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Su GY, Ning NX, Lin KH, Hwu CM. Low-Density Lipoprotein Cholesterol Is Not a Major Determinant of High-Sensitivity C-Reactive Protein Levels in People Without Known Diabetes Mellitus. Metab Syndr Relat Disord 2023; 21:567-572. [PMID: 37768731 DOI: 10.1089/met.2023.0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
Abstract
Background: It has been well established that high-sensitivity C-reactive protein (hs-CRP) is strongly associated with obesity, insulin resistance, high blood pressure, and dyslipidemia. However, the effects of different lipid parameters on hs-CRP levels are less deliberated. The purpose of the study was to compare the relative contribution of triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) to the levels of hs-CRP. Methods: Three hundred seventy-eight subjects without known history of diabetes were recruited for the study. No concomitant antilipid or antidiabetes agents were allowed. Each subject received anthropometric measurements, fasting sampling for lipid profile and hs-CRP, and a 75-gram oral glucose tolerance test for the measurements of insulin resistance (surrogated by insulin sensitivity index ISI0,120). Results: Levels of hs-CRP levels were positively correlated with Log (TG) and negatively correlated with HDL-C in partial correlation after adjustments for confounding variables, but not with LDL-C. The hs-CRP levels in the three groups by tertiles of LDL-C were similar. Subsequently, we found that body mass index (first step), Log (ISI0,120) (second step), and Log (TG) (third step) independently predicted the variance of Log (hs-CRP) in stepwise multiple regression. However, both HDL-C and LDL-C failed to be entered into the models to explain Log (hs-CRP). Conclusions: Our data demonstrated that Log (TG) was a major lipid determinant of hs-CRP levels. The contribution of LDL-C to the levels of hs-CRP might be insignificant.
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Affiliation(s)
- Guan-Yu Su
- Section of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ng Xin Ning
- Division of Endocrinology and Metabolism, Buddhist Tzu Chi Medical Foundation Dalin Tzu Chi Hospital, Chiayi, Taiwan
| | - Kuan-Hung Lin
- Department of Internal Medicine, National Yang-Ming University Hospital, Yilan, Taiwan
| | - Chii-Min Hwu
- Section of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Internal Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Louca P, Berry SE, Bermingham K, Franks PW, Wolf J, Spector TD, Valdes AM, Chowienczyk P, Menni C. Postprandial Responses to a Standardised Meal in Hypertension: The Mediatory Role of Visceral Fat Mass. Nutrients 2022; 14:nu14214499. [PMID: 36364763 PMCID: PMC9655022 DOI: 10.3390/nu14214499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Postprandial insulinaemia, triglyceridaemia and measures of inflammation are thought to be more closely associated with cardiovascular risk than fasting measures. Although hypertension is associated with altered fasting metabolism, it is unknown as to what extent postprandial lipaemic and inflammatory metabolic responses differ between hypertensive and normotensive individuals. Linear models adjusting for age, sex, body mass index (BMI), visceral fat mass (VFM) and multiple testing (false discovery rate), were used to investigate whether hypertensive cases and normotensive controls had different fasting and postprandial (in response to two standardised test meal challenges) lipaemic, glycaemic, insulinaemic, and inflammatory (glycoprotein acetylation (GlycA)) responses in 989 participants from the ZOE PREDICT-1 nutritional intervention study. Compared to normotensive controls, hypertensive individuals had significantly higher fasting and postprandial insulin, triglycerides, and markers of inflammation after adjusting for age, sex, and BMI (effect size: Beta (Standard Error) ranging from 0.17 (0.08), p = 0.04 for peak insulin to 0.29 (0.08), p = 4.4 × 10-4 for peak GlycA). No difference was seen for postprandial glucose. When further adjusting for VFM effects were attenuated. Causal mediation analysis suggests that 36% of the variance in postprandial insulin response and 33.8% of variance in postprandial triglyceride response were mediated by VFM. Hypertensive individuals have different postprandial insulinaemic and lipaemic responses compared to normotensive controls and this is partially mediated by visceral fat mass. Consequently, reducing VFM should be a key focus of health interventions in hypertension. Trial registration: The ClinicalTrials.gov registration identifier is NCT03479866.
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Affiliation(s)
- Panayiotis Louca
- Department of Twin Research, King’s College London, St Thomas’ Hospital Campus, London SE1 7EH, UK
| | - Sarah E. Berry
- Department of Nutritional Sciences, King’s College London, Franklin Wilkins Building, London SE1 9NH, UK
| | - Kate Bermingham
- Department of Twin Research, King’s College London, St Thomas’ Hospital Campus, London SE1 7EH, UK
- Department of Nutritional Sciences, King’s College London, Franklin Wilkins Building, London SE1 9NH, UK
| | - Paul W. Franks
- Genetic & Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, SE-20502 Malmo, Sweden
| | | | - Tim D. Spector
- Department of Twin Research, King’s College London, St Thomas’ Hospital Campus, London SE1 7EH, UK
| | - Ana M. Valdes
- Nottingham NIHR Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK
| | - Phil Chowienczyk
- Vascular Risk & Surgery, King’s College London, St Thomas’ Hospital Campus, London SE1 7EH, UK
| | - Cristina Menni
- Department of Nutritional Sciences, King’s College London, Franklin Wilkins Building, London SE1 9NH, UK
- Correspondence: ; Tel.: +44-(0)-207-188-7188 (ext. 52594)
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Ekun OA, Oyekunle AO, Igbadumhe CO. Evaluation of peroxisome proliferator-activated receptor-gamma (Ppar-γ) and metabolic dysfunction among hypertensive nigerians. Endocrine and Metabolic Science 2021. [DOI: 10.1016/j.endmts.2021.100108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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Raz O, Steinvil A, Berliner S, Rosenzweig T, Justo D, Shapira I. The effect of two iso-caloric meals containing equal amounts of fats with a different fat composition on the inflammatory and metabolic markers in apparently healthy volunteers. J Inflamm (Lond) 2013; 10:3. [PMID: 23369030 PMCID: PMC3599567 DOI: 10.1186/1476-9255-10-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2012] [Accepted: 01/25/2013] [Indexed: 12/16/2022]
Abstract
Background Little is known about the time-course of the postprandial appearance of macronutrient-induced inflammatory response. Our aim was to investigate the postprandial inflammatory and metabolic response following high fat, high caloric popular meals in apparently healthy participants. Methods Fifty four apparently healthy normal weight volunteers (BMI of 25.9±0.9) were given two iso-caloric meals with similar amounts but different composition of fats: a meal high in monounsaturated fats (MUFA), and a meal high in saturated fat (SFA). Three main effects and the interactions between them were analyzed: the time (before and 2 and 4 hours following the meals), the meal (MUFA or SFA) and the gender. Results The effect of time from the meal on hs-CRP level was highly significant (p=0.004). The highest responses were observed 2 hours after the meal (p=0.002). A statistically significant interaction was found between the time and the meal (p≤0.0001), which reflects the higher increase in hs-CRP values 2 hours after the SFA meal, with no effect by the MUFA meal. The white blood cell counts were affected significantly by the time (p≤0.0001) however, other inflammatory markers (fibrinogen, IL-6, TNFα, ICAM and VICAM) were not. All the metabolic markers (insulin, glucose, HOMA-R, QUICKI and triglycerides) were affected by the time (p≤0.0001), with no interactions observed. Conclusions Metabolic and modest inflammatory changes occur within a few hours after the ingestion of a high SFA meal in apparently healthy adults.
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Affiliation(s)
- Olga Raz
- The Departments of Diet and Nutrition, The Tel-Aviv Sourasky Medical Center, 6 Weizman St, Tel Aviv, Israel.
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Abstract
BACKGROUND Prehypertension, a new category of blood pressure (BP) classification introduced by The Seven Report of the Joint National Commission (JNC-7) on High BP for individuals with systolic BP in the range of 120-139 mmHg or diastolic BP between 80 and 89 mmHg, is a strong predictor for the development of hypertension. Insulin resistance (IR) has been proposed to be a key feature of metabolic abnormalities of hypertension and may precede the elevation of BP. AIM The purpose of the study is to evaluate whether prehypertension is associated with IR. DESIGN This is a cross-sectional study. METHODS Anthropometric and BP measurements were performed in 83 prehypertensive subjects and 192 normotensives. All subjects received a 75-g oral glucose tolerance test (OGTT) for the measurements of IR. RESULTS The prehypertensive subjects were more obese and had higher levels of fasting triglycerides and 2-h insulin than the normotensives. The subjects with prehypertension were more insulin resistant than the counterparts, indicated by lower insulin sensitivity index, ISI(0,120), values. While there was no difference between the two groups in insulin response of OGTT after adjustments for confounders, the prehypertension group maintained significant between-group differences in glucose response even when the incremental insulin levels were added to covariates for adjustments. DISCUSSION Our data show that prehypertension is associated with IR. The subjects with prehypertension have clinical characteristics of the IR syndrome. It seems that the prehypertension group cannot handle oral glucose challenge as well as the normotension, probably a consequence of IR in prehypertension.
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Affiliation(s)
- C-M Hwu
- Section of Endocrinology and Metabolism, Taipei Veterans General Hospital, Taipei 112, Taiwan.
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Dekker MJ, Wright AJ, Mazurak VC, Marangoni AG, Rush JW, Graham TE, Robinson LE. Fasting triacylglycerol status, but not polyunsaturated/saturated fatty acid ratio, influences the postprandial response to a series of oral fat tolerance tests. J Nutr Biochem 2009; 20:694-704. [DOI: 10.1016/j.jnutbio.2008.06.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Revised: 06/10/2008] [Accepted: 06/17/2008] [Indexed: 12/28/2022]
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Chen P, Jou YS, Fann CSJ, Chen JW, Chung CM, Lin CY, Wu SY, Kang MJ, Chen YC, Jong YS, Lo HM, Kang CS, Chen CC, Chang HC, Huang NK, Wu YL, Pan WH. Lipoprotein lipase variants associated with an endophenotype of hypertension: hypertension combined with elevated triglycerides. Hum Mutat 2009; 30:49-55. [PMID: 18649389 DOI: 10.1002/humu.20812] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Previously, we observed that young-onset hypertension was independently associated with elevated plasma triglyceride(s) (TG) levels to a greater extent than other metabolic risk factors. Thus, focusing on the endophenotype--hypertension combined with elevated TG--we designed a family-based haplotype association study to explore its genetic connection with novel genetic variants of lipoprotein lipase gene (LPL), which encodes a major lipid metabolizing enzyme. Young-onset hypertension probands and their families were recruited, numbering 1,002 individuals from 345 families. Single-nucleotide polymorphism discovery for LPL, linkage disequilibrium (LD) analysis, transmission disequilibrium tests (TDT), bin construction, haplotype TDT association and logistic regression analysis were performed. We found that the CC- haplotype (i) spanning from intron 2 to intron 4 and the ACATT haplotype (ii) spanning from intron 5 to intron 6 were significantly associated with hypertension-related phenotypes: hypertension (ii, P=0.05), elevated TG (i, P=0.01), and hypertension combined with elevated TG (i, P=0.001; ii, P<0.0001), according to TDT. The risk of this hypertension subtype increased with the number of risk haplotypes in the two loci, using logistic regression model after adjusting within-family correlation. The relationships between LPL variants and hypertension-related disorders were also confirmed by an independent association study. Finally, we showed a trend that individuals with homozygous risk haplotypes had decreased LPL expression after a fatty meal, as opposed to those with protective haplotypes. In conclusion, this study strongly suggests that two LPL intronic variants may be associated with development of the hypertension endophenotype with elevated TG.
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Affiliation(s)
- Pei Chen
- Institute of Biomedical Sciences, Academia Sinica, Nankang, Taipei, Taiwan, R.O.C
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Abstract
BACKGROUND The contribution of triglycerides (TG) to the extent of coronary artery disease (CAD) in hypertensive patients remained unclear. METHODS Consecutive 821 (aged 64.5+/-11.5 years, 482 males) hypertensive patients undergoing coronary angiography were included. The relationship of TG levels (<150 vs. > or =150 mg/dl) to the extent of CAD in all patients was examined by multiple logistic regression, adjusting for other CAD risk factors. In the lipid group, low levels of HDL were also adjusted. RESULTS Higher levels of TG were found in subjects with severe CAD compared to those with no or minimal CAD. The adjusted odds ratios for high levels of TG in the severe CAD subgroup versus the no or minimal CAD subgroup were 5.20 (95% CI, 3.13 to 8.63) in all patients and 7.51 (95% CI, 3.19 to 17.65) in the lipid group. CONCLUSIONS High levels of TG are strong clinical markers of greater extent of CAD in hypertensive subjects undergoing coronary angiography. The results may have clinical relevance for physicians in therapeutic decision making.
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Affiliation(s)
- Chun-Yen Chen
- Cardiovascular Division, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
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Hwu CM, Lin MW, Liou TL, Hsiao LC, Liang KW, Tsai TT, Ho LT. Fasting triglyceride is a major determinant of postprandial triglyceride response in postmenopausal women. Menopause 2008; 15:150-6. [PMID: 17549035 DOI: 10.1097/gme.0b013e31800577856] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of the study was to examine the relative influences of fasting lipids, insulin resistance, and waist circumference (WC) on postprandial lipemia in postmenopausal women. DESIGN Forty-nine naturally postmenopausal women were recruited for the study. Each woman underwent a 75-g oral glucose tolerance test to measure insulin resistance and a 1,000-kcal high-fat mixed meal test for postprandial triglyceride (TG) response. RESULTS The participants were divided into three groups by tertiles of incremental TG response in the mixed meal test. The three groups were comparable in weight, WC, and fasting high-density lipoprotein cholesterol (HDL-C) levels. There were significant differences in fasting TG and non-HDL-C concentrations among the three groups. The women in the high-tertile group were more insulin resistant than those in the low-tertile group, indicated by higher homeostasis model assessment for insulin resistance (HOMA-IR) values. The postprandial TG response was significantly correlated with Log(fasting TG), fasting non-HDL-C and Log(HOMA-IR), but not with WC, in univariate regression analyses. Log(fasting TG) was the only variable that remained significantly related to incremental TG response when all the above were entered into multiple regression models. Subsequently, we found that Log(HOMA-IR) and fasting non-HDL-C independently predicted the variance of Log(fasting TG) in stepwise multiple regression. CONCLUSIONS Our data demonstrated that the fasting TG level is a major determinant of postprandial TG response in postmenopausal women. Insulin resistance and non-HDL-C may contribute independently to the fasting TG level. The influences of WC on postprandial lipemia seemed to be insignificant.
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Affiliation(s)
- Chii-Min Hwu
- Section of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
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Abstract
BACKGROUND Hyperuricemia is commonly associated with obesity, glucose intolerance, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. The resemblance of the metabolic syndrome and hyperuricemia has led to the suggestion that hyperuricemia is a part of the metabolic syndrome. The purpose of this study is to examine the contribution of uric acid (UA) as an additional component of the metabolic syndrome in middle-aged men. METHODS In total, 393 male participants, aged 45-60 years, were recruited from a professional health evaluation program. Anthropometric measurements and blood pressure (BP) were taken after an overnight fast. Fasting blood samples were collected for the measurements of glucose, UA, and lipid profile. Logistic regression models were fitted to examine the relationship between UA and the diagnosis of metabolic syndrome. Factor analysis was performed to explore the relationship between UA and the components of the metabolic syndrome. RESULTS The diagnosis of the metabolic syndrome was significantly associated with waist circumference (WC), glucose, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), systolic BP, and liver enzyme levels, but not associated with UA levels. The sensitivity of hyperuricemia (serum UA > or = 7.0 mg/dL) for the diagnosis of the metabolic syndrome was 58.0% and the specificity was 55.3%. In factor analysis, UA aggregated with body mass index, WC, glucose, log TG, and HDL-C as a metabolic factor. Systolic and diastolic BP were loaded on a second factor separately. The model loaded with UA explained a similar proportion of the total variance (56.9%), as did the model loaded without UA (62.5%). CONCLUSION Our results suggest that the contribution of UA as an additional component of the syndrome seems to be insignificant. We propose that hyperuricemia might not be an important facet for the understanding of the underlying structure of the metabolic syndrome.
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Affiliation(s)
- Teh-Ling Liou
- Section of General Medicine, Department of Medicine, Taipei Veterans General Hospital, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC
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Oakes ND, Thalén P, Hultstrand T, Jacinto S, Camejo G, Wallin B, Ljung B. Tesaglitazar, a dual PPARα/γ agonist, ameliorates glucose and lipid intolerance in obese Zucker rats. Am J Physiol Regul Integr Comp Physiol 2005; 289:R938-46. [PMID: 16183630 DOI: 10.1152/ajpregu.00252.2005] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Insulin resistance, impaired glucose tolerance, high circulating levels of free fatty acids (FFA), and postprandial hyperlipidemia are associated with the metabolic syndrome, which has been linked to increased risk of cardiovascular disease. We studied the metabolic responses to an oral glucose/triglyceride (TG) (1.7/2.0 g/kg lean body mass) load in three groups of conscious 7-h fasted Zucker rats: lean healthy controls, obese insulin-resistant/dyslipidemic controls, and obese rats treated with the dual peroxisome proliferator-activated receptor α/γ agonist, tesaglitazar, 3 μmol·kg−1·day−1for 4 wk. Untreated obese Zucker rats displayed marked insulin resistance, as well as glucose and lipid intolerance in response to the glucose/TG load. The 2-h postload area under the curve values were greater for glucose (+19%), insulin (+849%), FFA (+53%), and TG (+413%) compared with untreated lean controls. Treatment with tesaglitazar lowered fasting plasma glucose, improved glucose tolerance, substantially reduced fasting and postload insulin levels, and markedly lowered fasting TG and improved lipid tolerance. Fasting FFA were not affected, but postprandial FFA suppression was restored to levels seen in lean controls. Mechanisms of tesaglitazar-induced lowering of plasma TG were studied separately using the Triton WR1339 method. In anesthetized, 5-h fasted, obese Zucker rats, tesaglitazar reduced hepatic TG secretion by 47%, increased plasma TG clearance by 490%, and reduced very low-density lipoprotein (VLDL) apolipoprotein CIII content by 86%, compared with obese controls. In conclusion, the glucose/lipid tolerance test in obese Zucker rats appears to be a useful model of the metabolic syndrome that can be used to evaluate therapeutic effects on impaired postprandial glucose and lipid metabolism. The present work demonstrates that tesaglitazar ameliorates these abnormalities and enhances insulin sensitivity in this animal model.
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Abstract
AIM To compare the insulin sensitivity indices between Chinese vegetarians and omnivores. METHODS The study included 36 healthy volunteers (vegetarian, n=19; omnivore, n=17) who had normal fasting plasma glucose levels. Each participant completed an insulin suppression test. We compared steady-state plasma glucose (SSPG), fasting insulin, the homeostasis model assessment for insulin sensitivity (HOMA-IR and HOMA %S) and beta-cell function (HOMA %beta) between the groups. We also tested the correlation of SSPG with years on a vegetarian diet. RESULTS The omnivore subjects were younger than the vegetarians (55.7+/-3.7 vs 58.6+/-3.6 year of age, P=0.022). There was no difference between the two groups in sex, blood pressure, renal function tests and lipid profiles. The omnivores had higher serum uric acid levels than vegetarians (5.25+/-0.84 vs 4.54+/-0.75 mg/dl, P=0.011). The results of the indices were different between omnivores and vegetarians (SSPG (mean+/-s.d.) 105.4+/-10.2 vs 80.3+/-11.3 mg/dl, P<0.001; fasting insulin, 4.06+/-0.77 vs 3.02+/-1.19 microU/ml, P=0.004; HOMA-IR, 6.75+/-1.31 vs 4.78+/-2.07, P=0.002; HOMA %S, 159.2+/-31.7 vs 264.3+/-171.7%, P=0.018) except insulin secretion index, HOMA %beta (65.6+/-18.0 vs 58.6+/-14.8%, P=0.208). We found a clear linear relation between years on a vegetarian diet and SSPG (r=-0.541, P=0.017). CONCLUSIONS The vegetarians were more insulin sensitive than the omnivore counterparts. The degree of insulin sensitivity appeared to be correlated with years on a vegetarian diet.
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Affiliation(s)
- C-S Kuo
- Division of Endocrinology and Metabolism, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital and School of Medicine, Chia-Yi, Taiwan
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