OBJECTIVE: To explore the difference of body mass index(BMI) and insulin sensitivity index(ISI) in saltsensitive hypertension patients of different traditional Chinese medicine(TCM) syndrome types, so as to elucidate ...OBJECTIVE: To explore the difference of body mass index(BMI) and insulin sensitivity index(ISI) in saltsensitive hypertension patients of different traditional Chinese medicine(TCM) syndrome types, so as to elucidate the effect of the distribution of each syndrome on the degree of insulin resistance in salt-sensitive hypertension patients. METHODS: A total of 131 patients with salt-sensitive hypertension were included in the study. Factor analysis and cluster analysis were used to study the characteristics of TCM viscera, syndrome elements and syndrome differentiation. Furthermore, the following parameters were observed and corresponding differences were analyzed, including BMI, waist circumference, abdominal circumference, neck circumference and insulin sensitivity index among group s of different TCM syndrome types. RESULTS: There were 131 cases of saltsensitive hypertension. The results of factor analysis showed that the total variance contribution of F1-5 common factors was 75.8%. According to the pattern differentiation of zang-fu organs, a basic theory of traditional Chinese medicine(TCM), the main zang-fu organs involved in the five common factors are: liver, spleen, and kidney.The main syndrome factors that had been extracted include yin de?ciency, ?re, qi stagnation, yang hyperactivity,dampness, phlegm, qi reversal, heat, retained fluid, essence deficiency, qi descending, qi deficiency, and yang deficiency. Among them, factor 1 accounted for 18.32%, factor 2 accounted for 21.37%, factor 3 accounted for20.43%, factor 4 accounted for 20.61%, and factor 5 accounted for 22.14%. The proportion of zang-fu organs involvement was: 21.37% of the spleen, 17.56% of the kidney, 18.32% of the liver and spleen, and 42.75% of the spleen and kidney. Syndrome elements: yin de?ciency 18.32%, phlegm-dampness 21.37%, qi stagnation 39.69%, qi de?ciency 42.75%, retained ?uid 20.61%, yang de?ciency 60.31%, essence de?ciency 17.56%, qi sinking 17.56%,heat 21.37%, qi reversal 21.37%. Results of cluster analysis: there were 3 categories when the distance variance was 20-Category 1: Factor 1; Category 2: Factor 2; Category 3: Factor 3, Factor 4, Factor 5. Combined with the clinical practice of TCM, the classi?cation based on TCM syndromes was:Category 1, yin de?ciency and yang hyperactivity pattern(accounting for 18.32%); Category 2, excessive accumulation of phlegm-dampness(accounting for 21.37%); Category 3, spleen-kidney yang de?ciency and pattern of water-rheum collecting internally(accounting for 60.31%), including 24 cases of yin-de?ciency and yang-hyperactivity(YDYH), 28 cases of excessive phlegmdampness syndrome(EPDS), 79 cases of spleen and kidney yang-de?ciency and ?uid retention stagnating in the interior(SKFR). There was no difference in the distribution of age and sex among groups. In addition, no signi?cant difference was found regarding BMI, waist circumference, abdominal circumference, neck circumference among groups of salt-sensitive hypertension of different TCM syndrome types. Meanwhile, ISI was signi?cantly lower in cases of spleen and kidney yang-de?ciency and ?uid retention stagnating in the interior than in the other 2 groups,with statistical difference. CONCLUSION: Insulin resistance is the most serious in salt-sensitive hypertension patients with spleen and kidney yang-de?ciency and ?uid retention stagnating in the interior. Besides, obesity is not a critical factor in determining the distribution of TCM syndrome types in patients with salt-sensitive hypertension.展开更多
Insulin resistance increases the risk of developing diabetes,and the degree of resistance influences the glycemic control of patients with diabetes.Numerous researchers have focused on improving insulin sensitivity in...Insulin resistance increases the risk of developing diabetes,and the degree of resistance influences the glycemic control of patients with diabetes.Numerous researchers have focused on improving insulin sensitivity in order to prevent diabetes-related complications and other chronic diseases.Several studies have also linked vitamin D levels to insulin secretion and resistance,given that both vitamin D and its receptor complex play important roles in regulating pancreaticβ-cells.It has been suggested that vitamin D supplementation improves vitamin D levels,but further research is needed to confirm this as neither insulin function nor glycemic control improves when vitamin D levels increase.Magnesium is a cofactor for many enzymes.Although the role of magnesium in the management of diabetes has long been evaluated,it has not yet been determined whether magnesium supplements improve insulin function.However,several researchers have found that patients with good glycemic control have high magnesium levels.Magnesium is closely related to vitamin D and is necessary for the transport and activation of vitamin D in humans.Combined supplementation with vitamin D and magnesium improves glycemic control in patients with diabetes.展开更多
Background: We aimed to evaluate the short-term metabolic effects of a GLP-1a, (liraglutide) versus a DPP-4i, (vildagliptin) in a group of sub-Saharan type 2 diabetes patients. Methods: We conducted a randomized contr...Background: We aimed to evaluate the short-term metabolic effects of a GLP-1a, (liraglutide) versus a DPP-4i, (vildagliptin) in a group of sub-Saharan type 2 diabetes patients. Methods: We conducted a randomized controlled single blinded clinical trial in 14 uncontrolled type 2 diabetes patients (HbA1c ≥ 53 mmol/mol) with mean duration of diabetes of 8 [1 - 12] years and median age of 57 [49 - 61] years. Baseline treatment consisted of metformin in monotherapy or metformin plus sulfonylureas. Participants were randomly allocated to 2 groups of add-on 1.2 mg/day subcutaneous liraglutide in group 1 or 100 mg/day of oral vildagliptin in group 2 for 2 weeks. In all participants, insulin secretion in response to mixed meal tolerance test, insulin sensitivity by 80 mU/m<sup>2</sup>/min hyperinsulinemic-euglycemic clamp, body composition, and lipid profile were measured before and after intervention. Results: At the end of intervention, insulin sensitivity remained unchanged both with liraglutide from 6.6 [4.2 - 7.9] to 6.9 [4.3 - 10.8] mg/kg/min;p = 0.61 and vildagliptin from 7.1 [5.3 - 9.0] to 6.5 [5.6 - 9.4] mg/kg/min (p = 0.86). The area under the C-peptide curve varied from 5.5 [1.0 - 10.9] to 14.9 [10.8 - 17.2] nmol/L/120min, p = 0.09 in group 1 and from 1.1 [0.5 - 14.1] to 13.0 [9.6 - 16.9] nmol/L/120min (p = 0.17) in group 2. LDL Cholesterol levels decreased significantly with liraglutide from 0.85 g/L [0.51 - 1.02] to 0.54 g/L [0.50 - 0.73] (p = 0.04) but not with Vildagliptin. Body weight tended to decrease in group 1 (−0.6 kg) versus modest increase in group 2 (+1.1 kg). Conclusion: Short-term metabolic effects of Liraglutide and Vildagliptin add-on therapy are comparable in sub-Saharan type 2 diabetes patients with a more favorable trend for Liraglutide on body weight, lipid profile, and insulin secretion.展开更多
Introduction: Antiretrovirals (ARVs) and the human immunodeficiency virus (HIV) are implicated in the onset of insulin resistance. They cross the placental barrier thereby inducing early modifications of the fetal env...Introduction: Antiretrovirals (ARVs) and the human immunodeficiency virus (HIV) are implicated in the onset of insulin resistance. They cross the placental barrier thereby inducing early modifications of the fetal environment. The aim of our study was to assess insulin sensitivity in full-term newborns exposed in utero to HIV and ARVs in Yaoundé. Materials and Methods: We conducted an analytical cross-sectional study in 2 maternities in the city of Yaoundé from November 2021 to June 2022. We generated two groups of newborns (NBs): one group born to HIV positive mothers on ARVs and the other control group born to HIV negative mothers. Clinical data from mothers and NBs were collected. A homeostatic model assessment of insulin resistance (HOMA-IR) like index with C peptide served to assess insulin sensitivity. We used the Spearman correlation to measure the strength of association between insulin sensitivity and the different variables. A p-value Results: Of 70 neonates included, 35 were born to HIV positive mothers on ARVs and 35 to HIV negative mothers. The median age of HIV positive and negative mothers was 30 (27 - 32) and 34 (24 - 47) years, respectively (p = 0.791). The body mass index before pregnancy as well as the average newborn weights were comparable in both groups. The ARV protocol associating Tenofovir, Lamivudine, Efavirenz was used by 97.1% of HIV positive mothers. In the exposed NBs group, C peptide was significantly lower (p < 0.001) and blood glucose significantly higher (p < 0.001). The median values of HOMA-IR were 1.4 (0.8 - 1.9) and 2 (1.4 - 2.6) (p = 0.001) for exposed and unexposed NBs, respectively. Conclusion: Newborns exposed to HIV and ARVs had lower C peptide levels and were more sensitive to insulin. Close metabolic monitoring of these newborns would allow early diagnosis and management of any glucose regulation disorder.展开更多
Background and Objective:Self-monitoring of blood glucose(SMBG)is crucial for achieving a glycemic target and upholding blood glucose stability,both of which are the primary purpose of anti-diabetic treatments.However...Background and Objective:Self-monitoring of blood glucose(SMBG)is crucial for achieving a glycemic target and upholding blood glucose stability,both of which are the primary purpose of anti-diabetic treatments.However,the association between time in range(TIR),as assessed by SMBG,andβ-cell insulin secretion as well as insulin sensitivity remains unexplored.Therefore,this study aims to investigate the connections between TIR,derived from SMBG,and indices representingβ-cell functionality and insulin sensitivity.The primary objective of this study was to elucidate the relationship between short-term glycemic control(measured as points in range[PIR])and bothβ-cell function and insulin sensitivity.Methods:This cross-sectional study enrolled 472 hospitalized patients with type 2 diabetes mellitus(T2DM).To assessβ-cell secretion capacity,we employed the insulin secretion-sensitivity index-2(ISSI-2)and(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,while insulin sensitivity was evaluated using the Matsuda index and HOMA-IR.Since SMBG offers glucose data at specific point-in-time,we substituted TIR with PIR.According to clinical guidelines,values falling within the range of 3.9-10 mmol were considered"in range,"and the corresponding percentage was calculated as PIR.Results:We observed significant associations between higher PIR quartiles and increased ISSI-2,(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,Matsuda index(increased)and HOMA-IR(decreased)(all P<0.001).PIR exhibited positive correlations with log ISSI-2(r=0.361,P<0.001),log(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index(r=0.482,P<0.001),and log Matsuda index(r=0.178,P<0.001)and negative correlations with log HOMA-IR(r=-0.288,P<0.001).Furthermore,PIR emerged as an independent risk factor for log ISSI-2,log(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,log Matsuda index,and log HOMA-IR.Conclusion:PIR can serve as a valuable tool for assessingβ-cell function and insulin sensitivity.展开更多
BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses met...BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.展开更多
AIM:To test the efficacy of a proprietary nutraceutical combination in reducing insulin resistance associated with the metabolic syndrome(MetS).METHODS:Sixty-four patients with MetS followed at a tertiary outpatient c...AIM:To test the efficacy of a proprietary nutraceutical combination in reducing insulin resistance associated with the metabolic syndrome(MetS).METHODS:Sixty-four patients with MetS followed at a tertiary outpatient clinic were randomly assigned to receive either placebo or a proprietary nutraceutical combination(AP)consisting of berberine,policosanol and red yeast rice,in a prospective,double-blind,placebo-controlled study.Evaluations were performed at baseline and after 18 wk of treatment.The homeostasis model assessment of insulin resistance(HOMAIR)index was the primary outcome measure.Secondary endpoints included lipid panel,blood glucose and insulin fasting,after a standard mixed meal and after an oral glucose tolerance test(OGTT),ow-mediated dilation(FMD),and waist circumference.RESULTS:Fifty nine patients completed the study,2 withdrew because of adverse effects.After 18 wk there was a signif icant reduction in the HOMA-IR index in the AP group compared with placebo(ΔHOMA respectively-0.6 ± 1.2 vs 0.4 ± 1.9;P < 0.05).Total and low density lipoprotein cholesterol also significantly decreased in the treatment arm compared with placebo(Δlow density lipoprotein cholesterol-0.82 ± 0.68 vs-0.13 ± 0.55 mmol/L;P < 0.001),while triglycerides,high density lipoprotein cholesterol,and the OGTT were not affected.In addition,there were significant reductions in blood glucose and insulin after the standard mixed meal,as well as an increase in FMD(ΔFMD 1.9 ± 4.2 vs 0 ± 1.9 %;P < 0.05)and a significant reduction in arterial systolic blood pressure in the AP arm.CONCLUSION:This short-term study shows that AP has relevant beneficial effects on insulin resistance and many other components of MetS.展开更多
Objective: To examine the effect of Pandanus amaryllifolius(P. amaryllifolius) leaf extract on the insulin resistance state in obese ICR mice.Methods: Obesity was induced in mice fed with high-fat diet(45% fat) for 12...Objective: To examine the effect of Pandanus amaryllifolius(P. amaryllifolius) leaf extract on the insulin resistance state in obese ICR mice.Methods: Obesity was induced in mice fed with high-fat diet(45% fat) for 12 weeks. After the first six weeks on the diet, the obese mice were administered with the water extract of P. amaryllifolius leaf at 125 and 250 mg/kg/day, respectively for another six weeks. At the5 th week of treatment, oral glucose tolerance test was conducted. After six weeks of treatment, the levels of blood glucose, serum insulin, leptin, adiponectin, and lipid profiles were determined. The liver, muscle and epididymal fat tissues were removed for measuring the biochemical parameters and protein expression, as well as histological examination.Results: Six weeks of treatment with P. amaryllifolius led to a significant reduction in the blood glucose level as well as improvement in the insulin resistance. P. amaryllifolius also increased the liver glycogen storage and serum adiponectin and decreased the serum leptin levels. A reduction in the serum and hepatic triglyceride, and non-esterified fatty acid levels was also observed. The histological examination showed that the obese mice treated with P. amaryllifolius reduced the lipid droplet in liver tissue and adipocyte size in epididymal fat tissue. The treatment also increased the protein expression of glucose transporter 4 in the muscle and fat tissues.Conclusions: The treatment with P. amaryllifolius could decrease several parameters of impaired glucose and lipid metabolism. To the best of our knowledge, this is the first report on the role of P. amaryllifolius leaf extract in alleviating the insulin dysfunction in obesity state.展开更多
Diacylglycerol(DAG)-based edible oils have attracted increasing research interest owing to their healthpromoting properties.Recent animal and human studies showed that an increased 1,2-DAG content in the liver and ske...Diacylglycerol(DAG)-based edible oils have attracted increasing research interest owing to their healthpromoting properties.Recent animal and human studies showed that an increased 1,2-DAG content in the liver and skeletal muscle may cause insulin resistance.However,earlier studies using animal models or humans reported that dietary DAGs with a 1,2-DAGs to 1,3-D AGs ratio of approximately 3:7 could improve insulin sensitivity in type 2 diabetic patients.This conflict raises the question of whether there is a link between the ingested DAGs and endogenous DAGs during their metabolism.To make a contribution to this field,this review provides an overview of the metabolic pathways of ingested DAGs and biological roles of DAGs(ingested and endogenous)in the change of insulin sensitivity.Accordingly,strategies for further investigations on the metabolism of DAGs are proposed.展开更多
<div style="text-align:justify;"> <span style="font-family:Verdana;">Visceral adiposity mediates insulin resistance, but their association among adults with prediabetes is scarce in the...<div style="text-align:justify;"> <span style="font-family:Verdana;">Visceral adiposity mediates insulin resistance, but their association among adults with prediabetes is scarce in the literature. This study is aimed to determine the association of visceral adiposity index (VAI) with insulin resistance in adults with prediabetes. This cross-sectional study was done among 117 adults with newly detected prediabetes [m/f;23/94;mean ± SD: Age 36.30 ± 9.99 years, BMI 28.89 ± 4.35 kg/m<sup>2</sup>] based on American Diabetes Association 2018 criteria and 141 matched healthy controls [m/f: 28/113;mean ± SD: 35.30 ± 6.88 years, BMI 25.03 ± 4.58]. Waist circumference, body mass index, fasting triglyceride, HDL cholesterol, fasting blood glucose and insulin were measured in each group to calculate VAI and homeostatic model assessment of insulin resistance (HOMA-IR). People with prediabetes had significantly higher median value of VAI {3.08 (2.26) vs. 1.86 (2.31);p < 0.001} with higher frequency of high VAI (>1) (98.3% vs. 85.8%;p < 0.001) than the control population. HOMA-IR level was significantly higher in prediabetes with high VAI (cut-off of 2.64) than control with normal VAI [2.78 (2.22, 4.15) vs. 2.20 (1.53, 3.36);p = 0.002]. VAI was positively correlated with HOMA-IR in females with prediabetes (r = 0.299, p = 0.003). VAI had predictive association with prediabetes [OR (95% CI: 9.504 (2.173, 41.576);p = 0.03] and high insulin resistance (HOMA-IR ≥ 2.6) in females with prediabetes [OR (95% CI) = 3.50 (1.476, 8.297);p = 0.004] only. It could satisfactorily discriminate prediabetes in both sexes (male: AUC = 0.767, p = 0.001;female: AUC = 0.641, p < 0.001) and high insulin resistance in females with prediabetes (AUC = 0.641;p = 0.019) only. So, VAI was associated with prediabetes and insulin resistance only in females with prediabetes.</span> </div>展开更多
During the past ten years, a marine controlled source electromagnetic(CSEM) method has been developed rapidly as a technology for hydrocarbon exploration. For shallow water environments, two CSEM data acquisition syst...During the past ten years, a marine controlled source electromagnetic(CSEM) method has been developed rapidly as a technology for hydrocarbon exploration. For shallow water environments, two CSEM data acquisition systems: Seabed Logging(SBL) and towed streamer electromagnetics(TSEM) have been developed in recent years. The purpose is to compare the performance of the SBL and TSEM systems at different water depths. Three different methods for the comparison are presented. The first method is a quick one dimensional sensitivity modelling. As a result, the sensitivity of marine CSEM data increases with water depth for the SBL system. Further, the sensitivity decreases with the increasing water depth for the TSEM system. The two other methods use two dimensional synthetic data from a simple 2-D isotropic model. The second method is a reservoir sensitivity index(RSI) method which has been developed to provide a quick comparison of the two systems. The RSI is calculated as the amplitude of the scattered field dividing by data uncertainty. From the calculations, it is found that with the increasing water depth RSI increases for the SBL system, while it decreases for the TSEM system. The third method uses Occam's inversion, and applies an anomaly transverse resistance(ATR) ratio for evaluating the resulting resistivity image. In shallow water environments, the resolution of the CSEM inversion results is good for both the SBL and TSEM systems. In deep water environments, the resolution of the CSEM inversion is better for the SBL system than for the TSEM system. The ATR ratios of the resistivity images show the similar conclusion. The SBL data acquisition system has an advantage in deep water environments. The TSEM system, on the other hand, is preferable for the shallow water environments.展开更多
Real coded Accelerating Genetic Algorithm(RAGA),Chaos Algorithm(CA)were used to solve the sensitivity index of Jensen model which is one of models of crop water production function.After comparing with the outcome of ...Real coded Accelerating Genetic Algorithm(RAGA),Chaos Algorithm(CA)were used to solve the sensitivity index of Jensen model which is one of models of crop water production function.After comparing with the outcome of Least Square Regression(LSR),the result showed that RAGA not only had high accuracy and more effective,but also saved calculating time.The authors provides new effective methods for calculating index of crop water production function.展开更多
Despite improvements in glucose, lipids and bloodpressure control, vascular complications remain the most important cause of morbidity and mortality in patients with type 1 diabetes. For that reason, there is a need t...Despite improvements in glucose, lipids and bloodpressure control, vascular complications remain the most important cause of morbidity and mortality in patients with type 1 diabetes. For that reason, there is a need to identify additional risk factors to utilize in clinical practice or translate to novel therapies to prevent vascular complications. Reduced insulin sensitivity is an increasingly recognized component of type 1 diabetes that has been linked with the development and progression of both micro- and macrovascular complications. Adolescents and adults with type 1 diabetes have reduced insulin sensitivity, even when compared to their non-diabetic counterparts of similar adiposity, serum triglycerides, high-density lipoprotein cholesterol, level of habitual physical activity, and in adolescents, pubertal stage. Reduced insulin sensitivity is thought to contribute both to the initiation and progression of macro- and microvascular complications in type 1 diabetes. There are currently clinical trials underway examining the benefits of improving insulin sensitivity with regards to vascular complications in type 1 diabetes. Reduced insulin sensitivity is an increasingly recognized component of type 1 diabetes, is implicated in the pathogenesis of vascular complications and is potentially an important therapeutic target to prevent vascular complications. In this review, we will focus on the pathophysiologic contribution of insulin sensitivity to vascular complications and summarize related ongoing clinical trials.展开更多
To study the relationship between plasma insulin level, sodium sensitivity and blood pressure, 150 children aged from 10 to 15 years with higher blood pressure (HBP) and 150 children matched for age and sex but with n...To study the relationship between plasma insulin level, sodium sensitivity and blood pressure, 150 children aged from 10 to 15 years with higher blood pressure (HBP) and 150 children matched for age and sex but with normal blood pressure were measured for plasma insulin with radioimmunoassay and sodium sensitivity with the tests of oral saline load and furosemide sodium volume depletion and followed for 5 years. The results showed that: ①In children with HBP and positive family history of hypertension (FH +), the plasma insulin level was significantly higher than that in the respective control group (P<0 01);②In children with high plasma insulin level, the percentiles of systolic blood pressure kept high and had a rising tendency during the follow up period; ③In children with sodium sensitivity, the plasma insulin level was higher than that in children with sodium resistance (P<0 01) and the plasma insulin level correlated positively with blood pressure increasing rate of post load (P<0 05). It is suggested that insulin mediated salt and water retention may be a basic pathogenic mechanism in sodium sensitivity, and involved in the development of essential hypertension.展开更多
Selecting check index quantitatively is the core of the calibration of micro traffic simulation parameters at signal intersection. Five indexes in the node (intersection) module of VISSIM were selected as the check in...Selecting check index quantitatively is the core of the calibration of micro traffic simulation parameters at signal intersection. Five indexes in the node (intersection) module of VISSIM were selected as the check index set. Twelve simulation parameters in the core module were selected as the simulation parameters set. Optimal process of parameter calibration was proposed and model of the intersection of Huangcun west street and Xinghua street in Beijing was built in VISSIM to verify it. The sensitivity analysis between each check index and simulation parameter in their own set was conducted respectively. Sensitive parameter sets of different check indices were obtained and compared. The results show that different indexes have different size of set, and average vehicle delay’s is maximum, so it’s necessary to select index quantitatively. The results can provide references for scientific selection of the check indexes and improve the study efficiency of parameter calibration.展开更多
Diabetes mellitus is a metabolic disease possible to treat via pancreas/islet transplantation but most immunosuppressive drugs are diabetogenic. In this letter, we review current up to date methods to assess insulin a...Diabetes mellitus is a metabolic disease possible to treat via pancreas/islet transplantation but most immunosuppressive drugs are diabetogenic. In this letter, we review current up to date methods to assess insulin action and secretion (using the surrogate indexes) suggesting their use in large studies in populations of pancreas/ islets transplanted patients.展开更多
Phosphorus (P) risk indices are commonly used in the USA to estimate the field-scale risk of agricultural P runoff. Because the Ohio P Risk Index is increasingly being used to judge farmer performance, it is important...Phosphorus (P) risk indices are commonly used in the USA to estimate the field-scale risk of agricultural P runoff. Because the Ohio P Risk Index is increasingly being used to judge farmer performance, it is important to evaluate weighting/scoring of all P Index parameters to ensure Ohio farmers are credited for practices that reduce P runoff risk and not unduly penalized for things not demonstrably related to runoff risk. A sensitivity analysis provides information as to how sensitive the P Index score is to changes in inputs. The objectives were to determine 1) which inputs are most highly associated with P Index scores and 2) the relative impact of each input variable on resultant P Index scores. The current approach uses simulations across 6134 Ohio point locations and five crop management scenarios (CMSs), representing increasing soil disturbance. The CMSs range from all no-till, which is being promoted in Ohio, rotational tillage, which is a common practice in Ohio to full tillage to represent an extreme practice. Results showed that P Index scores were best explained by soil test P (31.9%) followed by connectivity to water (29.7%), soil erosion (13.4%), fertilizer application amount (11.3%), runoff class (9.5%), fertilizer application method (2.2%), and finally filter strip (2.0%). Ohio P Index simulations across CMSs one through five showed that >40% scored <15 points (low) while <1.5% scored >45 points (very high). Given Ohio water quality problems, the Ohio P Index needs to be stricter. The current approach is useful for Ohio P Index evaluations and revision decisions by spatially illustrating the impact of potential changes regionally and state-wide.展开更多
Rodent study suggests that interleukin (IL)-15 administration enhances insulin sensitivity. Although it is well known that circulating levels of typical inflammatory markers (C-reactive protein [CRP] and IL-6) are pos...Rodent study suggests that interleukin (IL)-15 administration enhances insulin sensitivity. Although it is well known that circulating levels of typical inflammatory markers (C-reactive protein [CRP] and IL-6) are positively associated with homeostasis model assessment-insulin resistance (HOMA-IR), there are no studies investigating the associations of other inflammatory markers including IL-15 with peripheral/hepatic insulin sensitivity in humans. The current study aimed to examine the relationship between the levels of adiopokines or inflammatory cytokines and insulin sensitivity in 8 healthy middle-aged men. Circulating levels of 10 insulin sensitizing adipokines or inflammatory cytokines (total adiponectin [APN], high molecular weight adiponectin [HMW-APN], IL-4, IL-5, IL-6, IL-8, IL-15, interferon [IFN]-γ, tumor necrosis factor [TNF]-α, and TNF-β) were measured. A stable-labeled frequently sampled intravenous glucose tolerance test was performed to assess peripheral () and hepatic () insulin sensitivity estimated by 2-compartment minimal model. The levels of 3 inflammatory cytokines (IL-4, IL-6, and IL-15) were significantly and inversely correlated with either and . The association between IL-15 and either or was significant even after adjusting for age and percent body fat (p < 0.01). The current study showed a possible inverse association between serum IL-15 level and peripheral/hepatic insulin sensitivity in healthy middle-aged males, independent of percent body fat;this association in humans warrants further study.展开更多
β-cell dysfunction and decreased insulin sensitivity are believed to be two chief mechanisms that participate in deterioration of glycemic control in Type 2 diabetes. Meformin is widely accepted as the first-line ora...β-cell dysfunction and decreased insulin sensitivity are believed to be two chief mechanisms that participate in deterioration of glycemic control in Type 2 diabetes. Meformin is widely accepted as the first-line oral agent in the treatment of Type 2 diabetes. However, the relative contributions of improved β-cell function and increased insulin sensitivity to reduction in hemoglobin A1c (HbA1c) are unclear in newly diagnosed Type 2 diabetic patients treated with metformin. We investigated β-cell function and insulin sensitivity in relation to reduction in HbA1c in 20 newly diagnosed Type 2 diabetic patients (17 men and 3 women, mean age 49.1 ± 10.1 years, mean body mass index 26.4 ± 5.2 kg/m2) treated with metformin for 16 weeks. We used homeostasis model assessment (HOMA) 2%B and HOMA2%S as estimates of β-cell function and insulin sensitivity, respectively. Median HOMA2%B and HOMA2%S significantly increased from 38.8 to 68.8 (p p = 0.004), respectively. In univariate regression analysis, reduction in HbA1c was highly correlated with change in HOMA2%B (r = -0.866, p < 0.001), but not with that in HOMA2%S (r = -0.264, p = 0.260). Furthermore, multivariate regression analysis with reduction in HbA1c as a dependent variable showed that increase in HOMA2%B but not that in HOMA2%S was a significant dependent variable (β = -0.847, p β-cell function rather than increased insulin sensitivity is associated with reduction in HbA1c. These results suggest that metformin reduces HbA1c chiefly through improved β-cell function rather than increased insulin sensitivity in patients with newly diagnosed Type 2 diabetes.展开更多
Background: Polycystic ovary syndrome (PCOS), characterized by ovulatory dysfunction, polycystic ovary(PCO),hyperandrogenism and insulin resistance is the commonest endocrine disorder in women of reproductive age. It ...Background: Polycystic ovary syndrome (PCOS), characterized by ovulatory dysfunction, polycystic ovary(PCO),hyperandrogenism and insulin resistance is the commonest endocrine disorder in women of reproductive age. It is an intriguing pathology that involves the perpetuation of a vicious circle with reproductive, endocrine and metabolic components. We aimed to assess the reproductive features and insulin sensitivity (IS) in infertile women with or without PCOS. Materials and Methods: We carried out a cross-sectional analytic study at the outpatient Obstetrics and Gynaecology Department of the Yaounde Gyneco-obstetric and Pediatrics Hospital, Cameroon from September 1st 2012 to March 31st 2013 giving total study duration of 07 months. Laboratory analyses were carried out at the National Obesity Centre(NOC)of the Yaounde Central Hospital, Cameroon. Results: Overall, 36 infertile females were enrolled, which included 15 diagnosed cases of PCOS according to Rotterdam consensus meeting of 2003 and 21 non PCOS subjects as control. PCOS women were younger than non PCOS women (28.8 ± 5.5 vs. 35.0 ± 4.2 years;p = 0.0004). The majority of the women in the PCOS group were spaniomenorrheic (11/15), and ultrasonographic findings were typical of PCOS. Hirsutism score was higher in the PCOS group with a median of 9 (7 - 13). Insulin sensitivity was impaired in two-thirds of the study population, with 12 women found to be insulin resistant(6 PCOS, 6 non PCOS), 12 patients had intermediate insulin sensitivity(2 PCOS, 10 non PCOS)and 12 insulin sensitive(7 PCOS, 5 non PCOS). Apart from blood glucose levels (p = 0.007), all other anthropometric and biological parameters were not significant. Spearman’s correlation identified fasting plasma glucose and total cholesterol as factors associated with insulin sensitivity in females with PCOS. Impaired fasting glucose was observed in 13 patients with 08 from the PCOS group. Conclusion: We conclude that young age, spaniomenorrhea and hirsutism are common findings in PCOS. Furthermore, our findings suggest that PCOS may be more of systemic metabolic disease than solely a purely gynecologic disorder as described hitherto. Despite normal fasting plasma glucose levels, a good proportion of these women has impaired insulin sensitivity and it is associated with a metabolic syndrome.展开更多
文摘OBJECTIVE: To explore the difference of body mass index(BMI) and insulin sensitivity index(ISI) in saltsensitive hypertension patients of different traditional Chinese medicine(TCM) syndrome types, so as to elucidate the effect of the distribution of each syndrome on the degree of insulin resistance in salt-sensitive hypertension patients. METHODS: A total of 131 patients with salt-sensitive hypertension were included in the study. Factor analysis and cluster analysis were used to study the characteristics of TCM viscera, syndrome elements and syndrome differentiation. Furthermore, the following parameters were observed and corresponding differences were analyzed, including BMI, waist circumference, abdominal circumference, neck circumference and insulin sensitivity index among group s of different TCM syndrome types. RESULTS: There were 131 cases of saltsensitive hypertension. The results of factor analysis showed that the total variance contribution of F1-5 common factors was 75.8%. According to the pattern differentiation of zang-fu organs, a basic theory of traditional Chinese medicine(TCM), the main zang-fu organs involved in the five common factors are: liver, spleen, and kidney.The main syndrome factors that had been extracted include yin de?ciency, ?re, qi stagnation, yang hyperactivity,dampness, phlegm, qi reversal, heat, retained fluid, essence deficiency, qi descending, qi deficiency, and yang deficiency. Among them, factor 1 accounted for 18.32%, factor 2 accounted for 21.37%, factor 3 accounted for20.43%, factor 4 accounted for 20.61%, and factor 5 accounted for 22.14%. The proportion of zang-fu organs involvement was: 21.37% of the spleen, 17.56% of the kidney, 18.32% of the liver and spleen, and 42.75% of the spleen and kidney. Syndrome elements: yin de?ciency 18.32%, phlegm-dampness 21.37%, qi stagnation 39.69%, qi de?ciency 42.75%, retained ?uid 20.61%, yang de?ciency 60.31%, essence de?ciency 17.56%, qi sinking 17.56%,heat 21.37%, qi reversal 21.37%. Results of cluster analysis: there were 3 categories when the distance variance was 20-Category 1: Factor 1; Category 2: Factor 2; Category 3: Factor 3, Factor 4, Factor 5. Combined with the clinical practice of TCM, the classi?cation based on TCM syndromes was:Category 1, yin de?ciency and yang hyperactivity pattern(accounting for 18.32%); Category 2, excessive accumulation of phlegm-dampness(accounting for 21.37%); Category 3, spleen-kidney yang de?ciency and pattern of water-rheum collecting internally(accounting for 60.31%), including 24 cases of yin-de?ciency and yang-hyperactivity(YDYH), 28 cases of excessive phlegmdampness syndrome(EPDS), 79 cases of spleen and kidney yang-de?ciency and ?uid retention stagnating in the interior(SKFR). There was no difference in the distribution of age and sex among groups. In addition, no signi?cant difference was found regarding BMI, waist circumference, abdominal circumference, neck circumference among groups of salt-sensitive hypertension of different TCM syndrome types. Meanwhile, ISI was signi?cantly lower in cases of spleen and kidney yang-de?ciency and ?uid retention stagnating in the interior than in the other 2 groups,with statistical difference. CONCLUSION: Insulin resistance is the most serious in salt-sensitive hypertension patients with spleen and kidney yang-de?ciency and ?uid retention stagnating in the interior. Besides, obesity is not a critical factor in determining the distribution of TCM syndrome types in patients with salt-sensitive hypertension.
文摘Insulin resistance increases the risk of developing diabetes,and the degree of resistance influences the glycemic control of patients with diabetes.Numerous researchers have focused on improving insulin sensitivity in order to prevent diabetes-related complications and other chronic diseases.Several studies have also linked vitamin D levels to insulin secretion and resistance,given that both vitamin D and its receptor complex play important roles in regulating pancreaticβ-cells.It has been suggested that vitamin D supplementation improves vitamin D levels,but further research is needed to confirm this as neither insulin function nor glycemic control improves when vitamin D levels increase.Magnesium is a cofactor for many enzymes.Although the role of magnesium in the management of diabetes has long been evaluated,it has not yet been determined whether magnesium supplements improve insulin function.However,several researchers have found that patients with good glycemic control have high magnesium levels.Magnesium is closely related to vitamin D and is necessary for the transport and activation of vitamin D in humans.Combined supplementation with vitamin D and magnesium improves glycemic control in patients with diabetes.
文摘Background: We aimed to evaluate the short-term metabolic effects of a GLP-1a, (liraglutide) versus a DPP-4i, (vildagliptin) in a group of sub-Saharan type 2 diabetes patients. Methods: We conducted a randomized controlled single blinded clinical trial in 14 uncontrolled type 2 diabetes patients (HbA1c ≥ 53 mmol/mol) with mean duration of diabetes of 8 [1 - 12] years and median age of 57 [49 - 61] years. Baseline treatment consisted of metformin in monotherapy or metformin plus sulfonylureas. Participants were randomly allocated to 2 groups of add-on 1.2 mg/day subcutaneous liraglutide in group 1 or 100 mg/day of oral vildagliptin in group 2 for 2 weeks. In all participants, insulin secretion in response to mixed meal tolerance test, insulin sensitivity by 80 mU/m<sup>2</sup>/min hyperinsulinemic-euglycemic clamp, body composition, and lipid profile were measured before and after intervention. Results: At the end of intervention, insulin sensitivity remained unchanged both with liraglutide from 6.6 [4.2 - 7.9] to 6.9 [4.3 - 10.8] mg/kg/min;p = 0.61 and vildagliptin from 7.1 [5.3 - 9.0] to 6.5 [5.6 - 9.4] mg/kg/min (p = 0.86). The area under the C-peptide curve varied from 5.5 [1.0 - 10.9] to 14.9 [10.8 - 17.2] nmol/L/120min, p = 0.09 in group 1 and from 1.1 [0.5 - 14.1] to 13.0 [9.6 - 16.9] nmol/L/120min (p = 0.17) in group 2. LDL Cholesterol levels decreased significantly with liraglutide from 0.85 g/L [0.51 - 1.02] to 0.54 g/L [0.50 - 0.73] (p = 0.04) but not with Vildagliptin. Body weight tended to decrease in group 1 (−0.6 kg) versus modest increase in group 2 (+1.1 kg). Conclusion: Short-term metabolic effects of Liraglutide and Vildagliptin add-on therapy are comparable in sub-Saharan type 2 diabetes patients with a more favorable trend for Liraglutide on body weight, lipid profile, and insulin secretion.
文摘Introduction: Antiretrovirals (ARVs) and the human immunodeficiency virus (HIV) are implicated in the onset of insulin resistance. They cross the placental barrier thereby inducing early modifications of the fetal environment. The aim of our study was to assess insulin sensitivity in full-term newborns exposed in utero to HIV and ARVs in Yaoundé. Materials and Methods: We conducted an analytical cross-sectional study in 2 maternities in the city of Yaoundé from November 2021 to June 2022. We generated two groups of newborns (NBs): one group born to HIV positive mothers on ARVs and the other control group born to HIV negative mothers. Clinical data from mothers and NBs were collected. A homeostatic model assessment of insulin resistance (HOMA-IR) like index with C peptide served to assess insulin sensitivity. We used the Spearman correlation to measure the strength of association between insulin sensitivity and the different variables. A p-value Results: Of 70 neonates included, 35 were born to HIV positive mothers on ARVs and 35 to HIV negative mothers. The median age of HIV positive and negative mothers was 30 (27 - 32) and 34 (24 - 47) years, respectively (p = 0.791). The body mass index before pregnancy as well as the average newborn weights were comparable in both groups. The ARV protocol associating Tenofovir, Lamivudine, Efavirenz was used by 97.1% of HIV positive mothers. In the exposed NBs group, C peptide was significantly lower (p < 0.001) and blood glucose significantly higher (p < 0.001). The median values of HOMA-IR were 1.4 (0.8 - 1.9) and 2 (1.4 - 2.6) (p = 0.001) for exposed and unexposed NBs, respectively. Conclusion: Newborns exposed to HIV and ARVs had lower C peptide levels and were more sensitive to insulin. Close metabolic monitoring of these newborns would allow early diagnosis and management of any glucose regulation disorder.
文摘Background and Objective:Self-monitoring of blood glucose(SMBG)is crucial for achieving a glycemic target and upholding blood glucose stability,both of which are the primary purpose of anti-diabetic treatments.However,the association between time in range(TIR),as assessed by SMBG,andβ-cell insulin secretion as well as insulin sensitivity remains unexplored.Therefore,this study aims to investigate the connections between TIR,derived from SMBG,and indices representingβ-cell functionality and insulin sensitivity.The primary objective of this study was to elucidate the relationship between short-term glycemic control(measured as points in range[PIR])and bothβ-cell function and insulin sensitivity.Methods:This cross-sectional study enrolled 472 hospitalized patients with type 2 diabetes mellitus(T2DM).To assessβ-cell secretion capacity,we employed the insulin secretion-sensitivity index-2(ISSI-2)and(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,while insulin sensitivity was evaluated using the Matsuda index and HOMA-IR.Since SMBG offers glucose data at specific point-in-time,we substituted TIR with PIR.According to clinical guidelines,values falling within the range of 3.9-10 mmol were considered"in range,"and the corresponding percentage was calculated as PIR.Results:We observed significant associations between higher PIR quartiles and increased ISSI-2,(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,Matsuda index(increased)and HOMA-IR(decreased)(all P<0.001).PIR exhibited positive correlations with log ISSI-2(r=0.361,P<0.001),log(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index(r=0.482,P<0.001),and log Matsuda index(r=0.178,P<0.001)and negative correlations with log HOMA-IR(r=-0.288,P<0.001).Furthermore,PIR emerged as an independent risk factor for log ISSI-2,log(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,log Matsuda index,and log HOMA-IR.Conclusion:PIR can serve as a valuable tool for assessingβ-cell function and insulin sensitivity.
基金Supported by Suzhou Municipal Science and Technology Program of China,No.SKJY2021012.
文摘BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.
文摘AIM:To test the efficacy of a proprietary nutraceutical combination in reducing insulin resistance associated with the metabolic syndrome(MetS).METHODS:Sixty-four patients with MetS followed at a tertiary outpatient clinic were randomly assigned to receive either placebo or a proprietary nutraceutical combination(AP)consisting of berberine,policosanol and red yeast rice,in a prospective,double-blind,placebo-controlled study.Evaluations were performed at baseline and after 18 wk of treatment.The homeostasis model assessment of insulin resistance(HOMAIR)index was the primary outcome measure.Secondary endpoints included lipid panel,blood glucose and insulin fasting,after a standard mixed meal and after an oral glucose tolerance test(OGTT),ow-mediated dilation(FMD),and waist circumference.RESULTS:Fifty nine patients completed the study,2 withdrew because of adverse effects.After 18 wk there was a signif icant reduction in the HOMA-IR index in the AP group compared with placebo(ΔHOMA respectively-0.6 ± 1.2 vs 0.4 ± 1.9;P < 0.05).Total and low density lipoprotein cholesterol also significantly decreased in the treatment arm compared with placebo(Δlow density lipoprotein cholesterol-0.82 ± 0.68 vs-0.13 ± 0.55 mmol/L;P < 0.001),while triglycerides,high density lipoprotein cholesterol,and the OGTT were not affected.In addition,there were significant reductions in blood glucose and insulin after the standard mixed meal,as well as an increase in FMD(ΔFMD 1.9 ± 4.2 vs 0 ± 1.9 %;P < 0.05)and a significant reduction in arterial systolic blood pressure in the AP arm.CONCLUSION:This short-term study shows that AP has relevant beneficial effects on insulin resistance and many other components of MetS.
基金Supported by the research grant from the Faculty of Medicine,Thammasat University(Contract number:GEN2-22/2015)
文摘Objective: To examine the effect of Pandanus amaryllifolius(P. amaryllifolius) leaf extract on the insulin resistance state in obese ICR mice.Methods: Obesity was induced in mice fed with high-fat diet(45% fat) for 12 weeks. After the first six weeks on the diet, the obese mice were administered with the water extract of P. amaryllifolius leaf at 125 and 250 mg/kg/day, respectively for another six weeks. At the5 th week of treatment, oral glucose tolerance test was conducted. After six weeks of treatment, the levels of blood glucose, serum insulin, leptin, adiponectin, and lipid profiles were determined. The liver, muscle and epididymal fat tissues were removed for measuring the biochemical parameters and protein expression, as well as histological examination.Results: Six weeks of treatment with P. amaryllifolius led to a significant reduction in the blood glucose level as well as improvement in the insulin resistance. P. amaryllifolius also increased the liver glycogen storage and serum adiponectin and decreased the serum leptin levels. A reduction in the serum and hepatic triglyceride, and non-esterified fatty acid levels was also observed. The histological examination showed that the obese mice treated with P. amaryllifolius reduced the lipid droplet in liver tissue and adipocyte size in epididymal fat tissue. The treatment also increased the protein expression of glucose transporter 4 in the muscle and fat tissues.Conclusions: The treatment with P. amaryllifolius could decrease several parameters of impaired glucose and lipid metabolism. To the best of our knowledge, this is the first report on the role of P. amaryllifolius leaf extract in alleviating the insulin dysfunction in obesity state.
基金supported by Chinese National Natural Foundation for Distinguished Young Scholars(31725022)Beijing Advanced Innovation Center for Food Nutrition and Human Health+1 种基金Beijing Technology and Business University(BTBU)(20171049)the Science&Technology Department of Shaanxi Province(2019JM-333)。
文摘Diacylglycerol(DAG)-based edible oils have attracted increasing research interest owing to their healthpromoting properties.Recent animal and human studies showed that an increased 1,2-DAG content in the liver and skeletal muscle may cause insulin resistance.However,earlier studies using animal models or humans reported that dietary DAGs with a 1,2-DAGs to 1,3-D AGs ratio of approximately 3:7 could improve insulin sensitivity in type 2 diabetic patients.This conflict raises the question of whether there is a link between the ingested DAGs and endogenous DAGs during their metabolism.To make a contribution to this field,this review provides an overview of the metabolic pathways of ingested DAGs and biological roles of DAGs(ingested and endogenous)in the change of insulin sensitivity.Accordingly,strategies for further investigations on the metabolism of DAGs are proposed.
文摘<div style="text-align:justify;"> <span style="font-family:Verdana;">Visceral adiposity mediates insulin resistance, but their association among adults with prediabetes is scarce in the literature. This study is aimed to determine the association of visceral adiposity index (VAI) with insulin resistance in adults with prediabetes. This cross-sectional study was done among 117 adults with newly detected prediabetes [m/f;23/94;mean ± SD: Age 36.30 ± 9.99 years, BMI 28.89 ± 4.35 kg/m<sup>2</sup>] based on American Diabetes Association 2018 criteria and 141 matched healthy controls [m/f: 28/113;mean ± SD: 35.30 ± 6.88 years, BMI 25.03 ± 4.58]. Waist circumference, body mass index, fasting triglyceride, HDL cholesterol, fasting blood glucose and insulin were measured in each group to calculate VAI and homeostatic model assessment of insulin resistance (HOMA-IR). People with prediabetes had significantly higher median value of VAI {3.08 (2.26) vs. 1.86 (2.31);p < 0.001} with higher frequency of high VAI (>1) (98.3% vs. 85.8%;p < 0.001) than the control population. HOMA-IR level was significantly higher in prediabetes with high VAI (cut-off of 2.64) than control with normal VAI [2.78 (2.22, 4.15) vs. 2.20 (1.53, 3.36);p = 0.002]. VAI was positively correlated with HOMA-IR in females with prediabetes (r = 0.299, p = 0.003). VAI had predictive association with prediabetes [OR (95% CI: 9.504 (2.173, 41.576);p = 0.03] and high insulin resistance (HOMA-IR ≥ 2.6) in females with prediabetes [OR (95% CI) = 3.50 (1.476, 8.297);p = 0.004] only. It could satisfactorily discriminate prediabetes in both sexes (male: AUC = 0.767, p = 0.001;female: AUC = 0.641, p < 0.001) and high insulin resistance in females with prediabetes (AUC = 0.641;p = 0.019) only. So, VAI was associated with prediabetes and insulin resistance only in females with prediabetes.</span> </div>
文摘During the past ten years, a marine controlled source electromagnetic(CSEM) method has been developed rapidly as a technology for hydrocarbon exploration. For shallow water environments, two CSEM data acquisition systems: Seabed Logging(SBL) and towed streamer electromagnetics(TSEM) have been developed in recent years. The purpose is to compare the performance of the SBL and TSEM systems at different water depths. Three different methods for the comparison are presented. The first method is a quick one dimensional sensitivity modelling. As a result, the sensitivity of marine CSEM data increases with water depth for the SBL system. Further, the sensitivity decreases with the increasing water depth for the TSEM system. The two other methods use two dimensional synthetic data from a simple 2-D isotropic model. The second method is a reservoir sensitivity index(RSI) method which has been developed to provide a quick comparison of the two systems. The RSI is calculated as the amplitude of the scattered field dividing by data uncertainty. From the calculations, it is found that with the increasing water depth RSI increases for the SBL system, while it decreases for the TSEM system. The third method uses Occam's inversion, and applies an anomaly transverse resistance(ATR) ratio for evaluating the resulting resistivity image. In shallow water environments, the resolution of the CSEM inversion results is good for both the SBL and TSEM systems. In deep water environments, the resolution of the CSEM inversion is better for the SBL system than for the TSEM system. The ATR ratios of the resistivity images show the similar conclusion. The SBL data acquisition system has an advantage in deep water environments. The TSEM system, on the other hand, is preferable for the shallow water environments.
基金Supported by Science and Technology Research Program of Heilongjiang Province(GB06B106-7)
文摘Real coded Accelerating Genetic Algorithm(RAGA),Chaos Algorithm(CA)were used to solve the sensitivity index of Jensen model which is one of models of crop water production function.After comparing with the outcome of Least Square Regression(LSR),the result showed that RAGA not only had high accuracy and more effective,but also saved calculating time.The authors provides new effective methods for calculating index of crop water production function.
文摘Despite improvements in glucose, lipids and bloodpressure control, vascular complications remain the most important cause of morbidity and mortality in patients with type 1 diabetes. For that reason, there is a need to identify additional risk factors to utilize in clinical practice or translate to novel therapies to prevent vascular complications. Reduced insulin sensitivity is an increasingly recognized component of type 1 diabetes that has been linked with the development and progression of both micro- and macrovascular complications. Adolescents and adults with type 1 diabetes have reduced insulin sensitivity, even when compared to their non-diabetic counterparts of similar adiposity, serum triglycerides, high-density lipoprotein cholesterol, level of habitual physical activity, and in adolescents, pubertal stage. Reduced insulin sensitivity is thought to contribute both to the initiation and progression of macro- and microvascular complications in type 1 diabetes. There are currently clinical trials underway examining the benefits of improving insulin sensitivity with regards to vascular complications in type 1 diabetes. Reduced insulin sensitivity is an increasingly recognized component of type 1 diabetes, is implicated in the pathogenesis of vascular complications and is potentially an important therapeutic target to prevent vascular complications. In this review, we will focus on the pathophysiologic contribution of insulin sensitivity to vascular complications and summarize related ongoing clinical trials.
文摘To study the relationship between plasma insulin level, sodium sensitivity and blood pressure, 150 children aged from 10 to 15 years with higher blood pressure (HBP) and 150 children matched for age and sex but with normal blood pressure were measured for plasma insulin with radioimmunoassay and sodium sensitivity with the tests of oral saline load and furosemide sodium volume depletion and followed for 5 years. The results showed that: ①In children with HBP and positive family history of hypertension (FH +), the plasma insulin level was significantly higher than that in the respective control group (P<0 01);②In children with high plasma insulin level, the percentiles of systolic blood pressure kept high and had a rising tendency during the follow up period; ③In children with sodium sensitivity, the plasma insulin level was higher than that in children with sodium resistance (P<0 01) and the plasma insulin level correlated positively with blood pressure increasing rate of post load (P<0 05). It is suggested that insulin mediated salt and water retention may be a basic pathogenic mechanism in sodium sensitivity, and involved in the development of essential hypertension.
文摘Selecting check index quantitatively is the core of the calibration of micro traffic simulation parameters at signal intersection. Five indexes in the node (intersection) module of VISSIM were selected as the check index set. Twelve simulation parameters in the core module were selected as the simulation parameters set. Optimal process of parameter calibration was proposed and model of the intersection of Huangcun west street and Xinghua street in Beijing was built in VISSIM to verify it. The sensitivity analysis between each check index and simulation parameter in their own set was conducted respectively. Sensitive parameter sets of different check indices were obtained and compared. The results show that different indexes have different size of set, and average vehicle delay’s is maximum, so it’s necessary to select index quantitatively. The results can provide references for scientific selection of the check indexes and improve the study efficiency of parameter calibration.
文摘Diabetes mellitus is a metabolic disease possible to treat via pancreas/islet transplantation but most immunosuppressive drugs are diabetogenic. In this letter, we review current up to date methods to assess insulin action and secretion (using the surrogate indexes) suggesting their use in large studies in populations of pancreas/ islets transplanted patients.
文摘Phosphorus (P) risk indices are commonly used in the USA to estimate the field-scale risk of agricultural P runoff. Because the Ohio P Risk Index is increasingly being used to judge farmer performance, it is important to evaluate weighting/scoring of all P Index parameters to ensure Ohio farmers are credited for practices that reduce P runoff risk and not unduly penalized for things not demonstrably related to runoff risk. A sensitivity analysis provides information as to how sensitive the P Index score is to changes in inputs. The objectives were to determine 1) which inputs are most highly associated with P Index scores and 2) the relative impact of each input variable on resultant P Index scores. The current approach uses simulations across 6134 Ohio point locations and five crop management scenarios (CMSs), representing increasing soil disturbance. The CMSs range from all no-till, which is being promoted in Ohio, rotational tillage, which is a common practice in Ohio to full tillage to represent an extreme practice. Results showed that P Index scores were best explained by soil test P (31.9%) followed by connectivity to water (29.7%), soil erosion (13.4%), fertilizer application amount (11.3%), runoff class (9.5%), fertilizer application method (2.2%), and finally filter strip (2.0%). Ohio P Index simulations across CMSs one through five showed that >40% scored <15 points (low) while <1.5% scored >45 points (very high). Given Ohio water quality problems, the Ohio P Index needs to be stricter. The current approach is useful for Ohio P Index evaluations and revision decisions by spatially illustrating the impact of potential changes regionally and state-wide.
文摘Rodent study suggests that interleukin (IL)-15 administration enhances insulin sensitivity. Although it is well known that circulating levels of typical inflammatory markers (C-reactive protein [CRP] and IL-6) are positively associated with homeostasis model assessment-insulin resistance (HOMA-IR), there are no studies investigating the associations of other inflammatory markers including IL-15 with peripheral/hepatic insulin sensitivity in humans. The current study aimed to examine the relationship between the levels of adiopokines or inflammatory cytokines and insulin sensitivity in 8 healthy middle-aged men. Circulating levels of 10 insulin sensitizing adipokines or inflammatory cytokines (total adiponectin [APN], high molecular weight adiponectin [HMW-APN], IL-4, IL-5, IL-6, IL-8, IL-15, interferon [IFN]-γ, tumor necrosis factor [TNF]-α, and TNF-β) were measured. A stable-labeled frequently sampled intravenous glucose tolerance test was performed to assess peripheral () and hepatic () insulin sensitivity estimated by 2-compartment minimal model. The levels of 3 inflammatory cytokines (IL-4, IL-6, and IL-15) were significantly and inversely correlated with either and . The association between IL-15 and either or was significant even after adjusting for age and percent body fat (p < 0.01). The current study showed a possible inverse association between serum IL-15 level and peripheral/hepatic insulin sensitivity in healthy middle-aged males, independent of percent body fat;this association in humans warrants further study.
文摘β-cell dysfunction and decreased insulin sensitivity are believed to be two chief mechanisms that participate in deterioration of glycemic control in Type 2 diabetes. Meformin is widely accepted as the first-line oral agent in the treatment of Type 2 diabetes. However, the relative contributions of improved β-cell function and increased insulin sensitivity to reduction in hemoglobin A1c (HbA1c) are unclear in newly diagnosed Type 2 diabetic patients treated with metformin. We investigated β-cell function and insulin sensitivity in relation to reduction in HbA1c in 20 newly diagnosed Type 2 diabetic patients (17 men and 3 women, mean age 49.1 ± 10.1 years, mean body mass index 26.4 ± 5.2 kg/m2) treated with metformin for 16 weeks. We used homeostasis model assessment (HOMA) 2%B and HOMA2%S as estimates of β-cell function and insulin sensitivity, respectively. Median HOMA2%B and HOMA2%S significantly increased from 38.8 to 68.8 (p p = 0.004), respectively. In univariate regression analysis, reduction in HbA1c was highly correlated with change in HOMA2%B (r = -0.866, p < 0.001), but not with that in HOMA2%S (r = -0.264, p = 0.260). Furthermore, multivariate regression analysis with reduction in HbA1c as a dependent variable showed that increase in HOMA2%B but not that in HOMA2%S was a significant dependent variable (β = -0.847, p β-cell function rather than increased insulin sensitivity is associated with reduction in HbA1c. These results suggest that metformin reduces HbA1c chiefly through improved β-cell function rather than increased insulin sensitivity in patients with newly diagnosed Type 2 diabetes.
文摘Background: Polycystic ovary syndrome (PCOS), characterized by ovulatory dysfunction, polycystic ovary(PCO),hyperandrogenism and insulin resistance is the commonest endocrine disorder in women of reproductive age. It is an intriguing pathology that involves the perpetuation of a vicious circle with reproductive, endocrine and metabolic components. We aimed to assess the reproductive features and insulin sensitivity (IS) in infertile women with or without PCOS. Materials and Methods: We carried out a cross-sectional analytic study at the outpatient Obstetrics and Gynaecology Department of the Yaounde Gyneco-obstetric and Pediatrics Hospital, Cameroon from September 1st 2012 to March 31st 2013 giving total study duration of 07 months. Laboratory analyses were carried out at the National Obesity Centre(NOC)of the Yaounde Central Hospital, Cameroon. Results: Overall, 36 infertile females were enrolled, which included 15 diagnosed cases of PCOS according to Rotterdam consensus meeting of 2003 and 21 non PCOS subjects as control. PCOS women were younger than non PCOS women (28.8 ± 5.5 vs. 35.0 ± 4.2 years;p = 0.0004). The majority of the women in the PCOS group were spaniomenorrheic (11/15), and ultrasonographic findings were typical of PCOS. Hirsutism score was higher in the PCOS group with a median of 9 (7 - 13). Insulin sensitivity was impaired in two-thirds of the study population, with 12 women found to be insulin resistant(6 PCOS, 6 non PCOS), 12 patients had intermediate insulin sensitivity(2 PCOS, 10 non PCOS)and 12 insulin sensitive(7 PCOS, 5 non PCOS). Apart from blood glucose levels (p = 0.007), all other anthropometric and biological parameters were not significant. Spearman’s correlation identified fasting plasma glucose and total cholesterol as factors associated with insulin sensitivity in females with PCOS. Impaired fasting glucose was observed in 13 patients with 08 from the PCOS group. Conclusion: We conclude that young age, spaniomenorrhea and hirsutism are common findings in PCOS. Furthermore, our findings suggest that PCOS may be more of systemic metabolic disease than solely a purely gynecologic disorder as described hitherto. Despite normal fasting plasma glucose levels, a good proportion of these women has impaired insulin sensitivity and it is associated with a metabolic syndrome.
