Search Results (61)

Background: Depression is approximately twice as prevalent in type 2 diabetes (T2D) compared to non-diabetic individuals, but its underlying mechanisms remain unclear. Insulin resistance (IR) and low-grade inflammation have been proposed as potential contributors. This study investigated whether IR and inflammatory markers are associated with depression in people with T2D. Methods: This cross-sectional study included 189 participants divided into four groups: T2D with depression (A, n = 38), T2D without depression (B, n = 60), depression without T2D (C, n = 44), and healthy controls (D, n = 47). Depression was diagnosed using the MINI-6 and HAMD scale. IR was assessed using the Matsuda index and HOMA-IR, while low-grade inflammation was evaluated by high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6). Results: The Matsuda index was significantly lower in group A compared with B, C and D groups (p < 0.001). HOMA-IR was higher in A than in C and D groups, though not significantly different from group B. Hs-CRP was highest in group A (p < 0.001), with no differences among B, C and D. IL-6 was significantly higher in A than B and D (p < 0.001), and similar between A and C. In multivariable analysis younger age, lower Matsuda index, and higher IL-6 independently predicted depression in people with T2D. ROC analysis detected an AUC of 0.75 (p < 0.001) for IL-6, with a sensitivity of 57% and specificity of 82% at the cutoff of 5.29 pg/mL. Conclusions: Our findings suggest that people with T2D and depression exhibit higher IR and elevated IL-6 and hs-CRP levels as parameters of low-grade inflammation. Depression in T2D was associated with younger age, lower Matsuda ISI, and higher IL-6, highlighting the potential relevance of those metabolic and inflammatory biomarkers in this co-occurrence. Further longitudinal studies are needed to clarify causal relationships. Full article

Background: Metabolic and bariatric surgery (MBS) results in significant changes in weight and body composition, along with glucose homeostasis improvement and type 2 diabetes resolution. In youth, sleeve gastrectomy (SG) is the most frequently performed MBS. Long-term studies assessing the duration over which glucose homeostasis parameters improve after SG are sparse. Objective: To examine the duration over which SG impacts glucose homeostasis in youth. Methods: This 24-month prospective study enrolled 65 youth (49 females) with moderate–severe obesity (mean age 18.0 ± 0.3 years). A total of 28 underwent SG, while 37 non-surgical (NS) participants received routine lifestyle counseling. At baseline, 12- and 24-month follow-up visits, HbA1c, and fasting and post-prandial insulin and glucose levels at 15, 30, 60, 90, and 120 min following a mixed meal tolerance test were obtained, and body composition was assessed. Results: At baseline, SG vs. NS had higher weight, body mass index (BMI) and percent fat mass (p ≤ 0.019), but did not differ for glucose homeostasis parameters. Over 24 months, reductions in weight-related parameters were noted in SG vs. NS (p ≤ 0.0001). Over 12 and 24 months, improvements occurred in HbA1c, fasting insulin, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and the Matsuda index in SG vs. NS (p ≤ 0.002). However, the between-group difference for changes in glucose homeostasis parameters between 12 and 24 months was not significant. Conclusions: Improvements in glucose homeostasis occur mostly in the first year following SG, with subsequent stabilization of these measures. Full article

Background: Effects on insulin sensitivity and postprandial glycemia through enzyme inhibition and regulation of glucose transport have been extensively researched; however, the role of sugarcane (poly)phenols remain underexplored. Methods: In a randomized, placebo-controlled, single-blinded crossover study, 12 healthy participants consumed a bread-based meal containing 50 g of carbohydrates, supplemented with either 0.5% or 5% liquid PRSE or sugar-balanced controls. Glucose and plasma insulin levels were assessed over 180 min. The extract was evaluated for its inhibitory effect on human α-amylases (salivary and pancreatic) and α-glucosidases (sucrase, maltase, and isomaltase) utilizing solid PRSE. Results: The postprandial glucose and insulin responses to bread sandwiches in healthy volunteers remained unchanged by both PRSE dosages. High-dose treatment reduced the Matsuda index by 9.8%, perhaps due to a subtle alteration in whole-body insulin sensitivity. Low-dose intervention postponed the insulin peak by 30 min without altering HOMA-IR. In vitro, PRSE diminished sucrase activity by 67% (IC₅₀ = 425.8 ± 18.7 µg/mL) and lowered maltase and isomaltase activity by 40% (IC₂₅ = 876.3 ± 131 and 960.6 ± 95.2 µg/mL, respectively). It enhanced the activity of human salivary and pancreatic α-amylases. Conclusion: In healthy people, acute PRSE supplementation had a minor impact on postprandial glucose and insulin levels. Low-dose PRSE postponed the insulin peak, whereas high-dose PRSE reduced Matsuda index potentially via α-amylase activation, suggesting a modest alteration in whole-body insulin sensitivity without significantly changing the glucose or insulin response. In vitro, PRSE exhibited modest inhibition of human α-glucosidases. Full article

Background: Cystic fibrosis-related diabetes (CFRD) is a frequent comorbidity in individuals with cystic fibrosis (CF). While insulin secretion defects are the primary mechanism in CFRD pathophysiology, insulin resistance may contribute as an additional risk factor. Early detection of insulin resistance may help identify patients at higher risk for earlier CFRD development. Objective: The aim of this study was to evaluate the ability of the Matsuda Index to identify insulin resistance in pediatric CF patients and to compare it with HOMA-IR as complementary indicators of glucose metabolism. Methods: In this cross-sectional study, fifty children with CF aged 6–16 years were included. The study involved measuring anthropometric data, fasting insulin, fasting glucose levels, glycated hemoglobin (HbA1c), and C-peptide. An assessment of glucose and insulin levels was performed on the patients through an oral glucose tolerance test (OGTT) at 0, 60, and 120 min. The Matsuda Index was computed, wherein a threshold of ≤4.5 signifies the presence of insulin resistance. Statistical analyses were conducted to compare insulin resistance and sensitivity across groups, using t-tests, correlation, and ANOVA. Results: Among the 50 observed patients, the average Matsuda index score was 17.08 with a standard deviation of 11.16. Eleven individuals (22%) exhibited insulin resistance with a Matsuda Index ≤ 4.5. These patients showed significantly higher insulin levels at 60 and 120 min during the OGTT, with statistically significant p-values of 0.008 and 0.002, respectively. Conclusions: The Matsuda Index may serve as a useful adjunctive tool to help identify insulin resistance in pediatric CF patients, particularly during puberty. Early detection of insulin resistance through the Matsuda Index may facilitate risk stratification and enable timely interventions that could potentially delay the onset or progression of CFRD. However, it should be noted that the ≤4.5 cut-off value was derived from adult studies, and its validity in pediatric CF populations has not been established, which represents a limitation of our finding. Full article

Background/Objectives: Mitochondrial damage is implicated in metabolic dysfunction and may contribute to inflammation and insulin resistance, key features of type 2 diabetes. This study examined the relationship among inflammatory markers, mtDNA DAMPs, and insulin sensitivity/resistance, and evaluated their response to three dietary interventions in type 2 diabetes. Methods: Data was pooled from two clinical trials involving adults aged 35 to 75 with type 2 diabetes (n = 39). Participants followed one of three 12-week diet interventions aimed at enhancing glucose metabolism without causing weight loss. The sample was 74% female and 64% African American with a mean age of 55.6 ± 7.7 years, and 92.3% (n = 36) had overweight/obesity. Participants were assigned to either a carbohydrate-restricted, low-fat, or fruit-rich Mediterranean diet. Primary outcomes included insulin resistance (HOMA-IR), insulin sensitivity (Matsuda index), mtDNA DAMPs (ND1, ND6), pro/anti-inflammatory cytokines (IFN-γ, IL-10, IL-6, IL-8, TNF-α), CRP, and cortisol. Associations among mtDNA DAMPs, inflammation, and insulin sensitivity/resistance were examined using regression analysis Results: The carbohydrate-restricted diet led to the greatest improvements in insulin sensitivity (72.7%) and reductions in HOMA-IR (41.3%) (p = 0.03). All diets increased mtDNA DAMPs, with most observed in the fruit-rich Mediterranean diet and low-fat diet groups and the smallest in the carbohydrate-restricted group. Total mtDNA DAMPs were associated with lower insulin sensitivity (Matsuda index: β = –0.77; SE = 0.31; p = 0.02), and ND6 mtDNA DAMP levels were associated with greater insulin resistance (HOMA-IR: β = 0.90; SE = 0.40; p = 0.03) and lower insulin sensitivity (Matsuda index: β = –0.86; SE = 0.33; p = 0.01), independent of BMI and race. Proinflammatory cytokines were associated with increased HOMA-IR (β = 0.45; p = 0.007) and reduced Matsuda index (β = –0.43; p = 0.009) and moderated effects of mtDNA DAMPs on insulin sensitivity/resistance. Conclusions: These findings highlight mtDNA DAMPs in metabolic dysfunction in the context of inflammation. Full article

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder connected with insulin resistance (IR), low-grade inflammation, dyslipidemia, and altered adipokine secretion. We evaluated serum levels of leptin, adiponectin, visfatin, resistin, IL-6, and TNF-α in 150 women with PCOS, stratified by IR status (IR, n = 76; non-IR, n = 74), and examined their associations with anthropometric, metabolic, hormonal, inflammatory, and atherogenic parameters. Anthropometric data included body weight, height, BMI, waist circumference, and waist-to-height ratio (WHtR), while IR was assessed using HOMA-IR and the Matsuda index. Serum adipokines were measured using ELISA, and lipid parameters and atherogenic indices—including non-HDL cholesterol, AIP, leptin/adiponectin, and adiponectin/resistin ratios—were calculated. Women with IR had higher levels of leptin, visfatin, resistin, and TNF-α, and lower levels of adiponectin. Leptin correlated positively with weight, WHtR, HOMA-IR, and atherogenic indices. Adiponectin showed the strongest and most consistent associations with anthropometric indices, HOMA-IR, and the Matsuda index. Resistin was linked to IR indices and IL-6, and visfatin correlated negatively with HDL-C and insulin sensitivity. In a multivariate general linear model, WHtR, but not HOMA-IR, remained independently associated with higher leptin levels and with atherogenic indices. These findings suggest that in PCOS, central adiposity rather than IR explains a substantial part of the adverse adipokine and inflammatory profile, thereby contributing to elevated cardiometabolic risk and highlighting the need for targeted treatment strategies. Full article

Background/Objectives: Nocturnal glucose regulation is a critical but underexplored determinant of next-day fasting glucose (FG), particularly in individuals with dysglycemia. This study examined the role of glucose levels after the last eating occasion (LEO) and during the overnight fast in predicting FG, considering the potential influence of carbohydrate content in LEO and insulin sensitivity. Methods: In a controlled 24 h protocol, 33 adults (50–75 years) with prediabetes or diet-controlled type 2 diabetes followed a standardized feeding schedule with meals at fixed times, including a LEO at 10:00 p.m. Continuous glucose monitoring was used to assess glucose during the 3 h postprandial period (LEO-PPGR) and two fasting intervals: chronological overnight fast (COF) and biological overnight fast (BOF). Associations with FG were tested using general linear models, adjusting for carbohydrate intake and insulin sensitivity (Matsuda index). Results: Glucose responses during LEO-PPGR—assessed by mean glucose, peak, and AUC—were strongly correlated with FG the next morning (r = 0.704, 0.535, and 0.708, p < 0.001). Similarly, glucose levels during COF and BOF were also correlated with FG (r = 0.878, p < 0.001 for both), but these associations weakened after adjustment for LEO carbohydrate content. The Matsuda index was positively correlated with glucose in all three periods (p < 0.05), yet its inclusion in the model attenuated all previously significant associations with FG. Conclusions: These findings suggest that the glycemic response to the last meal and subsequent overnight glucose levels contribute to next-day FG, but their impact is modulated by carbohydrate content and individual insulin sensitivity. Understanding nocturnal glycemic dynamics may inform strategies for improving metabolic outcomes in dysglycemia. Full article

Polycystic ovary syndrome (PCOS) is a complex endocrine disease. This study investigates the relationship between endothelial function, insulin resistance, and hormonal profiles in women with PCOS. Forty women with PCOS were included: metformin (n = 20), GLP1-RAs (n = 10), and oral contraceptive pills (n = 10). A 75 g oral glucose tolerance test (OGTT) was performed, and the 0, 60, and 120 min insulin, glucose, and endothelial functions were evaluated. The postprandial and fasting state Matsuda Index and HOMA Index were measured. All measurements were performed at baseline and at a 6-month follow-up. At baseline, the percentage change in the Perfused Boundary Region (PBR) was associated with the percentage change in glucose at 120 min of the OGTT (r = 0.42, p < 0.05). The Matsuda Index, Homa Index, and testosterone levels were associated with the PBR (2.91 ± 0.1 μm) at 120 min of the OGTT (r = 0.41, r = 0.38 and r = 0.28, respectively). MMP9 levels were associated with the Matsuda and Homa Index (r = 0.45, p < 0.05 and r = 0.41, p < 0.05, respectively). At the 6-month follow-up, all the participants presented improvements of the Matsuda Index (7 ± 0.31 vs. 9.1 ± 0.2), Homa Index (5.3 ± 0.8 vs. 2.91 ± 0.1), MMP9 (210 ± 30 vs. 178 ± 28 ng/mL), and testosterone levels (44.2 ± 5 vs. 39.1 ± 2 ng/dL) compared to the baseline (p < 0.05 for all the comparisons). Patients who received GLP1-RA agonists presented the greatest improvement in MMP9 levels. Postprandial hyperglycemia, insulin resistance, and testosterone levels are associated with an impaired glycocalyx thickness in women with PCOS. Full article

Type 2 diabetes mellitus (T2DM) represents a significant global health burden, especially in populations where rice constitutes a dietary staple. Parboiled rice (PBR), known for its lower glycemic index compared to conventional white rice (WR), may offer benefits in managing postprandial hyperglycemia. Nevertheless, the impact of PBR consumption on insulin sensitivity, β-cell function, and incretin hormone responses remains poorly understood. Methods: This randomized crossover pilot study aimed to assess and compare the acute effects of PBR and WR intake on postprandial glucose regulation, insulin sensitivity, β-cell functionality, and glucagon-like peptide-1 (GLP-1) responses in healthy subjects and individuals with T2DM. A total of 20 participants were recruited and evenly allocated into healthy (n = 10) and T2DM (n = 10) groups. Following the ingestion of either PBR or WR, blood samples were collected at fasting and various postprandial intervals to determine glucose, insulin, and GLP-1 levels. Insulin sensitivity and β-cell function were evaluated using HOMA-IR, Matsuda Index (MI), and Disposition Index (DI). Results: As expected, T2DM participants exhibited significantly elevated fasting glucose and insulin levels compared to healthy controls. Consumption of PBR led to significantly lower postprandial glucose responses in healthy subjects relative to WR. Although a similar trend of reduced glucose levels was observed in T2DM subjects after PBR intake, this reduction did not reach statistical significance. Parallel trends were observed in insulin secretion patterns. Moreover, GLP-1 responses were notably diminished in T2DM individuals compared to healthy participants. Importantly, MI and DI values significantly increased after PBR consumption in healthy individuals compared to those with T2DM, indicating improved insulin sensitivity and β-cell responsiveness. Conclusions: These preliminary findings suggest that PBR consumption may confer beneficial effects by lowering postprandial glucose and enhancing insulin sensitivity. Further studies with larger cohorts are warranted to confirm these outcomes and elucidate the physiological mechanisms behind PBR’s potential role in dietary management strategies for T2DM. Full article

Background: The mechanisms of diabetes remission following bariatric surgery independent of calorie restriction and weight loss remain unclear. Objectives: To undertake a systematic review and meta-analysis to investigate mechanisms underpinning diabetes remission. Methods: We included individuals with type 2 diabetes who have undergone RYGB, SG, and a very low-calorie diet (VLCD). In total, 234 studies were identified (N = 52 for qualitative; N = 40 for quantitative synthesis). Review Manager v5.4 and IBM SPSS for Windows (v28.0.1.1) were used for analysis. Results: Crude annualised diabetes relapse rates for RYGB and SG are as follows: −6.98 ± 16.19 (p = 0.046) and −2.75 ± 4.94 (p = 0.08); crude remission rates for RYGB and SG, respectively, are as follows: 39.59 ± 45.93 (p = 0.000) and 33.36 ± 33.87 SG (p = 0.006). Differences in other metabolic outcomes (standardised mean difference and 95% confidence intervals (CIs)) are BMI: ([RYGB: −2.73, 95%CI: −3.14 to −2.32, p < 0.000001) (SG: −2.82, 95%CI: −5.04 to −0.60, p = 0.01)]; HbA1c: [(RYGB: −1.58, 95%CI: −2.16 to −1.00, p < 0.00001) (SG: −1.42, 95%CI: −1.69 to −1.15, p < 0.00001)]; insulin: [(RYGB: 0.16, 95%CI: −0.19 to −0.50, p = 0.37) (SG: −3.00, 95%CI: −3.17 to −2.82, p = 0.75)]; and fat mass [(RYGB: −2.56, 95%CI: −4.49 to −0.64, p = 0.009) (SG: −1.69, 95%CI: −4.58 to 1.21, p = 0.25)]. RYGB and SG produced a significant improvement in HOMA-B measurements. Adiponectin and the Matsuda index were significantly increased with RYGB. No difference was observed for other metabolic markers (RYGB: GLP-1, GIP, leptin, ghrelin, PYY) (SG: GLP-1 and FGF19) (VLCD: leptin, GLP-1, GIP, and ghrelin). Conclusions: Diabetes remission following RYGB and SG was primarily driven by improvement in beta-cell function, with improvement in insulin resistance markers also observed for RYGB, driven by reductions in fat mass. No other metabolic mechanism explaining diabetes remission was observed based on clinical studies. Full article

Background: Spinal muscular atrophy (SMA) is a severe neuromuscular disorder characterized by the degeneration of alpha motor neurons in the spinal cord, leading to progressive proximal muscle weakness and paralysis. SMA is clinically categorized into four phenotypes based on age of onset and motor function achieved. Patients with SMA type 3 (juvenile, Kugelberg-Welander disease) initially have the ability to walk unaided, but experience a gradual decline in motor abilities over time. However, their lifespan is not affected by the presence of the disease. Leptin, a cytokine-like hormone secreted by adipocytes, has receptors widely distributed in musculoskeletal tissues. Several studies suggest that adiponectin deficiency contributes to the development of insulin resistance, with lower adiponectin levels closely associated with greater insulin resistance and hyperinsulinemia. However, the role of adiponectin in different types of sarcopenia and its connection to insulin sensitivity remains controversial. The purpose of this study was to measure leptin and adiponectin levels in patients with SMA type 3 and explore their association with markers of insulin sensitivity. Methods: This cross-sectional study included 23 adult patients with SMA type 3 (SMA group) and 18 community-based healthy volunteers (control group), conducted from July 2020 to September 2024. Anthropometric parameters, body composition, body fat percentage, surrogate markers of insulin sensitivity (Homeostasis model assessment of insulin resistance index—HOMA-IR and ISI Matsuda), and circulating levels of leptin and adiponectin were measured in all participants. Results: Insulin resistance was present in 91.3% of patients with SMA type 3, as determined by HOMA-IR and ISI Matsuda insulin sensitivity markers. In the control group, 64.7% had insulin resistance (IR) according to HOMA-IR, while 44.4% met the ISI Matsuda criterion for IR, showing a significant difference in peripheral insulin sensitivity between groups. A significant difference in serum adiponectin levels was observed between patients with SMA type 3 and the control group, whereas there was no significant difference in serum leptin concentrations. High adiponectin levels were observed in 50% of patients with SMA type 3. In the healthy control group, adiponectin levels positively correlated with ISI Matsuda and negatively correlated with HOMA-IR, confirming the insulin-sensitizing role of adiponectin. However, this correlation was not observed in patients with SMA type 3. Conclusions: Our results suggest that in this specific type of hereditary neuromuscular disease, the interplay between sarcopenia and insulin leads to adiponectin resistance, challenging the canonical narrative between insulin sensitivity and adiponectin, and indicating a need for further research. Full article

Background/Objectives: Muscle loss is a serious complication in chronic disease patients, yet studies on long-term changes in muscle mass based on insulin sensitivity in the absence of diabetes mellitus are scarce. This community-based cohort study analyzed the longitudinal association between insulin sensitivity and muscle loss in middle-aged South Korean adults. Methods: This study included 6016 subjects (aged 40–65 years) from the Korean Genome and Epidemiology Study, conducted between 2001 and 2016. Fat-free mass, fat mass, body weight, and kidney function were assessed biennially. Subjects were categorized into four groups based on the composite (Matsuda) insulin sensitivity index (ISI) quartiles. The primary outcome was muscle loss, defined as a decline in fat-free mass of 10% or more from baseline. The secondary outcome was the occurrence of all-cause mortality. Results: During 69,480 person–years of follow-up, muscle loss occurred in 311 (5.2%) subjects. Multivariable Cox regression revealed a reverse-graded association between insulin sensitivity and muscle loss risk. Hazard ratios (95% confidence intervals) for the second, third, and highest ISI quartiles were 0.70 (0.51–0.94), 0.69 (0.50–0.95), and 0.65 (0.46–0.92), respectively, compared with the lowest quartile. Insulin sensitivity, however, was not significantly associated with all-cause mortality, though the mortality risk was higher in individuals with muscle loss. Conclusions: A reverse-graded relationship between insulin sensitivity and muscle loss risk was identified in middle-aged South Korean adults, with the lowest risk in the highest ISI quartile. These findings suggest that higher insulin sensitivity may reduce the risk of muscle loss. Full article

Background/Objectives: Glucose tolerance progressively declines with age. However, the effects of aging on insulin secretion and insulin sensitivity in Japanese subjects are unclear. Methods: We conducted an oral glucose tolerance test (OGTT) in residents aged between 22 and 85 years in Koshi City, Kumamoto Prefecture, Japan, to clarify the characteristics of insulin secretion and insulin sensitivity in older adults. Participants were recruited using a flyer, and the OGTT was performed after an overnight fast (12–16 h) between 8:00 and 10:30 am. Results: HOMA-IR and the Matsuda index are indices of insulin action. No correlation of age with HOMA-IR or the Matsuda index was found, whereas HOMA-β, the insulinogenic index, and the disposition index, all indices of insulin secretion, were negatively correlated with age in all participants and in individuals with normal glucose tolerance. Multiple regression analysis showed that age was an explanatory factor for insulin secretion. Conclusions: Impaired insulin secretion may contribute to age-related glucose intolerance in Japanese individuals. Full article

Background/Objectives: Chronic low-grade inflammation is associated with insulin resistance and poor glycemic control, leading to the development of type 2 diabetes mellitus (T2DM). The present study investigated the effect of regular mango intake on inflammation and insulin sensitivity in participants with overweight or obesity and chronic low-grade inflammation. Methods: A human clinical study was performed using a randomized, controlled, two-arm, parallel design with a 2 h oral glucose tolerance test (OGTT) administered before and after 4 weeks (4 W) of mango or control product intake (1 cup/twice a day). Fasting and time course blood sampling for 2 h post-OGTT were analyzed for effects on plasma metabolic and inflammation endpoints using analysis of covariance and repeated-measure approaches (SAS 9.4). Results: Forty-eight adults (37.6 ± 2.8 years, 30.5 ± 4.1 BMI kg/m²) completed the study. Markers of inflammation (IL-6, TNFα, hs-CRP) were not different at the end of 4 W (p > 0.05). The intervention did not significantly influence fasting glucose concentrations; however, insulin was significantly lowered with the mango compared to the control intervention (8.2 ± 1.2 vs. 15.3 ± 1.2 µIU/mL respectively, p = 0.05). Furthermore, the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), along with the disposition index (DI), was significantly improved in the mango compared to the control interventions (HOMA-IR, 2.28 ± 1.19 vs. 4.67 ± 1.21, p = 0.03; DI, 2.76 ± 1.02 vs. 5.37 ± 1.03, p = 0.04). Mean insulin concentrations were also significantly lower at W4 compared to W0 after the OGTT in the mango vs. control intervention (intervention × week effect, p = 0.04). Relative expression of nuclear factor erythroid 2-related factor 2 (Nrf-2), a gene regulating endogenous antioxidant defense, was non-significantly increased twofold in the mango intervention (W4 vs. W0). Conclusions: Collectively, the data suggest that mango intake increased insulin sensitivity in individuals with chronic low-grade inflammation, possibly through activating Nrf-2 genes and increasing cellular antioxidant status. The data warrant further research on consuming mango fruit as part of a dietary pattern to address insulin resistance and the mechanisms underpinning the actions of mango intake. Full article

Background: Obesity in pregnancy is linked to adverse clinical outcomes such as gestational diabetes. Recently, a risk score calculated by different ceramide concentrations was recognized as a new way to investigate cardiovascular risk. The aim was to analyze if the ceramide risk score and cardiometabolic risk vary between normal-weight, obese, and females with prior Roux-en-Y bypass surgery (RYGB) during pregnancy. Methods: Three cohorts were investigated: first, 25 pregnant females with a history of RYGB; second, 19 with preconception BMI ≥ 35 kg/m²; and third, 19 normal-weight (preconception BMI < 25 kg/m²). Around the 24th to 28th weeks of gestation routine laboratory assessments, 3 h 75 g oral and intravenous glucose tolerance tests were carried out. The correlation of ceramide risk scores and ceramide ratios (Cer(d18:1/18:0)/Cer(d18:1/16:0)) with metabolic parameters was analyzed via Pearson correlation. The cohorts were compared via ANOVA and unpaired t-tests. Results: The RYGB cohort had lower ceramide risk scores and ratios compared to obese pregnant females (7.42 vs. 9.34, p = 0.025; 0.33 vs. 0.47, p < 0.001). Ceramide risk score and ratio were found to correlate negatively with insulin sensitivity (measured with the Matsuda (r = −0.376, p = 0.031; r = −0.455, p = 0.008) and calculated sensitivity index (r = −0.358, p = 0.044; r = −0.621, p < 0.001) in females without RYGB. The ceramide risk score correlated positively with body fat in RYGB females (r = 0.650, p = 0.012). Conclusions: We found that females after RYGB have lower ceramide risk scores and ceramide ratios compared to obese pregnant females, possibly indicating lower metabolic risk. Full article