analysis of insulin resistance during increase in body mass index
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WELCOME
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ANALYSIS OF INSULIN
RESISTANCE DURING INCREASE INBODY MASS INDEX
GUIDE
DR.JOSE JACOB, MDHEAD OF DEPARTMENT OF BIOCHEMISTRY,
AMALA INSTITUTE OF MEDICAL SCIENCE,THRISSUR.
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INTRODUCTION
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Insulin is a hormone and is secreted by groups of cellswithin the pancreas called islet cells. It is secreted in
response to increase in blood sugar.
Insulin resistance is defined as a decreased biologicalresponse to normal concentrations of circulating insulin.
Insulin resistance can lead to increase in fasting seruminsulin and glucose levels.
Measuring insulin resistance in a routine clinical setting is
difficult, surrogate measures, namely fasting insulin orthe insulin response to glucose, are used to provide anindirect assessment of insulin function.
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Body mass index is weight in Kilogram
divided by squares of height in meters
BMI = wt. in kg / Sqaure of ht. in meters
BMI between 18.5 24.9 normal
25 - 29.9 over wt30 or >30 obese
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OBJECTIVE
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Individuals who are willing to take part inthe study were grouped into normal or
overweight BMI class.
In these individuals fasting serum insulin,glucose, total triacylglycerol were
estimated. Mean and SD were calculatedin the different groups and thesignificance of variation in the levels wereanalyzed.
In a selected individual, serum insulin andglucose were estimated after oral glucosetolerance test.
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MATERIALS
&
METHODS
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Insulin was estimated by Mercodia
Ultrasensitive Insulin ELISAmethod.
Glucose was estimated by GOD-PAPmethod.
Triglyceride was estimatedby GPOPAPESPAS method.
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RESULT
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Table 1. Serum glucose, Total triacylglycerol and insulin
were estimated in fasting serum samples in two groups of
individuals. In one group BMI was
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Table 2. Serum glucose, Total Triacylglycerol and insulin
were estimated in fasting serum samples in two groups
of individuals . In one group BMI was
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Table 3. Serum Insulin and total serum triacylglycerols were
estimated in fasting serum samples in individuals with BMI
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Table. 4. Serum Insulin and total serum triacylglycerol were
estimated in fasting serum samples in individuals with BMI
>25. There were two groups of individuals, in one group
fasting serum glucose was
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Table 5. Oral Glucose tolerance test in an individual with BMI
29.5 . 75 gm of Glucose was given in 300 ml water in the
morning after overnight fasting. Blood was collected before
giving glucose at 30 min, 60 mins, 90 mins and 120 mins.Glucose and insulin were estimated in the serum.
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Peak glucose at 30 minutes was 155mg/dL. These values come in theimpaired glucose tolerance testcategory. But peak insulin at 1hr was
73 mlU/L. This level was above theupper limit of 65-70mlU/L. In theseresults showed that only peak insulin
value is above normal and showedsigns of insulin resistance.
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DISCUSSION
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In this study, we had examined fastingserum insulin, glucose andtriacylglycerol in individuals with normalBMI and at BMI which is slightlyincreased. It was observed that therewas no consistent and significantvariation in serum glucose, insulin andtriacylglycerol. This may be because the
serum glucose levels are near normalvalues and there is very little demandfor insulin secretion.
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We examined the levels of insulin and
glucose in selected individuals after oral
glucose tolerance test. This result showed
that the glucose and insulin levels can be a
probable marker of the metabolic changes in
obesity only after oral glucose tolerance test.
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CONCLUSION
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Obesity is characterised by insulinresistance and cytokine production
from adipose tissue. In this study, wehave shown that there was nosignificant increase in fasting serum
glucose, insulin or triacylglycerol inindividuals with higher BMI. But thestudy of a case of oral glucose
tolerance test in an individuals withBMI 29.5 showed that both insulinand glucose levels were elevated withincrease in BML.
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THANKS
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