scholarly journals The Effect of a Maternal Mediterranean Diet in Pregnancy on Insulin Resistance is Moderated by Maternal Negative Affect

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 420 ◽  
Author(s):  
Karen L. Lindsay ◽  
Claudia Buss ◽  
Pathik D. Wadhwa ◽  
Sonja Entringer
Keyword(s):  
Insulin Resistance ◽  
Negative Affect ◽  
Mediterranean Diet ◽  
Psychological State ◽  
Model Assessment ◽  
Third Trimester ◽  
Prospective Longitudinal Study ◽  
Prospective Longitudinal ◽  
In Pregnancy ◽  
Maternal Negative Affect

There is inconsistent evidence that healthy dietary interventions can effectively mitigate the risk of adverse outcomes associated with elevated insulin resistance in pregnancy, suggesting that other moderating factors may be at play. Maternal psychological state is an important factor to consider in this regard, because stress/mood state can directly influence glycemia and a bidirectional relationship may exist between nutrition and psychological state. The objective of this study was to examine the interaction between maternal negative affect and diet quality on third trimester insulin resistance. We conducted a prospective longitudinal study of N = 203 women with assessments in early and mid-pregnancy, which included an ecological momentary assessment of maternal psychological state, from which a negative affect score (NAS) was derived, and 24-h dietary recalls, from which the Mediterranean Diet Score (MDS) was computed. The homeostasis model assessment of insulin resistance (HOMA-IR) was computed from third trimester fasting plasma glucose and insulin values. Early pregnancy MDS was inversely associated with the HOMA-IR, but this did not maintain significance after adjusting for covariates. There was a significant effect of the mid-pregnancy MDS*NAS interaction term with the HOMA-IR in the adjusted model, such that a higher negative affect was found to override the beneficial effects of a Mediterranean diet on insulin resistance. These results highlight the need to consider nutrition and affective state concurrently in the context of gestational insulin resistance.

Changes in glucose, insulin, and insulin resistance from presurgery to post adjuvant treatment for breast cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1511-1511
Author(s):  
Emer M. Guinan ◽  
Juliette M. Hussey ◽  
Laura Healy ◽  
Paul A. Carroll ◽  
John Kennedy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Insulin Resistance ◽  
Cancer Diagnosis ◽  
Adjuvant Treatment ◽  
Breast Cancer Diagnosis ◽  
Model Assessment ◽  
Prospective Longitudinal Study ◽  
Insulin Levels ◽  
Increased Risk ◽  
Prospective Longitudinal

1511 Background: Elevated fasting insulin levels at breast cancer diagnosis are associated with increased risk of recurrence and reduced survival. (Goodwin PJ, et al. JCO. 2012;30:164-171) Weight gain related to adjuvant treatment coupled with sedentary activity habits may further alter insulin-related measures for breast cancer survivors. We present results from a prospective longitudinal study examining changes in insulin-related markers from pre breast cancer surgery to post adjuvant treatment. Methods: Subjects were recruited from St. James’s hospital, Dublin, Ireland at the time of breast cancer diagnosis (stage I-III). Fasting pre-surgery blood samples were drawn to measure insulin, glucose and glycosylated haemoglobin A1c (HBA1C). Insulin resistance was calculated using the homeostatic model assessment (HOMA). Subjects with no evidence of active cancer completed the same measurements 2-5 years later. Paired sample t-tests were used to measure changes from pre-surgery to post-adjuvant treatment. Statistical significance was set at P = .05. Results: Forty-four subjects (n = 22 postmenopausal) completed both measurements (mean ± SD age 54.1±8.6 years). Mean time since diagnosis to follow-up measures was 3.4±0.8 years. Adjuvant therapy included chemotherapy (n=37), radiotherapy (n=36), biological therapy (n=8) and concurrent hormonal therapy (n=37). There was a statistically significant increase in insulin (mean ± SD change 2.8±4.1mU/L, P=.000), insulin resistance (0.54±1.0, P=.001) and HBA1C (0.1±0.2 %, P= .003). Fasting glucose levels did not change (P = .06). Conclusions: Results indicate that patients with breast cancer experience significant increases in insulin, insulin resistance and HBA1C from pre-surgery to post adjuvant treatment. Elevated post-treatment insulin levels may further contribute to risk of breast cancer recurrence and mortality, while also predisposing to the development of cardiovascular disease and type 2 diabetes mellitus. Exercise and diet interventions are warranted in this population to improve markers of insulin resistance as a surrogate for improving breast cancer and overall health outcomes.

scholarly journals Nerve growth factor is closely related to glucose metabolism, insulin sensitivity and insulin secretion in the second trimester: a case–control study in Chinese

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Mengyang Tang ◽  
Mingjuan Luo ◽  
Wenqian Lu ◽  
Rong Zhang ◽  
Wei Liang ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Case Control Study ◽  
Model Assessment ◽  
Second Trimester ◽  
Homeostasis Model Assessment ◽  
Third Trimester ◽  
Β Cell ◽  
The Third ◽  
Tnf Α ◽  
Control Study

Abstract Objective Inflammation-related factors have been shown to play a significant role throughout pregnancy. In this study, we aimed to explore the relationships between selected inflammatory cytokines and gestational diabetes (GDM) in Chinese pregnant women. Design and methods This was a 1:1 matched case–control study that included 200 pairs of subjects in the second trimester and 130 pairs of subjects in the third trimester. Serum levels of nerve growth factor (NGF), Interleukin-6 (IL-6), leptin, Interleukin-8 (IL-8), monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-alpha (TNF-α) and Interleukin-1beta (IL-1β) were measured by enzyme immunoassay. The associations of these inflammatory factors with metabolic parameters were analysed. Results In the second trimester, GDM patients had higher NGF levels and lower IL-8 levels than did normal controls (P < 0.001 and P = 0.015, respectively). However, in the third trimester, only lower leptin levels were observed in the GDM group (P = 0.031). Additionally, in the second trimester, NGF levels were not only positively associated with fasting, 1-h and 2-h glucose levels and the area under curve of glucose, but also positively related to insulin sensitivity and secretion, as suggested by fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment index of β-cell secretion (HOMA-β) (all P < 0.05). Moreover, IL-6 and leptin levels were positively correlated with HOMA-IR and HOMA-β, and TNF-α levels were positively related to HOMA-IR (all P < 0.05). Except for the relationships between NGF and HOMA-β and TNF-α and HOMA-IR, the other correlations still existed even after adjusting for confounding factors (all P < 0.05). Conclusion In addition to the positive associations of IL-6 and leptin with insulin resistance and secretion, NGF was higher in the GDM patients and strongly linked to glucose metabolism, insulin resistance and pancreatic β cell function in Chinese pregnant women in the second trimester.

scholarly journals Somatotropic Axis and Obesity: Is There Any Role for the Mediterranean Diet?

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2228 ◽  
Author(s):  
Giovanna Muscogiuri ◽  
Luigi Barrea ◽  
Daniela Laudisio ◽  
Carolina Di Somma ◽  
Gabriella Pugliese ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Growth Hormone ◽  
Growth Factor ◽  
Mediterranean Diet ◽  
Adult Women ◽  
Model Assessment ◽  
Insulin Like Growth Factor ◽  
Somatotropic Axis ◽  
Peak Response ◽  
The Mediterranean

Obesity is associated with reduced spontaneous and stimulated growth hormone (GH) secretion and basal insulin-like growth factor I (IGF-1) levels—which in turn is associated with increased prevalence of cardiovascular risk factors. The aim of this study was to investigate: (1) the association of somatotropic axis with cardiometabolic status; (2) the association of somatotropic axis with the Mediterranean diet and nutritional pattern in people with obesity. Cross-sectional observational study was carried out in 200 adult women, aged 36.98 ± 11.10 years with severe obesity (body mass index—BMI of 45.19 ± 6.30 kg/m2). The adherence to the Mediterranean diet and the total calorie intake was assessed. Anthropometric measurements, body composition and biochemical profile were determined along with Growth Hormone (GH)/Insulin like Growth Factor 1 (IGF-1) axis and insulin resistance (homeostatic model assessment for insulin resistance—HoMA-IR). The enrolled subjects were compared after being divided according to GH peak response and according to IGF-1 standard deviation scores (SDS). Derangements of GH peak were detected in 61.5% of studied patients while IGF-1 deficiency was detected in 71% of the population. Both blunted GH peak response and IGF-1 SDS were indicators of derangements of somatotropic axis and were associated with comparable results in terms of cardiometabolic sequelae. Both GH peak and IGF-1 levels were inversely associated with anthropometric and metabolic parameters. The adherence to the Mediterranean diet predicts GH peak response. Fatty liver index (FLI), fat mass (FM) and phase angle (PhA) were predictive factors of GH peak response as well. In conclusion derangements of somatotropic axis is associated with a worse cardiometabolic profile in people with obesity. A high adherence to the Mediterranean diet—and in particular protein intake—was associated with a better GH status.

scholarly journals Glycolysis/gluconeogenesis- and tricarboxylic acid cycle–related metabolites, Mediterranean diet, and type 2 diabetes

2020 ◽  
Vol 111 (4) ◽  
pp. 835-844 ◽  
Author(s):  
Marta Guasch-Ferré ◽  
José L Santos ◽  
Miguel A Martínez-González ◽  
Clary B Clish ◽  
Cristina Razquin ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Relative Risk ◽  
Mediterranean Diet ◽  
Tca Cycle ◽  
Tricarboxylic Acid ◽  
Model Assessment ◽  
Weighted Score

ABSTRACT Background Glycolysis/gluconeogenesis and tricarboxylic acid (TCA) cycle metabolites have been associated with type 2 diabetes (T2D). However, the associations of these metabolites with T2D incidence and the potential effect of dietary interventions remain unclear. Objectives We aimed to evaluate the association of baseline and 1-y changes in glycolysis/gluconeogenesis and TCA cycle metabolites with insulin resistance and T2D incidence, and the potential modifying effect of Mediterranean diet (MedDiet) interventions. Methods We included 251 incident T2D cases and 638 noncases in a nested case-cohort study within the PREDIMED Study during median follow-up of 3.8 y. Participants were allocated to MedDiet + extra-virgin olive oil, MedDiet + nuts, or control diet. Plasma metabolites were measured using a targeted approach by LC–tandem MS. We tested the associations of baseline and 1-y changes in glycolysis/gluconeogenesis and TCA cycle metabolites with subsequent T2D risk using weighted Cox regression models and adjusting for potential confounders. We designed a weighted score combining all these metabolites and applying the leave-one-out cross-validation approach. Results Baseline circulating concentrations of hexose monophosphate, pyruvate, lactate, alanine, glycerol-3 phosphate, and isocitrate were significantly associated with higher T2D risk (17–44% higher risk for each 1-SD increment). The weighted score including all metabolites was associated with a 30% (95% CI: 1.12, 1.51) higher relative risk of T2D for each 1-SD increment. Baseline lactate and alanine were associated with baseline and 1-y changes of homeostasis model assessment of insulin resistance. One-year increases in most metabolites and in the weighted score were associated with higher relative risk of T2D after 1 y of follow-up. Lower risks were observed in the MedDiet groups than in the control group although no significant interactions were found after adjusting for multiple comparisons. Conclusions We identified a panel of glycolysis/gluconeogenesis-related metabolites that was significantly associated with T2D risk in a Mediterranean population at high cardiovascular disease risk. A MedDiet could counteract the detrimental effects of these metabolites. This trial was registered at controlled-trials.com as ISRCTN35739639.

A longitudinal study of thyroid function in pregnancy.

1989 ◽  
Vol 35 (2) ◽  
pp. 275-278 ◽  
Author(s):  
A Price ◽  
H Griffiths ◽  
B W Morris
Keyword(s):  
Longitudinal Study ◽  
Pregnant Women ◽  
Thyroid Function ◽  
Prospective Longitudinal Study ◽  
Prospective Longitudinal ◽  
In Pregnancy

Abstract We undertook a prospective longitudinal study of thyroid function in 36 pregnant women. There were significant increases in thyroxin-binding globulin, thyrotropin, and triiodothyronine. Albumin, free thyroxin (measured by an analog and a nonanalog method), and the free thyroxin index were significantly decreased. Results for the free thyroxin methods were correlated with each other in each trimester. We could find no evidence for artifacts related to albumin or thyroxin-binding globulin with either method for free thyroxin.

scholarly journals Longitudinal changes in glucocorticoid metabolism are associated with later development of adverse metabolic phenotype

2014 ◽  
Vol 171 (4) ◽  
pp. 433-442 ◽  
Author(s):  
Rachel K Crowley ◽  
Beverly Hughes ◽  
Joanna Gray ◽  
Theresa McCarthy ◽  
Susan Hughes ◽  
...  
Keyword(s):  
Metabolic Disease ◽  
Insulin Resistance ◽  
Glucose Tolerance ◽  
Hydroxysteroid Dehydrogenase ◽  
Metabolic Phenotype ◽  
Model Assessment ◽  
Observation Study ◽  
Longitudinal Changes ◽  
Glucocorticoid Metabolism ◽  
Prospective Longitudinal

ObjectiveDysregulation of enzymes that control local tissue steroid metabolism has been implicated in the pathogenesis of obesity and insulin resistance; however, longitudinal changes in glucocorticoid metabolism have not been investigated. This study was performed to evaluate the role of glucocorticoid metabolism in the development of insulin resistance and obesity and to identify biomarkers for future development of metabolic disease.DesignThis was a prospective longitudinal observation study conducted over 5 years.MethodsA 24-h collection was used to serially analyze urinary glucocorticoid and mineralocorticoid metabolites in 57 obese and overweight patients with no prior diagnosis of diabetes mellitus, recruited from the community.ResultsBaseline higher 5α-reductase (5αR) activity, but not 11β-hydroxysteroid dehydrogenase type 1 activity, was predictive of increased fasting insulin at final visit (11.4 compared with 7.4 mU/l in subjects with lower 5αR activity, P<0.05), area under the curve insulin response to oral glucose tolerance test (176.7 compared with 89.1 mU/l.h, P<0.01), and homeostasis model assessment (HOMA2-IR; 1.3 compared with 0.8, P<0.01). Higher total glucocorticoid production was associated with abnormal glucose tolerance and increased BMI. During this study, systolic blood pressure increased (equivalent to ∼1 mmHg/year), as did plasma sodium levels; this evidence of increased mineralocorticoid activity was associated with increased aldosterone metabolites and decreased 11β-hydroxysteroid dehydrogenase type 2 activity.ConclusionsIncreased 5αR activity and glucocorticoid secretion rate over time are linked with the development of metabolic disease, and may represent targets for therapeutic intervention, which merits further study.

scholarly journals Influence of Tacrolimus on Glucose Metabolism before and after Renal Transplantation: A Prospective Study

2001 ◽  
Vol 12 (3) ◽  
pp. 583-588 ◽  
Author(s):  
ELLY M. VAN DUIJNHOVEN ◽  
JOHANNES M. M. BOOTS ◽  
MAARTEN H. L. CHRISTIAANS ◽  
BRUCE H. R. WOLFFENBUTTEL ◽  
JOHANNES P. VAN HOOFF
Keyword(s):  
Insulin Resistance ◽  
Insulin Secretion ◽  
Insulin Sensitivity ◽  
Glucose Metabolism ◽  
Sensitivity Index ◽  
Intravenous Glucose ◽  
Prospective Longitudinal Study ◽  
C Peptide ◽  
Before And After ◽  
Prospective Longitudinal

Abstract. Most studies concerning the influence of tacrolimus on glucose metabolism have been performed either in animals or after organ transplantation. These clinical studies have largely been transversal with patients who were using steroids. Therefore, this prospective, longitudinal study investigated the influence of tacrolimus on glucose metabolism before and after transplantation. Eighteen Caucasian dialysis patients underwent an intravenous glucose tolerance test before and 5 d after the start of tacrolimus. Insulin sensitivity index (kG), insulin resistance (insulin/glucose ratio and homeostasis model assessment), and C-peptide and insulin secretion were calculated. Trough levels of tacrolimus were measured. After transplantation, the occurrence of posttransplantation diabetes mellitus (PTDM) was prospectively monitored. Statistical analysis was performed using the Wilcoxon signed ranks test and Spearman's rho for correlation. Before tacrolimus, kG was indeterminate in three patients. During tacrolimus, kG decreased in 16 of 18 patients, from a median of 1.74 mmol/L per min to 1.08 mmol/L per min (P < 0.0001). The correlation between C-peptide and insulin data was excellent. Insulin secretion decreased from 851.0 mU × min/L to 558.0 mU × min/L (P = 0.014), whereas insulin resistance did not change. Insulin sensitivity correlated negatively with tacrolimus trough level. After transplantation, three patients developed PTDM; before tacrolimus, two had an indeterminate and one a low normal kG. During tacrolimus administration, kG decreased in almost all patients as a result of a diminished insulin secretion response to a glucose load, whereas insulin resistance did not change. Patients with an abnormal or indeterminate kG seem to be at risk of developing PTDM while on tacrolimus.

scholarly journals Plasma N-glycome shows continuous deterioration as the diagnosis of insulin resistance approaches

2021 ◽  
Vol 9 (1) ◽  
pp. e002263
Author(s):  
Ana Cvetko ◽  
Massimo Mangino ◽  
Marko Tijardović ◽  
Domagoj Kifer ◽  
Mario Falchi ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Plasma Protein ◽  
Multiple Testing ◽  
Characteristic Curve ◽  
Predictive Biomarker ◽  
Ultra Performance Liquid Chromatography ◽  
Discriminative Performance ◽  
Prospective Longitudinal Study ◽  
Diagnostic Potential ◽  
Prospective Longitudinal

IntroductionPrediction of type 2 diabetes mellitus (T2DM) and its preceding factors, such as insulin resistance (IR), is of great importance as it may allow delay or prevention of onset of the disease. Plasma protein N-glycome has emerged as a promising predictive biomarker. In a prospective longitudinal study, we included patients with a first diagnosis of impaired glucose metabolism (IR or T2DM) to investigate the N-glycosylation’s predictive value years before diabetes development.Research design and methodsPlasma protein N-glycome was profiled by hydrophilic interaction ultra-performance liquid chromatography in 534 TwinsUK participants free from disease at baseline. This included 89 participants with incident diagnosis of IR or T2DM during the follow-up period (7.14±3.04 years) whose last sample prior to diagnosis was compared using general linear regression with 445 age-matched unrelated controls. Findings were replicated in an independent cohort. Changes in N-glycome have also been presented in connection with time to diagnosis.ResultsEight groups of plasma N-glycans were different between incident IR or T2DM cases and controls (p<0.05) after adjusting for multiple testing using Benjamini-Hochberg correction. These differences were noticeable up to 10 years prior to diagnosis and are changing continuously as becoming more expressed toward the diagnosis. The prediction model was built using significant glycan traits, displaying a discriminative performance with an area under the receiver operating characteristic curve of 0.77.ConclusionsIn addition to previous studies, we showed the diagnostic potential of plasma N-glycome in the prediction of both IR and T2DM development years before the clinical manifestation and indicated the continuous deterioration of N-glycome toward the diagnosis.

scholarly journals Negative Affect-Related Autonomic Arousal Mediates the Association Between Baroreflex Dysfunction and Insulin Resistance in Non-Diabetic Young Adults

2019 ◽  
Vol 33 (4) ◽  
pp. 243-253
Author(s):  
Paul A. Dennis ◽  
Julia M. Neal ◽  
Emili Travis ◽  
Lana L. Watkins ◽  
Patrick S. Calhoun ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Heart Rate ◽  
Young Adults ◽  
Negative Affect ◽  
Structural Equation ◽  
Equation Modeling ◽  
Autonomic Arousal ◽  
Model Assessment ◽  
Baseline Measure ◽  
Insulin Levels

Abstract. Autonomic dysfunction, in particular under-regulation of heart rate (HR) by the baroreflex, is implicated in development of insulin resistance (IR). According to reactivity hypothesis, sympathetic response to stressors may be more sensitive at predicting IR than baroreceptor sensitivity (BRS), a baseline measure of baroreflex functioning. Using ecological momentary assessment (EMA) of negative affect coupled with minute-to-minute HR and heart-rate variability (HRV) monitoring, we examined whether negative affect (NA)-related autonomic arousal mediates the association of BRS with IR. At baseline, BRS was measured, and fasting serum glucose and insulin levels were collected from 178 young adults (18–39 years old), from which homeostasis model assessment of IR (HOMA-IR) and beta-cell functioning (HOMA %B) were derived. Participants subsequently underwent one day of Holter HR and HRV monitoring while reporting NA levels via EMA. Multilevel modeling was used to assess the associations of momentary NA with HR and low- (LF) and high-frequency (HF) HRV during the 5-minute intervals following each EMA reading. Structural equation modeling was then used to determine whether individual differences in these associations mediated the association of BRS with IR, measured by HOMA-IR, HOMA %B, and insulin levels. As predicted, BRS was negatively associated with the IR (β = −.17, p = .024). However, NA-related autonomic arousal mediated their association, accounting for 56% of the covariance between BRS and IR. Not only do these results provide support for reactivity hypothesis, they reveal a potential point of intervention in the treatment of affective dysregulation.

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