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Background: Association between liver cirrhosis (LC) and glucose intolerance has been known since long. Many studies in the past have attempted to explore the correlation of glucose metabolism disorders (GMD) with the severity of LC with mixed results (some favouring i.e. higher prevalence of GMD in more severe LC; others negating). This study was conducted to shed further light on the significance of this association. Objective: This study has been carried out with the aim of studying the correlation between GMD and the severity of LC, as determined by the Child-Turcotte-Pughe (CTP) score. Methods: 100 patients with LC admitted in medical wards were studied and tested with fasting plasma glucose (FPG), 2 h post-75 g oral glucose load plasma glucose (PPG), glycosylated haemoglobin (HbA1c) and fasting plasma insulin. They were categorized based on the severity of LC into CTP A, B or C class and then patients belonging to different classes were compared for the presence of GMD and insulin resistance (IR). Conclusion: Out of 100 patients, 6, 21 and 73 were respectively found as falling under CTP class A, B and C of LC. The frequency of diabetes mellitus (DM) was found to progressively increase with worsening grade of cirrhosis (17%-A, 24%-B and 27%-C), however this was not significant (p value 0.82). The p values for IR, GMD (pre-diabetes or DM), pre-diabetes (pre-DM) were 0.629, 0.382 and 0.189 respectively. To conclude, development of GMD and IR may be independent of the severity of LC. However more studies may be required to further study this association. [ABSTRACT FROM AUTHOR]

Introduction: Approximately 5 to 10% of women of reproductive age suffer from the prevalent endocrine illness known as Polycystic Ovarian Syndrome (PCOS). Copeptin, irrespective of age and weight, has been found to have significant associations with cardiometabolic parameters. Studies on the diagnostic and prognostic significance of copeptin and its correlation with components of metabolic syndrome in PCOS are scarce, particularly in the Indian context. Aim: To assess the utility of copeptin as a diagnostic marker of PCOS and to evaluate the correlation of serum copeptin levels with metabolic syndrome components in women with PCOS. Materials and Methods: This cross-sectional analytical study was conducted at Father Muller Medical College Hospital, Mangalore, Karnataka, India, from June 2022 to September 2023. A total of 60 subjects with PCOS were selected through convenient sampling and divided into two groups: Group 1-subjects with PCOS having metabolic syndrome, and Group 2-subjects with PCOS but not having metabolic syndrome. Blood samples for serum copeptin were taken under aseptic precautions, and levels were analysed using a commercially available Enzyme-Linked Immunosorbent Assay (ELISA) kit (Biovendor, USA) following the manufacturers’ instructions. The copeptin ELISA kit had an assay range of 0-100 pmol/L and results were expressed in ng/mL. Serum insulin levels were measured using specific Electro-chemiluminescence immunoassays. Levels of total cholesterol, High-Density Lipoprotein Cholesterol (HDL-C), and Triglycerides (TG) were determined with enzymatic colorimetric assays by spectrophotometry. LowDensity Lipoprotein Cholesterol (LDL-C) was calculated using the Friedewald formula. Insulin resistance was calculated using the Homeostasis Model Assessment Insulin Resistance Index (HOMAIR). Statistical analysis was done by using descriptive statistics. A comparison was done by student’s unpaired t-test. The chi-square test and Pearson correlation test were used for categorical data. The Statistical Package for Social Sciences (SPSS) version 24.0 was used for analysis. Results: The mean age of the study participants was 24.24±4.721 years, ranging from 15 to 43 years. The mean age of patients with metabolic syndrome was 23.96±6.3 years, while those without metabolic syndrome was 24.40±3.52 years. The mean Body Mass Index (BMI) was 31.17±5.38 in those with metabolic syndrome and 23.2±4.7 in those without (p=0.0001). The Waistto-Hip Ratio (WHR) of Group 1 was significantly higher than Group 2 (p=0.001). The two groups did not differ significantly with regard to serum copeptin level, i.e., 7.386±4.58 in Group 1 and 8.66±6.03 in Group 2 (p=0.736). Serum copeptin levels showed a significant correlation with fasting serum insulin (0.006) and Homeostatic Model Assessment - Insulin Resistance (HOMA-IR) (0.012). Conclusion: Serum copeptin cannot be used as an independent marker for the diagnosis of metabolic syndrome in PCOS patients but may indicate other prognostic factors. [ABSTRACT FROM AUTHOR]

Millets are smart foods that have noteworthy nutritional and therapeutic benefits. Regular consumption of millets is beneficial as it manages postprandial glucose levels, lowers insulin resistance, positively affects HbA1c, reduces the risk of atherosclerotic changes and cardiovascular disease, lowers LDL and improves hypertension. The Government of India has taken a lead role in launching strategies for the promotion of millets to make India a global hub. Stakeholders associated with healthcare play a major role in advising millet-based diets. The present article of a questionnaire-based survey brings an analysis of knowledge, attitude and practices of healthcare professionals in our university regarding millet consumption. It is observed that a sizable number of participants (62%) could identify different types of millets; 66.4% of participants routinely consumed millet foods since childhood; 54% wish that it should be a part of therapeutic diet recommendation, but most of the participants are not completely aware of the therapeutic benefits of millets. [ABSTRACT FROM AUTHOR]

Objective: Increasing evidence revealed the role of adipokines in carbohydrates and fat metabolism. The present study was designed to evaluate the adiponectin, leptin, and resistin levels in prediabetes subjects and evaluate the relationship between these adipokines and insulin resistance. Methods: A hospital-based descriptive study was conducted for one year. 200 individuals who met the inclusion criteria were enrolled in the study. Based on the oral glucose tolerance test, the study subjects were grouped into healthy controls (n = 100), prediabetic non-obese (n = 61), and prediabetic obese (n = 39). Blood glucose estimation was done by the glucose oxidase peroxidase method. Chemiluminescent immunoassay was used for the measurement of insulin level and homeostasis model assessment-estimated insulin resistance was used for the assessment of insulin resistance. Serum adipokines levels were determined by ELISA. Statistical analysis was performed by using SPSS Software. Results: Serum adiponectin levels decreased significantly in obese prediabetes (7.21 ± 2.15 µg/ml) when compared to non-obese prediabetes (7.28 ± 2.41 µg/ml) and healthy control subjects (13.64 ± 2.88 µg/ml, p < 0.001). Serum leptin levels increased significantly in obese prediabetes (13.59 ± 2.59 ng/ml) when compared to non-obese prediabetes (9.84 ± 2.66 ng/ml) and healthy control subjects (12.28 ± 2.65 ng/ml, p < 0.001). Serum resistin levels increased significantly in obese prediabetes (17.67 ± 3.60 ng/ml) when compared to non-obese prediabetes (17.2 ± 3.93 ng/ml) and healthy control subjects (14.46 ± 4.16 ng/ml, p < 0.001). Adiponectin-leptin ratio decreased significantly in obese prediabetes (0.56 ± 0.22) when compared to non-obese prediabetes (0.79 ± 0.4) and healthy control subjects (1.15 ± 0.37; p < 0.001). Fasting insulin resistance was statistically significant (p < 0.001) in all groups. Conclusion: The present study strongly suggests that the adipokine profile is an ideal diagnostic tool to predict prediabetes and metabolic syndrome, especially among those with insulin resistance. [ABSTRACT FROM AUTHOR]

Objective: Impaired glucose control & Insulin resistance are reported to be risk factors for the development of cardiovascular diseases. To find the effects of a structured exercise program on insulin resistance, glycaemic control, functional capacity, and quality of life in patients with Type 2 diabetes mellitus. Design: Randomized, controlled trial. Setting: Diabetic Foot Clinic, Department of Physiotherapy & Department of General Medicine, Kasturba Hospital in Manipal, Karnataka, India. Participants: 160 participants aged between 30–65 years with Type 2 diabetes mellitus. Intervention: A set of structured exercise programs (aerobic, resistance, and combined) along with the standard hospital care was performed 3–5 times weekly for 12 weeks. Measurements: Primary outcome measures Fasting Insulin Level, Homa-IR, Six-minute walk test (6MWT), and WHOQOL-BREF questionnaire at baseline and 12th week. Secondary outcome measures: Body composition analysis, Fasting Blood Sugar, Postprandial Blood Sugar, Glycated Haemoglobin (HbA1c), and GPAQ questionnaire at baseline and 12th week. Results: Significant differences have been observed in Homeostasis model assessment for insulin resistance (Homa-IR) (F (1, 144) = 89.29, p < 0.001); Fasting insulin (FI) (F (1, 144) = 129.10, p < 0.001); Fasting blood sugar (FBS) (F (1, 144) = 12.193, p< 0.001); Post prandial blood sugar (PPBS) (F (1, 144) = 53.015, p< 0.001); glycated haemoglobin (HbA1c) (F (1, 144) = 80.050, p < 0.001); WHOQOL-Physical health (F (1, 144) = 20.008, p< 0.001), Psychological (F (1, 144) = 77.984, p< 0.001), Social relationship (F (1, 144) = 44.866, p< 0.001); Environmental (F (1, 144) = 69.974, p< 0.001); Six minute walk test (6MWT) (F (1, 144) = 84.135, p< 0.001) in the study group when compared with the control group from baseline to 12th week. Conclusions: The study reveals that a 12-week structured exercise training program effectively reduces insulin resistance, improves quality of life, enhances functional capacity, and improves glycaemic control in type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Metabolic syndrome (MetS) is a condition characterized by insulin resistance, diabetes mellitus, and impaired glucose intolerance, often associated with obesity, hypertension, dyslipidaemia, or microalbuminuria. The global health pattern is shifting towards chronic diseases like cardiovascular and diabetes mellitus, with a higher burden of non-communicable diseases. In India, the Epidemiological Transition Level (ETL) is <1, indicating a predominance of degenerative, non-communicable diseases and injuries. A community-based cross-sectional study was conducted to estimate the prevalence of Metabolic Syndrome (MET) and associated risk factors among the adult population in the urban field practice area of CIMS Bilaspur, Chhattisgarh. The study involved 540 systematic random samples and analyzed the dietary habits and substance abuse of 540 participants, ranging from 20 to 80 years old. The majority were from class-III socioeconomic status, with low education, bad diet, and obesity being key contributing variables. Recommendations include engaging in regular physical activity to reduce weight, abdominal obesity, and BMI, improving diet by reducing sugar, salt, and fat consumption, regular health check-ups, taking medication regularly, and quitting alcohol, smoking, and other addictions. Large-scale studies are necessary to discover all population risk variables. [ABSTRACT FROM AUTHOR]

Gestational diabetes mellitus (GDM) has conventionally been defined as any degree of glucose intolerance with onset or first recognition during pregnancy (Hinkle et al. in Sci Rep 8:12249, 2018). GDM has both short-term as well as long-term adverse materno-fetal consequences and increases the risk of future non-communicable diseases (NCDs), including type-2 diabetes. Probable epigenetic changes in children exposed to hyperglycemia in-utero predispose them to an increased risk for developing insulin resistance, obesity, type-2 diabetes, and associated NCDs in later life. Therefore, early detection and optimum management of GDM can go a long way in combating this rising epidemic of NCDs. It is pertinent to screen all pregnant women for glucose intolerance in pregnancy with the simple, economical and reliable single step test recommended by DIPSI and approved by the Ministry of Health & Family Welfare Government of India. An optimized strategy to achieve euglycemia can prevent the epidemic of NCD. Gestational programming is a distinctive process. The adverse stimuli (like hyperglycemia) or stresses that occur at critical or sensitive periods of fetal development ultimately lead to permanent changes in the structure, physiology, and metabolism of the growing fetus. This, in turn, predisposes these babies to increased NCD risk in their adult life — the famous J Endocrinol 2004;181:11–23 (Piper et al., 2004). [ABSTRACT FROM AUTHOR]

Introduction: Metabolic Syndrome (MetS) is one of the most significant global public health concerns. Leptin, adiponectin, and the Leptin-adiponectin (LA) ratio have been shown to be informative biomarkers for obesity, Type 2 Diabetes Mellitus (T2DM), and Cardiovascular Diseases (CVD). Many contributing factors, such as Insulin Resistance (IR), adipose tissue dysfunction, chronic inflammation, and genetic factors, are proposed to be the aetiological factors of MetS. Leptin and adiponectin have opposite effects on IR, so the combined use of these adipokines may serve as a better biomarker in MetS. Aim: To determine serum leptin levels, adiponectin levels, and the LA ratio in patients with and without MetS. Materials and Methods: This cross-sectional study was conducted in the Department of Biochemistry and Medicine at the Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, India, from January 2021 to October 2022. The study included 50 diagnosed cases of MetS and 50 individuals without MetS. Leptin, adiponectin, and parameters of MetS {Body Mass Index (BMI), weight, Waist Circumference (WC), skinfold thickness, High-density Lipoprotein (HDL), Triglycerides (TG), and Blood Pressure (BP)} were assessed in the study. The data were statistically analysed using Independent Sample t-test and Pearson's correlation test. Results: There were 23 males and 27 females in the study group. The mean age was found to be 61.10±12.52 years in cases and 57.08±10.67 years in controls. Leptin levels were significantly higher in cases (26.58±14.6 ng/mL) compared to controls (12.99±8.59 ng/mL). However, adiponectin levels were significantly decreased in cases (7.16±4.19 μg/mL) compared to controls (12.18±9.4 μg/mL). The LA ratio was found to be higher in cases (5.38±4.71 ng/μg) than in the controls (1.84±1.99 ng/ μg). Multiple linear regression analysis demonstrated that the LA ratio was strongly associated with MetS among Leptin, Adiponectin, and the LA ratio (p<0.05). Conclusion: Metabolic syndrome was strongly associated with an increased LA ratio, leptin, and decreased adiponectin levels. The LA ratio can better discriminate the risk of MetS than leptin and adiponectin alone and may be used as a sensitive clinical surrogate biomarker of MetS. [ABSTRACT FROM AUTHOR]

Background: Many studies have associated male androgenetic alopecia with the risk of cardiovascular disorders but very few studies have addressed this association in women with FPHL. Materials and Methods: This was a cross-sectional hospital-based study in which a total of 50 women (18-45 years) were recruited. The objective was to measure carotid intima-media thickness (CIMT) by doppler ultrasound, Body mass index (BMI), waist circumference, lipid profile, fasting blood sugar (FBS), insulin, testosterone, Sex hormone binding globulin (SHBG), hs-CRP, ESR and fibrinogen, in pre-menopausal women having FPHL and to correlate these parameters with severity of FPHL. The prevalence of Metabolic syndrome (MetS) and Insulin resistance were evaluated. Results: Metabolic syndrome and insulin resistance were found in 12 (24%) and 17 (34%) cases respectively. Hypercholesterolemia, elevated LDL levels and hypertriglyceridemia, low HDL levels and hyperinsulinemia were found in 11 (22%), 31 (62%), 9 (18%), 17 (34%) and 7 (14%) cases respectively. 8 (16%) cases were diabetics. Elevated ESR, increased fibrinogen levels and elevated hs-CRP were found in 43 (86%), 10 (20%) and 21 (42%) cases respectively. CIMT was found to be within its normal range. Correlation of CIMT, anthropometric indices (BMI and WC), biochemical markers (serum cholesterol, triglycerides, FBS, and fibrinogen), and presence of metabolic syndrome with severity of FPHL in terms of Ludwig grade was found to be statistically significant. Conclusions: The determination of metabolic syndrome, insulin resistance and acute phase reactants such as hs-CRP and fibrinogen may be useful screening methods to detect increased cardiovascular risk in women with FPHL. [ABSTRACT FROM AUTHOR]

Background and Objectives: Rheumatoid Arthritis is closely linked to Metabolic Syndrome, which greatly enhances the risk of cardiovascular problems and consequently, morbidity and mortality. Managing Metabolic Syndrome reduces the occurrence of cardiovascular events and fatalities. This study assesses the frequency of metabolic syndrome in young patients diagnosed with Rheumatoid Arthritis. Material and Methods: This case-control study was carried out in two different groups. The study was conducted at the Department of General Medicine, NRI Medical College and Hospital, Mangalagiri, Andhra Pradesh, India. This study was conducted from October 2022 to November 2023. Total 100 participants are used in this study and were selected from the outpatient departments. Results: This study aimed to assess the impact of metabolic syndrome on the severity of rheumatoid arthritis, as well as the prevalence of metabolic syndrome in individuals with RA compared to those without RA. The frequencies of various components of Metabolic Syndrome were also assessed in Rheumatoid Arthritis. We also endeavoured to investigate the risk associated with illness biomarkers and disease severity in the development of Metabolic Syndrome. The study also evaluated the link between specific components of Metabolic Syndrome and disease biomarkers of Rheumatoid Arthritis. The incidence of Metabolic Syndrome in patients of Rheumatoid Arthritis was determined to be 41.6% in the population of northern India. Conclusion: The results of this study demonstrate that TNF-α speeds up the development of MetS by increasing insulin resistance. MetS worsens RA symptoms. More research is required to ascertain the mechanism by which insulin resistance and metabolic syndrome are caused by high TNF-α levels and other markers. [ABSTRACT FROM AUTHOR]

Sulfonylureas (SU) continue to be a vital therapeutic category of oral hypoglycemic agents (OHAs) for the management of type 2 diabetes mellitus (T2DM). Physicians consider modern SU (gliclazide and glimepiride) as "safe and smart" choices for T2DM management. The presence of multiple international guidelines and scarcity of a national guideline may contribute to the challenges faced by few physicians in choosing the right therapeutic strategy. The role of SU in diabetes management is explicit, and the present consensus aims to emphasize the benefits and reposition SU in India. This pragmatic, practical approach aims to define expert recommendations for the physicians to improve caregivers' knowledge of the management of T2DM, leading to superior patient outcomes. [ABSTRACT FROM AUTHOR]

Preliminary studies have shown that yoga as well as fenugreek are beneficial in patients with type 2 diabetes mellitus (T2DM). This clinical trial is the first of its kind to prospectively evaluate in a multicentric, randomized, and controlled design if yoga and fenugreek can prevent the composite outcome of T2DM in prediabetic individuals. It aims to investigate whether there is an effective and safe treatment modality for the prevention of T2DMwhich is also-cost effective and can be implemented easily on a large scale so as to reduce the burden of T2DM. One thousand five hundred obese prediabetic individual aged 30–70 years were proposed to be identified on the basis of a 75-g oral glucose tolerance test (OGTT) and randomized to one of the three intervention arms viz standard life style measures + placebo (n = 500), standard life style measures + placebo + yoga (n = 500), and Standard life style measures + fenugreek (n = 500). Yoga consisted of a 40-min session each day which included yoga asanas and pranayamas. Fenugreek was given as fenugreek powder. All subjects were followed on an outpatient basis for 3 years, and annual OGTTs were done to pick up incident cases of diabetes mellitus. Incident rates, time to event analysis, and hazard ratios were compared between the groups. Secondary outcomes studied were change in glycemia, quality of life, cardiovascular disease and cardiovascular risk factors, beta cell function (HOMA-B), insulin resistance (HOMA-IR), and adverse events. Trial registration: Clinical trial registration number: CTRI/2013/01/003316. [ABSTRACT FROM AUTHOR]

Introduction: The increased incidence of diabetes and Cardiovascular Disease (CVD) is attributed to the rising obesity rates, which is one of the major factors contributing to Insulin Resistance (IR). Although there is a close relationship between obesity and IR, not all cases of obesity lead to cardiometabolic complications. Visceral fat is considered to be the primary cause of IR. Lipid Accumulation Product (LAP) is postulated as a new continuous biomarker of visceral adiposity. Aim: To determine the association between LAP and IR in T2DM. Materials and Methods: This institution-based cross-sectional study was conducted over a period of three months at the Department of Biochemistry, Rajarajeswari Medical College and Hospital in Bengaluru, Karnataka, India. A total of 60 Type 2 diabetic patients (including newly diagnosed and known cases) were recruited as cases, along with 30 healthy controls. Height, weight, and Waist Circumference (WC) were measured. Fasting blood samples were collected for laboratory biochemical estimation of glucose, Total Cholesterol (TC), Triglycerides (TG), High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), and fasting insulin. Statistical analysis for continuous variables was performed using unpaired Student’s t-test, and Analysis of Variance (ANOVA) test was used for group comparisons. Results: Fasting serum insulin (p-value=0.007), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (p-value=0.001), and LAP index (p-value<0.001) were significantly higher in the case group. LAP index was divided into quartiles, Insulin and HOMA-IR showed statistical significance across the quartiles (p-value=0.005). The lipid profile analysis across LAP quartiles revealed a progressive increase in TG levels (p<0.001) and a decrease in HDL levels from Q1 to Q4 quartiles. Conclusion: The study concludes that increased LAP levels are associated with IR in T2DM. LAP can serve as a useful marker for cardiometabolic risk in early-stage T2DM, enabling better disease stratification for improved prognosis. [ABSTRACT FROM AUTHOR]

Introduction: A number of metabolic disorders are linked to obesity, which is a global health concern. Although renal impairment is a serious side-effect of obesity, its connection to insulin resistance is still a subject of discussion. Aim: To assess the correlation between microalbuminuria and HbA1c levels, as well as the association between Insulin Resistance (IR) and renal function in obese individuals. Materials and Methods: The present study was a crosssectional study conducted in patients attending the obesity clinic, in Endocrinology department, of a tertiary hospital in Kerala, India. A total of 144 obese individuals participated, meeting age, Body Mass Index (BMI), and health-related. Insulin resistance was measured using Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), while renal function was measured using the Urine Albumin Creatinine Ratio (UACR). Correlation analysis was conducted to investigate relationships between variables. Results: The study found a weak association between UACR and HbA1c levels and insulin resistance (r-value=0.159, p-value=0.056). Subjects with insulin resistance had significantly higher levels of microalbuminuria. Despite these connections, the mean UACR levels remained within the typical reference range. Conclusion: This study emphasises the importance of early renal health screening in obese individuals, with HbA1c and microalbuminuria measurements as promising methods for preventing kidney impairment. To establish causation in the complex interplay between metabolic variables and renal function in obesity and insulin resistance, future research should focus on understanding the underlying mechanisms and conducting longitudinal examinations. [ABSTRACT FROM AUTHOR]

The glucokinase regulatory protein (GCKR) regulates glycogen metabolism and insulin secretion, and the GCKR rs1260326 is a putative single nucleotide polymorphism (SNP) associated with metabolic disorders including nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). This study was conducted to investigate the genetic association of the GCKR rs1260326 in NAFLD and T2DM in our population. NAFLD (n = 103), T2DM (n = 100), and control (n = 100) samples were collected and genotyped for GCKR rs1260326 by tetra-arm PCR. The genetic variant GCKR rs1260326 was significantly linked with NAFLD and T2DM, while the GCKR rs1260326 was significantly associated with the progression of obesity only in NAFLD subjects. The frequency of the C allele (mutant) was higher in both NAFLD (f = 0.69) and T2DM (f = 0.66) subjects as compared to healthy controls of NAFLD (0.52) and T2DM (f = 0.32). The frequency of the C allele was also positively linked with the progression of obesity in both diseases. The frequency of the C allele was 0.66, 0.67, and 0.74 in NAFLD normal weight, overweight, and obese subjects, respectively, while the frequency of the C allele was 0.60, 0.60, and 0.74 in T2DM in normal weight, overweight, and obese subjects, respectively. Homozygous mutant (CC) was 53% in both NAFLD and T2DM subjects, while heterozygous mutant (CT) was 15.53% in NAFLD and 22% in T2DM subjects. Wild-type allele (TT) was 31.06% in NAFLD and 25% in T2DM subjects. In conclusion, the GCKR rs1260326 is a highly prevalent SNP in NAFLD and T2DM subjects, which possibly contributed to obesity, insulin resistance, and metabolic disorders in our population. [ABSTRACT FROM AUTHOR]

Introduction: Acne is a common dermatological condition primarily seen in teenage and adolescent patients and is a major concern for cosmological issues. Along with environmental factors, the proliferation of basal keratinocytes in the sebaceous-pilosebaceous unit, abnormal desquamation of follicular corneocytes, and metabolic abnormalities play a significant role in the pathogenesis of acne development. Aim: To study the causal relation between acne vulgaris and insulin resistance by calculating Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and identify the relation between insulin resistance and the severity of acne. Materials and Methods: This was a retrospective study, where the data of patients with persistent Acne Vulgaris who were referred to the Endocrine department for evaluation of the hormonal and metabolic causes for acne vulgaris were analysed. The patient's clinical records were evaluated in whom there was no significant hormonal or metabolic abnormality identified known to cause persistent acne were included after proper consent and HOMA-IR was calculated. Results: Of several patients with persistent acne, 150 patients were included in our study with the male-to-female ratio was 23:27. The mean age of patients was 33.2 years. The mean HOMA-IR in our acne patients was 1.62 ranging from 0.9-3.7. Sixty four (42.67%) patients had HOMA-IR more than 2.0, thereby suggesting insulin resistance. Conclusion: Our study suggests the prevalence of insulin resistance in 42.67% of patients with acne, thereby providing the possibility of use of insulin modifiers as an adjunct acne treatment and stratifying the possible risk of metabolic syndrome in patients with acne. Also recommended is the control of dietary factors and lifestyle modification for the management of acne with insulin resistance. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome is a multifactorial endocrine disorder impacting women of reproductive age. Variations within the FTO gene have been linked to both obesity and type 2 diabetes mellitus. Given that PCOS is frequently associated with obesity and compromised glucose tolerance, we investigated the prevalence of the rs9939609 variant within the FTO gene among women diagnosed with PCOS and a control group. Our aim is to uncover potential correlations between this genetic variant, metabolic attributes, and endocrine markers within the Gujarat province of India. Method: We enrolled a total of 114 participants, (62 individuals diagnosed with PCOS and 52 healthy controls). DNA extraction from venous blood was conducted for all participants. The rs9939609 polymorphism was investigated through tetra-primer amplification refractory mutation system-polymerase chain reaction. Furthermore, we performed biochemical assessments to quantify levels of estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), thyroid-stimulating hormone (TSH), total testosterone, prolactin (PRL), and Dehydroepiandrosterone sulfate (DHEAS). Statistical analyses were carried out utilizing SPSS version 21 (IBM, USA). Results: The present study did not reveal any noteworthy association between cases and controls. The frequencies of genotypes and alleles within the cohorts displayed no statistically significant differences (p = 0.25, p = 0.68, and p = 0.78, respectively). The dominant model indicated a modest risk (OR:1.13, 95%CI: 0.55 to 2.38) toward PCOS development. There was a noticeable statistical difference observed in the levels of total testosterone, DHEAS, and BMI between the case and control groups (p < 0.002, p < 0.0002, p < 0.0008). However, no variations in clinical variables were observed among genotypes within the PCOS group. Conclusion: This is the first study to investigate the association of FTO gene polymorphism and PCOS in Gujarati population. Our study findings indicate that the FTO gene variant is not directly linked to the onset of PCOS. However, it appears to exert an influence on metabolic factors such as obesity and insulin resistance. Notably, our results suggest that insulin resistance is more frequently observed among PCOS patients who are obese, as compared to those with non-obese PCOS patients. [ABSTRACT FROM AUTHOR]

Gestational diabetes mellitus (GDM) is a serious and most frequent health complication during pregnancy which is associated with a significant increase in the risk of maternal and neonatal outcomes. GDM is usually the result of β-cell dysfunction along with chronic insulin resistance during pregnancy. Seshiah et al. pioneer work led to the adoption of Diabetes in Pregnancy Study Group in India criteria as the norm to diagnose GDM, especially in the community setting. In 2014, the Maternal Health Division of the Ministry of Health and Family Welfare, Government of India, updated guidelines and stressed upon the proper use of guidelines such as using a glucometer for self-monitoring and the use of oral hypoglycaemic agents. The 2018 Government of India guidelines stress the importance of counselling about lifestyle modifications, weight control, exercise, and family planning. [ABSTRACT FROM AUTHOR]

Alectra parasitica subsp. chitrakutensis (M.A. Rau) K.K. Khanna & An. Kumar (Orobanchaceae) is a parasitic plant indigenous to India. Locally, the plant is known as 'Midaki and Nirgundikand'. It is used to treat fever, piles, cardiovascular disorders, and blood-borne non-infectious diseases by ethnic communities. The phytochemical investigation of A. parasitica subsp. chitrakutensis rhizome led to the isolation of azafrin (1), rehmaionoside-C (2), and mussaenoside (3). Compounds (2) and (3) are being reported for the first time from this plant. Compounds were evaluated for their intercellular glucose uptake activity in basal and insulin-TNF-α-stimulated L6 muscle cells. In particular, rehmaionoside C exhibited activity comparative to metformin, increasing uptake by basal- and insulin-TNF-α-stimulated cells by 4.88- and 3.90-fold and 5.04- and 4.04-fold. While azafrin and mussaenoside have produced 3.03- and 2.36-fold; 4.03- and 3.22-fold increase in intercellular glucose uptake. Compounds did not show toxicities in rat L6 myoblast cells. The study suggests that rehmaionoside-C from A. parasitica subsp. chitrakutensis might activate glucose uptake by insulin mimics and could be a nontoxic anti-diabetes lead for drug discovery. [ABSTRACT FROM AUTHOR]

Background: Osteocalcin (OC), also known as bone Gla (gamma-carboxyglutamic acid) protein, is a marker of bone formation. OC has effect on glucose and fat metabolism. Role of OC in type 2 diabetes mellitus (T2DM) is not well studied in Indian population. Our study aimed to see the relationship between OC and parameters of glucose metabolism in type 2 diabetes mellitus. Methods: This cross-sectional study included 120 subjects with T2DM. In each subject, fasting insulin, serum osteocalcin (measured by ELISA), fasting plasma glucose (FPG), post prandial plasma glucose (PPG), and glycated Hb (HbA1c) were measured. HOMA 2.0 model was used to measure insulin resistance (HOMA-IR) and β-cell function (HOMA-β). Then, serum osteocalcin levels were correlated with HOMA-IR, HOMA-β, FPG, PPG, and HbA1c. Results: Serum OC levels reduced with increase in insulin resistance (HOMA-IR) (r = −0.274, p = 0.004); however, there was no association with the beta cell function. OC had negative association with FPG (r = −0.14, p = 0.12) and PPG (r = −0.123, p = 0.18); however, it was statistically insignificant. Glycated hemoglobin (HbA1c) was significantly reduced in diabetic patients with higher OC levels (r = −0.208, p = 0.025). Conclusion: Serum OC has significant association with insulin resistance and HbA1c in subjects with T2DM, which might suggest possible role of serum OC in glucose metabolism in T2DM. [ABSTRACT FROM AUTHOR]

Background: Prevalence of adult patients with acne is increasing and women comprise majority of the cases. There is lack of data on biochemical and hormonal abnormalities in adult female acne (AFA). Aims: To evaluate biochemical and hormonal parameters in 60 patients of AFA. Methods: A cross‐sectional observational study conducted from November 2018 to March 2020 in Dermatology outpatient department of a tertiary care hospital in North India. Adult females (age > 25 years) with a clinical diagnosis of acne were included in the study. Results: 60 cases of AFA were included. The age ranged between 26–41 years with mean age at presentation being 29.45 years. 53.3% patients had persistent acne while 46.7% had late‐onset acne. 50% patients had history of premenstrual flare‐up of their acne. Raised FBG was found in 25% patients. 10% had raised serum insulin levels. HOMA‐IR index was deranged in 55% patients. At least one lipid alteration was reported in 91.6% of patients. In hormonal parameters, raised TT was present in 6.7%, LH in 3.3%, FSH in 18.3%, prolactin in 3.3%, and TSH in 15%. No association was found between acne severity and biochemical and hormonal parameters. Conclusions: Our study highlighted the importance of measuring lipid profile in AFA and calculating HOMA‐IR index for measuring insulin resistance rather than simply measuring serum insulin levels. In our study, additional parameter deranged in significant number of patients was FBG. Hence, we recommend routine screening of lipid profile, FBG and calculation of HOMA‐IR index in AFA. [ABSTRACT FROM AUTHOR]

Background: The burden of diabetes is increasing day by day, and diabetic individuals are predisposed to develop micro- and macrovascular complications leading to increased mortality and morbidity. Platelet indexes can alert us regarding endothelial dysfunction in diabetes and in turn regarding microvascular complications. Materials and Methods: A case-control study was conducted on 100 diabetic patients with age and sex matched and 100 nondiabetic controls. All diabetic patients were evaluated for microvascular complications such as diabetic neuropathy, retinopathy, and nephropathy. Clinical history of all patients was taken regarding associated comorbidities and association. Fasting and postprandial blood sugar, HbA1c, platelet count, and platelet indices were measured. Statistical analysis was performed by using student unpaired t test and X2 test. Results: Platelet indices mean platelet volume, plateletcrit, platelet distribution width (PDW), and platelet large cell ratio (P-LCR) were significantly higher in diabetic patients compared with controls. It was also observed that changes in mean platelet volume, PDW, and P-LCR were more significant in diabetic patients with microvascular complications than diabetic patients without microvascular complications. Conclusion: Values of platelet indices were statistically associated with diabetes and its microvascular complications. [ABSTRACT FROM AUTHOR]

Context: Polycystic ovarian syndrome (PCOS) is a polygenic and multifactorial endocrinopathy. Vitamin D deficiency (VDD) is found to be interlinked with insulin resistance (IR), dyslipidemia, and obesity in PCOS. Aims: To find out the correlation of VDD with IR and dyslipidemia in PCOS population of West Bengal (WB). Settings and Design: The study was conducted in and around Kolkata, WB with PCOS patients and their age-matched controls. Materials and Methods: Nutritional status, vitamin D profile, obesity indices, and IR index of both PCOS and control groups were studied. Statistical Analysis Used: The statistical analysis was performed to estimate the difference and correlation of quantitative variables by using Statistical Package for the Social Sciences (SPSS, version 20, IBM). Results: Dietary fat and carbohydrate intake was significantly higher in PCOS individuals relative to recommended dietary allowance (RDA) and the control group. Deficiency of serum 25-OH vitamin D (VDD) is evident in both the control and PCOS groups. However, the prevalence of IR among PCOS patients is significantly higher (64%) than in control (4%), and it is significantly correlated with VDD (P < 0.01). homeostatic model assessment for insulin resistance is found to be a comorbidity of dyslipidemia in PCOS patients. Conclusions: VDD, IR, and obesity potentially aggravate the phenotypic manifestations of PCOS. VDD in the control individuals of young age might be an alarming forecast for the development of PCOS in future life. [ABSTRACT FROM AUTHOR]

In animal studies, β-nicotinamide mononucleotide (NMN) supplementation increases nicotinamide adenine dinucleotide (NAD) concentrations and improves healthspan and lifespan with great safety. However, it is unclear if these effects can be transferred to humans. This randomized, multicenter, double-blind, placebo-controlled, parallel-group, dose-dependent clinical trial included 80 middle-aged healthy adults being randomized for a 60-day clinical trial with once daily oral dosing of placebo, 300 mg, 600 mg, or 900 mg NMN. The primary objective was to evaluate blood NAD concentration with dose-dependent regimens. The secondary objectives were to assess the safety and tolerability of NMN supplementation, next to the evaluation of clinical efficacy by measuring physical performance (six-minute walking test), blood biological age (Aging.Ai 3.0 calculator), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and subjective general health assessment [36-Item Short Form Survey Instrument (SF-36)]. Statistical analysis was performed using the Per Protocol analysis with significant level set at p = 0.05. All 80 participants completed the trial without trial protocol violation. Blood NAD concentrations were statistically significantly increased among all NMN-treated groups at day 30 and day 60 when compared to both placebo and baseline (all p ≤ 0.001). Blood NAD concentrations were highest in the groups taking 600 mg and 900 mg NMN. No safety issues, based on monitoring adverse events (AEs), laboratory and clinical measures, were found, and NMN supplementation was well tolerated. Walking distance increase during the six-minute walking test was statistically significantly higher in the 300 mg, 600 mg, and 900 mg groups compared to placebo at both days 30 and 60 (all p < 0.01), with longest walking distances measured in the 600 mg and 900 mg groups. The blood biological age increased significantly in the placebo group and stayed unchanged in all NMN-treated groups at day 60, which resulted in a significant difference between the treated groups and placebo (all p < 0.05). The HOMA-IR showed no statistically significant differences for all NMN-treated groups as compared to placebo at day 60. The change of SF-36 scores at day 30 and day 60 indicated statistically significantly better health of all three treated groups when compared to the placebo group (p < 0.05), except for the SF-36 score change in the 300 mg group at day 30. NMN supplementation increases blood NAD concentrations and is safe and well tolerated with oral dosing up to 900 mg NMN daily. Clinical efficacy expressed by blood NAD concentration and physical performance reaches highest at a dose of 600 mg daily oral intake. This trial was registered with ClinicalTrials.gov, NCT04823260, and Clinical Trial Registry - India, CTRI/2021/03/032421. [ABSTRACT FROM AUTHOR]

Background: In this study, we wanted to evaluate the prevalence of insulin resistance in ischemic stroke (IS) by using a homeostasis model assessment for insulin resistance (IR). Methods: This was a hospital-based cross-sectional analytical study conducted among 100 patients who presented with acute ischemic stroke to the Department of General Medicine and Neurology, Sriram Chandra Bhanja Medical College & Hospital (SCBMCH), Cuttack, Odisha from September 2020 to August 2021. The study was conducted after obtaining clearance from the institutional ethics committee (IEC) and written informed consent from the study participants. Results: The range of FBS, PPBS, Fasting Plasma Insulin (FPI) and HbA1c in the study population was 77-164, 119-240, 4.2-12.9 and 4.3-7.1 respectively. High prevalence of Abnormal Glucose Metabolism (AGM) expressed as Impaired Glucose tolerance (IGT) and Diabetes mellitus (DM) was observed in patients with ischemic stroke (60%), out of which 38 with IGT and 22 with DM. The mean systolic and diastolic blood pressure in the study population was expressed in mean ± SD in which 73 (73%) cases were hypertensive while 27 (27%) were not hypertensive. The distribution of cases according to the presence of dyslipidaemia, history of smoking and presence of atrial fibrillation (AF) on ECG was 46 (46%), 21 (21%) and 11 (11%) respectively. The distribution of subtypes of ischemic stroke was according to the presence of AF on ECG. Only patients with cardio-embolic (CE) stroke showed AF on ECG with a statistically significant difference between the three of the Atherothrombotic infarct (ATI), Cardio-embolic (CE), Lacunar Infarct (LI) subgroups (p < 0.001). Hypertension, dyslipidaemia, and smoking were positively correlated with Insulin Resistance with p-value <0.01, <0.01 and 0.012 respectively. Conclusion: The frequency of ischemic stroke is more among older individuals (age > 55 years), suggesting that age is an independent risk factor for stroke. Hypertension and dyslipidaemia are the two most common modifiable risk factors for ischemic stroke, particularly in patients with atherothrombotic and lacunar infarction. Insulin resistance and abnormal glucose metabolism are common in acute ischemic stroke patients with no history of diabetes. IGT and Insulin resistance correlated significantly with pathogenic factors underlying the development of ischemic stroke. Insulin resistance can modify and influence the role of modifiable risk factors in patients with ischemic stroke. [ABSTRACT FROM AUTHOR]

Introduction: Raising trend of cardiovascular diseases (CVD) in developing countries created a platform for exploring the sociodemographic nexus in search of underlying cause. Aim and Objectives: The precise aim of the study is to detect any possible association of social determinants and metabolic derangement with CVDs risk, particularly focusing on comparative analysis of the data to decipher the most significant factor(s), if any among the studied parameters contributing toward prediction of such cardiometabolic risk in linked with insulin resistance. Results: In the present study, it was found that 2% of the studied population had high risk, and 13.3% had intermediate risk of developing cardiovascular events in next 10 years. Results also showed that estimated CVD risk was significantly higher in males with central obesity and age more >60 years as key determinants showing more insulin resistance at lower cut-off. Conclusion: This study also strongly suggests need to revise the cut-off values for HOMA index in defining insulin resistance to rural population with active the life style and need of redefining new targeted preventive health care planning. [ABSTRACT FROM AUTHOR]

Introduction: Leptin is an adipocyte derived hormone encoded by ob gene which serves as a relay link between metabolic signals and brain that regulate the hypothalamic pituitary ovarian axis. Leptin is related with obesity, which is a most important cause of Polycystic Ovarian Syndrome (PCOS) in women of reproductive age group. Aim: To evaluate leptin concentration and to analyse its correlation with Body Mass Index (BMI) and insulin resistance in PCOS. Materials and Methods: This case-control study was conducted from December 2018 to December 2019 at Department of Biochemistry in collaboration with Department of Obstetrics and Gynaecology, MKCG Medical College and Hospital, Berhampur, Odisha, India. A total of 60 PCOS subjects, aged between 15-30 years (30 obese PCOS and 30 lean PCOS) and 30 age-matched, normal ovulatory healthy controls were included in the study. Parameters such as serum leptin, fasting plasma insulin, Homeostatic Model Assessment-Insulin Resistance (HOMA-IR), Fasting Plasma Glucose (PPG), Postprandial Plasma Glucose (PPPG) were estimated using commercial kits. One-way Analysis of Variance (ANOVA) test was used for data analysis and the Pearson's correlation method was used to find the correlation between the parameters. Results: The mean age of women in all the three PCOS groups was found to be 22.4±3.13 years. The BMI of obese PCOS patients (31.9±4.7 kg/m²) and lean PCOS patients (21.4±2.2 kg/m²) were higher than that of healthy controls (20.7±1.8 kg/m²) which was statistically significant (p-value <0.001). The serum leptin in obese PCOS were significantly higher (28.0±17.8 ng/mL) than lean PCOS (5.8±2.2 ng/mL) and fasting plasma insulin in lean PCOS were (10.9±2.4 µIU/mL) significantly lower than obese PCOS (30.2±14.8 µIU/mL). Mean serum leptin levels had significant positive correlation with BMI in lean and obese PCOS and insulin resistance in obese PCOS. Conclusion: In the present study, high leptin concentration was observed in PCOS patients and there was positive correlation of leptin with BMI in both lean and obese PCOS groups and leptin was positively correlated with insulin resistance in obese PCOS. [ABSTRACT FROM AUTHOR]

Aim: Individuals with type 2 diabetes mellitus (T2D) were found to be more depressed compared to individuals without diabetes, but the reason remains unclear. An objective marker for the screening and management of depression could reduce the subjective variation commonly observed with existing questionnaire-based screening. No study has been conducted to observe the impact of lipid ratios on depression in T2D individuals. Hence, this study aimed at investigating the best association between depression with lipid ratios, an important indicator of cardiovascular status, and its cut off value for identifying the presence of depression. Subject and method: Depression was assessed among 50 consenting healthy individuals and 50 T2D patients in Uttarakhand using the Patient Health Questionnaire-9 (PHQ-9). The association between PHQ-9 score, lipid ratios and markers of insulin resistance and cut off value were analysed using regression analysis and receiver-operating characteristic (ROC) curve analysis. Result: A negative correlation between insulin sensitivity and depression was noted among total participants (p value < 0.001). Lipid ratios and depression were positively associated, both among total participants and those with diabetes (p value <0.001) which persisted even after adjustment with age. Among all the ratios, triglycerides (TG)/high density lipoprotein-cholesterol (HDL-C) was found to have the best association with depression (rho = 0.8 and AUC = 0.8, p < 0.001). A TG/HDL-C value of 1.90 was identified as a cut-off point for the presence of depression (PHQ-9 score > 10), with a sensitivity of 95.3% and specificity of 80.4%. Conclusion: The ease and wide accessibility of the TG/HDL-C ratio make it ideal for use as a screening tool for depression in individuals with diabetes. [ABSTRACT FROM AUTHOR]

Background: Retrospective analyses of perinatal databases have raised the suspicion that there could be a positive association between the fetal gender and gestational diabetes mellitus (GDM), but it is still unclear. We thus thought to evaluate the relationship between fetal sex and maternal glucose metabolism in a well-characterized cohort of women reflecting the full spectrum of GDM in a prospective cohort study. Research Design & Methods: It is a prospective cohort study with 104 pregnant women with GDM diagnosed by Diabetes in Pregnancy Societies of India (DIPSI) guidelines were selected for the study. Maternal BMI, and mode of treatment given for GDM was noted along with baby's birth weight and gender. Clinical risk factors were compared between women carrying a female fetus (n = 52) and those carrying a male fetus (n = 52). Statistical Analysis: GDM mother's glucose challenge test (GCT) values, mode of treatment of GDM mothers, baby birth weight, maternal body mass index (BMI) at term, and mode of delivery were expressed in percentage. A Chi-square test was used to estimate the association between the maternal GCT values versus fetal gender and fetal gender versus mode of maternal treatment, using SPSS 21.0 version. Results: Women carrying a male fetus had a poorer ß-cell function and higher range of GCT values as compared with those carrying a female fetus. Furthermore, women carrying a male fetus had higher proportions of developing GDM and its complications. Conclusion: Male fetus is associated with poorer ß-cell function, higher GCT values and an increased risk of GDM in the mother. Thus, fetal sex potentially may influence maternal glucose metabolism in pregnancy. [ABSTRACT FROM AUTHOR]

Background /purpose: Leptin—a protein hormone that plays vital role in the regulation of glucose homeostasis and insulin sensitivity, involved in regulating the circadian rhythms of gonadotropic, thyrotropic and adrenal axes in the endocrine system. This cross-sectional study was undertaken to correlate serum leptin levels and other demographic and biochemical parameters between prediabetic cases and control subjects of Kashmiri population. Furthermore, association of serum leptin levels with various demographic and biochemical parameters along with insulin resistance in pre-diabetic subjects was elucidated. In our study, pre-diabetic cases (n = 212) and healthy controls (n = 196) were enrolled. Methods: All study subjects underwent anthropometric assessment. Serum samples of all study subjects were analysed for biochemical parameters employing the principle of spectrophotometry and leptin levels using sandwich enzyme-linked immunosorbent assay (ELISA). Insulin levels of prediabetic cases were deduced by chemiluminescent micro particle immunoassay (CMIA) technology and thereby calculating their insulin resistance. Results: The cases had statistically increased leptin levels, lipid profile and obesity as compared to controls (p ≤ 0.05). Our study, showed a positive correlation between elevated leptin levels and increased lipid levels (total cholesterol, triglycerides; TG and very low density lipoproteins-cholesterol; VLDL-C) in prediabetics (p < 0.001). Conclusion: Beyond adiposity, leptin levels may increase the risk of pre-diabetes in Kashmiri population. Since the secretion, estimation and measurements of leptins are modest in contrast to insulin levels; therefore, leptin levels can also be included in the routine measurement as an indicator of metabolic syndrome and/or T2DM. [ABSTRACT FROM AUTHOR]

Introduction: Hepatitis C virus (HCV) infection is a serious global public health problem. It is estimated that 2% to 3% of the world's population is infected with the virus. It was found that chronic hepatitis C is an independent predictor of the development of type 2 diabetes mellitus. Infection with HCV or the inflammatory response to HCV infection likely contributes to the development of insulin resistance (IR), which increases the risk of developing type 2 diabetes in the long term. This study aimed to assess the insulin resistance in hepatitis C and its correlation with various metabolic parameters. Materials and Methods: This cross-sectional observational study was conducted at a tertiary care hospital in North India in the Department of Internal Medicine with hepatitis C-positive patients attending an out-patient or in-patient department. We took a total of 100 patients aged > 18 years and divided them into two groups: Group A with hepatitis C (cases) and Group B without hepatitis C (controls). There were a total of 50 hepatitis C patients and 50 patients without hepatitis C. Results: A total of 100 patients were included in the present study after obtaining informed consent. There was a significantly higher level of serum ferritin and insulin in group A patients than group B patients. There was a positive correlation of insulin resistance with the serum insulin, ferritin levels, cholesterol, LDL and triglyceride level and a negative correlation with the serum HDL level. The incidence of insulin resistance was positively correlated with changes in fibrosis in the liver due to the hepatitis C infection. Conclusions: From our study, we found that there is an increased incidence of insulin resistance in the patients with hepatitis-C infection, and insulin resistance is associated with the presence of altered hepatic function test results. [ABSTRACT FROM AUTHOR]

With the increasing global burden of dyslipidemia over the past 30 years, it is estimated that more than 200 million people worldwide are under statin therapy. In India, roughly 25–30% of urban populations and 15–20% of rural populations have abnormal lipid levels. Statin, which is deemed to be the gold standard lipid-lowering agent, is the first treatment of choice for these patients. Although statins at one end are highly effective against dyslipidemiaand cardiovascular diseases, at the other end, they cause adverse effects including an increased risk of diabetes mellitus. The objective of this study was to understand the coexistence of diabetes and dyslipidemia in patients undergoing statin therapy. A scoping review was conducted with published articles selected from PubMed and Google Scholar. The obtained results were filtered based on inclusion/exclusion criteria. Our database search provided a total of 822 articles, of which 48 were selected for this review, with results concluding that statin users are potentially at a greater risk of developing diabetes mellitus compared with patients who are not using statins. Although many studies have been conducted to ascertain the onset of diabetes mellitus amongst statin users, the exact mechanism is not yet precisely established. Future studies are essential for identifying the exact cause of diabetes mellitus in statin users. [ABSTRACT FROM AUTHOR]

Background: Vitamin D deficiency has been found to associated with numerous skeletal and non-skeletal diseases including Diabetes Mellitus. Insulin Resistance (IR) is considered as one of the primary reasons of Type-2 Diabetes Mellitus (T2DM). The association between vitamin D deficiency and IR has been extensively explore in previous studies, but none of them focused on Indian adolescents, and none of them used the TyG index as IR marker. Hence, this population-based cross-sectional study investigates the relationship between insulin resistance (IR) assessed using the Triglycerides Glucose Index (TyG index) and vitamin D measured by serum 25-hydroxyvitamin-D (25(OH)D). Methods: For this study, we utilized data from the Comprehensive National Nutrition Survey (CNNS, 2016–18). The study is based on a sample size of 10,167 adolescents aged 10–19 years. The TyG index cut-off value of 4.65 was used to classify IR. We examined associations between the TyG index and serum 25(OH)D using multiple linear regression models adjusted for potential confounders. Odds of Insulin Resistance among vitamin D deficient/insufficient adolescents were assessed using multivariable logistic regression. Results: A significant negative association was found between serum 25(OH)D and the TyG index, where a 10% increase in serum 25(OH)D was associated with 0.56 (95% CI = -0.67, -0.45) unit decrement in the TyG index. The odds of having IR were 90% higher among vitamin D deficient adolescents (OR: 1.90; 95% CI = 1.62—2.23) compared to adolescents with adequate levels of vitamin D. The association between vitamin D deficiency and IR was independent of sex; in other words, the association between vitamin D and IR was significant in both the sexes. Conclusion: Independent of sex, this study found a significant inverse association between vitamin D and insulin resistance in Indian adolescents. The findings of this study highlight the utility of TyG index and the importance of vitamin D in lowering the risk of T2DM in future generations of the country. [ABSTRACT FROM AUTHOR]

Introduction: Altered iron metabolism may be a risk factor for various diseases. There are studies showing that altered iron metabolism is frequently found in type 2 diabetes mellitus patients, but there is lacunae of literature in offspring's of diabetic parents. Aim: To compare serum iron indices in euglycaemic offsprings of diabetic and non diabetic parents and also to correlate serum iron indices with HOMA-IR. Materials and Methods: This was a case-control study conducted in RL Jalappa Hospital and Research Centre, Kolar, Karnataka, India, from February 2019 to January 2020. Total 80 euglycaemic healthy individuals were recruited. Out of 80 subjects 40 were cases and 40 were controls. Offspring of non diabetic parents as control group and offspring of diabetic parents as a case group were included in the study. Anthropometric measurements like weight, height was measured and Body Mass Index (BMI) was calculated. Laboratory parameters like complete haemogram, Fasting Blood Sugar (FBS), serum iron markers like serum iron, serum ferritin, serum Total Iron Binding Capacity (TIBC), serum insulin and high sensitive C-reactive protein were analysed and compared between cases and controls. Homeostasis Model Assessment-estimated Insulin Resistance (HOMA-IR) was calculated. Results: Mean age of cases was 34.65±3.06 years and controls was 35.75±3.43 years respectively. Out of total 24 were females and 56 were males. Serum iron markers like serum iron and serum ferritin was significantly increased and serum TIBC was significantly decreased among euglycaemic offspring's of diabetic parents compared to offspring's of non diabetic parents. Serum ferritin (r-value=0.389, p-value=0.007) and serum iron (r-value=0.483, p-value=0.001), showed positive correlation with HOMA-IR among euglycaemic offspring's of diabetic parents. On multiple regression analysis, in model 1 (HOMA-IR as dependent variable and serum ferritin, serum iron and serum TIBC as independent variable) serum iron emerged as a significant predictor of insulin resistance, whereas after adding confounding variables like BMI, high sensitivity C-Reactive Protein (hsCRP), lipid profile with serum iron markers in model 2, serum iron emerged as independent predictor of insulin resistance though regression equations was not statistically significant. Conclusion: Offsprings of diabetic parents showed iron overload and insulin resistance which predisposes them to develop T2DM and serum iron can be used as one of the marker of insulin resistance among offspring of diabetic parents along with other parameters. [ABSTRACT FROM AUTHOR]

Background and Objectives: The adverse metabolic effects of long-term antiepileptic drug (AED) therapy are well known. But there is limited data on the same in children from India. This study was designed to look into the effect of long-term AEDs on anthropometry, glycemic parameters, insulin resistance, lipid profile, and hepatic steatosis in a cohort of South Indian children compared to healthy controls. This cross-sectional study was done in a pediatric epilepsy clinic of a tertiary care university teaching hospital. Materials and Methods: Ambulant children aged 5 to 15 years with epilepsy on AEDs for at least one year were identified. This cohort was divided into monotherapy and polytherapy groups. Age- and sex-matched controls were selected from healthy children in the community. All the cases and controls underwent a detailed general physical examination and investigations, including fasting blood glucose, fasting insulin, fasting lipid profile, and liver transaminases along with ultrasonogram of abdomen. Statistical Analysis Used: Student's t-test, chi-square test, ANOVA/Kruskall--Walli test with Bonferroni adjustment. Results: Fifty children on long-term AED therapy (25 on monotherapy and 25 on polytherapy) and 22 controls were included in the study. Children on AED had significantly higher LDL-cholesterol, fasting blood glucose, and insulin resistance compared to controls. Four children on multiple AEDs had non-alcoholic fatty liver disease (NAFLD). Children taking oxcarbazepine regimen were found to have an adverse metabolic profile compared to those on other drugs. Conclusion: This cohort of South Indian children with epilepsy on long-term AED therapy had an adverse metabolic profile compared to matched healthy controls. Further larger community-based studies are needed to further characterize the association and develop successful intervention strategies. Emphasis on a healthy life style should be part of comprehensive epilepsy care program. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a major public health problem with a wide range of prevalence among different ethnic groups. Early recognition of pre-diabetes is important to prevent the development of the disease, its complications, co-morbidities, and consequently early death. Insulin resistance (IR) is considered a condition that precedes type 2 diabetes; thus, understanding its underlying causes (genetic and non-genetic factors) will bring us closer to preventing it. The present study aimed to investigate the genetic susceptibility to IR and its impact on estimated longevity in populations with different ethnic origins using randomly selected samples of 372 Hungarian general (HG, as a reference with Caucasian origin) and 334 Roma participants (largest ethnic minority in Europe, with a northern India origin). In the present study, we used the Homeostasis Model Assessment—Insulin Resistance (HOMA—IR) to identify people with IR (>3.63) at the population level. To investigate the genetic predisposition to IR, 29 single nucleotide polymorphisms (SNPs) identified in a systematic literature search were selected and genotyped in sample populations. In the analyses, the adjusted p < 0.0033 was considered significant. Of these 29 SNPs, the commutative effects of 15 SNPs showing the strongest association with HOMA—IR were used to calculate an optimized genetic risk score (oGRS). The oGRS was found nominally significantly (p = 0.019) higher in the Roma population compared to HG one, and it was more strongly correlated with HOMA—IR. Therefore, it can be considered as a stronger predictor of the presence of IR among the Roma (AUCRoma = 0.673 vs. AUCHG = 0.528). Furthermore, oGRS also showed a significant correlation with reduced estimated longevity in the Roma population (β = −0.724, 95% CI: −1.230–−0.218; p = 0.005), but not in the HG one (β = 0.065, 95% CI: −0.388–0.518; p = 0.779). Overall, IR shows a strong correlation with a genetic predisposition among Roma, but not in the HG population. Furthermore, the increased genetic risk of Roma is associated with shorter estimated longevity, whereas this association is not observed in the HG one. Increased genetic susceptibility of Roma to IR should be considered in preventive programs targeting the development of type 2 diabetes, which may also reduce the risk of preventable premature death among them. [ABSTRACT FROM AUTHOR]

Identification of novel subgroups of type 2 diabetes (T2D) has helped improve its management. Most classification techniques focus on clustering or subphenotyping but not on both. This study aimed to compare both these methods and examine the rate of T2D remission in these subgroups in the Indian population. K-means clustering (using age at onset, HbA1C, BMI, HOMA2 IR and HOMA2%B) and subphenotyping (using homeostatic model assessment (HOMA) estimates) analysis was done on the baseline data of 281 patients with recently diagnosed T2D who participated in a 1-year online diabetes management program. Cluster analysis revealed three distinct clusters: severe insulin-deficient diabetes (SIDD), severe insulin-resistant diabetes (SIRD), and mild obesity-related diabetes (MOD) while subphenotyping showed four distinct categories: hyperinsulinemic, insulinopenic, classical, and nascent T2D. Comparison of the two approaches revealed that the clusters aligned with phenotypes based on shared characteristics of insulin sensitivity (IS) and beta cell function (BCF). Clustering correctly identified individuals in nascent group (high IS and BCF) as having mild obesity related diabetes which subphenotyping did not. Post-one-year intervention, higher remission rates were observed in the MOD cluster (p = 0.383) and the nascent phenotype showing high IS and BCF (p = 0.061, Chi-Square test). In conclusion, clustering based on a comprehensive set of parameters appears to be a superior method for classifying T2D compared with pathophysiological subphenotyping. Personalized interventions may be highly effective for newly diagnosed individuals with high IS and BCF and may result in higher remission rates in these individuals. Further large-scale studies are required to validate these findings., (© 2024. The Author(s).)

Objective: To study the association between altered vitamin D profiles and different indices as well as clinical features of polycystic ovary syndrome (PCOS), including antimüllerian hormone (AMH) levels, phenotypes (A [hyperandrogenism {HA} + ovulatory dysfunction {OD} + polycystic ovarian morphology {PCOM}], B [HA + OD], C [HA + PCOM], and D [OD + PCOM]), insulin resistance, oligomenorrhea, hyperandrogenism, obesity indices, and stress biomarkers in the ethnic population of West Bengal., Design: Case-control observational study., Setting: Outpatient department of gynecology and obstetrics and environing., Participants (patients and Control): Sample size: case group (PCOS, n = 160), age: 16-38 years, and their gender, age, as well as ethnicity-matched healthy control (n = 160)., Intervention(s): In this observational study, a structured questionnaire for menstrual status and to determine the scores of cutaneous manifestations, a bioelectrical impedance analyzer for measurement of anthropometric indices, relevant biochemical assessments (vitamin D, AMH, insulin, glucose, and other associated hormonal profiles), statistical software for the social sciences, and Microsoft Office Excel were used to evaluate as well as analyze different indices., Main Outcome Measure(s): Study of the association of vitamin D deficiency with differential manifestations of PCOS such as phenotypes of the syndrome, altered AMH levels, and risk of insulin resistance. An attempt has been made to determine the cutoff value of AMH of the patients with PCOS belonging to the ethnic population of West Bengal using receiver operating characteristic (ROC)., Result(s): Vitamin D deficiency was found to be directly correlated with AMH level in PCOS phenotype A (67%), oligomenorrhea, and PCOM, along with a substantial agonistic relationship with insulin resistance in the PCOS population under study. In the PCOS phenotype B, the AMH level was highest, with a cutoff value of 5.27 ng/mL (asymptotic sig. = 0.000, 95% confidence interval: 8.37-9.95, derived by ROC analysis, with area under the ROC curve- area under the curve value = 0.949, sensitivity=0.882, and specificity = 0.880). Oligomenorrhic women with PCOS possess significantly higher values of AMH levels (8.70 ± 3.66 > 3.09 ± 1.86 ng/mL) level than the regular menstrual rhythm within the same group. Patients with PCOS had significantly less skeletal muscle mass and greater subcutaneous fat content than the control group., Conclusion(s): 25-hydroxy-vitamin D might be intermeshed with the underlying pathophysiology and severity of PCOS, as well as associated metabolic disorders like insulin resistance. The AMH level is finely tuned by most of the plausible effectors of PCOS and contends to be a promising biomarker for the diagnosis as well as prognosis of PCOS., Competing Interests: Declaration of Interests S.C. has nothing to disclose. T.K.N. has nothing to disclose. B.R.B. has nothing to disclose., (Copyright © 2024 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)

Type-2 diabetes (T2D) is a rapidly growing multifactorial metabolic disorder that induces the onset of various diseases in the human body. The compositional and metabolic shift of the gut microbiota is a crucial factor behind T2D. Hence, gaining insight into the metabolic profile of the gut microbiota is essential for revealing their role in regulating the metabolism of T2D patients. Here, we have focused on the genome-scale community metabolic model reconstruction of crucial T2D-associated gut microbes. The model-based analysis of biochemical flux in T2D and healthy gut conditions showed distinct biochemical signatures and diverse metabolic interactions in the microbial community. The metabolic interactions encompass cross-feeding of short-chain fatty acids, amino acids, and vitamins among individual microbes within the community. In T2D conditions, a reduction in the metabolic flux of acetate, butyrate, vitamin B5, and bicarbonate was observed in the microbial community model, which can impact carbohydrate metabolism. The decline in butyrate levels is correlated with both insulin resistance and diminished glucose metabolism in T2D patients. Compared to the healthy gut, an overall reduction in glucose consumption and SCFA production flux was estimated in the T2D gut environment. Moreover, the decreased consumption profiles of branch chain amino acids (BCAAs) and aromatic amino acids (AAAs) in the T2D gut microbiota can be a distinct biomarker for T2D. Hence, the flux-level analysis of the microbial community model can provide insights into the metabolic reprogramming in diabetic gut microbiomes, which may be helpful in personalized therapeutics and diet design against T2D., (© 2024. The Author(s).)

Introduction: Gestational Diabetes mellitus (GDM) increases the risk of foetal morbidity and mortality heralding the future risk of development of type 2 diabetes in mother. GDM develops mainly due to insulin resistance along with interplay of risk factors like advancing maternal age, family history of diabetes, obesity, ethnicity, history of macrosomia. Aim: To detect whether estimation of serum ferritin, C-reactive protein and insulin in 1st trimester can predict the subsequent occurrence of GDM and whether susceptible mothers can be managed cautiously to prevent foeto-maternal complications. Materials and Methods: This hospital-based longitudinal study was done in Department of Gynaecology and obstetrics in collaboration with the Department of Biochemistry, Medical College and Hospital, Kolkata, West Bengal, India, from January 2018 to June 2019. The study included 80 antenatal mothers attending the Antenatal Outpatient Department in first trimester. The blood samples were collected from them during first trimester and serum ferritin, C-reactive Protein (CRP) and insulin were estimated using different methods as specified later. The anthropometric measurements of the mother {Body Mass Index (BMI), skin fold thickness and waist hip ratio} were measured. These enrolled study participants have undergone Oral Glucose Tolerance Test (OGTT) with 75 gm of anhydrous glucose at 24-28 weeks of gestation. The performance parameters like sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratio of ferritin and CRP was calculated. results: The mean age of participants who developed diabetes (n=12) 25.75±2.92 and who did not developed diabetes (n=68) 23.91±3.74 years. There was 15% prevelance of GDM in study population. The median concentration of serum ferritin and CRP was significantly higher in patients who developed GDM (n=12) among the study population (n=80). The sensitivity of serum ferritin {83.33% (95% confidence interval=51.59-97.91%)} was higher in comparison to C-reactive protein {31.82% (95% CI=13.86-54.87%)}. conclusion: There was a remarkable decline of insulin sensitivity with the advancement of pregnancy. This implies that latent insulin resistance may start from first trimester and screening in high risk ethnicity group like India should be a routine protocol. [ABSTRACT FROM AUTHOR]

Metabolic syndrome (MS) is a cluster of conditions including central obesity, hypertriglyceridemia, low HDL cholesterol, hyperglycaemia, and hypertension with a prevalence rate of 20–25% of the world's adult population. Metabolic syndrome is often characterized by insulin resistance, which some have suggested is a major supportive connection between physical inactivity and MS. Various studies suggest that moderately elevated iron and ferritin levels are associated with an increased prevalence of metabolic syndrome and are markers of insulin resistance. Increased body iron stores are associated with the development of glucose intolerance, type 2 diabetes mellitus, and insulin resistance syndrome (IRS). This is a hospital-based cross-sectional observational study, which was conducted in the department of internal medicine of a tertiary care hospital in northern India. The study was conducted from 1 January 2019 to 30 June 2020 and included 100 patients and 100 controls. All subjects in the age group of 35–65 years were enrolled and investigated as per the study design. Metabolic syndrome patients were diagnosed according to the modified National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP-III) with BMI > 23 kg/m2. All baseline investigations were undertaken, including serum ferritin levels. Insulin resistance (IR) was calculated using the homeostasis model assessment IR (HOMA-IR) formula. We found a positive association between an increase in serum ferritin with the prevalence of metabolic syndrome and its clinical parameter. The serum ferritin level was positively correlated with the level of insulin resistance and inversely correlated with the insulin level of the patients. [ABSTRACT FROM AUTHOR]

Background and aim: Adenosine triphosphate-binding cassette transporter A1 (ABCA1) and hepatic lipase (LIPC) genes both play an important role in lipid metabolism. ABCA1 and LIPC gene polymorphism has been reported with conflicting results as genetic risk factor for T2DM in different populations. Due to lack of conclusive data from India, present study was conducted to assess the association of ABCA1 and LIPC gene polymorphisms with T2DM risk in the North Indian population. Methods: Two SNPs (G656A and C69T) in ABCA1 gene and one SNP (G-250A) in LIPC gene were genotyped in total of 270 subjects using PCR–RFLP genotyping method. Results: The polymorphism at position G656A in ABCA1 and at position G-250A in LIPC gene was significantly associated with development of T2DM (p = 0.016, p = 0.001). Significant association could not be observed between C69T variant of ABCA1 gene and T2DM. Regression analysis also showed that ABCA1 variant G656A and LIPC variant G-250A are associated with T2DM risk in adjusted model for clinical/demographic variables (p = 0.000 and p = 0.034). The levels of total Chl and LDL-C were significantly higher in T2DM patients having GA + AA genotype of ABCA1 gene at SNP G656A (p = 0.012 and p = 0.021). However, BMI, HOMA-IR, TG, and insulin levels were significantly higher in T2DM patients having GA + AA genotype of LIPC gene at SNP G-250A (p = 0.011, 0.048, 0.017, 0.045 respectively). Conclusion: It can be concluded that A allele of ABCA1 variant G656A and LIPC variant G-250A might serve as risk factors in the development of T2DM in the North Indian population. [ABSTRACT FROM AUTHOR]

Cirrhosis of liver is associated with loss of liver function, portal hypertension, and pancreatic β-cell dysfunction leading to hepatogenous diabetes (HD). Often HD is an underestimated and understudied problem, particularly in the Indian subcontinent, where the prevalence of both Chronic liver disease (CLD) and diabetes is high. Hence this study was planned to highlight the prevalence of HD and its association with the severity of cirrhosis. A total of 121 cirrhotic patients without a history of diabetes were included in this prospective cross-sectional study. Seventy five g oral glucose tolerance test (OGTT) was done in all patients. Fasting serum insulin levels were done to calculate insulin resistance (IR) using homeostatic model assessment-insulin resistance (HOMA-IR). Upper gastrointestinal endoscopy was done to detect varices. Patients were divided into HD group and non-HD group for comparison of results. HD was seen in 52 (42.98%) patients; among them, 63.4% did not show evidence of HD by fasting plasma glucose (FPG) levels. Impaired glucose tolerance (IGT) was seen in 58 (47.93%) patients. Compared with the non-HD group, the HD group had significantly higher model for end-stage liver disease (MELD) score (P = 0.038), HOMA-IR (P < 0.001), incidence of large varices (P < 0.001) and variceal bleeding (P < 0.001). A statistically significant association was noted between HD and Hepatocellular carcinoma (HCC) (P < 0.001). Patients with cirrhosis had a high prevalence of IGT, IR, and HD. The presence of HD is well associated with the severity of cirrhosis in the form of higher MELD score (>15), CTP score (>10), higher bilirubin levels, large varices, bleeding varices, and HCC. FPG levels and glycated hemoglobin (HbA1c) cannot be relied upon, and OGTT aids in the unmasking of HD in these patients. [ABSTRACT FROM AUTHOR]

Background: According to NFHS-4 survey, obesity has doubled in India. BMI cannot differentiate body fat from lean mass. Normal weight obesity was defined to distinguish people with normal BMI and increased body fat percentage (BF%). In contrast to conventional atherogenic prediction, Apolipoprotein B level is elevated before LDL cholesterol. Adiposity is also known for causing insulin resistance. Hence this study is an attempt to find the correlation of apo B and Insulin sensitivity in predicting future cardiovascular risk among normal weight obese. To study the role of apoB and insulin resistance in predicting cardio vascular risk. Methods: 269 participants of age group 18-24 in a medical teaching institute were selected for the first phase of the study through systematic random sampling. BF% was calculated with Harpenden skinfold callipers using Jackson Pollock's method. Second phase of the study involved biochemical investigation of 30 NWO participants. ApoB level and insulin sensitivity using HOMA model was estimated. Spearman correlations and simple linear regression were used. Analysis done using SPSSv16. Results: Male and Females were 56.4% and 43.6%, respectively. Out of 269, 44 were found to be having NWO. Hence Prevalence was 16.4%. There is a positive correlation found between apoB and insulin resistance with increasing body fat percentage. Conclusions: Elevated levels of apo B and insulin resistance are seen in NWO individuals as the BF% increases. NWO should be diagnosed early and thus apoB and insulin resistance can be screened for cardio vascular risk prediction. [ABSTRACT FROM AUTHOR]

Context: As synacthen use is not licensed in India and there are concerns about the safety of the insulin tolerance test (ITT), an alternative dynamic test to diagnose adrenal insufficiency (AI) is required. Objective: The study aimed to evaluate the diagnostic performance of the Acton Prolongatum stimulation test (APST) with a standard ITT for the diagnosis of AI. Design: Prospective study comparing two diagnostic tests. Participants: Six healthy volunteers and 53 suspected or known AI patients. Measurements: Serum cortisol response to ITT and APST. Results: The median (95% confidence interval [CI]) peak cortisol levels among healthy volunteers in ITT and APST were 17 (14.58–19.08) and 30.5 (22.57–34.5) μg/dL. Of the 53 patients (age: 39.6 ± 9.38 years; females: 38 [71.1%]), 34 had AI (peak ITT serum cortisol < 14.5 μg/dL) whereas 19 had a normal hypothalamic-pituitary-adrenocortical (HPA) axis. In the receiver operator characteristic curve analysis, 60-min APST cortisol had an area under the curve of 0.984 (95% CI: 0.904–1.00, P < 0.0001). The best accuracy was obtained at a cut-off of 16.42 μg/dL (sensitivity: 97.7% [95% CI: 87.7–99.9%]; specificity: 100% [69.2-100%]). Forty-three of the 53 patients with suspected AI had hypoglycemic symptoms during ITT and two of them required intravenous dextrose, whereas, none had adverse events during APST. The ITT was incomplete in two patients whereas all completed APST. Conclusions: APST is a simple, safe, and reliable alternative to ITT for the diagnosis of AI; 60-min serum cortisol of 16.42 μg/dL in APST best distinguishes the AI patients from those with adequate cortisol response. [ABSTRACT FROM AUTHOR]

Objective: The prevalence of diabetes mellitus in India is increasing day by day. This study was conducted to assess the impact of fenugreek with controlled diet in prediabetic patients of with fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c). Study Design: Interventional parallel randomized control trial. Materials and Methods: A total of 280 prediabetics were included in the study. Patients were randomized and one group of patients received 10 g of fenugreek powder in hot water every day, whereas the second group did not receive it. Strict dietary controls were followed as per the guidelines of American Diabetic Association (ADA) protocols. The parameters were assessed on the first visit and every 3 months for 24 months. Results: Dietary addition of fenugreek leads to a reduction in blood glucose levels. Statistical analysis shows that there was a significant reduction in FBGlevels in the 24 months in the study group (P < 0.001), whereas a significant reduction in HbA1c in the 24th month (P = 0.001). Half of the study participants (52.9%, 59.2%, and 57.1% at 6, 12, and 24 months, respectively) reported acceptable compliance about fenugreek treatment. Conclusion: Dietary addition of fenugreek can have a synergistic effect along with diet control on FBG and HbA1c. [ABSTRACT FROM AUTHOR]

Background: The genetic association studies of type 2 diabetes mellitus (T2DM) hitherto undertaken among the Indian populations are grossly inadequate representation of the ethnic and geographic heterogeneity of the country. In view of this and due to the inconsistent nature of the results of genetic association studies, it would be prudent to undertake large scale studies in different regions of India considering wide spectrum of variants from the relevant pathophysiological pathways. Given the reproductive dysfunctions associated with T2DM, it would be also interesting to explore if some of the reproductive pathway genes are associated with T2DM. The present study is an attempt to examine these aspects in the southern Indian population of Hyderabad. Methods: A prioritized panel of 92 SNPs from a large number of metabolic and reproductive pathway genes was genotyped on 500 cases and 500 controls, matched for ethnicity, age and BMI, using AGENA MassARRAYiPLEX™ platform. Results: The allelic association results suggested 14 SNPs to be significantly associated with T2DM at P = 0.05 and seven of those--rs2241766-G (ADIPOQ), rs6494730-T (FEM1B), rs1799817-A and rs2059806-T (INSR), rs11745088-C (FST), rs9939609-A and rs9940128-A (FTO)--remained highly significant even after correction for multiple testing. A great majority of the significant SNPs were risk in nature. The ROC analysis of the risk scores of the significant SNPs yielded an area under curve of 0.787, suggesting substantial power of our study to confer these genetic variants as predictors of risk for T2DM. Conclusions: The associated SNPs of this study are known to be specifically related to insulin signaling, fatty acid metabolism and reproductive pathway genes and possibly suggesting the role of overlapping phenotypic features of insulin resistance, obesity and reproductive dysfunctions inherent in the development of diabetes. Large scale studies involving gender specific approach may be required in order to identify the precise nature of population and gender specific risk profiles for different populations, which might be somewhat distinct. [ABSTRACT FROM AUTHOR]

There has been conflicting evidence regarding the potential role of vitamin D in glucose homeostasis. This double-blind randomized placebo-controlled trial was designed to investigate the effect of vitamin D3 supplementation on the disposition index in non-diabetic Indian subjects with obesity. Subjects with obesity [n = 120] were randomized to receive a monthly dose of 120,000 IU of vitamin D3 or matching placebo for 6 months. The primary outcome was a change in disposition index (DI) and secondary outcome measures were change in the homeostatic model assessment of insulin resistance and change in body composition. A total of 101 subjects [50 in the vitamin D group (VITD) and 51 in the Placebo group (PL)] completed the study. The mean baseline serum 25-hydroxyvitamin [25(OH) D] concentration was 11.6 ng/ml. There was no significant difference observed between the two groups in any of the primary or secondary outcomes. However, there were a significant increase in median serum 25(OH) D levels in the VITD group than the PL at 6 months of intervention. The results of the present study suggest that supplementation of vitamin D3 has no additional benefit over placebo on pancreatic β-cell functions in non-diabetic Indian subjects with obesity. Further larger studies are required to confirm the results of the study. The trial is registered with the Clinical Trials Registry of India, CTRI/2015/04/005727. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome is characterized by hypertension, dyslipidemia, central obesity, glucose intolerance, insulin resistance. Thyroid hormone acts as general pacemaker, accelerating metabolic process and may be associated with metabolic syndrome. There is no information available in literature regarding the prevalence and association of thyroid dysfunction in metabolic syndrome in this central region of the country. Aims and Objective: To estimate the prevalence of thyroid dysfunction in patients of metabolic syndrome. Materials and Methods: It is a duration based prospective cross sectional study including 200 patients of metabolic syndrome. A detailed history, clinical examination and relevant investigations including serum Free T4 (FT4), Free T3 (FT3), Thyroid Stimulating Hormone (TSH) were done. Range, frequencies, percentage, mean, standard deviation and P value were calculated. P value of < 0.05 was taken as significant. Results: Prevalence of thyroid dysfunction in metabolic syndrome patients was 28.5%. Prevalence of subclinical and overt hypothyroidism was 18.5% and 8.5% respectively. In patients with both metabolic syndrome and thyroid dysfunction, most common components associated are diabetes mellitus and hypertriglyceridemia. Conclusion: Thyroid dysfunction is significantly common in metabolic syndrome patients. It should be aggressively detected and treated in these patients for better outcome. [ABSTRACT FROM AUTHOR]