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Background: Serum urea, creatinine, and estimated glomerular filtration rate (eGFR) are the most widely accepted parameters for the assessment of renal impairment. Renal dysfunction in Indian obese adults has not been sufficiently investigated. Aims: To evaluate the renal function by using serum urea, serum creatinine, eGFR, and proteinuria in normal, overweight, and obese adults to identify renal impairment. Materials and Methods: This observational and cross-sectional study was done on a total of 100 normoglycemic, normotensive healthy adults, and these were divided into three groups as per the criteria of body mass index (BMI) as; normal, overweight and obese groups. Estimation of urea and creatinine was done by fully automated chemistry analyzer methods. eGFR was calculated by Modified Diet Renal Disease (MDRD) formula. The excretion of protein in urine was checked by the urine dipsticks method. p<0.05 was considered as significant level. Results: The present study was conducted in 100 normal study subjects which included 48 males and 52 females. A maximum number of subjects were found in the obese subgroup (34%). Among subjects low eGFR prevalence was found 3% and prevalence of chronic kidney disease (CKD) was also found 3%. The obese subjects showed higher urea and creatinine levels compared to normal subjects. A significant negative relationship was noted in eGFR (MDRD) and BMI. The prevalence of proteinuria among subjects was 3%. Conclusions: A total of 3% prevalence of renal dysfunction was noted among adults and out of this 2% was found in obese adults. Therefore, it can be concluded that increasing BMI has a significant contributing factor for renal impairment in obese adults.
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OBJECTIVES: The study was performed to see that, whether metabolic control and response to treatment in freshly diagnosed patients of type 2 diabetes mellitus is affected by primary pathology (hyperinsulinemia/inappropriate insulin secretion). METHODS: One hundred and eight freshly diagnosed patients of type 2 diabetes mellitus with age range from 30-65 years were followed for a period of three months. The blood glucose, serum triglyceride, and serum insulin levels were determined in each patient. Patients were found to have either higher or normal to low serum insulin values at fasting, and accordingly patients were distributed into two groups; group one (normal to low initial fasting serum insulin level i.e. < or = 30 microU/ml) and group two (high fasting serum insulin level i.e. > or = 30 microU/ml). Each group was further divided into two subgroups A and B. Subgroup A was treated with glipizide and B with metformin. RESULTS: Diabetic patients who had fasting hyperinsulinemia (n = 53, 100%) had blood pressure > or = 140/90 at the time of presentation. Patients who had fasting serum insulin within normal range only 30% (n = 17) had hypertension. Patients of group one had good recovery from hyperglycemia and reduction in triglyceride values when treated with sulphonylurea (subgroup A) as compared to patients treated with biguanide (subgroup B). On the contrary patients of group two showed poor glycemic control, increase in blood pressure and rise in serum triglyceride titre when treated with sulphonylurea (subgroup A) while in the same group biguanide effectively produced euglycemia with normalization of blood pressure and decrease in triglyceride levels (subgroup B). CONCLUSION: Assessment of initial serum insulin levels is helpful guide to decide about the type of oral hypoglycemic agent to be used in freshly diagnosed patients to type 2 diabetes mellitus.