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Trino Baptista,
Ana Serrano,
Euderruh Uzcátegui,
Yamily ElFakih,
Nairy Rangel,
Edgardo Carrizo, Virginia Fernández,
Lisette Connell,
Enma Araujo de Baptista,
Segundo Quiroz,
Marycelvia Uzcátegui,
Juana Rondón,
Yimber Matos,
Lilia Uzcátegui,
Roald Gómez,
Lenin Valery,
Darío Novoa-Montero
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ABSTRACT: Few studies on the association between atypical antipsychotic drug (AAP) administration and metabolic dysfunction have concurrently evaluated the general population (GP), other psychotropic drug treatments and drug-free psychiatric patients.
We assessed the frequency of the metabolic syndrome (MS) according to the National Cholesterol Education Program criteria (NCEP) and its constituting variables in a GP sample (n=271) and in patients receiving, for at least three consecutive months, antiepileptic drugs (n=93), olanzapine (n=162), clozapine (n=105), typical antipsychotics (n=117), other AAP (n=58), other psychotropic drugs (n=185), and drug-free individuals (n=636). Subjects were clinically classified as schizophrenia, bipolar or other axis I disorders (DSM-IV-RT), and as first-degree relatives of each diagnostic group.
The MS was detected in 26.6% of the GP (95% confidence interval: 21.5-31.8). No diagnostic or treatment group had a significantly higher age-adjusted frequency than the GP (p>0.05). Treatment duration did not significantly affect the results. However, significant differences were observed in the frequency of abnormal MS constituting variables in comparison to the GP. For example, schizophrenia patients and their relatives, bipolar subjects and olanzapine- and clozapine-treated patients had higher abnormal waist circumference values. In addition, bipolar patients and their relatives and subjects treated with olanzapine and other AAPs had higher frequencies of abnormal glucose levels. Neither schizophrenia nor bipolar patients in the diagnostic categories nor the olanzapine or the clozapine groups displayed higher proportions of abnormal triglycerides, high density cholesterol or blood pressure levels than the GP.
While we did not demonstrate an increased frequency of the MS in AAP-treated subjects, our results confirm that specific metabolic variables must be monitored in psychiatric patients. Besides they stress the importance, in epidemiological studies, of concurrently comparing the figures recorded in AAP-treated patients with those obtained in the local GP, other drug treatment groups and drug-free subjects when referring to the magnitude of the metabolic effects of specific antipsychotic agents.
Biological Psychiatry 11/2010; 126(1-3):93-102. · 8.28 Impact Factor
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Erika Fernández,
Edgardo Carrizo, Virginia Fernández,
Lisette Connell,
Ignacio Sandia,
Dexy Prieto,
Johana Mogollón,
Dennys Valbuena,
Iliana Fernández,
Enma Araujo de Baptista,
Trino Baptista
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ABSTRACT: The role of leptin in atypical antipsychotic-induced metabolic dysfunction was explored by assessing the anthropometric and metabolic profile and the response to metformin (MET) of clozapine- (CLZ) treated schizophrenia patients according to their single nucleotide polymorphisms (SNPs) in the leptin promoter (LEP2548/GA) and leptin receptor (LEPR Q223R) genes.
Phase 1. Body mass index (BMI), waist circumference, serum glucose, HbA1C, lipids, leptin, cortisol, insulin resistance index (HOMA-IR), metabolic syndrome and the frequencies of SNPs were assessed in 56 CLZ-treated patients (78.6% males). Phase 2. Fifty two phase 1 subjects were randomly assigned to MET XR (n=23) (1000 mg/day) or placebo (n=29) for 14 weeks. Changes in anthropometric and biochemical variables were compared between the SNPs.
Phase 1. The QQ group displayed the lowest triglyceride levels (p<0.05). No other significant difference was observed. Phase 2. Change in anthropometric variables did not differ between the genotypes in any treatment group. After MET, glucose levels significantly increased in the GG group (p<0.05), whereas the HOMA-IR and the low density cholesterol significantly decreased in the QQ- but not in the (QR+RR) group (p<0.05). No differences were observed after placebo.
BW response to CLZ was not related to LEP- and LEPR-SNPs. The GG and (QR+RR) genotypes showed an unexpectedly opposite and blunted response to MET administration respectively.
Biological Psychiatry 08/2010; 121(1-3):213-7. · 8.28 Impact Factor
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ABSTRACT: Individuals with insulin resistance (IR) usually have upper body obesity phenotype, often accompanied by an increase in plasma free fatty acids (FFA). Since the Venezuelan population has a high frequency of IR and central obesity, the purpose of this work was to determine FFA levels in 47 Venezuelan individuals, men and women, 24-58 years old, and analyze their relationship with central obesity and parameters of carbohydrate and lipid metabolism. Basal concentrations of TG, total cholesterol, LDL-C, and HDL-C were measured, and FFA, glucose and insulin, at basal state and at different times after a glucose load. Eighteen individuals presented insulin resistance (HOMA-IR > 2.7) and 29 were non-insulin resistant (non-IR). Insulin resistant individuals (IR) had higher waist circumference, BMI and basal concentrations of FFA than the non-IR. No differences were observed in skin folds and other basal lipids studied. The increased FFA seemed to be related to the IR associated to BMI and not to central obesity, since the difference between IR and non-IR disappeared when they were matched for waist circumference. After a glucose load, FFA decreased in both groups, but remained significantly elevated in IR subjects. This effect disappeared after matching for BMI or waist circumference, inferring that it was independent of anthropometries. FFA were positively associated with HOMA-IR, glucose and TG levels; however, there was.no association with BMI or waist circumference. These findings, and the lack of elements to support the presence of hepatic IR, common to increased visceral lipolysis, might suggest that the IR present in the obese individuals studied, might be due to an increase in subcutaneous fat.
Investigación clínica 03/2010; 51(1):115-26.
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Mariana Zambrano,
Erika Fernández,
Maciel López,
Annell Rangel,
Pilar de Romero, Virginia Fernández,
Luz Marina Morales,
Emperatriz Molero-Conejo,
Lissett Connell,
Xiomara Raleigh,
José Aranguren-Mendez
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ABSTRACT: The aim of this study was to determine the association of the Gly482Ser polymorphism of the PGC-1 gene with insulin resistance and type 2 diabetes mellitus in subjects from the city of Maracaibo. The study was performed on 64 no-diabetic subjects (36 without insulin resistance and 28 with insulin resistance) and 13 with type 2 diabetes. A clinical and nutritional history was carried out and the evaluation of anthropometric parameters was included. Fasting serum glucose, fasting serum insulin, total cholesterol, HDL-C and LDL-C, were measured. The Gly482Ser polymorphism was detected by PCR-RFLP. It was found that the allelic frequencies for A and G were 0.36 and 0.64, respectively. The population was found in genetic equilibrium of Hardy Weinberg. The genotypes of the polymorphism Gly482Ser were not associated with insulin resistance and type 2 diabetes mellitus (OR = 1.320, p = 0.74; OR = 2, p = 0.47 respectively). Nevertheless, the diabetic subjects with the genotype AA presented values of LDL-C higher (p < 0.05) than the individuals with the genotypes GG and GA. The diabetics with the genotype GA showed significantly higher concentrations of triglycerides (>150 mg/dL) compared with the genotype GG. According to the results, the polymorphism Gly482Ser of the PGC-1 gene would be able to contribute to the cardiovascular risk in type 2 diabetics, while in the insulin resistant individuals, this polymorphism was not associated with cardiovascular risk factors.
Investigación clínica 09/2009; 50(3):285-94.
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ABSTRACT: Clozapine is the most effective agent in treatment-resistant schizophrenia. However, it is frequently associated with excessive body weight (BW) gain, type 2 diabetes mellitus and hyperlipidemia. The antidiabetic metformin (MET) has proved effective to assist in BW control during olanzapine administration. Therefore, we aimed to test whether MET may improve the metabolic profile in patients under prolonged clozapine administration.
In a double-blind, parallel group protocol, 61 patients (94.4% with schizophrenia) receiving clozapine (196.8+/-132 mg daily, range: 25-500) for more than 3 consecutive months (86.5+/-40.6 months, range: 4-168) were randomly allocated to extended release MET (n=31; 500 to 1000 mg daily) or placebo (n=30) group for 14 weeks. The BW, the body mass index, waist circumference, serum glucose, insulin, lipids, glycated hemoglobin (HBA1c), leptin and cortisol, and the HOMA-IR index were assessed at baseline, and weeks 7 and 14.
MET was well tolerated and the mental state was not impaired during the study. The protocol was completed by all the placebo subjects and by 24 MET-treated patients. In a complete analysis at week 14, without including data of the 7 dropouts, the MET group lost -1.87+/-2.9 kg, whereas the placebo group had a stable BW: 0.16+/-2.9 kg, p=0.01 for the between group comparisons (effect size: 0.70). Leptin levels also tended to decrease after MET (p=0.08). Insulin and the triglyceride-HDL-C ratio significantly decreased (p<0.05, effect size 0.59 and 1.99 respectively) and the HDL-C significantly increased (p=0.001, effect size 0.95) after MET.
MET improves metabolic control during prolonged clozapine administration.
Biological Psychiatry 06/2009; 113(1):19-26. · 8.28 Impact Factor
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ABSTRACT: Leptin dysregulation has been implicated in the body weight gain and metabolic dysfunction observed with the second generation antipsychotic drugs (SGAD) olanzapine and clozapine.
This study quantified the frequency of subjects with abnormal correlation between leptin and the body mass index controlling for gender (defined as being out of the upper or lower 95% confidence interval in the regression line when combining each group with the drug-free subjects) after prolonged treatment with olanzapine (n=126), clozapine (n=62), first generation antiypsychotics (n=91), other SGAD (n=22), other psychotropic drugs (n=65) and drug-free subjects (n=229).
None of the analysis was significant (p>0.05). In fact, in 17 out of 20 comparisons, the drug-free group had numerically higher frequencies of outliers than the corresponding treatment group. There were 28 outliers (4.7% of the total sample). In agreement with previous studies, cross-sectional analysis did not report gross alterations in serum leptin levels during olanzapine or clozapine administration.
Longitudinal studies should focus on leptin regulation early on treatment, on the frequency of abnormal leptin receptor sensitivity and/or specific polymorphisms in the leptin allele and on several confounding factors in order to design personalized preventive and therapeutic measures.
Schizophrenia Research 10/2008; 106(2-3):315-9. · 4.75 Impact Factor
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ABSTRACT: Clinical studies suggest that the second generation antipsychotics (APs) clozapine and olanzapine and to a lesser extent the typical antipsychotics may be associated with a procoagulant and proinflammatory state that promotes venous thromboembolism. We evaluated here several blood factors associated with coagulation and inflammation in AP-treated schizophrenia patients and their first-degree relatives.
Procoagulant factors (fibrinogen and plasminogen activator inhibitor [PAI-1]), the anticoagulant factor antithrombin III [AT-III], and inflammation-related factors (C-reactive protein [CRP] and leptin) were assessed in patients chronically treated with clozapine (n=29), olanzapine (n=29), typical APs (n=30) and first degree relatives of clozapine (n=23) and olanzapine subjects (n=11).
The typical AP group had the highest CRP level (p=0.013) in spite of having the lowest body mass index (BMI). Patients as a single group had higher CRP levels than relatives (p=0.003). The typical AP group also had the highest AT-III levels (p=0.021). Fibrinogen levels did not differ between the groups (p=0.13). Olanzapine patients displayed the highest PAI-1 and leptin levels among the drug-treated subjects, but values were similar to those observed in their relatives, and were significantly correlated with the BMI.
A homogeneous negative profile of high inflammation and procoagulant factors along with low levels of anticoagulants was not detected in any group. While preliminary, our results suggest that the observed abnormalities were not related to a direct drug effect, but to elevated BMI (high PAI-1 and leptin in olanzapine-treated patients). We speculate that the high CRP in the typical AP group might be related to poor lifestyle habits, but this must we confirmed in future studies.
Schizophrenia Research 09/2008; 103(1-3):83-93. · 4.75 Impact Factor
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ABSTRACT: The purpose of this paper was to determine the relationship between fibrinogen concentration and cardiovascular ischaemic risk factors in a group of apparently healthy men from Maracaibo, Venezuela. Two hundred and forty six individuals, ages 31 to 65 years were evaluated by means of clinical and laboratory examination. In each person plasma fibrinogen concentration was measured by coagulometry, serum glucose and lipids by enzymatic methods and insulin by radioimmunoanalysis. 31.7% of subjects had fibrinogen values in the highest tertil of the whole group (> or = 311 mg/dL), they also showed significantly higher values of total cholesterol (p < 0.03) and LDL-C (p < 0.01). In addition, the individuals in this tertil showed a significant and positive correlation between the values of triglycerides with insulin (p < 0.02) and with HOMA-IR (p < 0.01). On the other hand, correlation analysis also showed a positive significant association between the fibrinogen levels and total cholesterol (p < 0.02), dependent of individuals with family history of ischaemic cardiovascular disease (total cholesterol: p < 0.02 and LDL-C: p < 0.003). In consideration of the high concentrations of fibrinogen found in 31.7% of apparently healthy men and their significant positive correlation with total cholesterol and LDL-C, on the group of men with a family history of ischaemic cardiovascular disease, it would be advisable to include the determination of fibrinogen in the cardiovascular evaluation of these particular subjects.
Investigación clínica 09/2008; 49(3):341-51.
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Trino Baptista,
Nairy Rangel, Virginia Fernández,
Edgardo Carrizo,
Yamily El Fakih,
Euderruh Uzcátegui,
Tatiana Galeazzi,
María A Gutiérrez,
Mercedes Servigna,
Adriana Dávila,
Marycelvia Uzcátegui,
Ana Serrano,
Lisette Connell,
Serge Beaulieu,
Enma Araujo de Baptista
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ABSTRACT: Excessive body weight gain (BWG) is a clinically relevant side effect of olanzapine administration. The primary objective of this study was to assess whether metformin prevents or reverses BWG in patients with schizophrenia or bipolar disorder under olanzapine administration. Secondarily we evaluated diverse metabolic variables.
Eighty patients taking olanzapine (5-20 mg daily for more than 4 consecutive months) were randomly allocated to metformin (n=40; 850 to 2550 mg daily) or placebo (n=40) group in a 12-week double-blind protocol. Waist circumference (WC) body weight (BW), body mass index (BMI) fasting glucose, glycated hemoglobin (Hb1c), insulin, an insulin resistance index (HOMA-IR) lipids, leptin, c-reactive protein, fibrinogen, cortisol and the growth hormone (GH) were evaluated at baseline and at week 12 of treatment.
The metformin group lost 1.4+/-3.2 kg (p=0.01) and tended to decrease its leptin levels, whereas the placebo group maintained a stable weight: -0.18+/-2.8 kg (p=0.7). The HOMA-IR significantly increased after placebo (p=0.006) and did not change after metformin (p=0.8). No ostensible differences were observed in the other variables, even though metformin did not improve the lipid profile and the Hb1c levels.
Metformin may safely assist olanzapine-treated patients in body weight and carbohydrate metabolism control.
Schizophrenia Research 08/2007; 93(1-3):99-108. · 4.75 Impact Factor
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ABSTRACT: In order to characterize components of the metabolic syndrome (MS) in Venezuelan black Hispanics and compare these metabolic abnormalities with those found in the predominant mixed Hispanic population, 2336 mixed Hispanics (69% women) and 281 black Hispanics (60% women), aged 20-78 years, without prior history of diabetes and/or cardiovascular disease were evaluated in a population-based study in Zulia State, Venezuela. Blood pressure (BP), waist circumference, as well as fasting insulin, fasting blood glucose (FBG), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) levels were measured. The criteria proposed by the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) to identify those with metabolic abnormalities were used. We found that black Hispanics showed higher frequency of age-adjusted elevated BP than mixed Hispanics in both men (66.9% vs. 52.3%, p < 0.01) and women (39.3% vs. 30.4%, p < 0.05). In men, elevated FBG was also more frequent in black Hispanics (32.7%) than in mixed Hispanics (22.3%), despite the lack of significant differences in fasting insulin, HOMA-insulin resistance and HOMA-beta cell function values. In women low HDL-C and higher abdominal obesity were more common in black Hispanics (71.8% and 54.1%, respectively) than in mixed Hispanics (56.2% and 44.5%, respectively), despite the greater frequency of high TG in mixed Hispanics (22.6%) when compared to black Hispanics (13.3%). Furthermore, in logistic regression analysis black Hispanic race was independently associated with higher risk for hypertension, fasting hyperglycemia, and low HDL-C. These results suggest that black Hispanics have worse cardiovascular risk profile than mixed Hispanics in Zulia State, with higher BP, higher FBG, more abdominal obesity, and lower HDL-C. Identification and intervention of these high-risk subjects are important strategies for diabetes and cardiovascular disease prevention in Venezuela.
Investigación clínica 03/2007; 48(1):45-55.
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ABSTRACT: The raising prevalence of obesity among children increases the risk of insulin resistance and its adverse metabolic consequences.
To determine the distributions of fasting serum glucose, insulin, HOMA IR and HOMA beta cell in a representative sample of children and adolescents from Maracaibo-Venezuela.
Fasting insulin and glucose were measured in 418 children and adolescents (191 boys and 227 girls) of 7, 9, 11, 13, 15 years of age. HOMA IR and HOMA beta cell were calculated.
Insulin levels were lower in 7 and 9 year-old girls and 7 year-old boys compared with 11, 13 and 15 year-old girls and boys. Fasting glucose concentrations were similar in boys and girls. HOMA IR was lower in 7 year-old girls compared to 11, 13 and 15 years-old girls, whereas boys in every age showed similar values. HOMA beta cell was higher in 11 and 13 year-old girls.
Our findings provide useful values to assess insulin resistance and ss-cell functioning in children and adolescents.
Revista medica de Chile 03/2007; 135(2):205-11. · 0.33 Impact Factor
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ABSTRACT: This study examines the basal insulin levels in a population from Zulia state (Venezuela). A total of 1703 subjects (1175 women and 528 men) from five different sanitary regions (Maracaibo, La Guajira, Perijá, Sur del Lago de Maracaibo, y Costa Oriental del Lago de Maracaibo) were studied. Weight, height, waist and hip circumferences, and blood pressure were determined. A blood sample was taken after a 12-h overnight fast to determine serum glucose, triglycerides, total cholesterol and HDL-C using enzymatic methods and insulin by radioimmunoassay. According to ATP III criteria two groups were established: a group without metabolic abnormalities (138 subjects) and a group with some metabolic abnormalities 84.8% of subjects of the non metabolic alteration groups and 80.4% of the group with some metabolic alteration were of mixed race. Non metabolic altered lean subjects (BMI <25 Kg/m2) had the lowest (p < 0.0001) basal insulin levels compared to the ones with overweight from the same group and the obese with metabolic abnormalities. This study proposes to consider a cutoff basal insulin levels of 13 microU/mL for women and 11 microU/mL for men, over 20 years of age, in the Zulia state region of Venezuela.
Investigación clínica 06/2006; 47(2):167-77.
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ABSTRACT: Leptin, insulin and growth hormone levels seem to regulate body composition, fat distribution and fat mass. The purpose of this study was to determine the relationship among insulin, leptin and growth hormone levels in a group of adolescents. Ninety five adolescents (31 boys and 64 girls) between 13 and 18 y. of age were studied. A medical and nutritional history was made which included body mass index (BMI) and subcutaneous skinfolds measurements. Basal levels of glucose, triglycerides, total cholesterol, HDL-C, LDL-C, VLDL-C, leptin, insulin and growth hormone were determined. The leptin and insulin levels were positively associated with body mass index (BMI) and obesity index (OBI). Insulin, leptin and obesity markers were negatively associated with growth hormone level. Fifty two percent of the adolescents with BMI = 21.09 kg/m2 were considered metabolically obese because they had elevated levels of insulin (18.68 +/- 1.52 vs. 10.08 +/- 0.38 microU/ml), HOMA IR (3.34 +/- 0.24 vs. 1.76 +/- 0.07), leptin (16.30 +/- 1.24 vs. 8.11 +/- 1.32 ng./dl) and triglycerides (78.56 +/- 4.38 vs. 64.39 +/- 5.48 mg/dl) and lower levels of HDL-C (39.09 +/- 1.27 vs. 43.30 +/- 2.38 mg/dl), compared with normal group. The same alterations were observed in the obese group, in which significative decrease in growth hormone level was added. We conclude that hyperinsulinemia, hyperleptinemia and low growth hormone levels, may be established as risk factors related to obesity markers, lipid alterations and insulin resistance that can lead to an early development of Type II diabetes and cardiovascular disease.
Archivos latinoamericanos de nutrición 04/2006; 56(1):29-35. · 0.23 Impact Factor
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ABSTRACT: Studies have highlighted the association between insulin resistance (IR) and several cardiovascular (CV) risk factors, including hypertension (HTN), obesity, dyslipidemia (i.e. high triglyceride and low HDL-cholesterol) and glucose intolerance, in a cluster known as the metabolic syndrome (MS). There are few data on the frequency of the MS and dyslipidemia in developing countries, and none in South America. To estimate the prevalence of the MS and its components in Zulia State, Venezuela, and to establish associated demographic and clinical factors, we evaluated 3108 Hispanic men and women aged 20 years or older from a cross-sectional survey of a random representative sample from each health district in Zulia State, Venezuela (1999-2001). Prevalence of the MS and dyslipidemia was defined according to the National Cholesterol Education Program (NCEP)/Adult Treatment Panel III (ATP III) criteria. The age-adjusted prevalence of MS and dyslipidemia was 31.2% and 24.1%, respectively, with higher rates in men than in women. Prevalence rates increased with age and with the degree of obesity. MS prevalence was lower in Amerindian (17.%) compared to Black (27.2%), White (33.3%) and Mixed (37.4%) men, but no differences were found among women. Overall, low HDL-cholesterol (65.3%), abdominal obesity (42.9%) and HTN (38.1%) were the most frequent MS components. After adjusting for age, sex and race groups, family history of diabetes, obesity and HTN were associated with the MS. Sedentary lifestyle also increased the risk of MS, event after adjusting for the same covariates, obesity and the degree of IR. These results suggest that MS is found in approximately one-third of the Venezuelan adult population in Zulia State, with higher prevalence in men related to the presence of dyslipidemia. Lifestyle interventions in MS subjects are needed in Venezuela to halt the burden of CV disease and diabetes.
Diabetes Research and Clinical Practice 08/2005; 69(1):63-77. · 2.75 Impact Factor
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ABSTRACT: Cardiovascular disease is a significant health problem affecting the adult population. Because atherosclerosis may begin in childhood, the aim of the present study was to identify biochemical markers for cardiovascular risk at an early stage of life. We studied 79 adolescents (48 girls and 31 boys) whose ages ranged from 13 to 17 years. A medical history (including pubertal stage by Tanner) was obtained from each subject. Anthropometric assessment was established by height, weight, body mass index (BMI), waist and hip circumferences, skinfolds, centrality index and obesity index. After a 12-h fast, basal blood glucose levels, total cholesterol, triglycerides, LDL-C and HDL-C were determined by enzymatic methods, mean basal insulin levels by radio immunoassays and apo A1, B, CIII by turbidimetric immunoassays. According to the BMI and taking 25 Kg/m2 as the cutoff value, 35% of the girls and 16% of the boys were obese. Eighty-five percent of the girls and 58% of the boys were hyperinsulinemic (basal insulin > 12 uU/ml). Circumferences, skinfolds, centrality and obesity index were higher (p < 0.05) in boys than in girls. In both, boys and girls, basal insulin levels were higher than the cutoff insulin value for our lab (>12 microU/ml), with the girls having higher insulin levels than the boys. Apo A1 was negatively associated with the obesity index and positively with HDL-C. Apo B was related to total cholesterol and LDL-C. Apo CIII was associated with basal insulin levels, triglycerides and VLDL-C. Our results suggest that apo CIII might be a good marker for higher insulin levels, insulin resistance and cardiovascular risk in adolescents.
Investigación clínica 03/2004; 45(1):29-42.
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ABSTRACT: In order to demonstrate the effect of family history (FH) coexisting with obesity in insulin resistance (IR) and secretion in subjects at risk for type 2 diabetes, fasting and 2 h post-glucose load serum glucose and insulin concentrations were measured in 143 individuals, 66 men and 77 women, ages ranging from 18 to 68 years, who were considered at risk but were normoglycemic following ADA criteria. Insulin resistance was estimated using HOMA(IR), basal hyperinsulinemia and I(0)/G(0) ratio. Insulin secretion was estimated by means of HOMA(beta-cell), DeltaI(30-0)/DeltaG(30-0) ratio and the insulin concentration at 30 min post-glucose load (I(30)). Disposition index (DI) was calculated to verify if insulin secretion compensate IR. Obesity in males produced an increase in all the parameters indicative of IR in both groups of individuals, with (FH(+)) or without (FH(-)) family history of diabetes, increase that was more pronounced in those FH(-). This effect was not observed in women. The parameters indicative of insulin secretion showed that only in males the presence of FH(+) was responsible for a significant decrease in insulin secretion, mainly expressed as lower values of HOMA(beta-cell) in obese as well as in non-obese. The I(30) and the ratio DeltaI(30-0)/DeltaG(30-0), although lower, did not reach statistical significance. The DI showed that only when obesity and FH were associated the decrease in insulin secretion was not a compensatory response to the IR present in those individuals. In conclusion, normoglycemic obese and non-obese male subjects of Hispanic (Latinos) origin with a family history of type 2 diabetes present not only IR but impaired insulin secretion, having the obese FH(+) and additional risk like low DI.
Diabetes Research and Clinical Practice 06/2003; 60(2):95-103. · 2.75 Impact Factor
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ABSTRACT: The aim of this study was to analyse the prevalence of obesity and hyperinsulinemia and their association with lipid profile alterations on apparently healthy individuals from Maracaibo, Venezuela. We evaluated 306 men and 41 women, ages ranging from 33 to 65 years. All subjects underwent cardiovascular evaluation and laboratory examination after 10-12 h fasting, for glycaemia, total cholesterol, TG, VLDL-C, LDL-C and HDL-C as well as insulin. Seventy-four percent of men and 56.1% of women showed obesity (BMI > 25 Kg/m2). Men showed high concentrations of TG (48.3%), total cholesterol (40.2%), VLDL-C (48.3%) and LDL-C (33.9%) and low HDL-C levels (48%). The most frequent alteration on the lipid profile in women was high total cholesterol (46%) and LDL-C (51.2%). Men had significantly higher insulin concentrations than women (p < 0.005). After they were classified as obese or non obese, the obese subjects (men and women) showed higher prevalence of lipid profile alterations and insulin concentrations than non obese. The insulin concentration in obese men correlated with BMI, TG, VLDL-C and HDL and, in women with BMI, TG and VLDL-C. In conclusion, a high percentage of men and women in this study showed obesity and this obesity, specially in men, was strongly associated with lipid profile alterations and high insulin concentrations both well known cardiovascular risk factors.
Investigación clínica 03/2003; 44(1):5-19.
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ABSTRACT: The aim of the present study was to determine in adolescents the relationship between insulin levels and body mass index (BMI), body fat distribution, diet, life style and lipid profile. We studied 167 adolescents (68 boys and 99 girls) whose ages ranged from 14 to 17 years. A detailed medical (including pubertal stage) and nutritional record was obtained from each subject. Biochemical measurements included fasting serum insulin, glucose, total cholesterol (TC), triglycerides (Tg), HDL-C, LDL-C and VLDL-C. HOMA insulin resistance (IR) and HOMA beta-cell function (beta-cell) were calculated. Insulin levels were over 84 pmol/L (cut off normal value in our lab) in 56% of the boys and 43% of the girls. Thirty-seven percent of lean adolescents whose BMI was 21.5 +/- 1.9 kg/m2 presented higher fasting insulin levels. HOMA IR, Tg, systolic (SBP) and diastolic blood pressure (DBP) values when compared to a lean normoinsulinemic group. Insulin levels were correlated (p < 0.01) with body mass index. Both boys and girls in the highest BMI quartile (BMI > 24 kg/m2) had significantly higher serum insulin, HOMA beta-cell, and Tg levels, and the lowest HDL-C levels. A high-energy intake rich in saturated fat and low physical activity were found in this lean but metabolically altered adolescents. We conclude that even with a BMI as low as 21 kg/m2 an inappropriate diet and low physical activity might be responsible for the high insulin levels and dislipidemias in adolescents.
Archivos latinoamericanos de nutrición 03/2003; 53(1):39-46. · 0.23 Impact Factor
