Many studies have shown that hyperinsulinemia and/or insulin resistance are related to various metabolic and physiological disorders including hypertension, dyslipidemia, and non-insulin-dependent diabetes mellitus. This syndrome has been termed Syndrome X. An important limitation of previous studies has been that they all have been cross sectional, and thus the presence of insulin resistance could be a consequence of the underlying metabolic disorders rather than its cause. We examined the relationship of fasting insulin concentration (as an indicator of insulin resistance) to the incidence of multiple metabolic abnormalities in the 8-yr follow-up of the cohort enrolled in the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease in Mexican Americans and non-Hispanic whites. In univariate analyses, fasting insulin was related to the incidence of the following conditions: hypertension, decreased high-density lipoprotein cholesterol concentration, increased triglyceride concentration, and non-insulin-dependent diabetes mellitus. Hyperinsulinemia was not related to increased low-density lipoprotein or total cholesterol concentration. In multivariate analyses, after adjustment for obesity and body fat distribution, fasting insulin continued to be significantly related to the incidence of decreased high-density lipoprotein cholesterol and increased triglyceride concentrations and to the incidence of non-insulin-dependent diabetes mellitus. Baseline insulin concentrations were higher in subjects who subsequently developed multiple metabolic disorders. These results were not attributable to differences in baseline obesity and were similar in Mexican Americans and non-Hispanic whites. These results support the existence of a metabolic syndrome and the relationship of that syndrome to multiple metabolic disorders by showing that elevations of insulin concentration precede the development of numerous metabolic disorders.

Prospective Analysis of the Insulin-Resistance Syndrome (Syndrome X)

BACKGROUND: Type 2 diabetes (T2D) is a complex disorder that is affected by multiple genetic and environmental factors Extensive efforts have been made to identify the disease-affecting genes to better understand the disease pathogenesis, find new targets for clinical therapy, and allow prediction of disease

CONTENT: Our knowledge about the genes involved in disease pathogenesis has increased substantially in recent years, thanks to genomewide association studies and international collaborations joining efforts to collect the huge numbers of individuals needed to study complex diseases on a population level We have summarized what we have learned so far about the genes that affect T2D risk and their functions Although more than 40 loci associated with T2D or glycemic traits have been reported and reproduced, only a minor part of the genetic component of the disease has been explained, and the causative variants and affected genes are unknown for many of the loci

SUMMARY: Great advances have recently occurred in our understanding of the genetics of T2D, but much remains to be learned about the disease etiology The genetics of T2D has so far been driven by technology, and we now hope that next-generation sequencing will provide important information on rare variants with stronger effects Even when variants are known, however, great effort will be required to discover how they affect disease risk

/pdf/genetics-of-type-2-diabetes-58thwmenms.pdf

Genetics of Type 2 Diabetes

Background:CrossFit is a type of competitive exercise program that has gained widespread recognition. To date, there have been no studies that have formally examined injury rates among CrossFit participants or factors that may contribute to injury rates.Purpose:To establish an injury rate among CrossFit participants and to identify trends and associations between injury rates and demographic categories, gym characteristics, and athletic abilities among CrossFit participants.Study Design:Descriptive epidemiology study.Methods:A survey was conducted, based on validated epidemiologic injury surveillance methods, to identify patterns of injury among CrossFit participants. It was sent to CrossFit gyms in Rochester, New York; New York City, New York; and Philadelphia, Pennsylvania, and made available via a posting on the main CrossFit website. Participants were encouraged to distribute it further, and as such, there were responses from a wide geographical location. Inclusion criteria included participating in C...

https://journals.sagepub.com/doi/pdf/10.1177/2325967114531177

Injury Rate and Patterns Among CrossFit Athletes.

Aims/hypothesis
To study the heritability and familiality of type 2 diabetes and related quantitative traits in families from the Botnia Study in Finland.

/pdf/heritability-and-familiality-of-type-2-diabetes-and-related-pppcrezmyp.pdf

Heritability and familiality of type 2 diabetes and related quantitative traits in the Botnia Study.

Cancer cachexia is a debilitating consequence of disease progression, characterised by the significant weight loss through the catabolism of both skeletal muscle and adipose tissue, leading to a reduced mobility and muscle function, fatigue, impaired quality of life and ultimately death occurring with 25–30 % total body weight loss. Degradation of proteins and decreased protein synthesis contributes to catabolism of skeletal muscle, while the loss of adipose tissue results mainly from enhanced lipolysis. These mechanisms appear to be at least, in part, mediated by systemic inflammation. Exercise, by virtue of its anti-inflammatory effect, is shown to be effective at counteracting the muscle catabolism by increasing protein synthesis and reducing protein degradation, thus successfully improving muscle strength, physical function and quality of life in patients with non-cancer-related cachexia. Therefore, by implementing appropriate exercise interventions upon diagnosis and at various stages of treatment, it may be possible to reverse protein degradation, while increasing protein synthesis and lean body mass, thus counteracting the wasting seen in cachexia.

https://link.springer.com/content/pdf/10.1007%2Fs13539-012-0096-0.pdf

Cancer cachexia prevention via physical exercise: molecular mechanisms

Impact of exercise intensity and duration on insulin sensitivity in women with T2D.

AIMS: To compare the clinical characteristics of Type 2 diabetes (T2DM) between immigrants from the Middle-East and Swedish patients. METHODS: The study group included 450 consecutive patients with T2DM, 379 Swedish-born aged 61 +/- 12 years and 71 patients originally from the Middle-East aged 50 +/- 11 years from the diabetes clinic of Malmo University Hospital. RESULTS: Onset of diabetes had occurred 12 years earlier in the Middle-East immigrants compared with the Swedish-born patients (43 +/- 10 vs. 55 +/- 12 years, P < 0.001). Immigrants had lower fasting serum C-peptide [0.7 (0.1-2.6) vs. 0.9 (0.1-4.0) nmol/l, P = 0.013], lower homeostasis model assessment (HOMA)-beta[1.7 (0.1-9.1) vs. 2.7 (0.1-59.0), P = 0.010], lower HOMA-IR [0.4 (0.02-1.19) vs. 0.4 (0.01-2.8), P = 0.005] than the Swedish group. A first-degree family history of diabetes was reported in 61% of immigrants, compared with 47% of Swedish-born (P = 0.022). CONCLUSIONS: Immigrants from the Middle-East have an earlier onset, stronger family history and more rapid decline of pancreatic B-cell function than Swedish patients, suggesting that they have a different form of T2DM compared with Swedish patients. (Less)

Immigrants from the Middle-East have a different form of Type 2 diabetes compared with Swedish patients

Evaluation of the effects of exercise on insulin sensitivity in Arabian and Swedish women with type 2 diabetes.

The primary aim of this study was to compare the maximal oxygen uptake as evaluated from a submaximal exercise test (EVO2peak) to direct measurements of VO2peak during a maximal exercise test as means of monitoring the aerobic endurance capacity in women with type 2 diabetes (T2D). Twenty-seven women with T2D participated in the study. The program consisted of combined group training 1 h twice a week during 12 weeks and walks 1 h per week. EVO2 max was estimated using a submaximal exercise test on a bicycle ergometer ad modum Astrand. VO2peak and maximal work rate were measured using an incremental maximal exercise test on an electrically braked bicycle ergometer at baseline and after 6 and 12 weeks. EVO2peak was higher than VO2peak at baseline and significantly higher at 12 weeks (EVO2peak1.92+/-0.54 l min(-1), VO2peak 1.41+/-0.36, P<0.005). Maximal work rate increased significantly after 12 weeks (12+/-15, P<0.005) compared to baseline. The main finding of this study was that EVO2peak assessed using a submaximal exercise test, systematically overestimated VO2peak. The combined group training increased maximal work rate but not VO2peak. This is likely to reflect peripheral adaptation to exercise and/or improved mechanical efficiency.

Assessment of exercise capacity in women with type 2 diabetes

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Impact of exercise intensity and duration on insulin sensitivity in women with T2D.

Immigrants from the Middle-East have a different form of Type 2 diabetes compared with Swedish patients

Evaluation of the effects of exercise on insulin sensitivity in Arabian and Swedish women with type 2 diabetes.

Assessment of exercise capacity in women with type 2 diabetes