Abstract:
OBJECTIVE:Hyperinsulinemic euglycemia, or insulin resistance syndrome (IRS), is associated with increased morbidity and mortality. Although thought to be associated with proinflammatory states, little work has been done in this area. Here, we determined the impact of IRS on functional, biochemical, metabolic, and inflammatory status in a high-risk population: elderly women in nursing homes. RESEARCH DESIGN AND METHODS:Functional, biochemical, metabolic, and inflammatory parameters were measured in 100 consecutive ambulatory, elderly women who resided in nursing homes. Diabetic subjects and residents with fasting blood glucose >or=110 mg/dl were excluded. Remaining residents were classified as insulin resistant (IR) (insulin >100 pmol/l) or non-IR (NIR). RESULTS:A total of 16 residents were IR and 53 NIR. No differences in functional status, BMI, renal function, C-reactive protein, or immune cell levels were found. Fasting blood glucose was higher in IR subjects ([means +/- SD] 94.1 +/- 8.1 vs. 87.9 +/- 8.2, P < 0.05), indicating a very mild glucose intolerance. Serum C-peptide (P < 0.05), amylin (P < 0.01), and leptin (P < 0.01), but not adiponectin or resistin, were higher in IR subjects. Higher leptin-to-BMI and insulin-to-C-peptide ratios suggested an increased percent body fat mass and altered clearance of insulin, respectively. Eleven of 13 cytokines had arithmetic elevations, but only tumor necrosis factor-alpha (TNF) reached statistical significance (P < 0.01). TNF and insulin levels were highly correlated. CONCLUSIONS:IRS in the healthiest of long-term care residents is relatively rare but is associated with mild glucose intolerance, increased percent body fat, altered insulin clearance, and a proinflammatory status as evidenced by an elevated TNF.
journal_name
Diabetes Carejournal_title
Diabetes careauthors
Banks WA,Willoughby LM,Thomas DR,Morley JEdoi
10.2337/dc07-0649subject
Has Abstractpub_date
2007-09-01 00:00:00pages
2369-73issue
9eissn
0149-5992issn
1935-5548pii
dc07-0649journal_volume
30pub_type
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