Sagittal abdominal diameter (SAD) has been proposed as a surrogate marker of insulin resistance (IR). However, the utilization of SAD requires specific validation for each ethnicity. We aimed to ...investigate the potential use of SAD, compared with classical anthropometrical parameters, as a surrogate marker of IR and to establish the cutoff values of SAD for screening for IR.
A multicenter population survey on metabolic disorders was conducted. A race-admixtured sample of 824 adult women was assessed. The anthropometric parameters included: BMI, waist circumference (WC), waist-to-hip ratio and SAD. IR was determined by a hyperglycemic clamp and the HOMA-IR index.
After adjustments for age and total body fat mass, SAD (r = 0.23 and r = -0.70) and BMI (r = 0.20 and r = -0.71) were strongly correlated with the IR measured by the HOMA-IR index and the clamp, respectively (p < 0.001). In the ROC analysis, the optimal cutoff for SAD in women was 21.0 cm. The women with an increased SAD presented 3.2 (CI 95%: 2.1-5.0) more likelihood of having IR, assessed by the HOMA-IR index compared with those with normal SAD (p < 0.001); whereas women with elevated BMI and WC were 2.1 (95% CI: 1.4-3.3) and 2.8 (95% CI: 1.7-4.5) more likely to have IR (p < 0.001), respectively. No statistically significant results were found for waist-to-hip ratio.
SAD can be a suitable surrogate marker of IR. Understanding and applying routine and simplified methods is essential because IR is associated with an increased risk of obesity-related diseases even in the presence of normal weight, slight overweight, as well as in obesity. Further prospective analysis will need to verify SAD as a determinant of clinical outcomes, such as type 2 diabetes and cardiovascular events, in the Brazilian population.
•The energy-adjusted dietary inflammatory index was associated with markers of insulin resistance, inflammation, and body adiposity.•The energy-adjusted dietary inflammatory index was inversely ...correlated with the abundance of the Eubacterium.xylanophilum.group.•The energy-adjusted dietary inflammatory index was directly correlated with the abundance of Actinomyces.•Actinomyces were significantly more abundant in the highest (most proinflammatory) energy-adjusted dietary inflammatory index quartile.•Actinomyces could be involved in the association between the dietary inflammatory index with visceral adiposity.
To deepen the understanding of the influence of diet on weight gain and metabolic disturbances, we examined associations between diet-related inflammation and body composition and fecal bacteria abundances in participants of the Nutritionists’ Health Study.
Early-life, dietary and clinical data were obtained from 114 women aged ≤45 years. A validated food frequency questionnaire was used to calculate the energy-adjusted dietary inflammatory index (E-DII). Participants’ data were compared by E-DII quartiles using ANOVA or Kruskal-Wallis. Associations of DXA-determined body composition with the E-DII were tested by multiple linear regression using DAG-oriented adjustments. Fecal microbiota was analyzed targeting the V4 region of the 16S rRNA gene. Spearman correlation coefficients were used to test linear associations; differential abundance of genera across the E-DII quartiles was assessed by pair-wise comparisons.
E-DII score was associated with total fat (b=1.80, p<0.001), FMI (b=0.08, p<0.001) and visceral fat (b=1.19, p=0.02), independently of maternal BMI, birth type and breastfeeding. E-DII score was directly correlated to HOMA-IR (r=0.30; p=0.004), C-reactive protein (r=0.29; p=0.003) and to the abundance of Actinomyces, and inversely correlated to the abundance of Eubacterium.xylanophilum.group. Actinomyces were significantly more abundant in the highest (most proinflammatory) E-DII quartile.
Association of E-DII with markers of insulin resistance, inflammation, body adiposity and certain gut bacteria are consistent with beneficial effects of anti-inflammatory diet on body composition and metabolic profile. Bacterial markers, such as Actinomyces, could be involved in the association between the dietary inflammation with visceral adiposity. Studies designed to explore how a pro-inflammatory diet affects both central fat deposition and gut microbiota are needed.
Early-life events are associated with the risk of obesity and comorbidities later in life. The gut microbiota-whose composition is influenced by genetics and environmental factors-could be involved. ...Since the microbiota affects metabolism and fat storage, early-life insults could contribute to the occurrence of obesity driven, in part, by microbiota composition. We examined associations of gut bacteria with early-life events, nutritional status, and body composition in the Nutritionist's Health Study (NutriHS).
A cross-sectional study of 114 female participants examining early-life data, body composition, and biological samples was conducted. Fecal microbiota structure was determined targeting the V4 region of the 16S rRNA gene. Principal coordinates analysis (PCoA) and permutational multivariate analysis of variance (PERMANOVA) were used to test the impact of variables on microbial diversity. Profiles were identified using the Jensen-Shannon divergence matrix and Calinski-Harabasz index. Differential abundance between the categories of exclusive breastfeeding duration and nutritional status was tested using DESeq2.
In the sample median age 28 years and body mass index (BMI) 24.5 kg/m
, 2 microbiota profiles driven by the
or
genus were identified. An estimated 9.1% of the variation was explained by the profiles (p < 0.001), 2.1% by nutritional status (p = 0.004), and 1.8% by exclusive breastfeeding (p = 0.012). The proportion of participants with BMI <25 kg/m
and who were breastfed for at least 6 months was higher in the
profile (p < 0.05).
Findings in a
-driven profile of healthy women reinforce that early-life events play a role in defining gut microbiota composition, confirming the importance of exclusive breastfeeding for infant gut colonization in establishing a protective profile against adiposity-related outcomes in adulthood.
Introduction: Many studies report that environmental factors occurring in childhood may modulate the composition of the gut microbiota in adulthood, which in turn, produces short chain fatty acids ...(SCFA) with metabolic effects on inflammatory cascades associated with glycemic homeostasis.
Objective: This study aims to analyze associations between type of delivery (vaginal/cesarean section), type of breast-feeding (maternal/artificial) and solid food introduction (start and quality) with fecal SCFA concentrations in women.
Method: A cross-sectional study including 106 women, 28±5 years old and BMI 25±5 kg/m2, a questionnaire regarding from birth until the first year of life. For quantification of acetate, butyrate and propionate it was used gas chromatography-mass spectrometry in fecal samples.
Results: Of the women surveyed 63% were cesarean delivered and 93% received maternal breast milk at some point. There was no correlation between SCFA concentration and type of delivery (p>0.05). Positive correlation was found between breastfeeding time and butyrate (r=0.24; p=0.02), there was a tendency with propionate (r=0.20; p=0.06). There was no correlation between time received infant formula and SCFA. There was a tendency of correlation between butyrate and beginning of cow’s milk intake (r=0.194; p=0.052). Age at solid food introduction correlates with propionate (r=0.22; p=0.026) and butyrate (r=0.25; p=0.012), and report a tendency with the acetate (r=0.18; p=0.07). In the first year of life, individuals who prefer salty crackers and pasta/potatoes had less concentration of propionate and acetate, respectively (p=0.026).
Conclusion: The type of delivery was not associated with SCFA, but there was a favorable association with prolonged breastfeeding, late beginning of cow’s milk intake, introduction of solids starting after 6 months of age and lower intake of refined cereals.
Disclosure
M.G. Barbosa: None. I. Solar: None. R.G. Freitas: None. F.B. Ribeiro: None. C.O. Ramos: None. M.R. Sant’Ana: None. A.S. Hanada: None. N.S.K. Crouchan: None. C.M. Xavier: None. B.G. Neto: None. L.G.D. Folchetti: None. I.T. Silva: None. B. Almeida-Pititto: None. S.G. Ferreira-Vivolo: None. A.J. Vasques: None.
Funding
São Paulo Research Foundation (2017/10185-9, 2019/05450-0)
Objective: To compare components of glycemic and energy homeostasis in women with metabolically healthy normal weight (MHNW) and metabolically unhealthy (MUNW), metabolically unhealthy ...overweight/obese (MUO) and metabolically healthy (MHO) phenotypes.
Methodology: Cross-sectional study with 104 women (18-45 years): 30 MHNW, 17 MUNW, 27 MHO, 30 MUO. Overweight was considered BMI ≥ 25 kg/m² and metabolic health without of changes in blood pressure, glycemic, lipemic levels and cardiovascular disease. The standard mixed meal tolerance test and indirect calorimetry were performed (assessments at -15, 0, 30, 60, 120 and 180 min). The quantifications were: areas under the curve (AUC) for glucose, insulin, C peptide, glucagon and GLP-1; insulin sensitivity (IS) by oral glucose insulin sensitivity index; energy expenditure, respiratory quotient, and carbohydrate and lipid oxidation rate were measured at rest and after oral stimulation.
Results: The groups did not differ regarding age and HbA1c levels. IS was decreased in MUO compared to MHNW and MHO (p<0.001). Insulin AUC was lower in MUO compared to MHNW (p=0.02), and C-peptide AUC was increased in MHO and MUO compared to MHNW (p<0.001). Resting energy expenditure was increased in overweight individuals compared to lean individuals (p <0.01). The lipid oxidation rate at time 30 min. was lower in MHNW and MUNW compared to MUO (p <0.01).
Conclusion: In young and normoglycemic women, there was lower IS and insulin secretion for the MUO phenotype. The greater rate of lipid oxidation in this group compared to the lean ones may be a reflection of the lower IS, and the inability to switch the use of energy substrate to the higher carbohydrate availability after oral stimulation. BMI is not an ideal indicator of the presence or absence of metabolic health. However, even in MHO individuals’, physiological adaptations may happen to maintain the metabolic parameters within normal range.
Disclosure
F.B. Ribeiro: None. I. Solar: None. R.G. Freitas: None. A.S. Hanada: None. M.G. Barbosa: None. C.M. Xavier: None. N.S.K. Crouchan: None. V.F.D. Santos: None. B.G. Neto: None. I.T. Silva: None. L.G.D. Folchetti: None. B. Almeida Pititto: None. S.G. Ferreira-Vivolo: None. A.J. Vasques: None.
Funding
Fundação de Apoio a Pesquisa do Estado de São Paulo (2017/10185-9)
To evaluate the association of the sagittal abdominal diameter (SAD) with insulin resistance (IR) and metabolic syndrome (MetS) components, and to compare SAD with waist circumference (WC).
This was ...a multicenter, cross-sectional study of 520 adolescents (10- to 18-years old). IR was assessed using the homeostasis model assessment of IR (HOMA-IR) and the hyperglycaemic clamp (n = 76).
SAD and WC were positively correlated with HOMA-IR (r = 0.637 and r = 0.653) and inversely correlated with the clamp-derived insulin sensitivity index (ISI) (r = -0.734 and r = -0.731); P < .001. In the multivariable linear regression analysis, SAD was positively associated with HOMA-IR (B = 0.046 ± 0.003) and inversely associated with the clamp-derived ISI (B = -0.084 ± 0.009) after adjusting for sex, age, and Tanner's stages (P < .001). When WC replaced the SAD, it was positively associated with HOMA-IR (B = 0.011 ± 0.001) and inversely associated with the clamp-derived ISI (B = -0.018 ± 0.002); P < .001. The values of the areas under the curves (AUC) were 0.823 and 0.813 for SAD and WC, respectively. In Bland-Altman analysis, there were agreement between both, SAD and WC, with the clamp-derived ISI (mean = 0.00; P > .05). The SAD and WC were positively associated with blood pressure, triglycerides, and uric acid, and inversely associated with high-density lipoprotein (HDL)-cholesterol after adjusting for sex, age, and Tanner's stages.
The SAD was associated with IR and MetS components, with a good discriminatory power for detecting IR. When compared to WC, SAD showed equivalent results.
Discovery of adipose-produced cytokines and gut hormones has improved the understanding obesity-related mechanisms. The developmental origins of diseases theory also helped to explain the obesity ...risk in adults exposed to adverse intrauterine environment. In contrast to maternal conditions, the role of paternal characteristics for outcomes has been less investigated. Whether paternal adiposity is associated with obesity biomarkers in adults prior to the development of metabolic disturbances is unknown. This cross-sectional analysis included 124 women (28±5yrs) who participated in the NutriHS baseline. Early life events questionnaire, anthropometry, DXA-determined body composition and blood sample were obtained. Associations of paternal BMI with outcomes were tested by multiple linear regression, using the minimal sufficient adjustments (pre-gestational maternal, paternal education levels and current family income) suggested by Directed Acyclic Graphs. Participants had mean BMI of 25±5 kg/m2 (49% were overweight but metabolically healthy). Blood pressure and biochemical values were within the normal range. Mean obestatin and visfatin levels were 58.9±22.2 mg/dl and 18.8±8.1 mg/dl, respectively; these values did not differ between subsets with BMI <25 and ≥25 kg/m2. Pre-gestational maternal BMI was correlated to paternal BMI (r=0.344, p=0.001) and 11.3% of mothers and 39.0% of fathers were overweight/obese. In linear regression model, offspring obestatin levels was inversely associated with paternal BMI (β=-0.22, p=0.049). No significant association was observed with visfatin levels. The inverse association of paternal BMI with offspring obestatin levels in healthy women raises a possibility of being a marker of protection against obesity-related disturbances in adulthood. Further analyses of the NutriHS cohort should investigate this hypothesis.
Disclosure
R.G. Freitas: None. A.J. Vasques: None. F.B. Ribeiro: None. I. Solar: None. M.G. Barbosa: None. A.S. Hanada: None. A.M. Valente: None. B. Almeida-Pititto: None. B.G. Neto: None. S.G. Ferreira-Vivolo: None.
Funding
Fundação de Amparo à Pesquisa do Estado de São Paulo (2018/11433-9); Fundação de Amparo à Pesquisa do Estado de São Paulo (2018/11401-0)
Insulin resistance and beta-cell dysfunction manifest differently across racial/ethnic groups, and there is a lack of knowledge regarding the pathophysiology of type 2 diabetes mellitus (T2DM) for ...ethnically admixed adolescents. This study aimed to investigate the influence of adiposity and family history (FH) of T2DM on aspects of insulin sensitivity, beta-cell function, and hepatic insulin extraction in Brazilian adolescents.
A total of 82 normoglycemic adolescents were assessed. The positive FH of T2DM was defined as the presence of at least one known family member with T2DM. The hyperglycemic clamp test consisted of a 120-min protocol. Insulin secretion and beta-cell function were obtained from C-peptide deconvolution. Analysis of covariance considered pubertal stage as a covariate.
Both lean and overweight/obese adolescents had similar glycemic profiles and disposition indexes. Overweight/obese adolescents had about 1/3 the insulin sensitivity of lean adolescents (1.1 ± 0.2 vs. 3.4 ± 0.3 mg·kg·min·pmol ∗ 1000), which was compensated by an increase around 2.5 times in basal (130 ± 7 vs. 52 ± 10 pmol·l·min) and total insulin secretion (130,091 ± 12,230 vs. 59,010 ± 17,522 pmol·l·min), and in the first and second phases of insulin secretion; respectively (p < 0.001). This increase was accompanied by a mean reduction in hepatic insulin extraction of 35%, and a 2.7-time increase in beta-cell glucose sensitivity (p < 0.05). The positive FH of T2DM was not associated with derangements in insulin sensitivity, beta-cell function, and hepatic insulin extraction.
In an admixed sample of adolescents, the hyperglycemic clamp test demonstrated that adiposity had a strong influence, and FH of T2DM had no direct influence, in different aspects of glucose metabolism.
The poor quality of sleep and the deprivation thereof have been associated with disruption of metabolic homeostasis, favoring the development of obesity and type 2 diabetes (T2DM). We aimed to ...evaluate the influence of biliopancreatic diversion (BPD) surgery on sleep quality and excessive daytime sleepiness of obese patients with T2DM, comparing them with two control groups consisting of obese and normal weight individuals, both normal glucose tolerant.
Forty-two women were divided into three groups: LeanControl (n = 11), ObeseControl (n = 13), and ObeseT2DM (n = 18). The LeanC and ObeseC groups underwent all tests and evaluations once. The ObeseT2DM underwent BPD and were reassessed after 12 months. Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were applied before and 12 months after BPD.
Before surgery, there was less daytime sleepiness in LeanC group (p = 0.013) compared with ObeseC and T2DMObese groups. The two obese groups did not differ regarding daytime sleepiness, demonstrating that the presence of T2DM had no influence on daytime sleepiness. After surgery, the daytime sleepiness (p = 0.002) and the sleep quality (p = 0.033) improved. The score for daytime sleepiness of operated T2DMObese group became similar to LeanC and lower than ObeseC (p = 0.047).
BPD surgery has positively influenced daytime sleepiness and sleep quality of obese patients with T2DM, leading to normalization of daytime sleepiness 12 months after surgery. These results reinforce previously identified associations between sleep, obesity and T2DM in view of the importance of sleep in metabolic homeostasis, quality of life and health.
Introduction: The effects of jabuticaba on health, particularly on glucose metabolism and GLP-1 deserve further clinical investigation.
Objective: The objective was to evaluate whether consumption of ...a jabuticaba juice preload containing 503 mg gallic acid equivalent and 2g of fibers would exert any effect on postprandial glycaemia, insulin, C-peptide, GLP-1, and appetite sensations.
Methods: Sixteen healthy subjects (11 women; 5 men; 28.4 ± 3.8 years; BMI 21.7 ± 2.3 kg m−2) completed a randomized, crossover intervention study. Jabuticaba or control beverage was consumed before a white wheat bread (WWB) challenge meal. Blood samples were taken frequently over the following 2 h. Blood glucose, serum insulin, C-peptide, and antioxidant capacity, plasma GLP-1, and appetite sensations were evaluated.
Results: Postprandial GLP-1 response as AUC, was higher after consumption of jabuticaba juice compared with control (95.6±41.4 vs. 82.7±24.6 ng/mL; p = 0.03). The GLP-1 significantly increased after jabuticaba juice, peaking at 60 min (1.21±0.5 vs. 0.71±0.2 ng/mL; p = 0,019). The AUC of antioxidant capacity was higher for jabuticaba juice vs. control (37.9±19.4 mmol TE/mL vs. 32.4±8.4; p = 0.005). Postprandial glucose, insulin, C-peptide levels, and appetite sensations were not significantly different between groups.
Conclusion: Inclusion of jabuticaba juice before a WWB challenge meal might be beneficial for antioxidant status and GLP-1 concentrations, but we did not find supporting evidence in glycaemia, C-peptide, insulin, insulin sensitivity and appetite sensations in healthy subjects.
Disclosure
M.V. Geraldi: None. C.B.B. Cazarin: None. A.J. Vasques: None. B.G. Neto: None. M.R. Marostica Junior: None.
Funding
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brazil (CAPES) (001); CNPq (403328/2016-0; 301108/2016-1); FAPESP (2015/50333-1)
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