Impact of clinical characteristics of individual metabolic syndrome on the severity of insulin resistance in Chinese adults

The impact the metabolic syndrome (MetS) components on the severity of insulin resistance (IR) has not been reported. We enrolled 564 subjects with MetS and they were divided into quartiles according to the level of each component; and an insulin suppression test was performed to measure IR. In males, steady state plasma glucose (SSPG) levels in the highest quartiles, corresponding to body mass index (BMI) and fasting plasma glucose (FPG), were higher than the other three quartiles and the highest quartiles, corresponding to the diastolic blood pressure and triglycerides, were higher than in the lowest two quartiles. In females, SSPG levels in the highest quartiles, corresponding to the BMI and triglycerides, were higher than in all other quartiles. No significant differences existed between genders, other than the mean SSPG levels in males were greater in the highest quartile corresponding to BMI than that in the highest quartile corresponding to HDL-cholesterol levels. The factor analysis identified two underlying factors (IR and blood pressure factors) among the MetS variables. The clustering of the SSPG, BMI, triglyceride and HDLcholesterol was noted. Our data suggest that adiposity, higher FPG and triglyceride levels have stronger correlation with IR and subjects with the highest BMI have the highest IR.     

Identifying subjects with insulin resistance by using the modified criteria of metabolic syndrome

The objectives of this cohort analysis were to explore the relationship between insulin resistance (IR) and the criteria for metabolic syndrome (MetS) and to evaluate the ability to detect IR in subjects fulfilling those criteria. We enrolled 511 healthy subjects (218 men and 283 women) and measured their blood pressure (BP), body mass index, high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), and fasting plasma glucose levels. Insulin suppression testing was done to measure insulin sensitivity as the steady-state plasma glucose (SSPG) value. Subjects with an SSPG value within the top 25% were considered to have IR. The commonest abnormality was a low HDL-C level, followed by high BP. The sensitivity to detect IR in subjects with MetS was about 47%, with a positive predictive value of about 64.8%, which has higher in men than in women. In general, the addition of components to the criteria for MetS increased the predictive value for IR. The most common combination of components in subjects with MetS and IR were obesity, high BP, and low HDL-C levels. All of the components were positive except for HDL-C, which was negatively correlated with SSPG. The correlation was strongest for obesity, followed by high TG values. In subjects with MetS, sensitivity for IR was low. However, body mass index and TG values were associated with IR and may be important markers for IR in subjects with MetS.     

Metabolic syndrome, insulin resistance and systemic inflammation as risk factors for reduced lung function in Korean nonsmoking males

The aim of this study was done to assess the association of lung function with insulin resistance (IR), systemic inflammation, and metabolic syndrome (MetS). In 9,581 apparently healthy non-smoking male adults, pulmonary function, fasting glucose, insulin, lipid profiles and serum high-sensitivity C-reactive protein (hs-CRP) levels were measured, and homeostatic model assessment (HOMA) was used to assess IR. The presence of MetS was defined according to the AHA/NHLBI criteria. The prevalence of MetS was 19.3%. The odds ratio of MetS for restrictive ventilatory pattern was 1.55 (95% confidence interval, 1.12-2.14), and that for obstructive ventilatory pattern was 1.39 (0.66-2.94) after adjustment for confounders. When subjects were divided in 4 groups according to quartiles of FVC or FEV(1) (% predicted [pred]), HOMA-IR significantly increased as the FVC or FEV(1) (% predicted [pred]) decreased. Individuals in the lowest FVC or FEV(1) quartile had the highest hs-CRP level. Prevalence of MetS increased as FVC or FEV(1) (% predicted [pred]) quartiles decreased. The abdominal obesity, hs-CRP and HOMA-IR were the independent predictors for the lowest FVC and FEV(1) (% predicted [pred]) even after adjustment for confounders. These results indicate that MetS, IR, and systemic inflammation are important risk factors for reduced lung function in nonsmoking Korean males.     

Incidence and risk factors of insulin resistance syndrome in 20-59 year-old Korean male workers

We investigated the incidence of insulin resistance syndrome (IRS) according to the criteria of diagnoses suggested by the American College of Endocrinology/ American Association of Clinical Endocrinologists and the risk factors associated with the development of IRS. Among 2,048 subjects without a history of/or drug treatment for hypertension, diabetes, dyslipidemia with normal findings at baseline, 1,578 subjects aged 20-59 yr were followed prospectively for 2 yr. The incidence of IRS was 6.9 per 100 persons/year. The relative risk (RR) due to age was 1.03 (95% CI: 1.00-1.05) with every one-year increase in age. The RR associated with an abnormal waist-hip ratio group (> or =0.9) was increased by 1.74 (95% CI: 1.17-2.58) compared to the normal group (<0.9); RR associated with abnormal alanine transferase was increased (> or =35 IU/L) by 1.70 (95% CI: 1.20-2.41) compared to the normal group (<35 IU/L); and the RR associated with abnormal lowdensity lipoprotein (LDL) cholesterol was increased (> or =160 mg/L) by 1.70 (95% CI: 1.19-2.44) compared to the normal LDL cholesterol (<160 mg/L). Lastly, the RR of current smokers was increased by 1.63 (95% CI: 1.09-2.42) compared to that of non-smokers. It is necessary to develop methods of prevention and therapeutic approach to manage the integrated risk factors as opposed to individual factors.     

The relation of thyroid function to components of the metabolic syndrome in Korean men and women

This study was to assess the relation of thyroid dysfunction to metabolic syndrome (MetS) at an earlier stage in Korean population. Metabolic parameters such as body composition, blood pressure (BP), fasting glucose, total cholesterol, triglyceride (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), thyroid-stimulating hormone (TSH) and free thyroxine 4 (fT(4)) were measured. During a mean follow-up of 3 yr, 5,998 Koreans ages over 18 yr were assessed. There were 694 cases of MetS at follow-up. The mean age of the subjects was 45.6 ± 9.5 yr. Mean level of TSH was 2.02 ± 1.50 mIU/L, mean level of fT(4) was 1.23 ± 0.20 ρM/L. At baseline, TSH levels and fT(4) levels were associated to waist circumference, BP, glucose and lipids in the subjects. Increase in systolic blood pressure, diastolic blood pressure (DBP), total cholesterol and TG were significantly associated with changes in TSH levels after adjustment. Changes in DBP, TG, HDL-C and fasting glucose were significantly associated with changes in fT(4) levels after adjustment. Increase in TSH levels even after further controlling for baseline TSH level predicted the MetS over the study period. In conclusion, there is a relationship between thyroid function and cardiovascular risk factors, such as BP, total cholesterol, TG, HDL-C and fasting glucose. Also, higher levels of TSH may predict the MetS in Korean.     

Effect of weight reduction on metabolic syndrome in Korean obese patients

The Third Report of the National Cholesterol Education Program Adult Treatment Panel III emphasized the importance of management of the metabolic syndrome. However, little information is available about the effect of weight reduction on the metabolic syndrome in obese patients among Koreans. A longitudinal clinical intervention study from the 12-week of weight reduction program, including life style modification and adjuvant appetite suppressants, in 78 obese persons was performed. Anthropometry and metabolic risk factors were measured before and after weight reduction. Visceral (VAT), subcutaneous (SAT), and total adipose tissue (TAT) on abdomen were determined by CT scan. Moderate decrease in weight (9.3%) induced significant reduction of waist circumference, systolic and diastolic blood pressure, and triglyceride. Weight reduction also resulted in significant decrease in total cholesterol, LDL-C, uric acid, fasting insulin, and HOMA score. The subjects with metabolic syndrome showed more improvements of metabolic components than those without metabolic syndrome through weight reduction. The reductions of visceral-subcutaneous fat ratio (VSR) and waist circumference were observed as for the predictable variables related to the improvement of metabolic component and insulin resistance in Korean obese patients.     

Obesity and the metabolic syndrome in Korean adolescents

This study evaluated the prevalence of metabolic syndrome and investigated its association with being overweight in Korean adolescents. Data were obtained from 1,393 students between 12 and 13 yr of age in a cross-sectional survey. We defined the metabolic syndrome using criteria analogous to the Third Report of the Adult Treatment Panel (ATP III) as having at least three of the following: fasting triglycerides > or =100 mg/dL; HDL <50 mg/dL; fasting glucose > or =110 mg/dL; waist circumference >75th percentile for age and gender; and systolic blood pressure >90th percentile for age, gender, and height. Weight status was assessed using the age- and gender-specific body mass index (BMI), and a BMI > or =85th percentile was classified as overweight. Of the adolescents, 5.5% met the criteria for the metabolic syndrome, and the prevalence increased with weight status; it was 1.6% for normal weight and 22.3% in overweight (p<0.001). In multivariate logistic regression analyses among adolescents, overweight status was independently associated with the metabolic syndrome (odds ratio, 17.7; 95% confidence interval, 10.0-31.2). Since childhood metabolic syndrome and obesity likely persist into adulthood, early identification helps target interventions to improve future cardiovascular health.     

Differential relationship between metabolic syndrome score and severity of coronary atherosclerosis as assessed by angiography in a non-diabetic and diabetic Korean population

Whether the metabolic syndrome (MetS) has prognostic value for coronary artery disease (CAD) beyond its individual components is controversial. We compared the relationship between the number of MetS components and CAD severity as assessed by angiography in non-diabetic and diabetic subjects. We consecutively enrolled 527 patients who underwent their first coronary angiography. Patients were divided into four groups according to the number of MetS components: 0/1, 2, 3, and 4/5. A coronary atherosclerosis score was used to quantify the extent of atherosclerotic involvement. The relationship between the MetS score and angiographic CAD severity or clinical presentation was compared between non-diabetic and diabetic subjects. Individuals with the MetS (n = 327) had a higher prevalence of CAD (60% vs 32%, P < 0.001), multi-vessel disease (34% vs 16%, P < 0.001), and acute coronary syndromes (49% vs 26%, P < 0.001) than those without the MetS. In the non-diabetic group, atherosclerosis score increased with the MetS score (1.0 ± 2.1, 2.0 ± 2.9, 2.8 ± 2.9, and 3.6 ± 3.9, P < 0.001) whereas there was no significant difference in the diabetic group (0.5 ± 1.0, 5.2 ± 4.7, 4.2 ± 2.9, and 4.4 ± 3.5, P = 0.102). The MetS score is related to CAD severity in non-diabetic patients but the association between the MetS score and angiographic CAD severity may be obscured in the presence of diabetes.     

Milk intake and its association with metabolic syndrome in Korean: analysis of the third Korea National Health and Nutrition Examination Survey (KNHANES III)

Although previous studies have shown that milk intake has some protective effects on metabolic syndrome (MS), there are few data on the relation between MS and milk consumption in Korean. To evaluate the association between milk intake frequency and MS, 4,890 subjects (2,052 men and 2,838 women) were included in the analysis, based on the national data from representative random sample of the third Korea National Health and Nutrition Examination Survey (KNHANES III) in 2005. We conducted both univariate and multivariate logistic regression analysis with adjustment for confounding factors associated with MS. Mean (±SD) age of subjects was 47.1±15.5 yr. In univariate analysis, the risk of MS was inversely associated with the frequency of milk intake, but this relation was attenuated in multivariate regression. In the individuals with BMI ≥23 kg/m(2), those with highest quartile of milk consumption (once daily or more) had significantly lower risk of MS (OR [95% CI] 0.72 [0.57-0.92] compared with lowest quartile [those rarely consumed]) after adjustment, but not among leaner individuals (BMI <23 kg/m(2)). Korean overweight adults who drink milk more frequently may be protected against MS. But it seems that this relation is somewhat different among MS components.     

The impact of metabolic syndrome on metabolic,pro-inflammatory and prothrombotic markers according to the presence of high blood pressure criterion

OBJECTIVES:

We explored whether high blood pressure is associated with metabolic, inflammatory and prothrombotic dysregulation in patients with metabolic syndrome.

METHODS:

We evaluated 135 consecutive overweight/obese patients. From this group, we selected 75 patients who were not under the regular use of medications for metabolic syndrome as defined by the current Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults criteria. The patients were divided into metabolic syndrome with and without high blood pressure criteria (≥130/≥85 mmHg).

RESULTS:

Compared to the 45 metabolic syndrome patients without high blood pressure, the 30 patients with metabolic syndrome and high blood pressure had significantly higher glucose, insulin, homeostasis model assessment insulin resistance index, total cholesterol, low-density lipoprotein-cholesterol, triglycerides, uric acid and creatinine values; in contrast, these patients had significantly lower high-density lipoprotein-cholesterol values. Metabolic syndrome patients with high blood pressure also had significantly higher levels of retinol-binding protein 4, plasminogen activator inhibitor 1, interleukin 6 and monocyte chemoattractant protein 1 and lower levels of adiponectin. Moreover, patients with metabolic syndrome and high blood pressure had increased surrogate markers of sympathetic activity and decreased baroreflex sensitivity. Logistic regression analysis showed that high-density lipoprotein, retinol-binding protein 4 and plasminogen activator inhibitor-1 levels were independently associated with metabolic syndrome patients with high blood pressure. There is a strong trend for an independent association between metabolic syndrome patients with high blood pressure and glucose levels.

CONCLUSIONS:

High blood pressure, which may be related to the autonomic dysfunction, is associated with metabolic, inflammatory and prothrombotic dysregulation in patients with metabolic syndrome.     

Association of serum 25-hydroxyvitamin D levels with markers for metabolic syndrome in the elderly: a repeated measure analysis

The purpose of current study was to investigate associations of serum 25-hydroxyvitamin D (OHVD) levels with markers for metabolic syndrome in elderly Koreans. We conducted a panel study on 301 individuals over 60 yr old in Seoul, Korea, and repeatedly measured serum OHVD, glucose, insulin, and lipid levels. Mixed effect model and generalized estimating equations were used to investigate relationships between serum OHVD levels with marker levels for metabolic syndrome and each of its categories. Of all subjects, 76.6% were vitamin D deficient (< 50 nM) and 16.9% were insufficient (< 75 nM). Inverse association was demonstrated between serum OHVD levels and insulin (P = 0.004), triglyceride (P = 0.023) and blood pressure (systolic blood pressure: P = 0.002; diastolic blood pressure: P < 0.001). Vitamin D deficiency was found to increase risk of 'hypertriglyceridemia' category of metabolic syndrome (odds ratio: 1.73, 95% confidence interval: 1.13-2.66). In conclusion, we found from our repeated measure analysis that decreasing serum OHVD levels are associated with increasing insulin resistance, increasing serum triglyceride levels and increasing blood pressure in elderly Koreans, and confirmed on the risk of 'hypertriglyceridemia' in vitamin D deficient subjects.     

Insulin resistance is associated with gallstones even in non-obese, non-diabetic Korean men

It remains unclear as to whether insulin resistance alone or in the presence of wellknown risk factors, such as diabetes or obesity, is associated with gallstones in men. The aim of this study was to determine whether insulin resistance is associated independently with gallstone disease in non-diabetic men, regardless of obesity. Study subjects were 19,503 Korean men, aged 30-69 yr, with fasting blood glucose level <126 mg/dL and without a documented history of diabetes. Gallbladder status was assessed via abdominal ultrasonography after overnight fast. Body mass index and waist circumference were measured. Insulin resistance was estimated by the Homeostasis Model Assessment of insulin resistance (HOMA-IR). The prevalence of obesity, abdominal obesity, and metabolic syndrome in the subjects with gallstones were higher than in those without. The prevalence of elevated HOMA (>75 percentile) in subjects with gallstones was significantly higher than in those without, and this association remained even after the obesity stratification was applied. In multiple logistic regression analyses, only age and HOMA proved to be independent predictors of gallstones. Insulin resistance was positively associated with gallstones in non-diabetic Korean men, and this occurred regardless of obesity. Gallstones appear to be a marker for insulin resistance, even in non-diabetic, nonobese men.     

The prevalence of metabolic syndrome in patients with gout: a multicenter study

It has been suggested that hyperuricemia and possibly gout are associated with the metabolic syndrome, but there have been no direct studies. This study was undertaken to obtain the prevalence of the metabolic syndrome in patients with gout and to compare it with those from the general population studies. This was a 4-institutional case-historical control study composed of 168 patients with gout. We assessed the prevalence of metabolic syndrome according to the ATP III criteria and compared the prevalence with that of the historical controls. To elucidate the factors in gout that were associated with metabolic syndrome, a multivariate analysis was done. The age-adjusted prevalence of metabolic syndrome in gout patients was 43.6%, which was significantly higher than that of the Korean control population (5.2%) from the previous studies. Patients with gout had more components of metabolic syndrome than did the controls. Body mass index (BMI, OR = 1.357 (95%CI 1.111-1.657)) and high density lipoprotein (HDL, OR = 0.774 (95%CI 0.705-0.850)) were the variables most significantly associated with the occurrence of metabolic syndrome in gout, but alcohol consumption did not show such associations. Gout is associated with the metabolic syndrome, and furthermore, obesity and dyslipidemia were the factors most associated with the syndrome in these patients.     

Uric acid: a surrogate of insulin resistance in older women

OBJECTIVES: The relationship between serum uric acid (UA) and cardiovascular disease has been debated extensively and no conclusion has been reached yet. The main purpose of this study was to explore the sex-different relationship among insulin resistance, metabolic syndrome (MS) and hyperuricemia. METHODS: A community-based prospective study was conducted among people aged over 40 years in I-Lan County, Taiwan. A complete history taking, physical examination and laboratory tests were performed for each subject by the well-trained research staff. Insulin resistance was determined by the homeostasis model assessment (HOMA-IR). Serial comparisons were performed to evaluate the associations between MS, insulin resistance and hyperuricemia in both sexes. RESULTS: A total of 852 subjects (mean age=64.6+/-11.3 years, 56.7% female) were enrolled. The prevalence of obesity, hyperuricemia, chronic kidney disease (CKD), insulin resistance and MS was 42.2, 31.2, 30.9, 36.0 and 47.5%, respectively. Subjects with MS were significantly older (63.4+/-10.0 years versus 60.4+/-12.4 years, P=0.019), higher in body mass index (BMI) (26.3+/-3.5 kg/m(2) versus 23.6+/-3.0 kg/m(2), P<0.001), serum UA (6.1+/-2.1mg/dl versus 5.5+/-1.7 mg/dl, P=0.003), HOMA-IR (2.7+/-3.4 versus 1.0+/-0.8, P<0.001) and lower in glomerular filtration rate (GFR) (66.3+/-17.7 ml/min/1.73 m(2) versus 72.0+/-15.2 ml/min/1.73 m(2), P=0.001). Male gender, CKD, BMI>23 kg/m(2) and insulin resistance were all independent risk factor for hyperuricemia with the covariate of age. When age and BMI were controlled, females had significantly higher prevalence of CKD and insulin resistance, but less hyperuricemia than males (P all<0.05). Adjusted for age, BMI and GFR, hyperuricemia and MS were both independent risk factors for insulin resistance in females (P=0.006, <0.001, respectively). In males, MS remained significantly associated with insulin resistance (P=0.002) but not hyperuricemia (P=0.813). When age, BMI and GFR were controlled, serum UA was positively related to HOMA-IR in females (gamma=0.117, P=0.012), but not in males (P=0.93). CONCLUSION: A positive association was identified between serum UA and insulin resistance in older women but not in men. Studies related to insulin resistance may be needed when hyperuricemia was identified in older women.     

脐带间充质干细胞治疗代谢综合征的作用机制

背景：研究表明,干细胞的主要功能有直接参与损伤修复、分泌生长因子促进损伤修复、促血管再生改善血液循环、调节免疫和炎症、抗氧化应激等,可用于治疗多种慢性疾病。 目的：综述脐带间充质干细胞治疗代谢综合征的作用机制。 方法：以“干细胞,脐带间充质干细胞,代谢综合征,胰岛素抵抗,高血糖,高血脂”为中文捡索词,以“stem cells,mbilical cord-derived mesenchymal stem cells,stem cells transplantation, metabolic syndrome,insulin resistance,diabetes, hyperlipidemia”为英文检索词,在维普、中国知网(CNKI)期刊全文数据库和PubMed数据库检索2004年1月至2014年10月有关干细胞移植治疗代谢综合征的文献。排除陈旧性和重复性研究,最终纳入42篇文献进行综述。 结果与结论：脐带间充质干细胞具有自我复制能力和多向分化潜能,是细胞替代治疗的理想种子细胞,同时它还具有旁分泌和免疫调节功能。目前脐带间充质干细胞的分离、培养、鉴定以及体外扩增等技术已相当成熟,且有动物实验研究证实脐带间充质干细胞治疗代谢综合征安全有效,可从根本上治疗靶器官损伤,改善胰岛素抵抗和糖、脂代谢紊乱,但应用于临床仍然有很多问题尚待解决。中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程全文链接：     

脂肪因子Chemerin在炎症和代谢综合征中的双重效应

背景：近年多项临床及基础研究显示脂肪因子chemerin与代谢综合征密切相关。 目的：综述脂肪因子chemerin在炎症和肥胖、高血压及糖脂代谢中的作用及机制,概括脂肪因子chemerin与炎症和代谢综合征的关系。 方法：由第一作者检索1990至2014年PubMed数据库以及万方数据库脂肪因子chemerin相关的文献,并进行系统整理、总结和分析。 结果与结论：研究表明脂肪因子chemerin水平与体脂含量、能量代谢、炎症相关,在肥胖和代谢综合征病理生理过程中扮演了重要角色。由于脂肪因子chemerin在炎症和代谢中的双重作用,它可能成为连接慢性炎症和肥胖及其相关疾病的一个关键因子。脂肪因子Chemerin在不同的炎症状态下作用不同,可能与其在不同的炎症环境中裂解方式的不同有关,但并没有明确脂肪因子chemerin在肥胖和代谢综合征中的功能。需要进一步研究明确血清脂肪因子chemerin水平与肥胖和代谢综合征之间的关系。  中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程全文链接：     

The usefulness of metabolic score for insulin resistance for the prediction of incident non-alcoholic fatty liver disease in Korean adults

Background/AimsThe early detection and prevention of non-alcoholic fatty liver disease (NAFLD) has been emphasized considering the burden of this disease. Both hepatic and peripheral insulin resistances are strongly associated with NAFLD. We aimed to compare the predictive powers of a hepatic insulin resistance index, the homeostatic model assessment for insulin resistance (HOMA-IR), and a novel peripheral insulin resistance index, the metabolic score for insulin resistance (METS-IR), for the prediction of prevalent and incident NAFLD.MethodsData from 8,360 adults aged 40–69 years at baseline and 5,438 adults without NAFLD who were followed-up at least once after the baseline survey in the Korean Genome and Epidemiology Study were analyzed. The survey was performed biennially, up to the eighth follow-up.ResultsThe predictive powers of the METS-IR and HOMA-IR for prevalent NAFLD were not significantly different (area under the receiver operating characteristic [ROC] curve [95% confidence interval]: METS-IR, 0.824 [0.814–0.834]; HOMA-IR, 0.831 [0.821–0.842]; P=0.276). The area under the time-dependent ROC curve (Heagerty’s integrated area under the curve) of the METS-IR for incident NAFLD was 0.683 (0.671–0.695), significantly higher than that of the HOMA-IR (0.551 [0.539–0.563], P<0.001).ConclusionsThe METS-IR is superior to the HOMA-IR for the prediction of incident NAFLD and is not inferior to the HOMA-IR for the prediction of prevalent NAFLD. This suggests that the METS-IR can be a more useful insulin resistance index than the HOMA-IR for the early detection and prevention of NAFLD in Korean population.     

Aerobic exercise training induces metabolic benefits in rats with metabolic syndrome independent of dietary changes

OBJECTIVES:

We evaluated the effects of aerobic exercise training without dietary changes on cardiovascular and metabolic variables and on the expression of glucose transporter Type 4 in rats with metabolic syndrome.

METHODS:

Twenty male spontaneously hypertensive rats received monosodium glutamate during the neonatal period. The animals were allocated to the following groups: MS (sedentary metabolic syndrome), MS-T (trained on a treadmill for 1 hour/day, 5 days/week for 10 weeks), H (sedentary spontaneously hypertensive rats) and H-T (trained spontaneously hypertensive rats). The Lee index, blood pressure (tail-cuff system), insulin sensitivity (insulin tolerance test) and functional capacity were evaluated before and after 10 weeks of training. Glucose transporter Type 4 expression was analyzed using Western blotting. The data were compared using analysis of variance (ANOVA) (p<0.05).

RESULTS:

At baseline, the MS rats exhibited lower insulin sensitivity and increased Lee index compared with the H rats. Training decreased the body weight and Lee index of the MS rats (MS-T vs. MS), but not of the H rats (H-T vs. H). There were no differences in food intake between the groups. At the end of the experiments, the systolic blood pressure was lower in the two trained groups than in their sedentary controls. Whole-body insulin sensitivity increased in the trained groups. Glucose transporter Type 4 content increased in the heart, white adipose tissue and gastrocnemius muscle of the trained groups relative to their respective untrained groups.

CONCLUSION:

In conclusion, the present study shows that an isolated aerobic exercise training intervention is an efficient means of improving several components of metabolic syndrome, that is, training reduces obesity and hypertension and increases insulin sensitivity.     

Marked suppression of ghrelin concentration by insulin in Prader-willi syndrome

The plasma ghrelin has been reported to be elevated in Prader-Willi syndrome (PWS) and modulated by insulin. It was hypothesized that insulin might have a more pronounced effect on reducing plasma ghrelin in PWS patients, which would influence appetite. This study investigated the degree of ghrelin suppression using an euglycemic hyperinsulinemic clamp in children with PWS (n=6) and normal children (n=6). After a 90-min infusion of insulin, the plasma ghrelin level decreased from a basal value of 0.86+/-0.15 to 0.58+/-0.12 ng/mL in the controls, and from 2.38+/-0.76 to 1.12+/-0.29 ng/mL in children with PWS (p=0.011). The area under the curve below the baseline level over the 90 min insulin infusion was larger in children with PWS than in controls (-92.82+/-44.4 vs. -10.41+/-2.87 ng/mL/90 min) (p=0.011). The insulin sensitivity measured as the glucose infusion rate at steady state was similar in the two groups (p=0.088). The decrease in the ghrelin levels in response to insulin was more pronounced in the children with PWS than in the controls. However, the level of ghrelin was always higher in the children with PWS during the clamp study. This suggests that even though insulin sensitivity to ghrelin is well maintained, an increase in the baseline ghrelin levels is characteristic of PWS.