peripheral tissue IS improved only with WL (57%-83%, p < 0.005). Inclusion of additional RS or NSP above amounts currently recommended resulted in little or no improvement in glycaemic control, whereas moderate WL (approximately 3 kg fat) improved IS.

Topics: Blood Glucose; C-Peptide; Carbohydrate Metabolism; Cross-Over Studies; Diet, Reducing; Dietary Proteins; Energy Intake; Energy Metabolism; Fasting; Homeostasis; Humans; Insulin; Insulin Resistance; Leucine; Male; Metabolic Syndrome; Models, Biological; Obesity; Polysaccharides; Starch; Weight Loss

Dietary fibre has a beneficial effect on metabolic syndrome, e.g. by influencing the absorption of glucose. The source and structure of fibre affect the glucose response. In this study, the glycaemic and insulinaemic response to oat bread, oat bread with lingonberry fibre, oat-buckwheat bread and buckwheat porridge were tested in a small-scale clinical study (KHSHP E514/09). Nine healthy volunteers consumed test foods after overnight fasting. Serum glucose and C-peptide levels were determined by colorimetric and ELISA methods, respectively, from samples taken at seven time points during 120 min. The mean glycaemic and C-peptide indexes (C-pepIs) were 32 and 100 for oat bread, 47 and 119 for oat-lingonberry fibre bread, 58 and 105 for oat-buckwheat bread and 71 and 77 for buckwheat porridge. Similar to rye, buckwheat porridge having a relatively high glycaemic index (GI) tended to have a low C-pepI. Buckwheat and lingonberry fibres provide new alternatives for low GI foods.

Topics: Adult; Avena; Blood Glucose; C-Peptide; Diet; Dietary Fiber; Fagopyrum; Fasting; Female; Food; Glycemic Index; Humans; Insulin; Male; Metabolic Syndrome; Middle Aged; Vaccinium vitis-idaea; Young Adult

Clustering of cardiovascular risk factors may lead to endothelial dysfunction. Physical exercise is an important factor in prevention and treatment of endothelial dysfunction. We wanted to determine the time course of adaptation to a single bout of exercise at either high or moderate intensity upon endothelial function both before and after a 16-week fitness program in patients with metabolic syndrome. Twenty-eight patients with metabolic syndrome participated in the study and were randomized and stratified (according to age and sex) into an aerobic interval exercise training group (AIT, n = 11), a continuously moderate-intensity exercise training group (CME, n = 8) or to a control group (n = 9). Flow-mediated dilatation (FMD) was determined at baseline, immediately, 24, 48, and 72 hours after 1 bout of exercise and repeated after 16 weeks of exercise. In the untrained state, FMD improved from 5 to 11% (p = 0.003) immediately after a single bout of aerobic interval training (AIT), an effect lasting 72 hours postexercise. In comparison, continuous moderate exercise (CME) improved FMD immediately after a single bout of exercise from 5 to 8% (p = 0.02), an effect lasting 24 hours postexercise (group difference, p < 0.001). In the trained state, a single bout of AIT resulted in a 2% (p = 0.007) acute increase of FMD lasting 48 hours postexercise. The CME increased FMD by 3% (p < 0.01), an effect lasting 24 hours postexercise (group difference p = 0.0012). Blood glucose level decreased after 1 single bout of AIT in the untrained state (p < 0.05), and the effect lasted at least 72 hours postexercise (p < 0.01). Acute CME decreased blood glucose with normalization of the values 24 hours postexercise (p < 0.01). A single bout of exercise in the trained state reduced fasting blood glucose by 10% (p < 0.05) after both AIT and CME. Exercise training, especially high intensity, thus appears to be highly beneficial in reducing blood glucose and improving endothelial function.

Topics: Adaptation, Physiological; Blood Glucose; Body Mass Index; C-Peptide; Cholesterol; Endothelium, Vascular; Exercise; Exercise Therapy; Fasting; Female; Glycated Hemoglobin; Humans; Lipoproteins, HDL; Lipoproteins, LDL; Male; Metabolic Syndrome; Triglycerides; Waist-Hip Ratio

Hormone treatment (HT) after the menopause affects lipid and carbohydrate metabolism and inflammation and may modify risk factors relevant for the clinical expression of the metabolic syndrome and cardiovascular disease. Tibolone has pharmacodynamic properties different from other hormone preparations. Here, we compare the effect of combined HT and tibolone on metabolic risk markers for the development of cardiovascular disease.. Postmenopausal women were randomly assigned to 1.25 or 2.5 mg/day of tibolone or oral continuous combined conjugated equine estrogen plus medroxyprogesterone acetate (CEE/MPA). Cardiovascular risk factors were determined at baseline and after 12 months of treatment.. Body mass index and blood pressure were unaffected by the HT. HOMA-IR decreased in the CEE/MPA group (3.69 vs. 3.38; p = 0.02). Treatment with tibolone increased tissue-type plasminogen activator activity (0.87 IU/ml vs. 1.21 IU/ml; p = 0.005) and C-reactive protein (0.83 mg/l vs. 1.88 mg/l; p < 0.001), and decreased plasminogen activator inhibitor activity (6.9 IU/ml vs. 2.0 IU/ml; p < 0.001) and triglycerides (0.99 vs. 0.87 mmol/l; p = 0.004). Both treatments decreased total cholesterol significantly.. CEE/MPA and tibolone have comparable effects on most metabolic risk factors investigated. The effect of tibolone on fibrinolysis and triglycerides suggests that tibolone has a favorable pharmacological profile on these risk factors when compared to CEE/MPA.

Topics: Blood Pressure; Body Composition; C-Peptide; Cardiovascular Diseases; Drug Therapy, Combination; Estrogen Receptor Modulators; Estrogens, Conjugated (USP); Female; Fibrinolysis; Humans; Medroxyprogesterone Acetate; Metabolic Syndrome; Middle Aged; Norpregnenes; Tissue Plasminogen Activator; Treatment Outcome; Triglycerides

Glucose and lipid metabolism dysfunction is a significant side effect associated with antipsychotics. Although there are many studies about the linkages between drugs and metabolic dysfunction, most of these studies have compared the effects of two antipsychotics on only one metabolic measure: either glucose or lipid metabolism.. The present study aimed to investigate the effects of clozapine, olanzapine, risperidone, and sulpiride on glucose and lipid metabolism in first-episode schizophrenia.. One hundred twelve schizophrenics were assigned randomly to receive clozapine, olanzapine, risperidone, or sulpiride for 8 weeks. Planned assessments included body mass index (BMI), waist-to-hip ratio, fasting glucose, insulin, C-peptide, insulin resistance index (IRI), cholesterol, and triglyceride. All measures were collected at baseline and at the end of the 8-week treatment.. After treatment, insulin, C-peptide, and IRI were significantly increased in the four groups, but not fasting glucose levels. Cholesterol and triglyceride levels were significantly increased in the clozapine and olanzapine groups. Patients treated with clozapine and olanzapine had higher fasting insulin, C-peptide, and IRI levels than those treated with risperidone and sulpiride. Among the four antipsychotics, the increases of mean BMI from high to low were as follows: clozapine, olanzapine, sulpiride, and risperidone.. This study confirmed that the four antipsychotic drugs were associated with an increase of insulin, C-peptide, and IRI. It was found that clozapine and olanzapine were associated with an increase in cholesterol and triglyceride levels. The effects of clozapine and olanzapine on the glucose and lipid metabolism outweighed those of risperidone and sulpiride.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Blood Glucose; Body Mass Index; C-Peptide; Cholesterol; Clozapine; Female; Homeostasis; Humans; Insulin; Insulin Resistance; Lipid Metabolism; Male; Metabolic Syndrome; Olanzapine; Prospective Studies; Risperidone; Schizophrenia; Sulpiride; Triglycerides; Waist-Hip Ratio

Large interventional studies have shown that statins may reduce the incidence of type 2 diabetes mellitus. However, it is uncertain whether short-term statin therapy can affect insulin sensitivity in patients with the metabolic syndrome. We evaluated the effect of atorvastatin (10 mg/day) in 10 insulin-resistant subjects (age 40 +/- 12 years, body mass index 33.6 +/- 5.2 kg/m(2), triglycerides 2.84 +/- 1.99 mmol/L [249 +/- 175 mg/dl], glucose 6.06 +/- 0.67 mmol/L [109 +/- 12 mg/dl)] using the homeostasis model assessment (HOMA) index (parameter of insulin resistance derived from fasting glucose and fasting insulin concentrations; 5.7 +/- 2.6) in a randomized placebo-controlled, double-blind, crossover study. Subjects were randomized to receive placebo or atorvastatin, each given for 6 weeks separated by a 6-week wash-out period. At the beginning and end of each treatment phase, the patients underwent an oral glucose tolerance test, a 72-hour continuous glucose measurement, and a detailed lipid determination, including a standardized fat tolerance test. Compared with placebo, atorvastatin resulted in a significant (p = 0.05) reduction in the HOMA index (-21%), fasting C-peptides (-18%), glucose (area under the curve during the oral glucose tolerance test, -7%), and a borderline (p = 0.08) reduction of insulin (-18%). The parameters derived from the continuous 72-hour glucose monitoring did not change. A significant reduction also occurred in the total and low-density lipoprotein cholesterol concentrations, although the fasting and postprandial triglyceride concentrations did not change significantly. However, we found a significant correlation between atorvastatin-induced changes in the HOMA and baseline HOMA and between the atorvastatin-induced changes in triglycerides and insulin concentrations. The free-fatty acid, interleukin-6, and high sensitivity C-reactive protein concentrations did not change. Our data indicated that in insulin-resistant, nondiabetic subjects, 6 weeks of atorvastatin (10 mg/day) resulted in significant improvement in insulin sensitivity.

Topics: Adult; Atorvastatin; Blood Glucose; C-Peptide; Cross-Over Studies; Diabetes Mellitus, Type 2; Double-Blind Method; Female; Heptanoic Acids; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Insulin; Insulin Resistance; Male; Metabolic Syndrome; Pyrroles; Treatment Outcome

Modest elevations in circulating IGF-I levels have been suggested to protect against the development of glucose intolerance in insulin-resistant subjects. To further understand the interactions of GH and IGF-I on beta-cell function and post-load glucose tolerance in glucose-intolerant subjects predisposed to diabetes, we performed a pilot study in 12 subjects with impaired glucose tolerance and the metabolic syndrome using a low GH dose (1.7 microg/kg per day) known to increase endogenous IGF-I production.. Fourteen daily GH or placebo injections in a double-blind cross-over study.. Baseline and post-treatment oral glucose tolerance tests were performed. The homeostasis model assessment and the insulinogenic index was used to estimate fasting insulin sensitivity (S(I)) and beta-cell function respectively, whereas changes in the incremental area under the curve were used to estimate post-load glucose tolerance (DeltaAUC(glu)) and post-load insulin levels (DeltaAUC(ins)).. GH increased total IGF-I (P<0.02), free IGF-I (P<0.04) and fasting insulin (P<0.04) levels, but did not modify plasma IGF-binding proteins (IGFBPs)-1 and -3, fasting glucose, non-esterified fatty acid and C-peptide levels, and fasting S(I). After oral glucose intake, glucose tolerance improved (P<0.03), but post-load insulin levels and beta-cell function remained unchanged.. Short-term low-dose GH administration induced fasting hyperinsulinaemia possibly by reducing insulin clearance but improved post-load glucose tolerance, suggesting that increased bioavailable IGF-I enhanced post-load S(I) without altering beta-cell function. Longer-term studies are required to ascertain whether these positive effects on post-load glucose tolerance and the preservation of beta-cell function can be sustained by this GH dose in these high-risk subjects.

Topics: Adult; Aged; Blood Glucose; C-Peptide; Cross-Over Studies; Fatty Acids, Nonesterified; Female; Glucose Intolerance; Glucose Tolerance Test; Human Growth Hormone; Humans; Insulin; Insulin-Like Growth Factor Binding Proteins; Insulin-Like Growth Factor I; Islets of Langerhans; Male; Metabolic Syndrome; Middle Aged; Prospective Studies

Excessive visceral adipose tissue (VAT) is associated with higher secretion of pro-inflammatory molecules, contributing to systemic inflammation and obesity-related metabolic disturbances.. This prospective analysis includes 117 overweight/obese adults (55-75 years) from the PREDIMED-Plus study. Fourteen inflammatory markers and adipokines are measured using a Bio-Plex assay with multiplex technology: insulin, glucagon, IL-6, visfatin, ghrelin, GLP-1, TNF-α, MCP-1, PAI-1, resistin, C-peptide, leptin, adipsin, and adiponectin. Participants are categorized into tertiles according to changes in VAT after 1-year of follow-up, determined by dual-energy X-Ray absorptiometry. Participants allocate in tertile 3, which represent an increase of VAT content after 1-year of follow-up compared to tertile 1, show significant differences in insulin (T3 vs T1, fully adjusted model: p = 0.037, p for trend 0.042), PAI-1 (fully adjusted model: p = 0.05, p for trend 0.06), c-peptide (fully adjusted model: p = 0.037, p for trend 0.042), and TNF-α (fully adjusted model p = 0.037, p for trend 0.042).. The results evidence that a reduction in VAT is associated with clinical improvements in several inflammatory and adiposity markers, mainly in insulin, c-peptide, and PAI-1 levels, and these improvements may contribute to a reduction in cardiometabolic disturbances observe in obesity.

Topics: Adult; C-Peptide; Humans; Intra-Abdominal Fat; Metabolic Syndrome; Obesity; Plasminogen Activator Inhibitor 1; Tumor Necrosis Factor-alpha

Both obesity and a poor diet are considered major risk factors for triggering insulin resistance syndrome (IRS) and the development of type 2 diabetes mellitus (T2DM). Owing to the impact of low-carbohydrate diets, such as the keto diet and the Atkins diet, on weight loss in individuals with obesity, these diets have become an effective strategy for a healthy lifestyle. However, the impact of the ketogenic diet on IRS in healthy individuals of a normal weight has been less well researched. This study presents a cross-sectional observational study that aimed to investigate the effect of low carbohydrate intake in healthy individuals of a normal weight with regard to glucose homeostasis, inflammatory, and metabolic parameters.. The study included 120 participants who were healthy, had a normal weight (BMI 25 kg/m. Low carbohydrate intake (<45% of total energy) was found to significantly correlate with dysregulated glucose homeostasis as measured by elevations in HOMA-IR, HOMA-β% assessment, and C-peptide levels. Low carbohydrate intake was also found to be coupled with lower serum bicarbonate and serum albumin levels, with an increased anion gap indicating metabolic acidosis. The elevation in C-peptide under low carbohydrate intake was found to be positively correlated with the secretion of IRS-related inflammatory markers, including FGF2, IP-10, IL-6, IL-17A, and MDC, but negatively correlated with IL-3.. Overall, the findings of the study showed that, for the first time, low-carbohydrate intake in healthy individuals of a normal weight might lead to dysfunctional glucose homeostasis, increased metabolic acidosis, and the possibility of triggering inflammation by C-peptide elevation in plasma.

Topics: Acidosis; Blood Glucose; C-Peptide; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Dietary Carbohydrates; Humans; Insulin; Insulin Resistance; Metabolic Syndrome; Obesity

Metabolic syndrome (Syndrome X, insulin resistance syndrome) consists of a constellation of metabolic abnormalities that confer increased risk of cardiovascular disease and diabetes mellitus. Serum uric acid and end product of purine metabolism, has been shown to be associated with an increased risk of hypertension, cardiovascular disorder and chronic kidney disease. Excess of intra abdominal or visceral adipose and not the amount of subcutaneous abdominal fat which is the key correlate of the metabolic abnormalities observed in overweight/obese patients. It is well documented that high level of insulin are associated with elevated "connecting peptide"(c-peptide) levels as both are produced in equimolar Amounts since metabolic syndrome is a well established major risk factor preceding the onset of type 2 diabetes mellitus, pre and post prandial c peptide and itís correlation with serum uric acid further strengthens this understanding and may help take preventive measures to delay/reverse the onset of type 2 diabetes mellitus.. This is a cross sectional study conducted on 60 patients with metabolic syndrome satisfying inclusion and exclusion criteria admitted in hospitals attached to Bangalore Medical College & Research Institute. All necessary investigations were done. The patients with other co-morbid condition that could affect nutritional status (diabetes mellitus, sepis, congestive heart failure, cancer) and pregnant females were excluded. Anthropometric measures, biochemical parameters were used for correlation with fasting c-peptide and post prandial c-peptide with serum uric acid in metabolic syndrome.. Patients with metabolic syndrome We can observe that the Blood urea level showed positive correlation with uric acid level (p value 0.276), uric acid showed positive correlation with fasting c-peptide (p value 0.001) and post prandial c-peptide with (p value < 0.023), very low density lipoprotein showed positive correlation with post prandial c-peptide (p value < 0.022), very low density lipoprotein showed positive correlation with uric acid (p value< 0.002) triglyceride showed postive correlation with uric acid (p value < 0.001,) body mass index showed positive correlation with post prandial c peptide (p value < 0.002), body mass index showed positive correlation with uric acid (p value < 0.006).. Patients diagnosed as Metabolic syndrome after clinical, biochemical and anthropometric findings should be investigated for c-peptide in them which can be used as additional diagnosis factor in metabolic syndrome post prandial cpeptide being a better investigation when compared to fasting c-peptide. References Iliesiu A, Campeanu A, Dusceac D. Serum uric acid and cardiovascular disease. Maedica (Bucur) 2021;5(3):186-192. Abdullah A, Hasan H, Raigangar V, et al. C-Peptide versus insulin: relationships with risk biomarkers of cardiovascular disease in metabolic syndrome in young arab females. Int J Endocrinol 2012;2012:420792.

Topics: Body Mass Index; C-Peptide; Cardiovascular Diseases; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Female; Humans; India; Insulin; Metabolic Syndrome; Uric Acid

Dysimmunity plays a key role in diabetes, especially type 1 diabetes mellitus. Islet-specific autoantibodies (ISAs) have been used as diagnostic markers for different phenotypic classifications of diabetes. This study was aimed to explore the relationships between ISA titers and the clinical characteristics of diabetic patients.. A total of 509 diabetic patients admitted to Department of Endocrinology and Metabolism at the Affiliated Hospital of Nantong University were recruited. Anthropometric parameters, serum biochemical index, glycosylated hemoglobin, urinary microalbumin/creatinine ratio, ISAs, fat mass, and islet β-cell function were measured. Multiple linear regression analysis was performed to identify relationships between ISA titers and clinical characteristics.. Compared with autoantibody negative group, blood pressure, weight, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), visceral fat mass, fasting C-peptide (FCP), 120 minutes C-peptide (120minCP) and area under C-peptide curve (AUCCP) of patients in either autoantibody positive or glutamate decarboxylase antibody (GADA) positive group were lower. Body mass index (BMI), waist circumference, triglycerides (TGs), body fat mass of patients in either autoantibody positive group were lower than autoantibody negative group. GADA titer negatively correlated with TC, LDL-C, FCP, 120minCP, and AUCCP. The islet cell antibody and insulin autoantibody titers both negatively correlated with body weight, BMI, TC, TG, and LDL-C. After adjusting confounders, multiple linear regression analysis showed that LDL-C and FCP negatively correlated with GADA titer.. Diabetic patients with a high ISA titer, especially GADA titer, have worse islet β-cell function, but less abdominal obesity and fewer features of the metabolic syndrome.

Topics: C-Peptide; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Glutamate Decarboxylase; Humans; Metabolic Syndrome

Metabolic syndrome (MS) is comprised of a cluster of abnormalities in glucose, lipid, and vascular homeostasis, which is most commonly linked to abdominal obesity. MS heralds increased risk for development of diabetes and is linked to impairment in insulin signaling. Insulin-degrading enzyme (IDE) is one of the mechanisms through which insulin blood levels are maintained. It has been previously suggested that controlling IDE levels could provide yet another potential therapeutic approach in diabetes. Here we aim to investigate whether changes in serum IDE levels correlate with the severity of MS. Using a highly sensitive ELISA assay of active IDE in human serum, we found a strong correlation between circulating IDE levels and circulating levels of triglycerides, insulin, and c-peptide and an inverse correlation with HDL cholesterol (HDLc). Serum IDE levels were higher in MS subjects than in control subjects. Hence, circulating IDE may serve as a tool to identify subjects with abnormal insulin metabolism, possibly those with MS that are at risk to develop diabetes.

Topics: C-Peptide; Glucose Tolerance Test; Humans; Insulin; Insulysin; Metabolic Syndrome

Topics: Acute Disease; Aged; Blood Glucose; C-Peptide; ChAdOx1 nCoV-19; Comorbidity; COVID-19; COVID-19 Vaccines; Emergencies; Humans; Hyperglycemia; Hypertension; Male; Metabolic Syndrome; Middle Aged; Prediabetic State; SARS-CoV-2

In view of the association of Ramadan intermittent fasting with profound changes in lifestyle both in nondiabetic and diabetic patients, the aim of this study was to investigate the effect of Ramadan fasting on adiponectin, leptin and leptin to adiponectin ratio (LAR), growth hormone (GH), human-sensitive C-reactive protein (hs-CRP), and diabetic and metabolic syndrome factors in patients with Type 2 Diabetes Mellitus (Type 2 DM), their first-degree relatives (FDRs), and healthy controls.. This cohort study involved 98 Yemeni male subjects aged 30-70 years old: 30 Type 2 DM, 37 FDRs of Type 2 diabetic patients, and 31 healthy control subjects. Subjects' body mass index (BMI), waist circumference (WC), and blood pressure (BP) were measured, and venous blood samples were collected twice: the first samples were collected a couple of days prior to Ramadan fasting (baseline) and the second samples after 3 weeks of fasting.. Ramadan fasting did not affect BMI, WC, and BP in Type 2 DM and their FDRs with respect to the baseline levels prior to Ramadan, whereas triglyceride and cholesterol were borderline significantly decreased in Type 2 DM with no effect in FDRs. Fasting blood glucose was not affected in Type 2 DM but was significantly increased in FDRs and control groups, whereas glycated haemoglobin (HbA1c) was slightly decreased in Type 2 DM, FDRs, and healthy controls. C-peptide, insulin, and insulin resistance (HOMA-IR) were significantly increased in Type 2 DM and FDRs, with no effect in the control group, whereas. Ramadan intermittent fasting decreased adiponectin and increased leptin, LAR, insulin, and insulin resistance in both Type 2 DM and FDRs as well as decreased GH in both FDRs and healthy controls and increased hs-CRP in healthy controls. Moreover, Ramadan intermittent fasting neither worsens a patient's glycemic parameters nor improves it, with the exception of a slight improvement in HbA1c in Type 2 DM, FDRs, and healthy controls.

Topics: Adipokines; Adiponectin; Adult; Aged; Blood Glucose; Blood Pressure; Body Mass Index; C-Peptide; C-Reactive Protein; Cohort Studies; Diabetes Mellitus, Type 2; Fasting; Glycated Hemoglobin; Humans; Insulin; Insulin Resistance; Leptin; Male; Metabolic Syndrome; Middle Aged; Triglycerides; Waist Circumference

A higher prevalence of nonalcoholic steatohepatitis (NASH) and advanced stages of fibrosis was observed in type 2 diabetes. We aim to investigate whether C-peptide is associated with nonalcoholic fatty liver disease (NAFLD) progression in type 2 diabetic adults.. A total of 4937 diabetic participants were enrolled from China in 2018. Liver steatosis was detected by ultrasound. Subjects with NAFLD were categorized into simple NAFLD and probable NASH by the concurrent presence of metabolic syndrome. NAFLD fibrosis score was used to identify patients with probable advanced fibrosis.. Individuals with a longer history of type 2 diabetes had a lower C-peptide level and a lower prevalence of probable NASH but a higher prevalence of advanced fibrosis. C-peptide was positively associated with simple NAFLD and probable NASH, with odds ratios (ORs) of 4.55 [95% confidence interval (CI) 3.16, 6.55] and 5.28 (95% CI 3.94, 7.09), respectively, comparing quartile 4 with quartile 1 (both p for trend <0.001). However, C-peptide quartiles were negatively associated with the probable presence of advanced fibrosis (Q4 vs. Q1, OR 0.59, 95% CI 0.36, 0.97, p for trend <0.05). A 1-SD increment of ln(C-peptide) was also significantly associated with inflammatory and fibrotic progression (OR 1.34, 95% CI 1.27, 1.41; OR 0.88, 95% CI 0.79, 0.98, respectively).. Significant but opposite associations between C-peptide and inflammatory and fibrotic progression of NAFLD were observed. Understanding islet hormone changes during type 2 diabetes and differentiating the stage of NAFLD may help to personalize treatment strategies for NAFLD patients with type 2 diabetes.

Topics: Adult; Aged; Aged, 80 and over; Biomarkers; Blood Glucose; C-Peptide; Diabetes Mellitus, Type 2; Disease Progression; Female; Follow-Up Studies; Humans; Inflammation; Liver Cirrhosis; Male; Metabolic Syndrome; Middle Aged; Non-alcoholic Fatty Liver Disease; Prognosis; Severity of Illness Index; Young Adult

This retrospective study investigated the effect of adding metformin to pharmacologic insulin dosing in type 1 diabetics on insulin therapy 1 year after treatment compared with patients on insulin therapy alone.. Twenty-nine adults with type 1 diabetes who had metformin added to their insulin therapy for 12 months were compared with 29 adults with type 1 diabetes who remained on insulin-alone therapy.. Fifty-eight patients with C peptide negative-type 1 diabetics (26 females, mean age: 29.01 ± 7.03 years, BMI: 24.18 ± 3.16 kg/m2) were analyzed. Age, sex, body weight, insulin dose requirement, plasma glucose (PG), blood pressure (BP), and lipids did not differ between groups before treatment (p > 0.05). Metabolic syndrome (44.8 vs 41.4%, p > 0.05) did not differ between the metformin-insulin and insulin alone groups before treatment. Metabolic syndrome was more decreased in the metformin-insulin group than in the insulin alone group after treatment (-8.9 ± 1.3 vs. 2.5 ± 0.6%, p = 0.028). Insulin dose requirement was lower in the metformin-insulin group than in the insulin alone group (-0.03 vs. 0.11 IU/kg/d, p = 0.006). Fasting PG (-26.9 ± 54.2 vs. 0.7 ± 29.5 mg/dL, p = 0.022) and postprandial PG (-43.1 ± 61.8 mg/dL vs. -3.1 ± 40.1 mg/dL, p = 0.010) was more decreased in the metformin-insulin group than in the insulin alone group. Body weight, lipids, and HbA1c did not differ between the groups (p > 0.05).. Metformin decreased glucose concentrations, reduced metabolic syndrome, as well as insulin dose requirement more than insulin therapy alone, 1 year after treatment. These results were independent of blood lipid improvement or weight loss, although on average weight remained decreased with metformin-insulin therapy, whereas the average weight increased with insulin therapy alone.

Topics: Adult; Biomarkers; Blood Glucose; Body Weight; C-Peptide; Case-Control Studies; Diabetes Mellitus, Type 1; Drug Therapy, Combination; Female; Follow-Up Studies; Glycated Hemoglobin; Humans; Hypoglycemic Agents; Insulin; Lipids; Male; Metabolic Syndrome; Metformin; Prognosis; Retrospective Studies

Various cardiovascular disease (CVD) risk factors have been implicated to correlate with the severity of the disease. Present study was conducted to correlate one such risk factor i.e. fasting serum C-peptide with the presence or absence and the severity of CVD in Indian population.. 68 patients with metabolic syndrome who underwent coronary angiogram for suspected CVD were included. Their fasting serum C-peptide levels were measured in addition to routine biochemical and cardiological tests. They were divided into 2 groups - those with a positive coronary angiography findings (Group 1) and those with normal coronary angiograms (Group 2). The former group was further divided into those with an Acute Coronary Syndrome (ACS) (Group 1a) and those with Chronic Stable Angina (CSA) (Group 1b). SYNTAX scoring was done to assess the severity of coronary artery disease in groups 1a and 1b. Levels of C-peptide were compared between the groups.. The mean C-peptide of all patients was 1.9 (±0.8) ng/mL. Among the group 2 patients, mean serum C-peptide value was 1.6 (±0.4) ng/mL. And it was 2.7 (±0.8) ng/mL and 1.7 (±0.9) ng/mL among the ACS and the CSA groups respectively. The ACS and CSA group had statistically significant higher values of C-peptide compared to patients with normal coronary angiograms. The two-way ANOVA done to find out the variability of C-peptide among the 3 groups revealed significant differences among the groups with a p-value of <0.001. When correlated with SYNTAX scores, this yielded significant results.. C-peptide levels appear to correlate with the severity of the CVD as measured by SYNTAX score.

Topics: Adolescent; Adult; Aged; Biomarkers; C-Peptide; Coronary Angiography; Coronary Artery Disease; Female; Humans; Incidence; India; Male; Metabolic Syndrome; Middle Aged; Prognosis; Risk Assessment; Risk Factors; Severity of Illness Index; Young Adult

To assess the relation between bioimpedance measurements and metabolic parameters and C-peptide in patient with type 2 diabetes mellitus (DM).. Cross-sectional study.. Kartal Dr Lutfi Kirdar Training and Research Hospital, Pendik Kaynarca Diabetes Center, Exercise and Metabolism Unit, between January and March 2015.. Patients with DM, aged less than 65 years, were assessed for bioimpedance analysis, fasting plasma glucose (FPG), HbA1c, C-peptide levels, triglyceride levels, LDL-cholesterol, and HDL-cholesterol levels. Skeletal muscle index, total muscle index, skeletal muscle percentage, and total muscle percentage were used for muscle-related analyses. Mann-Whitney U-test or independent t-test were used to compare differences between two independent groups. Pearson correlation test or Spearman correlation test were used to find out correlation between variables.. Atotal of 359 DM patients were enrolled in the study. Mean age was 51.6 ±8.0 years, and 278 (77.7%) of the participants were females. After adjusting age and gender variables, there was no relation between muscle-related measurements and FPG, triglyceride, LDL-cholesterol (p>0.05). However, there was muscle-related indexes (MRI) positively correlation with C-peptide and inversely associated with HDL-cholesterol (p<0.05).. Muscle-related indices positively correlated with C-peptide, which showed endogenous insulin reserve.

Topics: Adult; Blood Glucose; Body Mass Index; C-Peptide; Cholesterol, HDL; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Female; Humans; Male; Metabolic Syndrome; Middle Aged; Muscles; Obesity, Abdominal; Sarcopenia; Young Adult

Metabolic syndrome (MetS) is a collection of clinical conditions, including central obesity, hypertension, glucose intolerance and dyslipidemia. The long-term inflammatory and metabolic dysfunction associated with MetS may contribute to osteoarthritic processes leading up to total joint arthroplasty (TJA). The purpose of this study was to investigate levels of metabolic biomarkers and the prevalence of MetS in patients undergoing TJA.. Under IRB approval, citrated plasma samples were collected from 41 patients undergoing total hip and knee arthroplasty (THA/TKA) preoperatively and day 1 postoperatively. Control group consisted of 25 healthy human plasma samples (female and male, 18-35 years old) purchased from George King Biomedical Inc. (Overland Park, KS, USA). Samples were profiled for c-peptide, ferritin, IL-6, insulin, resistin, TNF-α, IL-1a, leptin, and PAI-1 using metabolic biochips purchased from RANDOX Co. (Antrim, Northern Ireland). NCEP/ATP III guidelines were used to evaluate which patients met MetS criteria.. Levels of IL-6, resistin, TNF-a, IL-1a, leptin, and PAI-1 were significantly elevated in patients undergoing TJA compared to normal. C-peptide and insulin were both decreased in TJA compared to normal. No significance was found when comparing TJA to normal for ferritin. TNFα was significantly lower in TJA+MetS compared to TJA-MetS, while other biomarkers showed no difference in TJA±MetS populations. Insulin & c-peptide both showed a significant decrease in TJA-MetS compared to normal, but levels in TJA+MetS patients were not significantly different from controls. Resistin showed significant increases in TJA+MetS vs. normal, but not in TJA-MetS vs. normal.. Overall, the differing metabolic profile seen in patients undergoing TJA suggest ongoing metabolic dysfunction. Insulin and c-peptide patterns among the different test groups hint toward a complex and dysfunctional metabolic process involved, with leptin and underlying insulin resistance playing a role. Increased resistin in TJA+MetS, but not in TJA-MetS, compared to normal, suggests that while elevated resistin levels may be associated with the osteoarthritic process, levels are further attenuated by MetS, which is highly prevalent in this population. Increased TNFα in TJA-MetS compared to TJA+MetS may be an artifact of differing sample populations or a true complication of the complex pathophysiology and medical regimen seen in patients with both OA and MetS. The lack of difference seen in the remaining biomarkers suggest that having MetS as a comorbidity does not contribute to the elevated levels seen in patients undergoing TJA.

Topics: Adolescent; Adult; Aged; Arthroplasty, Replacement; Biomarkers; C-Peptide; Case-Control Studies; Female; Ferritins; Humans; Insulin Resistance; Leptin; Male; Metabolic Syndrome; Tumor Necrosis Factor-alpha; United States; Young Adult

Individuals with metabolic syndrome (MS) show several metabolic abnormalities including insulin resistance, dyslipidaemia, and oxidative stress (OS). Diet is one of the factors influencing the development of MS, and current nutritional advice emphasises the benefits of fruit and vegetable consumption. Here, we assessed the effects of naturally occurring antioxidants, red wine polyphenols (RWPs), on MS and OS.. Wistar rats (n = 20) weighing 200-220 g received a high-fat diet (HFD) for 2 months before they were divided into two groups that received either HFD only or HFD plus 50 mg/kg RWPs in their drinking water for an additional 2 months. A control group (n = 10) received a normal diet (ND) for 4 months.. Rats receiving HFD increased body weight over 20 % throughout the duration of the study. They also showed increased blood levels of C-peptide, glucose, lipid peroxides, and oxidised proteins. In addition, the HFD increased OS in hepatic, pancreatic, and vascular tissues, as well as induced pancreatic islet cell hyperplasia and hepatic steatosis. Addition of RWPs to the HFD attenuated these effects on plasma and tissue OS and on islet cell hyperplasia. However, RWPs had no effect on blood glucose levels or hepatic steatosis.. RWPs showed an antioxidant mechanism of action against MS. This result will inform future animal studies exploring the metabolic effects of RWPs in more detail. In addition, these findings support the use of antioxidants as adjunctive nutritional treatments for patients with diabetes.

Topics: Animals; Antioxidants; Blood Glucose; C-Peptide; Diet, High-Fat; Disease Models, Animal; Lipid Peroxides; Liver; Male; Metabolic Syndrome; Oxidative Stress; Polyphenols; Rats; Rats, Wistar; Wine

Healthful dietary patterns have been associated with lower risks of type 2 diabetes and coronary artery disease, but their relations with intermediate markers of cardiometabolic and endocrine health are less established.. We evaluated the Dietary Approaches to Stop Hypertension (DASH), the alternate Mediterranean diet (aMED), and the Alternate Healthy Eating Index (aHEI) diet-quality scores with cardiometabolic and endocrine plasma biomarkers in US women.. The trial was a cross-sectional analysis of 775 healthy women in the Women's Lifestyle Validation Study that was conducted within the NHS (Nurses' Health Study) and NHS II longitudinal cohorts. Multiple linear regression models adjusted for potential confounders were used to estimate associations between quartiles of dietary pattern-adherence scores that were derived from a food-frequency questionnaire and plasma biomarker concentrations that were collected simultaneously.. In multivariable models in which highest and lowest quartiles of dietary pattern scores were compared, 1) DASH was significantly associated with higher concentrations of high-density lipoprotein (9%) and sex-hormone binding globulin (SHBG) (21%), and lower concentrations of leptin (28%), triglycerides (19%), and C-peptide (4%) (all P-trend ≤ 0.04); 2) the aMED was associated with 19% higher SHBG and 16% lower triglycerides (P-trend = 0.02 and 0.003, respectively); and 3) the aHEI was associated with significantly higher concentrations of insulin (16%) and SHBG (19%) and lower concentrations of leptin (18%) (all P-trend ≤ 0.02). Further adjustment for body mass index (BMI) attenuated these associations but remained significant for 1) DASH with leptin and triglycerides and 2) the aMED with triglycerides (all P-trend ≤ 0.03).. Adherence to healthful dietary patterns is associated with favorable concentrations of many cardiometabolic and endocrine biomarkers. These relations are mediated in part by BMI.

Topics: Adiponectin; Aged; Biomarkers; Body Mass Index; C-Peptide; Cardiovascular Diseases; Cholesterol, HDL; Cross-Sectional Studies; Diet, Mediterranean; Female; Folic Acid; Follow-Up Studies; Humans; Insulin-Like Growth Factor Binding Protein 3; Insulin-Like Growth Factor I; Leptin; Metabolic Syndrome; Middle Aged; Receptors, Leptin; Reproducibility of Results; Risk Factors; Sex Hormone-Binding Globulin; Surveys and Questionnaires; Triglycerides; United States

Topics: Birth Weight; Body Mass Index; C-Peptide; Diabetes, Gestational; Female; Fetal Blood; Humans; Incidence; Infant, Newborn; Metabolic Syndrome; Overweight; Pregnancy; Pregnancy Complications; Weight Gain

Metabolic Syndrome (MetS) is associated with elevated risk for developing diabetes and cardiovascular disease. A key component of MetS is the development of insulin resistance (IR). The homeostatic model assessment (HOMA) model can determine IR by using insulin or C-peptide concentrations; however, the efficiency of insulin and C-peptide to determine MetS has not been compared. The aim of the study was to compare the efficiency of C-peptide and insulin to determine MetS in Mexicans.. Anthropometrics, glucose, insulin, C-peptide, triglycerides, and high-density lipoproteins were determined in 156 nonpregnant females and 114 males. Subjects were separated into normal or positive for MetS. IR was determined by the HOMA2 calculator using insulin or C-peptide. Correlations were calculated using the Spearman correlation coefficient (ρ). Differences between correlations were determined by calculating Steiger's Z. The sensitivity was determined by the area under receiver operating characteristics curve (AUC) analysis.. Independent of the MetS definition [Adult Treatment Panel III (ATP III), International Diabetes Federation (IDF), or World Health Organization (WHO)], C-peptide and insulin were significantly higher in MetS subjects (P < 0.05). C-peptide and insulin correlated with all components of MetS; however, for waist circumference, waist-to-hip ratio, and fasting plasma glucose, C-peptide correlated better than insulin (P < 0.05). Moreover, C-peptide (AUC = 0.72-0.78) was a better marker than insulin (AUC = 0.62-0.72) for MetS (P < 0.05). Finally, HOMA2-IR calculated with C-peptide (AUC = 0.80-0.84) was more accurate than HOMA2-IR calculated with insulin (AUC = 0.68-0.75, P < 0.05) at determining MetS.. C-peptide is a strong indicator of MetS. Since C-peptide has recently emerged as a biomolecule with significant importance for inflammatory diseases, monitoring C-peptide levels will aid clinicians in preventing MetS.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anthropometry; Area Under Curve; C-Peptide; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Female; Humans; Inflammation; Insulin; Insulin Resistance; Lipoproteins, HDL; Male; Metabolic Syndrome; Mexico; Middle Aged; Postprandial Period; Reproducibility of Results; ROC Curve; Triglycerides; Waist Circumference; Waist-Hip Ratio; Young Adult

To analyze the serum lipid and inflammatory biomarker profile in the early insulin resistance (e-IR).. Cross-sectional study of 5943 adults without diabetes, stratified into no IR group (C-peptide

Topics: Adipokines; Adult; Age of Onset; Aged; Biomarkers; Blood Glucose; C-Peptide; C-Reactive Protein; Cholesterol, HDL; Cholesterol, LDL; Cross-Sectional Studies; Female; Humans; Male; Metabolic Syndrome; Middle Aged; Plasminogen Activator Inhibitor 1; Protective Factors; Risk Factors; Spain; Triglycerides

Diabetes is a risk factor for colorectal cancer. We studied the association between markers of glucose metabolism and metabolic syndrome and the presence of colorectal adenomas in a large number of asymptomatic men and women attending a health screening program in South Korea. We also investigated whether these associations depend on adenoma location.. In a cross-sectional study, we measured fasting levels of glucose, insulin, hemoglobin A1c, and C-peptide and calculated homeostatic model assessment (HOMA) values (used to quantify insulin resistance) for 19,361 asymptomatic South Korean subjects who underwent colonoscopy examinations from January 2006 to June 2009. Participants completed a standardized self-administered health questionnaire and a validated semiquantitative food frequency questionnaire. Blood samples were collected on the day of the colonoscopy; fasting blood samples were also collected. Robust Poisson regression was used to model the associations of glucose markers with the prevalence of any adenoma.. Using detailed multivariable-adjusted dose-response models, the prevalence ratios (aPR, 95% confidence interval [CI]) for any adenoma, comparing the 90th with the 10th percentile, were 1.08 (1.00-1.16; P = .04) for fasting glucose, 1.07 (0.99-1.15; P = .10) for insulin, 1.09 (1.02-1.18, P = .02) for HOMA, 1.09 (1.01-1.17; P = .02) for hemoglobin A1c, and 1.14 (1.05-1.24; P = .002) for C-peptide. The corresponding ratios for nonadvanced adenomas were 1.11 (0.99-1.25; P = .08), 1.10 (0.98-1.24; P = .12), 1.15 (1.02-1.29; P = .02), 1.14 (1.01-1.28; P = .03), and 1.20 (1.05-1.37; P = .007), respectively. The corresponding ratios for advanced adenomas were 1.32 (0.94-1.84; P = .11), 1.23 (0.87-1.75; P = .24), 1.30 (0.92-1.85; P = .14), 1.13 (0.79-1.61; P = .50), and 1.67 (1.15-2.42; P = .007), respectively. Metabolic syndrome was associated with the prevalence of any adenoma (aPR, 1.18; 95% CI, 1.13-1.24; P < .001), nonadvanced adenoma (aPR, 1.30; 95% CI, 1.20-1.40; P < .001), and advanced adenoma (aPR, 1.42; 95% CI, 1.14-1.78; P = .002). Associations were similar for adenomas located in the distal versus proximal colon.. Increasing levels of glucose, HOMA values, levels of hemoglobin A1c and C-peptide, and metabolic syndrome are significantly associated with the prevalence of adenomas. Adenomas should be added to the list of consequences of altered glucose metabolism.

Topics: Adenoma; Adult; Biomarkers; Blood Glucose; C-Peptide; Colorectal Neoplasms; Cross-Sectional Studies; Diabetes Complications; Female; Glucose; Glycated Hemoglobin; Humans; Insulin; Male; Metabolic Syndrome; Middle Aged; Regression Analysis; Retrospective Studies; Risk Factors

To investigate the clinical characteristics, metabolic status, insulin resistance and insulin secretory function of diabetic patients with early onset.. The study was undertaken in the West China Hospital of Sichuan University. Characteristics of 342 admitted diabetic patients with early onset (EOD group, diagnosed at age 15-45 years old) were reviewed and compared with 296 admitted patients with late onset (LOD group, diagnosed at age >45 years old). All of the participants had negative islet autoantibodies. Homeostasis model assessment 2 of insulin resistant (HOMA2-IR) and HOMA2 of insulin sencitivity (HOMA2-% S) were measured to estimate insulin resistance and insulin sensitivity. HOMA2 of beta-cell function (HOMA2-% beta) index was used to estimate beta-cell secretory function. We also compared clinical characteristics and metabolic status between the two groups.. EOD patients were more likely to have ketosis, ketoacidosis, insulin therapy and positive diabetic family history than LOD patients (P < 0.05). Levels of systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), waist-to-hip ratio (WHR), fasting and postprandial insulin (Fins, PIns), fasting and postprandial plasma C-peptide (FCP, PCP) were significantly lower, and glycosylated hemoglobin A1c (HbA1), triglycerides (TG), fasting and postprandial blood glucose (FPG, PPG) were significantly higher in EOD patients than in LOD patients (P < 0.05). EOD patients had lower prevalence of hypertension, central obesity, hyperuricemia, metabolic syndrome (MS) and co-exist of three or more metabolic disorders than LOD patients (P < 0.05). EOD patients had decreased levels of HOMA2-% beta, deltaI30/deltaG30 and HOMA2-IR, increased HOMA2-%S, and increased proportions with FCP < 0.2 nmol/L and FIns < 2.9 microU/mL compared with LOD patient (P < 0.05). Linear regression analyses showed that HOMA2-%beta, deltaI30/deltaG30, positive diabetic family history were independent risk factors predicting early onset of diabetes.. Early onset diabetic patients are characterized with low prevalence of metabolic disorders, insulin resistance and severe insulin secretion dysfunction. Loss of beta-cell function may play a major role in the development of early onset diabetes in this population.

Topics: Adolescent; Adult; Blood Glucose; Body Mass Index; C-Peptide; China; Diabetes Mellitus, Type 2; Glycated Hemoglobin; Humans; Hypertension; Insulin; Insulin Resistance; Metabolic Syndrome; Middle Aged; Obesity, Abdominal; Prevalence; Risk Factors; Triglycerides; Waist-Hip Ratio; Young Adult

The aim of the present study was to investigate the relationship of C-peptide levels with insulin, resistance; components of metabolic syndrome and cardiovascular disease in patients with diabetes mellitus type 2. The study included 98 patients with diabetes mellitus type 2, who were divided into two groups by the level of C-peptide. The first group consisted of 54 patients with elevated levels of C-peptide; the second group consisted of 44 patients with normal levels of C-peptide. Our study has shown a positive correlation between C-peptide levels and a body mass index (BMI), triglyceride levels and the triglyceride/high-density lipoprotein ratio. Correlation analysis also allowed identifying a statistically significant association of the HOMA-2-IR-C-peptide with a BMI, triglycerides and the triglyceride/high-density lipoprotein ratio. In the group of patients with elevated levels of C-peptide found in practically all components of metabolic syndrome, as well as a high incidence of arterial hypertension and ischemic heart disease. The study shows that the detection of the C-peptide level is preferred in comparison with insulin for assessment of insulin resistance, presence of metabolic syndrome and can be used in type 2 diabetic patients for early detection of cardiovascular risk.

Topics: Adult; Aged; C-Peptide; Cardiovascular Diseases; Diabetes Complications; Diabetes Mellitus, Type 2; Female; Humans; Male; Metabolic Syndrome; Middle Aged; Risk Factors

The aim of this study was to characterize the clinical characteristics and insulin secretion in adults with latent autoimmune diabetes in adults (LADA). We also compared these characteristics in subjects with antibody-negative type 2 diabetes (T2DM) or adult-onset type 1 diabetes (T1DM) to subjects with LADA.. In this cross-sectional study, 82 patients with LADA, 78 with T1DM and 485 with T2DM were studied. Clinical and metabolic data, in particular those that related to metabolic syndrome, fasting C-peptide and islet-cell autoantibodies [glutamic acid decarboxylase (GADAb) and IA2 (IA2Ab)] were measured.. The frequency of metabolic syndrome in patients with LADA (37.3%) was higher than in those with T1DM (15.5%; p = 0.005) and lower than in patients with T2DM (67.2%; p < 0.001). During the first 36 months of the disease, the C-peptide concentration in LADA patients was higher than in subjects with T1DM but was lower than in T2DM patients (p < 0.01 for comparisons). Glycemic control in LADA patients (HbA1c 8.1%) was worse than in patients with T2DM (HbA1c 7.6%; p =0.007). An inverse association between GADAb titers and C-peptide concentrations was found in subjects with LADA (p < 0.001). Finally, LADA patients rapidly progressed to insulin treatment.. As in other European populations, patients with LADA in Spain have a distinct metabolic profile compared with patients with T1DM or T2DM. LADA is also associated with higher impairment of beta-cell function and has worse glycemic control than in T2DM. Beta cell function is related to GADAb titers in patients with LADA.

Topics: Adult; Aged; Autoantibodies; Autoimmunity; C-Peptide; Cross-Sectional Studies; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Humans; Insulin; Insulin Secretion; Male; Metabolic Syndrome; Middle Aged; Spain

Effect of light regimens (standard 12:12 light/dark, constant light, natural lightning of the north-west of Russia) and that of melatonin on the development of metabolic syndrome during aging of rats was studied. It was found out that during the process of aging of rats kept in the conditions of the broken rhythm of day and night, different disturbances of metabolism in the form of abdominal obesity, hyperinsulinemia, hypercholesterolemia, hyperglycemia, hyperbetalipoproteinemia and glycosuria occurred. These disturbances can be considered to be metabolic syndrome or the syndrome of insulin resistance. The use of melatonin at night time starting in the rats of 4 month old allowed to decrease the age metabolism disorders in the rats. This fact indirectly proves the insufficiency of this hormone in human in the conditions of natural lighting of the north-west of Russia.

Topics: Animals; Blood Glucose; C-Peptide; Circadian Rhythm; Darkness; Light; Male; Melatonin; Metabolic Syndrome; Rats; Russia

Genome-wide association studies have revealed several gene variants associated with obesity; however, only a few studies have further investigated their association with metabolic syndrome. We performed a study of eleven variants in/near genes TMEM18, SH2B1, KCTD15, PCSK1, BDNF, SEC16B, MC4R, and FTO in Czech adolescents and analysed their association with obesity, metabolic syndrome and related traits. Genotyping was performed in 1,443 adolescents aged 13.0-17.9 years. Anthropometric parameters, biochemical parameters and blood pressure were assessed. Metabolic syndrome was defined according to the International Diabetes Federation. The FTO rs9939609 variant was associated with overweight/obesity (OR 1.40, 95% CI 1.21-1.63, P < 0.001). The minor allele of TMEM18 rs7561317 was related to underweight (OR 1.78, 95% CI 1.14-2.79, P = 0.015). BDNF rs925946 and MC4R rs17782313 were associated with metabolic syndrome (OR 1.53, 95% CI 1.14-2.04, P = 0.005; 1.51, 95% CI 1.12-2.04, P = 0.009). The PCSK1 rs6235 variant was negatively related to increased blood glucose (OR 0.69, 95% CI 0.49-0.97, P = 0.040). In conclusion, the FTO variant was associated with overweight/obesity in Czech adolescents. Moreover, MC4R and BDNF variants increased the risk of metabolic syndrome, probably through their effect on abdominal obesity. The PCSK1 variant may have a protective role in the development of type 2 diabetes.

Topics: Adiposity; Adolescent; Anthropometry; Blood Glucose; C-Peptide; Cohort Studies; Czech Republic; Female; Gene Frequency; Genetic Predisposition to Disease; Genome-Wide Association Study; Genotype; Humans; Insulin; Lipids; Male; Metabolic Syndrome; Obesity; Overweight; Thinness

Metabolic surgery causes the remission of type 2 diabetes mellitus (T2DM), hypertension, and hyperlipidemia to varying degrees, depending on the patient characteristics and the surgical procedure. The aim of this study was to find predictors for the remission of T2DM and hypertension after biliopancreatic diversion with duodenal switch (BPDDS).. Eighty patients with T2DM were followed up for 2 years or more after BPDDS, and changes in body weight and metabolic status were noted. Remission was defined as fasting glucose <7 mmol/l with HbA1C <6.5 %, blood pressure <140/90 mmHg, and low-density lipoprotein (LDL) <2.6 mmol without the use of medication.. Preoperatively, the mean age was 44 years, body mass index (BMI) was 48 kg/m(2), and duration of diabetes was 5 years. Of the 80 patients, 38 patients were using insulin, 48 patients were using antihypertensives, and 38 patients were using a lipid-lowering drug. Five percent of the patients had recommended levels for HbA1C, blood pressure, and LDL prior to the operation. The remission rate at 2 years was 94 % for T2DM, 54 % for hypertension, and 86 % for LDL hyperlipidemia. Preoperative predictors for nonremission of T2DM were a higher BMI, insulin usage, and low insulin C-peptide, and for hypertension, older age and more severe hypertension. Postoperative weight loss was important for both.. Surgical intervention with BPDDS is an effective treatment of T2DM, hypertension, and hyperlipidemia. The duration of T2DM and age of the patient are the most important preoperative predictors for the remission of T2DM and hypertension, respectively.

Topics: Adult; Antihypertensive Agents; Biliopancreatic Diversion; Blood Glucose; C-Peptide; Diabetes Mellitus, Type 2; Duodenum; Female; Follow-Up Studies; Humans; Hyperlipidemias; Hypertension; Hypoglycemic Agents; Hypolipidemic Agents; Male; Metabolic Syndrome; Predictive Value of Tests; Remission Induction; Time Factors; Treatment Outcome; Weight Loss

Adult non-insulin requiring diabetes includes latent autoimmune diabetes of adults (LADA), distinguished from type 2 diabetes by the presence of islet autoantibodies. LADA China determined the characteristics of Chinese LADA. This nationwide, multicenter, clinic-based cross-sectional study was conducted in 46 university-affiliated hospitals in 25 Chinese cities. All 4,880 ketosis-free diabetic patients (<1 year postdiagnosis, without insulin therapy for >6 months, aged ≥30 years) had GAD antibody (GADA) and HLA-DQ genotype measured centrally with clinical data collected locally. GADA-positive subjects were classified as LADA. Of the patients, 5.9% were GADA positive with LADA. LADA showed a north-south gradient. Compared with GADA-negative type 2 diabetes, LADA patients were leaner, with lower fasting C-peptide and less metabolic syndrome. Patients with high GADA titers are phenotypically different from those with low GADA titers, while only a higher HDL distinguished the latter from those with type 2 diabetes. HLA diabetes-susceptible haplotypes were more frequent in LADA, even in those with low-titer GADA. HLA diabetes-protective haplotypes were less frequent in LADA. Our study implicates universal immunogenetic effects, with some ethnic differences, in adult-onset autoimmune diabetes. Autoantibody positivity and titer could be important for LADA risk stratification and accurate therapeutic choice in clinical practice.

Topics: Adult; Autoantibodies; C-Peptide; China; Cross-Sectional Studies; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Genetic Predisposition to Disease; Glutamate Decarboxylase; Haplotypes; HLA-DQ Antigens; Humans; Lipoproteins, HDL; Male; Metabolic Syndrome; Middle Aged; Prediabetic State; Risk

Genetic background may interact with habitual dietary fat composition, and affect development of the metabolic syndrome (MetS). The phosphoenolpyruvate carboxykinase gene (PCK1) plays a significant role regulating glucose metabolism, and fatty acids are key metabolic regulators, which interact with transcription factors and influence glucose metabolism. We explored genetic variability at the PCK1 gene locus in relation to degree of insulin resistance and plasma fatty acid levels in MetS subjects. Moreover, we analyzed the PCK1 gene expression in the adipose tissue of a subgroup of MetS subjects according to the PCK1 genetic variants.. Insulin sensitivity, insulin secretion, glucose effectiveness, plasma concentrations of C-peptide, fatty acid composition and three PCK1 tag-single nucleotide polymorphisms (SNPs) were determined in 443 MetS participants in the LIPGENE cohort.. The rs2179706 SNP interacted with plasma concentration of n - 3 polyunsaturated fatty acids (n - 3 PUFA), which were significantly associated with plasma concentrations of fasting insulin, peptide C, and HOMA-IR. Among subjects with n - 3 PUFA levels above the population median, carriers of the C/C genotype exhibited lower plasma concentrations of fasting insulin (P = 0.036) and HOMA-IR (P = 0.019) as compared with C/C carriers with n - 3 PUFA below the median. Moreover, homozygous C/C subjects with n - 3 PUFA levels above the median showed lower plasma concentrations of peptide C as compared to individuals with the T-allele (P = 0.006). Subjects carrying the T-allele showed a lower gene PCK1 expression as compared with carriers of the C/C genotype (P = 0.015).. The PCK1 rs2179706 polymorphism interacts with plasma concentration of n - 3 PUFA levels modulating insulin resistance in MetS subjects.

Topics: Adipose Tissue; Adult; Aged; Alleles; Blood Glucose; Body Mass Index; C-Peptide; Cross-Sectional Studies; Dietary Fats; Fasting; Fatty Acids, Omega-3; Female; Gene-Environment Interaction; Genetic Loci; Genotype; Homozygote; Humans; Insulin; Insulin Resistance; Insulin Secretion; Intracellular Signaling Peptides and Proteins; Linear Models; Male; Metabolic Syndrome; Middle Aged; Phosphoenolpyruvate Carboxykinase (GTP); Polymorphism, Single Nucleotide; Randomized Controlled Trials as Topic

To investigate the effect of novel probiotics on the clinical characteristics of high-fructose induced metabolic syndrome.. Male Wistar rats aged 4 wk were fed a 70% w/w high-fructose diet (n = 27) or chow diet (n = 9) for 3 wk to induce metabolic syndrome, the rats were then randomized into groups and administered probiotic [Lactobacillus curvatus (L. curvatus) HY7601 and Lactobacillus plantarum (L. plantarum) KY1032] at 10(9) cfu/d or 10(10) cfu/d or placebo by oral gavage for 3 wk. Food intake and body weight were measured once a week. After 6 wk, the rats were fasted for 12 h, then anesthetized with diethyl ether and sacrificed. Blood samples were taken from the inferior vena cava for plasma analysis of glucose, insulin, C-peptide, total-cholesterol, triglycerides and thiobarbituric acid-reacting substances. Real-time polymerase chain reaction was performed using mouse-specific Taqman probe sets to assess genes related to fatty acid β-oxidation, lipogenesis and cholesterol metabolism in the liver. Target gene expression was normalized to the housekeeping gene, glyceraldehyde-3-phosphate dehydrogenase.. Rodents fed a high-fructose diet developed clinical characteristics of the metabolic syndrome including increased plasma glucose, insulin, triglycerides, total cholesterol and oxidative stress levels, as well as increased liver mass and liver lipids compared to chow fed controls. Probiotic treatment (L. curvatus HY7601 and L. plantarum KY1032) at high (10(10) cfu/d) or low dosage (10(9) cfu/d) lowered plasma glucose, insulin, triglycerides and oxidative stress levels. Only high-dose probiotic treatment reduced liver mass and liver cholesterol. Probiotic treatment reduced lipogenesis via down-regulation of SREBP1, FAS and SCD1 mRNA levels and increased β-oxidation via up-regulation of PPARα and CPT2 mRNA levels.. Probiotic L. curvatus HY7601 and L. plantarum KY1032 combined suppressed the clinical characteristics of high-fructose-induced metabolic syndrome, therefore, may provide a natural alternative for the treatment of diet-induced metabolic syndrome.

Topics: Animals; Blood Glucose; C-Peptide; Cholesterol; Dietary Carbohydrates; Disease Models, Animal; Fructose; Insulin; Lactobacillus; Male; Metabolic Syndrome; Oxidative Stress; Probiotics; Rats; Thiobarbituric Acid Reactive Substances; Triglycerides

Metabolic syndrome (MetS) is correlated with the activity of hypothalamic-pituitary-adrenal axis (HPA), but the underlying mechanism still remains elusive. The aim of this study was to investigate the HPA axis function in patients with MetS. This case-control study included 159 people. They were divided into 2 groups. The first group included 73 healthy volunteers (control group: 19 males, 54 females, mean±SD: 49.9±7.5 years old, with BMI: 27.9±4.42 kg/m2) and the second group included 86 patients with MetS (case group: 48 males, 38 females, mean±SD: 52.2±7.6 years old, with BMI: 30.5±5.35 kg/m2). An oral glucose tolerance test (OGTT) was performed for all subjects after a 12-h overnight fast, and blood samples were obtained for determination of ACTH, cortisol, insulin, C-peptide, and glucose levels. Serum cortisol after an overnight dexamethasone suppression test was determined in both groups. Patients with MetS had serum cortisol levels after an overnight dexamethasone suppression test significantly higher than controls. During OGTT plasma ACTH levels were higher at all time points in patients with MetS compared to controls, whereas serum cortisol levels were comparable between the 2 groups. Plasma ACTH during OGTT was also correlated with most of the components of MetS. The HPA axis in patients with MetS seems to be more active as evidenced by the higher cortisol levels after the overnight dexamethasone suppression test and by the higher ACTH levels during OGTT. This functional hypercortisolism might be involved in the pathogenesis of the metabolic syndrome.

Topics: Adrenocorticotropic Hormone; Adult; C-Peptide; Case-Control Studies; Female; Glucose Tolerance Test; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Insulin; Male; Metabolic Syndrome; Middle Aged; Pituitary-Adrenal System; Up-Regulation

Aim of this study was the investigation of feature of hormonal status in patients with metabolic syndrome (MetS). 111 reproductive age women were included in the study. According to diagnostic criteria for MetS of Society of Cardiology of the Russian Federation (2009) they were divided into two groups--study group (n=52) and control group (n=59). It was studied composition of body (fat mass, skeletal mass, lean mass, total, intracellular and extracellular fluid), parameter of lipid and carbohydrate metabolism, parameter of hormonal status. Study of hormonal status in reproductive age women with MetS showed a higher level of fasting and postprandial levels of insulin and C-peptide, hyperleptinemia and a reduced level of sex hormone-binding globulinn (SHBG). We suggest that serum leptin and SHBG levels may be used as an additional diagnostic criteria in these patients.

Topics: Adipose Tissue; Adolescent; Adult; Biomarkers; Blood Chemical Analysis; Body Composition; Body Mass Index; C-Peptide; Female; Gonadal Steroid Hormones; Health Status; Humans; Insulin; Leptin; Lipoproteins, HDL; Lipoproteins, LDL; Metabolic Syndrome; Middle Aged; Obesity; Reproduction; Risk Factors; Sex Hormone-Binding Globulin; Triglycerides; Waist-Hip Ratio

Changes in the clinical presentation of diabetes mellitus in childhood and adolescence associated with obesity have resulted in an overlap of the two most common types of diabetes with a greater clinical heterogeneity. In order to characterize the type of diabetes at onset and assess the effect of obesity, 50 children with diabetes were studied. The patients were divided into two groups according to their nutritional status at diagnosis (over-weight/obese vs. normal weight). Insulin reserve was evaluated by measuring basal C-peptide and stimulated C-peptide in response to a mixed meal (MMTT) as well as HLA-DQB1 genotype, antibodies, and family history of risk factors for metabolic disease. Of all 50 patients, 38% was overweight/obese, 84% had a positive family history of metabolic syndrome, 82% had positive antibodies, and 100% were positive for the high-risk HLA-DQB1 genotype. No significant differences were found in fasting C-peptide or glycemic index/C-peptide levels between the two groups. In the overweight/obese group C-peptide response to MMTT showed higher levels at 60 and 120 minutes (p = 0.02 and 0.03) and the area under the curve for C-peptide was also higher (1.77 ng / ml vs. 5.5 ng/ ml, p = 0.0007) than in the normal-weight group. In conclusion, overweight/obese patients with type 1A diabetes had a greater pancreatic reserve, suggesting that nutritional status may accelerate disease onset.

Topics: Adolescent; Autoimmunity; Biomarkers; C-Peptide; Chi-Square Distribution; Child; Diabetes Mellitus, Type 1; Female; Genotype; Glutamate Decarboxylase; HLA-DQ beta-Chains; Humans; Insulin Antibodies; Male; Metabolic Syndrome; Obesity; Prospective Studies; Receptor-Like Protein Tyrosine Phosphatases, Class 8; Risk Factors

Pulses are low in energy density, supporting their inclusion in the diet for the management of risk factors of the metabolic syndrome (MetSyn). The aim of the present study was to describe the effects of frequent consumption (five cups/week over 8 weeks) of pulses (yellow peas, chickpeas, navy beans and lentils), compared with counselling to reduce energy intake by 2093 kJ/d (500 kcal/d), on risk factors of the MetSyn in two groups (nineteen and twenty-one subjects, respectively) of overweight or obese (mean BMI 32·8 kg/m2) adults. Body weight, waist circumference, blood pressure, fasting blood parameters and 24 h food intakes were measured at weeks 1, 4 and 8. Blood glucose, insulin, C-peptide, glucagon-like peptide-1 (GLP-1) and ghrelin were measured after a 75 g oral glucose load at weeks 1 and 8. At week 8, both groups reported reductions in energy intake, waist circumference, systolic blood pressure, glycosylated Hb (HbA1c) and glucose AUC and homeostasis model of insulin resistance (HOMA-IR) following the glucose load (P < 0·05). However, HDL, fasting C-peptide and insulin AUC responses were dependent on diet (P < 0·05). HDL and C-peptide increased by 4·5 and 12·3 %, respectively, in the pulse group, but decreased by 0·8 and 7·6 %, respectively, in the energy-restricted group. Insulin AUC decreased in both females and males on the energy-restricted diet by 24·2 and 4·8 %, respectively, but on the pulse diet it decreased by 13·9 % in females and increased by 27·3 % in males (P < 0·05). In conclusion, frequent consumption of pulses in an ad libitum diet reduced risk factors of the MetSyn and these effects were equivalent, and in some instances stronger, than counselling for dietary energy reduction.

Topics: Adult; Blood Glucose; C-Peptide; Caloric Restriction; Counseling; Diet; Fabaceae; Female; Glucagon-Like Peptide 1; Humans; Insulin; Male; Metabolic Syndrome; Middle Aged; Obesity; Overweight; Risk Factors; Seeds; Waist Circumference

The aim of the presented study is to evaluate metabolic features in adolescents with polycystic ovary syndrome (PCOS) in comparison with age- and BMI-matched subjects. Forty-three adolescents with PCOS according to ESHRE criteria were prospectively evaluated and compared with 48 control subjects. Blood sampling was done in the early follicular phase of menstrual cycle, between 1st and 5th day, for plasma glucose, total and high-density lipoprotein (HDL)-cholesterol, triglycerides, insulin and C peptide. The diagnosis of metabolic syndrome was done according to IDF adolescent criteria. Adolescents with PCOS have increased low-density lipoprotein (LDL)-cholesterol (p < 0.002), decreased HDL-cholesterol (p <0.0007) and increased C peptide levels (p < 0.02) in comparison with healthy adolescents. Total cholesterol, triglycerides, fasting blood glucose, fasting insulin, HOMA-IR, waist-to-hip ratio, systolic and diastolic blood pressure did not differ between the groups. There was no difference when we compared the prevalence of adolescents with at least one feature of metabolic syndrome between PCOS (17 from 43) and healthy controls (27 from 48). In conclusion, adolescents with PCOS have less favourable blood lipid profiles with higher LDL-cholesterol and lower levels of HDL-cholesterol and are more insulin resistant than their healthy counterparts having higher fasting C peptide levels.

Topics: Adolescent; Adult; Body Mass Index; C-Peptide; Cholesterol, HDL; Cholesterol, LDL; Czech Republic; Female; Follicular Phase; Humans; Hypercholesterolemia; Insulin Resistance; Metabolic Syndrome; Obesity; Polycystic Ovary Syndrome; Prevalence; Prospective Studies; Young Adult

We evaluated the relationship between insulin resistance (IR) and insulin secretion with the metabolic syndrome (MS) in 885 subjects (377 men/508 women, age 49±11 years, BMI 29±5.2kgm(-2)) at risk of diabetes enrolled in the genetics, pathophysiology and evolution of type 2 diabetes (GENFIEV) study.. All subjects underwent a 75-g oral glucose tolerance test (OGTT) for the estimation of plasma levels of glucose and C-peptide, as well as fasting insulin and lipid profile. IR was arbitrarily defined as HOMA-IR value above the 75th centile of normal glucose tolerance (NGT) subjects. Overall MS prevalence (National Cholesterol Treatment Panel-Adult Treatment Panel (NCEP-ATPIII) criteria) was 33%, 19% in subjects with NGT, 42% in impaired fasting glucose (IFG), 34% in impaired glucose tolerance (IGT), 74% in IFG+IGT subjects, and 56% in newly diagnosed diabetic patients. Prevalence was slightly higher with IDF criteria. MS prevalence was >50% in subjects with 2h glucose >7.8mmoll(-1), independently of fasting plasma glucose. IR prevalence was higher in subjects with MS than in those without (63% vs. 23%; p<0.0001) and increased from 54% to 73% and 88% in the presence of three, four or five traits, respectively. IR occurred in 42% of subjects with non-diabetic alterations of glucose homeostasis, being the highest in those with IFG+IGT (IFG+IGT 53%, IFG 45%, IGT 38%; p<0.0001). Individuals with MS were more IR irrespective of glucose tolerance (p<0.0001) with no difference in insulinogenic index. Hypertriglyceridaemia (OR: 3.38; Confidence Interval, CI: 2.294.99), abdominal obesity (3.26; CI: 2.18-4.89), hyperglycaemia (3.02; CI: 1.80-5.07) and hypertension (1.69; CI: 1.12-2.55) were all associated with IR.. These results show that in subjects with altered glucose tolerance (in particular IFG+IGT) MS prevalence is high and is generally associated to IR. Some combinations of traits of MS may significantly contribute to identify subjects with IR.

Topics: Adult; Blood Glucose; C-Peptide; Diabetes Mellitus, Type 2; Female; Glucose Intolerance; Glucose Tolerance Test; Humans; Hyperglycemia; Hypertension; Insulin Resistance; Italy; Logistic Models; Male; Metabolic Syndrome; Middle Aged; Prediabetic State; Prevalence; Risk Factors

Topics: Antipsychotic Agents; Blood Glucose; C-Peptide; Cholesterol; Cooperative Behavior; Diabetes Mellitus, Type 2; Health Promotion; Humans; Hyperlipidemias; Insulin; Insulin Resistance; Interdisciplinary Communication; Metabolic Syndrome; Mind-Body Relations, Metaphysical; Patient Admission; Patient Care Team; Psychotic Disorders; State Medicine; Triglycerides; Weight Gain

Most studies evaluating the relation between periodontal disease and diabetes in children have not considered diabetes type.. To evaluate the relationship between periodontal damage and risk factors of diabetes complications among youth by diabetes type in a pilot study.. 155 participants (126 with type 1 diabetes; 29 with type 2 diabetes) from the SEARCH for Diabetes in Youth study in South Carolina who were <20 yr of age at diagnosis.. Cross-sectional analysis of periodontal damage (bone loss ≥3 mm on ≥1 permanent tooth site on pre-existing bitewing radiographs) and diabetes type assigned by the provider at diagnosis.. Periodontal damage was observed in 52 individuals (34%) overall, but was more common in type 2 (16/29, 55%) vs. type 1 diabetes (37/126, 29%). Among youth with type 2 diabetes, those with periodontal damage had lower fasting c-peptide (2.3 vs. 3.4 ng/mL, p-value=0.01), and higher triglyceride levels (171.8 vs. 87.2, p-value=0.01) than those without periodontal damage after adjustment for age, sex, race, education level, family income, duration of diabetes, diabetes control, time between study visit and date of radiograph, tooth brushing, and visits to the dentist. Blood pressure, waist circumference, LDL cholesterol and A1c were not associated with periodontal damage.. The associations between periodontal disease and risk factors for diabetes complications differ by diabetes type. Periodontal damage is associated with impaired beta cell function and metabolic syndrome components in type 2 but not type 1 diabetes. These findings need to be confirmed in larger, prospective studies.

Topics: Adolescent; Blood Glucose; C-Peptide; Child; Child, Preschool; Cross-Sectional Studies; Diabetes Complications; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Humans; Male; Metabolic Syndrome; Periodontal Diseases; Pilot Projects; Risk Factors; South Carolina; Triglycerides

NASH (non-alcoholic steatohepatitis) is considered the hepatic manifestation of the metabolic syndrome (MS). We aimed to analyze lipid, carbohydrate, and iron metabolism in NASH.. 37 patients with MS (17 M/20 F, 51+/-15 years), elevated transaminases; 25 patients had histologically proven NASH (NAS score≥5), 12 patients had toxic background (nonNASH). 37 age, sex, BMI-matched healthy controls. Lipid variables, LDL-subfractions, iron, ferritin, transferrin (T), transferrin saturation (TS), and hepcidin (H) were measured in patients/controls. Oral glucose tolerance tests were performed.. NASH patients with steatosis gr. 2 and 3 (>33% hepatic fat) had higher sd-LDL (mg/dl) concentrations than patients with steatosis gr. 1 (<33%) (p=0.002), nonNASH patients (p=0.03) and controls (p=0.001). Sd absolute (mg/dl) correlated directly with the steatosis grade only in patients with NASH and steatosis >33% (p=0.04). NASH-patients showed higher insulin, C-peptide and IRI values than nonNASH patients (p=0.034; 0.032; 0.04). H was increased in patients versus controls (p<0.001). H correlated with ferritin in MS-patients (p=0.01), correlated directly with sd-LDL (mg/dl) (p=0.017) and IRI (p<0.001) and indirectly with HDL (p=0.05) in NASH. No associations between hepatic inflammation/iron content on liver biopsy and variables of lipid metabolism were found but hepcidin correlated with hepatic inflammation in all patients and with NAS scores in NASH.. NASH-patients show insulin resistance and increased sd-LDL subfractions, suggesting an atherogenic profile. The correlation of H with sd-LDL and IRI, without relation to hepatic iron content suggests a putative link between inflammation, carbohydrate and lipid metabolism in NASH.

Topics: Adult; Aged; Antimicrobial Cationic Peptides; C-Peptide; Carbohydrate Metabolism; Cholesterol, LDL; Fatty Liver; Female; Ferritins; Glucose Tolerance Test; Hepcidins; Humans; Insulin; Iron; Lipid Metabolism; Male; Metabolic Syndrome; Metabolome; Middle Aged; Non-alcoholic Fatty Liver Disease; Transferrin

This study aimed to investigate the associations of hepatocyte nuclear factor 4 (HNF4) alpha single nucleotide polymorphisms (SNPs) and haplotype with insulin resistance and metabolic syndrome parameters. Nine SNPs spanning the HNF4 alpha P2 promoter (rs4810424, rs1884613 and rs1884614) and coding region (rs2144908, rs6031551, rs6031552, rs1885088, rs1028583 and rs3818247) were genotyped in 160 subjects without diabetes or metabolic syndrome. The HNF4 alpha P2 promoter SNPs rs4810424, rs1884613 and rs1884614 were associated with insulin resistance (p = 0.017; 0.037; 0.024) and body mass index (BMI) (p = 0.03; 0.035; 0.039). The intron 1D SNP rs2144908 was associated with high-density lipoprotein cholesterol (HDLc) (p = 0.020) and the intron 9 SNP rs3818247 showed association with systolic (p = 0.02) and diastolic (p = 0.034) blood pressure. HNF4 alpha common haplotype CCCGTC associated with higher insulin resistance (p = 0.022), fasting blood glucose (FBG) (p = 0.035) and lower HDLc (p = 0.001). In conclusion, subjects with HNF4 alpha P2 variants and haplotypes have been shown to have a higher insulin resistance and are therefore at a higher risk for developing type 2 diabetes mellitus.

Topics: Adult; Blood Glucose; Blood Pressure; Body Mass Index; C-Peptide; Female; Genetic Association Studies; Haplotypes; Hepatocyte Nuclear Factor 4; Humans; Lipids; Male; Metabolic Syndrome; Middle Aged; Multivariate Analysis; Polymorphism, Single Nucleotide; Promoter Regions, Genetic; Waist Circumference

Our study was carried out to ascertain the role of valproic acid for inducing metabolic disorders like hyperinsulinemia, insulin resistance and metabolic syndrome. Seventy-nine subjects were enrolled into the study. They were divided in 3 groups: 26 patients with epilepsy on VPA monotherapy and 28 patients with epilepsy on CBZ monotherapy and 25 healthy controls. Blood samples for fasting insulin, glucose, C-peptide, TG and HDL were collected. We compared insulin, C-peptide, C-peptide/insulin ratio, HOMA-IR, BMI, central obesity and metabolic syndrome in patients treated with VPA, patients treated with CBZ and in healthy controls. VPA treatment was associated with insulin resistance (30.8%) in opposite to CBZ treatment (7.1%). Metabolic syndrome existed in 34,6%, 14,3% and 12% among VPA, CBZ and control groups, respectively. There was no difference in C peptide/insulin ratio between study groups. Interestingly lean VPA treated patients showed high frequency of insulin resistance and metabolic syndrome compared to lean CBZ treated patients and controls. Therefore we suppose that obesity should not be an obligatory factor for VPA induced metabolic disturbances. VPA treatment is associated with insulin resistance and metabolic syndrome. This metabolic disorders were not connected with diminished hepatic insulin extraction. Although VPA treated patients showed central obesity predominance, we suggest that VPA can induce such metabolic and endocrine changes without obesity.

Topics: Adult; Blood Glucose; Body Mass Index; C-Peptide; Carbamazepine; Cholesterol, HDL; Epilepsy; Female; Humans; Hyperinsulinism; Insulin; Insulin Resistance; Male; Metabolic Syndrome; Middle Aged; Obesity; Triglycerides; Valproic Acid

The progress of metabolic syndrome (MetS) continues with the onset of type-2 diabetes mellitus (Type-2 DM) along with linkage to other disorders such as neurodegenerative, especially Alzheimer's disease (AD), via oxidative stress and low grade systemic inflammatory process. Type-2 DM and AD are health disorders of priority research. The treatment for an individual suffering with Type- 2 DM and/or AD requires monitoring by clinicians. The aim of this study was to investigate the role of C-peptide and its correlation to insulin resistance, body mass index (BMI), β cell function, insulin sensitivity, lipid profile and hemoglobin A1c (HbA1c). The study was designed to include 96 Type-2 DM individuals from India. 58.3% males and 41.7% females were selected and fasting blood samples were collected for estimation of fasting C-peptide, fasting blood sugar (FBS), postprandial blood sugar (PPBS), HbA1c and lipid profile. Analysis was done on Hitachi912 and Elecsys 2010 using Roche reagents and standard controls. Anthropometries to calculate BMI and β cell function, insulin sensitivity, and insulin resistance were obtained. The statistical tool ANOVA, followed by calculation of p-value and r � value were applied for investigating correlation of C-peptide levels to those of high density lipoprotein-C (HDL-C), low density lipoprotein-C (LDL-C), triglycerides (TGL), HbA1c, β cell function, insulin sensitivity and insulin resistance. Highly significant positive correlations were observed in different quantiles of C-peptide levels to the studied parameters of MetS, BMI and % β cell function. Lower HDL-C level was found to be significantly related to higher C-peptide levels. Similarly, TGL and C-peptide levels displayed a significant positive correlation. A significant negative correlation was observed between C-peptide quantiles and % sensitivity. Thus, insulin resistance showed a positive correlation until the fourth quantile. No significant correlation was observed between C-peptide and HbA1c levels. This study demonstrates that assessment of C-peptide levels is a useful tool to monitor the progress of MetS among patients suffering from Type-2 DM and AD, as these disorders are intertwined to each other by common metabolic pathways. Assessment of C-peptide levels, along with HDL-C levels, in patients can be used to monitor insulin resistance.

Topics: Adult; Aged; Aged, 80 and over; Alzheimer Disease; Biomarkers; Body Mass Index; C-Peptide; Cholesterol, HDL; Diabetes Mellitus, Type 2; Female; Humans; Insulin Resistance; Male; Metabolic Syndrome; Middle Aged; Prospective Studies; Young Adult

The metabolic syndrome (MS) includes a clustering of metabolic derangements. Low testosterone levels have been shown to be associated with both components of MS and MS per se. As most androgen-related effects are mediated thorough the androgen receptor (AR), we wanted to investigate to which degree the AR CAG and GGN repeat polymorphisms might be related to MS. Sixty-eight men, 60-80 years old, with subnormal total testosterone levels (11.0 nmol/L), participating in a nested case-control study were investigated in this study. Body weight, height, waist circumferences and blood pressure were measured. Fasting blood samples were drawn and an oral glucose tolerance test (OGTT) was performed. The CAG and GGN polymorphisms in the AR gene were determined by direct sequencing of leucocyte DNA. Men with MS had lower CAG repeat number than healthy men (p = 0.007). There were, however, no difference in CAG or GGN repeats length between the groups with subnormal or normal testosterone concentrations. In cross-sectional analyses, men with CAG repeat lengths

Topics: Aged; Aged, 80 and over; Androgens; C-Peptide; Case-Control Studies; Cross-Sectional Studies; Genes; Humans; Male; Metabolic Syndrome; Middle Aged; Polymorphism, Genetic; Receptors, Androgen; Risk; Testosterone

The metabolic syndrome (MS) has become an epidemiological problem in Western countries. We developed a diet-induced obese rat model that mimics all the symptoms of MS in humans, but whose insulin resistance, hyperphagia and hyperleptinemia are caused by nutrition rather than genetic modifications.. Spontaneously hypertensive rats (SHR) were allowed for 12 weeks to choose between a cafeteria diet (CD, 20.3 kJ/g) and standard rat chow (11.7 kJ/g). Controls received rat chow.. Body weight (BW) exceeded control levels when SHR were fed with CD. The increase in BW was attributed to enhanced energy intake. The abundance of abdominal fat as well as the plasma levels of leptin and triglycerides increased concomitant with glucose, insulin and C-peptide. This prediabetic condition was further confirmed by a markedly increased insulin response following glucose challenge and by impaired glucose utilization after insulin tolerance tests.. Increases in food intake and BW despite hyperleptinemia indicate leptin resistance following CD feeding. CD-fed SHR feature leptin and insulin resistance, hypertension and obesity, thus mimicking the situation of MS patients. As such, our model is more suitable than the genetically modified rat models used to study human MS.

Topics: Abdominal Fat; Animals; Biomarkers; Blood Glucose; Blood Pressure; Body Weight; C-Peptide; Diet; Disease Models, Animal; Energy Intake; Heart Rate; Hyperphagia; Insulin; Insulin Resistance; Leptin; Male; Metabolic Syndrome; Obesity; Rats; Rats, Inbred SHR; Rats, Sprague-Dawley; Triglycerides

Subjects with the diagnosis of latent autoimmune diabetes in adults (LADA) are more prone to need insulin treatment than those with type 2 diabetes. However, not all patients with LADA develop the need for insulin treatment, indicating the heterogeneity of LADA. We investigated this heterogeneity by comparing phenotypes of LADA with and without perceived need for insulin treatment (data obtained at times when diagnosis of LADA was not investigated) and also compared LADA and type 2 diabetes phenotypes.. We used data from the all population-based Nord-Trøndelag Health study (n = 64,931), performed in 1995-1997. Data were assembled for individuals with LADA (n = 106) and type 2 diabetes (n = 943).. In the comparison of individuals with LADA both with and without the need for insulin, insulin-treated subjects had higher titers of GAD antibodies (P < 0.001) and lower fasting C-peptide levels (P < 0.001). GAD antibodies and C-peptide correlated negatively (r = -0.40; P = 0.009). In the comparison of individuals with LADA and type 2 diabetes, all without the need for insulin, markers of metabolic syndrome were equally prevalent and pronounced. Age, C-peptide, and glucose levels were also similar. In the comparison of insulin-treated individuals with LADA and type 2 diabetes, more patients with LADA received insulin (40 vs. 22%, P < 0.001) and C-peptide levels were lower (P < 0.001). Patients with LADA were leaner but were still overweight (mean BMI 28.7 vs. 30.9 kg/m2 in type 2 diabetes, P < 0.001). In the comparison of type 2 diabetic patients with and without insulin, insulin-treated subjects were more obese and had higher A1C and lower C-peptide levels (P < 0.001).. Our conclusions are that 1) the need for insulin treatment in LADA is linked to the degree of autoimmunity and beta-cell failure, 2) subjects with LADA and type 2 diabetes without the need for insulin treatment are phenotypically similar, and 3) insulin treatment in type 2 diabetic patients is associated with both insulin resistance and beta-cell insufficiency.

Topics: Adult; Aged; Autoantibodies; Autoimmunity; Blood Glucose; C-Peptide; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Glutamate Decarboxylase; Humans; Hypoglycemic Agents; Insulin; Metabolic Syndrome; Middle Aged; Norway; Perception; Phenotype; Surveys and Questionnaires; Young Adult

We aimed to establish the prevalence and characteristics of latent autoimmune diabetes in adults (LADA) and compare it with type 2 diabetes in 1370 Korean patients. The prevalence of LADA was 5.1%. Low C-peptide level and absence of metabolic syndrome were variables independently associated with the diagnosis of LADA.

Topics: Adult; Age of Onset; Aged; C-Peptide; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Humans; Insulin Resistance; Korea; Male; Metabolic Syndrome; Middle Aged; Prevalence

We investigated the relation between C-peptide levels and the prevalence of diabetic complications in patients with type 2 diabetes and the metabolic syndrome.. This study includes all patients with diabetes and treated only with oral hypoglycemic agents who were admitted to our department in 2006. The chronic complications of diabetes (vascular disease, retinopathy, nephropathy, neuropathy) were evaluated.. The 77 patients with type 2 diabetes and treated only with oral hypoglycemic agents were divided in two groups, with and without the metabolic syndrome. The two groups did not differ in glycemic control, blood pressure levels, or duration of diabetes. CRP levels were higher in patients with the metabolic syndrome (p=0.03), and nephropathy was more common (70%, compared with 33%). Similar, C-peptide levels were higher in patients with the metabolic syndrome: 3.12+/-1.36 compared with 1.82+/-1.25 (p<0.001). In patients with the metabolic syndrome, C-peptide levels did not differ in patients with or without diabetic complications (3.01+/-1.16, compared with 3.96+/-2.55; p=0.51). Similarly, C-peptide levels in patients without the metabolic syndrome did not differ according to the presence of complications of diabetes (2.25+/-1.21 versus 1.36+/-1.16; p=0.07). However, C-peptide levels were higher in patients with diabetes and the metabolic syndrome who had either nephropathy or vascular disease, compared with those with those complications but without the metabolic syndrome (p=0.01). CRP levels did not correlate with C-peptide levels in any patient group.. Higher C-peptide levels were associated with metabolic syndrome in patients with type 2 diabetes and in diabetes patients who also had nephropathy and vascular disease.

Topics: Aged; Biomarkers; Blood Glucose; C-Peptide; C-Reactive Protein; Confidence Intervals; Diabetes Complications; Diabetes Mellitus, Type 2; Diabetic Angiopathies; Diabetic Nephropathies; Diabetic Neuropathies; Diabetic Retinopathy; Female; Humans; Hypoglycemic Agents; Male; Metabolic Syndrome; Middle Aged; Prevalence

Prolactin (PRL) has been proposed to play an important role in the pathophysiology of obesity. To further elucidate the relationship between PRL and obesity-related metabolic disturbances, we performed a large cross-sectional study and also reassessed serum PRL levels in a subsample approximately 1 year after gastric bypass surgery.. In the cross-sectional part of the study, we assessed basal serum PRL levels in 344 obese subjects (68% women; BMI mean+/-SD, 44.3+/-6.6 kg/m2; range 27.0-67.0 kg/m2) along with measurements of glucose, insulin, C-peptide, triglycerides, total cholesterol, LDL-cholesterol, HDL-cholesterol, high sensitive (hs) C-reactive protein, and fat mass assessed by bioelectrical impedance analysis. In 38 patients, we reassessed PRL levels approximately 1 year after they have undergone a gastric bypass operation.. Women displayed higher basal PRL levels than men (9.0+/-4.8 vs. 7.9+/-3.6 microg/l, P=0.03). Basal PRL levels were neither significantly correlated with the BMI of the subjects (r=-0.05, P=0.77) nor with any other of the assessed variables (all r<0.16, P>0.06) even after adjusting for the influence of sex. After massive surgically induced weight loss that on average almost approached 50 kg, basal serum PRL levels remained completely unchanged (before vs. after, 9.1+/-6.0 vs. 9.2+/-4.6 microg/l, P=0.86). However, preoperative PRL levels significantly correlated with that assessed after the operation (r=0.47; P=0.005).. In contrast to our expectation, we could detect neither any significant association between basal PRL levels and the degree of obesity or related metabolic disturbances nor any systematic changes in basal concentrations of the hormone after massive weight loss. In sum, our data do not support the notion of a major role of PRL in the pathophysiology of obesity.

Topics: Adiposity; Adolescent; Adult; Aged; Blood Glucose; Body Mass Index; C-Peptide; C-Reactive Protein; Cholesterol; Cross-Sectional Studies; Female; Follow-Up Studies; Gastric Bypass; Humans; Insulin; Male; Metabolic Syndrome; Middle Aged; Obesity, Morbid; Prolactin; Treatment Outcome; Triglycerides; Weight Loss; Young Adult

So far, high prevalence of metabolic symptoms accompanying diffuse idiopathic skeletal hyperostosis (DISH) appears not definitely elucidated because of their possible origin from other disorders such as diabetes and/or body mass differences. From such reasons this study was aimed to compare non-diabetic DISH patients to a group of age and BMI matched controls in order to distinguish the influence of DISH proper on metabolic parameters free of additional metabolic effects caused by diabetes and/or body weight differences.. Both groups of patients were subjected to oral glucose tolerance test (OGTT) and fasting serum levels of glucose, insulin, C-peptide, growth hormone, insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGF-BP3) were assayed. Fasting serum total cholesterol, HDL cholesterol, triglycerides, non-esterified fatty acids (NEFA) and uric acid were determined as well. The indices of insulin sensitivity and insulin secretion were calculated.. With the exception of decreased NEFA serum level and decreased insulinogenic index and insulin/C-peptide ratio in DISH patients any other significant differences in serum parameters and indices of insulin sensitivity were not found.. The data obtained suggest impaired beta-cell pancreatic stimulation and increased insulin hepatic extraction in DISH. It is assumed that the above mentioned conditions, if persisting for a long time, might lead to decreased ability of insulin to maintain normal serum glucose level and consequently to insulin resistance which is highly prevalent in symptomatic DISH patients.

Topics: Blood Glucose; C-Peptide; Fatty Acids, Nonesterified; Female; Glucose Tolerance Test; Human Growth Hormone; Humans; Hyperostosis, Diffuse Idiopathic Skeletal; Insulin; Insulin Resistance; Insulin Secretion; Insulin-Like Growth Factor Binding Protein 3; Insulin-Like Growth Factor I; Insulin-Secreting Cells; Lipids; Male; Metabolic Syndrome; Middle Aged

To investigate the relationships between fitness and components of the metabolic syndrome in sedentary men.. 39 subjects (34-53 years) were evaluated for fitness (VO(2max)) and anthropometric, metabolic, and skeletal muscle phenotypes. VO(2max) was assessed on a bicycle ergometer whereas other variables were obtained from an oral glucose tolerance test (OGTT), hydrostatic weighing, and a muscle biopsy.. Pearson and partial correlations adjusted for fat mass (FM), waist circumference (WC), muscle enzyme activities (citrate synthase (CS), cytochrome c oxidase (COX)), and capillary density were used to investigate the independent relationships be tween variables. Negative correlations between VO(2max) and WC as well as blood pressure and OGTT test were observed. When adjusted for FM, correlations remained between VO(2max) and WC (r = -0.46, p < 0.01) and systolic blood pressure (r = -0.35, p < 0.05). When adjusted for WC and CS activity, all correlations were lost except for high-sensitivity C-reactive protein (hs-CRP) (r = -0.34, p < 0.05) which remained when adjusted for CS activity. Adjustment for COX activity failed to remove correlations with hs-CRP (r = -0.36, p < 0.05), age (r = 0.34, p < 0.05), WC (r = -0.35, p < 0.05), and blood pressure. Negative correlations persisted when fitness was adjusted for the mean number of capillaries.. The effects of fitness on components of the metabolic syndrome in sedentary men are explained by abdominal obesity and muscle phenotypes.

Topics: Adult; Biopsy; Blood Glucose; Blood Pressure; C-Peptide; Capillaries; Cross-Sectional Studies; Humans; Insulin; Life Style; Lipids; Male; Metabolic Syndrome; Middle Aged; Motor Activity; Muscle, Skeletal; Obesity, Abdominal; Oxygen Consumption; Physical Fitness; Waist Circumference

To determine the serum levels of adiponectin and plasminogen activator inhibitor-1 in metabolic syndrome versus healthy controls and to see the relation of them with each other and with the metabolic syndrome components.. Adiponectin and plasminogen activator inhibitor-1 levels were measured in 53 subjects with metabolic syndrome and 30 healthy controls by ELISA. All subjects of metabolic syndrome had the criterias of metabolic syndrome (obesity, insulin resistance, hypertension, dyslipidemia, glucose metabolism disorders). Adiponectin and plasminogen activator inhibitor-1 levels in serum were compared between the groups and relations of them with each other, with metabolic syndrome components, also HbA1c and C peptide were examined. For statistical analysis student-t test and pearson's correlations were used.. Metabolic syndrome group had significantly lower adiponectin and higher plasminogen activator inhibitor-1 levels than healthy controls (p<0.001). There was no difference between the average age of both groups. There was an inverse relationship between plasma adiponectin and plasminogen activator inhibitor-1 ( r= -0.653, p<0.001). Also adiponectin levels were inversely correlated with body mass index (BMI), waist and hip circumferences, systolic and diastolic pressures, fasting plasma glucose, 2 hour postprandial serum glucose, HbA1c, C peptide, triglycerides, total cholesterol, insulin and insulin resistance (HOMA). Plasminogen activator inhibitor-1 levels were correlated positively with these parameters.. Hypoadiponectinemia and elevated plasminogen activator inhibitor-1 levels were closely associated with the metabolic syndrome and its components, inverse relationship was present between adiponectin and plasminogen activator inhibitor-1 levels in metabolic syndrome patients. It is suggested that measuring and regulating the plasma concentration of adiponectin and plasminogen activator inhibitor-1 may be useful for management of the metabolic syndrome so this may prevent the development of obesity, cardiovascular diseases and diabetes.

Topics: Adiponectin; Adult; C-Peptide; Case-Control Studies; Glycated Hemoglobin; Humans; Metabolic Syndrome; Middle Aged; Plasminogen Activator Inhibitor 1; Prospective Studies

During the last 10 years we have experienced an increasing number of referrals due to hyperferritinemia. This is probably due to increased awareness of hereditary hemochromatosis, and the availability of a genetic test for this condition. Most of these referred patients were over-weight middle-aged men with elevated ferritin levels, but without the hemochromatosis-predisposing gene mutations. We evaluated the relationship between hyperferritinemia and the metabolic syndrome in 40 patients.. Forty consecutive patients referred for hyperferritinemia were investigated. The examination programme included medical history, clinical investigation and venous blood samples drawn after an overnight fast. This resulted in 34 patients with unexplained hyperferritinemia, which were further examined. Liver biopsy was successfully performed in 29 subjects. Liver iron stores were assessed morphologically, and by quantitative phlebotomy in 16 patients.. The majority of the patients had markers of the metabolic syndrome, and 18 patients (52%) fulfilled the IDF-criteria for the metabolic syndrome. Mean body mass index was elevated (28.8+/-4.2), mean diastolic blood pressure was 88.5+/-10.5 mmHg, and mean fasting insulin C-peptide 1498+/-539 pmol/l. Liver histology showed steatosis and nuclear glycogen inclusions in most patients (19 out of 29). Only four patients had increased iron stores by histology, of which two could be explained by alcohol consumption. Fourteen of 16 patients normalized ferritin levels after phlebotomy of a cumulative blood amount corresponding to normal iron stores. Ferritin levels were significantly related to insulin C-peptide level (p<0.002) and age (p<0.002).. The present results suggest that liver steatosis and insulin resistance but not increased iron load is frequently seen in patients referred for suspected hemochromatosis on the basis of hyperferritinemia. The ferritin level seems to be positively associated to insulin resistance.

Topics: Adult; Aged; Alanine Transaminase; Blood Sedimentation; C-Peptide; C-Reactive Protein; Fatty Liver; Female; Ferritins; Humans; Insulin Resistance; Iron Metabolism Disorders; Iron Overload; Lipids; Male; Metabolic Syndrome; Middle Aged; Thyrotropin

To examine the relation of well-known factors of the metabolic syndrome (MetS) as well as related circulating factors, with risk of colorectal cancer.. We performed a case control study of 306 colorectal cancer cases and 595 matched controls nested in the Northern Sweden Health and Disease Cohort. Levels of C-peptide, glycated haemoglobin (HbA1c), leptin and adiponectin were measured in cryopreserved samples. Body mass index (BMI), systolic and diastolic blood pressure and fasting and post-load plasma glucose, had been measured in a subcohort. Conditional logistic regression was used to calculate odds ratios (OR) of disease, including risk assessments for the MetS factors: obesity (BMI>30 kg m(-2)), hypertension (blood pressure > or =140/90 mmHg or use of anti-hypertensive drugs) and hyperglycaemia (fasting glucose > or =6.1 mmol l(-1) or post-load glucose in capillary plasma > or =8.9 mmol l(-1)).. None of the studied variables were significantly associated with risk across quartiles. Presence of obesity, hypertension and hyperglycaemia significantly increased the risk of colorectal cancer; OR for three vs null factors was 2.57 (95% Confidence Interval [CI] 1.20-5.52; P (trend)=0.0021), as compared to a 30 to 70% increased risk for the factors in single. Similarly, top decile levels of C-peptide, HbA1c and leptin/adiponectin ratio were associated with an increased risk; ORs for top vs deciles 1-9 were 1.56 (95% CI 0.93-2.62; P=0.090), 1.83 (95% CI 1.00-3.36; P=0.051) and 1.50 (95% CI 0.83-2.71; P=0.18), respectively.. Our study support the view that components of the MetS increase risk of colorectal cancer, and further suggests that only very high levels of metabolic factors confer an increased risk.

Topics: Adiponectin; Adult; Aged; Aged, 80 and over; Blood Glucose; C-Peptide; Colorectal Neoplasms; Epidemiologic Methods; Female; Glycated Hemoglobin; Humans; Hyperglycemia; Hypertension; Leptin; Male; Metabolic Syndrome; Middle Aged; Obesity; Sweden

Prevalence of metabolic syndrome (MetS) in type 2 diabetes and its association with vascular complications were studied in 637 Japanese type 2 diabetic patients. MetS was diagnosed using criteria proposed by the Japanese study group for the definition of MetS in 2005. The prevalence of MetS in patients studied was higher in males (45.9%) than females (28.0%). The prevalence of MetS was 53.0% in males and 35.4% in females in patients with duration of less than 10 years, and decreased with an increase in duration. Upon comparing patients groups complicated with and without MetS, we determined the MetS group had significantly higher levels of fasting serum C-peptide and high-sensitivity C-reactive protein, and a significantly lower level of serum adiponectin. However, the prevalence of coronary heart disease, brain infarction, or peripheral arterial disease was not significantly different between these groups. On the other hand, the prevalence of microangiopathy in the group with MetS was significantly higher than in that without MetS, and became significantly higher along with an increase in duration. This study clarifies the prevalence of MetS in Japanese type 2 diabetic patients, and suggests that MetS is associated with microangiopathy rather than macroangiopathy in Japanese type 2 diabetic patients.

Topics: Age of Onset; Aged; Body Mass Index; C-Peptide; Chronic Disease; Diabetes Mellitus, Type 2; Female; Humans; Japan; Male; Metabolic Syndrome; Middle Aged; Prevalence; Vascular Diseases

Prior studies report slightly lower prostate-specific antigen (PSA) levels among obese men. To understand this effect, we investigated the association between PSA and blood HbA1c, C-peptide, leptin and adiponectin levels in African-American (AA) (n=121) and Caucasian (CA) (n=121) men. Among AA men, PSA levels decreased with increasing C-peptide levels (PSA=0.99, 0.93, 0.75 and 0.53 ng ml(-1) across quartiles of C-peptide, respectively; P(trend)=0.005). Among CA men, PSA levels decreased with increasing HbA1c (PSA=0.84, 0.73, 0.77 and 0.45 ng ml(-1) across quartiles of HbA1c, respectively; P(trend)=0.005). This may suggest that metabolic disturbances related to metabolic syndrome or diabetes affect the ability to detect early-stage prostate cancer.

Topics: Adiponectin; Adult; Aged; Black or African American; Body Mass Index; C-Peptide; Cohort Studies; Diabetes Complications; Early Diagnosis; Glycated Hemoglobin; Humans; Leptin; Male; Metabolic Syndrome; Middle Aged; Prostate-Specific Antigen; Prostatic Neoplasms; White People

Metabolic syndrome (MetS) is known to increase the risk of cardiovascular disease. C-reactive protein (CRP) has been reported to be elevated in subjects with MetS. However, which component of MetS contributes mostly to the elevation has not been studied in detail.. We studied 628 apparently healthy Japanese subjects (men 262, women 366, age 19-85 years). Body mass index, waist circumference (WC), blood pressure, lipids, glucose, insulin and CRP were measured. MetS was defined according to the National Cholesterol Education Program's Adult Treatment Panel III report.. In partial correlation analysis, WC showed the strongest correlation with CRP among the variables related to MetS. CRP increased as the number of MetS components increased. The mean CRP value adjusted for demographic variables was higher in subjects with MetS than those without MetS, and further adjustments with variables related to MetS revealed that the significant difference between the two groups disappeared only when further adjustment was made for WC. In multiple linear regression analysis, the independent variable that most strongly explained the CRP level was WC, which was followed by HDL-cholesterol. Finally, comparison of the CRP levels in groups stratified by abdominal obesity and the number of MetS components revealed that those with abdominal obesity tended to show higher CRP levels compared with those without abdominal obesity regardless of the number of MetS components other than WC.. Subjects with MetS showed higher levels of CRP and the main determinant of the CRP elevation was WC.

Topics: Adult; Aged; Aged, 80 and over; Blood Glucose; Blood Pressure; Body Mass Index; C-Peptide; Exercise; Female; Humans; Hyperglycemia; Hypertension; Insulin; Lipids; Male; Metabolic Syndrome; Middle Aged; Obesity; Patient Selection; Waist-Hip Ratio

The aim of this study was to establish the reference values of the Homeostasis Model Assessment (HOMA) and Quantitative Insulin Sensitivity Check (QUICKI) indexes, as well as those of insulin and C-peptide levels in healthy children and adolescents with a view to determining reference percentiles to detect those at cardiovascular risk.. A total of 372 children boys and girls of different ages and at distinct pubertal stages with normal body mass index participated in the study. Fasting glucose, insulin and C-peptide values were measured by chemiluminescence and the HOMA and QUICKI indexes were calculated.. Fasting glucose levels were normal in all children. The mean values obtained for each variable were (mean (SD)): fasting glucose 87(7.75) mg/dL, insulin 7.74 (5.35) microU/mL, C-peptide: 1.76 (0.79) ng/mL, HOMA index 1.72 (1.27) and QUICKI index 0.72 (0.29). All the variables progressively increased with age, with statistically significant differences between prepubertal and pubertal children. The QUICKI index showed an inverse relationship. In addition, significant differences were found between sexes. The 90th percentile for all the variables was as follows: insulin 15.05 microU/mL, C-peptide: 2.85 ng/mL, HOMA index 3.43 and QUICKI index 1.10.. Values of fasting glucose, insulin, C-peptide and the HOMA index significantly increased with age and pubertal stage, while the QUICKI index decreased. We defined the 90th percentile for all the parameters studied as the cut-off point to identify children at cardiovascular risk in our population.

Topics: Adolescent; C-Peptide; Cardiovascular Diseases; Child; Child, Preschool; Female; Homeostasis; Humans; Infant; Insulin; Male; Metabolic Syndrome; Reference Values; Risk Factors

The liver, once fatty, overproduces components of the metabolic syndrome, such as glucose and lipids. The amount of liver fat in subjects with and without the metabolic syndrome has not been determined. It is unknown which clinically available markers best reflect liver fat content.. Components of the metabolic syndrome as defined by the International Diabetes Federation and liver fat content by proton magnetic resonance spectroscopy were measured in 271 nondiabetic subjects (162 women, 109 men). In addition, other features of insulin resistance (serum insulin, C-peptide), intraabdominal and sc fat by magnetic resonance imaging, and liver enzymes (serum alanine aminotransferase and serum aspartate aminotransferase) were measured.. Liver fat was 4-fold higher in subjects with [n = 116; median 8.2% (interquartile range 3.2-18.7%)] than without [n = 155; 2.0% (1.0-5.0%); P < 0.0001] the metabolic syndrome. This increase in liver fat remained significant after adjusting for age, gender, and body mass index. All components of the metabolic syndrome correlated with liver fat content. The best correlate was waist in both women (r = 0.59, P < 0.0001) and men (r = 0.56, P < 0.0001). Liver fat correlated significantly with serum alanine aminotransferase (r = 0.39, P < 0.0001 for women; r = 0.44, P < 0.0001 for men) and aspartate aminotransferase (r = 0.27, P = 0.0005 for women; r = 0.31, P = 0.0012 for men) concentrations. The best correlates of liver fat were fasting serum insulin (r = 0.61; P < 0.0001 for both women and men) and C-peptide (r = 0.62; P < 0.0001 for both women and men).. Liver fat content is significantly increased in subjects with the metabolic syndrome as compared with those without the syndrome, independently of age, gender, and body mass index. Of other markers, serum C-peptide is the strongest correlate of liver fat.

Topics: Abdominal Fat; Adult; Aged; Body Composition; C-Peptide; Female; Humans; Lipids; Liver; Male; Metabolic Syndrome; Middle Aged; Radiography; Sex Characteristics

This study was conducted to explore the association between nonalcoholic fatty liver disease and glucose metabolism as well as insulin resistance using the homeostasis model assessment method (HOMA).. From July 2003 to June 2004, 23 patients with ultrasound-proved fatty liver and either normal (10 patients) or abnormal (13 patients) serum aminotransferase levels were enrolled. Blood tests included a routine biochemistry, a 75-g glucose oral glucose tolerance test (OGTT) with blood sampled at 30-minute intervals during a 120-minute period. Fasting and 120-minute serum leptin, insulin, and C-peptide concentrations were also measured.. Using the Mann-Whitney U test, significant differences were found in gamma glutamyl transpeptidase (28.6+/-7.9 vs. 65.1+/-65.9 U/L, P=0.008), fasting insulin (FI) (13.11+/-7.53 vs. 31.76+/-42.95 muU/mL, P=0.02), fasting C-peptide (3.82+/-3.00 vs. 2.17+/-0.43 ng/mL, P=0.01), fasting leptin (10.34+/-4.05 vs. 24.27+/-24.97 ng/mL, P=0.01), HOMA-IR (3.34+/-1.06 vs. 8.81+/-13.18, P=0.02), and HOMA beta-cell function (120.32+/-52.50 vs. 242.20+/-247.29, P=0.02) between normal and abnormal ALT/AST function groups. From the 75-g OGTT, no significant difference of plasma glucose was noted at 0, 30, 60, and 90 minutes but significant change was noted in 120-minute plasma glucose (99.3+/-21.5 vs. 131.4+/-27.3 mg/dL, P=0.004) of 2 groups.. In conclusion, patients with fatty liver proved by ultrasound sonography might be at high risk of developing type 2 diabetes, especially when they had elevated liver enzymes. OGTT is warranted for the early diagnosis of these high risk patients.

Topics: Adult; Alanine Transaminase; Aspartate Aminotransferases; Biomarkers; C-Peptide; Fatty Liver; Female; Food Deprivation; Glucose Tolerance Test; Homeostasis; Humans; Hyperglycemia; Insulin; Leptin; Liver Function Tests; Male; Metabolic Syndrome; Postprandial Period; Ultrasonography

IGFs and their binding proteins are increasingly recognised as important in understanding the pathogenesis of cardiovascular disease. Low IGFBP-1, particularly coupled with low IGF-I, is associated with increased cardiovascular risk. In relation to structural and regulatory parallels between IGFBP-1 and - 2 we have now examined the hypothesis that IGFBP-2 may be a marker for cardiovascular risk.. Fasting IGFBP-2, IGFBP-1, IGFBP-3, IGF-I, IGF-II, insulin, C-peptide, glucose, lipids, NEFAs, and HbA1c were measured in a cohort of 163 patients with type 2 diabetes. Individuals were categorised according to the presence or absence of the metabolic syndrome.. Patients with the metabolic syndrome had a lower IGFBP-2 concentration. Low circulating IGFBP-2 was associated with elevated fasting glucose (rho = - 0.23, p = 0.003). IGFBP-2 correlated negatively with triglycerides (rho = - 0.19, p = 0.01) and LDL-cholesterol (rho = - 0.20, p = 0.01), and positively with insulin sensitivity (HOMA-S) (rho = 0.26, p = 0.02). Multivariate logistic regression demonstrated that low IGFBP-2 was independently associated with an increased risk of the metabolic syndrome (OR 0.31 [95 % CI 0.11 - 0.90]; p = 0.03). IGFBP-3 did not differ according to the presence or absence of metabolic syndrome.. Low IGFBP-2 is associated with multiple cardiovascular risk factors similarly to IGFBP-1. Such associations were not apparent for IGFBP-3. Lack of marked prandial regulation of IGFBP-2, in contradistinction to IGFBP-1, may make IGFBP-2 a more robust biomarker for identification of insulin-resistant individuals at high cardiovascular risk in epidemiological studies.

Topics: Biomarkers; Blood Glucose; Blood Pressure; C-Peptide; C-Reactive Protein; Diabetes Mellitus, Type 2; Diet, Diabetic; Humans; Hypoglycemic Agents; Insulin; Insulin-Like Growth Factor Binding Protein 1; Insulin-Like Growth Factor Binding Protein 2; Insulin-Like Growth Factor Binding Protein 3; Lipids; Metabolic Syndrome; Middle Aged

Metabolic syndrome (MetS) defines cardiovascular disease (CVD) risks. Despite higher rates of obesity, type 2 diabetes, and hypertension, African Americans have lower rates of MetS when compared to Caucasians, which is paradoxical, since African Americans are more insulin resistant and have higher rates of cardiovascular morbidity and mortality when compared to White Americans. We hypothesized that genetic inheritance predisposes African Americans to the greater cardiovascular risk and the associated morbidity and mortality. Therefore, we investigated the prevalence of components of MetS in obese, glucose-tolerant, first degree relatives of African American patients with type 2 diabetes.. We examined the clinical and metabolic characteristics of 201 first-degree relatives (159 females and 42 males, mean age 41 +/- 8 years, and mean body mass index (BMI) of 32 +/- 8 (kg/m2). The subjects were categorized with MetS according to the Adult Treatment Panel (ATP) III criteria. Insulin sensitivity (Bergman minimal model method) and insulin resistance (homeostasis model assessment [HOMA]) were determined. We compared the clinical and metabolic characteristics in the relatives with and without MetS. Where appropriate, we compared the prevalence of the components of MetS in our African American sample with those of African American data in the National Health and Nutrition Evaluation Survey (NHANES) III.. Comparing the MetS group (n=65) vs control subjects (n=136), the mean age, BMI, and percent body fat were greater in the MetS group. Mean fasting serum glucose, insulin and C-peptide levels were also greater in the MetS group. Insulin resistance index (HOMA-IR) was higher in the MetS group (HOMA-IR: 3.7 +/- 2.7 vs 2.2 +/- 1.7, P=.0002). Mean insulin sensitivity tended to be lower in the MetS group (2.16 +/- 2.64 vs 2.82 +/- 2.31, P=.08). In addition, despite the moderately severe insulin resistance, the MetS group had very low serum triglyceride levels and was the parameter least likely to meet the ATP criteria. The metabolic cutoff points for ATP III criteria were much lower in African American first-degree relatives with MetS. Of the five components of the ATP III criteria, waist circumference was the single most common parameter to likely meet the MetS criteria. We found that the prevalence of MetS was 29% in women and 40% in men when compared with 20.9% in African American women and 13.9% for African American men in the NHANES III.. We found that: 1) the prevalence of MetS is higher in a subgroup of African Americans who were first-degree relatives of patients with type 2 diabetes than that of African Americans in the NHANES III; and 2) waist circumference rather than metabolic parameters was the single most important parameter and was more likely to meet the MetS criteria in African American relatives.

Topics: Adult; Biomarkers; Black or African American; Blood Glucose; Blood Pressure; Body Mass Index; C-Peptide; Case-Control Studies; Cholesterol, HDL; Cholesterol, LDL; Diabetes Mellitus, Type 2; Family; Female; Genetic Predisposition to Disease; Glucose Tolerance Test; Humans; Insulin; Insulin Resistance; Male; Metabolic Syndrome; Middle Aged; Nutrition Surveys; Obesity; Ohio; Pedigree; Prevalence; Research Design; Severity of Illness Index; Sex Factors; Triglycerides; Waist-Hip Ratio

The levels of the liporegulatory hormone leptin are increased in obesity, which contributes to the metabolic syndrome; the latter is associated with elevated cardiovascular risk and morbidity. Leptin may play a role in the metabolic syndrome since correlations have been observed between serum leptin levels and several components of the metabolic syndrome. The association of leptinemia and hypertension or diabetes is inconsistent. Leptin levels are higher in females versus males and obese versus lean individuals. We investigated if correlations exist between leptin levels and several indices of the metabolic syndrome in obese and lean Moroccan subjects with (63 males, 129 females) and without (123 males, 234 females) diabetes and/or hypertension. Plasma glucose and insulin and systolic and diastolic blood pressures were higher in obese versus lean individuals. Obesity had no effect on lipid profile, plasma IGF-1, or C-peptide levels. Leptin levels were higher in females versus males and in obese versus lean individuals. The levels correlated significantly with body mass index. Serum leptin concentration did not correlate with either systolic or diastolic blood pressure, although there was a trend for higher blood pressure with increased leptin levels in females. There was no significant difference in leptin levels between NIDDM patients and healthy controls. However, in hypertensive patients, leptin levels were significantly higher in both lean males and females with diabetes as compared to those without diabetes. Similarly, the higher leptin levels paralleled elevated insulin levels in obese nondiabetic males and females, and in male and female diabetics with hypertension. Correlations were observed between leptin levels and C-peptide (an estimate of endogenous insulin secretion), but not with serum IGF-1. The calculated values of HOMA-IR, a marker of insulin resistance, were somewhat higher, parallel with elevated leptin levels, in obese male and female individuals compared to their lean counterparts. There was no relationship between leptin levels and serum lipids. There was a trend for increased serum uric acid levels with higher leptin concentrations. Thus, leptinemia is related to some components of metabolic syndrome, and in turn, it may contribute to the syndrome. This study is novel in that relationships were determined between leptin levels and various indices of metaboli syndrome in a large population of the same ethnic/regional background.

Topics: Aged; Blood Glucose; Blood Pressure; Body Mass Index; C-Peptide; Diabetes Mellitus, Type 2; Female; Humans; Hypertension; Insulin; Insulin Resistance; Insulin-Like Growth Factor I; Leptin; Lipids; Male; Metabolic Syndrome; Middle Aged; Morocco; Obesity; Sex Characteristics; Uric Acid

Increased levels of C-peptide, a cleavage product of proinsulin, circulate in patients with insulin resistance and early type 2 diabetes, a high-risk population for the development of a diffuse and extensive pattern of arteriosclerosis. This study tested the hypothesis that C-peptide might participate in atherogenesis in these patients.. We demonstrate significantly higher intimal C-peptide deposition in thoracic aorta specimens from young diabetic subjects compared with matched nondiabetic controls as determined by immunohistochemical staining. C-peptide colocalized with monocytes/macrophages in the arterial intima of artery specimen from diabetic subjects. In vitro, C-peptide stimulated monocyte chemotaxis in a concentration-dependent manner with a maximal 2.3+/-0.4-fold increase at 1 nmol/L C-peptide. Pertussis toxin, wortmannin, and LY294002 inhibited C-peptide-induced monocyte chemotaxis, suggesting the involvement of pertussis toxin-sensitive G-proteins as well as a phosphoinositide 3-kinase (PI3K)-dependent mechanism. In addition, C-peptide treatment activated PI3K in human monocytes, as demonstrated by PI3K activity assays.. C-peptide accumulated in the vessel wall in early atherogenesis in diabetic subjects and may promote monocyte migration into developing lesions. These data support the hypothesis that C-peptide may play an active role in atherogenesis in diabetic patients and suggest a new mechanism for accelerated arterial disease in diabetes.

Topics: Adolescent; Adult; Androstadienes; Aorta, Thoracic; Aortic Diseases; Arteriosclerosis; C-Peptide; Cells, Cultured; Chemotaxis; Chromones; Diabetes Mellitus, Type 2; Disease Progression; Enzyme Inhibitors; Female; GTP-Binding Proteins; Humans; Hyperinsulinism; Insulin Resistance; Macrophages; Male; Metabolic Syndrome; Models, Biological; Monocytes; Morpholines; Pertussis Toxin; Phosphatidylinositol 3-Kinases; Wortmannin

To compare brain perfusion in hypertensive patients with diabetes mellitus type 2 (DM2) or metabolic (MS) syndrome and hypertensive patients without clinicobiochemical signs of DM2 or MS; to study enoxaparin effects on brain perfusion in DM2 and arterial hypertension (AH).. Seventy patients included in the study were divided into three groups: 30 patients with DM2 and AH (group 1), 30 patients with MS and AH (group 2) and 10 AH patients without manifestations of MS or DM2 (group 3). All the patients have undergone single-photon emission computed tomography (SPECT) of the brain, carbohydrate and lipid metabolism were examined.. Deterioration of brain perfusion was more prominent in DM2 and MS patients with AH than in hypertensive patients with normal metabolism. Stress test with acetasolamide revealed defective autoregulation of cerebral blood flow in hypertensive patients with DM2. A 6-week therapy with enoxaparin significantly improved brain perfusion in hypertensive patients with DM2.. Enoxaparin treatment of hypertensive DM2 and MS patients with abnormal perfusion of the brain can be used for prevention of cerebrovascular complications.

Topics: Adult; Anticoagulants; Blood Glucose; Blood Pressure; Body Mass Index; Brain; C-Peptide; Cardiovascular Diseases; Cerebrovascular Circulation; Diabetes Mellitus, Type 2; Enoxaparin; Female; Glucose Tolerance Test; Humans; Hypertension; Insulin Resistance; Lipids; Male; Metabolic Syndrome; Postprandial Period; Radionuclide Imaging; Risk

The aim of the present study was to investigate the association between the serum lipid profile and components of the metabolic syndrome, such as central obesity (anthropometric, computed tomography and fat cell data), insulin, sex-hormone-binding-globulin (SHBG) and different hormones influencing this important syndrome, e.g. sex steroids, leptin and tumor necrosis factor-alpha (TNF-alpha). The sample consisted of 85 obese patients (30 men and 55 women) who had undergone abdominal surgery. Fasting serum lipids were analysed, as well as anthropometric and computed tomography data, perivisceral and subcutaneous fat cell size and serum glucose and hormones. Abdominal fat revealed itself as an important correlator of the adverse changes in plasma lipoprotein levels, the waist-to-hip-ratio and waist-to-thigh-ratio being the best morphological correlators in men and women, respectively. Intra-abdominal fat (VA) correlated significantly and positively to perivisceral fat cell size in women, while no correlation was found between subcutaneous fat accumulation (SA) and adipocyte size in both genders. Perivisceral fat cell size showed the greatest number of correlations with the adverse plasma lipid profile compared to that in the subcutaneous depot. SHBG and sex steroids showed a negative correlation with serum lipids considered a cardiovascular risk. In contrast, TNF-alpha and C-peptide were inversely correlated with potential protector lipids. In conclusion, abdominal obesity, adipocyte hypertrophy from visceral fat, serum TNF-alpha and C-peptide seem to be the best correlators of the lipoprotein disturbance characteristic of the metabolic syndrome, whereas SHBG and sex steroids could play a protective role regarding the lipid profile associated to this syndrome.

Topics: Adipocytes; Adipose Tissue; Adult; Aged; Body Constitution; Body Mass Index; C-Peptide; Cell Size; Female; Hormones; Humans; Insulin; Leptin; Lipids; Male; Metabolic Syndrome; Middle Aged; Obesity; Postmenopause; Risk Factors; Sex Factors; Sex Hormone-Binding Globulin; Steroids; Tumor Necrosis Factor-alpha; Viscera

Insulin resistance with increased insulin and C-peptide levels is the basis of the metabolic X-syndrome, so it is reasonable to expect them to be a good predictor of associated cardiovascular risk factors.. A total of 29 patients (21 postmenopausal women and 8 men) with type 2 diabetes mellitus (mean duration 14.6 years, 95% CI 11.9 to 17.3 years), all older than 50, were studied for possible links between fasting serum C-peptide levels and other vascular risk factors. The mean value of the C-peptide in the group was 0.627 nmol/l (95% CI: 0.464 to 0.789 nmol/l).. We found statistically significant correlations between C-peptide and triacylglycerols (TG; r=0.474; p=0.009), HDL-cholesterol (inverse; r = -0.567; p = 0.001) and various lipoprotein ratios: atherogenic index (= total/HDL cholesterol: r = 0.599; p = 0.0006) or TG/HDL (r = 0.587; p = 0.0008). C-peptide also correlated with the body mass index (BMI: r = 0.519; p= 0.004) and leptin (r = 0.492; p = 0.007). After the coefficient CpG (C-peptide x fasting glycemia) was introduced, the correlations with lipoproteins became even stronger.. We suggest that elevated (fasting) serum C-peptide levels constitute a clinically important marker of the cardiovascular risks associated with the metabolic X-syndrome. It can be used as an effective tool for the early detection of diabetic patients at particular risk for atherosclerotic cardiovascular diseases and needing early preventive measures or aggressive treatment.

Topics: Aged; C-Peptide; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Female; Humans; Hyperlipoproteinemias; Insulin; Insulin Resistance; Lipoproteins; Male; Metabolic Syndrome; Middle Aged; Peptides; Postmenopause; Risk Factors

To clarify informative value of secretory ability of pancreatic beta-cells and correspondence of insulin values to glycemia in the course of standard glucose tolerance test (GTT) in detection of insulin-resistance in patients with arterial hypertension (AH) to verify metabolic syndrome (MS).. Correlation and factor analyses were performed of correlations between glycemia, immunoreactive insulin (IRI), C-peptide, glucose/IRI in the course of GTT in 111 AH patients divided into groups by the sum of metabolic disturbances.. The greatest number of correlations were seen for glucose/IRI fasting index. According to the factor analysis, changed sensitivity to insulin and hyperinsulinemia are the first stage of metabolic disturbances in AH irrespective of body mass. In obesity the number of the above correlations is maximal. Multivariance analysis has shown significant differences between AH patients and healthy subjects irrespective of body mass and glucose tolerance.. Basal index glucose/IRI < 6 relative units is informative in all the studied variants of metabolic syndrome as regards insulin resistance.

Topics: Adult; Blood Glucose; C-Peptide; Factor Analysis, Statistical; Female; Glucose Tolerance Test; Humans; Hypertension; Insulin; Insulin Resistance; Male; Metabolic Syndrome; Middle Aged; Predictive Value of Tests; Sensitivity and Specificity

The objective of the study reported here was to induce obesity in the female Göttingen minipig to establish a model of the human metabolic syndrome. Nine- to ten-month-old female Göttingen minipigs received a high-fat high-energy (HFE) diet or a low-fat, low-energy (LFE) diet. The energy contents derived from fat were 55 and 13 %, respectively. After 5 weeks, animals were subjected to dual energy x-ray absorptiometry (DEXA) scanning, intravenous glucose tolerance testing (IVGTT), and 6-h growth hormone profile recording. After treatment, mean body weight of pigs of the LFE group was 21.0 +/- 0.4 kg, and was 26.8 +/- 0.2 kg in pigs of the HFE group (P < 0.0001). The DEXA scanning indicated that the fat content of the LFE group was 10.0 +/- 1.2 % versus 15.2 +/- 0.7 % in the HFE group (P < 0.003). Triglycerides concentration was significantly (P < 0.05) increased in pigs of the HFE group (0.24 +/- 0.03 mM), compared with that in pigs of the LFE group (0.13 +/- 0.04 mM). Preprandial plasma glucose and insulin concentrations were not affected, but insulin area under the curve during IVGTT was significantly high in the obese animals. Growth hormone (GH) secretion was low in both groups of pigs. The obese minipig shares some of the metabolic impairments seen in obese humans, and may thus serve as a model of the metabolic syndrome.

Topics: Absorptiometry, Photon; Animals; Area Under Curve; Blood Glucose; C-Peptide; Diet, Fat-Restricted; Dietary Fats; Disease Models, Animal; Fasting; Female; Fructosamine; Glucose Tolerance Test; Growth Hormone; Humans; Hypercholesterolemia; Hypertriglyceridemia; Insulin; Insulin Secretion; Insulin-Like Growth Factor I; Lipids; Metabolic Syndrome; Obesity; Pituitary Gland, Anterior; Species Specificity; Swine, Miniature