Does insulin resistance correlate with routine blood examination? A review on erythrocytes of obese patients.

Aim: to identify whether hyperinsulinemia/insulin resistance affects the hematologic parameter of routine blood, especially the erythrocytes. Methods: cross sectional study was conducted on seventy one non-smoking obese patients who were not pregnant, not having lactating period, aged >22 years of age and visited the outpatient clinic of Endocrinology and outpatient clinic of Kidney and Hypertension division at the department of Internal Medicine Dr. Sardjito Hospital, Yogyakarta. Patients with cerebrovascular and blood disease; taking drugs affecting blood e.g.: cytostatics, and erythropoietin; and patients taking insulin, beta blocker, or steroids were excluded. Data on age, gender, body weight, and body height were recorded. Examinations on fasting blood glucose, fasting insulin, total cholesterol, triglycerides, high density lipoprotein (HDL), low density lipoprotein (LDL), and routine blood were performed in the condition of ten hours of fasting. All laboratory examination was conducted at Prodia Laboratory, Yogyakarta. Results: of seventy one obese patients, 51.5% were male, and 9.1% were diagnosed with diabetes mellitus (DM) during the study and the mean age was 47.09+5.74 years, the mean body mass index was 28.07+4.07 kg/m2, the mean of hemoglobin level was 13.75+1.57 g%; the mean of leukocyte count was 7.86+1.19 103/mm3; erythrocytes count was 4.93+0.44 106/mm3; platelet count 300.28+80.57 103/mm3; and hematocrite count 41.23+4.28. There were very weak and statistically insignificant negative correlation between Log HOMA IR and erythrocytes (r= -0.048; p=0.693) Conclusion: this study demonstrates that insulin resistance has a very weak correlation with erythrocytes counts and it is statistically insignificant.

Correlation Between Lower-extremity Functional Status and Obesity in Type-II Diabetic Patients with and without Peripheral Arterial Disease at Dr. Sardjito Central General Hospital, Yogyakarta.

Aim: to recognize the correlation between lower-extremity functional status and obesity in patients with type-2 DM with PAD complication (with and without peripheral arterial disease). Methods: the study was a cross-sectional study conducted at Outpatients Clinic of Internal Medicine, Dr. Sardjito Central General Hospital in August-December 2006. Fifty-five subjects who were patients with type-2 DM aged more than 50 years agreed to participate and were eligible for the study; while the exclusion criteria included smoking, diabetic ulcer or gangrene, history of amputation due to diabetic ulcer or gangrene. The diagnosis of PAD was based on Ankle Brachial Index < 0.90. Results: mean age was 62.53 +/- 6.82 years old and mean value of BMI was 24.26 +/- 3.57 kg/m2, 18 subjects (32.7%) were obese. The proportion of obese subjects with PAD was higher compared to the non-obese subjects (41% vs. 27%, p = 0.372). Lower-extremity functional status of type-2 diabetic patients either with or without PAD in obese subjects needs longer period of time (7.17 +/- 1.74 minute and 6.94 +/- 1.48 minute vs. 5.13 +/- 1.47 minute and 4.58 +/- 1.17 minute, p < 0.05 and p < 0.001). Conclusion: the functional status of lower extremities in obese patients with DM is poorer than the non-obese subjects.

Hypoadiponectinemia: a risk factor for metabolic syndrome.

Aim: to find out correlation between plasma adiponectin levels, insulin resistance and IDF criteria of Mets Patients. Methods: a case-control study was conducted on Native Javanese people from June 2006 to Januari 2007 in Outpatients Clinic of Dr Sardjito Hospital. The case group involved patients aged between 20 to 55 years old. The diagnosis of metabolic syndrome was confirmed according to IDF criteria. Patients without metabolic syndrome with matching age and sex,were taken as control group. Results: there were significant differences between case andh control group for BMI (body mass index) (30.2 +/- 4.1 vs 26.9 +/- 4.7 kg/m2), waist circumference (93.5 +/- 7.9 vs 84.4 +/- 11.5 cm), triglyceride (207.4 +/- 101.8 vs. 119.3 +/- 71.5 mg/dL) , HDL cholesterol (48.6 +/- 9.4 vs. 59.9 +/- 11.8m g/dL), systolic blood pressure (132.8 +/- 17.9mmHg vs 120.6 +/- 13.5 mmHg) and diastolic blood pressure (83.8 +/- 8.5 mmHg vs. 79.4 +/- 10.7), fasting blood glucose (128.3 +/- 40.8 mg/dL vs. 100.7 +/- 29.4 mg/dL), HOMA index (6.7 +/- 17.4 vs. 2.0 +/- 2.0) and adiponectin levels (3.8 +/- 1.4 vs. 5.9 +/- 2.5), respectively. For metabolic syndrome, hypoadiponectinemia showed the OR value of 6.0 (95% CI 2.13 to 16.98); insulin resistance showed the OR value of 5.7 (95% CI 1.3 to 25.02), after adjustment for waist circumference, TG, HLD, blood pressure, fasting blood glucose. Conclusion: hypoadiponectinemia and insulin resistance represent independent risk factors for metabolic syndrome development.