ABSTRACT
Background: Diabetes Mellitus (DM) is one of theleading non-communicable disorders, leading tovarious complications viz. cardiovascular diseases,retinopathy, nephropathy, neuropathy and peripheralvascular disorders. Diabetic Nephropathy (DN)patients further develop into End Stage Renal Disease(ESRD) and they have to undergo the repeated bloodtransfusions, increasing the social and economicburden. The number of risk factors are known forcausation of diabetic nephropathy including theenvironmental, biochemical as well as genetic factors.The association of nephropathy with various genes hasbeen proved. Aim and Objectives: In the present studywe attempted to check the association ofInsertion/Deletion (I/D) polymorphism of AngiotensinConverting Enzyme (ACE) in diabetic patients withand without nephropathy and also with thebiochemical markers. Material and Methods: Eachgroup consisted of 110 individuals viz. diabetics withand without nephropathy and age and gender matchedhealthy controls. Results: The determination of I/Dpolymorphism by polymerase chain reaction revealedthe significant increased 'D' allele frequencies inpatients of diabetes with and without nephropathy thanthe controls, while no significant difference was notedin genotype frequencies. The odds ratios for thispolymorphism were calculated to be 1.84 and 2.41 forDM and DN respectively in comparison with thehealthy controls. The regression analysis indicated I/Dpolymorphism is associated positively with all thelipid parameters, except High Density LipoproteinCholesterol (HDL-C) which was negatively associatedwith the polymorphism. The levels of lipid parameterswere also significantly increased in patients of diabeteswith and without nephropathy carriers for 'D' allelethan the patients having 'I' allele, while the level ofHDL-C was significantly decreased. Conclusion: Theconclusion can be made from these results that, thepresence of I/D polymorphism of ACE may increasethe risk of development of nephropathy in generalpopulation, with the role of 'D' allele in its causation,along with its effect on the biochemical markers.
ABSTRACT
The aim of the present study was to assess Apolipoprotein B (Apo-B) and Triglyceride/High Density Lipoprotein Cholesterol (TG/HDL-C) ratio as indicators of insulin resistance (IR) with Homeostasis Model of assessment of insulin resistance (HOMA IR)) in metabolic syndrome patients . Study Design: Observational and prospective. Place and Duration of Study: The study was carried out in Department of Biochemistry and Department of Medicine, MGM Medical College, Navi-Mumbai from March 2012 to June 2013. Methodology: Total 110 normal subjects and patients were recruited in the study after obtaining informed written consent. They were divided in to two groups. Group I was healthy controls (n=50) and Group II included subjects with MS (n=60) as per NCEP ATP III criteria. Anthropometric measurements & biochemical analysis was performed in all subjects. IR was defined by HOMA IR. Simple & multiple regression analysis were used to obtain relationship between IR (HOMA IR) using TG/HDL-C (model -1) and Apo-B (Model- 2) as independent variables. Result: There were statistically significant differences in anthropometric, glycemic and lipid parameters between the control and study group (p<0.0001).The regression model between HOMA IR and TG/HDL-C ratio showed a positive correlation, (r=0.29, p < 0.05). HOMA IR & Apo-B also showed a significantly positive correlation (0. 41, p < 0.001). But combined multivariate analysis indicated that Apo-B is a better predictor of IR compared to TG/HDL-C ratio. Conclusion: We concluded in our study that Apo-B may be a better predictor of IR than TG/HDL-C and hence could be adopted in routine laboratory practice as a lipid marker for prediction of insulin resistance (IR) in metabolic syndrome patients at an early stage. Keywords: Insulin resistance; Apo B; metabolic syndrome; Insulin resistance indicators; lipid