Exp Clin Endocrinol Diabetes 2015; 123 - P13_09
DOI: 10.1055/s-0035-1547768

The insulin resistance indices and tissue damage markers in obesity, impaired glucose tolerance and type 2 diabetes mellitus

A Alieva 1, Z Shamansurova 2, A Tashmanova 1
  • 1Republican Specialized Scientific-Practical Medical Centre of Endocrinology
  • 2Institute of Endocrinology; Dept of Diabetology

The aim was to study relationship of insulin resistance indices with markers of blood plasma and tissues metabolic abnormalities in obesity (O), impaired glucose tolerance (IGT), and type 2 diabetes mellitus (DM 2).

Materials and methods: In 25 patients with O, 24 with IGT, 46 with DM 2, and 29 healthy subjects (HS) clinical examinations and anthropometrical data measurement were performed with calculation of body mass index (BMI), HbA1c, IRI, C-peptide, stable metabolites of NO (SMNO) level were measured, erythrocytes sialidase activity (ESA), and erythrocytes glucose uptake (EGU) were detected by their incubation, insulin resistance indices were calculated mathematically as HOMA-IR, QUICKI, and insulin sensitivity index (ISI).

Results: HbA1c level was significantly increased in O group (5.6%, p < 0.05), IGT (5.9%, p < 0.05), and DM 2 (8.2%, p < 0.005) comparing to the control group. HOMA-IR, QUICKI and ISI were significantly increased in patients with O (5.2, 0.3 and 4.1, p < 0.05, respectively), IGT (7.6, 0.29, 4.8, p < 0.05) and DM 2 (3.39, 0.32, 5.8, p < 0.05) comparing to HS (1.74, 0.35, 7.36) showing the presence of insulin resistance in all observed groups. The results show inter-dependence of IR indices with ESA, SMNO, and EGU: ESA was 3.8 times (p < 0.05) increased in O group, 4.3 times (p < 0.05) in IGT, and 7.9 times (p < 0.01) in DM 2, the SMNO level was decreased by 44% (ns) in O, by 56% (ns) in IGT, and by 117% (p < 0.05) in DM 2 suggesting decrease of NO level. The EGU was increased in O group by 85.7% (ns), in IGT by 104.5% (ns), and by 211.6% in DM 2 (p < 0.05) comparing to HS showing increase of basal glucose transport. Strong correlation of ESA, SMNO and EGU with IR indices reflected the degree of disturbances on the cell plasma membrane surface and the severity of tissue damage and order of their appearance and manifestation at different stages of metabolic syndrome.

Conclusion: The comparison of IR indices (HOMA-IR, QUICKI, ISI) in O, IGT, and DM 2 showed their correlation with ESA, EGU, and SMNO, reflecting their role in pathogenesis of MS and significance in early diagnosis at different stages of metabolic syndrome.