scholarly journals 20/(fasting C-peptide × fasting plasma glucose) is a simple and effective index of insulin resistance in patients with type 2 diabetes mellitus: a preliminary report

2013 ◽  
Vol 12 (1) ◽  
pp. 21 ◽  
Author(s):  
Tsuyoshi Ohkura ◽  
Hideki Shiochi ◽  
Youhei Fujioka ◽  
Keisuke Sumi ◽  
Naoya Yamamoto ◽  
...  
BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e041269
Author(s):  
Tullaya Sitasuwan ◽  
Raweewan Lertwattanarak

ObjectivesAbout 11%–30% of individuals with impaired fasting plasma glucose (IFG) have type 2 diabetes mellitus (T2DM), diagnosed by the 75 g oral glucose tolerance test (75 g OGTT). This study investigated (1) the prevalence and cut-off levels for fasting plasma glucose (FPG) and glycated haemoglobin A1c (HbA1c) in IFG individuals that most effectively predict the presence of T2DM diagnosed by a 75 g OGTT; (2) the predictors associated with T2DM; and (3) the pathophysiological characteristics of patients with IFG.Materials and methodsA single-centre, cross-sectional study was conducted in a primary care setting. A standard 75 g OGTT was performed on 123 subjects with IFG. Their beta-cell function and insulin resistance were calculated through plasma glucose and insulin levels monitored during the 75 g OGTT.ResultsIn the IFG subjects, the prevalence of T2DM using the 2-hour postload plasma glucose (2hPG) criterion was 28.5%. Pre-diabetes and normal glucose metabolism were found in 48.7% and 22.8%, respectively, by 75 g OGTT. An HbA1c level ≥6.0% or FPG ≥5.9 mmol/L were the optimal cut-off thresholds for the prediction of the presence of T2DM. HbA1c had a sensitivity of 76.7% and specificity of 55.7% (95% CI 57.7% to 90.1% and 95% CI 43.3% to 67.6%, respectively), while FPG had a sensitivity of 85.7% and specificity of 23.9% (95% CI 69.7% to 95.2% and 95% CI 15.4% to 34.1%, respectively). The presence of metabolic syndrome, a higher HbA1c and higher FPG levels were associated with the risk of T2DM in the Thai IFG population.ConclusionsAlmost one-third of the people with IFG had T2DM diagnosed by the 2hPG criterion. HbA1c was more effective than FPG in predicting the presence of T2DM in the IFG subjects. IFG individuals with HbA1c≥6.0% or FPG≥5.9 mmol/L should be advised to undergo a 75 g OGTT to detect T2DM earlier than otherwise.


2014 ◽  
Vol 6 (3) ◽  
pp. 197-205 ◽  
Author(s):  
Masami Tanaka ◽  
Risa Sekioka ◽  
Takeshi Nishimura ◽  
Toshihide Kawai ◽  
Shu Meguro ◽  
...  

2020 ◽  
Vol 28 (3) ◽  
pp. 299-314
Author(s):  
Simona Cernea ◽  
Emőke Both ◽  
Adriana Fodor

AbstractAim: We evaluated the association between anthropometric parameters and markers of insulin and leptin secretion/resistance in patients with type 2 diabetes mellitus (T2DM).Material and methods: This post-hoc data analysis from a cross-sectional study included 176 T2DM patients. Laboratory tests (serum leptin, soluble form of leptin receptor (sObR), C peptide, glycemic and lipid parameters) and anthropometric parameters were obtained, adiposity indexes (including body adiposity index (BAI), visceral adiposity index (VAI)), indicators of insulin resistance, β-cell function, and leptin resistance (Free Leptin Index, FLI) were calculated.Results: The body mass index (BMI), diabetes duration, VAI and leptin correlated independently with HOMA-IR, while BMI, diabetes duration and HbA1c with HOMA-B. The total body fat mass (TBFM), C peptide, diabetes duration, BMI and BAI correlated with leptin concentrations, while the first three with FLI. VAI was an indicator of insulin resistance (β=0.166, p=0.003), while BAI of leptin secretion (β=0.260, p=0.010). TBFM strongly associated with leptin resistance and secretion (β=0.037, r=0.688, p<0.0001, and β=0.521, r=0.667, p<0.0001), and BMI correlated weakly with insulin secretion and resistance. While insulin and leptin secretion increased progressively with BMI, leptin and insulin resistance became significant only in case of obesity. The sObR was significantly associated with C peptide concentrations (β=-0.032; p=0.044), but not with HOMA-B or -IR. A strong positive correlation between the C peptide/leptin ratio and non-fat mass /TBFM ratio was noted (r=0.62 [0.52, 0.71], p<0.0001).Conclusions: Parameters of peripheral adiposity correlated better with markers of leptin system, and those of visceral adiposity with markers of insulin secretion/resistance. The sObR correlated independently and negatively with C peptide.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Do Kyeong Song ◽  
Young Sun Hong ◽  
Yeon-Ah Sung ◽  
Hyejin Lee

Abstract Background Reduced skeletal muscle has been suggested as a potential risk factor for type 2 diabetes mellitus (T2DM). Serum creatinine is the primary metabolite of creatine in skeletal muscle. Therefore, low serum creatinine levels may be associated with an increased risk of T2DM. We aimed to evaluate the association between serum creatinine levels and the risk of T2DM in Korea. Methods We analyzed a total of 264,832 nondiabetic adults older than 40 years of age who had undergone a national health examination at least once from 2009 to 2015 in the Korean National Health Insurance Service Cohort. Hazard ratios for T2DM were calculated. Results In men, serum creatinine levels and the risk for T2DM showed an inverse J-shaped association. This association was confirmed after adjustment for age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting plasma glucose. In women, there was a trend that serum creatinine levels were inversely associated with the risk of T2DM among those with serum creatinine below 1.1 mg/dl. However, serum creatinine levels were not significantly associated with the risk of T2DM after adjustment for age, BMI, SBP, DBP, and fasting plasma glucose. Conclusions Reduced levels of serum creatinine were significantly associated with an increased risk of T2DM in men with creatinine below 1.20 mg/dl. There was a trend that decreased levels of serum creatinine were associated with an increased risk of T2DM among women with serum creatinine below 1.1 mg/dl, although this result was not statistically significant.


Author(s):  
Mukul Sharma ◽  
Kapil Bhatia ◽  
Pratibha Misra ◽  
Sibin MK ◽  
Vivek N Ambade ◽  
...  

Introduction: Diabetes mellitus (DM) is a metabolic disorder occurring due to either defect in the secretion of insulin or defect in the action of insulin characterized by hyperglycemia. Hyperglycemia causes oxidative stress due to increased production of mitochondrial Reactive oxygen species (ROS) in T2DM. Ceruloplasmin (Cp) acts as an antioxidant through its ferroxidase activity. There is an association between the raised serum Cp levels and elevated plasma glucose levels in Type-2 Diabetes mellitus (T2DM) patients. Aim and objectives: The aim of this study is to evaluate the correlation between the fasting plasma glucose (FPG), 2hour plasma glucose (2hPG), and serum Cp level in T2DM patients as compared to non diabetics. Materials and methods: 165 cases of T2DM were recruited along with the 40 healthy age and sex matched controls. The blood samples were analyzed for serum Cp and FPG and 2hPG after 75-gram oral glucose. Results: The serum Cp levels of the patient group with T2DM were significantly higher than the control group (p = 0.000). There was a significant positive association between serum Cp level and 2hPG level of the patient population (r = 0.283, p = 0.000), but there was no significant correlation found between serum Cp levels and fasting plasma glucose levels in patients (r = 0.146, p =0.061). Similar findings were seen in the sub group analysis. Conclusion: Our study concludes a significant positive correlation between serum Cp and 2hPG levels in T2DM patients. Hence Cp levels may be considered as a part of the routine diagnostic panel to assess diabetes mellitus. Keywords: Serum Ceruloplasmin, Type-2 Diabetes Mellitus, Fasting plasma glucose, 2hour plasma glucose


Author(s):  
Sandinti Deepa ◽  
V Lakshmaiah ◽  
K Prabhakar ◽  
A Raveesha ◽  
CR Vidyasagar ◽  
...  

Introduction: Insulin Resistance (IR) can develop into type 2 diabetes mellitus and is closely associated with obesity. However, the non-obese population has also shown a predisposition to the risk of IR due to genetics. Aim: To assess the relationship between IR and obesity in Type 2 Diabetes Mellitus (T2DM) by comparing the proportion of subjects with IR in lean and obese T2DM and to identify the factors predicting IR in T2DM. Materials and Methods: A cross-sectional, hospital-based study was done at Department of Medicine of RL Jalappa hospital, Kolar, Karnataka on 106 T2DM patients aged >18 years. The study population was grouped into lean (BMI <19 kg/m2) and obese adults (BMI >30 kg/m2). IR was calculated using Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) and was considered as primary outcome variable. Obesity was considered as primary explanatory variable. Age, Gender, fasting insulin, C-peptide, Fasting Blood Sugar, Glycated haemoglobin (GHB or HbA1c) were the other explanatory variables. Descriptive analysis was carried out using mean and standard deviation for quantitative variables, frequency and proportion for categorical variables. Chi-square test was used to test statistical significance between the groups. Univariate logistic regression analysis was done to identify the predictors of IR. IBM Statistical Package for Social Sciences (SPSS) version 22 was used for statistical analysis. The p-value <0.05 was considered to be statistically significant. Results: The 106 subjects involved in the study had a mean age of 53.88±9.21 years. 44 subjects (41.5%) had IR. Obese to lean diabetic patients were in the ratio of 1:4. The proportion of obese diabetic subjects was (n=84, 79.2%) whereas lean diabetics were (n=22, 20.8%). The proportion of obese diabetic subjects with IR was 38.1% while the proportion of lean diabetic subjects with IR was 54.55%, but this difference was statistically not significant (p=0.163). On univariate logistic regression analysis, fasting insulin (odds ratio of 2.442 with 95% CI of 1.665 to 3.851, p<0.001**) and C-peptide (odds ratio of 1.446 with 95% CI of 1.123, p=0.004) were statistically significant factors attributing to IR. Conclusion: There was no significant relationship between IR and obesity. IR was independently associated with Fasting insulin levels and C-peptide levels.


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