Posts Tagged ‘insulin resistance’

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Inflammation and insulin resistance genes are activated by surgery

Monday, June 28th, 2010

Journal of Clinical Endocrinology & MetabolismThis interesting paper recently published in the Journal of Clinical Endocrinology & Metabolism describes one of the reasons why support when undergoing a surgical procedure is so important (and links to the risks for delirium and accelerated dementia after surgery in the elderly). The authors set out to investigate the…

“…mechanisms behind postoperative insulin resistance and impaired glucose utilization…”

They shrewdly analyzed the expression of 21 target genes in abdominal adipose (fat) tissue from samples taken at the beginning and end of patients undergoing abdominal surgery. What did the data show?

“After surgery, both sc [subcutaneous] and omental adipose tissue mRNA levels of genes involved in the IL6 and nicotinamide phosphoribosyltransferase pathways were increased, whereas mRNA levels of insulin receptor substrate 1 and adiponectin were reduced. TNF pathway genes were differently regulated between sc and omental adipose tissue, and glucose transporter 4 mRNA levels were decreased only in omental adipose tissue.”

In other words, surgery elicits a shift in genetic expression that favors insulin resistance and inflammation. The authors conclude:

“The transcriptional output of pivotal inflammatory and insulin signaling pathway genes is altered after surgery…This could be of importance for the metabolic aberrations associated to postsurgical complications…”

This helps to understand why patients who are lucky enough to receive adjunctive support for the insulin and inflammatory signaling pathways and receptors recover faster and with less complications.

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Posted in Autoimmune, Brain Health, General Science & Health, Insulin & Diabetes | No Comments »

A new and convenient biomarker for early insulin resistance

Wednesday, June 16th, 2010

PLoS OneElevated levels of insulin due to insulin resistance can do so much damage throughout the body long before the onset of type 2 diabetes that better tools for making the diagnosis early enough for lifestyle changes to have their maximum benefit are always welcome. This research article just published in PLoS One (Public Library of Science) validates the use of an ‘old friend’, α-hydroxybutyrate (α–HB, α = alpha), as a valuable warning sign in the non-diabetic population. The authors first note that…

“Current diagnostic tests, such as glycemic indicators, have limitations in the early detection of insulin resistant individuals. We searched for novel biomarkers identifying these at-risk subjects.”

The authors use of ‘random forest statistical analysis’ of 399 nondiabetic subjects (representing a broad spectrum of insulin sensitivity and glucose tolerance) selected α-hydroxybutyrate (α–HB) as the most accurate biochemical for detecting insulin resistance.

“α–HB also separated subjects with normal glucose tolerance from those with impaired fasting glycemia or impaired glucose tolerance independently of, and in an additive fashion to, insulin resistance. These associations were also independent of sex, age and BMI.”

Thus the authors conclude:

“α–hydroxybutyrate is an early marker for both insulin resistance and impaired glucose regulation.“

I have been testing α–HB for years as part of an organic acids panel because it is also an indicator of toxin-stimulated upregulation of detoxification pathways and glutathione demand. So it makes sense that the authors would also add:

“The underlying biochemical mechanisms may involve increased lipid oxidation and oxidative stress.”

I’m looking at an organic acids report from the file of a patient with other signs of insulin resistance plus a recurrence of breast cancer and, sure enough, α–hydroxybutyrate is abnormally elevated.

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Diet induced weight loss can rapidly improve sexual function for men

Monday, May 3rd, 2010

International Journal of ObesityReaders of these posts know about the profound impact of insulin resistance on glandular and metabolic function; as the authors of this study just published in the International Journal of Obesity note…

“Abdominal obesity and type 2 diabetes mellitus are associated with erectile and urinary dysfunction in men.”

The investigators set out to determine the extent to which weight loss would impact overall sexual function and lower urinary tract symptoms by measuring the effects of an 8 week low-calorie diet using meal replacements* on insulin sensitivity, testosterone, erectile function, sexual desire, prostate symptoms, abdominal obesity and waist circumference. What did their data show?

“Weight loss of ~10% was significantly associated with increased insulin sensitivity, plasma testosterone levels, IIEF-5 (erectile function) and SDI (sexual desire) scores, as well as reduced WC (waist circumference) and IPSS (prostate) scores, in diabetic as well as nondiabetic men.”

They further observed that…

“The degree of weight loss was significantly associated with improvements in plasma testosterone levels, erectile function and LUTS. Reduction in LUTS was significantly associated with increased plasma testosterone, erectile function and sexual desire.”

Hence their clear-cut conclusion:

“Diet-induced weight loss significantly and rapidly improves sexual function, and reduces LUTS, in obese middle-aged men with or without diabetes.”

This is a compelling illustration of the link between insulin resistance and male sexual function.

* Although effective in this study (at 800 calories per day) there are better meal replacement products available for weight loss than this one loaded with fructose, milk protein, and low grade minerals and fish oil.

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Posted in Insulin & Diabetes, Men's Health | 3 Comments »

Insulin resistance and cancer

Wednesday, April 14th, 2010

Cancer ScienceInsulin resistance is the loss of sensitivity of the receptors on each cell that respond to insulin from to repeated over-stimulation by insulin due to high blood sugar levels. High levels of insulin “in the background” do many kinds of damage in the run-up to type 2 diabetes when the body’s capacity to produce ever higher compensatory levels of insulin finally fails and the blood sugar goes up. My patients will certainly recognize that insulin is, of course, a hormone—and that excessive levels are a tumor promoter (along with the related insulin-like growth factor (IFG1). This paper recently published in the journal Cancer Science looks at the epidemiological link between insulin resistance and cancer.

“Epidemiological evidence from our prospective study, the Japan Public Health Center-based Prospective (JPHC) study, and systematic literature reviews generally support the idea that factors related to diabetes or insulin resistance are associated with an increased risk of colon (mostly in men), liver, and pancreatic cancers… The suggested mechanism of these effects is that insulin resistance and the resulting chronic hyperinsulinemia and increase in bioavailable insulin-like growth factor 1 (IGF1) stimulate tumor growth.”

The data from the Japan Public Health Center-based Prospective (JPHC) study support this conclusion:

“…there is substantial evidence to show that cancers of the colon, liver, and pancreas are associated with insulin resistance, and that these cancers can be prevented by increasing physical activity, and possibly coffee consumption.”

That’s right, coffee consumption—see the numerous posts documenting the benefits of coffee. Past and forthcoming posts report on studies that describe the association of insulin resistance and other cancers. The ‘take home’ message is that it’s important to maintain insulin at a healthy level long before the onset of type 2 diabetes by lifestyle factors (good eating and exercise) and evidence-based supplementation appropriate to your genetic and circumstantial needs.

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Posted in Insulin & Diabetes, Oncology | 6 Comments »

Coffee protects against fatty liver disease

Sunday, March 28th, 2010

Digestive Diseases and SciencesThere seems to be one study after another about the benefits of coffee. This paper just published in the journal Digestive Diseases and Sciences verifies that coffee protects against Non-alcoholic Fatty Liver Disease (NAFLD), the most common cause of non-infectious hepatitis and a growing cause of liver failure. I very often see elevated liver enzymes on laboratory tests; no wonder, since this is commonly fueled by insulin resistance. The authors of this study began by observing…

“The benefits of coffee on abnormal liver biochemistry, cirrhosis and hepatocellular carcinoma have been reported…this study aims to investigate if coffee use has any relationship with bright liver, measured by ultrasound bright liver score (BLS), in patients with non-alcoholic fatty liver disease (NAFLD), and which relationship, if any, is present with BMI and insulin resistance.”

‘Bright liver’ refers to the appearance of a fatty liver on ultrasound imaging, and a higher BLS measurement means more fat deposits in the liver. What did they find?

“Less fatty liver involvement is present in coffee vs. non-coffee drinkers. Odds ratios show that obesity, higher insulin resistance, lower HDL cholesterol, older age and arterial hypertension are associated with a greater risk of more severe BLS; to the contrary, coffee drinking is associated with less severe BLS…Coffee use is inversely associated with the degree of bright liver, along with insulin resistance and obesity…”

Their conclusion is similar to numerous other studies:

“A possible opposite, if not antagonistic, role of coffee with regard to overweightness and insulin resistance, similar to that reported in hepatocarcinoma and cirrhosis, is envisaged in the natural history of NAFLD.”

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Posted in General Science & Health, Insulin & Diabetes | 6 Comments »

Low testosterone is associated with insulin resistance

Wednesday, March 24th, 2010

European Journal of EndocrinologyA study published recently in the European Journal of Endocrinology links to the previous post on erectile dysfunction as a predictor of death with cardiovascular disease. The authors mention the well-known fact that:

“Insulin resistance is associated with metabolic syndrome and type 2 diabetes, representing a risk factor for cardiovascular disease.”

They set out to investigate a link between insulin resistance and low testosterone, even in the absence of overweight. What did their data show?

“In older men, lower total testosterone is associated with insulin resistance independently of measures of central obesity. This association is seen with testosterone levels in the low to normal range.”

Do you see the connections between erectile dysfunction, cardiovascular disease, insulin resistance and low testosterone that are emerging here?

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Posted in Cardiovascular, Insulin & Diabetes, Men's Health | 1 Comment »

Children and fatty liver disease

Thursday, January 28th, 2010

GUT 0709Parents, if your children are overweight it is prudent to protect them by having their liver enzymes measured. Non-alcoholic fatty liver disease (NAFLD) is being seen much more frequently in children due to the marked increase in metabolic syndrome associated with being overweight. This paper published in the journal GUT (International Journal of Gastroenterology and Hepatology) “aimed at determining the long-term outcomes and survival of children with NAFLD.” Liver biopsies were obtained when indicated. The investigators documented a disturbing progression to end-stage liver disease and liver transplantation: “Children with NAFLD may develop end-stage liver disease with the consequent need for liver transplantation. NAFLD in children…may be associated with a significantly shorter survival as compared to the general population.”. Their findings are encouragement to help children eat well and exercise. What is the key: “Insulin resistance is almost a universal finding in paediatric NAFLD.”

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Posted in Children's Health, Insulin & Diabetes | No Comments »

Insulin resistance and colorectal cancer

Wednesday, December 9th, 2009

Two papers have been recently published documenting the link between insulin resistance and colorectal cancer. Insulin was higher and adiponectin (see forthcoming posts) lower with colorectal cancer, and both correlated with the stage of the disease according to the study published in the journal Colorectal Disease. The authors of the second paper published in the World Journal of Gastroenterology state: “In addition to cardiovascular disease, individual components of the metabolic syndrome have been linked to the development of cancer, particularly to colorectal cancer…The physiopathological mechanism that links metabolic syndrome and colorectal cancer is mostly related to abdominal obesity and insulin resistance.” There has been a lot written about screening for colorectal cancer; I’m sure you can appreciate the implications of these papers for prevention.

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Posted in Insulin & Diabetes, Oncology | No Comments »

Insulin resistance and dementia or Alzheimer’s disease

Sunday, November 29th, 2009

No doubt about it, you have to take care of your blood sugar and insulin to prevent your brain from degenerating. Here are several papers published in prestigious journals that show the strong connection between insulin resistance and dementia or Alzheimer’s disease:

  1. Insulin resistance and cognitive impairment in Archives of Neurology
  2. Hyperinsulinemia and risk of Alzheimer’s disease in Neurology
  3. Insulin resistance and executive dysfunction in the Journal of the American Geriatrics Society
  4. Hyperinsulinemia and Alzheimer’s disease in the journal Age and Ageing
  5. Body mass index, cardiovascular risk factors, and dementia in Archives of Internal Medicine

Testing your levels of hemoglobin A1C,  glucose, insulin and triglycerides along with measuring your waist-to-hip ratio are among the ways we can see how you’re doing.

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Fat accumulation around organs linked to decreased heart function

Saturday, November 28th, 2009

There are a few newsworthy findings reported in this study, recently published in the journal Obesity, that used MRI and MRS (proton MR spectroscopy) to measure the accumulation of fat around the heart and in the liver.

  1. Fat accumulation around organs is linked to decreased heart function
  2. Body mass index (BMI) is not a reliable predictor of fat accumulation
  3. Fat in the liver was associated with insulin resistance and triglycerides.

I have seen numerous individuals who do not appear overweight and whose BMI was normal, but bioelectric impedance analysis (an objective measurement of body fat percentage) revealed that they were ‘metabolically obese’—there was excess fat around their organs. Insulin resistance was a factor in each case.

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Posted in Cardiovascular | 3 Comments »

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