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EN
Insulin sensitivity (IS) is one of the important diagnostic parameters used in treatments of diabetes, hypertension and other diseases as well as during evaluation of new drug therapies. Euglycaemic glucose clamp is the most accurate method of the IS measurement. Effectiveness of this procedure depends on accuracy of the tissue glucose utilization measurements (GU) and proper realization of the insulin infusion. Application of the accurate glucose control algorithm, sampling site, sampling frequency, duration of the procedure are also very important factors. Possible technical realization includes manual, semi-automatic and automatic modes. Recently the computerized semi-automatic system realizing this type of measurement has been designed and developed in the IBBE PAS. A developed system consist of control unit, infusion unit, glycaemia measurement unit and printer. Endogenous glucose secretion is suppressed by insulin infusion, which is determined according to individual patients parameters. The newest version of the measurement procedure allows to realize euglycaemic or normoglycaemic clamp studies. TISS system is inexpensive and easily operated by one person from middle medical staff. Till now GU measurements using TISS system were performed on over 200 patients in 4 Polish clinical centers. Developed and clinically tested TISS system seems to provide satisfying quality of the GU measurement in men.
EN
The aim of the studies was to compare lean and obese high-producing milk Holstein-Fresian cows in terms of their insulin sensitivity. 17 animals, 2-8 years of age, weighing 480-725 kg, with a daily milk yield fluctuating between 25.4 and 46.5 kg, were divided into two groups, depending on the body weight and condition: lean and obese cows. Subsequently, both groups were divided into subgroups according to the month of lactation. Their condition was evaluated on a five-point Body Condition Score (BCS) scale. Throughout the entire experiment, the cows were fed ad libitum with the same feed and had free access to fresh water. Blood samples were collected every week directly after milking from the subcutaneous abdominal vein. In the whole blood the glucose level was measured, whereas in the plasma, insulin and FFA concentrations were analysed. On the basis of the results obtained, insulin sensitivity was analysed according to the RQUICKI formula (“Revised Quantitative Insulin Sensitivity Check Index”), and the energy balance was calculated. In both experimental groups of lactating cows, the plasma insulin level was found to be several times higher than the physiological norm for non-lactating animals. The highest insulin concentration was noted in obese cows with BCS 3.5. Moreover, in the obese group a high negative correlation (r = -0.62) between insulin sensitivity and BCS, and a positive correlation between the insulin level and BCS were found. The level of free fatty acids (FFA) increased during the lactation, and in both groups it was higher than the reference data. The highest FFA concentration, similarly to insulin, was found in obese cows with BCS 3.5. The glucose level increased during the lactation in both groups of animals, but it was lower than the physiological norm for non-lactating cows. According to our results, there is a relationship between the insulin concentration, insulin sensitivity, and body condition (BCS) in high-producing milk cows. In high-yielding dairy cows elevated levels of FFA may indicate that insulin sensitivity is suppressed. The fat high-producing cows maintained on a positive energy balance are more likely to develop insulin resistance and succumb to production diseases. The RQUICKI test enables an easy assessment of tissue response to insulin.
EN
Insulin resistance (IR) is a multifactorial metabolic disorder associated with the development of cardiometabolic syndrome, cardiovascular diseases and obesity. Factors such as inflammation, hyperinsulinemia, hyperglucagonemia, mitochondrial dysfunction, glucotoxicity and lipotoxicity contribute to the development of IR. Despite being extensively studied for over 60 years, assessing the incidence of IR, developing effective prevention strategies, and implementing appropriate therapeutic approaches remain challenging. This review explores the multifaceted nature of IR, including its association with various conditions such as obesity, primary hypertension, dyslipidemia, obstructive sleep apnea, Alzheimer’s disease, non-alcoholic fatty liver disease, polycystic ovary syndrome, chronic kidney disease and cancer. Additionally, we discuss the complexity of diagnosing and quantifying IR, emphasizing the lack of absolute, common criteria for classification. We delve into the use of mathematical models in clinical and epidemiological studies, focusing on the choice between insulin, triglycerides, or waist-to-hip ratio as IR determinants. Furthermore, we highlight the importance of reliable input data and caution in interpreting results when utilizing mathematical models for IR assessment. This narrative review aims to provide insights into the challenges and considerations involved in conducting IR diagnostics, with implications for clinical practice, epidemiological research, and future advancements in this field.
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