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Halama A, Suleiman NN, Kulinski M, Bettahi I, Hassoun S, Alkasem M, Abdalhakam I, Iskandarani A, Samra TA, Atkin SL, Suhre K, Abou-Samra AB. The metabolic footprint of compromised insulin sensitivity under fasting and hyperinsulinemic-euglycemic clamp conditions in an Arab population. Sci Rep 2020; 10:17164. [PMID: 33051490 PMCID: PMC7555540 DOI: 10.1038/s41598-020-73723-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 09/15/2020] [Indexed: 11/29/2022] Open
Abstract
Metabolic pathways that are corrupted at early stages of insulin resistance (IR) remain elusive. This study investigates changes in body metabolism in clinically healthy and otherwise asymptomatic subjects that may become apparent already under compromised insulin sensitivity (IS) and prior to IR. 47 clinically healthy Arab male subjects with a broad range of IS, determined by hyperinsulinemic-euglycemic clamp (HIEC), were investigated. Untargeted metabolomics and complex lipidomics were conducted on serum samples collected under fasting and HIEC conditions. Linear models were used to identify associations between metabolites concentrations and IS levels. Among 1896 identified metabolites, 551 showed significant differences between fasting and HIEC, reflecting the metabolic switch in energy utilization. At fasting, 336 metabolites, predominantly di- and tri-acylglycerols, showed significant differences between subjects with low and high levels of IS. Changes in amino acid, carbohydrate and fatty acid metabolism in response to insulin were impaired in subjects with low IS. Association of altered mannose and amino acids with IS was also replicated in an independent cohort of T2D patients. We identified metabolic phenotypes that characterize clinically healthy Arab subjects with low levels of IS at their fasting state. Our study is providing further insights into the metabolic pathways that precede IR.
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Affiliation(s)
- Anna Halama
- Department of Physiology and Biophysics, Weill Cornell Medicine-Qatar, Doha, Qatar.
| | - Noor N Suleiman
- Department of Internal Medicine, Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | - Michal Kulinski
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Ilham Bettahi
- Department of Internal Medicine, Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar.,Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Shaimaa Hassoun
- Department of Internal Medicine, Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | - Meis Alkasem
- Department of Internal Medicine, Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar.,Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Ibrahem Abdalhakam
- Department of Internal Medicine, Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | - Ahmad Iskandarani
- Department of Internal Medicine, Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar.,Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Tareq A Samra
- Department of Internal Medicine, Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar.,Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Stephen L Atkin
- Weill Cornell Medicine-Qatar, Doha, Qatar.,Royal College of Surgeons in Ireland, Busaiteen, Bahrain
| | - Karsten Suhre
- Department of Physiology and Biophysics, Weill Cornell Medicine-Qatar, Doha, Qatar.
| | - Abdul Badi Abou-Samra
- Department of Internal Medicine, Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar. .,Weill Cornell Medicine-Qatar, Doha, Qatar.
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Ibrahim WH, Suleiman NN, El-Allus F, Suleiman J, Elbuzidi AA, Guerrero MD, Guerrero AN, Akkari A, Karim H, Awouda SA, Suliman S. The burden of adult asthma in a high GDP per capita country: the QASMA study. Ann Allergy Asthma Immunol 2014; 114:12-7. [PMID: 25240334 DOI: 10.1016/j.anai.2014.08.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 08/18/2014] [Accepted: 08/20/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Asthma is a major health problem worldwide. Suboptimal asthma care and poor asthma control are common even in developed countries. Qatar has the highest gross domestic product per capita in the world and high per capita health expenditure. No prior study has assessed the burden of adult asthma in this country. OBJECTIVES To assess asthma control, patients' level of education about asthma, and level of asthma care in a country with the highest gross domestic product per capita in the world. METHODS A face-to-face, cross-sectional study of 520 adults with physician-diagnosed asthma conducted in various health care facilities in Qatar. RESULTS Thirty-three percent, 41%, and 26% of patients had uncontrolled, controlled, and partly controlled asthma, respectively. Only 4.9% of patients had previously received a written asthma management plan, 3.5% had a flow meter at home, and 37.2% had a spirometry performed in the previous 5 years. In addition, 42.9% misunderstood the role of reliever and controller medications. Inhaler technique was incorrect in 47% of these patients. There was a significant association between the type of physician practice and level of asthma control, with worst control being at the general practice level. Moreover, 57.3% of patients had at least 1 asthma-related visit to the emergency department in 1 year and 18.7% had more than 3 visits. CONCLUSION The very high gross domestic product per capita in Qatar and the high health expenditure per capita do not seem to have led to better asthma care and control. A comprehensive national asthma service improvement program is much needed.
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Affiliation(s)
- Wanis H Ibrahim
- Department of Medicine, Pulmonary Section, Hamad General Hospital and Weill-Cornell Medical College, Doha, Qatar.
| | | | - Fathi El-Allus
- Department of Medicine, Hamad General Hospital, Doha, Qatar
| | - Jamal Suleiman
- Department of Public Health, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Aldwin N Guerrero
- Department of Emergency Medicine, Hamad General Hospital, Doha, Qatar
| | | | - Hanfa Karim
- Department of Medicine, Hamad General Hospital, Doha, Qatar
| | - Samah A Awouda
- Department of Medicine, Hamad General Hospital, Doha, Qatar
| | - Salma Suliman
- Department of Medicine, Hamad General Hospital, Doha, Qatar
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