Instituto Medico Of La Mujer Instituto Medico Metabolico

Lima, Peru

Instituto Medico Of La Mujer Instituto Medico Metabolico

Lima, Peru
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Benites-Zapata V.A.,University of San Martín de Porres | Urrunaga-Pastor D.,University of San Martín de Porres | Torres-Mallma C.,University of San Martín de Porres | Prado-Bravo C.,University of San Martín de Porres | And 2 more authors.
Diabetes and Metabolic Syndrome: Clinical Research and Reviews | Year: 2017

Objective: To determine the association between thyroid hormones and insulin resistance in a population of healthy individuals. Materials and methods: We conducted an analytical cross-sectional study in adults who attended a private clinic from 2012 to 2014. We excluded those participants with fasting glucose values compatible with diabetes mellitus, abnormal thyroid hormone values, chronic use of corticosteroids, and incomplete medical records. Participants were divided into tertiles (low, intermediate and high) according to their free triiodothyronine and free thyroxine values. We defined Insulin resistance as a Homeostasis Model Assessment (HOMA-IR) value greater than 3.8. We conducted a univariate and multivariate Poisson regression model to assess the association between thyroid hormones and insulin resistance. The association measure reported was the prevalence ratio (PR) with their confidence interval (CI) at 95%. Results: We evaluated 600 participants. The mean age was 36.8. ±. 14.2. years and 33% were male. The frequency of insulin resistance was 29.5%. In the univariate regression, we found association between free triiodothyronine tertiles and insulin resistance. In the multivariate regression adjusted for age, sex, body mass index and thyroid stimulating hormone, the association between free triiodothyronine tertiles and insulin resistance remained; intermediate tertile (PR = 1.54; CI95%: 1.10-2.15) and high tertile (PR = 1.70; CI95%: 1.21-2.39). We found no association between T4 and insulin resistance. Conclusions: High levels of free triiodothyronine are associated with insulin resistance. The use of free trioodothyronine to assess insulin resistance in healthy patients should be considered. © 2017 Diabetes India.


Hernandez A.V.,Instituto Medico Of La Mujer Instituto Medico Metabolico | Hernandez A.V.,Peruvian University of Applied Sciences | Hernandez A.V.,Cleveland Clinic Lerner Research Institute | Guarnizo M.,Instituto Medico Of La Mujer Instituto Medico Metabolico | And 10 more authors.
PLoS ONE | Year: 2014

Objective: This study was undertaken to evaluate the association between components defining insulin resistance and breast cancer in women. Study Design: We conducted a systematic review of four databases (PubMed-Medline, EMBASE, Web of Science, and Scopus) for observational studies evaluating components defining insulin resistance in women with and without breast cancer. A meta-analysis of the association between insulin resistance components and breast cancer was performed using random effects models. Results: Twenty-two studies (n = 33,405) were selected. Fasting insulin levels were not different between women with and without breast cancer (standardized mean difference, SMD -0.03, 95%CI -0.32 to 0.27; p = 0.9). Similarly, non-fasting/fasting C-peptide levels were not different between the two groups (mean difference, MD 0.07, -0.21 to 0.34; p = 0.6). Using individual odds ratios (ORs) adjusted at least for age, there was no higher risk of breast cancer when upper quartiles were compared with the lowest quartile (Q1) of fasting insulin levels (OR Q2 vs. Q1 0.96, 0.71 to 1.28; OR Q3 vs. Q1 1.22, 0.91 to 1.64; OR Q4 vs. Q1 0.98, 0.70 to 1.38). Likewise, there were no differences for quartiles of non-fasting/fasting C-peptide levels (OR Q2 vs. Q1 1.12, 0.91 to 1.37; OR Q3 vs. Q1 1.20, 0.91 to 1.59; OR Q4 vs. Q1 1.40, 1.03 to 1.92). Homeostatic model assessment (HOMAIR) levels in breast cancer patients were significantly higher than in people without breast cancer (MD 0.22, 0.13 to 0.31, p<0.00001). Conclusions: Higher levels of fasting insulin or non-fasting/fasting C-peptide are not associated with breast cancer in women. HOMA-IR levels are slightly higher in women with breast cancer. © 2014 Hernandez et al.


PubMed | Cleveland Clinic, Instituto Medico Of La Mujer Instituto Medico Metabolico and Case Western Reserve University
Type: Journal Article | Journal: PloS one | Year: 2014

This study was undertaken to evaluate the association between components defining insulin resistance and breast cancer in women.We conducted a systematic review of four databases (PubMed-Medline, EMBASE, Web of Science, and Scopus) for observational studies evaluating components defining insulin resistance in women with and without breast cancer. A meta-analysis of the association between insulin resistance components and breast cancer was performed using random effects models.Twenty-two studies (n=33,405) were selected. Fasting insulin levels were not different between women with and without breast cancer (standardized mean difference, SMD -0.03, 95%CI -0.32 to 0.27; p=0.9). Similarly, non-fasting/fasting C-peptide levels were not different between the two groups (mean difference, MD 0.07, -0.21 to 0.34; p=0.6). Using individual odds ratios (ORs) adjusted at least for age, there was no higher risk of breast cancer when upper quartiles were compared with the lowest quartile (Q1) of fasting insulin levels (OR Q2 vs. Q1 0.96, 0.71 to 1.28; OR Q3 vs. Q1 1.22, 0.91 to 1.64; OR Q4 vs. Q1 0.98, 0.70 to 1.38). Likewise, there were no differences for quartiles of non-fasting/fasting C-peptide levels (OR Q2 vs. Q1 1.12, 0.91 to 1.37; OR Q3 vs. Q1 1.20, 0.91 to 1.59; OR Q4 vs. Q1 1.40, 1.03 to 1.92). Homeostatic model assessment (HOMA-IR) levels in breast cancer patients were significantly higher than in people without breast cancer (MD 0.22, 0.13 to 0.31, p<0.00001).Higher levels of fasting insulin or non-fasting/fasting C-peptide are not associated with breast cancer in women. HOMA-IR levels are slightly higher in women with breast cancer.

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