Biomarkers of Metabolic Health

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He who has health, has hope; and he who has hope has everything” – Thomas Carlyle

The quote makes sense in terms of metabolic health, as metabolic well-being is important for overall health and can have a significant impact on one’s outlook on life. Good metabolic health contributes to overall health and vitality, laying the groundwork for a positive perspective on the future.

What is Metabolic Health?

Metabolic health is defined as the absence of any metabolic disease that may impair the body’s various metabolic functions. This means that the food we eat helps our body cells reduce the risk of heart disease, stroke, diabetes, kidney problems, obesity, fatty liver, and other organ or system damage. In simple terms, metabolic health means having ideal levels of blood sugar, triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure, and waist circumference without the use of medications.

What are biomarkers?

A biomarker is an objective measure of what is happening in a cell at any given time. For example, We frequently visit our doctors for check-ups and lab tests, during which they examine some of our innate measurable parameters that provide key insights into the state of our health. These criteria are known as biomarkers. Biomarkers can serve as health-related early warning systems.

What are the different Metabolic Health Biomarkers?

  1. Blood sugar levels
  2. HBA1C
  3. HOMA IR
  4. Triglycerides & HDL
  5. CRP
  6. Waist circumference
  7. Sleep
  8. Gut health
  9. Blood pressure
What is diabetes

Blood sugar levels: The most important carbohydrate fuel in the body is glucose. The majority of circulating glucose in the fed state comes from the diet; in the fasting state, gluconeogenesis and glycogenolysis maintain glucose concentrations. The majority of glucose in the diet is found in more complex carbohydrates that are broken down into monosaccharides during the digestive process. When blood glucose levels are high, the body experiences a variety of disruptions. High levels indicate that your body is either not producing enough insulin, an anabolic hormone in charge of regulating blood glucose and assisting it to enter cells for energy, or is not using it effectively. 

Interpretation of fasting plasma glucose in mg/dL-

Normal

<100

Impaired fasting glucose

100-125

Diabetes

>126

HBA1C: Hemoglobin A1c (HbA1c) in the blood can be thought of as a biomarker for the presence and severity of hyperglycemia, implying diabetes or prediabetes, or as a “biomarker for a risk factor,” ie, hyperglycemia as a risk factor for diabetic retinopathy, nephropathy, and other vascular complications of diabetes. 

Interpretation For HbA1c% As per American Diabetes Association (ADA)

Reference Group

HbA1c in %

Non-diabetic adults >=18 years 

<5.7

At risk (Prediabetes)

5.7 – 6.4

Diagnosing Diabetes

>= 6.5

 

HOMA IR: “Homeostatic Model Assessment for Insulin Resistance” is abbreviated as HOMA-IR. – A value less than one indicates that you are insulin-sensitive (optimal). – A value greater than 1.9 denotes early insulin resistance. – A value greater than 2.9 indicates severe insulin resistance. Insulin resistance has been linked to metabolic and hemodynamic changes, as well as an increased risk of cardiovascular disease. The threshold homeostasis model assessment of insulin resistance (HOMA-IR) levels used to define insulin resistance varies greatly. 

Triglycerides & HDL: Triglycerides are a type of lipid (fat) found in the blood. When you eat, your body converts any calories that aren’t immediately used into triglycerides. Triglycerides are stored in the fat cells of your body. Triglycerides are then released by hormones for energy between meals. The normal range of triglycerides is considered to be less than 150 mg/dL, High is in between 200 to 499 mg/dL & very high is considered above 500 mg/dL. The ratio of triglycerides to high-density lipoprotein (HDL) cholesterol (TG/HDL-C) and the level of non-HDL cholesterol (non-HDL-C) have been proposed as markers for predicting metabolic syndrome. 

CRP: C-reactive protein (CRP) is a non-specific biomarker that is commonly used in disease activity evaluation, infection diagnosis, and management, as well as the differential diagnosis or classification of inflammatory diseases. Metabolic syndrome has become the most important issue in family medicine and primary care because it is a cluster of metabolic abnormalities that are a burden on health care in many countries. Monocyte-derived macrophages in adipose tissue can produce susceptible C-reactive protein (hsCRP), which is elevated in inflammatory conditions. hsCRP less than 1 mg/L indicates low risk, 1 to 3 mg/L is moderate risk & more than 3 mg/L indicates high risk of metabolic syndrome.

WAIST CIRCUMFERENCE

Waist circumference: The waist circumference is a more important biomarker than body weight because it indicates abdominal obesity. When enough fat is stored in the hips and other body parts, fat accumulates only in the stomach and abdomen, indicating a higher risk of developing type 2 diabetes, heart disease, and hypertension. A waist circumference of 35 inches or more in women and 40 inches or more in men is considered large.

Sleep: Getting enough restorative sleep each night is a basic requirement for human health. Inadequate sleep and sleep disorders have been studied extensively in the last 20 years in relation to cardiometabolic factors such as the pathogenesis of obesity, hypertension, dyslipidemia, and hyperglycemia. Multiple studies show that people with normal sleep duration and about 7 hours of sleep per night have the lowest risk of Metabolic syndrome. Insomnia raises the risk of Metabolic syndrome in a variety of populations.

Gut health: Our gut microbiota is a complex community of over 100 trillion microbial cells that influence human physiology, metabolism, nutrition, and immune function, and disruption to the gut microbiota has been linked to gastrointestinal conditions like inflammatory bowel disease and obesity. Regarding metabolism, gut microbiota can influence lipid accumulation, lipopolysaccharide content, and the production of short-chain fatty acids, all of which influence food intake, inflammatory tone, and insulin signaling.

Blood pressure: Blood pressure is a measurement of the force used by your heart to circulate blood throughout your body. Blood pressure measurement is an important part of diagnosing and managing hypertension, and it can be done using small, wearable monitoring devices. A blood pressure reading of less than 120/80 mm Hg is normal. Obesity is strongly linked to high blood pressure. It is frequently found in people who have insulin resistance.

How to improve metabolic health?

Improve Metabolic Health
  1. Workout: Physical activity on a regular basis improves our metabolic health. Regular exercise and/or moderate to vigorous physical activity have been shown to significantly reduce the risk of metabolic disease. Exercise training also increases total muscle mass while decreasing resting heart rate and blood pressure and increasing VO2 max. 
  2. Nutrition: The most important pillar for improving metabolic health is nutrition, as the foods we eat have a direct impact on our cholesterol, blood pressure, waist circumference, and, of course, blood sugar. A well-balanced diet rich in macronutrients and micronutrients improves metabolic health. A diet high in carbohydrates, low in protein, and low in fat can be harmful. 
  3. Sleep: Sleep is intricately linked to various hormonal and metabolic processes in the body and is essential for metabolic homeostasis. According to research, sleep deprivation, and sleep disorders can have serious metabolic and cardiovascular consequences. In addition to a regular sleeping pattern of 7-8 hours, the quality of sleep is critical. Avoiding screen time closer to bedtime is a simple way to improve sleep quality because blue light inhibits the production of melatonin, the hormone that induces sleep.

Conclusion:

Metabolic health plays a crucial role in overall well-being, influencing factors such as heart disease, diabetes, and obesity. Biomarkers like blood sugar levels, HbA1c, HOMA-IR, triglycerides, HDL, CRP, waist circumference, sleep, and gut health provide valuable insights into one’s metabolic status. Maintaining optimal levels of these biomarkers is essential for preventing metabolic diseases.

Exercise emerges as a powerful tool for enhancing metabolic health, promoting muscle mass, and reducing the risk of metabolic diseases. Nutrition is another key pillar, emphasizing the importance of a well-balanced diet rich in macronutrients and micronutrients. Sleep, intricately linked to hormonal and metabolic processes, is crucial for metabolic homeostasis, and a consistent 7-8 hours of quality sleep is recommended.

Awareness and management of biomarkers, along with adopting a healthy lifestyle encompassing regular exercise, balanced nutrition, and sufficient sleep, contribute to a positive outlook on life and overall well-being.

Click on the link below to learn more about your metabolic health

Reference:

  1. Chasens, Eileen R., et al. “Sleep and Metabolic Syndrome.” Nurs Clin North Am., vol. 56, no. 2, 2021, pp. 203–217.
  2. Cho, Younghye, and Sang Yeoup Lee. “Useful Biomarkers of Metabolic Syndrome.” Int J Environ Res Public Health, vol. 19, no. 22, 2022. 
  3. Gayoso-Diz, Pilar, et al. “Insulin resistance (HOMA-IR) cut-off values and the metabolic syndrome in a general adult population: effect of gender and age: EPIRCE cross-sectional study.” BMC Endocrine Disorders volume, 2013.
  4. Lee, Jieun, et al. “Comparison of Lipid-Derived Markers for Metabolic Syndrome in Youth: Triglyceride/HDL Cholesterol Ratio, Triglyceride-Glucose Index, and non-HDL Cholesterol.” Tohoku J Exp Med, vol. 256, no. 1, 2022, pp. 53-62.
  5. Lyons, Timothy J., and Arpita Basu. “Biomarkers in diabetes: hemoglobin A1c, vascular and tissue markers.” Transl Res, vol. 159, no. 4, 2012, pp. 303-12.
  6. Sharma, Sunil, and Mani Kavuru. “Sleep and Metabolism: An Overview.” Int J Endocrinol.
  7. Thyfault, John P., and Audrey Bergouignan. “Exercise and metabolic health: beyond skeletal muscle.” Diabetologia, vol. 63, no. 8, 2020, pp. 1464–147.

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