• Title, Summary, Keyword: HOMA IR

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The Relative Factors to Insulin Resistance and β Cell Function Determined by Homeostasis Model Assessment in Nondiabetic Adults

  • Kwon, Se-Young;Na, Young-Ak
    • Korean Journal of Clinical Laboratory Science
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    • v.45 no.4
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    • pp.131-138
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    • 2013
  • Insulin resistance and pancreatic beta cell dysfunction have been established as being related to the diabetes. Lately, what is emphasizing is that those have been shown as something related to the metabolic syndrome and cardiovascular disease. Homeostasis model assessment (HOMA), simple index is calculated on blood levels of fasting glucose and insulin. And HOMA has been widely validated and applied for insulin resistance and pancreatic beta cell dysfunction. We also assessed the factors relative to insulin resistance and ${\beta}$ cell function determined by HOMA. The data from the 2010 Korean National Health and Nutrition Examination Survey were used. Analysis was done for 3,465 nondiabetic subjects (male 1,357, female 2,108). At baseline, anthropometric measurements were done and fasting glucose, insulin, lipid (Total cholesterol, HDL cholesterol, LDL cholesterol and Triglycerides) profiles were measured. HOMA-insulin resistance (HOMA-IR) and beta cell function (HOMA ${\beta}$-cell) were calculated from fasting glucose and insulin levels. In male, the value of HOMA-IR and HOMA ${\beta}$-cell was the highest among 30's and decreased as the age increased. In female, the value of HOMA-IR increased with age, while HOMA ${\beta}$-cell decreased. High HOMA-IR and low HOMA ${\beta}$-cell were associated with the highest value of fasting glucose and systolic blood pressure. Low HOMA-IR and high HOMA ${\beta}$-cell showed the lowest concentration of fasting glucose and the highest concentration of HDL cholesterol. High HOMA-IR and high HOMA ${\beta}$-cell were connected with BMI, Total cholesterol, LDL cholesterol, and Triglycerides. There was a negative correlation between HOMA ${\beta}$-cell and age. The correlation coefficients of HOMA-IR and HOMA ${\beta}$-cell showed the highest value among weight, BMI and WC.

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Impact of Insulin Resistance on Acetylcholine-Induced Coronary Artery Spasm in Non-Diabetic Patients

  • Kang, Kwan Woo;Choi, Byoung Geol;Rha, Seung-Woon
    • Yonsei Medical Journal
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    • v.59 no.9
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    • pp.1057-1063
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    • 2018
  • Purpose: Coronary artery spasm (CAS) and diabetes mellitus (DM) are implicated in endothelial dysfunction, and insulin resistance (IR) is a major etiological cause of type 2 DM. However, the association between CAS and IR in non-diabetic individuals has not been elucidated. The aim of the present study was to evaluate the impact of IR on CAS in patients without DM. Materials and Methods: A total of 330 eligible patients without DM and coronary artery disease who underwent acetylcholine (Ach) provocation test were enrolled in this study. Inclusion criteria included both hemoglobin A1c <6.0% and fasting glucose level <110 mg/dL without type 2 DM. Patients were divided into quartile groups according the level of homeostasis model assessment of insulin resistance (HOMA-IR): 1Q (n=82; HOMA-IR<1.35), 2Q (n=82; $1.35{\leq}HOMA-IR<1.93$), 3Q (n=83; $1.93{\leq}HOMA-IR<2.73$), and 4Q (n=83; $HOMA-IR{\geq}2.73$). Results: In the present study, the higher HOMA-IR group (3Q and 4Q) was older and had higher body mass index, fasting blood glucose, serum insulin, hemoglobin A1c, total cholesterol, and triglyceride levels than the lower HOMA-IR group (1Q). Also, poor IR (3Q and 4Q) was considerably associated with frequent CAS. Compared with Q1, the hazard ratios for Q3 and Q4 were 3.55 (95% CI: 1.79-7.03, p<0.001) and 2.12 (95% CI: 1.07-4.21, p=0.031), respectively, after adjustment of baseline risk confounders. Also, diffuse spasm and accompanying chest pain during Ach test were more strongly associated with IR patients with CAS. Conclusion: HOMA-IR was significantly negatively correlated with reference diameter measured after nitroglycerin and significantly positively correlated with diffuse spasm and chest pain.

Different Criteria for the Definition of Insulin Resistance and Its Relation with Dyslipidemia in Overweight and Obese Children and Adolescents

  • Nogueira-de-Almeida, Carlos Alberto;de Mello, Elza Daniel
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.1
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    • pp.59-67
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    • 2018
  • Purpose: to compare cut off points corrected for age and gender (COOP) with fixed cut off points (FCOP) for fasting plasma insulin and Homeostatic model assessment-insulin resistance (HOMA-IR) for the diagnosis of IR in obese children and adolescents and their correlation with dyslipidemia. Methods: A multicenter, cross-sectional study including 383 subjects aged 7 to 18 years, evaluating fasting blood glucose, plasma insulin, and lipid profile. Subjects with high insulin levels and/or HOMA-IR were considered as having IR, based on two defining criteria: FCOP or CCOP. The frequency of metabolic abnormalities, the presence of IR, and the presence of dyslipidemia in relation to FCOP or CCOP were analyzed using Fisher and Mann-Whitney exact tests. Results: Using HOMA-IR, IR was diagnosed in 155 (40.5%) and 215 (56.1%) patients and, using fasting insulin, 150 (39.2%) and 221 (57.7%), respectively applying FCOP and CCOP. The use of CCOP resulted in lower insulin and HOMA-IR values than FCOP. Dyslipidemia was not related to FCOP or CCOP. Blood glucose remained within normal limits in all patients with IR. There was no difference in the frequency of IR identified by plasma insulin or HOMA-IR, both for FCOP and CCOP. Conclusion: The CCOP of plasma insulin or of HOMA-IR detected more cases of IR as compared to the FCOP, but were not associated with the frequency of dyslipidemia. As blood glucose has almost no fluctuation in this age group, even in the presence of IR, fasting plasma insulin detected the same cases of IR that would be detected by HOMA-IR.

Effects of Aerobic Exercise on Serum Blood Lipids, Leptin, Ghrelin, and HOMA-IR Factors in Postmenopausal Obese Women (유산소 운동이 폐경 후 비만여성의 혈청지질, 렙틴, 그렐린 및 인슐린저항성지수에 미치는 영향)

  • Lee, Jeong-Ah;Kim, Ji-Hyeon;Kim, Jong-Won;Kim, Do-Yoen
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.2
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    • pp.549-558
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    • 2017
  • The aim of this study was to analyze the effects of aerobic exercise on the blood lipids, leptin, ghrelin, and HOMA-IR factors in obese postmenopausal Korean women. Thirty-six healthy postmenopausal women (mean age, $54.47{\pm}2.50$ years) with >32 % body fat were assigned randomly to an aerobic exercise group (n = 18) or to a "no exercise" control group (n = 18). The subjects' body composition, blood lipid, leptin, ghrelin levels, and HOMA-IR were measured before and after a 16-week line-dancing program. The exercise group showed a significant decrease in body weight, percent body fat, body mass index, visceral fat area, leptin, insulin, glucose, HOMA-IR, total cholesterol, triglycerides, apolipoprotein B, low-density lipoprotein cholesterol, and systolic and diastolic blood pressure. In addition, this group exhibited a significant increase in the apolipoprotein A-I, ghrelin, and high-density lipoprotein cholesterol levels. The energy metabolic factors that influenced the visceral fat included ghrelin, leptin, insulin, glucose, and HOMA-IR. The t-value, which determined the statistical significance of the independent variables, was significant for ghrelin, glucose, insulin, and HOMA-IR (p < 0.05). Regular and continuous aerobic exercise (e.g., line dancing) effectively improved the body composition, visceral fat, serum blood lipids, leptin, ghrelin, and HOMA-IR factors in obese postmenopausal Korean women.

The relationship between leptin adiponectin ratio and insulin resistance in healthy children (건강한 소아에서 렙틴 아디포넥틴 비와 인슐린 저항성의 관계)

  • Ahn, Gae-Hyun;Kim, Shin-Hye;Yoo, Eun-Gyong
    • Korean Journal of Pediatrics
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    • v.51 no.3
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    • pp.256-261
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    • 2008
  • Purpose : Leptin and adiponectin are two representative adipocytokines. Leptin increases, but adiponectin decreases, with obesity and insulin resistance. We aimed to study the relationship between the leptin/adiponectin ratio and insulin resistance in healthy children. Methods : Seventy-seven healthy children (36 boys and 41 girls) were enrolled in this study. Anthropometric measurements were performed, and the percentage of weight for height (%WFH) was calculated in each subject. Fasting plasma levels of glucose, insulin, leptin, adiponectin, testosterone, estradiol, and sex-hormone binding globulin (SHBG) were measured. The free androgen index (FAI) was used as a representative of testosterone bioactivity. The homeostasis model assessment was used to estimate the degree of insulin resistance (HOMA-IR). Results : In the boys, HOMA-IR was significantly correlated with age, pubertal stage, free androgen index (FAI), leptin, and the leptin/adiponectin ratio. HOMA-IR was also significantly related to age, percentage of weight for height (%WFH), pubertal stage, estradiol, leptin, and the leptin/adiponectin ratio in girls. The leptin/adiponectin ratio was independently related to HOMA-IR after adjusting for age, %WFH, and FAI in the boys (P<0.05). The leptin/adiponectin ratio was not independently related to HOMA-IR after adjusting for age, %WFH, and estradiol in girls. Conclusion : In non-obese healthy children, the leptin/adiponectin ratio was significantly correlated with insulin resistance. The leptin/adiponectin ratio was independently related to insulin resistance even after adjusting for age, degree of obesity, and androgen levels in healthy boys.

Relationship between the Body Fat Mass Measured by Bioelectrical Impedance Analysis(BIA) and Dual Energy X-ray Absorptiometry(DEXA), and by the Indices of Insulin Sensitivity (생체 임피던스 방법과 이중 방사선 흡수법으로 측정한 체지방량과 인슐린감수성 지표와의 연관성)

  • Lim, In Seok;Yun, Ki Wook
    • Korean Journal of Pediatrics
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    • v.48 no.8
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    • pp.857-864
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    • 2005
  • Purpose : The objectives of this study was to evaluate the correlations between the indices of insulin sensitivity using fasting glucose and insulin level, and the body fat mass measured by bioelectrical impedance analysis(BIA) and dual energy X-ray absorptiometry(DEXA), and to determine the clinical usefulness of insulin sensitivity indices when obese children were followed up. Methods : In this study, 28 simple obese children and adolescents were included. Anthropometric data including body weight, height, obesity degree(OD), body mass index(BMI), and waist-to-hip ratio were collected and then body fat mass was measured by using BIA and DEXA. For metabolic data, 12 hour fasting serum glucose, insulin and lipid profiles were measured and indices for insulin sensitivity(G/I ratio, $log_{insulin}$, HOMA-IR, $log_{HOMA-IR}$, QUICKI) were calculated. Results : BMI had a higher correlation with insulin sensitivity indices than OD(G/I ratio, -0.463 vs -0.209; $log_{insulin}$, 0.417 vs 0.196; HOMA-IR, 0.301 vs 0.238; $log_{HOMA-IR}$, 0.403 vs 0.198; QUICKI, -0.451 vs -0.224). But OD had a higher correlation with body fat mass measured by BIA and DEXA than BMI(BIA, 0.612 vs 0.316; DEXA, 0.667 vs 0.512). The G/I ratio was correlated with body fat mass in BIA(r=-0.420, P<0.05) and DEXA(r=-0.512, P<0.01), percentage of body fat(percentage of fat) in BIA(r=-0.366, P<0.05) and DEXA(r=-0.449, P<0.01). HOMA-IR was only correlated with body fat mass in DEXA(r=0.341, P<0.05). Conclusion : This study revealed that G/I ratios had a statistically significant correlation with anthropometric obesity indices(OD and BMI) and also had a correlation with both body fat mass and percentage of fat. These results suggest that G/I ratios could be used as useful index when obese children and adolescence are followed up.

Development of metabolic syndrome and its correlation with insulin resistance in adult patients with Turner syndrome (터너증후군을 가진 성인 환자에서 대사증후군의 발생과 인슐린저항성과의 관계)

  • Kim, Joo Hwa;Kang, Min Jae;Shin, Choong Ho;Yang, Sei Won
    • Korean Journal of Pediatrics
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    • v.52 no.3
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    • pp.370-375
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    • 2009
  • Purpose : The risk of metabolic syndrome (MS) and cardiovascular disease in Turner syndrome (TS) patients is high. We analyzed metabolic factors in adults with TS and evaluated the metabolic risk of insulin resistance. Methods : Forty-three adults with TS were enrolled. The frequency of MS and the values of the metabolic factors were analyzed. Patients were divided into insulin resistant and non-resistant groups according to values of homeostasis model assessment of insulin resistance (HOMA-IR). The correlations of HOMA-IR with metabolic parameters were analyzed. Results : The frequency of MS was 7% and those of each metabolic parameter were as follows: insulin resistance, 16.3%; central obesity, 15.4%; hypertriglyceridemia, 2.3%; low HDL cholesterol, 9.3%; hypertension, 36.8%. The insulin-resistant group had significantly higher values of body mass index (BMI), waist circumference (WC), fasting plasma glucose (FPG), HOMA-IR, and systolic blood pressure (SBP) than the non-resistant group (P<0.05). HOMA-IR showed a significantly positive correlation with BMI, WC, FPG, and SBP and showed a negative correlation with HDL cholesterol. Conclusion : This study suggests that adults with TS have a high risk of metabolic syndrome, and insulin resistance is correlated with metabolic factors. Therefore, TS patients should have their metabolic parameters monitored regularly to minimize metabolic complications and prevent cardiovascular diseases.

Effects of Line Dance Exercise on HOMA-IR and Energy Metabolic Factors in Postmenopausal Obese Women (라인댄스 운동이 폐경 후 비만여성의 인슐린저항성지수와 에너지대사조절인자에 미치는 영향)

  • Lee, Jeong-Ah;Kim, Do-Yoen
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.10
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    • pp.4636-4644
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    • 2012
  • The purpose of this study was to analyze the effects of line dance exercise on HOMA-IR and energy metabolic factors in postmenopausal obese women. The subjects were 24 obese women composed of the line dance group(n=12) trained for 12-week and the control group(n=12). The variables of body composition, HOMA-IR and energy metabolic factors were measured in all the subjects before and after the 12-week line dance exercise. The results of the study in the line dance group were as follows; The body weight, %fat, BMI, WHR and VFA had significantly decreased, but LBM had increased. The ghrelin, HDL-C had significantly increased, but leptin, insulin, glucose, HOMA-IR, TC, TG, LDL-C, SBP and DBP had decreased. And ghrelin, leptin, insulin, and glucose were the energy metabolic factors affecting the HOMA-IR in the line dance group. Therefore, regular and continuous line dance exercise will be effective for preventing the life-style diseases with improvement of the energy metabolic factors and insulin resistance by decreasing the body fat.

Resistin and Insulin Resistance: A Link Between Inflammation and Hepatocarcinogenesis

  • Elsayed, Engy Yousry;Mosalam, Nesreen Ahmed;Mohamed, Noha Refaat
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7139-7142
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    • 2015
  • Background: Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third leading cause of cancer related death overall. The role of insulin resistance in the development of HCC associated with chronic HCV infection has not been established. Resistin is a polypeptide hormone belonging to the adipokine family which could contribute to tumorigenesis and angiogenesis. Our aim was to study serum resistin and insulin resistance as risk factors for HCC in HCV cirrhotic patients. Materials and Methods: This prospective case controlled study included 100 patients with HCV related liver cirrhosis and HCC, 100 patients with HCV related liver cirrhosis without HCC and 50 apparently healthy participants as controls. For all subjects, liver profile, serologic markers for viral hepatitis, lipid profile, alpha-fetoprotein level (AFP), homeostasis model assessment (HOMA) were examined along with resistin. Results: HCC patients had higher mean values of HOMA-IR and resistin than cirrhotic patients and the control subjects (p<0.01). HOMA and resistin were considered independent risk factors in development of HCC, those patients with resistin > 12 ng/ml and HOMA > 4 being 1.6 times more likely to have HCC. Conclusions: HOMA and serum resistin allow for early identification of patients with cirrhosiswho are at substantially increased risk of HCC. Recommendation: HOMA and serum resistin could represent novel markers to identify HCV cirrhotic patients at greater risk of development of HCC.

Comparison of Serum Insulin, Leptin, Adiponectin and High Sensitivity C-Reactive Protein Levels according to Body Mass Index and their Associations in Adult Women (비만도에 따른 성인 여성의 혈청 인슐린, 렙틴, 아디포넥틴 및 hs-CRP 농도 비교와 상호 관련성)

  • Lee, Mi-Young;Kim, Jung-Hee
    • Korean Journal of Community Nutrition
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    • v.16 no.1
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    • pp.126-135
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    • 2011
  • Obesity is characterized by increased storage of fatty acids in an adipose tissue and closely associated with the development of insulin resistance and cardiovascular diseases (CVD) through secretion of adipokines. This study was done to compare serum insulin, leptin, adiponectin and high sensitivity C-reactive protein (hs-CRP) levels according to body masss index (BMI) in Korean adult women aged 19 to 50. In addition, we examined the association of BMI, serum lipids and Homa-IR with serum adiponectin, leptin and hs-CRP levels. The subjects were divided into 3 groups by their BMI, normal weight (BMI ${\leq}$ 22.9, n = 30), overweight (23.0 ${\leq}$ BMI ${\leq}$ 24.9, n = 71) and obese group (25.0 ${\leq}$ BMI, n = 59). Serum levels of total-cholesterol, TG, and LDL-cholesterol were significantly higher in obese group than in normal weight group. LDL/HDL ratio and AI were significantly higher in obese group than in normal or overweight group. Fasting serum levels of glucose and insulin and Homa-IR as a marker of insulin resistance were significantly higher in obese group than in overweight group. Serum leptin level was significantly higher in obese group while serum adiponectin level was significantly lower in obese group compared to other two groups. hs-CRP was significantly increased in obese group. Correlation data show that serum adiponectin level was positively correlated with serum HDLcholesterol level and was negatively correlated with BMI, WC, TG, LDL-cholesterol, Homa-IR, hs-CRP and leptin. In addition, serum leptin level was positively correlated with BMI, WC, glucose, insulin, Homa-IR and hs-CRP. These results might imply that the regulation of key adipokines such as adiponectin might be a strategy for the prevention or treatment of obesity-associated diseases such as diabetes and CVD.