Relationship of obesity to adipose tissue insulin resistance

Jiang, Jiajia; Cai, Xueli; Pan, Yuesong; Du, Xiaoyan; Zhu, Huiping; Yang, Xinghua; Zheng, Deqiang; Gaisano, Herbert Y.; Wei, Tiemin; He, Yan

doi:10.1136/bmjdrc-2019-000741

Cited by 40 publications

(31 citation statements)

References 27 publications

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“…To assess the contribution of each risk factor to the residual risk of new stroke, attributable risk percent (ARP) (1) and population attributable risk percent (PARP) (2) were calculated as follows [ 21 ]:…”

Section: Methodsmentioning

confidence: 99%

Residual Risk and Its Risk Factors for Ischemic Stroke with Adherence to Guideline-Based Secondary Stroke Prevention

Pan

et al. 2021

J Stroke

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Background and Purpose Despite administration of evidence-based therapies, residual risk of stroke recurrence persists. This study aimed to evaluate the residual risk of recurrent stroke in acute ischemic stroke or transient ischemic attack (TIA) with adherence to guideline-based secondary stroke prevention and identify the risk factors of the residual risk.Methods Patients with acute ischemic stroke or TIA within 7 hours were enrolled from 169 hospitals in Third China National Stroke Registry (CNSR-III) in China. Adherence to guideline-based secondary stroke prevention was defined as persistently receiving all of the five secondary prevention medications (antithrombotic, antidiabetic and antihypertensive agents, statin and anticoagulants) during hospitalization, at discharge, at 3, 6, and 12 months if eligible. The primary outcome was a new stroke at 12 months.Results Among 9,022 included patients (median age 63.0 years and 31.7% female), 3,146 (34.9%) were identified as adherence to guideline-based secondary prevention. Of all, 864 (9.6%) patients had recurrent stroke at 12 months, and the residual risk in patients with adherence to guidelinebased secondary prevention was 8.3%. Compared with those without adherence, patients with adherence to guideline-based secondary prevention had lower rate of recurrent stroke (hazard ratio, 0.85; 95% confidence interval, 0.74 to 0.99; P=0.04) at 12 months. Female, history of stroke, interleukin-6 ≥5.63 ng/L, and relevant intracranial artery stenosis were independent risk factors of the residual risk.Conclusions There was still a substantial residual risk of 12-month recurrent stroke even in patients with persistent adherence to guideline-based secondary stroke prevention. Future research should focus on efforts to reduce the residual risk.

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Section: Methodsmentioning

confidence: 99%

Residual Risk and Its Risk Factors for Ischemic Stroke with Adherence to Guideline-Based Secondary Stroke Prevention

Pan

et al. 2021

J Stroke

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“…Adiposity, particularly abnormal fat accumulation, is a key MetS-causing factor since it has a strong influence on insulin sensitivity and β-cell function and thereby increases the risks of CVD and T2D [ 7 , 8 ]. It was found that abdominal obesity accounted for approximately two-thirds of the strongest factors contributing to adipose tissue-derived insulin resistance (IR) in both men and women [ 9 ]. Since IR will lead to a gradual progression from hyperinsulinemia to glucose intolerance and eventually, T2D [ 10 ], the early detection of MetS risks (including IR) is important for the prevention of chronic metabolic diseases [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…It was found that abdominal obesity accounted for approximately two-thirds of the strongest factors contributing to adipose tissue-derived insulin resistance (IR) in both men and women [ 9 ]. Since IR will lead to a gradual progression from hyperinsulinemia to glucose intolerance and eventually, T2D [ 10 ], the early detection of MetS risks (including IR) is important for the prevention of chronic metabolic diseases [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Circulating GLP-1 Levels as a Potential Indicator of Metabolic Syndrome Risk in Adult Women

et al. 2021

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Glucagon-like peptide-1 (GLP-1), an incretin hormone, plays an important role in regulating glucose homeostasis. In this study, the applicability of circulating GLP-1 levels as an early indicator of metabolic syndrome (MetS) risk was examined. Women without diagnosed diseases were grouped according to their number of MetS risk factors (MetS RFs) (no RFs as Super-healthy, n = 61; one or two RFs as MetS risk carriers, n = 60; 3 ≤ RFs as MetS, n = 19). The circulating GLP-1 levels and homeostasis model assessment insulin resistance (HOMA-IR) scores were significantly higher in the MetS group than in the other two groups. The GLP-1 levels correlated positively with adiposity, HOMA-IR, blood pressure, and high sensitivity C-reactive protein (hs-CRP), but not with fasting glucose and lipid profiles, whose significances were maintained after adjustments for age, smoking and drinking habits, menopausal status, and total calorie intake. The GLP-1 levels also increased proportionally with the number of MetS RFs. In the MetS group, the GLP-1 levels were much higher in individuals with obesity (body mass index ≥ 25 kg/m2). In conclusion, the circulating GLP-1 level may be applicable as a potential early indicator of MetS risk in women without diagnosed diseases. Further study with a large population is needed to confirm the conclusion.

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“…Although the exact etiology of the MetS is not clearly understood, insulin resistance (IR) is considered as the principal factor for the pathogenesis of this syndrome [ 6 , 11 , 18 , 45 ]. As found by the insulin-modified, frequently sampled intravenous glucose tolerance assay, insulin sensitivity is significantly lower in patients with two or more components of the MetS compared to those with none of these components [ 2 ].…”

Section: Metabolic Syndrome: Definitions and Criteriamentioning

confidence: 99%

Lipid-Induced Mechanisms of Metabolic Syndrome

et al. 2020

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Metabolic syndrome (MetS) has a worldwide tendency to increase and depends on many components, which explains the complexity of diagnosis, approaches to the prevention, and treatment of this pathology. Insulin resistance (IR) is the crucial cause of the MetS pathogenesis, which develops against the background of abdominal obesity. In light of recent evidence, it has been shown that lipids, especially fatty acids (FAs), are important signaling molecules that regulate the signaling pathways of insulin and inflammatory mediators. On the one hand, the lack of n-3 polyunsaturated fatty acids (PUFAs) in the body leads to impaired molecular mechanisms of glucose transport, the formation of unresolved inflammation. On the other hand, excessive formation of free fatty acids (FFAs) underlies the development of oxidative stress and mitochondrial dysfunction in MetS. Understanding the molecular mechanisms of the participation of FAs and their metabolites in the pathogenesis of MetS will contribute to the development of new diagnostic methods and targeted therapy for this disease. The purpose of this review is to highlight recent advances in the study of the effect of fatty acids as modulators of insulin response and inflammatory process in the pathogenesis and treatment for MetS.

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Relationship of obesity to adipose tissue insulin resistance

Cited by 40 publications

References 27 publications

Residual Risk and Its Risk Factors for Ischemic Stroke with Adherence to Guideline-Based Secondary Stroke Prevention

Residual Risk and Its Risk Factors for Ischemic Stroke with Adherence to Guideline-Based Secondary Stroke Prevention

Circulating GLP-1 Levels as a Potential Indicator of Metabolic Syndrome Risk in Adult Women

Lipid-Induced Mechanisms of Metabolic Syndrome

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