Prevalence of insulin resistance in first degree relatives of type-2 diabetes mellitus patients: A prospective study in north Indian population |
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| Authors: | Arvind Kumar Poornima Tewari Sibasis S Sahoo Arvind Kumar Srivastava |
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| Institution: | (1) Central Drug Research Institute, 226 003 Lucknow, India;(2) Department of Medicine, King George’s Medical University, 226003 Lucknow |
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| Abstract: | A total of 172 first degree relatives (FDRs) and 178 controls were included in this study. All the cases and controls were
subjected to various anthropometric measurements, fasting and postprandial glucose estimation, fasting insulin measurement
and fasting lipid profile. Results revealed the prevalence of Impaired Fasting Glucose (IFG) (cases 37% Vs controls 11.6%),
Impaired Glucose Tolerance (IGT) (cases 34.3% Vs controls 11.2%) and diabetes (cases 11.05% controls 3.37%) was significantly
higher in first degree relatives. Insulin resistance was measured using various methods, which included fasting plasma insulin
(FPI), Homeostasis Model Assessment for Insulin Resistance (HOMAIR), insulin sensitivity index (ISI) (Mffm/l). Prevalence of insulin resistance (Insulin Resistance) as observed comparing FPI
and HOMAIR in cases and controls was 43.6% and 11.24% (P=0.005) and 37.8% and 12.47% (P=0.000) respectively. Prevalence of IR (Insulin
Resistance) observed in cases having Normal Glucose Tolerance (NGT), Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance
(IGT) and diabetes mellitus measuring FPI Vs HOMAIR was 37.5% vs 30.2%, 45% vs 40%, 38.98% vs 37.28% and 36.84% vs 31.57% as accordingly. However, ISI (Mffm/l) was not found
to be a promising index for IR due to its poor specificity. Though HOMA is taken as gold standard for measurement of IR globally,
our study observed fasting plasma insulin representing high sensitivity (89.7%) and specificity (93.3%) as compared to HOMA.
Thus FPI had emerged in this work as a simple and reliable test for diagnosing insulin resistance across the population susceptible
to develop diabetes including FDRs. |
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| Keywords: | HOMAIR (Homeostasis Model Assessment for Insulin Resistance) FDR (First Degree Relatives) IR (Insulin Resistance) FPI (Fasting Plasma Insulin) IFG (Impaired Fasting Glucose) IGT (Impaired Glucose Tolerance) ISI (Insulin Sensitivity Index) Mffm/l (Insulin sensitivity index corrected for fat-free mass) |
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