Evaluation of affective temperament and anxiety-depression levels of patients with polycystic ovary syndrome.
Asik Mehmet,Altinbas Kursat,Eroglu Mustafa,Karaahmet Elif,Erbag Gokhan,Ertekin Hulya,Sen Hacer
Journal of affective disorders
BACKGROUND:Women with polycystic ovary syndrome (PCOS) are reported to experience depressive episodes at a higher rate than healthy controls (HC). Affective temperament features are psychiatric markers that may help to predict and identify vulnerability to depression in women with PCOS. Our aim was to evaluate the affective temperaments of women with PCOS and to investigate the association with depression and anxiety levels and laboratory variables in comparison with HC. METHODS:The study included 71 women with PCOS and 50 HC. Hormonal evaluations were performed for women with PCOS. Physical examination, clinical history, Hospital Anxiety and Depression Scale (HADS) and TEMPS-A were performed for all subjects. Differences between groups were evaluated using Student's t-tests and Mann-Whitney U tests. Correlations and logistic regression tests were performed. RESULTS:All temperament subtype scores, except hyperthymic, and HADS anxiety, depression, and total scores were significantly higher in patients with PCOS compared to HC. A statistically significant positive correlation was found between BMI and irritable temperament, and insulin and HADS depression scores in patients with PCOS. Additionally, hirsutism score and menstrual irregularity were correlated with HADS depression, anxiety and total scores in PCOS patients. In logistic regression analysis, depression was not affected by PCOS, hirsutism score or menstrual irregularity. However, HADS anxiety score was associated with hirsutism score. CONCLUSIONS:Our study is the first to evaluate the affective temperament features of women with PCOS. Consequently, establishing affective temperament properties for women with PCOS may help clinicians predict those patients with PCOS who are at risk for depressive and anxiety disorders.
Vitamin D is independently associated with depression in overweight women with and without PCOS.
Moran L J,Teede H J,Vincent A J
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology
BACKGROUND:Depression, anxiety, and inflammation are common in polycystic ovary syndrome (PCOS). Inflammation may adversely impact on mood and vitamin D has been associated with both mood disorders and inflammation in the general population, but these relationships have not been studied in PCOS. The aim of this study was to investigate the association among 25 hydroxy-Vitamin D (25OHVD) status, anxiety, depression, and inflammation in women with and without PCOS. METHODS:Cross-sectional study in overweight or obese premenopausal women with (n = 50) and without (n = 23) PCOS. Primary outcome measures were 25OHVD, mood (Hospital Anxiety and Depression questionnaire), and inflammation (highly sensitive C-reactive protein (hsCRP)). RESULTS:Vitamin D deficiency (25OHVD<50 nmol/L) (46% versus 39%, p = 0.311) and 25OHVD (50.4 ± 22.2 nmol/L versus 51.6 ± 19.0 nmol/L, p = 0.828) were not significantly different in women with and without PCOS. For all women combined, 25OHVD was the only significant independent predictor of depression (β = -0.063 ± 0.021, p = 0.005) and hsCRP (β = -0.041 ± 0.015, p = 0.010). CONCLUSIONS:Vitamin D deficiency is common in both women with and without PCOS with no differences between the groups. Vitamin D is independently associated with depression and inflammation in overweight women both with and without PCOS. Further investigation to clarify the interrelationship among vitamin D, inflammation and depression is required to identify optimal prevention and treatment strategies for psychological and metabolic dysfunction in PCOS.
Comparison of myo-inositol and metformin on mental health parameters and biomarkers of oxidative stress in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial.
Jamilian Hamidreza,Jamilian Mehri,Foroozanfard Fatemeh,Afshar Ebrahimi Faraneh,Bahmani Fereshteh,Asemi Zatollah
Journal of psychosomatic obstetrics and gynaecology
INTRODUCTION:Data on comparison of myo-inositol and metformin on mental health parameters and biomarkers of oxidative stress in subjects with polycystic ovary syndrome (PCOS) are scarce. This purpose of this study was to compare of myo-inositol and metformin on mental health parameters and biomarkers of oxidative stress in subjects with PCOS. METHODS:This randomized controlled trial was conducted among 60 subjects diagnosed with PCOS according to the Rotterdam criteria. Subjects were randomly assigned into two groups to intake either myo-inositol (n = 30) or metformin (n = 30) for 12 weeks. Parameters of mental health were recorded at baseline and after the 12-week intervention. Fasting blood samples were obtained at baseline and the end of the study to determine biomarkers of biomarkers of oxidative stress. RESULTS:After the 12-week intervention, changes in beck depression inventory total score (-1.0 ± 1.7 vs. -0.3 ± 0.7, p = 0.03), general health questionnaire scores (-1.7 ± 2.9 vs. -0.5 ± 1.2, p = 0.02), depression anxiety and stress scale scores (-3.9 ± 6.4 vs. -0.9 ± 1.9, p = 0.01) and plasma total antioxidant capacity (TAC) concentrations (+106.1 ± 69.6 vs. +2.1 ± 132.4 mmol/L, p < 0.001) in the myo-inositol group were significantly different from the changes in these indicators in the metformin group. Myo-inositol supplementation for 12 weeks among patients with PCOS did not affect plasma glutathione and malondialdehyde levels. CONCLUSIONS:Overall, our data supported that myo-inositol supplementation for 12 weeks among patients with PCOS had favorable effects on parameters of mental health and plasma TAC levels.
Insulin Resistance in Polycystic Ovary Syndrome Improved by Chinese Medicine Dingkun Pill (): A Randomized Controlled Clinical Trial.
Deng Yan,Xue Wei,Wang Yan-Fang,Liu Xiao-Hui,Zhu Shi-Yang,Ma Xiao,Zuo Hong-Ling,Jiang Jian-Fa,Zheng Ting-Ping,Sun Ai-Jun
Chinese journal of integrative medicine
OBJECTIVE:To assess the efficacy and safety of the Chinese medicine Dingkun Pill (, DKP) on insulin resistance in women with polycystic ovary syndrome (PCOS). METHODS:A total of 117 women with PCOS were randomly assigned to Group A (38 women), Group B (40 women), or Group C (39 women) in a randomization sequence with SAS software and a 1:1:1 allocation ratio using random block sizes of 6, and were given 7 g of oral DKP daily (Group A), 1 tablet of Diane-35 orally daily (Group B), or 7 g of oral DKP daily plus 1 tablet of Diane-35 orally daily (Group C). Patients took all drugs cyclically for 21 consecutive days, followed by 7 drug-free days. The treatment course for the 3 groups was continued for 3 consecutive months. Oral glucose tolerance tests (OGTT) were performed before treatment and again after 2 and 3 months of therapy, respectively, and homeostasis model assessment for insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) were calculated. RESULTS:Of 117 women with PCOS, 110 completed the entire course of therapy: 35 in Group A, 36 in Group B, and 39 in Group C. After treatment, all three groups showed significant decreases in fasting glucose: at 1 h glucose decreased significantly in Group A (by 0.5 ± 1.4 mmol/L, P=0.028) and Group C (by 0.5 ± 1.2 mmol/L, P=0.045); while showing a tendency to increase in Group B (by 0.4 ± 1.9 mmol/L, P=0.238). HOMA-IR decreased significantly in Group C [by 0.5 (-2.2 to 0.5) mIU mmol/L, P=0.034]. QUICKI was significantly increased in Groups A and C (by 0.009 ± 0.02, P=0.033 and by 0.009 ± 0.027, P=0.049, respectively), while no change was observed in Group B. Repeated-measure ANOVA showed that the absolute changes in all parameters (except for glucose at 1 h), including glucose and insulin levels at all time-points during OGTT and in HbA1c, HOMA-IR, and QUICKI, were not significantly different among the 3 groups after treatment (P>0.05). CONCLUSION:DKP or DKP combined with Diane-35 produce a slight improvement in insulin sensitivity compared with Diane-35 alone in PCOS patients (Trial Registration: ClinicalTrials.gov, NCT03264638).
Vitamin D Decreases Serum VEGF Correlating with Clinical Improvement in Vitamin D-Deficient Women with PCOS: A Randomized Placebo-Controlled Trial.
Irani Mohamad,Seifer David B,Grazi Richard V,Irani Sara,Rosenwaks Zev,Tal Reshef
Vascular endothelial growth factor (VEGF) has been suggested to play a role in the pathophysiology of polycystic ovary syndrome (PCOS) and may contribute to increased risk of ovarian hyperstimulation syndrome (OHSS) in affected individuals. Vitamin D (VitD) supplementation improves multiple clinical parameters in VitD-deficient women with PCOS and decreases VEGF levels in several other pathologic conditions. Unveiling the basic mechanisms underlying the beneficial effects of vitamin D on PCOS may enhance our understanding of the pathophysiology of this syndrome. It may also suggest a new treatment for PCOS that can improve it through the same mechanism as vitamin D and can be given regardless of vitamin D levels. Therefore, we aimed to explore the effect of VitD supplementation on serum VEGF levels and assess whether changes in VEGF correlate with an improvement in characteristic clinical abnormalities of PCOS. This is a randomized placebo-controlled trial conducted between October 2013 and March 2015. Sixty-eight VitD-deficient women with PCOS were recruited. Women received either 50,000 IU of oral VitD3 or placebo once weekly for 8 weeks. There was a significant decrease in serum VEGF levels (1106.4 ± 36.5 to 965.3 ± 42.7 pg·mL; < 0.001) in the VitD group. Previously reported findings of this trial demonstrated a significant decrease in the intermenstrual intervals, Ferriman-Gallwey hirsutism score, and triglycerides following VitD supplementation. Interestingly, ∆VEGF was positively correlated with ∆triglycerides (² = 0.22; = 0.02) following VitD supplementation. In conclusion, VitD replacement significantly decreases serum VEGF levels correlating with a decrease in triglycerides in women with PCOS. This is a novel molecular explanation for the beneficial effects of VitD treatment. It also suggests the need to investigate a potential role of VitD treatment in reducing the incidence or severity of OHSS in VitD-deficient women with PCOS.
Insulin resistance and lipid accumulation product in corelation to body mass index in women with polycystic ovary syndrome.
Godinjak Amina,Godinjak Zulfo,Burekovic Azra,Surkovic Ismana,Dizdarevic-Bostandzic Amela,Velija-Asimi Zelija
Medical archives (Sarajevo, Bosnia and Herzegovina)
INTRODUCTION:Women with Polycystic Ovary Syndrome (PCOS) are at increased risk for cardiovascular morbidity and metabolic disorders including: dyslipidaemia, hypertension, insulin resistance, gestational diabetes, type 2 diabetes, systemic inflammation and endothelial dysfunction. The prevalence of obesity and insulin resistance in women with PCOS is significantly higher compared to the general population. Lipid accumulation product is a new, cheap and easily available predictor for metabolic syndrome both in general population and in women with PCOS. MATERIALS AND METHODS:The study included 50 patients at the Clinic of Endocrinology, Diabetes and Metabolic Disorders, Clinical Center University of Sarajevo. All patients were diagnosed with PCOS according to the Rotterdam ESHRE criteria and were divided into two groups according to their body mass index (BMI). A prospective study established the following parameters: anthropometric measurements (waist circumference, height, weight), BMI, and serum triglycerides and insulin resistance. LAP was calculated using the formula: LAP (women) = [waist circumference (cm)-58] x [triglycerides (mmol/L)]. RESULTS:Waist circumference in women with BMI < or = 24.9 kg/m2 was 31 cm lower than waist circumference in women with a BMI > 25 kg/m2. Mean triglyceride value of the patients in group BMI < or = 24.9 kg/m2 was 1.15 mmol/l lower than the mean value of triglycerides in women with a BMI > 25 kg/m2. Insulin resistance was present in 66.7% in group with BMI < or = 24.9 kg/m2, and in 75.0% in the group with BMI > 25.0 kg/m2. LAP was shown to be a marker for the differentiation of insulin-resistant and nonresistant patients with a cut-off value of 17.91. CONCLUSION:Patients with PCOS and BMI < or = 24.9 kg/m2 were significantly different from those with BMI > 25 kg/m2 in the values of body weight, waist circumference and triglycerides. There was no statistically significant difference in insulin resistance. LAP values were higher in patients in the group with BMI > 25 kg/m2. LAP was a marker for differentiation of insulin--resistant and non-resistant women with PCOS.
Defining a cutoff point for vitamin D deficiency based on insulin resistance in children.
Sharifi Faranak,Mousavinasab Nouraddin,Mellati Ali Awsat
Diabetes & metabolic syndrome
BACKGROUND:Vitamin D deficiency is a common worldwide problem. Low levels of serum 25-hydroxy vitamin D [25(OH)D], as a marker of vitamin D deficiency, have been linked to a wide field of health problems, including metabolic diseases such as insulin resistance, type 1 and type 2 DM. There is no universal definition for cutoff value of vitamin D deficiency and it seems that it varies in different populations. OBJECTIVE:Most previous studies have used a start rise of PTH as a criteria to detect threshold of serum 25(OH)D, However, the aim of this study was to determine a cutoff point of serum 25(OH)D for vitamin D deficiency based on HOMA-IR. MATERIALS AND METHODS:Two hundred and ninety seven healthy children (aged 7-11 years) were enrolled. Serum 25(OH)D and PTH were measured and HOMA-IR was calculated. The ROC curve was utilized to obtain a cutoff of vitamin D deficiency based on HOMA-IR. RESULTS:25(OH)D concentrations were inversely correlated with HOMA-IR levels (Spearman's r=-0.14, p=0.016). Serum 25(OH)D cutoff point was 11.6ng/mL (29nmol/L) in relation with HOMA-IR >2.1. By using this cutoff value, the prevalence of vitamin D deficiency was 43.4% in this study population of healthy children. CONCLUSION:We found that serum 25(OH)D levels are inversely associated with insulin resistance. These results suggest that in MetS patients it may benefit to determine cutoff value of 25(OH)D levels based on HOMA-IR.
Triglyceride to HDL-C Ratio is Associated with Insulin Resistance in Overweight and Obese Children.
Iwani Nur Ahmad Kamil Zati,Jalaludin Muhammad Yazid,Zin Ruziana Mona Wan Mohd,Fuziah Md Zain,Hong Janet Yeow Hua,Abqariyah Yahya,Mokhtar Abdul Halim,Wan Nazaimoon Wan Mohamud
The purpose of this study was to investigate the usefulness of triglyceride to hdl-c ratio (TG:HDL-C) as an insulin resistance (IR) marker for overweight and obese children. A total of 271 blood samples of obese and overweight children aged 9-16 years were analysed for fasting glucose, lipids and insulin. Children were divided into IR and non-insulin resistance, using homeostasis model assessment (HOMA). The children were then stratified by tertiles of TG: HDL-C ratio. The strength between TG:HDL-C ratio and other parameters of IR were quantified using Pearson correlation coefficient (r). Odds ratio was estimated using multiple logistic regression adjusted for age, gender, pubertal stages and IR potential risk factors. Children with IR had significantly higher TG:HDL-C ratio (2.48) (p = 0.01). TG:HDL-C ratio was significantly correlated with HOMA-IR (r = 0.104, p < 0.005) and waist circumference (r = 0.134, p < 0.001). Increasing tertiles of TG:HDL-C ratio showed significant increase in mean insulin level (p = 0.03), HOMA-IR (p = 0.04) and significantly higher number of children with acanthosis nigricans and metabolic syndrome. The odds of having IR was about 2.5 times higher (OR = 2.47; 95% CI 1.23, 4.95; p = 0.01) for those in the highest tertiles of TG:HDL-C ratio. Hence, TG:HDL-C may be a useful tool to identify high risk individuals.
Insulin resistance and oxidative marker in women with PCOS.
Bannigida Doddappa M,Nayak B Shivananda,Vijayaraghavan R
Archives of physiology and biochemistry
Polycystic Ovary Syndrome is a multifactorial reproductive problem and a leading cause of female infertility worldwide. Evidences have shown that Oxidative Stress and decreased antioxidant status are often linked with PCOS. Insulin Resistance in PCOS patients ranges from 50% to 70% and may encourage OS by production of reactive oxygen species. Our study determines serum MDA levels along with plasma glucose, serum insulin, and insulin resistance in obese and nonobese PCOS subjects. A case control study was conducted on diagnosed 100 PCOS patients and 100 controls. Fasting plasma glucose was measured by enzymatic method. Insulin was estimated by chemiluminescent microparticle immunoassay using Abott Architect i 2000 SR analyser. Insulin resistance was calculated by HOMA-IR. Malonaldehyde is determined as Thiobarbituric acid reactive substances. CRP and serum MDA levels were increased in women with PCOS irrespective of obesity compared to their respective controls with a value of < .001. However, though fasting glucose, serum insulin, and IR were increased in both obese and nonobese women with PCOS compared to their BMI adjusted controls with value of < .001, the values were within reference range in nonobese women. Our study suggests that women with PCOS have oxidative stress and elevated CRP irrespective of obesity. However, hyperinsulinemia and Insulin resistance are seen only in obese women with PCOS, indicating that these women are at high risk for developing low grade inflammation and cardiovascular diseases.
Retinol-binding protein 4 (RBP4) as the causative factor and marker of vascular injury related to insulin resistance.
Majerczyk Marcin,Olszanecka-Glinianowicz Magdalena,Puzianowska-Kuźnicka Monika,Chudek Jerzy
Postepy higieny i medycyny doswiadczalnej (Online)
One of adipokines involved in the development of insulin resistance is retinol-binding protein 4(RBP4). The physiological role of RBP4 is transport of retinol from the liver to peripheral tissues. One of the first events related to the excessive visceral fat accumulation is the development of inflammation followed by hormonal adipose tissue dysfunction, including excessive RBP4 production. Reduced density of the membrane-type glucose transporter 4 (GLUT4) is considered as a direct cause for the stimulation of RBP4 release to the circulation by adipocytes. Circulating RBP4 inhibits the signal pathways stimulated by insulin in skeletal muscle cells, resulting in the development of insulin resistance. Drugs stimulating receptor peroxisome proliferator-activated gamma (PPARγ) - thiazolidinediones - inhibit the production of RBP4 by adipose tissue and increase the insulin sensitivity of the tissues. Increased secretion of RBP4 stimulates the expression of adhesion molecules in the endothelial cells, promoting development of atherosclerosis and arterial hypertension. Population studies demonstrated an association between serum RBP4 in the circulation, and the severity of atherosclerosis and risk of the cardiovascular events and type 2 diabetes. It also appears that the rbp4 gene functional polymorphisms may influence the risk of metabolic complications of obesity, including vascular injury. Therefore, the concentration of RBP4 in the circulation may be considered both as the causative factor and marker of chronic vascular injury. This article summarizes the current state of knowledge on the potential role of RBP4 in the pathogenesis of cardiovascular diseases, particularly related to insulin resistance.
Evaluation of TG-HDL Ratio Instead of HOMA Ratio as Insulin Resistance Marker in Overweight and Children with Obesity.
Behiry Eman G,El Nady Nazih Mohamed,AbdEl Haie Omima M,Mattar May Kamel,Magdy Amira
Endocrine, metabolic & immune disorders drug targets
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.
Fetuin-A as an Alternative Marker for Insulin Resistance and Cardiovascular Risk in Prepubertal Children.
Shim Young Suk,Kang Min Jae,Oh Yeon Jeong,Baek Joon Woo,Yang Seung,Hwang Il Tae
Journal of atherosclerosis and thrombosis
AIM:Fetuin-A plays a role in insulin resistance and cardiovascular disease. This study aims to determine the relationship between fetuin-A levels and cardiometabolic risk factors, as well as to investigate the effect of serum fetuin-A on insulin resistance indices to determine whether fetuin-A is an additional marker for insulin resistance in prepubertal children. METHODS:A total of 99 prepubertal Korean children (59 males) aged from 6.0 to 10.0 years was included in this study. Subjects were divided into underweight/normal-weight and overweight/obese groups. Serum fetuin-A levels were measured using an enzyme-linked immunosorbent assay and were natural logarithm (ln)-transformed. RESULTS:Serum fetuin-A concentrations were significantly elevated in overweight/obese children as compared with underweight/normal-weight children (P=0.029). Ln serum fetuin-A was significantly positively correlated with body mass index (BMI) standard deviation scores (SDSs) (r=0.239, P=0.017), triglyceride levels (r=0.285, P=0.004), ln insulin (r=0.377, P＜0.001), systolic blood pressure (BP) (r=0.274, P=0.006), and diastolic BP (r=0.304, P=0.006) and was significantly inversely correlated with high-density lipoprotein cholesterol (HDL-C) levels (r=-0.236, P=0.019). In univariate linear regression analysis, ln fetuin-A was significantly positively associated with the homeostasis model assessment of insulin resistance (HOMA-IR) (r=0.356, P＜0.001) and significantly inversely associated with the quantitative insulin sensitivity check index (QUICKI) (r=-0.309, P=0.002). Following adjustment for age, gender, BMI, and lipid profiles in multivariate linear regression analysis, fetuin-A was significantly positively associated with HOMA-IR (P=0.048) and marginally inversely associated with QUICKI (P=0.054). CONCLUSIONS:Our results suggest that fetuin-A can be an alternative marker for insulin resistance and cardiovascular risk in prepubertal children.
Metabolic syndrome and inflammation markers in patients with schizophrenia and recurrent depressive disorder.
Lasić Davor,Bevanda Milenko,Bošnjak Nada,Uglešić Boran,Glavina Trpimir,Franić Tomislav
BACKGROUND:The high prevalence of metabolic syndrome in patients with psychiatric disorders, almost double the prevalence reported for the general population, is worrying. The aim of this study is to investigate the presence of metabolic syndrome and inflammatory marker levels in patients with schizophrenia and recurrent depressive disorder in a Croatian psychiatric sample. SUBJECTS AND METHODS:This study included 62 inpatients with schizophrenia and 62 with recurrent depressive disorder treated at the Department of Psychiatry, University Hospital Centre Split, enrolled from November 2011 until May 2012. The cases were compared to 124 healthy subjects from the general population. RESULTS:The presence of metabolic syndrome was found in 56.5% of the patients with schizophrenia and 53.2% of the patients with depression, which was significantly more prevalent than in the control group (32.3%). The levels of inflammation markers (i.e., C-reactive protein and PAI-1) were significantly higher among patients with metabolic syndrome. CONCLUSIONS:Patients with schizophrenia and recurrent depressive disorder demonstrate a high prevalence of metabolic syndrome that is also related to inflammation processes. In the context of integrative medicine, clinicians and researchers should consider psychiatric patients within a holistic approach.
Waist Circumference Coupled with Either HDL-C or TG Can Be Used as a Diagnostic Marker for Metabolic Syndrome in Chinese Women with Polycystic Ovary Syndrome.
Sun Yan,Wang Wenxiang,Shen Qi,Du Shengrong,Guo Yiwei,He Fei,Zhang Wenchang
International journal of endocrinology
Although quite a few polycystic ovary syndrome (PCOS) patients suffering from metabolic syndrome (MS) have been reported in previous studies, no reliable and early diagnostic biomarkers for MS in PCOS patients have yet been identified. To identify early and reliable diagnostic biomarkers for MS in Chinese women with PCOS, a total of 401 patients (200 PCOS patients and 201 controls) were enrolled in our present study. All of the subjects were examined for anthropometric (weight, waist circumference, blood pressure, etc.) and biochemical (fasting glucose, serum lipid indices, total testosterone, etc.) parameters. Our results showed that the prevalence of MS in the PCOS patients (20.50%) was 6.8-fold higher ( < 0.05) than that in the controls (2.99%). Nearly 71.0% of the PCOS patients had at least one component of MS, of which dyslipidemia was the most prevalent. Furthermore, within the PCOS group, the prevalence of MS increased with increasing age and body mass index (BMI). Logistic analysis indicated that BMI, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), hypertension, and fasting glucose were significantly associated with the presence of MS in PCOS patients. Analysis of the ability of the potential diagnostic biomarkers to indicate MS in PCOS patients showed that the PPV, NPV, specificity, sensitivity, and Youden's index for waist circumference (WC) coupled with HDL-C were 59.68%, 97.10%, 84.28%, 90.24%, and 74.52, respectively, and those for WC coupled with TG were 93.33%, 92.35%, 98.74%, 68.29%, and 67.03%, respectively. ROC curve analysis showed that the areas under the ROC curves (AUCs) for WC coupled with HDL-C and for WC coupled with TG were 0.882 and 0.901, respectively. Our present study demonstrates that WC coupled with either HDL-C or TG can be used as a relatively early and reliable diagnostic biomarker for MS in Chinese PCOS patients.
Soluble CD36- a marker of the (pathophysiological) role of CD36 in the metabolic syndrome?
Koonen Debby P Y,Jensen Majken K,Handberg Aase
Archives of physiology and biochemistry
CD36 is a class B scavenger receptor observed in many cell types and tissues throughout the body. Recent literature has implicated CD36 in the pathogenesis of metabolic dysregulation such as found in obesity, insulin resistance, and atherosclerosis. Genetic variation at the CD36 loci have been associated with obesity and lipid components of the metabolic syndrome, with risk of heart disease and type 2 diabetes. Recently, non-cell bound CD36 was identified in human plasma and was termed soluble CD36 (sCD36). In this review we will describe the functions of CD36 in tissues and address the role of sCD36 in the context of the metabolic syndrome. We will also highlight recent findings from human genetic studies looking at the CD36 locus in relation to metabolic profile in the general population. Finally, we present a model in which insulin resistance, oxLDL, low-grade inflammation and liver steatosis may contribute to elevated levels of sCD36.
Exercise improves the ApoB/ApoA-I ratio, a marker of the metabolic syndrome in obese children.
Ben Ounis O,Elloumi M,Makni E,Zouhal H,Amri M,Tabka Z,Lac G
Acta paediatrica (Oslo, Norway : 1992)
AIM:This study was designed to examine the effect of training on components of the metabolic syndrome and ApoB/ApoA-I ratio in obese children. METHODS:We studied thirty-two obese children (13.3 ± 0.4 years) with 16 subjects who participated to 8-week training and 16 subjects serving as a control group. Training was individualized at the point where fat oxidation was maximal (Fat max). In each subject, pre- and postintervention anthropometric measures and biochemical tests on fasting blood were performed. RESULTS:After the programme, the training group showed an increase in VO(2peak) and fat oxidation during exercise. Body mass index (BMI), blood glucose and triglycerides were reduced, and high-density lipoprotein (HDL) was increased. ApoB/ApoA-I ratio decreased significantly (-0.43%, p < 0.01). Systolic and diastolic blood pressure also decreased (-8.4% and -10.9%, respectively). Among the training group, 10 subjects were classified as having the metabolic syndrome before the intervention and none after. No significant changes in any other variables were measured in the control group. CONCLUSIONS:Training targeted at Fat max reduces the prevalence of metabolic syndrome and its associated factors in obese children. In particular, this intervention decreases the ApoB/ApoA-I ratio, which may be considered as a marker for following this syndrome.
Leptin/Adiponectin ratio as a potential biomarker for metabolic syndrome in patients with schizophrenia.
Chen Vincent Chin-Hung,Chen Chun-Hsin,Chiu Yi-Hang,Lin Tsang-Yaw,Li Feng-Chiao,Lu Mong-Liang
OBJECTIVE:Leptin and adiponectin are adipokines which have opposing roles in the development of insulin resistance and metabolic syndrome (MetS). Leptin/adiponectin ratio (L/A ratio) has been proposed as a good biomarker for MetS in general population. This study aimed to compare the strength of association between MetS and leptin, adiponectin and L/A ratio, as well as to assess their performance to diagnose MetS in patients with schizophrenia. METHODS:Patients diagnosed with DSM-IV schizophrenia and under clozapine or olanzapine monotherapy for at least six months were recruited. We used the modified ATP III criteria for Asians to evaluate subjects for a diagnosis of MetS. RESULTS:We recruited 262 study subjects with schizophrenia, and classified them into those with MetS (n = 87) and those without MetS (n = 175). Leptin level was positively correlated with BMI, waist circumference, and insulin level. Adiponectin level was negatively correlated with most metabolic parameters, except glucose level. L/A ratio was positively correlated with most metabolic parameters, except levels of glucose and HDL-C. Significant gender differences existed in leptin levels, adiponectin levels, and L/A ratio. Without and with adjustment of age and gender, binary logistic regression analysis showed that leptin level, adiponectin level, and L/A ratio were significantly associated with MetS. The area under curve (AUC) of L/A ratio and leptin level for MetS was 0.744 (95% CI = 0.685-0.802) and 0.666 (95% CI = 0.601-0.731). The AUC of adiponectin level for the absence of MetS was 0.717 (95% CI = 0.655-0.780). The discriminative strength of L/A ratio for MetS was better in men than in women. CONCLUSIONS:The present study results suggest that L/A ratio may be a preferential marker of metabolic syndrome in patients with schizophrenia compared to leptin or adiponectin alone.
Creatine Kinase Is a Marker of Metabolic Syndrome in Qatari Women With and Without Polycystic Ovarian Syndrome.
Al-Hail Noora,Butler Alexandra E,Dargham Soha R,Abou Seif Ahmed,Atkin Stephen L
Frontiers in endocrinology
To correlate features of metabolic syndrome with creatine kinase (CK) in women with and without polycystic ovary syndrome (PCOS). Comparative cross-sectional analysis. Demographic and metabolic data from Qatari women aged 18-40 years from the Qatar Biobank (97 diagnosed with PCOS, 563 controls). The primary outcome was the association between plasma CK and features of metabolic syndrome. CK increased when the waist circumference was >80 cm ( < 0.015) and when associated with 2 or more features of the metabolic syndrome ( < 0.01). CK correlated with BMI ( < 0.003) but not with waist/hip ratio. Overall, CK did not differ between PCOS and controls, rising equally in both as body mass index (BMI) increased. C reactive protein (CRP) was higher in obese PCOS ( < 0.05) compared to controls, but did not correlate with CK ( > 0.05). CK was associated with an increase in BMI, waist circumference >80 cm and 2 or more features of the metabolic syndrome, in accord with the central role of type II skeletal muscle fibers in energy metabolism and obesity. CK was, however, independent of the PCOS phenotype.
The adipokines and inflammatory marker in young type 2 diabetics with metabolic syndrome: A pilot study.
Wen Min-Jie,Hsieh Chang-Hsun,Wu Chung-Ze,Hsiao Fone-Ching,Hsia Te-Lin,Hung Yi-Jen,Pei Dee
Obesity research & clinical practice
OBJECTIVE:The purpose of the metabolic syndrome (MetS) concept was to early identify subjects having risk for developing cardiovascular diseases and diabetes, which of both are involved in low grade inflammation and obesity. We wish to explore the role of adipokines and inflammatory marker in young type 2 diabetics (YDM) with MetS. METHODS:Forty-eight YDM patients were divided to 2 and 3 groups according to the presence of the MetS (MetS+ and MetS-), and the numbers of MetS component (MetS-2 to MetS-4 with 1-2, 3, and 4-5 components) respectively. Plasma adipokines (tumor necrosis factor-α; TNF-α and adiponectin) and C-reactive protein (CRP) were measured and compared among groups. RESULTS:Blood pressure (BP), body mass index (BMI), and plasma triglyceride (TG) levels were higher in the group with MetS+ than that of MetS-. Except for diastolic BP, BMI, waist, and plasma TG levels, which were generally lower in the MetS-2 group, the rest demographic characteristics were not different among these three groups. Finally, the plasma adiponectin, CRP and TNF-αlevels were not different between both groups with or without MetS; and also among these three groups regardless the component numbers they had. CONCLUSION:YDM with MetS might have non-significant lower adiponectin and higher CRP levels compared to subjects without MetS. It needs prospective study with larger scale to explicit the role of cytokines and inflammatory markers in YDM with MetS.
Impact of Serum Leptin to Adiponectin Ratio on Regression of Metabolic Syndrome in High-Risk Individuals: The ARIRANG Study.
Kang Dae Ryong,Yadav Dhananjay,Koh Sang Baek,Kim Jang Young,Ahn Song Vogue
Yonsei medical journal
PURPOSE:The ratio of serum leptin to adiponectin (L/A ratio) could be used as a marker for insulin resistance. However, few prospective studies have investigated the impact of L/A ratio on improvement of metabolic components in high-risk individuals with metabolic syndrome. We examined the association between L/A ratio and the regression of metabolic syndrome in a population-based longitudinal study. MATERIALS AND METHODS:A total of 1017 subjects (431 men and 586 women) with metabolic syndrome at baseline (2005-2008) were examined and followed (2008-2011). Baseline serum levels of leptin and adiponectin were analyzed by radioimmunoassay. Area under the receiver operating characteristics curve (AUROC) analyses were used to assess the predictive ability of L/A ratio for the regression of metabolic syndrome. RESULTS:During an average of 2.8 years of follow-up, metabolic syndrome disappeared in 142 men (32.9%) and 196 women (33.4%). After multivariable adjustment, the odds ratios (95% confidence interval) for regression of metabolic syndrome in comparisons of the lowest to the highest tertiles of L/A ratio were 1.84 (1.02-3.31) in men and 2.32 (1.37-3.91) in women. In AUROC analyses, L/A ratio had a greater predictive power than serum adiponectin for the regression of metabolic syndrome in both men (p=0.024) and women (p=0.019). CONCLUSION:Low L/A ratio is a predictor for the regression of metabolic syndrome. The L/A ratio could be a useful clinical marker for management of high-risk individuals with metabolic syndrome.
Leptin as a predictive marker for metabolic syndrome.
Ghadge Abhijit A,Khaire Amrita A
Metabolic syndrome poses a major threat on human health affecting the quality of life. Adipose tissue is an important organ which plays a crucial role in the pathogenesis of metabolic syndrome. Adipocytokines secreted by the adipose tissue plays a critical role in storage, food intake, energy expenditure, lipid and glucose metabolism. Leptin is primarily involved in regulating food intake, body weight and energy homeostasis through neuroendocrine functions. Contemporary research suggests that leptin also influences insulin sensitivity and lipid metabolism. High leptin concentrations are directly associated with the obesity subsequent development of metabolic disease sequelae such as insulin resistance, type 2 diabetes and cardiovascular diseases. Elucidation of the mechanism of action of leptin would help to develop novel therapeutic approaches for there metabolic disorders like obesity and diabetes. This review provides an updated 'state-of-the-art' about the leptin and its role in the pathophysiology of metabolic syndrome at the molecular level.
Sagittal Abdominal Diameter as a Surrogate Marker of Insulin Resistance in an Admixtured Population--Brazilian Metabolic Syndrome Study (BRAMS).
Vasques Ana Carolina J,Cassani Roberta S L,Forti Adriana C e,Vilela Brunna S,Pareja José Carlos,Tambascia Marcos Antonio,Geloneze Bruno,
BACKGROUND:Sagittal abdominal diameter (SAD) has been proposed as a surrogate marker of insulin resistance (IR). However, the utilization of SAD requires specific validation for each ethnicity. We aimed to investigate the potential use of SAD, compared with classical anthropometrical parameters, as a surrogate marker of IR and to establish the cutoff values of SAD for screening for IR. METHODS:A multicenter population survey on metabolic disorders was conducted. A race-admixtured sample of 824 adult women was assessed. The anthropometric parameters included: BMI, waist circumference (WC), waist-to-hip ratio and SAD. IR was determined by a hyperglycemic clamp and the HOMA-IR index. RESULTS:After adjustments for age and total body fat mass, SAD (r = 0.23 and r = -0.70) and BMI (r = 0.20 and r = -0.71) were strongly correlated with the IR measured by the HOMA-IR index and the clamp, respectively (p < 0.001). In the ROC analysis, the optimal cutoff for SAD in women was 21.0 cm. The women with an increased SAD presented 3.2 (CI 95%: 2.1-5.0) more likelihood of having IR, assessed by the HOMA-IR index compared with those with normal SAD (p < 0.001); whereas women with elevated BMI and WC were 2.1 (95% CI: 1.4-3.3) and 2.8 (95% CI: 1.7-4.5) more likely to have IR (p < 0.001), respectively. No statistically significant results were found for waist-to-hip ratio. CONCLUSIONS:SAD can be a suitable surrogate marker of IR. Understanding and applying routine and simplified methods is essential because IR is associated with an increased risk of obesity-related diseases even in the presence of normal weight, slight overweight, as well as in obesity. Further prospective analysis will need to verify SAD as a determinant of clinical outcomes, such as type 2 diabetes and cardiovascular events, in the Brazilian population.
[C-peptide level as an early diagnostic marker of metabolic syndrome and predictor of cardiovascular disease in patients with diabetes mellitus type 2].
Beliakin S A,Serebrennikov V N,Shklovskiĭ B L,Patsenko M B
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.
Folate and vitamin B12 status is associated with insulin resistance and metabolic syndrome in morbid obesity.
Li Zhen,Gueant-Rodriguez Rosa-Maria,Quilliot Didier,Sirveaux Marie-Aude,Meyre David,Gueant Jean-Louis,Brunaud Laurent
Clinical nutrition (Edinburgh, Scotland)
BACKGROUND:Low vitamin B12 and high folate during pregnancy are associated with visceral obesity and insulin resistance in offspring. In the general population, high folate exacerbates the increase of methylmalonic acid, a marker of vitamin B12 deficiency. However, the influence of vitamin B12 and folate and their related markers on insulin resistance and metabolic syndrome remains unknown in severe obesity. AIM:To evaluate the influence of vitamin B12 and folate on HOMA-IR and components of metabolic syndrome in severe obesity. METHODS:278 consecutive obese patients were assessed prospectively for HOMA-IR, red blood cell (RBC) folates, homocysteine and methylmalonic acid. We compared the associations with the components of metabolic syndrome during the preoperative multidisciplinary evaluation (period-1) and before bariatric surgery (period-2). RESULTS:The HOMA-IR was higher in patients with highest tertile of RBC and either lowest tertile of plasma B12 or highest tertile of MMA (p < 0.034 and 0.011, respectively). Lg HOMA-IR was negatively correlated with Lg homocysteine (p < 0.0001) and positively correlated with Lg serum folate (p < 0.001). The independent predictors for HOMA-IR at period 2 were either BMI and homocysteine (model 1 without serum folate, p = 0.010 and p = 0.002, respectively) or BMI and MMA (model 2 without homocysteine, p = 0.030 and p = 0.004, respectively). Age and RBC folate remained independently associated with the number of metabolic syndrome components (p = 0.006 and 0.020, respectively). CONCLUSIONS:RBC folate, homocysteine, and MMA predict HOMA-IR in severe obesity. Our findings challenge the benefit of folate fortified food in severe obesity, in particular in patients with a deficit of vitamin B12. The cohort study was registered at clinicaltrials.gov as NCT02663388.
The association between Metabolic Syndrome and serum levels of lipid peroxidation and interleukin-6 in Gorgan.
Sarbijani Hamide Mojaz,Khoshnia Masoud,Marjani Abdoljalal
Diabetes & metabolic syndrome
BACKGROUND:There are limited studies on the relationship between inflammatory marker such as IL-6 and lipid peroxidation and metabolic syndrome. OBJECTIVE:The aim of present study was to assess IL-6 and lipid peroxidation in subjects with and without the metabolic syndrome and their association with metabolic syndrome components. METHODS:Age and gender matched 40 subjects with metabolic syndrome and 40 control groups took part in this study. RESULTS:The mean malondialdehyde level was significantly higher in overweight and obese subjects with metabolic syndrome than control groups (P<0.05). The mean level of IL-6 in men and the mean level of malondialdehyde in women with metabolic syndrome was significantly higher than control groups (p<0.05). There were significant positive correlation between malondialdehyde and fasting blood glucose, triglyceride and systolic blood pressure (p<0.05). CONCLUSIONS:Our results suggest that higher levels of IL-6 and malondialdehyde may cause insulin resistance and metabolic disorders in all subjects with metabolic syndrome. Malondialdehyde level shows strong association with some metabolic syndrome components. This means the greater risk of metabolic syndrome.
A possible role of serum uric acid as a marker of metabolic syndrome.
Lee Y-J,Cho S,Kim S R
Internal medicine journal
BACKGROUND/AIMS:The association between serum uric acid (SUA) levels and metabolic syndrome (MetS) has recently been reported in several cross-sectional and longitudinal studies. We investigated SUA as a biomarker to predict future development of MetS in healthy Korean men without diabetes or hypertension and determined the optimal cut-off levels of SUA. METHODS:A retrospective cohort study was conducted using data from healthy men who received a general health check-up in 2003. A total of 1809 participants free of MetS, diabetes and hypertension was enrolled. Participants were classified into three groups based on SUA levels: group 1 (<5.5 mg/dL), group 2 (5.5-6.9 mg/dL) and group 3 (≥7.0 mg/dL). RESULTS:During 13,802 person-years of follow up, 127 participants developed MetS. After adjusting for multiple associated parameters, SUA was significantly associated with incident MetS (hazard ratios comparing groups 2 and 3 vs group 1, 2.45 and 3.47 respectively; P < 0.001). In receiver operating characteristic curve analysis, the optimal cut-off level for SUA to predict the development of MetS was 6.5 mg/dL. CONCLUSION:Our results indicate that an increased level of SUA, even within the normal range, is associated with future development of MetS in healthy middle-aged men.
Serum uric acid level as a determinant of the metabolic syndrome: A case control study.
Khichar Satyendra,Choudhary Shyama,Singh Veer Bahadur,Tater Priyanka,Arvinda R V,Ujjawal Vivek
Diabetes & metabolic syndrome
AIMS:To determine whether elevations of uric acid levels are associated with the cluster of disorders described in metabolic syndrome and to evaluate whether hyperuricemia may be considered a component of this syndrome. METHODS:One year case-control study was conducted in Bikaner, Rajasthan, India from January to December 2013. The study population consisted of 200 subjects, 100 with metabolic syndrome (case) and 100 without metabolic syndrome (control) aged between 18 and 80 years, attending OPD at PBM Hospital were studied. Controls were age and sex matched to the cases. Blood tests and all physical variables were examined using standard methods. Subjects were divided into 6 groups according to their possession of 0, 1, 2, 3, 4 or 5 components of the metabolic syndrome. Statistical analysis was done using ANOVA, linear regression analysis and multivariate linear regression model. RESULTS:Mean serum UA level was significantly associated with all components of metabolic syndrome (p<0.001) and had strong positive correlation (r=+0.66 to +0.77, p<0.0001) with all of them except serum HDL with which it showed strong negative correlation(r=-0.71, p<0.0001). It increased as the number of metabolic factors increased showing a highly significant trend (p<0.0001). On multivariate regression analysis UA contributed to 66.84% variance of metabolic syndrome. CONCLUSION:The current multivariate regression analysis clearly infers that uric acid can be considered as a marker and potential modifier of metabolic syndrome.
Apolipoprotein B/apolipoprotein A1 ratio is a good predictive marker of metabolic syndrome and pre-metabolic syndrome in Chinese adolescent women with polycystic ovary syndrome.
Yin Qianqian,Chen Xiaoli,Li Lin,Zhou Ran,Huang Jia,Yang Dongzi
The journal of obstetrics and gynaecology research
AIM:The apolipoprotein B/apolipoprotein A1 (ApoB/ApoA1) ratio is well known to be related to metabolic syndrome (MS) and its components in adults of different races. There is low prevalence of MS but high occurrence of various metabolic disorders in Chinese adolescent women with polycystic ovary syndrome (PCOS). We sought to assess if the ApoB/ApoA1 ratio can be used as a predictive marker of MS and pre-MS in Chinese adolescent women with PCOS. MATERIAL AND METHODS:This cross-sectional study included 160 Chinese adolescent women. Based on International Diabetes Federation criteria for MS, patients who had no less than two components of MS but did not meet the criteria for the diagnosis of MS were considered as having pre-MS. RESULTS:The ApoB/ApoA1 ratio was higher in obese subjects with high free androgen index (FAI). The ApoB/ApoA1 ratio increased significantly as the number of MS components increased and provided 87.5% of sensitivity and 78.9% of specificity with a threshold value of 0.63 for MS, 86.2% of sensitivity and 79.4% of specificity with a threshold value of 0.58 for pre-MS in Chinese adolescent women with PCOS. CONCLUSION:The ApoB/ApoA1 ratio was a good predictive marker of MS and pre-MS in Chinese adolescent women with PCOS. FAI could be involved in obesity-related metabolic abnormalities.
Neutrophil-to-lymphocyte ratio as a predictive marker of metabolic syndrome.
Liu Chuan-Chuan,Ko Hung-Ju,Liu Wan-Shan,Hung Chung-Lieh,Hu Kuang-Chun,Yu Lo-Yip,Shih Shou-Chuan
Neutrophil-to-lymphocyte ratio (NLR) serves as a strong prognostic indicator for patients suffering from various diseases. Neutrophil activation promotes the recruitment of a number of different cell types that are involved in acute and chronic inflammation and are associated with cancer treatment outcome. Measurement of NLR, an established inflammation marker, is cost-effective, and it is likely that NLR can be used to predict the development of metabolic syndrome (MS) at an early stage. MS scores range from 1 to 5, and an elevated MS score indicates a greater risk for MS. Monitoring NLR can prevent the risk of MS.A total of 34,013 subjects were enrolled in this study. The subjects (score 0-5) within the 6 groups were classified according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, and all anthropometrics, laboratory biomarkers, and hematological measurements were recorded. For the 6 groups, statistical analysis and receiver operating characteristic (ROC) curves were used to identify the development of MS.Analysis of the ROC curve indicated that NLR served as a good predictor for MS. An MS score of 1 to 2 yielded an acceptable discrimination rate, and these rates were even higher for MS scores of 3 to 5 (P < .001), where the prevalence of MS was 30.8%.NLR can be used as a prognostic marker for several diseases, including those associated with MS.
Circulating C1q/TNF-related protein isoform 15 is a marker for the presence of metabolic syndrome.
Mi Qiao,Li Yanxin,Wang Miao,Yang Gangyi,Zhao Xili,Liu Hua,Zheng Hongting,Li Ling
Diabetes/metabolism research and reviews
BACKGROUND:C1q/TNF-related protein isoform 15 (CTRP15) has been reported to be related to glucose and lipid metabolism, but the results are inconsistent. Metabolic syndrome (MetS) is a cluster of metabolic disorders. The aim of this study is to determine circulating CTRP15 levels in individuals with MetS and investigate the association among circulating CTRP15 and markers for MetS as well as insulin resistance. METHODS:A total of 341 individuals were recruited for this cross-sectional study. These subjects were screened for MetS. Serum CTRP15 concentrations were measured by ELISA. RESULTS:Serum CTRP15 levels were significantly higher in MetS individuals relative to those of the healthy individuals. Circulating CTRP15 correlated positively with WHR, BMI, SBP, FAT %, 2 h-BG, FIns, 2 h-Ins, TG, FFA, HbA1c, HOMA-IR, and AUC , while negatively with HDL-C and ISI. Multiple linear regression showed that HOMA-IR and HDL-C are independently related factors influencing serum CTRP15 concentrations. In addition, binary logistic regression analysis showed that serum CTRP15 concentrations were significantly related to MetS. When the mean concentrations of circulating CTRP15 in MetS subjects were stratified by the number of components of the MetS, circulating CTRP15 was found to increase progressively with increasing number of the MetS components. Finally, ROC curve analysis showed that the best cutoff values for circulating CTRP15 to predict MetS and insulin resistance were 63.6 and 64.0 μg/L. CONCLUSIONS:Serum CTRP15 concentrations were associated with the key components of MetS and insulin resistance.
Thrombospondin 1 as a novel biological marker of obesity and metabolic syndrome.
Matsuo Yoshiyuki,Tanaka Masashi,Yamakage Hajime,Sasaki Yousuke,Muranaka Kazuya,Hata Hiroaki,Ikai Iwao,Shimatsu Akira,Inoue Mayumi,Chun Tae-Hwa,Satoh-Asahara Noriko
Metabolism: clinical and experimental
CONTEXT:Thrombospondin 1 (THBS1 or TSP-1) is an adipose-derived matricellular protein, which has recently been highlighted as a potential mediator of insulin resistance and adipose inflammation in obesity. OBJECTIVE:In this study, we aimed to determine the clinical significance of THBS1 as a novel biological marker of visceral obesity, metabolic syndrome, and diabetes. METHODS:The THBS1 mRNA level was quantified with real-time PCR in human adipose tissues obtained from 16 non-obese subjects. The relationships between serum THBS1 level and obesity/diabetes traits as well as the diagnostic components of metabolic syndrome were assessed in 164 normal-weight or overweight/obese subjects (78 males and 86 females; mean age, 50.4; mean BMI, 29.8) with analysis of covariance (ANCOVA) and regression analyses. RESULTS:THBS1 was predominantly expressed in visceral adipose tissues relative to subcutaneous adipose tissues (P<0.001). The visceral THBS1 expression was positively associated with the body mass index (BMI; γs=0.54, P=0.033). ANCOVA demonstrated that the THBS1 level is associated with abdominal obesity (P<0.001), hyperglycemia (P=0.02), and hypertension (P=0.04). Multivariable regression analysis suggested an association between serum THBS1 and fasting plasma glucose levels. The associations between serum THBS1 levels and obesity/diabetes traits were found preferentially in women (BMI, γs=0.30, P=0.05; FPG, γs=0.26, P=0.016). Subanalyses demonstrated that the association with obesity traits was predominantly found in premenopausal women (BMI, γs=0.41, P=0.007), whereas the association with diabetes traits was predominant in postmenopausal women (HbA1c, γs=0.38, P=0.01). During medical weight reduction treatment, the change in the serum THBS1 level was associated with the change in BMI and HbA1c in pre- and postmenopausal women, respectively. CONCLUSIONS:Serum THBS1 is a useful biological marker of obesity and metabolic syndrome in Japanese subjects, particularly in women. THBS1 may act as a critical circulating factor that couples obesity with metabolic syndrome and diabetes in humans.