RESUMO
The homeostasis model assessment of insulin resistance [HOMA-IR] is a useful model for application at large epidemiologic studies. The aim of this study was to determine the HOMA cut off values to identify insulin resistance [IR] and metabolic syndrome [MS] in Qazvin, central Iran. Overall, 480 men and 502 women aged 20-72 yr attended in this cross sectional study from September 2010 to April 2011. The diagnostic criteria proposed by national cholesterol education program third adult treatment panel [ATPIII], International Diabetes Federation [IDF] and new Joint Interim Societies [JIS]; were applied to define MS. Lower limit of the top quintile of HOMA values in normal subjects was considered as the threshold of IR. The receiver operating characteristic [ROC] curves of HOMA for MS diagnosis were depicted. The optimal cut point to determine MS was assessed by maximum Youden index and the shortest distance from the point [0, 1] on the ROC curve. The threshold of HOMA for IR was 2.48. Fifty one percent of the subjects were insulin resistant. The cut point for diagnosis of JIS, IDF, ATP III and Persian IDF defined MS was 2.92, 2.91, 2.49 and 3.21, respectively. Sensitivity and specificity of ATP III defined MS to diagnose IR was 33.95% and 84.78%, of IDF defined MS was 39.13%, 81.29% and of JIS defined MS was 43.77% and 78.11% and of Persian IDF defined MS was 27.32% and 88.76%, in that order. The high prevalence of IR in the present study warns about the future burden of type 2 diabetes. Only the ATP III criteria introduced more specific cut point for putative manifestations of IR
RESUMO
Diabetes is a common metabolic disease in the world that has many adverse effects. Olibanum gum resin [from trees of the genus Boswellia] has traditionally been used in the treatment of various diseases such as diabetes. The aim of this study was the comparison of Olibanum gum resin effect with placebo on the treatment of type 2 diabetes. Inclusion criteria was diabetic patients with fasting blood sugar [FBS] =140-200 mg/dL. This study has been designed as double-blined clinical trial on 71 patients with type 2 diabetes and the patients randomly were divided to interventional and placebo groups. The patients on standard anti-diabetic therapy [metformin] treated with Olibanum gum resin [400 mg caps] and placebo tow times per day for 12 weeks, respectively. At the end of 12 weeks the FBS, HbA1c, Insulin, total Cholesterol [Chol], LDL, Triglyceride [TG], HDL and other parameters were measured. The Olibanum gum resin lowered the FBS, HbA1c, Insulin, Chol, LDL and TG levels significantly [p<0.001, p<0.001, p<0.001, p=0.003, p 0.05] compared with the placebo at the endpoint. Moreover, this plant showed anti-oxidant effect and also no adverse effects were reported. The results suggest that Olibanum gum resin could be used as a safe anti-oxidant, anti-hyperglycemic and anti-hyperlipidemic agent for type 2 diabetic patients