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  • 1
    Online Resource
    Online Resource
    Adipocytokines as features of the metabolic syndrome determined using confirmatory factor analysis
    Elsevier BV ; 2013
    In:  Annals of Epidemiology Vol. 23, No. 7 ( 2013-7), p. 415-421
    Details
    In: Annals of Epidemiology, Elsevier BV, Vol. 23, No. 7 ( 2013-7), p. 415-421
    Type of Medium: Online Resource
    ISSN: 1047-2797
    URL: Article
    DOI: 10.1016/j.annepidem.2013.03.001
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2013
    detail.hit.zdb_id: 2003468-4
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  • 2
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    Intra-Abdominal Fat Is a Major Determinant of the National Cholesterol Education Program Adult Treatment Panel III Criteria for the Metabolic Syndrome
    American Diabetes Association ; 2004
    In:  Diabetes Vol. 53, No. 8 ( 2004-08-01), p. 2087-2094
    Details
    In: Diabetes, American Diabetes Association, Vol. 53, No. 8 ( 2004-08-01), p. 2087-2094
    Abstract: The underlying pathophysiology of the metabolic syndrome is the subject of debate, with both insulin resistance and obesity considered as important factors. We evaluated the differential effects of insulin resistance and central body fat distribution in determining the metabolic syndrome as defined by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III. In addition, we determined which NCEP criteria were associated with insulin resistance and central adiposity. The subjects, 218 healthy men (n = 89) and women (n = 129) with a broad range of age (26–75 years) and BMI (18.4–46.8 kg/m2), underwent quantification of the insulin sensitivity index (Si) and intra-abdominal fat (IAF) and subcutaneous fat (SCF) areas. The metabolic syndrome was present in 34 (15.6%) of subjects who had a lower Si [median: 3.13 vs. 6.09 × 10−5 min−1/(pmol/l)] and higher IAF (166.3 vs. 79.1 cm2) and SCF (285.1 vs. 179.8 cm2) areas compared with subjects without the syndrome (P & lt; 0.001). Multivariate models including Si, IAF, and SCF demonstrated that each parameter was associated with the syndrome. However, IAF was independently associated with all five of the metabolic syndrome criteria. In multivariable models containing the criteria as covariates, waist circumference and triglyceride levels were independently associated with Si and IAF and SCF areas (P & lt; 0.001). Although insulin resistance and central body fat are both associated with the metabolic syndrome, IAF is independently associated with all of the criteria, suggesting that it may have a pathophysiological role. Of the NCEP criteria, waist circumference and triglycerides may best identify insulin resistance and visceral adiposity in individuals with a fasting plasma glucose & lt;6.4 mmol/l.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    URL: Article
    DOI: 10.2337/diabetes.53.8.2087
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2004
    detail.hit.zdb_id: 1501252-9
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  • 3
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    Impact of Differences in Fasting Glucose and Glucose Tolerance on the Hyperbolic Relationship Between Insulin Sensitivity and Insulin Responses
    American Diabetes Association ; 2006
    In:  Diabetes Care Vol. 29, No. 2 ( 2006-02-01), p. 356-362
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 29, No. 2 ( 2006-02-01), p. 356-362
    Abstract: OBJECTIVE—To determine whether the hyperbolic relationship between insulin sensitivity and the acute insulin response to glucose (AIRg) exists in subjects with impaired fasting glucose (IFG) or decreased glucose tolerance. RESEARCH DESIGN AND METHODS—We studied 219 healthy subjects (88 male and 131 female subjects, aged 26–75 years) with fasting plasma glucose (FPG) & lt;6.11 mmol/l. Subjects underwent an intravenous glucose tolerance test to determine the insulin sensitivity index (Si), AIRg, and the glucose disappearance constant (Kg), the latter a measure of intravenous glucose tolerance. RESULTS—Si and AIRg were inversely related for the entire cohort, and this relationship was not significantly different from hyperbolic. The inverse relationship between Si and AIRg was not significantly different when compared between groups based on fasting glucose (normal fasting glucose [NFG], FPG & lt;5.56 mmol/l vs. IFG, FPG 5.56–6.11 mmol/l) or by the Kg quartile. However, the curve relating Si and AIRg was left shifted in the IFG compared with NFG group (P & lt; 0.001) and was progressively more left shifted with decreasing Kg (P & lt; 0.001), consistent with decreasing β-cell function. These changes were not observed for the curves relating Si and fasting insulin, suggesting that in the fasting state β-cell function is maintained even in patients with mild IFG. Finally, the disposition index (DI) (Si × AIRg) was calculated as a measure of β-cell function. The DI progressively decreased with increasing FPG, even in the group of subjects classified as NFG. CONCLUSIONS—The inverse relationship between insulin sensitivity and AIRg is consistent with a hyperbola not only in subjects with normal glucose tolerance but also with mild IFG or decreased Kg. Based on a hyperbolic relationship, a decrease in β-cell function can be detected as FPG increases, even in patients who are normal glucose tolerant.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.29.02.06.dc05-1963
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2006
    detail.hit.zdb_id: 1490520-6
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  • 4
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    Impact of Intra-Abdominal Fat and Age on Insulin Sensitivity and β-Cell Function
    American Diabetes Association ; 2004
    In:  Diabetes Vol. 53, No. 11 ( 2004-11-01), p. 2867-2872
    Details
    In: Diabetes, American Diabetes Association, Vol. 53, No. 11 ( 2004-11-01), p. 2867-2872
    Abstract: The prevalence of glucose intolerance and type 2 diabetes increases with age. To determine whether the hyperbolic relationship between insulin sensitivity and the insulin response is affected by age and whether the decline in β-cell function with age is related to increases in intra-abdominal fat or age per se, we studied 220 healthy subjects with fasting glucose & lt;6.1 mmol/l (89 men and 131 women, aged 26–75 years, BMI 18.7–40.4 kg/m2). The insulin sensitivity index (Si) and the acute insulin response to glucose (AIRg) were determined, and from these β-cell function was estimated as the disposition index (Si × AIRg). Intra-abdominal fat and subcutaneous fat areas were quantified by computed tomography. Si (5.40 ± 0.5 vs. 7.86 ± 0.7 ×10−5 min−1/[pmol/l]), P & lt; 0.01) was decreased and intra-abdominal fat (117 ± 10 vs. 81 ± 9 cm2, P & lt; 0.05) was increased in the oldest (age 60–75 years) versus the youngest (age 26–44 years) quartile. The hyperbolic relationship between Si and AIRg was present independent of age; thus, β-cell function measured as the disposition index (1,412 ± 120 vs. 2,125 ± 150 ×10−5 min−1, P & lt; 0.01) was lower in the oldest versus the youngest quartile. In multiple regression, intra-abdominal fat (r = −0.470, P & lt; 0.001) but not age was associated with Si, but both intra-abdominal fat (r = −0.198, P = 0.003) and age (r = −0.131, P = 0.05) were correlated with the disposition index. These data suggest that although intra-abdominal fat is a strong determinant of insulin sensitivity and β-cell function, age has an independent effect on β-cell function that may contribute to the increased prevalence of type 2 diabetes in older populations.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    URL: Article
    DOI: 10.2337/diabetes.53.11.2867
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2004
    detail.hit.zdb_id: 1501252-9
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  • 5
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    Online Resource
    Relationship of Liver Enzymes to Insulin Sensitivity and Intra-Abdominal Fat
    American Diabetes Association ; 2007
    In:  Diabetes Care Vol. 30, No. 10 ( 2007-10-01), p. 2673-2678
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 30, No. 10 ( 2007-10-01), p. 2673-2678
    Abstract: OBJECTIVE— The purpose of this study was to determine the relationship between plasma liver enzyme concentrations, insulin sensitivity, and intra-abdominal fat (IAF) distribution. RESEARCH DESIGN AND METHODS— Plasma γ-glutamyl transferase (GGT), aspartate transaminase (AST), alanine transaminase (ALT) levels, insulin sensitivity (insulin sensitivity index [SI]), IAF area, and subcutaneous fat (SCF) area were measured in 177 no ndiabetic subjects (75 men and 102 women, aged 31–75 years) with no history of liver disease. On the basis of BMI ( & lt; or ≥27.5 kg/m2) and SI ( & lt; or ≥7.0 × 10−5 min/pmol) subjects were divided into lean insulin sensitive (LIS, n = 53), lean insulin resistant (LIR, n = 60), and obese insulin resistant (OIR, n = 56) groups. RESULTS— Levels of all three liver enzymes were higher in men than in women (P & lt; 0.0001 for each). In men, GGT levels were higher in insulin-resistant than in insulin-sensitive subjects (P & lt; 0.01). In women, GGT levels were higher in the OIR than in the LIS group (P & lt; 0.01) but no different in the LIR group. There was no difference in ALT and AST levels among the LIS, LIR, and OIR groups. GGT was associated with SI (r = −0.26, P & lt; 0.0001), IAF area (r = 0.22, P & lt; 0.01), waist-to-hip ratio (WHR) (r = 0.25, P = 0.001), BMI (r = 0.17, P & lt; 0.05), and SCF area (r = 0.16, P & lt; 0.05) after adjustments for age and sex. In men, only SI (r = −0.29, P & lt; 0.05) remained independently correlated with GGT in multiple regression analysis. In women, IAF area (r = 0.29, P & lt; 0.01) and WHR (r = 0.29, P & lt; 0.01) were independently associated with GGT, but SI was not. CONCLUSIONS— In nondiabetic men GGT but not AST or ALT levels, are inversely related to insulin sensitivity independent of IAF area. However in women, GGT is related to measures of central body fat rather than to insulin sensitivity.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc06-1758
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2007
    detail.hit.zdb_id: 1490520-6
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