A RELEVANT RESEARCH OF INSULIN RESISTANCE IN NEW-ONSET TYPE 2 DIABETES MELLITUS WITH DIFFERENT BODY WEIGHT

Lixin Zhou^*, Zhaoyan Wang, Ying Zhang, Wei Gu, Yuli Lu

Department of Endocrinology, Hengshui People’s Hospital, Hengshui, Hebei 05300, China

Introduction: The purpose of this research was to compare the differences in general clinical data of type 2 diabetes mellitus (T2DM) patients with different body mass index (BMI), and to probe the correlation of obesity index and insulin resistance, pancreatic β-cell secretory function in T2DM patients, as well as to probe the influence of BMI on the evaluation of insulin resistance in T2DM patients. 

Materials and methods: A total of 300 patients containing 210 males and 90 females with newly diagnosed T2DM hospitalized in Hengshui People’s Hospital from May 2019 to June 2020 were collected and divided into 3 groups according to BMI: group I: 18.5≤BMI<24 kg/m2; group II: 24≤BMI<28 kg/m2; group III: BMI≥28 kg/m2; there were about 100 patients in every group. The clinical data of the three groups were collected, the glucose metabolism indexes, lipid metabolism indexes and renal and liver function indexes in three groups were compared. The relation between blood biochemical index in T2DM patients with different BMI and HOMA-IR, HOMA-β were analyzed by Spearman correlation analysis. ROC curve was utilized to measure the diagnostic value of BMI for insulin resistance in T2DM patients. 

Results: Age, gender, family history, smoking history, height, SBP and DBP in 3 groups were no difference (P>0.05). Meanwhile, weight, WC, WtHR and BMI of people with normal weight and those with overweight were significance (P<0.05), and weight, WC, WtHR and BMI of patients with overweight and those with obesity were statistical difference (P<0.05). HbA1c in 3 groups were no difference (P>0.05). At the same time, FPG, FINS, FCP, HOMA-IR and HOMA-β between people with normal weight and those with overweight were significance (P<0.05), and theses indexes between patients with overweight and those with obesity were statistical difference (P<0.05). TC and LDL-C in 3 groups showed no difference (P>0.05). Besides, TG, HDL-C, TG/HDL-C and TC/HDL-C between people with normal weight and those with overweight were significance (P<0.05), and theses indexes between patients with overweight and those with obesity were statistical difference (P<0.05). UA, Scr, ALT, and AST between people with normal weight and those with overweight were significant (P<0.05), and the above indexes between patients with overweight and those with obesity were statistical difference (P<0.05). Additionally, Spearman correlation analysis indicated that WC, WtHR, TG, UA, TyG, TC/HDL-C, TG/HDL-C, ALT and AST of T2DM patients with different BMI were positively related to HOMA-IR and negatively related to HOMA-β, while HDL-C of those was negatively correlated with HOMA-IR and positively related to HOMA-β. Among them, TyG of T2DM patients with normal body weight had the highest correlation with HOMA-IR and HOMA-β, while TG/HDL-C of T2DM patients with overweight or obesity had the highest correlation with HOMA-IR and HOMA-β (P<0.001). Moreover, the area under the ROC curve for BMI assess the degree of insulin resistance in T2DM patients was 0.8892 (95%CI: 0.8435-0.9348, P<0.0001). 

Conclusion: BMI exerted an important role in insulin resistance of T2DM patients. TyG was an independent risk factor to assess insulin resistance in T2DM patients with normal weight, and TG/HDL-C was an independent risk factor to assess insulin resistance in T2DM patients with overweight and obesity.