Association Between Fasting Plasma Insulin And Insulin Resistance Syndrome In Type2Diabetes Mellitus

Objective: This test is designed to research the relationship betweenfasting plasma insulin level of type2diabetes and insulin resistance syndrome(like obesity, blood pressure, blood lipids, blood sugar, insulin sensitivity),even macroangiopathy. T2DM is rapidly emerging as one of the greatestglobal health challenges of the21stcentury. Insulin resistance is a importantrole for T2DM. Besides cell failure, the major pathophysiological eventcontributing to the development of T2DM is the resistance of target tissues toinsulin, which is usually associated with abnormal insulin secretion. Clinically,the term “insulin resistance” implies that higher-than-normal concentrations ofinsulin are required to maintain normoglycemia. On a cellular level, it definesthe inadequate strength of insulin signaling from the insulin receptordownstream to the final substrates of insulin action involved in multiplemetabolic and mitogenic aspects of cellular function. Insulin resistance andhyperinsulinism are always to coexist. In this test, fasting plasma insulin(FINS) was measured by a method using radioimmunoassay, insulinsensitivity index (ISI) was a parameter for insulin sensitivity. The purpose is toestablish the relationship between FINS and insulin resistance syndrome, tosearch association between FINS and macroangiopathy, so as to provide moreefficient precaution and cure method for T2DM.Methods：A total of109subjects with type2diabetes are all in-patientsof The Third Hospital Of Hebei Medical University. The height, weight, waistcircumference, abdominal circumference, hip circumference and bloodpressure were recorded. And FINS, blood lipid, glycosylated hemoglobin(HbA1c) and fasting plasma glucose were surveied. Completed the calculationof BMI, waist-to-hip ratio (WHR), ISI and HOMA-IR. The diagnosis ofmacroangiopathy was based on auxiliary examination and the history of past illness. According to the course of disease all subjects were classified into twogroups: A group (course of disease≤5years,38males,11females), B group(course of disease＞5years,34males,26females). The other two groupswere based on FINS level, they were FINS-L (FINS<12uIU/ml,47males and17females) and FINS-H(FINS≥12uIU/ml,26males and19females). Tocompare all index between these groups. Stepwise multivariate regressionanalysis was used for association between FINS and BMI, WHR, bloodpressure, blood lipid, FPG, HbA1c, ISI and HOMA-IR. Then establish theregression equation.Results: In group A and group B, the age had significantly higher meanin group B (P<0.05). There were no significant differences in BMI, WHR,blood pressure, HbA1c, FINS, HOMA-IR and ISI (P＞0.05); In FINS-L groupand FINS-H group, BMI and WHR in FINS-H group were significant higherthan that in FINS-L group (P<0.01). There were no significant differences inblood pressure among the2groups (P＞0.05). TG in FINS-H group wassignificant higher than that in FINS-L group (P<0.05). TC, HDL and LDLvalue was no significant difference among2groups (P＞0.05). ISI in FINS-Hgroup was significant lower than that in FINS-L group (P<0.05). HOMA-IR inFINS-H was significant higher than that in FINS-L. There were not significantdifferences in FPG and HbA1c among the2groups (P＞0.05).Macroangiopathy in group FINS-L and FINS-H were not significantdifferences (P＞0.05). Stepwise multivariate regression analysis:FINS=0.083+0.035BMI (F-to-enter:<0.05; F-to-remove:＞0.10).Conclusion:1The course of disease and the age in type2diabetes are not associatedwith fasting plasma insulin level. It indicates that the change of-cell functionis not evaluated by the course of disease and the age in type2diabetes;2A higher fasting insulin level always be with hypertriglyceridemia andobesity (especially abdominal adiposity);3A higher fasting plasma insulin level is not the most important reason formacroangiopathy in type2diabetes.