scholarly journals Insulin resistance and endothelial function are improved after folate and vitamin B12 therapy in patients with metabolic syndrome: relationship between homocysteine levels and hyperinsulinemia

2004 ◽  
pp. 483-489 ◽  
Author(s):  
E Setola ◽  
LD Monti ◽  
E Galluccio ◽  
A Palloshi ◽  
G Fragasso ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Folic Acid ◽  
Endothelial Dysfunction ◽  
Vitamin B12 ◽  
Model Assessment ◽  
Insulin Levels ◽  
Group 2 ◽  
Folate And Vitamin B12 ◽  
Group 1

OBJECTIVE: The purpose of this study was (a) to study whether a folate and vitamin B12 treatment, aimed at decreasing homocysteine levels, might ameliorate insulin resistance and endothelial dysfunction in patients with metabolic syndrome according to the National Cholesterol Education Program-Adult Treatment Panel-III criteria and (b) to evaluate whether, under these metabolic conditions, there is a relationship between hyperhomocysteinemia and insulin resistance. DESIGN AND METHODS: A double-blind, parallel, identical placebo-drug, randomized study was performed for 2 months in 50 patients. Patients were randomly allocated to two groups. In group 1, patients were treated with diet plus placebo for 2 months. In group 2, patients were treated with diet plus placebo for 1 month, followed by diet plus folic acid (5 mg/day) plus vitamin B12 (500 microg/day) for another month. RESULTS: In group 2, folate treatment significantly decreased homocysteine levels by 27.8% (12.2+/-1.2 vs 8.8+/-0.7 micromol/l; P<0.01). A significant decrement was observed for insulin levels (19.9+/-1.7 vs 14.8+/-1.6 microU/ml; P<0.01) accompanied by a 27% reduction in the homeostasis model assessment levels. A positive relationship was found between the decrement of homocysteine and insulin levels (r=0.60; P<0.002). In parallel, endothelial dysfunction significantly improved in the treated group, since post-ischemic maximal hyperemic vasodilation increased by 29.8% and cGMP by 13.6% while asymmetrical dimethylarginine levels decreased by 21.7%. On the contrary, in group 1 patients, treated with placebo, no changes were shown in any of the variables. CONCLUSIONS: Folate and vitamin B12 treatment improved insulin resistance and endothelial dysfunction, along with decreasing homocysteine levels, in patients with metabolic syndrome, suggesting that folic acid has several beneficial effects on cardiovascular disease risk factors.

scholarly journals Relationship between insulin and hypogonadism in men with metabolic syndrome

2009 ◽  
Vol 53 (8) ◽  
pp. 1005-1011 ◽  
Author(s):  
Amanda D. A. Caldas ◽  
Adriana Lofrano Porto ◽  
Lucilia Domingues Casulari da Motta ◽  
Luiz Augusto Casulari
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Serum Insulin ◽  
Resistance Index ◽  
Free Testosterone ◽  
Total Testosterone ◽  
Model Assessment ◽  
Insulin Levels ◽  
Group 2 ◽  
Group 1

OBJECTIVE: To evaluate the incidence of hypogonadism in men with metabolic syndrome and its correlation with serum insulin levels. METHODS: Observational, transversal study with 80 men with metabolic syndrome. The individuals were divided into two groups: Group 1: 56 patients (70%) with total testosterone > 300 ng/dL (normal gonadal function); Group 2: 24 patients (30%) with total testosterone < 300 ng/dL (hypogonadic). RESULTS: The subjects from Group 2 compared to Group 1 presented higher body mass index (BMI), waist and hip circumferences, insulin, homeostasis model assessment insulin resistance index (Homa-IR) and beta cell (Homa-β), and triglycerides, but lower SHBG and free testosterone values. Inverse correlations between insulin levels and total testosterone and SHBG, as well as between Homa-IR and total testosterone were observed. CONCLUSION: In this series of men with metabolic syndrome, hypogonadism was associated with insulin resistance and may be a marker of metabolic abnormalities.

scholarly journals Plasma Total Homocysteine, Folate, and Vitamin B12 Status and Hospitalizations for Cardiovascular Disease

Pteridines ◽  
2007 ◽  
Vol 18 (1) ◽  
pp. 122-127
Author(s):  
Bakhouche Houcher ◽  
Mirande Candito ◽  
Pierre Gibelin
Keyword(s):  
Vitamin B12 ◽  
Serum Vitamin ◽  
Inverse Correlation ◽  
Serum Folate ◽  
Plasma Thcy ◽  
Total Homocysteine ◽  
Group 2 ◽  
Folate And Vitamin B12 ◽  
Plasma Total Homocysteine ◽  
Group 1

Abstract Elevated plasma total homocysteine (tHcy) is an independent risk factor for cardiovascular disease (CVD). Also known is that plasma folate and vitamin B12 influence homocysteine metabolism as cosubstrate and cofactor, respectively. This population-based study was conducted to evaluate the plasma concentrations of tHcy, folate, and vitamin B12 in 54 older patients aged ≥51 years (40 males; 14 females) of Nice hospital cardiology service. After excluding cases with a serum creatinine >120 mmol/L, we established the test properties of a plasma tHcy concentration <15 μmol/L (Group 1) or ≥15 μmol/L (Group 2). In the population aged ≥51 years, plasma tHcy was higher in women (18.0 μmol/L) than in men (15.5 μmol/L; not significant), conversely, serum vitamin B12 was higher in men (376.9 pg/ml) than in women (340.7 pg/ml; not significant). Average plasma tHcy was 11.5 μmol/L in Group 1 and 21.6 μmol/L in Group 2. Vice versa, serum vitamin B12 was higher in Group 1 (419.5 pg/ml) than in Group 2 (307.2 pg/ml) (p <0.05). Correlation analysis (Pearson's r) in the total study population (20-84 years) indicated an inverse correlation between serum folate and age (r = -0.231, p <0.05). In the subjects, aged ≥51 years, there was a significant negative correlation between age and tHcy levels (r = -0.283, p <0.05) and serum vitamin B12 concentrations (r = -0.326, p <0.01) but not with serum folate. However, in subjects with tHcy <15 μmol/L, a significant inverse correlation existed between plasma tHcy and serum folate (r = -0.455; p <0.05). In conclusion, these results highlight the relevance of the vitamin status and particularly of folate levels in the modulation of fasting tHcy levels in the patients with clinical hyperhomocysteinemia, defined as plasma tHcy >15 μmol/L.

scholarly journals Hyperhomocysteinemia is an independent risk factor of atherosclerosis in patients with metabolic syndrome

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Giuseppina Piazzolla ◽  
Mafalda Candigliota ◽  
Margherita Fanelli ◽  
Anna Castrovilli ◽  
Elsa Berardi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Uric Acid ◽  
Folic Acid ◽  
Carotid Stenosis ◽  
Color Doppler ◽  
Elevated Serum ◽  
C Peptide ◽  
Group 2 ◽  
Group 1

Abstract Background Metabolic syndrome (MetS) is a clinical condition potentially promoting the development of atherosclerotic disease. To date, the clinical impact of elevated serum homocysteine (Hcy) levels in MetS is still under discussion. The aim of this cross sectional study was to evaluate the relationship between MetS and hyperhomocysteinemia and the potential role of Hcy in the pathogenesis of atherosclerotic complications of MetS. Methods We recruited 300 outpatients with MetS. All patients underwent a medical history collection, physical examination, blood sampling and carotid ultrasound echo-color Doppler. According to Hcy levels, MetS patients were divided into two groups: “normal” (< 10.7 μmol/l; n = 140, group 1) and “high” Hcy (≥ 10.7 μmol/l; n = 160, group 2). Comparisons between groups were made by Student’s t-test or Chi-square test. The effects of potential covariates on group differences were evaluated by general linear models. The relationships between continuous variables were assessed by simple or multiple correlation and by linear regression. Multiple regression models were built to evaluate the effects of Hcy, together with other potential risk factors, on carotid atherosclerosis. Results Patients with high Hcy were predominantly male and slightly older than group 1 patients. Smokers and non-smokers exhibited similar Hcy levels, nor was a statistical relationship between pack-years and Hcy observed. Group 2 showed lower levels of folic acid, vitamin D, high density lipoprotein (HDL)-cholesterol and glomerular filtration rate (e-GFR) than group 1, but higher levels of C-peptide, uric acid and triglycerides. In all patients, Hcy was positively correlated with C-peptide and uric acid and negatively with folic acid and e-GFR. Intima-media thickness (IMT) and carotid stenosis degree were significantly higher in patients with high Hcy and a positive relationship between Hcy and both IMT and carotid stenosis was detected in all patients. Finally, Hcy atherogenic effects were independent of other well-known atherosclerosis risk factors. Conclusions Our results highlight a link between MetS and hyperhomocysteinemia and a direct effect of Hcy on atherogenic process during MetS. Early correction of folic acid levels may contribute to prevent cardiovascular complications in MetS patients.

scholarly journals INSULIN RESISTANCE IN PATIENTS WITH NEWLY DIAGNOSED PULMONARY TUBERCULOSIS WITH DIFFERENT TREATMENT OUTCOME

2019 ◽  
pp. 10-14 ◽  
Author(s):  
R. N. Yasinskyi
Keyword(s):  
Insulin Resistance ◽  
Pulmonary Tuberculosis ◽  
Fasting Glucose ◽  
Negative Impact ◽  
Fasting Insulin ◽  
Newly Diagnosed ◽  
Insulin Levels ◽  
Glucose Levels ◽  
Group 2 ◽  
Group 1

The aim of the study – to evaluate fasting glucose, insulin levels and homeostasis model assessment (HOMA-IR) index in patients with newly diagnosed pulmonary tuberculosis treatment failure (TFT) compared to data of patients who have successfully completed course of treatment (NDT). Materials and methods. 49 newly diagnosed pulmonary tuberculosis patients were examined. Patients were divided into 2 groups. Group 1 included 28 patients with TFT. Group 2 (comparison group) included 21 NDT patients. Blood sampling in the patients was done before treatment, after 3 months of the treatment start and after 2–3 months of treatment of patients in the group 1. Fasting plasma glucose level was determined by the hexokinase method by using Beckman Coulter AU640 biochemical analyzer, Japan. Fasting serum insulin level was determined by electrochemiluminescence method on Cobas e411 analyzer, Switzerland. Insulin resistance index was calculated by HOMA-IR by Matthews et al., 1985. Results. Fasting glucose levels were normal and almost similar in both groups before and after treatment, p˃0.05. Fasting insulin levels were also normal, but they were higher in patients of the group 1 than in the group 2, p˂0.05. It means there was a relative slight hyperinsulinemia in TFT patients. HOMA-IR index was also significantly greater among patients in the group 1, p˂0.05. Fasting glucose levels increase was in 10.7 % of patients in the group 1 and in 4.8 % patient in the group 2. Decrease of glucose levels was in 4.8 % of patients from the group 2. Fasting insulin levels increase was determined in 1 case among the group 1 patients and there were not cases with increased insulin levels among the patients of the group 2; fasting insulin levels reduction was identified in 14.3 % of patients from the group 1 only, p˃0.05. There was HOMA-IR index increase among patients of the group 1 mostly: 9 cases (33.3 %) versus 1 case (4.8 %) in the group 2, p˂0.05. Thus, a relative slight hyperinsulinemia in normal glucose levels and HOMA-IR index increase could be a signs of preclinical disorders of carbohydrate metabolism in patients with TFT. Conclusion. It may indicate negative impact of virulent mycobacteria and more severe clinical and radiological changes on carbohydrate metabolism or/and negative impact of such disorders to prognosis of tuberculosis.

Abstract 554: Vitamin D in Chronic Kidney Disease is Not Associated with Insulin Resistance

Hypertension ◽  
2014 ◽  
Vol 64 (suppl_1) ◽  
Author(s):  
MARIA INES BARRETO SILVA ◽  
VANESSA VICENTE ◽  
CARLA LEMOS ◽  
MARCIA R KLEIN ◽  
RACHEL BREGMAN
Keyword(s):  
Insulin Resistance ◽  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Serum Levels ◽  
Model Assessment ◽  
Body Adiposity ◽  
Group 2 ◽  
Total Body ◽  
Group 1

INTRODUCTION: Vitamin D deficiency is reported to be associated with Insulin Resistance (IR) in general population. Although the impaired homeostasis of vitamin D and IR are common conditions in chronic kidney disease (CKD), the underlying mechanisms of IR remain unclear and it is not known if vitamin D status is associated with IR in nondialyzed CKD patients. OBJECTIVE: To investigate if serum levels of 25 hidroxivitamin D [25(OH)D] are associated with IR in nondialyzed CKD patients. Methods: Cross-sectional study conducted in nondialyzed CKD outpatients under regular treatment, clinically stable, age≥18 years, estimated glomerular filtration rate (CKD-EPI) (eGFR)≤ 60 ml/min., not using vitamin D, corticosteroids and immunosuppressive drugs and without malignant diseases. Body adiposity: body mass index (BMI); total body adiposity by dual-energy X-ray absorptiometry-DXA; waist-to-height ratio (WheiR). Vitamin D was determined by analysing 25(OH)D by Passing-Bablok method; insulin by radioimmunoassay; Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Results: Patients included in this study were 158 (men:55%/n=87) nondialyzed CKD patients presenting age=66±13years; eGFR=29±13ml/min.; BMI=26±5kg/m2 (54%/n=86 overweight/obese: BMI>25). Total body adiposity-DXA=34±9% and central body adiposity-WheiR=0.6±0.08. Patients were grouped according to HOMA-IR as: Group 1 (HOMA-IR<2.7; n=110) and Group 2 (HOMA-IR ≥2.7; n=48). VitD levels (ng/ml) were not different (p≥0.05) between Group 1 (27±9) and Group 2 (28±9). Participants were also stratified as: VitD-deficient (<20ng/ml; 25%/n=40) and VitD-no-deficient (≥20 ng/ml; 75%/n=118). VitD-deficient patients compared to VitD-no-deficient presented, respectively, similar values (p≥0.05) of HOMA-IR (median; interquartil interval: 1.7; 1-3 vs. 1.6; 1-3.4), insulin (7; 5-12 vs. 6; 5-13 μU/mL); glucose (105±28 vs. 109±62 mg/dl), glycosylated hemoglobin (GHb=6±1 vs. 6±2 %). No correlation (adjusted for confounders) was observed between VitD with HOMA-IR (r=0.01,p=0.87), insulin (r=0.02,p=0.8), glucose (r=-0.05,p=0.5) and GHb (r=-0.1,p=0.6). Conclusion: The present study suggests that serum levels of 25(OH)D are not associated with IR in nondialyzed CKD patients.

Evaluation of endothelial function and arterial stiffness in obese individuals with insulin resistance

2019 ◽  
Vol 25 (2) ◽  
pp. 85-92 ◽  
Author(s):  
VP Menezes ◽  
C Cohen ◽  
J Del-Rei ◽  
W Oigman ◽  
MF Neves ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Arterial Stiffness ◽  
Endothelial Function ◽  
Statistical Significance ◽  
Hdl Cholesterol ◽  
Intima Media Thickness ◽  
Abdominal Circumference ◽  
Model Assessment ◽  
Group 2 ◽  
Group 1

Background: Obesity is associated with metabolic imbalance, including insulin resistance and endothelial dysfunction. Aim: We aimed to evaluate clinical and vascular parameters in obese with or without insulin resistance. Methods: Participants ( n=39) were divided into two groups according to Homeostasis Model Assessment – Insulin Resistance lower (group 1) or higher (group 2) than 2.7. All patients were submitted to clinical, anthropometric, biochemical, vascular structure and endothelial function assessment. Results: The mean age (53±9 vs. 52±7 years, p=0.784) and body mass index (34.3±4.1 vs. 35.2±3.9 kg/m2, p=0.464) were similar in both groups, and 74.4% were treated hypertensive subjects. Fasting glucose (84±7 vs. 97±18 mg/dl, p=0.004) and insulin (9.32±2.48 vs. 22.74±7.49 μU/ml, p<0.001) were higher in group 2. Group 2 presented lower HDL-cholesterol (59±14 vs. 42±12 mg/dl, p<0.001) and higher triglycerides (122±87 vs. 191±112 mg/dl, p=0.042) levels compared with group 1. HOMA-IR was correlated with abdominal circumference ( r=0.51, p=0.001), abdominal/hip ratio ( r=0.57, p<0.001) and triglycerides/HDL ratio ( r=0.53, p=0.001). Differences in brachial flow-mediated dilation did not reach statistical significance (10.2±6.2 vs. 7.9±4.7%, p=0.245). Carotid intima–media thickness, carotid-femoral pulse wave velocity (8.5±1.9 vs. 9.1±1.5 m/s, p=0.334) and central hemodynamic parameters were also similar between groups. Conclusion: Obese individuals with insulin resistance have higher visceral adiposity associated with impaired glucose and lipid metabolism. Endothelial function and arterial stiffness were similar between the groups, perhaps because of antihypertensive treatment in most of these subjects.

Folate and vitamin B12 status is associated with insulin resistance and metabolic syndrome in morbid obesity

2018 ◽  
Vol 37 (5) ◽  
pp. 1700-1706 ◽  
Author(s):  
Zhen Li ◽  
Rosa-Maria Gueant-Rodriguez ◽  
Didier Quilliot ◽  
Marie-Aude Sirveaux ◽  
David Meyre ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Morbid Obesity ◽  
Vitamin B12 ◽  
Folate And Vitamin B12

Evaluation of TG-HDL Ratio Instead of HOMA Ratio as Insulin Resistance Marker in Overweight and Children with Obesity

2019 ◽  
Vol 19 (5) ◽  
pp. 676-682 ◽  
Author(s):  
Eman G. Behiry ◽  
Nazih Mohamed El Nady ◽  
Omima M. AbdEl Haie ◽  
May Kamel Mattar ◽  
Amira Magdy
Keyword(s):  
Insulin Resistance ◽  
Cross Sectional Study ◽  
Mean Value ◽  
P Value ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Cross Sectional ◽  
Laboratory Investigations ◽  
Group 2 ◽  
Group 1

Background: Homeostasis model assessment for insulin resistance (HOMA-IR) is widely used as a marker of insulin resistance in adults and has also been validated in children and adolescents. Triglyceride (TG) and HDL-C on the other hand is a routine test and inexpensive compared to insulin. Previous studies reported conflicting findings on the usefulness of the triglyceride to HDL-C ratio (TG:HDL-C ratio) as predictor or marker of IR. The aim of this work was to investigate the usefulness of Triglyceride to HDL-C ratio (TG/HDL-C) as an Insulin Resistance (IR) marker in overweight and children with obesity. Methods: This study was a comparative cross sectional study which was conducted on ninety overweight and children with obesity attending National Nutrition Institute “Pediatric obesity clinic. They were classified into 2 groups as follows: group (1) included overweight and children with obesity with insulin resistance, group (2) included overweight and children with obesity with non-insulin resistance. All the subjects were subjected to history, clinical examination and laboratory investigations including total lipid profile, fasting glucose, insulin and TG:HDL-C ratio instead of HOMA ratio. Results: Prevalence of IR among the studied sample was 42 (46.7%). Mean value of TG/ HDL-C ratio was greater among the insulin resistance group than non insulin resistance group (p value= < 0.001)value). TG/HDL ratio ≥1.36 had 85.7% sensitivity, 66.7% specificity. There was statistically significant positive correlation between TG/HDL ratio and HOMA-IR. Conclusion: TG:HDL ratio ≥1.36 is a significant early and sensitive predictor of insulin resistance in children instead of HOMA-IR.

scholarly journals Role of markers of inflammation and endothelial dysfunction in the prognosis of the development of cardiovascular complications in patients with coronary artery disease and metabolic syndrome after coronary stenting

Kardiologiia ◽  
2020 ◽  
Vol 60 (8) ◽  
pp. 98-105
Author(s):  
A. V. Svarovskaya ◽  
A. T. Teplyakov ◽  
A. M. Gusakova ◽  
A. A. Garganeeva
Keyword(s):  
Metabolic Syndrome ◽  
Endothelial Dysfunction ◽  
Roc Curve ◽  
Cardiovascular Events ◽  
Control Group ◽  
Endothelin 1 ◽  
Atherosclerosis Progression ◽  
Group 2 ◽  
Group 1

Aim To study the role of inflammation markers and endothelial dysfunction in predicting the risk of cardiovascular event following a percutaneous coronary intervention (PCI) in patients with ischemic heart disease (IHD) and metabolic syndrome (MS).Materials and methods 80 patients (72 men; median age, 56 (50;63) years) with IHD and PCI were evaluated. Based on the presence of MS according to NCEP-ATP III criteria, patients were divided into two groups, group 1 without MS (n=32) and group 2 with MS (n=48). The control age- and sex-matched group included 15 people without cardiovascular diseases. Serum concentrations of tumor necrosis factor α (TNFα), interleukin 6 (IL-6), IL-10, lipoprotein-associated phospholipase A2 (LP-PLA2), and endothelin 1 were measured by enzyme-linked immunosorbent assay (ELISA). Patients were followed up for 12 months after PCI with evaluation of the incidence of adverse cardiovascular events. Statistical analysis was performed with Statistica 10.0 and Medcalc 19.2.6 software. Differences between variables were considered statistically significant at р<0.05. Potential predictors were determined by the ROC analysis with construction of ROC curves, calculation of AUC (area under the curve), identification of COP (cut-off point by the Youden’s index), and sensitivity (Se) and specificity corresponding to the COP.Results Patients with MS had statistically significantly higher serum levels of inflammatory markers than patients of the control group. Concentration of the intravascular inflammation marker, PL-PLA2, was 2.7 times higher in group 1 and 5.1 times higher in group 2 than in the control group (р<0.001). Concentrations of endothelin 1 were 1.9 times higher in group 1 and 3.7 times higher in the MS group compared to the control. At one year after PCI, the incidence of adverse outcomes in the form of cardiovascular events was higher for patients with MS: 10 (20.8 %) cases of stent restenosis and 13 (27.1 %) episodes of coronary atherosclerosis progression according to results of repeated coronarography vs. 2 (6.3%) restenosis cases (χ2–10.853; р=0.002) and 2 (6.3%) episodes of atherosclerosis progression (χ2–23.651; р=0.001) for patients without MS. The groups did not differ in rates of myocardial infarction and cardiac death. The most significant predictors of unfavorable prognosis were LP-PLA2 concentration >983.83 ng/ml (area under the ROC curve, 0.867; sensitivity, 80 %; specificity, 100%; р<0.001) and endothelin 1 overexpression >0.852 fmol/ml (area under the ROC curve, 0.885; sensitivity, 85.5 %; specificity, 83.6 %; р<0.001).Conclusion Patients with MS were characterized by more pronounced imbalance of pro- and anti-inflammatory factors. Concentrations of LP-PLA2 >983.83 ng/ml and endothelin 1 >0.852 fmol/ml were shown to be predictors of unfavorable prognosis for patients with IHD and MS after PCI with coronary stenting.

Sign in / Sign up

Export Citation Format

Share Document