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ANALYSIS OF INSULIN RESISTANCE DURING INCREASE IN BODY MASS INDEX

GUIDE
DR.JOSE JACOB, MD HEAD OF DEPARTMENT OF BIOCHEMISTRY, AMALA INSTITUTE OF MEDICAL SCIENCE, THRISSUR.

INTRODUCTION

Insulin is a hormone and is secreted by groups of cells within the pancreas called islet cells. It is secreted in response to increase in blood sugar.

Insulin resistance is defined as a decreased biological response to normal concentrations of circulating insulin.
Insulin resistance can lead to increase in fasting serum insulin and glucose levels. Measuring insulin resistance in a routine clinical setting is difficult, surrogate measures, namely fasting insulin or the insulin response to glucose, are used to provide an indirect assessment of insulin function.

Body mass index is weight in Kilogram divided by squares of height in meters

BMI = wt. in kg / Sqaure of ht. in meters

BMI between 18.5 24.9 25 - 29.9 30 or >30

normal over wt obese

OBJECTIVE

Individuals who are willing to take part in the study were grouped into normal or overweight BMI class.

In these individuals fasting serum insulin, glucose, total triacylglycerol were estimated. Mean and SD were calculated in the different groups and the significance of variation in the levels were analyzed.

In a selected individual, serum insulin and glucose were estimated after oral glucose tolerance test.

MATERIALS & METHODS

 Insulin was estimated by Mercodia

Ultrasensitive method. method.

Insulin

ELISA

Glucose was estimated by GOD-PAP Triglyceride was estimated by GPO

PAP ESPAS method.

RESULT

Table 1. Serum glucose, Total triacylglycerol and insulin

were estimated in fasting serum samples in two groups of individuals. In one group BMI was <25 and in the other group BMI was from 25 29.9

Table 2. Serum glucose, Total Triacylglycerol and insulin were estimated in fasting serum samples in two groups

of individuals . In one group BMI was <25 and other

group had BMI 30.

Table 3. Serum Insulin and total serum triacylglycerols were

estimated in fasting serum samples in individuals with BMI

<25. There were two groups of individuals, in one group fasting serum glucose was <100 mg/dL and in the other group

100 mg/dL.

Table. 4. Serum Insulin and total serum triacylglycerol were

estimated in fasting serum samples in individuals with BMI

>25. There were two groups of individuals, in one group fasting serum glucose was <100 mg/dL and in another group

100 mg/dL.

Table 5. Oral Glucose tolerance test in an individual with BMI 29.5 . 75 gm of Glucose was given in 300 ml water in the morning after overnight fasting. Blood was collected before giving glucose at 30 min, 60 mins, 90 mins and 120 mins. Glucose and insulin were estimated in the serum.

Peak glucose at 30 minutes was 155 mg/dL. These values come in the impaired glucose tolerance test category. But peak insulin at 1hr was 73 mlU/L. This level was above the upper limit of 65-70mlU/L. In these results showed that only peak insulin value is above normal and showed signs of insulin resistance.

DISCUSSION

In this study, we had examined fasting serum insulin, glucose and triacylglycerol in individuals with normal BMI and at BMI which is slightly increased. It was observed that there was no consistent and significant variation in serum glucose, insulin and triacylglycerol. This may be because the serum glucose levels are near normal values and there is very little demand for insulin secretion.

We examined the levels of insulin and glucose in selected individuals after oral glucose tolerance test. This result showed that the glucose and insulin levels can be a probable marker of the metabolic changes in

obesity only after oral glucose tolerance test.

CONCLUSION

Obesity is characterised by insulin resistance and cytokine production from adipose tissue. In this study, we have shown that there was no significant increase in fasting serum glucose, insulin or triacylglycerol in individuals with higher BMI. But the study of a case of oral glucose tolerance test in an individuals with BMI 29.5 showed that both insulin and glucose levels were elevated with increase in BML.

THANKS