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Abstract

The Metabolic Syndrome in Diabetic Hispanic Adults and the Role of Secondary Actos Treatment in Insulin Sensitivity Based on Gender

Background: The prevalence of the metabolic syndrome in diabetics is highest among Hispanic adults. A thiazolidinedione antidiabetic agent found in Actos contributes to its mechanism of action. Actos also decreases insulin resistance in margin of the liver, resulting in increased insulin-dependent glucose disposal and decreased hepatic glucose output. This study primarily focuses on the effects of the secondary treatment of Actos on a group of South Texas Hispanics at risk for Type II diabetes; the participants’ ages ranged from 22 to 86 years. These results were based on their metabolic syndrome health data and the extent of recovery on the basis of their gender. Multiple regression analyses have been conducted to determine the factors affecting the metabolic syndrome data on the gender after secondary treatment. Some auxiliary analyses pertaining to cholesterol levels and weight vs. gender comparisons have been carried out to show the gender disparity.

Aims and Objectives: The purpose of this study was to establish the prevalence of the metabolic syndrome in the South Texas region and of individual variables which contributed to obesity of Hispanics at risk for Type II diabetes. Patients with the metabolic syndrome have three or more of these risk factors that include excessive abdominal fat, hypertension, low amounts of HDL cholesterol, elevated triacylglyceride levels, and abnormal blood sugar. They are also three-and-a-half times as likely to die from risks associated with coronary heart disease, as well as an increased risk of liver and kidney disease, and possibly cancer. Nondrug treatment programs for metabolic syndrome such as weight loss, dietary changes, and increased physical activity, decreased the incidence of metabolic syndrome by almost 41 percent, whereas the incidence rate among these patients on drug therapy was reduced by only 17 percent to conclude that there are other options available.

Methods and Experimental Design: A group of individuals comprising of both males and females, had been treated with Actos. Some were administered secondary medication. They were frequently monitored and health data was collected afterwards. Participants in the study were selected by the utilization of a convenience sample technique from those who lived in Laredo, Webb County, Texas, US. Criteria for inclusion included being treated with Actos for metabolic syndrome or diabetes mellitus. The patients were of Hispanic background ranging in age from 22 to 86 with a roughly equal gender representation. Half of the sample was treated with Actos and the other half was not. Data collection included levels of total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triacylglycerides, fasting blood glucose prior to each scheduled visit with the provider every three to four months. Blood pressure, height, weight, and abdominal girth measurements were taken on the scheduled appointment day.

Results and Findings: Statistical analysis was done to determine the gender differences in physical and metabolic characteristics after secondary Actos treatment using the general linear model and other relevant statistical determinations. Some auxiliary analyses have been done to show the effects of secondary medications on weight, cholesterol, as well as on the gender. For each category of data, the percentages of the average metabolic syndrome data reductions using means ± standard error of means (SEM) among Weight, Girth, B/P (blood pressure), BMI (body mass index), FBS (fasting blood sugar), Chol. (Cholesterol), HDL (high-density lipoprotein), LDL (low-density lipoprotein), and TG (triacylglycerides or Trigl.) were computed. However, the lower B/P reading is noted as more critical than upper reading for the analysis of the individual metabolic syndrome health data. The aggregate test indicator (ATI) was introduced to measure overall benefit from all metabolic syndrome variables. Conclusion: Data concluded that 8 percent of the participants using ATP III criterion and 11 percent of the participants using WHO criterion as potentially at risk of having metabolic syndrome. It was determined that the secondary treatment helped 77.78 percent of males and 66.67 percent of females. Also 55.56 percent of all subjects without the secondary treatment demonstrated noticeable reduction of metabolic syndrome concluding that the secondary dose of medication was needed for stronger long-term relief from Actos treatment. This secondary treatment was more effective for males than for their female counterparts. Linear correlations between health data appeared more insignificant for males compared to that of females. For all other subjects, regardless of gender, the secondary treatment helped to reduce their metabolic syndrome variables. The aggregate test indicator (ATI), which measures the effectiveness of the secondary medication, showed that males were doing better as compared to females.


Author(s): Rohitha Goonatilake, Doris J. Rosenow, Irma A. Lara, Horacio Palacios, Gustavo E. Villarreal

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