The possible role of Interleukin-6 as a regulator of insulin sensitivity in patients with neuromyelitis optica spectrum disorder

Background Neuromyelitis optica spectrum disorder (NMOSD) is associated with inflammatory mediators that may also trigger downstream signaling pathways leading to reduce insulin sensitivity. Methods We aimed to determine the risk association of hyperinsulinemia in NMOSD patients with seropositive AQP4-IgG and the serum levels of interleukin (IL)-6 and IL-17A compared with the control group. Serum levels of metabolic (Insulin, Fasting Blood Sugar (FBS), lipid profile) and inflammatory (IL-6 and IL-17) markers were assessed in 56 NMOSD patients and 100 controls. Results Hyperinsulinemia was more prevalent in NMOSD patients independent of age, sex and body mass index (BMI) (48.2% vs. 26%, p = 0.005) compared to control group. After adjusting age, sex and BMI, there was significant association between lower insulin sensitivity (IS) and NMOSD risk (95% CI: Beta = 0.73, 0.62 to 0.86, p = 0.0001). Circulating levels of IL-6 and IL-17 were higher in NMOSD patients, and only IL-6 had an effect modifier for the association between lower insulin sensitivity and NMOSD risk. Conclusions Our data suggests that inflammatory pathogenesis of NMOSD leads to hyperinsulinemia and increases the risk of insulin resistance.

Metformin, Oxidative Stress and Male Infertility: Way Forward

Madam, There is an increased prevalence of infertility in male population. With reference to a variety of mechanisms, oxidative stress (OS) is responsible for alteration in structural and functional integrity of sperm leading to altered sperm parameters, hence leading to infertility (1). Metformin though proved to be a first-line hypoglycemic agent has demonstrated antioxidant properties in numerous tissues. It inhibits the mitochondrial respiratory chain in the liver, which leads to stimulation of AMP-activated protein kinase (AMPK)-dependent as well as AMPK-independent mechanisms (2). Metformin triggers alanine production within the Sertoli cells (SCs,) balances the NADH/NAD+ equilibrium and provides antioxidant environment. This drug is a treatment of choice in treating females with Polycystic Ovaries (PCOS) on the basis of its capability to reduce insulin sensitivity as well as angiogenesis through the nuclear factor ?B (NF-?B) pathway which renders it to reduce oxidant species, thus improving the reproductive environment (3). Continuous....

Cigarette Smoking: An Accessory to the Development of Insulin Resistance

Insulin resistance is a condition characterized by decreased sensitivity of a skeletal or adipose cell to insulin, resulting in decreased glucose uptake by the cell. This can lead to hyperinsulinemia and further reduce insulin sensitivity. Insulin resistance is one of the primary factors contributing to metabolic syndrome (MetS), causing elevated glucose and fatty acid concentrations in the blood. Smoking is associated with insulin resistance in a dose-dependent manner. It directly increases the risk for insulin resistance, mainly via hormone activation, and may indirectly cause insulin resistance due to its effects on abdominal obesity. Nicotine may be the factor underlying these potential mechanisms. With the prevalence of prediabetes and diabetes on the rise, and considering the role of smoking and its relationship to insulin resistance, smoking reduction or cessation may be a viable option for those who are at risk or already identified as insulin resistant. Therefore, smoking cessation or reduction would serve as a beneficial component in any diabetes prevention or treatment plan.