RESUMO
Objective: To determine the association of serum SPARC with insulin resistance in type-2 diabetes. Study Design: Descriptive study. Place and Duration of Study: Physiology department and CREAM lab, Army medical college, Rawalpindi, in collaboration with Military Hospital Rawalpindi, from Feb 2016 to Oct 2016
Material and Methods: Sixty individuals were recruited in this descriptive study. Thirty diagnosed cases of type2 DM were included, while thirty age and gender matched healthy individuals were included as controls through non-probability purposive sampling. Controls were labelled as group A, while cases were labelled as group B. Patients with type-1 DM, type-2 DM on insulin therapy, hyperglycemic states other than DM and inflammatory disorders were excluded from the study. Data were collected after informed and written consent. Blood samples were withdrawn under strict aseptic measures and serum was stored at -20oC. Serum insulin levels and serum SPARC levels were analyzed by enzyme linked immunosorbent assay [ELISA]. Insulin resistance was determined using homeostasis model assessment of insulin resistance [HOMA-IR], and its value >1.5 was considered significant
Results: Fasting insulin levels were significantly higher in group B as compared with group A, supporting the diagnosis of type-2 DM. HOMA-IR values were greater than 1.5 in group B, thus establishing significant insulin resistance. Serum SPARC levels were significantly higher in group B than group A [17.7 +/- 1.14 vs 8.7 +/- 1.08 ng/ml] with p-value<0.001. Serum SPARC levels showed positive correlation with fasting insulin levels and HOMA-IR values
Conclusion: Our study showed a positive correlation between serum SPARC levels and insulin resistance, which indicates that SPARC plays an important role in the development of insulin resistance in type-2 diabetes mellitus
RESUMO
Background: Diabetes mellitus is a global health issue. Chronic hyperglycaemia induces endothelial dysfunction and metabolic derangements which are postulated to be the cornerstone for the pathogenesis of diabetic microangiopathic complications. The interplay of oxidative stress, endothelial dysfunction and inflammation in this regard has led to investigation of role of inflammatory biomarkers as adjuncts to routine diagnostic testing. This study was designed to elucidate the association between serum ferritin and high sensitivity CRP levels and diabetic retinopathy
Methods: The study was carried out at Department of Physiology and Centre for Research in Experimental and Applied Medicine [CREAM], Army Medical College, in collaboration with Armed Forces Institute of Ophthalmology, Rawalpindi for a period of one year. A total of 90 subjects were recruited into three equal groups; healthy subjects, diabetics and patients with diabetic retinopathy. Serum high sensitivity C-reactive protein [hs-CRP] was estimated by Enzyme Immunoassay [EIA] and serum ferritin levels were carried out by enzyme linked immunosorbent assay
Results: The mean age was 48.50+/-5.32, 50.90+/-3.83 and 50.83+/-3.54 years respectively. Insignificant differences in height, weight and BMI were found across the groups. Highly significant difference was noted in the mean CRP levels in normal subjects. The mean ferritin levels were also found to be significantly different. Univariate multinomial regression revealed that variance in CRP levels could account for 91.1% of variance in status of patients and that in ferritin levels could account for 96.7%
Conclusion: These prognostic markers correlate well with diabetic retinopathy and have an independent predictive ability as well. This may in future be inculcated into screening and surveillance of diabetic microangiopathic complications