El Shabrawy Arafa M, Elbana Khaled A, Abdelsalam Noha M
Endocrinology and Diabetes Unit, Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Endocrinology and Diabetes Unit, Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Diabetes Metab Syndr. 2019 May-Jun;13(3):2094-2096. doi: 10.1016/j.dsx.2019.04.044. Epub 2019 Apr 25.
Insulin resistance (IR) and β-cell dysfunction are key pathological features of type 2 diabetes mellitus, the aim of this study was to investigate the role of proinsulin level and proinsulin/insulin ratio in early prediction of beta cell dysfunction and insulin resistance in obese Egyptian adolescent.
This Case control study was conducted from June 2017 to March 2018. Total of 60 patients were divided into 2 groups after exclusion of patients with diabetes: normal body weight group and Obese group. Demographic, clinical data were collected. Laboratory investigation included fasting insulin, proinsulin, and estimation of HOMA IR and HOMA-B were done.
There are highly statistically significant increase in obese group regarding insulin, proinsulin, proinsulin/insulin ratio and HOMA-IR while there is significant decrease in HOMA-B in this group. The best cutoff value of Proinsulin in prediction of beta cell function was ≥7.829 pmol/L with sensitivity 95.8, specificity 72.2. The best cutoff value of Proinsulin/insulin ratio in prediction of insulin resistance was ≥0.1545 with sensitivity 87.5, specificity 61.1.
both beta cell dysfunction and insulin resistance increased in obese group and so increased risk of type 2 diabetes. We found that Pro insulin/insulin ratio is a significant predictor for insulin resistance and Proinsulin is good predictor for beta cell dysfunction.
胰岛素抵抗(IR)和β细胞功能障碍是2型糖尿病的关键病理特征,本研究旨在探讨胰岛素原水平和胰岛素原/胰岛素比值在肥胖埃及青少年β细胞功能障碍和胰岛素抵抗早期预测中的作用。
本病例对照研究于2017年6月至2018年3月进行。在排除糖尿病患者后,将60例患者分为2组:正常体重组和肥胖组。收集人口统计学、临床数据。实验室检查包括空腹胰岛素、胰岛素原,并进行了HOMA-IR和HOMA-B的评估。
肥胖组胰岛素、胰岛素原、胰岛素原/胰岛素比值和HOMA-IR有高度统计学意义的升高,而该组HOMA-B有显著降低。胰岛素原预测β细胞功能的最佳截断值为≥7.829 pmol/L,敏感性为95.8,特异性为72.2。胰岛素原/胰岛素比值预测胰岛素抵抗的最佳截断值为≥0.1545,敏感性为87.5,特异性为61.1。
肥胖组β细胞功能障碍和胰岛素抵抗均增加,2型糖尿病风险也增加。我们发现胰岛素原/胰岛素比值是胰岛素抵抗的重要预测指标,胰岛素原是β细胞功能障碍的良好预测指标。