Bockarie Ansumana Sandy, Derkyi-Kwarteng Leonard, Obeng Jeffrey Amankona, Adatsi Richard Kujo, Aniakwaa-Bonsu Ebenezer, Apprey Charles, Ampofo-Asiama Jerry, Acquah Samuel
Department of Internal Medicine and Therapeutics, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
Department of Pathology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
PLOS Glob Public Health. 2025 Apr 24;5(4):e0004506. doi: 10.1371/journal.pgph.0004506. eCollection 2025.
The long-term impact of the coronavirus disease 2019 (COVID-19) pandemic on metabolic risk factors in different populations has not been fully investigated. Insulin resistance (IR) is a cardinal risk factor for the development of type 2 diabetes mellitus. The current study sought to determine the prevalence and determinants of insulin resistance in selected Ghanaians with and without past COVID-19 status in the Cape Coast and Tamale metropolitan areas. Using a cross-sectional study design involving 510 adult participants, body mass index (BMI), waist-to-hip ratio, systolic blood pressure, lipid profile, insulin, plasma glucose, C-reactive protein (CRP), beta-cell function and insulin resistance levels were measured and compared between participants with and without past COVID-19 status. IR was determined by the homeostatic model (HOMA-IR) and the triglyceride-glucose index (TyG). Percentage prevalence and Poisson regression with prevalence ratio and 95% confidence intervals were applied. IR prevalence ranged from 70.69% to 79.09% (HOMA-IR) and 88.62% to 90.91% (TyG) respectively for Tamale and Cape Coast residents. IR prevalence values of 70.98% and 88% (HOMA-IR) and 89.02% and 90.2% (TyG) for without and with past COVID-19 groups respectively were observed. Irrespective of background, low (31.18%) and high (19.41%) levels of beta-cell function were detected. Additionally, high levels of very-low density lipoprotein cholesterol (8.31%), triglycerides (24.9%), total cholesterol (27.45%), low-density lipoprotein cholesterol (44.71%) and low level of high-density lipoprotein cholesterol (11.96%) coupled with low-grade inflammation (50.59%) were observed. Irrespective of surrogate marker used or past COVID-19 status, age, educational level and triglycerides could significantly associate with IR. With HOMA-IR, fasting plasma glucose, insulin and total cholesterol predicted IR in participants without prior COVID-19 status. With TyG, age, BMI, triglycerides and CRP were the predictors of IR in participants with past COVID-19 status. The risk of development of type 2 diabetes mellitus through insulin resistance is high in our setting. Measures to reduce the rising pace of IR are urgently needed in our setting.
2019冠状病毒病（COVID-19）大流行对不同人群代谢危险因素的长期影响尚未得到充分研究。胰岛素抵抗（IR）是2型糖尿病发生的主要危险因素。本研究旨在确定在海岸角和塔马利都会区选定的有和没有COVID-19病史的加纳人中胰岛素抵抗的患病率及其决定因素。采用横断面研究设计，纳入510名成年参与者，测量并比较有和没有COVID-19病史的参与者的体重指数（BMI）、腰臀比、收缩压、血脂谱、胰岛素、血糖、C反应蛋白（CRP）、β细胞功能和胰岛素抵抗水平。通过稳态模型（HOMA-IR）和甘油三酯-葡萄糖指数（TyG）确定胰岛素抵抗。应用患病率百分比以及带有患病率比和95%置信区间的泊松回归分析。塔马利和海岸角居民的胰岛素抵抗患病率分别为70.69%至79.09%（HOMA-IR）和88.62%至90.91%（TyG）。在没有和有COVID-19病史的组中，胰岛素抵抗患病率分别为70.98%和88%（HOMA-IR）以及89.02%和90.2%（TyG）。无论背景如何，均检测到低水平（31.18%）和高水平（19.41%）的β细胞功能。此外，观察到极低密度脂蛋白胆固醇（8.31%）、甘油三酯（24.9%）、总胆固醇（27.45%）、低密度脂蛋白胆固醇（44.71%）水平较高，高密度脂蛋白胆固醇（11.96%）水平较低，同时伴有低度炎症（50.59%）。无论使用何种替代指标或是否有COVID-19病史，年龄、教育程度和甘油三酯都可能与胰岛素抵抗显著相关。对于没有COVID-19病史的参与者，使用HOMA-IR时，空腹血糖、胰岛素和总胆固醇可预测胰岛素抵抗。对于有COVID-19病史的参与者，使用TyG时，年龄、BMI、甘油三酯和CRP是胰岛素抵抗的预测因素。在我们的研究环境中，通过胰岛素抵抗发展为2型糖尿病的风险很高。我们迫切需要采取措施来减缓胰岛素抵抗上升的速度。
