Efeitos de diferentes graus de sensibilidade a insulina na função endotelial de pacientes obesos

Galvão, Roberto; Plavnik, FL; Ribeiro, Fernando Flexa; Ajzen, Sérgio Aron; Christofalo, Dejaldo M. de J.; Kohlmann, Osvaldo

doi:10.1590/s0066-782x2011005000119

Cited by 11 publications

(12 citation statements)

References 29 publications

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“…Only a handful of previous studies have examined the relationship between insulin resistant status and endothelial function [19, 20]. In a cross-sectional study by Galvao et al.…”

Section: Discussionmentioning

confidence: 99%

“…In a cross-sectional study by Galvao et al. [19], obese non-diabetic subjects were divided into tertiles according to level of insulin resistance determined by HOMA-IR [19]. Results revealed a negative correlation between HOMA-IR scores and FMD [19].…”

Section: Discussionmentioning

confidence: 99%

“…[19], obese non-diabetic subjects were divided into tertiles according to level of insulin resistance determined by HOMA-IR [19]. Results revealed a negative correlation between HOMA-IR scores and FMD [19]. Specifically, subjects in the lowest tertile of HOMA-IR (mean 0.9) exhibited the highest FMD (+18%), while subjects in the highest tertile of HOMA-IR (mean 2.1) demonstrated the lowest FMD (9%) [19].…”

Section: Discussionmentioning

confidence: 99%

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Effects of different degrees of insulin resistance on endothelial function in obese adults undergoing alternate day fasting

Hoddy

Bhutani

Phillips

et al. 2016

NHA

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BACKGROUND: Obesity can have deleterious effects on insulin sensitivity leading to endothelial dysfunction. Whether alternate day fasting (ADF) can ameliorate insulin sensitivity in a way that improves endothelial function remains unknown.OBJECTIVE: This study examined the impact of ADF on endothelium dependent flow mediated dilation (FMD) in obese subjects with different degrees of insulin resistance.METHODS: Obese non-diabetic adults (n = 54) participated in an 8-week ADF protocol (25% energy intake “fast day”, alternated with ad libitum intake “feast day”). Subjects were divided into tertiles according to degree of insulin resistance based on HOMA-IR (Homeostatic model assessment-Insulin resistance): tertile 1 (0.8–2.4), tertile 2 (2.5–3.6), tertile 3 (3.7–12.4).RESULTS: Body weight decreased (P < 0.001) by 4% in each tertile. Fat mass, lean mass, and visceral fat mass also decreased (P < 0.001) similarly in each tertile. After 8 weeks of ADF, FMD and adiponectin differed (P < 0.05) between tertile 1 (3±0%; 26±23%) versus tertile 3 (–3±0%; –13±10%). Changes in leptin did not differ between tertiles (tertile 1: –23±7%; tertile 2: –20±7%; tertile 3: –9±7%). Fasting glucose did not change in any tertile. Fasting insulin and HOMA-IR differed (P < 0.05) between tertile 1 (10±11%; 11±11%) versus tertile 3 (–27±8%; –30±9%). Plasma lipids, blood pressure and heart rate did not change in any tertile.CONCLUSION: Our data suggest that ADF may be effective for decreasing insulin resistance in insulin resistant subjects, but these changes have no effect on endothelial function.

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“…Only a handful of previous studies have examined the relationship between insulin resistant status and endothelial function [19, 20]. In a cross-sectional study by Galvao et al.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of different degrees of insulin resistance on endothelial function in obese adults undergoing alternate day fasting

Hoddy

Bhutani

Phillips

et al. 2016

NHA

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“…De acordo com Galvão et al (2012), a hiperinsulinemia é o fator-chave na resistência à insulina entre pacientes normoglicêmicos e não-diabéticos, sendo considerada um fator de risco independente para doenças isquêmicas do coração. A resistência à insulina é um processo lento e gradual, que pode evoluir para intolerância à glicose e DM2.…”

Section: Resultsunclassified

Comparação Dos Índices Homa-Ir Na Avaliação Da Resistência Insulínica Em Adultos

Feitosa¹,

Brune²

2015

Arq. Ciênc. Saúde Unipar

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FEITOSA, A. M. O.; BRUNE, M. F. S. S. Comparação dos índices homa-ir na avaliação da resistência insulínica em adultos. Arq. Cienc. Saúde UNIPAR, Umuarama, v. 19, n. 2, p, 95-100, jan./abr. 2015 RESUMO: Este estudo tem como objetivo analisar a resistência à insulina em pacientes adultos usuários do Sistema Único de Saúde do município de Torixoréu-MT, comparando os índices HOMA1-IR e HOMA2-IR e também relacionando à glicemia e insulinemia em jejum dos pacientes. Para tanto, realizou-se um estudo epidemiológico, descritivo de corte transversal. Foi desenvolvido com base em dados oriundos de aplicação de questionário e exames clínicos laboratoriais, realizados no mês de Junho de 2014. Participaram 61 adultos, de ambos os gêneros, usuários do SUS no município de Torixoréu-MT. Os resultados evidenciaram a importância do exercício físico no controle da glicemia, mostrando que a hiperinsulinemia está associada ao excesso de peso. Além de mostrar o papel importante dos índices de HOMA1-IR e HOMA2-IR, que apesar de não se apresentarem de forma igual entre os grupos em estudo, possuíram boa correlação. Conclui-se que, ambos os índices garantem resultados que levam a detecção da resistência à insulina, que é um fator determinante para o DM2. PALAVRAS-CHAVE: Resistência à insulina; Glicemia; Diabetes mellitus. COMPARISON OF HOMA-IR INDEXES IN EVALUATING INSULIN RESISTANCE IN ADULTS ABSTRACT:This study aims to analyze insulin resistance in adult patients that use the Unified Health System in the city of Torixoréu-MT, comparing HOMA1-IR and HOMA2-IR indexes, as well as relating blood glucose and insulin levels in fasting patients. Therefore, an epidemiological study was developed using a cross-sectional description. It was developed based on data from a questionnaire and clinical laboratory tests performed in June 2014. A total of 61 adults from both genders participated in the survey. They are users of the SUS in the city of Torixoréu-MT. The results emphasize the importance of physical exercise on glycemic control, showing that hyperinsulinemia is associated with excessive weight. In addition to showing the important role of HOMA1-IR and HOMA2-IR indexes, although not equally present among the study groups, they presented good correlation. In conclusion, both indexes guarantee results that lead to the detection of insulin resistance, which is a key factor for T2DM.

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“…Other previous studies had suggested a relationship between endothelial function and insulin, HOMA-IR and triglycerides in obese subjects [20] but without establishing a clear causal relationship since the design of the study did not allow for comparing people with insulin-resistance versus people without insulin-resistance. Supporting our findings there is another study showing that IR and not BMI is the major determinant in the impairment of flow mediated dilation in morbid obese subjects [21].…”

Section: Discussionmentioning

confidence: 99%

Preserved endothelial function in human obesity in the absence of insulin resistance

et al. 2013

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BackgroundInsulin resistance (IR) is frequently associated with endothelial dysfunction and has been proposed to play a major role in cardiovascular disease (CVD). On the other hand, obesity has long been related to IR and increased CVD. However it is not known if IR is a necessary condition for endothelial dysfunction in human obesity, allowing for preserved endothelial function in obese people when absent. Therefore, the purpose of the study was to assess the relationship between IR and endothelial dysfunction in human obesity and the mechanisms involved.MethodsTwenty non-insulin resistant morbid obese (NIR-MO), 32 insulin resistant morbid obese (IR-MO), and 12 healthy subjects were included. Serum concentrations of glucose, insulin, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), resistin and adiponectin were determined. IR was evaluated by HOMA-index. Endothelium-dependent relaxation to bradykinin (BK) in mesenteric microvessels was assessed in wire myograph.ResultsSerum IL-6, and TNF-α levels were elevated only in IR-MO patients while resistin was elevated and adiponectin reduced in all MO individuals. Mesenteric arteries from IR-MO, but not from NIR-MO subjects displayed blunted relaxation to BK. Vasodilatation was improved in IR-MO arteries by the superoxide scavenger, superoxide dismutase (SOD) or the mitochondrial-targeted SOD mimetic, mito-TEMPO. NADPH oxidase inhibitors (apocynin and VAS2870) and the nitric oxide synthase (NOS) cofactor, tetrahydrobiopterin failed to modify BK-induced vasodilatations. Superoxide generation was higher in vessels from IR-MO subjects and reduced by mito-TEMPO. Blockade of TNF-α with infliximab, but not inhibition of inducible NOS or cyclooxygenase, improved endothelial relaxation and decreased superoxide formation.ConclusionsEndothelial dysfunction is observed in human morbid obesity only when insulin resistance is present. Mechanisms involved include augmented mitochondrial superoxide generation, and increased systemic inflammation mediated by TNF-α. These findings may explain the different vascular risk of healthy vs unhealthy obesity.

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Efeitos de diferentes graus de sensibilidade a insulina na função endotelial de pacientes obesos

Cited by 11 publications

References 29 publications

Effects of different degrees of insulin resistance on endothelial function in obese adults undergoing alternate day fasting

Effects of different degrees of insulin resistance on endothelial function in obese adults undergoing alternate day fasting

Comparação Dos Índices Homa-Ir Na Avaliação Da Resistência Insulínica Em Adultos

Preserved endothelial function in human obesity in the absence of insulin resistance

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