Serum Proinsulin in Bangladeshi Subjects with Impaired Glucose Tolerance.
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Date
2014
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Abstract
Hyperproinsulinemia is commonly present in subjects with impaired glucose tolerance. The present
study was undertaken to investigate the proinsulin level in Bangladeshi IGT subjects and to explore
its association with insulin resistance. This observational study was conducted under a case-control
design with IGT subjects (n=50) and controls (n=44). IGT was diagnosed following the WHO
Study Group Criteria. Serum glucose was measured by glucose-oxidase method, serum lipid profile
by enzymatic method and serum insulin and serum proinsulin were measured by ELISA method.
Insulin secretory capacity (HOMA%B) and insulin sensitivity (HOMA%S) were calculated from
fasting serum glucose and fasting serum insulin by homeostasis model assessment. The study
subjects were age- and BMI- matched. Mean (±SD) age (yrs) of the control and IGT subjects were
40±6 and 40±5 respectively (p=0.853). Mean (±SD) BMI of the control and IGT subjects were
23±3 and 22±2 respectively (p=0.123). Fasting glucose was not significantly higher in IGT
subjects, but serum glucose 2 hours after 75 gm glucose load was significantly higher in IGT
subjects. Median (Range) value of fasting serum glucose (mmol/l) of control and IGT subjects were
5.3 (3.8-6) and 5.2 (4-12) respectively; (p=0.297). Median (Range) value of serum glucose
(mmol/l) 2 hours after 75 gm glucose load of control and IGT subjects were 6.1 (3-7.8) and 7.9 (5-
21) respectively; (p=0.001). Fasting TG was significantly higher in IGT subjects and LDL-c was
significantly lower in IGT subjects. Serum Total cholesterol and HDL-c were not significantly
different between the IGT and control subjects. Median (Range) value of fasting serum TG (mg/dl)
of control and IGT subjects were 119 (51-474) and 178 (82-540) respectively; (p=0.001). Median
(Range) value of fasting serum T chol (mg/dl) of control and IGT subjects were 180 (65-272) and
186 (140-400) respectively; (p=0.191). Median (Range) value of fasting serum HDL-C (mg/dl) of
control and IGT subjects were 29 (19-45) and 31 (15-78) respectively; (p=0.914). Median (Range)
value of fasting serum LDL-C (mg/dl) of control and IGT subjects were 117(29-201) and 111(41-
320) respectively; (p=0.001). Fasting serum proinsulin was significantly higher in IGT subjects.
Median (Range) value of fasting serum proinsulin (pmol/l) of control and IGT subjects were
9.2(1.8-156) and 17(3-51) respectively; (p=0.001). Insulin secretory capacity (HOMA%B) was
higher but insulin sensitivity (HOMA%S) was significantly lower in case of IGT subjects. Median
(Range) value of HOMA%B of control and IGT subjects were 97(46-498) and 164(17-300)
respectively; (p=0.001). Median (Range) value of HOMA%S of control and IGT subjects were
68(19-270) and 39(15-110) respectively (p=0.001). In multiple regression analysis a significant
negative association was found between fasting proinsulin and insulin sensitivity (p=0.037). The
data led to the following conclusions: a) Insulin resistance is the predominant defect in Bangladeshi
IGT subjects. b) Basal proinsulin level is significantly increased in IGT subjects. c) Insulin
resistance is negatively associated with serum proinsulin in IGT subjects.
Description
Keywords
Proinsulin, Hyperproinsulinemia, IGT, Insulin Resistance
Citation
Sultana S, Zeba Z, Hossain A, Khaleque A, Zinnat R, Ali L. Serum Proinsulin in Bangladeshi Subjects with Impaired Glucose Tolerance. Bangladesh Journal of Medical Biochemistry. 2014; 7(2): 41-46.