Thesis (doctoral)--Lund University, 1997. / Added t.p. with thesis statement inserted.

Thesis (doctoral)--Lund University, 1997. / Added t.p. with thesis statement inserted.

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Metabolic syndrome includes several metabolic and hormonal disorders, such as abdominal obesity, insulin resistance, and lower blood ghrelin. Women with breastfeeding history exhibit a reduced risk for metabolic syndrome in later life. The purpose of aim 1 was to determine the incidence of metabolic syndrome in low income, overweight/obese women in early postpartum and to assess its relationship to lactation status. It has been found that the incidence of metabolic syndrome is much higher in formula feeding women than that of the breastfeeding ones (44.3% vs. 22.4%, p < 0.01). The breastfeeding mothers had reduced triglycerides (109.07 mg/dl vs. 143.10 mg/dl, p < 001) and elevated serum high-density lipoprotein (HDL)-cholesterol (58.59 mg/dl vs. 51.76 mg/dl, p < 0.01). The goal of aim 2 was to explore associations between ghrelin, metabolic syndrome and infant feeding methods in low income, overweight/obese women in early postpartum. In our study, the breastfeeding mothers in early postpartum had higher plasma ghrelin, as compared to those who formula fed (584.73 pg/ml vs. 450.77 pg/ml, p < 0.01). Additionally, it is found that plasma ghrelin was negatively associated with incidence and numbers of risk factors for metabolic syndrome, before and after controlling for body mass index (BMI). After adjusting for ghrelin in logistic regression analyses, significant relationships between lactation status and metabolic syndrome disappeared. Thus, the protective function of breastfeeding against metabolic syndrome in overweight/obese women in early postpartum may related to the plasma ghrelin values. The purpose of aim 3 was to detect the influence of weight loss on insulin resistance and plasma adiponectin, zinc (Zn), manganese (Mn) and copper (Cu) in low income, overweight/obese women in early postpartum. After an eight-week weight loss intervention, plasma levels of adiponectin, Zn and Mn were significantly enhanced, and plasma concentrations of insulin (7.53±0.56 vs. 6.23±0.49, p <0.01) and insulin resistance (1.84±0.15 vs. 1.44±0.12, p <0.01) were reduced. The increase of adiponectin, Zn and Mn was positively associated with weight reduction. However, the plasma Cu was not significantly affected. The relationships between weight loss and reduced insulin resistance disappeared after adjusting the increases of adiponectin, Zn and Mn during weight loss. Thus, weight loss had beneficial effects on insulin resistance, plasma values of adiponectin Zn and Mn. It is plausible that the influence of weight loss on insulin resistance may be associated with improvements of plasma of adiponectin, Zn and Mn. Collectively, the results of this study demonstrate the important benefits of breastfeeding on prevention of metabolic syndrome in overweight/obese women in early postpartum. This study also emphasizes the influence of ghrelin on risk factors of metabolic syndrome and lactation status. / text

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M.Tech. (Homeopathy) / Insulin resistance (IR) is a metabolic derangement and a documented clinical feature of the metabolic syndrome. It is an important risk factor in the development of cardiovascular disease and Type 2 Diabetes mellitus. Insulin resistance is often characterized by an increased Homeostasis Model Assessment (HOMA) index and hyperinsulinaemia, but it may also be present without increased insulin levels. Metabolic syndrome is a cluster of risk factors characterized by visceral adiposity (a girth exceeding 102cm in men and 88cm in women), dyslipidaemia (low HDL and raised triglycerides levels), hypertension and dysglycaemia, particularly raised fasting blood glucose levels, predisposing individuals to cardiovascular disease and Type 2 Diabetes mellitus. Diaglukon™ Dr Reckeweg R40 is formulated as an adjunct in the treatment of type 2 diabetes mellitus to assist in lowering the blood glucose (hyperglycaemia). The aim of the research was to evaluate and document its efficacy in the treatment of insulin resistance. A cohort of forty five participants between the ages of nineteen to forty five years was randomized into a double blind placebo controlled, 16 week, clinical study. Participants were matched according to age, race and gender. Anthropometric evaluation consisted of weight, height, BMI, waist circumference and blood pressure readings; these were recorded at 4 weekly intervals for sixteen weeks. Metabolic data included fasting insulin, glucose and a full lipogram at baseline (Week 0) and at study conclusion (Week 16). The insulin and glucose was used to calculate the HOMA index as a measure of insulin resistance (IR). Non parametric statistical analysis was conducted on all parameters using the SPSS statistical programme...

MSc Pharmacology, Faculty of Health Sciences, University of the Witwatersrand / Natural remedies from medicinal plants are considered to be effective and safe alternative treatment for diabetes mellitus. The aim of this study was to demonstrate the hypoglycaemic and antidiabetic activity of the aqueous extract of Icacina tracantha (tuber) (fam Icacinaceae)Ananas cosmos (fam. Bromeliaceae)and Uraria picta (leaves) (fam leguminosae) on an animal model of insulin resistance, a condition which predisposes to type 2 diabetes. The plants have a long history of use as anti-diabetic agents in western Nigeria. Method: 120 male Sprague-Dawley rats were assigned into two major groups. One group was fed on normal rat chow with the other group fed on a high calorie diet for four months a period sufficient for the animals to be fed to attain insulin resistance. The animals were then randomly assigned into different groups (each containing 6 male rats). The plant crude extracts were made by weighing specific dried quantities of each plant, boiling in distilled water for about 2 hours, cooling overnight and separating solid from liquid by filtration. The solution was then poured into preweighed 250 ml beakers and allowed to dry in an oven at a temperature of 60oC. The dried, crude extracts were then weighed out and required doses prepared from the extracts. A non-treated group of animals was used as the control. The mixed dose of extract was administered at 300 mg/kg. Over a 3 week period, all the animals were orally dosed with the different doses of plant extracts daily while metformin was administered through the animals’ drinking water, blood was collected from the tail vein of each rat prior to dosing and thereafter weekly, plasma was preserved and 6 analysed for glucose, insulin, free fatty acid concentrations and calculation of HOMA values to determine insulin sensitivity. During this period, the animals were weighed weekly and food intake was measured every three days. An oral glucose tolerance test (OGTT) was performed after the dosing period and fasting, 0, 30, 60 and 120 minute blood samples were taken and assayed for glucose concentration. Animals were terminated and blood analysed. Statistical analysis: The results were tabulated as mean ± standard deviation and percentage median ± quartile range. The statistical analysis for other parameters was carried out via ANOVA (between groups) and Student’s paired T test (within groups). Only data from percentage median and quartile range was used because of the observed variation in glucose concentration between groups even at baseline values. Statistica software (StatSoft, Tulsa, OK, USA) was used for the analysis. Results: All plant extracts in the study showed differing concentration of significant difference in their effect on the plasma glucose, insulin and free fatty acid concentrations in the rat. The most significant effect was observed on the insulin concentration in the normal rat chow and high calorie diet fed animals. The plant extracts were observed to improve insulin sensitivity in most of the groups. This effect was more significant in the normal rat chow fed rats. The effect of the plant extracts on the weight, food consumed glucose and free fatty acid was minimal and in most of the groups was not significant. Conclusion: In conclusion, the results obtained suggest that the plant extracts may be used to improve insulin resistance in the management of diabetes mellitus.

Thesis advisor: Catherine Y. Read / Background and Significance: The metabolic syndrome is a heterogeneous disorder leading to increased morbidity and mortality. Components of the metabolic syndrome are known to be inherited, however efforts to identify genomic markers in humans have been unsuccessful and a candidate-gene/intermediate phenotype approach may be useful. Evidence supports a relationship between altered metabolic function and three candidate genes, caveolin-1 (CAV1), peroxisome proliferator receptor-activated gamma, and angiotensinogen (AGT). These genes may serve as markers for the co-aggregation of insulin resistance and hypertension. Research Question: To examine whether single nucleotide polymorphisms (SNPs) in the CAV1, PPARg and AGT genes are associated with the co-aggregation of insulin resistance and hypertension. Methods: Three gene association studies were conducted in a Caucasian hypertensive cohort (HyperPATH). The homeostasis assessment model (HOMA-IR), hyperinsulinemic euglycemic clamp, and salt sensitive blood pressure were determined in each subject. Statistical analyses were conducted using a general linear model accounting for relatedness and adjusting for the following covariates: age, gender, body mass index, study site. Replication was assessed in a hypertensive Mexican-American cohort (HTN-IR) for the CAV1 gene and a hypertensive African American cohort (HyperPATH) for the PPARg gene. Results: SNPs of the CAV1 gene were significantly associated with insulin resistance in Caucasians from HyperPATH. These results were replicated in the HTN-IR cohort. A SNP of the PPARg gene was associated with salt sensitive blood pressure and increased plasma renin levels in Caucasians and African Americans from HyperPATH. SNPs of the AGT gene were associated with insulin sensitivity in Caucasians from HyperPATH. Conclusion: CAV1 and AGT are genomic markers for the co-aggregation of insulin resistance and hypertension. The PPARg gene is a potential genomic marker for vascular dysfunction in hypertension. Clinical Perspective: Genomic markers for insulin resistance exist in human populations with hypertension. These markers explain the inter-individual variability of insulin resistance and hypertension and help identify potential underlying mechanisms. Use of these bio-markers in clinical practice may improve individualized prevention and treatment strategies, decreasing the incidence of and improving outcomes for this chronic disease. Promoting health through individualized care makes the incorporation of genomic markers into nursing practice essential. / Thesis (PhD) — Boston College, 2010. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.