Insulin resistance: Is it time for primary prevention?

Mercurio, Valentina; Carlomagno, Guido; Fazio, Valeria; Fazio, Serafino

doi:10.4330/wjc.v4.i1.1

Cited by 34 publications

(31 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Insulin resistance is associated with development and progression of atherosclerosis and hypercoagulability 1, 2. Previous studies have shown that insulin resistance is associated with an increased risk of coronary heart disease and stroke in the nondiabetic population 3, 4, 5, 6, 7.…”

Section: Introductionmentioning

confidence: 99%

Post–Glucose Load Measures of Insulin Resistance and Prognosis of Nondiabetic Patients With Ischemic Stroke

Pan

Jing

Chen

et al. 2017

JAHA

View full text Add to dashboard Cite

BackgroundInsulin resistance is associated with an increased risk of cardiovascular events in the general population. This study aimed to estimate the association between post–glucose load measures of insulin resistance and prognosis of nondiabetic patients with ischemic stroke.Methods and ResultsData were derived from the ACROSS‐China (Abnormal Glucose Regulation in Patients with Acute Stroke across China) registry. Patients with ischemic stroke without a history of diabetes mellitus were included. Two post–glucose load measures of insulin sensitivity, the insulin sensitivity indices ISI(composite) and the ISI 0,120, were calculated. Outcomes included stroke recurrence, all‐cause death, and poor functional outcome at 12 months. Among 1203 patients, 63.3% were male with an average age of 62.1 years. At 12 months, 168 (14.4%) patients had recurrent stroke, 111 (9.2%) had died, and 288 (24.4%) had poor outcome. After adjustment for potential covariates, the first quartile of the ISI(composite) was associated with increased 12‐month stroke recurrence (adjusted hazard ratio 2.02, 95% CI 1.28–3.18, P=0.003), death (adjusted hazard ratio 2.78, 95% CI 1.59–4.86, P<0.001), and poor outcome (adjusted odds ratio 2.67, 95% CI 1.69–4.21, P<0.001) compared with the fourth quartile. Similar results were observed for the ISI 0,120 but with a larger magnitude of association. Using a multivariable regression model with restricted cubic spline, we found an L‐shaped association between the insulin sensitivity indices and the risk of each end point.ConclusionsIn this large‐scale registry, post–glucose load measures of insulin resistance with the ISI(composite) and the ISI 0,120 were associated with 12‐month poor outcomes of nondiabetic patients with ischemic stroke.

show abstract

Section: Introductionmentioning

confidence: 99%

Post–Glucose Load Measures of Insulin Resistance and Prognosis of Nondiabetic Patients With Ischemic Stroke

Pan

Jing

Chen

et al. 2017

JAHA

View full text Add to dashboard Cite

show abstract

“…which is associated with GLUT-4 activity. As a result, decrease translocation of GLUT -4 in cell membrane yield insulin signaling defect and insulin resistance 10 .…”

Section: Discussionmentioning

confidence: 99%

“…The pathological changes associated with hyperinsulinemia are altered glucose metabolism, endothelial dysfunction, hypercoagulability, haemodynamic changes, chronic inflammation 10 , hypertension, decreased high-density lipoprotein cholesterol concentration, increased triglyceride concentration and non-insulin-dependent diabetes mellitus 11 .Insulin secretion of pancreatic â cell is estimated by HOMA method. In homeostasis model assessment (HOMA), insulin secretory capacity is expressed as HOMA%B, the higher the value of HOMA%B, the more the beta-cells capacity to secrete insulin 12 .…”

Section: Introductionmentioning

confidence: 99%

Insulin Secretory Status in Obese Female

Tasnim

Akhter

et al. 2015

J Bangladesh Soc Physiol

View full text Add to dashboard Cite

Background: In obesity insulin hypersecretion is a key feature indicating the abnormal pancreatic beta cell function which is the fundamental defect in the development of NIDDM, hypertension and cardiovascular diseases. Objective: To assess the secretory status of insulin in adult obese female. Methods: The present study was a cross sectional analytical study and conducted in the Department of Physiology, Dhaka Medical College, Dhaka from July 2012 to June 2013. 50 obese female subjects of 20-40 years were included from Out-patient Department (Obesity clinic) of BIRDEM Hospital, Dhaka and by personal contact from different areas of Dhaka city. 50 age matched, healthy non-obese female subjects selected as controls . Fasting serum insulin level was measured by ELISA and fasting glucose level was measured by Glucose oxidase method. The insulin secretory status was calculated by HOMA-%B using HOMA software. For statistical analysis unpaired Student's 't' test and Pearson's correlation coefficient (r) test were performed as applicable . Result: Mean fasting serum insulin and HOMA%B (P<0.001) were higher in the obese than that non obese. Fasting serum insulin level and HOMA%B showed significantly positive correlation with WHR. Conclusion: This study concludes that obese individual develops a state of insulin hypersecretion and hyperinsulinemia.

show abstract

“…Similarly, hyperinsulinemia with insulin resistance increased intracellular Ca++ accumulation, increases secretion of growth factors and increases vascular smooth muscle cell proliferation, as a result narrowing of blood vessels and hypertension develops. 4,24 . Again, some researcher suggested that chronic hyperglycemia is one of the important factor for development of oxidative stress.…”

Section: Discussionmentioning

confidence: 99%

“…3 Insulin resistance represents the earliest detectable abnormality in of type 2 diabetes mellitus and is one of the major underlying mechanisms of hypertension and cardiovascular diseases. 4 Insulin is the most potent anabolic hormone which is secreted by beta cells of pancreatic islets of Langerhans in response to increased circulating level of glucose and amino acid after a meal. Insulin regulated glucose homeostasis by increasing the rate of glucose uptake into skeletal muscle and adipose tissue and reducing hepatic glucose output.…”

Section: Bangladesh J Medicine 2018; 29 : 7-12mentioning

confidence: 99%