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Buscemi C, Randazzo C, Barile AM, Bo S, Ponzo V, Caldarella R, Malavazos AE, Caruso R, Colombrita P, Lombardo M, Buscemi S. Factors associated with body weight gain and insulin-resistance: a longitudinal study. Nutr Diabetes 2024; 14:21. [PMID: 38649714 PMCID: PMC11035547 DOI: 10.1038/s41387-024-00283-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 04/08/2024] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Obesity is the result of energy intake (EI) chronically exceeding energy expenditure. However, the potential metabolic factors, including insulin resistance, remain unclear. This study longitudinally investigated factors associated with changes in body weight. SUBJECTS A cohort of 707 adults without diabetes were investigated at the 4-year follow-up visit. The habitual intake of energy and macronutrients during the past 12 months was assessed using a validated Food Frequency Questionnaire for the local population. Homeostatic model assessment of β-cell function and insulin resistance (HOMA-IR) was used as a surrogate measure of insulin resistance. Additionally, PNPLA3 was genotyped. RESULTS Eighty-seven participants were weight gainers (G; cutoff value = 5 kg), and 620 were non-gainers (NG). Initial anthropometric (G vs. NG: age, 44 ± 13 vs 51 ± 13 years, P < 0.001; body mass index, 27.8 ± 6.5 vs 28.1 ± 5.1 kg/m2, P = ns; body weight, 76.7 ± 22.1 vs 74.2 ± 14.7 kg, P = ns; final body weight, 86.3 ± 23.7 vs 72.9 ± 14.2 kg, P < 0.001) and diet characteristics, as well as insulin concentrations and HOMA-IR values, were similar in both groups. Four years later, G showed significantly increased EI, insulin concentrations, and HOMA-IR values. G had a higher prevalence of the PNPLA3 CG and GG alleles than NG (P < 0.05). The presence of G was independently associated with age (OR = 1.031), EI change (OR = 2.257), and unfavorable alleles of PNPLA3 gene (OR = 1.700). Final body mass index, waist circumference, and EI were independently associated with final HOMA-IR (P < 0.001). CONCLUSIONS EI is associated with body weight gain, and genetic factors may influence the energy balance. Insulin resistance is a consequence of weight gain, suggesting a possible intracellular protective mechanism against substrate overflow. CLINICAL TRIAL REGISTRATION ISRCTN15840340.
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Affiliation(s)
- Carola Buscemi
- Unit of Internal Medicine, "V. Cervello Hospital", Palermo, Italy
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palermo, Italy
| | - Cristiana Randazzo
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palermo, Italy.
- Unit of Clinical Nutrition, Obesity and Metabolic Diseases; AOU Policlinico "P. Giaccone", Palermo, Italy.
| | - Anna Maria Barile
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palermo, Italy
- Unit of Clinical Nutrition, Obesity and Metabolic Diseases; AOU Policlinico "P. Giaccone", Palermo, Italy
| | - Simona Bo
- Department of Medical Sciences, University of Torino, Torino, Italy
| | - Valentina Ponzo
- Department of Medical Sciences, University of Torino, Torino, Italy
| | - Rosalia Caldarella
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palermo, Italy
- Unit of Laboratory Medicine, AOU Policlinico "P. Giaccone", Palermo, Italy
| | - Alexis Elias Malavazos
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Roberta Caruso
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palermo, Italy
| | - Piero Colombrita
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palermo, Italy
| | - Martina Lombardo
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palermo, Italy
| | - Silvio Buscemi
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palermo, Italy
- Unit of Clinical Nutrition, Obesity and Metabolic Diseases; AOU Policlinico "P. Giaccone", Palermo, Italy
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Podmore L, Poloz Y, Iorio C, Mouaaz S, Nixon K, Smirnov P, McDonnell B, Lam S, Zhang B, Tharmapalan P, Sarkar S, Vyas F, Ennis M, Dowling R, Stambolic V. Insulin receptor loss impairs mammary tumorigenesis in mice. Cell Rep 2023; 42:113251. [PMID: 37913774 DOI: 10.1016/j.celrep.2023.113251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 09/05/2023] [Accepted: 09/27/2023] [Indexed: 11/03/2023] Open
Abstract
Breast cancer (BC) prognosis and outcome are adversely affected by obesity. Hyperinsulinemia, common in the obese state, is associated with higher risk of death and recurrence in BC. Up to 80% of BCs overexpress the insulin receptor (INSR), which correlates with worse prognosis. INSR's role in mammary tumorigenesis was tested by generating MMTV-driven polyoma middle T (PyMT) and ErbB2/Her2 BC mouse models, respectively, with coordinate mammary epithelium-restricted deletion of INSR. In both models, deletion of either one or both copies of INSR leads to a marked delay in tumor onset and burden. Longitudinal phenotypic characterization of mouse tumors and cells reveals that INSR deletion affects tumor initiation, not progression and metastasis. INSR upholds a bioenergetic phenotype in non-transformed mammary epithelial cells, independent of its kinase activity. Similarity of phenotypes elicited by deletion of one or both copies of INSR suggest a dose-dependent threshold for INSR impact on mammary tumorigenesis.
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Affiliation(s)
- Lauren Podmore
- Department of Medical Biophysics, University of Toronto, Princess Margaret Cancer Research Tower, Toronto, ON M5G 1L7, Canada
| | - Yekaterina Poloz
- Princess Margaret Cancer Centre, University Health Network, Princess Margaret Cancer Research Tower, Toronto, ON M5G 1L7, Canada
| | - Catherine Iorio
- Princess Margaret Cancer Centre, University Health Network, Princess Margaret Cancer Research Tower, Toronto, ON M5G 1L7, Canada
| | - Samar Mouaaz
- Princess Margaret Cancer Centre, University Health Network, Princess Margaret Cancer Research Tower, Toronto, ON M5G 1L7, Canada
| | - Kevin Nixon
- Princess Margaret Cancer Centre, University Health Network, Princess Margaret Cancer Research Tower, Toronto, ON M5G 1L7, Canada
| | - Petr Smirnov
- Department of Medical Biophysics, University of Toronto, Princess Margaret Cancer Research Tower, Toronto, ON M5G 1L7, Canada
| | - Brianna McDonnell
- Department of Medical Biophysics, University of Toronto, Princess Margaret Cancer Research Tower, Toronto, ON M5G 1L7, Canada
| | - Sonya Lam
- Princess Margaret Cancer Centre, University Health Network, Princess Margaret Cancer Research Tower, Toronto, ON M5G 1L7, Canada
| | - Bowen Zhang
- Department of Medical Biophysics, University of Toronto, Princess Margaret Cancer Research Tower, Toronto, ON M5G 1L7, Canada
| | - Pirashaanthy Tharmapalan
- Department of Medical Biophysics, University of Toronto, Princess Margaret Cancer Research Tower, Toronto, ON M5G 1L7, Canada
| | - Soumili Sarkar
- Department of Medical Biophysics, University of Toronto, Princess Margaret Cancer Research Tower, Toronto, ON M5G 1L7, Canada
| | - Foram Vyas
- Department of Medical Biophysics, University of Toronto, Princess Margaret Cancer Research Tower, Toronto, ON M5G 1L7, Canada
| | | | - Ryan Dowling
- Princess Margaret Cancer Centre, University Health Network, Princess Margaret Cancer Research Tower, Toronto, ON M5G 1L7, Canada
| | - Vuk Stambolic
- Department of Medical Biophysics, University of Toronto, Princess Margaret Cancer Research Tower, Toronto, ON M5G 1L7, Canada; Princess Margaret Cancer Centre, University Health Network, Princess Margaret Cancer Research Tower, Toronto, ON M5G 1L7, Canada.
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Atoum MF, Alzoughool F, Al-Hourani H. Linkage Between Obesity Leptin and Breast Cancer. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2020; 14:1178223419898458. [PMID: 31975779 PMCID: PMC6956603 DOI: 10.1177/1178223419898458] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 12/12/2019] [Indexed: 12/22/2022]
Abstract
Many cancers might be influenced by obesity, including breast cancer, the leading cause of cancer death among women. Obesity is a complex state associated with multiple physiological and molecular changes capable of modulating the behavior of breast tumor cells and the surrounding microenvironment. This review discussed the inverse association between obesity and breast cancer among premenopausal breast cancer females and the positive association among postmenopausal. Four mechanisms may link obesity and breast cancer including leptin and leptin receptor expression, adipose chronic inflammation, sex hormone alternation, and insulin and insulinlike growth factor 1 (IGF-1) signaling. Leptin has been involved in breast cancer initiation, development, and progression through signaling transduction network. Leptin functions are strengthened through cross talk with multiple oncogenes, cytokines, and growth factors. Adipose chronic inflammation promotes cancer growth and angiogenesis and modifies the immune responses. A pro-inflammatory microenvironment at tumor site promotes cytokines and pro-inflammatory mediators adjacent to the tumor. Leptin stimulates pro-inflammatory cytokines and promotes T-helper 1 responses. Obesity is common of chronic inflammation. In obese patients, white adipose tissue (WAT) will promote pro-inflammatory mediators that will encourage tumor growth and WAT inflammation. Sex hormone alternation of estrogens is associated with increased risk for hormone-sensitive breast cancers. Estrogens cause tumorigenesis by its effect on signaling pathways that lead to DNA damage, stimulation angiogenesis, mutagenesis, and cell proliferation. In postmenopausal females, and due to termination of ovarian function, estrogens were produced extra gonadally, mainly in peripheral adipose tissues where adrenal-produced androgen precursors are converted to estrogens. Active estradiol leads to breast cancer development by binding to ERα, which is modified by receptor’s interaction of various signal transduction pathways. Hyperinsulinemia and IGF-1 activate the MAPK and PI3K pathways, leading to cancer-promoting effects. Cross talk between insulin/IGF and estrogen signaling pathways promotes hormone-sensitive breast cancer development. Hyperinsulinemia is a risk factor for breast cancer that explains the obesity-breast cancer association. Controlling IGF-1 level and targeting IGF-1 receptors among different breast cancer subtypes may be useful for breast cancer treatment. This review discussed several leptin signaling pathways, highlighting the potential advantage of targeting leptin as a potential target of the novel therapeutic strategies for breast cancer treatment.
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Affiliation(s)
- Manar Fayiz Atoum
- Faculty of Allied Health Sciences, Hashemite University, Zarqa, Jordan
| | - Foad Alzoughool
- Faculty of Allied Health Sciences, Hashemite University, Zarqa, Jordan
| | - Huda Al-Hourani
- Department of Clinical Nutrition and Dietetics, Hashemite University, Zarqa, Jordan
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Li Y, Zhang T, Han T, Li S, Bazzano L, He J, Chen W. Impact of cigarette smoking on the relationship between body mass index and insulin: Longitudinal observation from the Bogalusa Heart Study. Diabetes Obes Metab 2018; 20:1578-1584. [PMID: 29446554 PMCID: PMC5999532 DOI: 10.1111/dom.13259] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 02/06/2018] [Accepted: 02/08/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Despite the inverse association between cigarette smoking and body mass index (BMI), it is unknown whether the effect of smoking on insulin is mediated through decreased BMI. This study aims to examine the temporal relationship between BMI and insulin, the impact of smoking on this relationship and the mediation effect of BMI on the association between smoking and insulin levels. METHODS The longitudinal cohort consisted of 1121 adults (807 white and 314 black participants, mean age, 42.0 years at follow-up) for whom BMI and fasting insulin were measured twice, with an average follow-up period of 17.1 years. Cross-lagged panel and mediation analysis models were used to examine the temporal relationship between BMI and insulin, and the mediation effect of BMI on the smoking-insulin association. RESULTS Smoking was inversely associated with insulin (regression coefficient, -0.073; P = .015 at baseline and -0.121; P < .001 at follow-up), adjusting for age, race and gender. After additional adjustment for follow-up periods, the cross-lagged path coefficient from BMI to insulin (β, 0.226; P < .001) was significantly greater than that from insulin to BMI (β, -0.029; P = .208), with P < .001 for the difference. The path coefficient from BMI to insulin was significantly greater in non-smokers (β, 0.273; P < .001) than in smokers (β, 0.122; P = .046), with P = .013 for the difference. The mediation effect of BMI on the smoking-insulin association was estimated at 53.4% (P = .030) at baseline and 58.7% (P < .001) at follow-up. CONCLUSIONS These findings suggest that cigarette smoking has a significant impact on the one-directional relationship from BMI to insulin. The insulin-lowering effect of smoking is predominantly mediated through decreased BMI as the result of smoking.
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Affiliation(s)
- Ying Li
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Tao Zhang
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Tianshu Han
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Shengxu Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Lydia Bazzano
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Jiang He
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Wei Chen
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
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Zhang T, Zhang H, Li Y, Li S, Fernandez C, Bazzano L, He J, Xue F, Chen W. Long-term Impact of Temporal Sequence from Childhood Obesity to Hyperinsulinemia on Adult Metabolic Syndrome and Diabetes: The Bogalusa Heart Study. Sci Rep 2017; 7:43422. [PMID: 28230104 PMCID: PMC5322533 DOI: 10.1038/srep43422] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 01/24/2017] [Indexed: 01/21/2023] Open
Abstract
This study aims to delineate the temporal relations between body mass index (BMI) and insulin in childhood and their impact on adult metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM).The longitudinal cohort consisted of 609 whites and 339 blacks who had BMI and fasting insulin measured twice in childhood (mean age = 10.5 years at baseline and 15.9 years at follow-up). Incident MetS and T2DM were identified in adulthood (mean age = 30.5 years). Cross-lagged panel and mediation analysis models were used. After adjusting for age, race, gender, and follow-up years, the cross-lagged path coefficient of BMI → insulin (β = 0.326, p < 0.001) was significantly greater than that of insulin → BMI (β = −0.023, p = 0.207) in childhood, with p < 0.001 for the difference in βs. The path coefficient for BMI → insulin was significantly greater in MetS than in non-MetS groups (0.510 vs 0.190, p < 0.001), and greater in hyperglycemia than in normoglycemia groups (0.503 vs 0.285, p = 0.026). The mediation effect of childhood insulin on the BMI-MetS and BMI-hyperglycemia associations was estimated at 19.2% (p < 0.001) and 18.3% (p < 0.001), respectively. These findings provide evidence that higher BMI levels precede hyperinsulinemia during childhood, and this one-directional relation plays a significant role in the development of MetS and T2DM in adult life.
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Affiliation(s)
- Tao Zhang
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China.,Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Huijie Zhang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.,Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, Xiamen, China
| | - Ying Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.,Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Shengxu Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Camilo Fernandez
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Lydia Bazzano
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Jiang He
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Wei Chen
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
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Engin A. Obesity-associated Breast Cancer: Analysis of risk factors. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 960:571-606. [PMID: 28585217 DOI: 10.1007/978-3-319-48382-5_25] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Several studies show that a significantly stronger association is obvious between increased body mass index (BMI) and higher breast cancer incidence. Furthermore, obese women are at higher risk of all-cause and breast cancer specific mortality when compared to non-obese women with breast cancer. In this context, increased levels of estrogens due to excessive aromatization activity of the adipose tissue, overexpression of pro-inflammatory cytokines, insulin resistance, hyperactivation of insulin-like growth factors (IGFs) pathways, adipocyte-derived adipokines, hypercholesterolemia and excessive oxidative stress contribute to the development of breast cancer in obese women. While higher breast cancer risk with hormone replacement therapy is particularly evident among lean women, in postmenopausal women who are not taking exogenous hormones, general obesity is a significant predictor for breast cancer. Moreover, increased plasma cholesterol leads to accelerated tumor formation and exacerbates their aggressiveness. In contrast to postmenopausal women, premenopausal women with high BMI are inversely associated with breast cancer risk. Nevertheless, life-style of women for breast cancer risk is regulated by avoiding the overweight and a high-fat diet. Estrogen-plus-progestin hormone therapy users for more than 5 years have elevated risks of both invasive ductal and lobular breast cancer. Additionally, these cases are more commonly node-positive and have a higher cancer-related mortality. Collectively, in this chapter, the impacts of obesity-related estrogen, cholesterol, saturated fatty acid, leptin and adiponectin concentrations, aromatase activity, leptin and insulin resistance on breast cancer patients are evaluated. Obesity-related prognostic factors of breast cancer also are discussed at molecular basis.
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Affiliation(s)
- Atilla Engin
- Faculty of Medicine, Department of General Surgery, Gazi University, Besevler, Ankara, Turkey. .,, Mustafa Kemal Mah. 2137. Sok. 8/14, 06520, Cankaya, Ankara, Turkey.
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Sedaka NM, Olsen CH, Yannai LE, Stutzman WE, Krause AJ, Sherafat-Kazemzadeh R, Condarco TA, Brady SM, Demidowich AP, Reynolds JC, Yanovski SZ, Hubbard VS, Yanovski JA. A longitudinal study of serum insulin and insulin resistance as predictors of weight and body fat gain in African American and Caucasian children. Int J Obes (Lond) 2017; 41:61-70. [PMID: 27534840 PMCID: PMC5209266 DOI: 10.1038/ijo.2016.145] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 06/16/2016] [Accepted: 07/20/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND The influence of insulin and insulin resistance (IR) on children's weight and fat gain is unclear. OBJECTIVE To evaluate insulin and IR as predictors of weight and body fat gain in children at high risk for adult obesity. We hypothesized that baseline IR would be positively associated with follow-up body mass index (BMI) and fat mass. SUBJECTS/METHODS Two hundred and forty-nine healthy African American and Caucasian children aged 6-12 years at high risk for adult obesity because of early-onset childhood overweight and/or parental overweight were followed for up to 15 years with repeated BMI and fat mass measurements. We examined baseline serum insulin and homeostasis model of assessment-IR (HOMA-IR) as predictors of follow-up BMI Z-score and fat mass by dual-energy X-ray absorptiometry in mixed model longitudinal analyses accounting for baseline body composition, pubertal stage, sociodemographic factors and follow-up interval. RESULTS At baseline, 39% were obese (BMI⩾95th percentile for age/sex). Data from 1335 annual visits were examined. Children were followed for an average of 7.2±4.3 years, with a maximum follow-up of 15 years. After accounting for covariates, neither baseline insulin nor HOMA-IR was significantly associated with follow-up BMI (Ps>0.26), BMIz score (Ps>0.22), fat mass (Ps>0.78) or fat mass percentage (Ps>0.71). In all models, baseline BMI (P<0.0001), body fat mass (P<0.0001) and percentage of fat (P<0.001) were strong positive predictors for change in BMI and fat mass. In models restricted to children without obesity at baseline, some but not all models had significant interaction terms between body adiposity and insulinemia/HOMA-IR that suggested less gain in mass among those with greater insulin or IR. The opposite was found in some models restricted to children with obesity at baseline. CONCLUSIONS In middle childhood, BMI and fat mass, but not insulin or IR, are strong predictors of children's gains in BMI and fat mass during adolescence.
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Affiliation(s)
- N M Sedaka
- Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA
| | - C H Olsen
- Biostatistics Consulting Center, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - L E Yannai
- Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA
| | - W E Stutzman
- Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA
| | - A J Krause
- Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA
| | - R Sherafat-Kazemzadeh
- Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA
| | - T A Condarco
- Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA
| | - S M Brady
- Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA
| | - A P Demidowich
- Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA
| | - J C Reynolds
- Nuclear Medicine Department, Hatfield Clinical Research Center, NIH, Bethesda, MD, USA
| | - S Z Yanovski
- Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA
- Nutritional Sciences Branch, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD, USA
| | - V S Hubbard
- Nutritional Sciences Branch, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD, USA
- Division of Nutrition Research Coordination, NIH, Bethesda, MD, USA
| | - J A Yanovski
- Section on Growth and Obesity (SGO), Program in Developmental Endocrinology and Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA
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Zhang T, Zhang H, Li Y, Sun D, Li S, Fernandez C, Qi L, Harville E, Bazzano L, He J, Xue F, Chen W. Temporal Relationship Between Childhood Body Mass Index and Insulin and Its Impact on Adult Hypertension: The Bogalusa Heart Study. Hypertension 2016; 68:818-23. [PMID: 27432860 DOI: 10.1161/hypertensionaha.116.07991] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 06/28/2016] [Indexed: 12/22/2022]
Abstract
Although obesity and insulin resistance are closely correlated, their temporal sequences in early life and influence on adult hypertension are largely unknown. This study aims to delineate the temporal relationship patterns between body mass index (BMI) and insulin in childhood and their impact on adult hypertension. The longitudinal cohort consisted of 990 adults (630 whites and 360 blacks) who had BMI and fasting insulin measured twice 5.4 years apart in childhood (mean age, 10.5 years at baseline and 15.9 years at follow-up) and blood pressure measured 14.7 years later in adulthood (mean age, 30.5 years). Cross-lagged panel and mediation analysis models were used to examine the temporal relationship between childhood BMI and insulin and its impact on adult hypertension. After adjusting for age, race, sex, and follow-up years, the cross-lagged path coefficient (β=0.33; P<0.001) from baseline BMI to follow-up insulin was significantly greater than the path coefficient (β=-0.02; P>0.05) from baseline insulin to follow-up BMI in childhood with P<0.001 for the difference in βs. Blacks and whites showed similar patterns of the temporal relationship. The path coefficient (β=0.59; P<0.001) from BMI to insulin in the hypertensive group was significantly greater than that (β=0.24; P<0.001) in normotensive group, with P<0.001 for the difference in βs between these 2 groups. The mediation effect of childhood insulin on the childhood BMI-adult hypertension association was estimated at 21.1% (P<0.001). These findings provide evidence that higher BMI levels precede hyperinsulinemia during childhood, and this 1-directional relation plays a role in the development of hypertension.
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Affiliation(s)
- Tao Zhang
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z., F.X.); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (T.Z., H.Z., Y.L., D.S., S.L., C.F., L.Q., E.H., L.B., J.H., W.C.); Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, China (Y.L.)
| | - Huijie Zhang
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z., F.X.); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (T.Z., H.Z., Y.L., D.S., S.L., C.F., L.Q., E.H., L.B., J.H., W.C.); Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, China (Y.L.)
| | - Ying Li
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z., F.X.); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (T.Z., H.Z., Y.L., D.S., S.L., C.F., L.Q., E.H., L.B., J.H., W.C.); Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, China (Y.L.)
| | - Dianjianyi Sun
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z., F.X.); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (T.Z., H.Z., Y.L., D.S., S.L., C.F., L.Q., E.H., L.B., J.H., W.C.); Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, China (Y.L.)
| | - Shengxu Li
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z., F.X.); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (T.Z., H.Z., Y.L., D.S., S.L., C.F., L.Q., E.H., L.B., J.H., W.C.); Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, China (Y.L.)
| | - Camilo Fernandez
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z., F.X.); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (T.Z., H.Z., Y.L., D.S., S.L., C.F., L.Q., E.H., L.B., J.H., W.C.); Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, China (Y.L.)
| | - Lu Qi
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z., F.X.); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (T.Z., H.Z., Y.L., D.S., S.L., C.F., L.Q., E.H., L.B., J.H., W.C.); Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, China (Y.L.)
| | - Emily Harville
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z., F.X.); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (T.Z., H.Z., Y.L., D.S., S.L., C.F., L.Q., E.H., L.B., J.H., W.C.); Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, China (Y.L.)
| | - Lydia Bazzano
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z., F.X.); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (T.Z., H.Z., Y.L., D.S., S.L., C.F., L.Q., E.H., L.B., J.H., W.C.); Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, China (Y.L.)
| | - Jiang He
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z., F.X.); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (T.Z., H.Z., Y.L., D.S., S.L., C.F., L.Q., E.H., L.B., J.H., W.C.); Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, China (Y.L.)
| | - Fuzhong Xue
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z., F.X.); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (T.Z., H.Z., Y.L., D.S., S.L., C.F., L.Q., E.H., L.B., J.H., W.C.); Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, China (Y.L.).
| | - Wei Chen
- From the Department of Biostatistics, School of Public Health, Shandong University, Jinan, China (T.Z., F.X.); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (T.Z., H.Z., Y.L., D.S., S.L., C.F., L.Q., E.H., L.B., J.H., W.C.); Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, China (H.Z.); and Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, China (Y.L.).
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9
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Bakshi AA, Bavikar JS, Asegaonkar SB, Bardapurkar JS, Domple V, Rai PS, Pawar S. Evaluation of usefulness of serum insulin as sensitive predictor of cardiovascular dysfunction in obese individuals with normal lipid profile. J Clin Diagn Res 2014; 8:CC10-2. [PMID: 25478336 DOI: 10.7860/jcdr/2014/9759.4980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 07/29/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND Prevalence of obesity and its subsequent cardiometabolic complications is on exponential rise. Hyperinsulinemia develops in obese individuals long before other metabolic derangements of obesity take place and may be a common pathophysiological factor tying together various components of cardiometabolic dysfunction. AIM Present study was aimed at evaluating the role of insulin as a sensitive and independent cardiovascular risk marker in apparently healthy overweight and obese individuals with normal lipid profile. SETTINGS AND DESIGN This was an opd based case Control study including 100 overweight and obese individuals with normal lipid profile & 100 age and sex matched normal weight healthy controls. MATERIALS AND METHODS Participants were evaluated based on detailed history, clinical examination and laboratory investigations. Blood samples were collected after overnight fast. Serum insulin was estimated by chemiluminescence method, glucose and lipid profile (CHOLESTEROL, HDL, TG, LDL) by chemical assays on a fully automated analyser system. STATISTICAL ANALYSIS RESULTS were analyzed by unpaired t-test, p-value was determined & Correlation coefficient was calculated amongst various parameters. RESULTS Significant difference was noted in mean values of BMI (29.69±1.28 VS 23.47±1.09), waist / hip ratio (0.91±0.07 VS 0.79±0.05) and serum insulin (10.54±2.5 VS 5.94±1.53) (p<0.01) in cases as compared to controls respectively. Glucose levels were high in cases (89.58±8.0 mg/dl) as compared to controls (88.8±7.56 mg/dl) but the difference was statistically insignificant (p=0.11). Hyperinsulinemia was observed in 41 cases & 4 controls. Serum insulin highly correlated with Waist/ hip ratio (R=0.53) than BMI (R=0.26). CONCLUSION Study suggests Insulin; a simple, sensitive & independent cardiovascular risk predictor in obesity even with normal lipid profile with a potential to reveal hidden burden of metabolic dysfunction and offers a hope that, cardiovascular event can be well prevented with appropriate interventions.
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Affiliation(s)
- Amruta A Bakshi
- Assistant Professor, Department of Biochemistry, Terna Medical College , Nerul, Navi Mumbai, Maharashtra, India
| | - Jayashree S Bavikar
- Associate Professor, Department of Biochemistry, Government Medical College , Aurangabad, Maharashtra, India
| | - Shilpa B Asegaonkar
- Assistant Professor, Department of Biochemistry, Government Medical College , Aurangabad, Maharashtra, India
| | | | - Vijay Domple
- Assistant Professor, Department of Community Medicine, Government Medical College , Nanded, Maharashtra, India
| | - Pooja Sk Rai
- Associate Professor, Department of Biochemistry, Lokmanya Tilak med College , Mumbai, Maharashtra, India
| | - Smita Pawar
- Assistant Professor, Department of Biochemistry, Lokmanya Tilak med College , Mumbai, Maharashtra, India
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10
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Martin LJ. Implications of adiponectin in linking metabolism to testicular function. Endocrine 2014; 46:16-28. [PMID: 24287788 DOI: 10.1007/s12020-013-0102-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 10/23/2013] [Indexed: 12/16/2022]
Abstract
Obesity is a major health problem, contributing to the development of various diseases with aging. In humans, obesity has been associated with reduced testosterone production and subfertility. Adipose tissue is an important source of hormones having influences on both metabolism and reproduction. Among them, the production and secretion of adiponectin is inversely correlated to the severity of obesity. The purpose of this review of literature is to present the current state of knowledge on adiponectin research to determine whether this hormone affects reproduction in men. Surprisingly, evidences show negative influences of adiponectin on GnRH secretion from the hypothalamus, LH and FSH secretion from the pituitary and testosterone at the testicular level. Thus far, the involvement of adiponectin in the influence of metabolism on reproduction in men is limited. However, adiponectin and its receptors are expressed by different cell types of the male gonad, including Leydig cells, spermatozoa, and epididymis. In addition, actions of adiponectin at the testicular level have been shown to promote spermatogenesis and sperm maturation. Therefore, autocrine/paracrine actions of adiponectin in the testis may contribute to support male reproductive function.
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Affiliation(s)
- Luc J Martin
- Biology Department, Université de Moncton, 18, Avenue Antonine Maillet, Moncton, NB, E1A 3E9, Canada,
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11
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Catsburg C, Gunter MJ, Chen C, Cote ML, Kabat GC, Nassir R, Tinker L, Wactawski-Wende J, Page DL, Rohan TE. Insulin, estrogen, inflammatory markers, and risk of benign proliferative breast disease. Cancer Res 2014; 74:3248-58. [PMID: 24755474 DOI: 10.1158/0008-5472.can-13-3514] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Women with benign proliferative breast disease (BPBD) are at increased risk for developing breast cancer. Evidence suggests that accumulation of adipose tissue can influence breast cancer development via hyperinsulinemia, increased estrogen, and/or inflammation. However, there are limited data investigating these pathways with respect to risk of BPBD. We evaluated serologic markers from these pathways in a case-control study of postmenopausal women nested within the Women's Health Initiative Clinical Trial. Cases were the 667 women who developed BPBD during follow-up, and they were matched to 1,321 controls. Levels of insulin, estradiol, C-reactive protein (CRP), and adiponectin were measured in fasting serum collected at baseline. Conditional logistic regression models were used to estimate ORs for the association of each factor with BPBD risk. Among nonusers of hormone therapy, fasting serum insulin was associated with a statistically significant increase in risk of BPBD (OR for highest vs. lowest quartile = 1.80; 95% confidence interval, CI, 1.16-2.79; Ptrend = 0.003) as were levels of estradiol (OR for highest vs. lowest tertile = 1.89; 95% CI, 1.26-2.83; Ptrend = 0.02) and CRP (OR for highest vs. lowest quartile = 2.46; 95% CI, 1.59-3.80; Ptrend < 0.001). Baseline adiponectin level was inversely associated with BPBD risk (OR for highest vs. lowest quartile = 0.47; 95% CI, 0.31-0.71; Ptrend < 0.001). These associations persisted after mutual adjustment, but were not observed among users of either estrogen alone or of estrogen plus progestin hormone therapy. Our results indicate that serum levels of estrogen, insulin, CRP, and adiponectin are independent risk factors for BPBD and suggest that the estrogen, insulin, and inflammation pathways are associated with the early stages of breast cancer development.
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Affiliation(s)
- Chelsea Catsburg
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Marc J Gunter
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Chu Chen
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Michele L Cote
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Geoffrey C Kabat
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Rami Nassir
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Lesley Tinker
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Jean Wactawski-Wende
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - David L Page
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Thomas E Rohan
- Authors' Affiliations: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx; Department of Social and Preventive Medicine, University at Buffalo, The State University of New York, Buffalo, New York; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Population Studies and Prevention Program, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan; Department of Public Health Sciences, University of California - Davis, Davis, California; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; and Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
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12
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Özçaka Ö, Buduneli N, Ceyhan BO, Akcali A, Hannah V, Nile C, Lappin DF. Is Interleukin-17 Involved in the Interaction Between Polycystic Ovary Syndrome and Gingival Inflammation? J Periodontol 2013; 84:1827-37. [DOI: 10.1902/jop.2013.120483] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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13
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Implications of leptin in neuroendocrine regulation of male reproduction. Reprod Biol 2013; 13:1-14. [DOI: 10.1016/j.repbio.2012.12.001] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 12/20/2012] [Accepted: 12/21/2012] [Indexed: 01/14/2023]
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14
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Özçaka Ö, Ceyhan BÖ, Akcali A, Biçakci N, Lappin DF, Buduneli N. Is There an Interaction Between Polycystic Ovary Syndrome and Gingival Inflammation? J Periodontol 2012; 83:1529-37. [DOI: 10.1902/jop.2012.110588] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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15
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Abstract
There is considerable epidemiological evidence that a Western-style diet may increase the risk of certain hormone-dependent conditions in men via its effects on hormone metabolism. Experimental evidence also suggests that dietary factors may exert subtle effects on hormone metabolism. Here we review the clinical and epidemiological evidence that diet is associated with circulating sex hormone levels in men. In comparison with factors such as age and BMI, nutrients do not appear to be strong determinants of sex hormone levels. Dietary intervention studies have not shown that a change in dietary fat and/or dietary fibre intake is associated with changes in circulating sex hormone concentrations over the short term. The data on the effects of dietary phyto-oestrogens on sex hormone levels in men are too limited for conclusions to be drawn. Observational studies between men from different dietary groups have shown that a vegan diet is associated with small but significant increases in sex-hormone-binding globulin and testosterone concentrations in comparison with meat-eaters. However, these studies have not demonstrated that variations in dietary composition have any long-term important effects on circulating bioavailable sex hormone levels in men. This lack of effect may be partly explained by the body's negative feedback mechanism, which balances out small changes in androgen metabolism in order to maintain a constant level of circulating bioavailable androgens. It appears, therefore, that future studies should look for dietary effects on the feedback mechanism itself, or on the metabolism of androgens within the target tissues.
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Affiliation(s)
- N E Allen
- Imperial Cancer Research Fund Cancer Epidemiology Unit, Gibson Building, Radcliffe Infirmary, Woodstock Road, Oxford OX2 6HE, UK
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16
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Hosking J, Metcalf BS, Jeffery AN, Voss LD, Wilkin TJ. Direction of causality between body fat and insulin resistance in children--a longitudinal study (EarlyBird 51). ACTA ACUST UNITED AC 2011; 6:428-33. [PMID: 21867370 DOI: 10.3109/17477166.2011.608800] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate the direction of causality in the association between adiposity and insulin resistance in children. METHODS Body composition by DEXA, and insulin resistance by HOMA-2 IR were measured annually in 238 children aged from 7-13 years. Longitudinal modelling was used to establish whether baseline and/or trends in adiposity were associated with change in IR or whether, conversely, baseline and/or trends in IR were associated with change in adiposity. RESULTS Baseline adiposity was associated with change in IR in the short-term (p < 0.001) but less so in the long-term (p < 0.09) in both genders. Baseline IR was not associated with short-term change in adiposity in either gender (p > 0.42). In the long-term, baseline IR appeared to be positively associated with change in adiposity in boys (p = 0.02) but inversely associated with change in adiposity (the higher the baseline IR, the lower the gain in %fat) in girls (p < 0.001). CONCLUSIONS The dominant direction of causality appears to be from adiposity to insulin resistance. In boys, adiposity appears to be both a cause and an effect of IR in the long term. In girls, however, higher insulin resistance appeared to limit further gain in body fat in the long term, an observation consistent with insulin desensitization as an adaptive response to weight gain.
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Affiliation(s)
- Joanne Hosking
- Department of Endocrinology & Metabolism, Peninsula Medical School, Plymouth campus, UK
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17
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Mediano MFF, Sichieri R. Insulin resistance influences weight loss in non-obese women who followed a home-based exercise program and slight caloric restriction. Diabetes Res Clin Pract 2011; 92:361-7. [PMID: 21466903 PMCID: PMC3110645 DOI: 10.1016/j.diabres.2011.02.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Revised: 11/18/2010] [Accepted: 02/28/2011] [Indexed: 12/30/2022]
Abstract
This study aimed to evaluate the influence of insulin resistance status on weight changes in non-obese women who followed a home-based exercise program and slight caloric restriction over a period of 12 months. Middle-aged (25-45 year), non-obese (body mass index of 23-29.9 kg/m(2)) women were randomly assigned to control (CG) or home-based exercise group (HB). The HB group received a booklet explaining the physical exercises to be practiced at home at least three times per week (40 min/session). Both groups were required to follow a small energy restriction of 100-300 calories per day. For the analysis, women were stratified in two groups according to baseline insulin sensitivity: NIR (non-insulin resistant; n = 121) and IR (insulin resistant; n = 64). Women classified as IR at baseline had greater weight loss after 12 months of follow-up (-1.6 kg vs. -1.1 kg; p = 0.01), and HB exercise helped to reduce weight only among NIR women (-1.5 vs. -0.7; p = 0.04); no differences were observed between intervention groups for IR women (-1.5 vs. -1.7; p = 0.24). There were no differences between IR and NIR groups for lipid profile after adjustment for weight changes. Insulin resistance facilitated weight loss, and home-based exercise promoted greater weight loss only in non-insulin resistance women.
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18
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Lai GY, Helzlsouer KJ, Clipp SL, Rifai N, Platz EA. Association between C-peptide concentration and prostate cancer incidence in the CLUE II cohort study. Cancer Prev Res (Phila) 2010; 3:1334-41. [PMID: 20858760 DOI: 10.1158/1940-6207.capr-10-0053] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Diabetes, characterized by perturbations in insulin production and signaling, is inversely associated with prostate cancer risk irrespective of stage. Obesity, a diabetes risk factor, is inversely associated with localized disease but positively associated with advanced disease. To understand the complex association between hyperinsulinemia and prostate cancer, we evaluated the association of plasma C-peptide, an insulin secretion marker, with prostate cancer risk in a case-control study nested in a prospective community cohort. Prostate cancer cases (n = 264) and matched controls (n = 264) were identified in the CLUE II cohort between 1989 (baseline) and 2002. C-peptide concentration was measured in baseline plasma by ELISA. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using conditional logistic regression, adjusting for being overweight or obese and family history. Median C-peptide concentration was lower in cases (1,180 pmol/L) than in controls (1,365 pmol/L; P = 0.03). Men in the highest (versus lowest) fourth of C-peptide had a lower risk for prostate cancer (OR, 0.65; 95% CI, 0.37-1.14; P-trend = 0.08), primarily localized disease (OR, 0.44; 95% CI, 0.19-1.03; P-trend = 0.04). Associations were similar to overall, when excluding cases diagnosed during the first 5 years of follow-up, men with diabetes, or men who had not had a prostate-specific antigen test. C-peptide concentration was inversely associated with subsequent diagnosis of prostate cancer, primarily localized disease, similar to the association for obesity. However, we cannot rule out detection bias that might result if men with higher C-peptide have lower prostate-specific antigen irrespective of whether prostate cancer is present or not.
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Affiliation(s)
- Gabriel Y Lai
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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19
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Chiu CJ, Wray LA, Beverly EA. Relationship of glucose regulation to changes in weight: a systematic review and guide to future research. Diabetes Metab Res Rev 2010; 26:323-35. [PMID: 20578206 DOI: 10.1002/dmrr.1095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Although weight gain and obesity are risk factors for poor glucose regulation, the relationship, if any, of glucose regulation to changes in weight is not well understood. The purpose of this study was to conduct a systematic review of research examining the relationship of glucose regulation to changes in weight in human-based studies and to provide guidelines for future research in this area. We searched electronic databases and reference sections of relevant articles, including both diabetic and non-diabetic populations, to locate all the literature published before February 2010, and then conducted a systematic review across studies to compare the research designs and findings. The 22 studies meeting our criteria for review generally supported the relationship of glucose regulation to changes in weight. Three studies reported that poor glucose regulation is associated with weight gain; 12 studies concluded that poor glucose regulation is associated with weight loss; 5 showed complex relationships depending on age, sex, or race/ethnicity; and 2 suggested no relationship. The diverse findings may imply that the direction (negative or positive) of the relationship may depend on specific conditions. More research focused on different subpopulations may provide more definitive information supplemental to the current preliminary findings. Recommendations regarding future research in this particular area are provided in the discussion.
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Affiliation(s)
- Ching-Ju Chiu
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA.
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Wedick NM, Snijder MB, Dekker JM, Heine RJ, Stehouwer CDA, Nijpels G, van Dam RM. Prospective investigation of metabolic characteristics in relation to weight gain in older adults: the Hoorn Study. Obesity (Silver Spring) 2009; 17:1609-14. [PMID: 19197256 DOI: 10.1038/oby.2008.666] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The objective of this investigation was to determine the relation between baseline glucose, insulin, adiponectin, and leptin levels and subsequent 6-year weight and waist change in older men and women without diabetes in a prospective cohort study. Participants were 1,198 Dutch men and women without diabetes who were aged 50-77 years when baseline metabolic and anthropometric measurements were evaluated (1989-1991). Approximately 6 years later, body weight and waist circumference were re-measured at a follow-up examination (1996-1998). Metabolic variables (fasting plasma glucose, 2-h postchallenge plasma glucose, homeostasis model assessment of insulin resistance (HOMA-IR), adiponectin, and leptin) were evaluated as predictors of changes in weight and waist circumference. Postchallenge plasma glucose (mmol/l) significantly predicted less gain in both weight and waist circumference (beta = -0.28 kg, s.e. = 0.11; beta = -0.31 cm, s.e. = 0.14, respectively) during follow-up. Leptin (microg/l) significantly predicted greater increases in weight (beta = 0.29 kg, s.e. = 0.07) and waist (beta = 0.16 cm, s.e. = 0.08) among men and in waist among women (beta = 0.06 cm, s.e. = 0.02). Fasting plasma glucose (mmol/l) predicted an increase in waist among women (beta = 1.59 cm, s.e. = 0.63), but not in men (beta = -0.74 cm, s.e. = 0.55). Adiponectin and insulin did not predict weight or waist change. The authors conclude that lower postchallenge plasma glucose and higher fasting leptin levels significantly predicted long-term increases in weight and waist circumference. In contrast, measures of insulin resistance and adiponectin were not associated with weight change in this cohort of older persons without diabetes.
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Affiliation(s)
- Nicole M Wedick
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA.
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Molenaar EA, Massaro JM, Jacques PF, Pou KM, Ellison RC, Hoffmann U, Pencina K, Shadwick SD, Vasan RS, O'Donnell CJ, Fox CS. Association of lifestyle factors with abdominal subcutaneous and visceral adiposity: the Framingham Heart Study. Diabetes Care 2009; 32:505-10. [PMID: 19074991 PMCID: PMC2646037 DOI: 10.2337/dc08-1382] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The purpose of this study was to assess the relationship between lifestyle factors and abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in a community-based setting. RESEARCH DESIGN AND METHODS Cross-sectional associations between lifestyle factors (dietary quality, physical activity, smoking, and alcohol consumption) and SAT and VAT volumes were examined in 2,926 Framingham Heart Study participants (48.6% women, aged 50 +/- 10 years). RESULTS Diets consistent with the 2005 Dietary Guidelines Adherence Index and greater physical activity were inversely associated with SAT and VAT (P < 0.0001-0.002). In men, former smoking was associated with higher SAT (2,743 +/- 56 cm(3)) compared with current smokers (2,629 +/- 88 cm(3)) or those who never smoked (2,538 +/- 44 cm(3); P = 0.02). Both former and current smoking was associated with higher VAT (P = 0.03 [women]; P = 0.005 [men]). Women with high amounts of alcohol intake (>7 drinks/week) had lower SAT (2,869 +/- 106 cm(3)) than those who consumed less alcohol (3,184 +/- 44 cm(3), P = 0.006); significant differences in VAT were not observed (P = 0.18). In men, high amounts of alcohol intake (>14 drinks/week) were associated with higher VAT (2,272 +/- 59 cm(3)) compared with intake of <or=14 drinks/week (2,139 +/- 25 cm(3), P = 0.04), whereas SAT did not differ (P = 0.91). An increasing number of healthy lifestyle factors were associated with lower SAT and VAT volumes (all P < 0.003). CONCLUSIONS Adherence to recommended dietary guidelines and physical activity are associated with lower SAT and VAT volumes. However, both smoking and high alcohol intake are differentially associated with VAT volumes. Further research to uncover the putative mechanisms is warranted.
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Affiliation(s)
- Esther A Molenaar
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Municipal Health Service Utrecht, Utrecht, the Netherlands
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Gunter MJ, Hoover DR, Yu H, Wassertheil-Smoller S, Rohan TE, Manson JE, Li J, Ho GYF, Xue X, Anderson GL, Kaplan RC, Harris TG, Howard BV, Wylie-Rosett J, Burk RD, Strickler HD. Insulin, insulin-like growth factor-I, and risk of breast cancer in postmenopausal women. J Natl Cancer Inst 2009; 101:48-60. [PMID: 19116382 PMCID: PMC2639294 DOI: 10.1093/jnci/djn415] [Citation(s) in RCA: 375] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2008] [Revised: 09/25/2008] [Accepted: 10/14/2008] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The positive association between obesity and postmenopausal breast cancer has been attributed, in part, to the fact that estrogen, a risk factor for breast cancer, is synthesized in adipose tissue. Obesity is also associated with high levels of insulin, a known mitogen. However, no prospective studies have directly assessed associations between circulating levels of insulin and/or insulin-like growth factor (IGF)-I, a related hormone, and the risk of breast cancer independent of estrogen level. METHODS We conducted a case-cohort study of incident breast cancer among nondiabetic women who were enrolled in the Women's Health Initiative Observational Study (WHI-OS), a prospective cohort of 93,676 postmenopausal women. Fasting serum samples obtained at study entry from 835 incident breast cancer case subjects and from a subcohort of 816 randomly chosen WHI-OS subjects were tested for levels of insulin, glucose, total IGF-I, free IGF-I, insulin-like growth factor binding protein-3, and estradiol. Multivariable Cox proportional hazards models were used to estimate associations between levels of the serologic factors and baseline characteristics (including body mass index [BMI]) and the risk of breast cancer. All statistical tests were two-sided. Results Insulin levels were positively associated with the risk of breast cancer (hazard ratio [HR] for highest vs lowest quartile of insulin level = 1.46, 95% confidence interval [CI] = 1.00 to 2.13, P(trend) = .02); however, the association with insulin level varied by hormone therapy (HT) use (P(interaction) = .01). In a model that controlled for multiple breast cancer risk factors including estradiol, insulin level was associated with breast cancer only among nonusers of HT (HR for highest vs lowest quartile of insulin level = 2.40, 95% CI = 1.30 to 4.41, P(trend) < .001). Obesity (BMI >or=30 kg/m(2)) was also associated with the risk of breast cancer among nonusers of HT (HR for BMI >or=30 kg/m(2) vs 18.5 to <25 kg/m(2) = 2.12, 95% CI = 1.26 to 3.58, P(trend) = .003); however, this association was attenuated by adjustment for insulin (P(trend) = .40). CONCLUSION These data suggest that hyperinsulinemia is an independent risk factor for breast cancer and may have a substantial role in explaining the obesity-breast cancer relationship.
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Affiliation(s)
- Marc J Gunter
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, New York, NY 10461, USA.
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Chiriboga DE, Ma Y, Li W, Olendzki BC, Pagoto SL, Merriam PA, Matthews CE, Hebert JR, Ockene IS. Gender differences in predictors of body weight and body weight change in healthy adults. Obesity (Silver Spring) 2008; 16:137-45. [PMID: 18223626 PMCID: PMC4355617 DOI: 10.1038/oby.2007.38] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Overweight and obesity are important predictors of a wide variety of health problems. Analysis of naturally occurring changes in body weight can provide valuable insights in improving our understanding of the influence of demographic, lifestyle, and psychosocial factors on weight gain in middle-age adults. OBJECTIVE To identify gender-specific predictors of body weight using cross-sectional and longitudinal analyses. METHODS AND PROCEDURES Anthropometric, lifestyle and psychosocial factors were measured at baseline and then quarterly for 1 year in 572 healthy adult volunteers from Central Massachusetts who were recruited between 1994 and 1998. Linear mixed models were used to analyze the relationship between body weight and potential predictors, including demographic (e.g., age, educational level), lifestyle (e.g., diet, physical activity, smoking), and psychosocial (e.g., anxiety, depression) factors. RESULTS Over the 1-year study period, on average, men gained 0.3 kg and women lost 0.2 kg. Predictors of lower body weight at baseline in both men and women included current cigarette smoking, greater leisure-time physical activity, and lower depression and anxiety scores. Lower body weights were associated with a lower percentage of caloric intake from protein and greater occupational physical activity levels only among men; and with higher education level only among women. Longitudinal predictors of 1-year weight gain among women included increased total caloric intake and decreased leisure-time physical activity, and among men, greater anxiety scores. DISCUSSION Demographic, lifestyle and psychosocial factors are independently related to naturally occurring changes in body weight and have marked differential gender effects. These effects should be taken into consideration when designing interventions for weight-loss and maintenance at the individual and population levels.
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Affiliation(s)
- David E Chiriboga
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
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Berentzen T, Petersen L, Pedersen O, Black E, Astrup A, Sørensen TIA. Long-term effects of leisure time physical activity on risk of insulin resistance and impaired glucose tolerance, allowing for body weight history, in Danish men. Diabet Med 2007; 24:63-72. [PMID: 17227326 DOI: 10.1111/j.1464-5491.2007.01991.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To determine if the level of leisure time physical activity (LTPA) in young adulthood in obese and non-obese men reduces the risk of insulin resistance (IR) and impaired glucose tolerance (IGT) in middle age, and if such an effect is explained by the current level of LTPA, or by the body mass index (BMI) history preceding and subsequent to the assessment of LTPA. METHODS Longitudinal study of groups of obese and randomly selected non-obese men identified at around age 19, and re-examined at mean ages of 32, 44 and 51. BMI was measured at all four examinations. LTPA was assessed by self-administrated questionnaires at the last three examinations. IR and the presence of IGT was determined by an oral glucose tolerance test at the last examination. RESULTS LTPA in young adulthood reduced the risk of IR and IGT in middle age throughout the range of BMI. Adjustment for the BMI history preceding and subsequent to the assessment of LTPA attenuated the association with IR and IGT, but active men remained at low risk of IR and IGT. Adjustment for subsequent and current levels of LTPA, smoking habits, alcohol intake, educational level and family history of diabetes had no notable influence on the results. CONCLUSION LTPA appears to reduce the risk of IR and IGT, an effect which is not explained by the current level of physical activity, and only partially explained by the BMI history preceding and subsequent to the assessment of LTPA.
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Affiliation(s)
- T Berentzen
- Institute for Preventive Medicine, Center for Health and Society, Copenhagen, Denmark
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25
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Hivert MF, Langlois MF, Carpentier AC. The entero-insular axis and adipose tissue-related factors in the prediction of weight gain in humans. Int J Obes (Lond) 2006; 31:731-42. [PMID: 17130851 DOI: 10.1038/sj.ijo.0803500] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Obesity has now reached epidemic proportions. Epidemiological studies in the past decades have shown that adults gain weight and adiposity from the early twenties until their sixties. In the paediatric population, growing numbers of children and adolescents put on unhealthy weight. Many environmental, socio-economical and biological determinants that predispose to weight gain have been identified thus far. The aim of the present review is to summarize the current knowledge on the role of the circulating levels of adipokines and other entero-insular hormones and biological markers of obesity to predict weight gain in humans. The review focuses on relationship between hormonal and biochemical markers (insulin, insulin-like growth factors, gastrointestinal hormones, leptin, adiponectin, resistin, inflammatory proteins and cytokines) and weight gain in prospective studies. The complex relationships displayed by these hormonal factors with future weight gain in humans are critically reviewed and integrative models are proposed. Overall, most of the studies reported to date made adjustments for baseline body mass index but failed to consider dietary intake and physical activity as confounding factors. Outstanding questions are raised and new directions for future prospective studies are proposed in order to improve our understanding of the role of biological determinants of energy balance and development of obesity in humans.
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Affiliation(s)
- M-F Hivert
- Division of Endocrinology, Department of Medicine, Faculté de Médecine et des Sciences de la Santé, Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Québec, Canada
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Pittas AG, Roberts SB. Dietary Composition and Weight Loss: Can We Individualize Dietary Prescriptions According to Insulin Sensitivity or Secretion Status? Nutr Rev 2006. [DOI: 10.1111/j.1753-4887.2006.tb00174.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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27
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Howard BV, Adams-Campbell L, Allen C, Black H, Passaro M, Rodabough RJ, Rodriguez BL, Safford M, Stevens VJ, Wagenknecht LE. Insulin resistance and weight gain in postmenopausal women of diverse ethnic groups. Int J Obes (Lond) 2004; 28:1039-47. [PMID: 15254486 DOI: 10.1038/sj.ijo.0802645] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This study was conducted to examine the influence of insulin resistance on weight change in postmenopausal women of various ethnic groups. SUBJECTS Data were obtained from 3389 women (60% White, 20% Black, 12% Hispanic, and 8% Asian/Pacific Islander), ages 50-79, enrolled in either the Women's Health Initiative Clinical trial or Observational Study, whose blood samples were selected randomly from the full cohort of 161 809 women for analyses. MEASUREMENTS Glucose, insulin, and lipids were measured on fasting serum samples drawn at baseline and after 3 y of follow-up. Weight, height, waist circumference, and blood pressure were measured. Physical activity and energy intake were assessed via questionnaire. Insulin resistance was estimated using the HOMA (homeostasis model) calculation. RESULTS Average age was 62 y, average BMI (body mass index) was 27.4 kg/m2, and average weight change was a gain of 0.4 kg in 3 y. In a multivariate analysis, insulin resistance and insulin concentrations were independent predictors of increases in weight in White women (P=0.002 and 0.004, respectively) and in the combined group (P=0.027 and 0.039). For the whole group, after adjustment for other covariates, those in the highest quartile of insulin resistance gained 0.4 kg in 3 y, whereas those in the lowest quartile lost 0.06 kg. Similar trends were found for insulin resistance and weight gain in Hispanic and Asian/Pacific Islander women, but they did not reach statistical significance. In Black women, no relation was seen between either insulin or insulin resistance and weight change. A significant interaction between obesity and insulin resistance was observed (P=0.002 for White women and 0.032 for the whole group), so that there is weight gain with increasing insulin resistance in the leaner women, but weight loss with increasing insulin resistance in the most obese. CONCLUSION Insulin resistance appears to be a predictor of weight gain in postmenopausal women, except for the most obese women. The effect is more pronounced in women who have a lower BMI, and the effect was not seen in the Black women who as a group had a higher BMI.
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Affiliation(s)
- B V Howard
- MedStar Research Institute, Washington, DC 20783, USA.
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Mosca CL, Marshall JA, Grunwald GK, Cornier MA, Baxter J. Insulin resistance as a modifier of the relationship between dietary fat intake and weight gain. Int J Obes (Lond) 2004; 28:803-12. [PMID: 15146168 DOI: 10.1038/sj.ijo.0802621] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate whether insulin resistance modifies the rate of weight gain associated with a high percent of energy intake from dietary fat. DESIGN Longitudinal, observational population study. SUBJECTS A total of 782 nondiabetic Hispanic and non-Hispanic white free-living adult residents of the San Luis Valley in Colorado. MEASUREMENTS Subjects were seen up to three times over a 14-y period. Weight, height, fasting insulin and glucose, diet by 24 h recall, and self-reported physical activity were collected at each visit. RESULTS Percentage of energy intake from dietary fat was positively associated with weight gain over time (P=0.0103). High intake of dietary fat was more strongly related to weight gain in women than in men, and in those with lower total energy intake levels. The relationship between weight change and relative macronutrient intake also varied by baseline insulin sensitivity (P=0.0025). Weight gain over time in individuals with relative insulin resistance at baseline, as measured by QUICKI, was the greatest among those who consumed a higher percent of energy from fat. CONCLUSION Percentage of total intake from dietary fat predicts weight change independent of total energy intake. Nondiabetic, insulin-resistant individuals are particularly susceptible to the weight gain associated with high levels of dietary fat intake. Further investigation into the relationship between insulin resistance, diet, and weight gain is warranted.
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Affiliation(s)
- C L Mosca
- University of Colorado Health Sciences Center, Campus Box B119, Denver, CO, USA.
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29
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Shea S, Aymong E, Zybert P, Berglund L, Shamoon H, Deckelbaum RJ, Basch CE. Fasting plasma insulin modulates lipid levels and particle sizes in 2- to 3-year-old children. OBESITY RESEARCH 2003; 11:709-21. [PMID: 12805392 DOI: 10.1038/oby.2003.101] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Obesity and hyperinsulinemia are associated with dyslipidemia in adults and older children, but little is known about these relationships in very young children. We examined the relation of fasting insulin to lipid levels and lipid particle size in young healthy children. RESEARCH METHODS AND PROCEDURES Analyses were performed on data from 491 healthy 2- and 3-year old Hispanic children enrolled in a dietary study conducted in New York City, 1992-1995. Obesity measures included BMI, ponderal index, skinfold thickness, and waist circumference. Low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol particle size were measured by nuclear magnetic resonance. RESULTS Fasting insulin level was positively correlated with triglyceride levels (r = 0.24 for boys and r = 0.23 for girls; p < 0.001 for both) and inversely correlated with HDL-cholesterol level in boys (r = -0.20; p < 0.01). Higher fasting insulin level was also correlated with smaller mean HDL particle size in both boys (r = -0.21; p < 0.001) and girls (r = -0.14; p < 0.05) and smaller mean LDL particle size in boys (r = -0.13; p < 0.05). The associations of fasting insulin level with triglyceride and HDL-cholesterol levels and HDL and LDL particle size remained significant after multivariate regression adjustment for age, sex, and BMI or ponderal index. DISCUSSION Fasting insulin level is associated with relative dyslipidemia in healthy 2- and 3-year-old Hispanic children.
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Affiliation(s)
- Steven Shea
- Division of General Medicine, Columbia University College of Physicians & Surgeons, New York, New York 10032, USA.
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Shea S, Aymong E, Zybert P, Shamoon H, Tracy RP, Deckelbaum RJ, Basch CE. Obesity, fasting plasma insulin, and C-reactive protein levels in healthy children. OBESITY RESEARCH 2003; 11:95-103. [PMID: 12529491 DOI: 10.1038/oby.2003.15] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Obesity is associated with hyperinsulinemia and increased level of C-reactive protein in older children and adults, but little is known about these relationships in very young children. We examined these relationships in healthy 2- to 3-year-old children. RESEARCH METHODS AND PROCEDURES Analyses were performed on data from 491 healthy 2- to 3-year-old Hispanic children enrolled in a dietary study conducted in New York City, 1992 to 1995. RESULTS Body mass index (BMI), ponderal index, and sum of four skinfolds were highly correlated (r > 0.75) in both boys and girls. Fasting insulin and glucose levels were only modestly correlated (r = 0.37 for boys and r = 0.28 for girls; p < 0.001 for both), but essentially all of the variability in a calculated index of insulin resistance was attributable to variability in fasting insulin level. The correlations of BMI with fasting insulin level were r = 0.16 (p < 0.05) in boys and r = 0.14 (p < 0.05) in girls. In separate multivariate regression analyses adjusting for age and sex, BMI and ponderal index were associated with fasting plasma insulin level (p < 0.001 for both obesity measures). In multivariate regression analyses adjusting simultaneously for age, sex, and either BMI or ponderal index, fasting insulin level, but not these obesity measures, was associated with C-reactive protein level. DISCUSSION Obesity is associated with higher fasting insulin level, and fasting insulin is associated with C-reactive protein level, in healthy 2- to 3-year-old children.
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Affiliation(s)
- Steven Shea
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
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Tan RS, Pu SJ. Impact of obesity on hypogonadism in the andropause. INTERNATIONAL JOURNAL OF ANDROLOGY 2002; 25:195-201. [PMID: 12121568 DOI: 10.1046/j.1365-2605.2002.00356.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Obesity is an issue that is increasingly affecting ageing men. With ageing, there is a decline in androgens as well. There are implications for the health of ageing men as a result of hypogonadism. Overall, there seems to be an inverse relationship between body mass index and testosterone levels, as is also demonstrated in our cross-sectional study. Obesity seems to depress the production of testosterone. It has been hypothesized that there is increased aromatization of testosterone to oestradiol and alteration of the hypothalamic-pituitary-adrenal axis in obese older men. Some hormones can affect obesity in ageing men including leptin, insulin, dehydroepiandrostenedione and growth hormone. The relationship of obesity to these hormones in ageing men will be reviewed. Testosterone replacement in ageing men can alter body composition whereby fat is exchanged for muscle. These studies will also be reviewed. Further studies in this field are recommended to evaluate long-term benefits and risks.
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Affiliation(s)
- R S Tan
- University of Texas School of Medicine, Geriatric Medicine Fellowship Program, Department of Family and Community Medicine, Houston, TX 77030, USA.
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Furler SM, Poynten AM, Kriketos AD, Lowy AJ, Ellis BA, Maclean EL, Courtenay BG, Kraegen EW, Campbell LV, Chisholm DJ. Independent influences of central fat and skeletal muscle lipids on insulin sensitivity. OBESITY RESEARCH 2001; 9:535-43. [PMID: 11557834 DOI: 10.1038/oby.2001.70] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Insulin resistance is closely associated with two disparate aspects of lipid storage: the intracellular lipid content of skeletal muscle and the magnitude of central adipose beds. Our aim was to determine their relative contribution to impaired insulin action. RESEARCH METHODS AND PROCEDURES Eighteen older (56 to 75 years of age) men were studied before elective knee surgery. Insulin sensitivity (M/Delta I) was determined by hyperinsulinemic-euglycemic clamp. Central abdominal fat (CF) was assessed by DXA. Skeletal muscle was excised at surgery and assayed for content of metabolically active long-chain acyl-CoA esters (LCAC). RESULTS Significant inverse relationships were observed between LCAC and M/Delta I (R(2) = 0.34, p = 0.01) and between CF and M/Delta I (R(2) = 0.38, p = 0.006), but not between CF and LCAC (R(2) = 0.0005, p = 0.93). In a multiple regression model (R(2) = 0.71, p < 0.0001), both CF (p = 0.0006) and LCAC (p = 0.0009) were independent statistical predictors of M/Delta I. Leptin levels correlated inversely with M/Delta I (R(2) = 0.60, p = 0.0002) and positively with central (R(2) = 0.41, p = 0.006) and total body fat (R(2) = 0.63, p = 0.0001). DISCUSSION The mechanisms by which altered lipid metabolism in skeletal muscle influences insulin action may not be related directly to those linking central fat and insulin sensitivity. In particular, it is unlikely that muscle accumulation of lipids directly derived from labile central fat depots is a principal contributor to peripheral insulin resistance. Instead, our results imply that circulating factors, other than nonesterified fatty acids or triglyceride, mediate between central fat depots and skeletal muscle tissue. Leptin was not exclusively associated with central fat, but other factors, secreted specifically from central fat cells, could modulate muscle insulin sensitivity.
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Affiliation(s)
- S M Furler
- Diabetes and Metabolism Research Program, Garvan Institute of Medical Research, St. Vincent's Hospital, Sydney NSW, Australia
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Abstract
Obesity is commonly cited as a risk factor for the development of coronary heart disease (CHD). Epidemiologic studies tend to support this contention, particularly those focusing on patients with central obesity. Such studies however, are imprecise and prone to misclassification bias. Angiographic and post mortem studies have demonstrated little or no correlation of total fat mass and coronary atherosclerosis except in those with abdominal obesity. There is a strong association of obesity, particularly central obesity, and traditional risk factors for CHD such as hypertension, type II diabetes mellitus, and dyslipidemia. There may also be an association between obesity and several nontraditional risk factors such as hyperhomocystinemia, elevated Lp(a) levels and factors that increase thrombogenesis. Obesity may also alter endothelial function. Weight loss, although associated with favorable modification of multiple risk factors for CHD, has not been shown to independently and definitively reduce CHD risk.
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Affiliation(s)
- J K Alexander
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
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Srinivasan SR, Myers L, Berenson GS. Temporal association between obesity and hyperinsulinemia in children, adolescents, and young adults: the Bogalusa Heart Study. Metabolism 1999; 48:928-34. [PMID: 10421238 DOI: 10.1016/s0026-0495(99)90231-7] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Obesity is generally associated with hyperinsulinemia. However, whether obesity precedes or follows hyperinsulinemia is not clear. The present study examined the temporal nature of the association between obesity and hyperinsulinemia in a biracial (black-white) community-based population enrolled in the Bogalusa Heart Study. Three longitudinal cohorts of children (n = 427; baseline age, 5 to 7 years), adolescents (n = 674; baseline age, 12 to 14 years), and young adults (n = 396; baseline age, 20 to 24 years) were selected retrospectively, with a follow-up period of approximately 3 years. In general, longitudinal changes in the mean body mass index (kilograms per meter squared), an indicator of adiposity, and fasting insulin level did not parallel each other. In a bivariate analysis, baseline insulin levels correlated significantly with the follow-up body mass index in adolescents and adults, but not in children. On the other hand, the baseline body mass index correlated significantly with follow-up insulin levels in all cases. Logistic regression analysis showed that the proportion of subjects who developed obesity (body mass index > 75th percentile, specific for age, race, gender, and survey year) at follow-up study increased significantly across baseline quintiles (specific for age, race, gender, and survey year) of insulin only among adolescents, irrespective of race and gender. This relationship disappeared after adjusting for the baseline body mass index. By contrast, a significant positive trend between baseline quintiles of the body mass index and incidence of hyperinsulinemia (> 75th percentile) at follow-up study was noted among all age groups independent of race, gender, and baseline insulin levels. Further, in a multiple stepwise regression model, the best predictor of the follow-up insulin level was the baseline body mass index in children and adults and the baseline insulin in adolescents. The baseline body mass index was the best predictor of the follow-up body mass index in all three age groups. These results, by showing the temporal nature of the relation between obesity and hyperinsulinemia beginning in childhood, support the role of obesity in the development of hyperinsulinemia.
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Affiliation(s)
- S R Srinivasan
- Tulane Center for Cardiovascular Health and the Department of Biostatistics and Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
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