Acquah Samuel, Boampong Johnson Nyarko, Eghan Jnr Benjamin Ackon, Eriksson Magdalena
Department of Medical Biochemistry, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana.
Department of Biomedical and Forensic Sciences, School of Biological Sciences, University of Cape Coast, Cape Coast, Ghana.
Malar Res Treat. 2014;2014:136148. doi: 10.1155/2014/136148. Epub 2014 Dec 23.
The study aimed at investigating the effects of adult uncomplicated malaria on insulin resistance. Fasting levels of blood glucose (FBG), glycosylated hemoglobin (HbA1c), and serum insulin were measured in 100 diabetics and 100 age-matched controls before and during Plasmodium falciparum malaria. Insulin resistance and beta cell function were computed by homeostatic models assessment of insulin resistance (HOMAIR) and beta cell function (HOMAB) formulae, respectively. Body mass index (BMI) was computed. At baseline, diabetics had significantly (P < 0.05) higher levels of BMI, FBG, HbA1c, and HOMAIR but lower level of HOMAB than controls. Baseline insulin levels were comparable (P > 0.05) between the two study groups. During malaria, diabetics maintained significantly (P < 0.05) higher levels of BMI, FBG, and HbA1c but lower levels of insulin and HOMAB than controls. Malaria-induced HOMAIR levels were comparable (P > 0.05) between the two study groups but higher than baseline levels. Apart from BMI and HOMAB, mean levels of all the remaining parameters increased in malaria-infected controls. In malaria-infected diabetics, significant (P < 0.05) increase was only observed for insulin and HOMAIR but not the other measured parameters. Uncomplicated malaria increased insulin resistance in diabetics and controls independent of BMI. This finding may have implications for the evolution of T2DM in malaria-endemic regions.
该研究旨在调查成人非复杂性疟疾对胰岛素抵抗的影响。在100名糖尿病患者和100名年龄匹配的对照者中，于恶性疟原虫疟疾发作前及发作期间测量空腹血糖（FBG）、糖化血红蛋白（HbA1c）和血清胰岛素水平。分别通过胰岛素抵抗稳态模型评估（HOMAIR）公式和β细胞功能（HOMAB）公式计算胰岛素抵抗和β细胞功能。计算体重指数（BMI）。在基线时，糖尿病患者的BMI、FBG、HbA1c和HOMAIR水平显著高于对照组（P<0.05），但HOMAB水平低于对照组。两个研究组的基线胰岛素水平相当（P>0.05）。在疟疾发作期间，糖尿病患者的BMI、FBG和HbA1c水平仍显著高于对照组（P<0.05），但胰岛素和HOMAB水平低于对照组。疟疾诱导的HOMAIR水平在两个研究组之间相当（P>0.05），但高于基线水平。除BMI和HOMAB外，疟疾感染对照组中所有其余参数的平均水平均升高。在疟疾感染的糖尿病患者中，仅观察到胰岛素和HOMAIR显著升高（P<0.05），其他测量参数未见升高。非复杂性疟疾使糖尿病患者和对照组的胰岛素抵抗增加，且与BMI无关。这一发现可能对疟疾流行地区2型糖尿病的发展具有重要意义。
