Resistant starch supplementation influences blood lipid concentrations and glucose control in overweight subjects. Baseline insulin sensitivity affects response to high-amylose maize resistant starch in women: a randomized, controlled trial [Effects of resistant starch on insulin resistance of type 2 diabetes mellitus patients]. A Randomized Placebo Controlled Clinical Trial to Determine the Impact of Digestion Resistant Starch MSPrebiotic® on Glucose, Insulin, and Insulin Resistance in Elderly and Mid-Age Adults Impact of Resistant Starch on Body Fat Patterning and Central Appetite Regulation Effects of wheat bran extract rich in arabinoxylan oligosaccharides and resistant starch on overnight glucose tolerance and markers of gut fermentation in healthy young adults Differential effect of chronic treatment with two beta‐blocking agents on insulin sensitivity: the carvedilol‐metoprolol study Resistant Starch Bagels Reduce Fasting and Postprandial Insulin in Adults at Risk of Type 2 Diabetes. Prior short-term consumption of resistant starch enhances postprandial insulin sensitivity in healthy subjects TNFα dynamics during the oral glucose tolerance test vary according to the level of insulin resistance in pregnant women. Resistant starch intake at breakfast affects postprandial responses in type 2 diabetics and enhances the glucose-dependent insulinotropic polypeptide--insulin relationship following a second meal. Reformulating cereal bars: high resistant starch reduces in vitro digestibility but not in vivo glucose or insulin response; whey protein reduces glucose but disproportionately increases insulin. Elevated circulating microRNA-122 is associated with obesity and insulin resistance in young adults. α-Hydroxybutyrate Is an Early Biomarker of Insulin Resistance and Glucose Intolerance in a Nondiabetic Population Efficacy of increased resistant starch consumption in human type 2 diabetes Lowering Uric Acid With Allopurinol Improves Insulin Resistance and Systemic Inflammation in Asymptomatic Hyperuricemia Study of comparative effects of antioxidants on insulin sensitivity in type 2 diabetes mellitus. The Therapeutic Potential of Resistant Starch in Modulation of Insulin Resistance, Endotoxemia, Oxidative Stress and Antioxidant Biomarkers in Women with Type 2 Diabetes: A Randomized Controlled Clinical Trial N-acetyl-cysteine treatment improves insulin sensitivity in women with polycystic ovary syndrome. [Impact of weight loss on adipocytokines, C-reactive protein and insulin sensitivity in hypertensive women with central obesity]. THE EFFECT OF INFLIXIMAB TREATMENT ON INSULIN RESISTANCE IN PATIENTS WITH RHEUMATOID ARTHRITIS Helminth infections and type 2 diabetes: a cluster-randomized placebo controlled SUGARSPIN trial in Nangapanda, Flores, Indonesia Acute ingestion of resistant starch reduces food intake in healthy adults.
Resistant starch ( RS ) includes the sum of starch and degradation products of starch that resist small intestinal digestion and enter the colon . This study was planned to examine the effect of resistant starch on hypolipidemic actions , blood glucose , insulin levels and humoral immune responses in healthy overweight subjects . Healthy overweight subjects ( over 120 % of their ideal body weights ) were fed either 24 g/d of resistant corn starch ( RS ) or regular corn starch ( CS ) for 21 d with their regular meals . Although this double-blind feeding regiment result ed in no significant changes in their weights or other physical parameters for the relatively acute period of intakes , there were significant lowering effects of serum total cholesterol ( p < 0.05 ) and serum LDL-cholesterol ( p < 0.05 ) in subjects supplemented RS . Compared with the control starch group , the RS supplementation also reduced the mean fasting serum glucose concentrations ( p < 0.05 ) . Resistant starch supplement result ed in the increase in serum immunoglobulin G ( IgG ) concentrations . Serum insulin and complement 3 ( C3 ) were unaffected . Tested resistant starch supplementation was reported to be palatable with minimal bowel discomfort . These results suggest that RS supplementation improves the blood lipid profile and controls the blood glucose levels in healthy overweight subjects without bowel discomfort . Therefore , RS has a potential to be used as one of the promising food ingredients for reducing risk factors involved in the development of atherosclerosis and type 2 diabetes in overweight individuals . However , in order to prove RS as a novel therapeutic agent of cardiovascular diseases and diabetes , controlled trials with larger sample sizes and longer duration are warranted Background Resistant starch ( RS ) is a type of dietary fiber that can improve glucose metabolism , but its effects may be modulated by sex or baseline insulin sensitivity . This study was design ed to examine the effect of high-amylose maize resistant starch ( HAM-RS2 ) on insulin sensitivity ( SI ) in women , and to determine if SI status affects the response to RS . Methods This was a r and omized , placebo-controlled , double-blind , cross-over study . Participants were 40 healthy , non-diabetic women aged 22–67 years in the normal-weight to obese BMI range ( 20.6–47.4 kg/m2 ) . Two doses of HAM-RS2 were tested , 15 and 30 g per day , administered in the form of cookies . Participants were r and omized to the order in which they received the experimental and placebo product . Each arm was 4 weeks , with a 4-week wash-out period in between . SI was assessed at the end of each 4-week arm of product consumption by frequently- sample d , insulin-modified , intravenous glucose tolerance test and minimal modeling . Participants were categorized as being insulin resistant ( IR ; SI < 7.8 ) or insulin sensitive ( IS ; SI ≥ 7.8 ) based on Gaussian analysis . The effect of treatment arm on SI was examined by mixed-model analysis within IR and IS sub-groups , using all available data . In addition , SI was examined by ANOVA among just those women who completed all three arms of the study with valid SI results . Results Among IR participants , SI was on average ~16 % higher after the 30 g arm when compared to the control arm by mixed-model analysis ( n = 40 , P < 0.05 ) , and tended to be 23 % higher by ANOVA among women who completed all arms ( n = 23 , P = 0.06 ) . HAM-RS2 did not affect SI in IS women . Conclusion Consumption of HAM-RS2 at 30 g/day in the form of a snack food item was associated with improved insulin sensitivity in women with insulin resistance . Clinical trials registry numberNCT01521806 OBJECTIVE To observe the effects of resistant starch ( RS ) on insulin resistance ( IR ) in type 2 diabetes mellitus patients . METHODS All 40 patients with type 2 diabetes mellitus were r and omly divided into two groups : Group A and Group B. Cross- design of two stages ( I , II ) was used during observation . Group A received RS 30 g/d as an intervention group for ahead of 4 weeks ( I stage ) , while group B as a control group . Group B was given RS in late 4 weeks ( II stage ) , while Group A as served control group . Blood was taken the first day and on the latest day in each stage . Fasting blood glucose ( FBG ) , post blood glucose ( PBG ) , fructosamine ( FMN ) , total cholesterol ( TC ) , triglyceridemic ( TG ) , insulin sensitive index ( ISI ) , and body mass index ( BMI ) were measured , respectively . RESULTS As Compared with the control group , ISI was higher and FBG , PBG , TC , TG , FMN and BMI were significantly lower in intervention group ( P < 0.05 ) . CONCLUSION RS should be effective in improving IR of type 2 diabetes mellitus patients Introduction Type 2 diabetes ( T2D ) has reached epidemic proportions in North America . Recent evidence suggests that prebiotics can modulate the gut microbiome , which then plays an important role in regulating lipid metabolism , blood glucose , and insulin sensitivity . As such , prebiotics are appealing potential therapeutic strategies for prediabetes and T2D . The key objectives of this study were to determine the tolerability as well as the glucose and insulin modulating ability of  MSPrebiotic ® digestion resistant starch ( DRS ) in healthy mid-age ( MID ) and elderly ( ELD ) adults . Material s and methods This was a prospect i ve , blinded , placebo-controlled study . Prediabetes and diabetes were among the exclusion factors . ELD ( > 70 years ) and MID ( 30–50 years ) Canadian adults were recruited and , after 2 weeks of consuming placebo , they were r and omized to consume 30 g of either MSPrebiotic ® or placebo per day for 12 weeks . In total , 42 ELD and 42 MID participants completed the study . Blood sample s were collected over the 14-week study and analyzed for glucose , lipid profile , and CRP , lipid particles , TNF-α , IL-10 , insulin , and insulin resistance ( IR ) . Results At baseline , the ELD population had a significantly higher percentage ( p < 0.01 ) with elevated glucose and significantly higher TNF-α ( p < 0.01 ) compared to MID adults .  MSPrebiotic ® DRS was well tolerated in both MID and ELD adults . There was a significant difference over time in blood glucose ( p = 0.0301 ) and insulin levels ( p = 0.009 ) , as well as IR ( HOMA-IR ; p = 0.009 ) in ELD adults who consumed MSPrebiotic ® compared to placebo . No significant changes were found in MID adults . Conclusion Our results suggest that dietary supplementation with prebiotics such as MSPrebiotic ® may be part of an effective strategy to reduce IR , a major risk factor for developing T2D , in the ELD . Clinical Trial Registration NCT01977183 listed on NIH website : Clinical Trials.gov , The meta data generated in this study have been su bmi tted to the NCBI Sequence Read Archive ( http://www.ncbi.nlm.nih.gov/bioproject/381931 ) Background Adipose tissue patterning has a major influence on the risk of developing chronic disease . Environmental influences on both body fat patterning and appetite regulation are not fully understood . This study was performed to investigate the impact of resistant starch ( RS ) on adipose tissue deposition and central regulation of appetite in mice . Methodology and Principle Findings Forty mice were r and omised to a diet supplemented with either the high resistant starch ( HRS ) , or the readily digestible starch ( LRS ) . Using 1H magnetic resonance ( MR ) methods , whole body adiposity , intrahepatocellular lipids ( IHCL ) and intramyocellular lipids ( IMCL ) were measured . Manganese-enhanced MRI ( MEMRI ) was used to investigate neuronal activity in hypothalamic regions involved in appetite control when fed ad libitum . At the end of the interventional period , adipocytes were isolated from epididymal adipose tissue and fasting plasma collected for hormonal and adipokine measurement . Mice on the HRS and LRS diet had similar body weights although total body adiposity , subcutaneous and visceral fat , IHCL , plasma leptin , plasma adiponectin plasma insulin/glucose ratios was significantly greater in the latter group . Adipocytes isolated from the LRS group were significantly larger and had lower insulin-stimulated glucose uptake . MEMRI data obtained from the ventromedial and paraventricular hypothalamic nuclei suggests a satiating effect of the HRS diet despite a lower energy intake . Conclusion and Significance Dietary RS significantly impacts on adipose tissue patterning , adipocyte morphology and metabolism , glucose and insulin metabolism , as well as affecting appetite regulation , supported by changes in neuronal activity in hypothalamic appetite regulation centres which are suggestive of satiation Abstract Purpose Specific combinations of dietary fiber ( DF ) have been observed to result in improved glucose tolerance at a subsequent st and ardized breakfast . Arabinoxylan oligosaccharides ( AXOS ) are considered as DF with prebiotic potential , but so far no studies have investigated their metabolic effects in humans . This r and omized cross-over study evaluated the overnight impact of breads containing AXOS-rich wheat bran extract and resistant starch ( RS , Hi-Maize ) , separately or combined , on glucose tolerance , related metabolic parameters and markers of gut fermentation in healthy subjects . Methods Evening reference and test products were : ( 1 ) reference white wheat flour bread ( WWB ) , WWB supplemented with ( 2 ) AXOS and RS ( WWB + AXOS + RS ) , ( 3 ) an increased content of either AXOS ( WWB + hiAXOS ) or ( 4 ) RS ( WWB + hiRS ) . At the subsequent st and ardized breakfast , blood was sample d for 3 h to monitor glucose , insulin , nonesterified fatty acids , glucagon-like peptide (GLP)-1 and GLP-2 . Breath hydrogen ( H2 ) and short chain fatty acids ( SCFA ) were measured as markers of gut fermentation , and subjective appetite was rated using visual analog scales . Results Dose-dependent decreases in glucose responses were observed with increased AXOS over the duration of 3 h. Insulin sensitivity index was improved in the morning after the WWB + hiAXOS evening meal . An increase in breath H2 concentration and circulating SCFA was observed in the morning after both evening meals containing AXOS . Conclusion The present study indicates that AXOS have the potential of improving glucose tolerance in an overnight perspective and suggested mechanisms are improved insulin sensitivity and increased gut fermentation Background Hypertensive patients frequently show resistance to insulin-stimulated glucose uptake and hyperinsulinemia . Diuretics and β-adrenoceptor blocking agents have been found to decrease insulin sensitivity , whereas α1-blockers and angiotensin converting enzyme inhibitors seem to improve it . Objective To compare the effects of a 3 months ' antihypertensive treatment with carvedilol , a non-selective β-adrenoceptor blocker with α1-blocking properties , with the β1-selective receptor blocker metoprolol on insulin sensitivity in non-diabetic hypertensive patients . Design A multicenter double-blind r and omized study . Subjects and methods Seventy-two non-diabetic hypertensive patients were r and omly assigned to treatment with either carvedilol or metoprolol . An isoglycemic , hyperinsulinemic glucose clamp was conducted before and after 12 weeks of treatment ; the metabolic clearance rate for glucose was taken as an indicator of insulin sensitivity . Results The two groups did not differ in age , sex , body mass index , blood pressure or lipids , and treatment effectively lowered blood pressure . In both groups , insulin sensitivity was impaired at baseline . After metoprolol treatment , insulin sensitivity further decreased significantly by about 14 % , whereas it increased after carvedilol . There was also a decrease in high-density lipoprotein and an increase in triglycerides levels in patients in the metoprolol-treated group , whereas these parameters remained unchanged in patients in the carvedilol-treated group . Conclusion This study confirms previous findings of a reduction in insulin sensitivity after chronic metoprolol treatment . Carvedilol treatment , however , result ed in a slight increase in insulin resistance and a better lipid profile . We thus demonstrate that a β-blocker with α1-blocking properties has favorable effects on glucose metabolism , suggesting a potentially important role of peripheral blood flow in regulating glucose uptake . These findings imply that β-blocker treatment , when combined with α1-blocking activity has advantageous effects on insulin sensitivity and lipids and could therefore be suitable for patients with the metabolic syndrome BACKGROUND Type 2 diabetes ( T2D ) incidence continues to rise . Although increasing dietary fiber intake is an established strategy for improved glycemic control , most adults consume insufficient amounts . Fiber-enhanced functional foods can increase fiber intake , and there is particular interest in resistant starch ( RS ) as a high-fiber ingredient . Studies show that high-amylose maize resistant starch , type 2 ( HAM-RS2 ) improves acute and chronic glycemic responses , but more studies are needed in individuals at high risk of T2D with RS delivered in commonly consumed foods . OBJECTIVE The objective of this study was to examine the chronic effects of consuming bagels high in HAM-RS2 on fasting and postpr and ial glycemic markers in adults at increased risk of T2D . METHODS With the use of a r and omized , double-blind crossover design , 24 men and women with a mean ± SE age of 55.3 ± 1.59 y and body mass index ( in kg/m2 ) of 30.2 ± 0.57 consumed 1 bagel containing 25 g HAM-RS2/d or 1 control wheat bagel/d for 56 d each , separated by a 4-wk washout . Fasting and postpr and ial oral-glucose-tolerance test ( OGTT ) glucose and insulin were measured on study days 1 and 57 of each bagel treatment . RESULTS The RS bagel treatment result ed in significantly lower fasting ( 22.1 % , P = 0.04 ) , 2-h ( 23.3 % , P < 0.008 ) , and 3-h ( 18.9 % , P = 0.05 ) insulin incremental areas under the curve and fasting insulin resistance ( homeostasis model assessment of insulin resistance ; 23.1 % , P = 0.04 ) than did the control bagel treatment . Fasting and postpr and ial OGTT glucose concentrations did not differ between the RS and control bagel treatments on study days 1 or 57 . CONCLUSIONS These data suggest that consumption of a high-HAM-RS2 bagel improves glycemic efficiency by reducing the amount of insulin required to manage postpr and ial glucose while improving fasting insulin sensitivity in adults at increased risk of T2D . This research provides support for a feasible dietary strategy for T2D risk reduction . This trial was registered at clinical trials.gov as NCT02129946 Aims /hypothesisDiets rich in insoluble-fibre are linked to a reduced risk of both diabetes and cardiovascular disease ; however , the mechanism of action remains unclear . The aim of this study was to assess whether acute changes in the insoluble-fibre ( resistant starch ) content of the diet would have effects on postpr and ial carbohydrate and lipid h and ling . Methods Ten healthy subjects consumed two identical , low-residue diets on separate occasions for 24 h ( 33 % fat ; < 2 g dietary fibre ) . Of the diets one was supplemented with 60 g resistant starch ( Novelose 260 ) . On the following morning a fibre-free meal tolerance test ( MTT ) was carried out ( 59 g carbohydrate ; 21 g fat ; 2.1 kJ ) and postpr and ial insulin sensitivity ( SIORAL ) assessed using a minimal model approach . Results Prior resistant starch consumption led to lower postpr and ial plasma glucose ( p=0.037 ) and insulin ( p=0.038 ) with a higher insulin sensitivity(44±7.5 vs 26±3.5 × 10−4 dl kg−1 min−1 per µUml−1 ; p=0.028 ) and C-peptide-to-insulin molar ratio ( 18.7±6.5 vs 9.7±0.69 ; p=0.017 ) . There was no effect of resistant starch consumption on plasma triacylglycerol although non-esterified fatty acid and 3-hydroxybutyrate levels were suppressed 5 h after the meal tolerance test . Conclusion Prior acute consumption of a high-dose of resistant starch  enhanced carbohydrate h and ling in the postpr and ial period the following day potentially due to the increased rate of colonic fermentation INTRODUCTION TNFα is suspected to play a role in inflammation and insulin resistance leading to higher risk of metabolic impairment . Controversies exist concerning the role of TNFα in gestational insulin resistance . We investigated the interrelations between TNFα and insulin resistance in a large population -based cohort of pregnant women . METHODS Women ( n = 756 ) were followed prospect ively at 5 - 16 weeks and 24 - 28 weeks of pregnancy .  Anthropometric measures and blood sample s were collected at both visits . A 75-g oral glucose tolerance test ( OGTT ) was conducted at the second trimester to assess insulin sensitivity status ( homeostasis model of assessment of insulin resistance and Matsuda index ) . TNFα was measured at the first trimester ( nonfasting ) and at each time point of the OGTT . RESULTS Participants were 28.4 ± 4.4 years old and had a mean body mass index of 25.5 ± 5.5 kg/m(2 ) at first trimester . Median TNFα levels were 1.56 ( interquartile range , 1.18 - 2.06 ) pg/mL at first trimester and 1.61 ( interquartile range , 1.12 - 2.13 ) pg/mL at second trimester ( 1 h after glucose load ) . At second trimester , higher TNFα levels were associated with higher insulin resistance index levels ( r = 0.37 and -0.30 for homeostasis model of assessment of insulin resistance and Matsuda index , respectively ; P < .0001 ) , even after adjustment for age , body mass index , triglycerides , and adiponectin . Women with higher insulin resistance showed a continuing decrease in TNFα levels during the OGTT , whereas women who were more insulin sensitive showed an increase in TNFα at hour 1 and a decrease at hour 2 of the test . CONCLUSION Higher insulin resistance is associated with higher levels of circulating TNFα at first and second trimesters of pregnancy . TNFα level dynamics during an OGTT at second trimester vary according to insulin-resistance state Resistant starch ( RS ) consumption can modulate postpr and ial metabolic responses , but its effects on carbohydrate ( CHO ) h and ling in type 2 diabetics ( T2D ) are unclear . It was hypothesized that a bagel high in RS would improve glucose and insulin homeostasis following the 1st meal , regardless of the amount of available CHO , and that in association with incretins , the effects would carry over to a 2nd meal . Using a r and omized crossover design , 12 T2D ingested four different bagel treatments ( their 1st meal ) determined by available CHO and the weight or amount of bagel consumed : treatment A , without RS ( 50 g of available CHO ) ; treatment B , with RS ( same total CHO as in A ) ; treatment C , with RS ( same available CHO as in A ) ; and treatment D , with the same RS as in B and available CHO as in A and C. A st and ard 2nd meal was ingested 3 h later . Following the first meal , B elicited a lower glucose incremental area under the curve ( iAUC ) than C ( P < 0.05 ) , D ( P < 0.05 ) , and A ( trend ; P = 0.07 ) , lower insulin iAUC than A ( P < 0.05 ) and C ( P < 0.05 ) , and lower glucose-dependent insulinotropic polypeptide ( GIP ) iAUC than A ( P < 0.05 ) . There was a positive correlation ( P < 0.05 ) between GIP and insulin iAUCs after the 2nd meal , and C had a 3 times greater slope than the other treatments ( r = 0.91 , P < 0.001 ) , yet lacked a significant concomitant improvement in glucose disposal . These results show that for the 1st meal , RS was effective when it replaced a portion of the available CHO , while ingesting more RS influenced the GIP-insulin axis following the 2nd meal BACKGROUND Resistant starch ( RS ) and whey protein are thought to be effective nutrients for reducing glycemic responses . OBJECTIVE We aim ed to determine the effect of varying the sucrose , RS , and whey protein content of cereal bars on glucose and insulin responses . DESIGN Twelve healthy subjects [ mean ± SD age : 36 ± 12 y ; mean ± SD body mass index ( in kg/m2 ) : 24.9 ± 2.7 ] consumed 40 g available-carbohydrate ( avCHO ) portions of 5 whole-grain cereal bars that contained varying amounts of RS and whey protein concentrate [ WPC ; 70 % protein ; RS : WPC , % wt : wt : 15:0 ( Bar15/0 ) ; 15:0 , low in sucrose ( Bar15/0LS ) ; 15:5 ( Bar15/5 ) ; 10:5 ( Bar10/5 ) ; and 10:10 ( Bar10/10 ) ] and 2 portion sizes of a control bar low in whole grains , protein , and RS [ control 1 contained 40 g avCHO ( Control1 ) ; control 2 contained total carbohydrate equal to Bar15/0LS ( Control2 ) ] on separate days by using a r and omized crossover design . Glucose and insulin responses in vivo and carbohydrate digestibility in vitro were measured over 3 h. RESULTS Incremental area under the curve ( iAUC ) over 0 - 3 h for glucose ( min × mmol/L ) differed significantly between treatments ( P < 0.001 ) [ Bar15/0LS ( mean ± SEM ) , 169 ± 14 ; Control2 , 164 ± 20 ; Bar15/0 , 144 ± 15 ; Control1 , 140 ± 17 ; Bar10/5 , 117 ± 12 ; Bar15/5 , 116 ± 9 ; and Bar10/10 , 100 ± 9 ; Tukey 's least significant difference = 42 , P < 0.05 ] , but insulin iAUC did not differ significantly . Higher protein content was associated with a lower glucose iAUC ( P = 0.028 ) and a higher insulin-to-glucose iAUC ratio ( P = 0.002 ) All 5 RS-containing bars were digested in vitro ∼30 % more slowly than the control bars ( P < 0.05 ) ; however , in vivo responses were not related to digestibility in vitro . Glucose and insulin responses elicited by high-RS , whey protein-free bars were similar to those elicited from control bars . CONCLUSIONS The inclusion of RS in cereal bar formulations did not reduce glycemic responses despite slower starch digestion in vitro . Thus , caution is required when extrapolating in vitro starch digestibility to in vivo glycemic response . The inclusion of whey protein in cereal bar formulations to reduce glycemic response requires caution because this may be associated with a disproportionate increase in insulin as judged by an increased insulin-to-glucose iAUC ratio . This trial was registered at clinical trials.gov as NCT02537587 OBJECTIVE MicroRNAs ( miRNAs ) are involved in the regulation of adiposity , but functional studies have yielded inconclusive results . Examining the associations of circulating miRNAs levels with obesity and insulin sensitivity in humans may lead to improved insights . DESIGN AND METHODS  Serum  sample s collected from 112 obese and control subjects ( 50.0 % men ) were r and omly divided and combined into four pools ( 28 sample s in each obese or control pool ) . The genome-wide circulating miRNA profiles were detected via microarray . Elevated miR-122 was selected and vali date d in individual serum sample s from 123 obese ( 46.7 % men ) and 107 control ( 50.0 % men ) young adults . Associations between circulating miR-122 levels and parameters related to adiposity , insulin resistance , lipid profiles and hepatic enzymes were further assessed . RESULTS Thirty-four miRNAs were found to be expressed differently in the sera of obese patients compared with control subjects ( P<0.001 ) . Further analyses confirmed that obese patients had 3.07-fold higher circulating miR-122 levels than controls ( P<0.001 ) . Serum miR-122 levels were correlated with BMI ( r=0.469 ) , alanine aminotransferase ( r=0.634 ) , triglycerides ( r=0.448 ) , HDL-cholesterol ( r=-0.351 ) and homeostasis model assessment of insulin resistance ( r=0.401 , all P<0.01 ) . After controlling for confounding factors , miR-122 remained as an independent risk factor for insulin resistance ( OR=3.379 , 95 % CI=1.141 - 10.007 , P=0.028 ) . CONCLUSIONS Elevated circulating miR-122 is positively associated with obesity and insulin resistance in young adults . These findings provide a better underst and ing regarding the role of miRNAs in adiposity and insulin sensitivity Background Insulin resistance is a risk factor for type 2 diabetes and cardiovascular disease progression . Current diagnostic tests , such as glycemic indicators , have limitations in the early detection of insulin resistant individuals . We search ed for novel biomarkers identifying these at-risk subjects . Methods Using mass spectrometry , non-targeted biochemical profiling was conducted in a cohort of 399 nondiabetic subjects representing a broad spectrum of insulin sensitivity and glucose tolerance ( based on the hyperinsulinemic euglycemic clamp and oral glucose tolerance testing , respectively ) . Results R and om forest statistical analysis selected α-hydroxybutyrate ( α – HB ) as the top-ranked biochemical for separating insulin resistant ( lower third of the clamp-derived MFFM = 33 [ 12 ] µmol·min−1·kgFFM −1 , median [ interquartile range ] , n = 140 ) from insulin sensitive subjects ( MFFM = 66 [ 23 ] µmol·min−1·kgFFM −1 ) with a 76 % accuracy . By targeted isotope dilution assay , plasma α – HB concentrations were reciprocally related to MFFM ; and by partition analysis , an α – HB value of 5 µg/ml was found to best separate insulin resistant from insulin sensitive subjects . α – HB also separated subjects with normal glucose tolerance from those with impaired fasting glycemia or impaired glucose tolerance independently of , and in an additive fashion to , insulin resistance . These associations were also independent of sex , age and BMI . Other metabolites from this global analysis that significantly correlated to insulin sensitivity included certain organic acid , amino acid , lysophospholipid , acylcarnitine and fatty acid species . Several metabolites are intermediates related to α-HB metabolism and bio synthesis . Conclusions α – hydroxybutyrate is an early marker for both insulin resistance and impaired glucose regulation . The underlying biochemical mechanisms may involve increased lipid oxidation and oxidative stress Resistant starch ( RS ) has been shown to beneficially affect insulin sensitivity in healthy individuals and those with metabolic syndrome , but its effects on human type 2 diabetes ( T2DM ) are unknown . This study aim ed to determine the effects of increased RS consumption on insulin sensitivity and glucose control and changes in postpr and ial metabolites and body fat in T2DM . Seventeen individuals with well-controlled T2DM ( HbA1c 46.6±2 mmol/mol ) consumed , in a r and om order , either 40 g of type 2 RS ( HAM-RS2 ) or a placebo  , daily for 12 weeks with a 12-week washout period in between . At the end of each intervention period , participants attended for three metabolic investigations : a two-step euglycemic – hyperinsulinemic clamp combined with an infusion of [ 6,6 - 2H2 ] glucose , a meal tolerance test ( MTT ) with arterio-venous sampling across the forearm , and whole-body imaging . HAM-RS2 result ed in significantly lower postpr and ial glucose concentrations ( P=0.045 ) and a trend for greater glucose uptake across the forearm muscle ( P=0.077 ) ; however , there was no effect of HAM-RS2 on hepatic or peripheral insulin sensitivity , or on HbA1c . Fasting non-esterified fatty acid ( NEFA ) concentrations were significantly lower ( P=0.004 ) and NEFA suppression was greater during the clamp with HAM-RS2 ( P=0.001 ) . Fasting triglyceride ( TG ) concentrations and soleus intramuscular TG concentrations were significantly higher following the consumption of HAM-RS2 ( P=0.039 and P=0.027 respectively ) . Although fasting GLP1 concentrations were significantly lower following HAM-RS2 consumption ( P=0.049 ) , postpr and ial GLP1 excursions during the MTT were significantly greater ( P=0.009 ) . HAM-RS2 did not improve tissue insulin sensitivity in well-controlled T2DM , but demonstrated beneficial effects on meal h and ling , possibly due to higher postpr and ial GLP1 Background Hyperuricemia is an independent predictor of impaired fasting glucose and type 2 diabetes , but whether it has a causal role in insulin resistance remains controversial . Here we tested the hypothesis that lowering uric acid in hyperuricemic nondiabetic subjects might improve insulin resistance . Methods Subjects with asymptomatic hyperuricemia ( n = 73 ) were prospect ively placed on allopurinol ( n = 40 ) or control ( n = 33 ) for 3 months . An additional control group consisted of 48 normouricemic subjects .  Serum uric acid , fasting glucose , fasting insulin , HOMA-IR ( homeostatic model assessment of insulin resistance ) , and high-sensitivity C-reactive protein were measured at baseline and at 3 months . Results Allopurinol-treated subjects showed a reduction in serum uric acid in association with improvement in fasting blood glucose , fasting insulin , and HOMA-IR index , as well as a reduction in serum high-sensitivity C-reactive protein . The number of subjects with impaired fasting glucose significantly decreased in the allopurinol group at 3 months compared with baseline ( n = 8 [ 20 % ] vs n = 30 [ 75 % ] , 3 months vs baseline , P < 0.001 ) . In the hyperuricemic control group , only glucose decreased significantly and , in the normouricemic control , no end point changed . Conclusions Allopurinol lowers uric acid and improves insulin resistance and systemic inflammation in asymptomatic hyperuricemia . Larger clinical trials are recommended to determine if lowering uric acid can help prevent type 2 diabetes OBJECTIVES This study intended to assess the effects of the antioxidants ; Alpha Lipoic Acid ( ALA ) , omega 3 fatty acids and vitamin E on the parameters of insulin sensitivity , oxidative stress , lipid metabolism and glycaemic control in patients of type 2 diabetes mellitus . METHODS This was a prospect i ve , r and omized , double blind , placebo controlled , single centred study . One hundred four patients with type 2 diabetes mellitus with insulin resistance were recruited for the study . They were given ALA , omega 3 fatty acids , vitamin E or placebo . Their weight , Body Mass Index ( BMI ) and Waist circumference were measured . The investigations which were fasting glucose and fasting total cholesterol . The insulin resistance was calculated on the basis of the BMI and the waist circumference . RESULTS In the intra group analysis at the baseline ( V1 ) vs at the end of the treatment period ( V5 ) , we observed a significant decrease in the BMI , waist circumference and the total cholesterol in the three treatment groups . In the intergroup analysis at V5 , ALA , omega 3 fatty acids and vitamin E showed a significant improvement in the total cholesterol as compared to the placebo and vitamin E showed the maximum improvement . CONCLUSION ALA , omega 3 fatty acids and vitamin E showed the improvement in insulin sensitivity . Since they differ in improving different parameters all of these three can be used as an add on therapy in patients with type 2 diabetes mellitus to improve their insulin sensitivity and lipid metabolism Aims : This trial aims to determine the effects of resistant starch ( RS ) subtype 2 ( RS2 ) on glycemic status , metabolic endotoxemia and markers of oxidative stress . Methods : A r and omized , controlled , parallel-group clinical trial group of 56 females with type 2 diabetes mellitus ( T2DM ) was divided to 2 groups . The intervention group ( n = 28 ) and control group ( n = 28 ) received 10 g/day RS2 or placebo for 8 weeks , respectively . Fasting blood sample s were taken to determine glycemic status , endotoxin , high sensitivity C-reactive protein ( hs-CRP ) , malondialdehyde ( MDA ) , total antioxidant capacity ( TAC ) , antioxidant enzymes concentrations as well as uric acid at baseline and after the intervention . Results : After 8 weeks , RS2 caused a significant decrease in the levels of MDA ( -34.10 % ) , glycosylated hemoglobin ( -9.40 % ) , insulin ( -29.36 % ) , homeostasis model of insulin resistance ( -32.85 % ) and endotoxin ( -25.00 % ) , a significant increase in TAC ( 18.10 % ) and glutathione peroxidase ( 11.60 % ) as compared with control . No significant changes were observed in fasting plasma glucose , quantitative insulin sensitivity check index , hs-CRP , superoxide dismutase , catalase and uric acid in the RS2 group as compared with the control group . Conclusion : Supplementation with RS2 may be improved glycemic status , endotoxemia and markers of oxidative stress in patients with T2DM OBJECTIVE To evaluate the effect of N-acetyl-cysteine ( NAC ) on insulin secretion and peripheral insulin resistance in subjects with polycystic ovary syndrome ( PCOS ) . DESIGN Prospect i ve data analysis . SETTING Volunteer women in an academic research environment . PATIENT(S ) Six lean and 31 obese subjects , aged 19 - 33 years . INTERVENTION(S ) Patients were treated for 5 - 6 weeks with NAC at a dose of 1.8 g/day orally . A dose of 3 g/day was arbitrarily chosen for massively obese subjects . Six of 31 obese patients with PCOS were treated with placebo and served as controls . MAIN OUTCOME MEASURE(S ) Before and after the treatment period , the hormonal and lipid blood profile and insulin sensitivity , assessed by an hyperinsulinemic euglycemic clamp , were evaluated and an oral glucose tolerance test ( OGTT ) was performed . RESULT ( S ) Fasting glucose , fasting insulin , and glucose area under curve ( AUC ) were unchanged after treatment . Insulin AUC after OGTT was significantly reduced , and the peripheral insulin sensitivity increased after NAC administration , whereas the hepatic insulin extraction was unaffected . The NAC treatment induced a significant fall in T levels and in free and rogen index values ( P<.05 ) . In analyzing patients according to their insulinemic response to OGTT , normoinsulinemic subjects and placebo-treated patients did not show any modification of the above parameters , whereas a significant improvement was observed in hyperinsulinemic subjects . CONCLUSION ( S ) NAC may be a new treatment for the improvement of insulin circulating levels and insulin sensitivity in hyperinsulinemic patients with polycystic ovary syndrome OBJECTIVE To assess the impact of weight reduction on serum adipocytokines , C-reactive protein ( CRP ) , and insulin sensitivity in hypertensive female patients with central obesity . METHODS This study was performed using the data base and stored serum sample s of female patients who had participated in an intervention study focused on weight loss . Thirty hypertensive women aged 18 to 65 , body mass index ( BMI ) > 27 kg/m2 , and central obesity were selected . They were r and omly assigned to receive either a low-calorie diet plus orlistat 120 mg three times daily or a low-calorie diet alone for 16 weeks . Patients who experienced weight loss greater than 5 % ( n = 24 ) were assessed for blood pressure , anthropometric parameters , visceral fat , insulin resistance ( HOMA-R - homeostasis model assessment of insulin resistance ) and sensitivity ( ISI - Insulin Sensitivity Index ) indices , plus serum lipids , adipocytokines ( adiponectin , leptin , IL-6 , and TNF-alpha ) and CRP levels . RESULTS After BMI had been reduced by approximately 5 % in both groups , visceral fat , fasting glucose , triglycerides , and TNF-alpha decreased . Only the orlistat group , which was more insulin resistant at baseline , showed a significant reduction in blood glucose after oral glucose load , in addition to increased insulin sensitivity . CONCLUSION This study 's findings indicate that a weight loss greater than 5 % is associated with improved inflammatory status and decreased insulin resistance , regardless of changes in adiponectin and TNF-a levels . The greatest improvements in insulin sensitivity experienced by the orlistat-treated patients could not be attributed to the use of this drug because of the higher number of insulin-resistant subjects in this group Abstract Aim : It is well known that increased insulin resistance is associated with the development of cardiovascular disease in patients with rheumatoid arthritis and that tumour necrosis factor- alpha plays an important role in this process . Infliximab is a chimeric monoclonal anti- tumour necrosis factoralpha antibody . This study investigates the effects of long term infliximab treatment on insulin resistance in patients with rheumatoid arthritis . Material s and Methods : Seven rheumatoid arthritis patients ( 6 female and 1 male ; mean age : 44.6±12.3 , mean duration of disease : 6.8 y ) for whom infliximab treatment had been planned at the rheumatology and internal medicine clinics were included . Patients were evaluated during and at the end of the study with a mean follow-up duration of 9.6 months . Fasting plasma glucose , fasting plasma insulin levels and serum lipid profile were assessed at baseline and throughout the treatment period ( prior to every infusion ) . Homeostasis Model Assessment of Insulin Resistance model was used for the assessment of insulin sensitivity . Results : Fasting insulin and Homeostasis Model Assessment of Insulin Resistance levels decreased after treatment ( from 19.4±7.7 μU/ml to 8.9±4.1 μU/ml and from 2.4±1 to 1.1±0.5 , respectively ; p<0.05 for both ) . No significant change was observed in other parameters . Conclusion : An improvement in insulin sensitivity was observed in patients receiving long term infliximab treatment for rheumatoid arthritis Background Insulin resistance is a strong predictor of the development of type 2 diabetes mellitus . Chronic helminth infections might protect against insulin resistance via a caloric restriction state and indirectly via T-helper-2 polarization of the immune system . Therefore the elimination of helminths might remove this beneficial effect on insulin resistance . Methods / Design To determine whether soil-transmitted helminth infections are associated with a better whole-body insulin sensitivity and whether this protection is reversible by anthelmintic treatment , a household-based cluster-r and omized , double blind , placebo-controlled trial was conducted in the area of Nangap and a on Flores Isl and , Indonesia , an area endemic for soil-transmitted helminth infections . The trial incorporates three monthly treatment with albendazole or matching placebo for one year , whereby each treatment round consists of three consecutive days of supervised drug intake . The presence of soil-transmitted helminths will be evaluated in faeces using microscopy and /or PCR . The primary outcome of the study will be changes in insulin resistance as assessed by HOMA-IR , while the secondary outcomes will be changes in body mass index , waist circumference , fasting blood glucose , 2 h-glucose levels after oral glucose tolerance test , HbA1c , serum lipid levels , immunological parameters , and efficacy of anthelmintic treatment . Discussion The study will provide data on the effect of helminth infections on insulin resistance . It will assess the relationship between helminth infection status and immune responses as well as metabolic parameters , allowing the establishment of a link between inflammation and whole-body metabolic homeostasis . In addition , it will give information on anthelmintic treatment efficacy and effectiveness . Trial registration This study has been approved by the ethical committee of Faculty of Medicine Universitas Indonesia ( ref : 549/H2.F1/ETIK/2013 ) , and has been filed by the ethics committee of Leiden University Medical Center , clinical trial number : IS RCT N75636394 . The study is reported in accordance with the CONSORT guidelines for cluster-r and omised trials Resistant starch ( RS ) , a non-viscous dietary fibre , may have postpr and ial effects on appetite regulation and metabolism , although the exact effects and mechanisms are unknown . An acute r and omised , single-blind crossover study , aim ed to determine the effects of consumption of 48 g RS on appetite compared to energy and available carbohydrate-matched placebo .  Twenty young healthy adult males consumed either 48 g RS or the placebo divided equally between two mixed meals on two separate occasions . Effects on appetite were assessed , using an ad libitum test meal and 24-h diet diaries for energy intake , and using visual analogue scales for subjective measures . Changes to postpr and ial glucose , insulin and C-peptide were also assessed . There was a significantly lower energy intake following the RS supplement compared to the placebo supplement at both the ad libitum test meal ( 5241 ( sem 313 ) v. 5606 ( sem 345 ) kJ , P = 0.033 ) and over the 24 h ( 12 603 ( sem 519 ) v. 13 949 ( sem 755 ) kJ , P = 0.044 ) . However , there was no associated effect on subjective appetite measures . Postpr and ial plasma glucose concentrations were not significantly different between supplements , but there was a significantly lower postpr and ial insulin response following the RS supplement ( P = 0.029 ) . The corresponding C-peptide concentrations were not significantly different , although the ratio of C-peptide to insulin was higher following the RS supplement compared to placebo ( P = 0.059 ) . These results suggest that consumption of 48 g RS , over a 24-h period , may be useful in the management of the metabolic syndrome and appetite . Further studies are required to determine the exact mechanisms
Conclusions This meta- analysis has provided evidence that RS supplementation can improve fasting glucose , fasting insulin , insulin resistance and sensitivity , especially for diabetic with overweight or obesity .
Background The role of resistant starch ( RS ) in glucose , insulin , insulin resistance or sensitivity , and lipid parameters have been reported in several studies and remained controversial .
A pooled analysis which assessed these parameters has not been performed .
Thus , we conducted a meta- analysis to sum up existing evidence about the issue .