Serum osteocalcin is related to abdominal obesity in Korean obese and overweight men

BackgroundGrowing evidence suggests a link between body composition and serum osteocalcin. Here we examined such an association between serum osteocalcin and body composition in Korean obese men.MethodsEighty-six men, aged 20 to76 years, who visited the obesity clinic at the Division of Family Medicine, Severance hospital, Seoul, Korea were recruited for this study. Abdominal fat computed tomography (CT) scans were performed to measure the visceral fat area (VFA) and subcutaneous fat area (SFA).ResultsSerum osteocalcin levels were negatively correlated with age, VFA, and VFA/SFA ratio. In addition, serum osteocalcin levels were significantly decreased in obese and overweight subjects with visceral obesity (12.7 ± 3.2) compared to those without visceral obesity (18.6 ± 4.9). Multiple regression analysis showed that serum osteocalcin levels were associated with VFA in obese and overweight men after adjustment for age, insulin resistance, current smoking, alcohol consumption and adiposity indices.ConclusionOsteocalcin was inversely related to visceral obesity in Korean obese and overweight men. These results suggest cross-talk between bone and adipose tissue.     

Reduced serum vaspin concentrations in obese children following short-term intensive lifestyle modification

BackgroundRecently, visceral adipose tissue-derived serpin (vaspin) was identified as a potential insulin sensitizing adipokine, however, the factors determining the levels of circulating vaspin levels have not been fully understood. We investigated the association between adiposity, insulin resistance, lipid profiles and inflammatory markers including vaspin levels, and the effects of short-term intensive lifestyle modification on circulating vaspin levels in overweight or obese children.MethodsA total of 50 (25 boys, 25 girls) overweight or obese children aged 11 to 13 years (average age: 12.0 ± 0.9 y, BMI: 25.35 ± 86 kg/m²) who complied with inclusion criteria participated in our study. To determine the association between adiposity, insulin resistance, lipid profiles and inflammatory markers including vaspin levels, cross-sectional analyses were performed. Thereafter, subjects underwent a tightly controlled seven-day intensive lifestyle modification including physical activity, dietary modification, and behavioral modification education in residence of a local university dormitory.ResultsThere was a negative correlation between vaspin concentration and fasting insulin (r = ?.325, p < 0.05) and homeostasis model assessment of insulin resistance (HOMA-IR) (r = ?.331, p < 0.05) when percent body fat was controlled. Multivariate linear regression analysis found serum vaspin level to be an independent predictor of insulin and HOMA-IR. Short-term intensive lifestyle modification significantly decreased vaspin levels by 39.28% (pre: .84 ± 1.0, post: .51 ± 1.0 ng/ml, p < 0.001) while adiponectin levels increased by 11.2% (pre: 6.50 ± 2.89, post: 7.28 ± 2.98 ng/ml, p < 0.01). In addition, short-term lifestyle modification significantly improved HOMA-IR (pre: 3.58 ± 1.93, post 1.30 ± 1.9, p < 0.001) and lipid profiles.ConclusionsSerum vaspin level is one of the predictors for insulin resistance and was significantly reduced following short-term lifestyle modification.     

Association of G-2548A LEP polymorphism with plasma leptin levels in Tunisian obese patients

ObjectivesThe aim of this study was to examine the association of the G-2548A polymorphism of the human leptin gene (LEP) with body mass index (BMI), plasma leptin, insulin, and lipid parameters in a sample of Tunisian population.Design and methodsTwo hundred and twenty nine obese patients (BMI ≥ 30 kg/m²) were screened and compared to 251 normal weight subjects (BMI < 25 kg/m²). The human leptin gene promoter G-2548A genotype was determined by polymerase chain reaction followed by a digestion with the restriction of endonuclease CfoI.ResultsIn the entire study sample, carriers of -2548A allele had significantly lower leptin levels than homozygous for -2548G allele (14.28 ± 9.10 ng/mL vs. 18.27 ± 12 ng/mL, p < 0.001 respectively) adjusted for BMI and gender. In obese patients but not control, subjects carrying the -2548A allele exhibited lower leptin levels than those with GG genotype (16.96 ± 8.27 ng/mL vs. 21.37 ± 11.72 ng/mL, p = 0.001 respectively) adjusted for BMI and gender. In this group, carriership of the -2548A allele was identified, by multiple linear regression models, as significant independent predictor for leptin levels variability. Separate analyses by gender revealed that only in obese women, the -2548A allele was found to be associated with lower leptin levels independently of BMI (p = 0.004).ConclusionsThe present study showed that G-2548A LEP polymorphism is associated with lower leptin levels in Tunisian obese women.     

Serum levels of pigment epithelium-derived factor,a novel marker of insulin resistance,are independently associated with fasting apolipoprotein B48 levels in humans

ObjectivesFasting apolipoprotein B48 (apoB48) levels are associated with postprandial hyperlipidemia and carotid artery intima-media thickness (IMT), one of the markers of metabolic derangements and atherosclerosis, respectively. However, it remains unknown whether fasting serum levels of apoB48 are independently correlated with insulin resistance and vascular inflammation in humans.Design and methodsThe study involved 315 consecutive outpatients in our hospital (218 males and 97 females) with a mean age of 62.0 ± 9.2. We examined which anthropometric, metabolic and inflammatory variables, including serum levels of pigment epithelium-derived factor (PEDF), a novel marker of insulin resistance were independently associated with fasting apoB48. Moreover, we investigated whether fasting apoB48 levels were correlated with atherosclerotic plaque inflammation evaluated by [¹⁸F]-fluorodeoxyglucose positron emission tomography (FDG-PET). Carotid [¹⁸F]-FDG uptake, an index of vascular inflammation within the atherosclerotic plaques, was measured as blood-normalized standardized uptake value, known as the target-to-background ratio (TBR).ResultsMean serum levels of apoB48, PEDF, carotid IMT and TBR values were 2.77 ± 0.21 μg/mL, 13.45 ± 1.03 μg/mL, 0.71 ± 0.15 mm, and 1.43 ± 0.21, respectively. Univariate analysis revealed that apoB48 levels were weakly, but not significantly associated with TBR (p = 0.057). In multiple stepwise regression analysis, triglycerides (p < 0.001), male (p = 0.039), age (inversely, p = 0.010), uric acid (p = 0.007), medication for diabetes (p = 0.029), and PEDF (p = 0.049) were independently correlated to fasting apoB48 levels (R² = 0.371).ConclusionsThe present study reveals that serum levels of PEDF are independently associated with fasting apoB48 levels, suggesting that PEDF level is a novel biomarker that could reflect postprandial hyperlipidemia in humans.     

Immediate effects of Pilates based therapeutic exercise on postural control of young individuals with non-specific low back pain: A randomized controlled trial

ObjectivesLow back pain affects the person's ability to keep balance, especially in challenging conditions. The purpose of this study was to determine the immediate effects of Pilates exercises on postural sway and dynamic balance of young individuals with non-specific low back pain.DesignControlled laboratory design.Settings and main outcome measuresForty-six participants with non-specific low back pain were randomized to a Pilates (n = 23, 10 males; age: 21.8 ± 3.2 years) and a control group (n = 23, 9 males; age: 22.8 ± 3.6 years). Postural sway was assessed with a force platform and dynamic balance with the Star Excursion Balance Test, before and after the intervention or rest period. To assess postural sway, participants stood still on an unstable surface set on the force plate for 90s, with eyes closed.InterventionThe intervention lasted 20 min and consisted on four Pilates exercises: single leg stretch (level 1), pelvic press (level 1), swimming (level 1) and kneeling opposite arm and leg reach.ResultsAt baseline, no differences were found between groups. The Pilates group improved in all the postural sway values (area of CoP: 11.5 ± 3.4 to 9.7 ± 2.7 cm², p = 0.002 and CoP velocity: 2.8 ± 0.6 to 2.3 ± 0.5 cm/s, p < 0.001) and in the Star Excursion Balance Test. Control group only improved in CoP velocity, however, this improvement was significantly inferior compared to the Pilates group.ConclusionsPilates exercises immediately improved postural sway and dynamic balance in young adults with non-specific low back pain.     

Bone turnover markers in Spanish adult men: The Camargo Cohort Study

BackgroundThis cross-sectional study was performed to determine the reference ranges for two bone turnover markers—aminoterminal propeptide of type I collagen (P1NP) and C-terminal telopeptide of type I collagen (β-CTX)—in normal adult Spanish men as measured in serum by automated methods.MethodsA community-based population of 660 healthy men ≥ 50 years was evaluated. Fasting serum levels of P1NP, β-CTX, 25-hydroxyvitamin D, and intact parathyroid hormone were measured on the Elecsys 2010 automated analyzer (Roche). BMD at lumbar spine, femoral neck and total hip was determined by DXA.ResultsMean age of participants was 65 ± 9 years. Logarithmic transformation of both markers was performed to allow for normal distribution. Mid-95% ranges for P1NP and β-CTX were 15–78 ng/ml and 0.069–0.760 ng/ml, respectively. Median and interquartile range of serum P1NP and β-CTX were 33.5 [25.5;44.4] ng/ml and 0.27 [0.19;0.38] ng/ml, respectively. Mean values of P1NP (37.1 ± 16.7 ng/ml) were similar to those previously described. β-CTX mean values (0.300 ± 0.171 ng/ml) were also similar to those quoted by the manufacturers in men younger than 70 years, but slightly lower than those reported in subjects older than 70 years. Both markers were higher among osteoporotic men. After excluding from the analysis those men who were found to have BMD below ?2.5 T-score, 25OHD serum level below 30 ng/ml or serum PTH above 65 pg/ml, P1NP and β-CTX ranges were 17–71 ng/ml and 0.070–0.681 ng/ml, again respectively.ConclusionsValues obtained from this well-characterized population study provide reference ranges for serum automated P1NP and β-CTX in normal Spanish adult men.     

Omega-3 fatty acids improve postprandial lipemia and associated endothelial dysfunction in healthy individuals – a randomized cross-over trial

BackgroundPostprandial elevation of triglycerides impairs endothelial function and contributes to the development of atherosclerosis. We investigated the effects of omega-3 fatty acids on postprandial endothelial function and lipid profiles.MethodsHealthy volunteers [10] were given supplementation at 4 g/day omega-3 fatty acids (or were not treated) for 4 weeks in a randomised crossover study. Postprandial levels of various lipids were monitored and endothelial function assessed by brachial artery flow-mediated dilation during fasting and after a standard cookie test.ResultsOmega-3 fatty acids reduced postprandial endothelial dysfunction compared with the control diet (flow-mediated dilation at 4 h = −0.5 ± 1.2 vs. −2.0 ± 1.6%, P = 0.03). Postprandial levels of triglycerides, apolipoprotein B-48, and remnant lipoprotein-cholesterol increased in untreated subjects, peaked at 2–4 h, and returned to baseline at 8 h, whereas low-density lipoprotein-cholesterol levels did not change. Supplementation with omega-3 fatty acids significantly suppressed postprandial elevation of triglycerides (incremental area under the curve = 220 ± 209 vs. 374 ± 216 mg/h/dL, P = 0.04) and remnant lipoprotein-cholesterol (incremental area under the curve = 21.7 ± 13.8 vs. 13.3 ± 12.9 mg/h/dL, P = 0.04). Supplementation with omega-3 fatty acids significantly suppressed the increase in triglyceride content in chylomicrons as well as in very-low-density lipoproteins from baseline to 4 h after the cookie test.ConclusionOmega-3 fatty acids significantly decreased postprandial triglyceride elevation and postprandial endothelial dysfunction, suggesting that omega-3 fatty acids may have vascular protective effects in postprandial state.     

Profiles of inflammatory markers and lipoprotein subclasses in patients undergoing continuous ambulatory peritoneal dialysis

BackgroundPatients undergoing continuous ambulatory peritoneal dialysis (CAPD) often have inflammation and dyslipidemia that accelerate to atherosclerosis. This study aimed to evaluate chronic inflammation and dyslipidemia in CAPD patients.MethodsWe measured inflammatory markers and lipoprotein subclasses in 20 CAPD patients (12 men and 8 women, aged 59.5 ± 9.9 y) and 20 gender-matched controls. Lipoproteins were separated by high-performance liquid chromatography (HPLC) using an anion-exchange column.ResultsHigh-sensitivity C-reactive protein and serum amyloid A protein (SAA) were higher among CAPD patients vs. controls (1.6 ± 2.2 vs. 0.8 ± 1.2 mg/l, p < 0.05; 11.9 ± 12.8 vs. 4.5 ± 2.4 mg/l). HPLC analysis revealed that chylomicron, VLDL, and IDL cholesterol levels were higher among CAPD vs. controls. In contrast, HDL cholesterol was lower among CAPD patients vs. controls. In the subgroup analysis, SAA levels were significantly lower among patients receiving CAPD for > 3 y than among controls. However, IDL cholesterol was consistently higher among CAPD patients vs. controls.ConclusionsCAPD patients have chronic inflammation and dyslipidemia. IDL cholesterol is the only lipoprotein subclass that is consistently elevated regardless of CAPD duration. More attention should be paid to dyslipidemia in the management of the CAPD patients.     

Relationship between obesity and metabolic syndrome among Argentinean elementary school children

BackgroundArgentina has experienced marked increases in the prevalence of childhood overweight (OW)/obesity over the last few decades.ObjectivesWe examined (1) the distribution of the mean values of lipids, glucose, and HOMA-IR according to the presence of OW/obesity, age, and sex and (2) the association between metabolic syndrome and OW/obesity, Tanner stage, gender, and HOMA-IR.MethodsData were collected from 1009 children (508 males) in 10 elementary schools between April and September 2007. BMI, waist circumference, blood pressure, Tanner, lipids, insulin, and glucose were determined. Criteria analogous to ATPIII were used for metabolic syndrome in children.ResultsOver 1009 children (508 males) aged 9.4 ± 2.0 years were evaluated. One hundred and sixty-five (16.4%) were obese (> 95th percentile), and 166 (16.5%) were OW (85-95th). Twenty-five (2.5%) were severely obese (BMI > 99th). Most of the children (62%; 613/979) were at Tanner 1. Triglycerides, insulin, and HOMA-IR were higher (p < 0.001) and HDL-C lower (p < 0.001) in OW/obesity in both age groups and genders. The prevalence of metabolic syndrome was 5.8% overall, 32% in severely obese, 16.4% in OW/obese and 0.4% in normal weight children. Multiple logistic regression showed that BMI (OR 24.48; 95% CI 9.14–65.57), and HOMA-IR (OR 2.09; 95% CI 1.04–4.18) were associated with metabolic syndrome adjusted by gender and Tanner stage. Multiple linear regression also showed that BMI and HOMA-IR were independently associated with the number of metabolic syndrome components (R² = 0.46).ConclusionsA substantial number of OW/obese children have the metabolic syndrome. HOMA-IR and BMI were strong predictors of metabolic syndrome in children suggesting that OW/obese school children are at a higher risk for future cardiovascular disease.     

Persistent elevation of paraoxonase-1 specific enzyme activity after weight reduction in obese non-diabetic men with metabolic syndrome

BackgroundParaoxonase-1 (PON1) is an esterase associated with the high-density lipoprotein (HDL) in serum. To date, there have been few reports about circulating PON1 protein concentration and specific activity in subjects with metabolic syndrome (MetS). More importantly, it is unknown whether weight loss could alter PON1 protein expression or specific activity in obese non-diabetic men with MetS.MethodsWe prospectively enrolled a total of 40 obese non-diabetic men with MetS. Among them, 22 subjects finished the 3-month course of weight loss program and complied for longer follow-ups post-weight loss at the 3rd, 12th, and 18th month from the beginning of the program. Twenty-six healthy volunteers served as controls. Serum circulating PON1 concentration was measured by an enzyme linked immunosorbent kit (ELISA) and PON1 activity was measured by an automated PON1 activity assay.ResultsObese non-diabetic men with MetS (n = 40) had a higher PON1 protein concentration (31.0 ± 11.3 vs. 24.8 ± 9.7 μg/ml, p = 0.025) but lower specific enzyme activity (7.5 ± 4.0 vs. 11.2 ± 7.2 mU/μg, p = 0.023) than those of the controls. Multivariate regression analysis of baseline PON1 specific activity revealed that adiponectin was a significant positive predictor (p = 0.044) while monocyte chemotactic protein-1 (MCP-1) was a negative predictor (p = 0.031). After a 3-month weight loss program, obese MetS men (n = 22) had a significant weight reduction (95.8 ± 9.0 to 86.3 ± 10.4 kg, with a 9.9 ± 5.4% decrease, p < 0.001). PON1 protein decreased significantly after weight loss and kept declining through the 3rd month till the 18th month follow-up. PON1 specific enzyme activity (baseline 7.5 ± 2.6 mU/μg) increased significantly after weight loss and kept increasing through the 12th month till the 18th month follow-ups (11.8 ± 6.4 mU/μg, p = 0.001 vs. baseline).ConclusionsWeight loss by a 3-month diet and exercise program time-sequentially increased PON1 specific enzyme activity in obese non-diabetic men with MetS.     

Gender-specific effect of Pro12Ala polymorphism in peroxisome proliferator-activated receptor γ-2 gene on obesity risk and leptin levels in a Tunisian population

ObjectivesThis study was undertaken to investigate the impact of the Pro12Ala (rs1801282) polymorphism of the peroxisome proliferator-activated receptor γ-2 (PPARγ-2) gene on obesity or body mass index (BMI) and plasma leptin, insulin, adiponectin and lipid levels in a sample of the Tunisian population.Design and MethodsThe study included 387 obese patients and 288 control subjects. The Pro12Ala genotype was determined by polymerase chain reaction followed by a digestion with the restriction of endonuclease BstUI.ResultsIn the whole population, there is no significant difference in genotype frequencies of the Pro12Ala polymorphism between obese patients and controls. However, separate analysis by gender revealed that obese men (but not women) had significantly higher frequency of Pro/Ala genotypes compared to controls (12.2% vs. 4.1%; χ² = 6.76, p = 0.009). In comparison to Pro/Pro homozygotes, Ala-allele bearers had a significantly higher risk of obesity [OR (95% CI) = 3.26 (1.28–8.33)]. When obese subjects were stratified according to type 2 diabetes status, the association with obesity was only significant in obese non-diabetic patients [OR (95% CI) = 3.74 (1.43–9.74), p =  0.007]. Additionally, obese male patients carrying the Ala-allele had significantly higher body mass index (p =  0.007) and plasma leptin levels (p =  0.023) compared to those homozygous for Pro-allele. The significant effect of Pro12Ala polymorphism on plasma leptin levels disappeared after adjustment for age and BMI.ConclusionThe present study provides evidence that the Pro12Ala polymorphism of the PPARγ-2 gene is associated with obesity in non-diabetic men from Tunisian origin.     

Design of a randomized trial to determine the optimum protein intake to preserve lean body mass and to optimize response to a promyogenic anabolic agent in older men with physical functional limitation

The dietary protein allowance for older men to maintain lean body mass and muscle strength and to accrue optimal anabolic responses to promyogenic stimuli is poorly characterized. The OPTIMEN trial was designed to assess in older men with moderate physical dysfunction and insufficient habitual protein intake (< recommended dietary allowance, RDA, 0.8 g·kg^− 1·d^− 1) the efficacy of consuming diets containing 163% RDA (1.3 g·kg^− 1·d^− 1) for protein, compared to RDA, to increase lean mass, muscle performance, and physical function. A second aim was to determine whether increasing protein intake to 1.3 versus 0.8 g·kg^− 1·d^− 1 would augment anabolic responses to a promyogenic agent, testosterone.For this randomized, double-blind, placebo-controlled six-month intervention trial, 92 men, 65 years or older, with Short Physical Performance Battery scores 3–10, and habitual protein intakes < RDA, were assigned to one of four groups: 100% RDA plus placebo intramuscular injections weekly; 100% RDA plus weekly intramuscular injections of 100 mg testosterone enanthate; 163% RDA plus placebo injections; or 163% RDA plus testosterone injections. All participants received portion-controlled packaged meals and group-specific dietary supplements containing either mixtures of casein and whey or carbohydrate, with identical appearance. The primary outcome was change in lean body mass assessed using dual energy X-ray absorptiometry. Secondary outcomes included maximal voluntary strength and power in leg press and chest press exercises, 6-minute walking distance, stair climbing power, and self-reported physical function.Results of the OPTIMEN trial have important implications for dietary protein guidance and policy, and efficacy of promyogenic drugs.     

Decreased serum brain-derived neurotrophic factor concentration in young nonobese subjects with low insulin sensitivity

ObjectiveInsulin resistance and type 2 diabetes are associated with an increased risk of neurodegenerative diseases. Decreased brain-derived neurotrophic factor (BDNF) levels might play a role in the pathogenesis of neuropsychiatric disorders. The aim of our study was to estimate serum BDNF concentration in nonobese women divided into subgroups according to their insulin sensitivity.Design and methodsWe studied 46 young, healthy, nonobese women. Insulin sensitivity was estimated with the euglycemic–hyperinsulinemic clamp technique. Then, participants were divided into subgroups of high (mean, 12.79 ± 2.01 mg/kg fat-free mass/min) and low insulin sensitivity (mean, 7.33 ± 1.66 mg/kg fat-free mass/min).ResultsWe observed decreased serum BDNF concentration in women with low insulin sensitivity in comparison to high insulin sensitivity group (3306.11 ± 603.10 vs 4141.91 ± 755.37 pg/mL, p = 0.001). Serum BDNF was positively related to insulin sensitivity (r = 0.43, p = 0.003). This correlation remained significant after adjustment for other estimated parameters.ConclusionsSerum BDNF is decreased in young nonobese women with low insulin sensitivity. Early detection and prevention of insulin resistance might be useful in the prevention of neurodegenerative disorders.     

Design and implementation of a randomized controlled social and mobile weight loss trial for young adults (project SMART)

PurposeTo describe the theoretical rationale, intervention design, and clinical trial of a two-year weight control intervention for young adults deployed via social and mobile media.MethodsA total of 404 overweight or obese college students from three Southern California universities (M_age = 22(± 4) years; M_BMI = 29(± 2.8); 70% female) were randomized to participate in the intervention or to receive an informational web-based weight loss program. The intervention is based on behavioral theory and integrates intervention elements across multiple touch points, including Facebook, text messaging, smartphone applications, blogs, and e-mail. Participants are encouraged to seek social support among their friends, self-monitor their weight weekly, post their health behaviors on Facebook, and e-mail their weight loss questions/concerns to a health coach. The intervention is adaptive because new theory-driven and iteratively tailored intervention elements are developed and released over the course of the two-year intervention in response to patterns of use and user feedback. Measures of body mass index, waist circumference, diet, physical activity, sedentary behavior, weight management practices, smoking, alcohol, sleep, body image, self-esteem, and depression occur at 6, 12, 18, and 24 months. Currently, all participants have been recruited, and all are in the final year of the trial.ConclusionTheory-driven, evidence-based strategies for physical activity, sedentary behavior, and dietary intake can be embedded in an intervention using social and mobile technologies to promote healthy weight-related behaviors in young adults.     

Association of genetic variations in aromatase gene with serum estrogen and estrogen/testosterone ratio in Chinese elderly men

BackgroundSingle nucleotide polymorphism (SNP) rs2470152 of the gene CYP19A1 is associated with serum estradiol (E2) levels in Caucasian men. However, it remains to be verified if rs2470152 is the sole determinant accounting for the association. We determined whether 2 CYP19A1 SNPs tagging different haploblocks (rs2470152 and rs2899470) are associated with sex steroid levels in Chinese men.MethodSerum sex steroid level including E2, estrone (E1) and testosterone (T), of 1402 Chinese men aged ≥ 65 years were analyzed. Genotyping of the two CYP19A1 SNPs was performed using T_m-shift allele-specific PCR.ResultsSNP rs2899470 was significantly associated with serum E2, E1 levels and E2/T ratio (p < 0.001). However, SNP rs2470152 was only modestly associated with E2/T ratio (p = 0.023). Analysis of haplotype showed a significant association between C-G, T-T haplotype with serum E2/T ratio (p = 0.019 and p = 1 × 10^? 5, respectively). Similarly, E2 levels was also associated the T-T and T-G haplotypes (p = 1 × 10^? 5).ConclusionThe genetic variation of CYP19A1 was associated with circulating estrogen levels in Chinese elderly men. In addition, it revealed that haplotype of rs2899470 and rs2470152, rather than rs2899470 alone, was a better indicator for the serum E2/T ratio and E2 levels.     

A novel ultra-sensitive enzyme immunoassay for soluble human insulin receptor ectodomain and its measurement in urine from healthy subjects and patients with diabetes mellitus

ObjectiveFor the early identification of patients at risk of developing diabetes mellitus, and to prevent the onset of diabetes by performing dietary counseling and exercise guidance, we have developed an ultra-sensitive immune complex transfer enzyme immunoassay (ICT-EIA) to measure soluble human insulin receptor ectodomain (sIRα) in urine which is collected non-invasively.Design and methodsWe developed ICT-EIA for sIRα and measured urinary sIRα from 106 healthy volunteers, 35 obese volunteers and 42 patients with diabetes.ResultsThe detection limit of ICT-EIA (0.04 pg/mL), using a urine sample of as little as 100 μL, was a few hundred-fold higher than that of conventional ELISA. Using ICT-EIA, the urinary sIRα level in patients with diabetes (9.7 ± 20.1 pg/mg creatinine) was significantly higher than those in healthy volunteers (1.4 ± 0.9; P < 0.001).ConclusionICT-EIA for sIRα may be useful as a good marker for evaluating diabetes risk.     

Relationship of proprotein convertase subtilisin-kexin type 9 levels with resistin in lean and obese subjects

ObjectivesProprotein convertase subtilisin-kexin type 9 (PCSK9), a key regulator of low density lipoprotein receptor expression, has recently been reported to be upregulated by resistin in HepG2 cells and human primary hepatocytes. Whether this translates into a positive relationship of plasma PCSK9 with resistin levels in humans with varying degrees of obesity is unknown.Design and methodsWe assessed the extent to which plasma PCSK9 levels are determined by resistin in individuals with varying degrees of obesity.ResultsIn 80 subjects (35 women; no diabetes mellitus) with body mass index ranging from 19.4 to 40.4 kg/m², plasma PCSK9 levels were not positively related to resistin (r = ? 0.161, p = 0.154). Despite positive correlations of non-high density lipoprotein cholesterol (r = 0.378, p < 0.001), low density lipoprotein (r = 0.292, p < 0.01) and apolipoprotein B (apoB) (r = 0.266, p < 0.05) with PCSK9, none of these apolipoprotein (apo) B-containing lipoprotein measures was positively related to resistin (p > 0.10 for all). In subjects with BMI < 25.0 kg/m² (n = 38), PCSK9 was even inversely related to resistin (r = ? 0.322, p = 0.049), and this relationship remained present after controlling for either leptin (p = 0.027) or insulin resistance (P = 0.031). In subjects with BMI ≥ 25.0 kg/m² (n = 42), PCSK9 was unrelated to resistin (r = ? 0.064, p = 0.69).ConclusionsThis study demonstrates that there is no positive association of plasma PCSK9 with resistin in lean and moderately obese individuals. Our data question whether circulating resistin is a physiologically important determinant of higher PCSK9 levels.     

Does serum cystatin C level reflect insulin resistance in patients with type 1 diabetes?

ObjectivesThe aim of study was to evaluate the relationship between serum cystatin C and insulin resistance (IR) in type 1 diabetic patients being the participants of Poznan Prospective Study.Design and methodsThe study was performed on 71 Caucasian patients (46 men); with type 1 diabetes, who were recruited into the Poznan Prospective Study, at the age of 39 ± 6.1 meanly, and treated with intensive insulin therapy since the onset of the disease. The follow-up period and diabetes duration were 15 ± 1.6 years. Insulin resistance (IR) was assessed by estimated glucose disposal rate (eGDR) calculation with cut-off point 7.5 mg/kg/min. Patients were divided into two groups, according to the presence or absence of IR.ResultsFrom among 71 patients, 31 patients (43.7%) presented decreased sensitive to insulin with eGDR below 7.5 mg/kg/min. Patients who had eGDR < 7.5 mg/kg/min (insulin resistant), compared with subjects with eGDR > 7.5 mg/kg/min (insulin sensitive), had higher level of serum cystatin C [0.59 (IQR:0.44–0.84) vs 0.46 (IQR:0.37–0.55) mg/L, p = 0.009]. A significant negative correlation between cystatin C and eGDR was revealed (Rs = − 0.39, p = 0.001). In regression model cystatin C was related to insulin resistance, adjusted for sex, BMI, eGFR and duration of diabetes [OR 0.03 (0.001–0.56), p = 0.01].ConclusionsHigher level of serum cystatin C is related to decreased insulin sensitivity in patients with type 1 diabetes. This relationship seems to have an important clinical implication.     

Effects of a home-based rehabilitation program in obese type 2 diabetics

ObjectiveTo assess, in obese type 2 diabetics (T2D), the impact of a home-based effort training program and the barriers to physical activity (PA) practice.MethodTwenty-three obese T2D patients (52.7 ± 8.2 years, BMI = 38.5 ± 7.6 kg/m²) were randomized to either a control group (CG), or an intervention group (IG) performing home-based cyclergometer training during 3 months, 30 min/day, with a monthly-supervised session. The initial and final measurements included: maximal graded effort test on cyclergometer, 6-minute walk test (6MWT) and 200-meter fast walk test (200mFWT), quadriceps maximal isometric strength, blood tests and quality of life assessment (SF- 36). A long-term assessment of the amount of physical activity (PA) and the barriers to PA practice was conducted using a questionnaire by phone call.ResultsPatients in the CG significantly improved the maximal power developed at the peak of the cyclergometer effort test (P < 0.05) as well as the quadriceps strength (P < 0.01). There were no significant changes in the other physical and biological parameters, neither in quality of life. At a mean distance of 17 ± 6.4 months, the PA score remained low in the two groups. The main barriers to PA practice identified in both groups were the perception of a low exercise capacity and a poor tolerance to effort, lack of motivation, and the existence of pain associated to PA.ConclusionThis home-based intervention had a positive impact on biometrics and physical ability in the short term in obese T2D patients, but limited effects in the long term. The questionnaires completed at a distance suggest considering educational strategies to increase the motivation and compliance of these patients.     

FTO and MC4R gene variants determine BMI changes in children after intensive lifestyle intervention

ObjectivesThis study aimed to determine whether there is a relationship between common FTO (rs17817449) and MC4R (rs17782313) gene variants and body mass reduction or weight loss after a one-month lifestyle intervention in overweight/obese children.Design and methodsWe genotyped 357 unrelated non-diabetic Czech children (age 13.7 ± 4.9 years, average BMI at baseline 30.8 ± 4.6 kg/m²). Biochemical and anthropometrical measurements were performed before and after 4 weeks of lifestyle interventions (comprising a reduction in energy intake to the age-matched optimum and a supervised exercise program consisting of 5 exercise units per day, 50 min each).ResultsThe mean weight loss achieved was 6.2 ± 2.1 kg (P < 0.001). Significant associations were found between a BMI decrease and the FTO and MC4R variants. Carriers of the FTO GG genotype and/or MC4R CC genotype lost significantly more body weight compared to noncarriers (P < 0.0009 for BMI and P < 0.002 for body weight). These differences remained significant following adjustment for sex, age and baseline values (P = 0.004 for BMI and P = 0.01 for body weight).ConclusionsFTO and MC4R gene variants modify the impact of an intensive lifestyle intervention on BMI decrease in overweight/obese children. Carriers of the FTO GG genotype and MC4R CC genotype benefit significantly more from the lifestyle intervention.