A study of fasting insulin level among obese and non-obese patients at tertiary health care centre

 

Pitchai Ansar Khalifullah¹, N Ananthi^2*

 

Abstract               Background: Obesity has become one of the major health problems in advanced society. It has been proved that obesity is a risk factor for a number of chronic disorders such as cardiovascular diseases, Non-insulin dependent diabetic mellitus, gout, gallstones, intestinal blockage, kidney disease, sleep apnea, hernia and arthritis. Aims and Objectives: To Study Fasting Insulin level among Obese and Non Obese patients at tertiary health care centre. Methodology: This was a cross-sectional study carried out in the department of Medicine of a tertiary health care centre during the one year period i.e. May 2016 to May 2017, all the patients at the Outpatient department were screened for Obesity by Body Mass Index and those having BMI >30 were classified as Obese and those Below 25 were classified as non obese, so during the one year period 35 in each such Obese and Non obese were selected randomly. All details of the patients like age, sex were noted, All the patients undergone fasting Insulin level. The statistical analysis done by unpaired t-test, analyzed by SPSS 19 version. Result: In our study we have seen that the average age of the patients in both the groups was 45 ± 5.76 and 47 ± 7.12 (p p>0.05, df=68, unpaired -t=2.34) was comparable to each other. The Male: Female sex ratio was 2.33 and 3.44 was comparable to each other (X2>0.05, df=1, p>0.05). The average Fasting Insulin level (µIU/L) was 19.23 ± 5.65 in the Obese individuals and 10.12 ± 3.45 in the non-obese individuals, this observed difference was statistically significant (t=8.1413, df=68, p<0.0001). Conclusion: It can be concluded from our study that Fasting Insulin level were significantly higher in Obese patients as compared to Non obese patients indicating that obese patients are having insulin resistance as compared to non obese.

Key Word: BMI, Insulin resistance, Fasting Insulin (FI).

 

 

INTRODUCTION

Obesity has become one of the major health problems in advanced society. It has been proved that obesity is a risk factor for a number of chronic disorders such as cardiovascular diseases, Non-insulin dependent diabetic mellitus, gout, gallstones, intestinal blockage, kidney disease, sleep apnea, hernia and arthritis. Obesity is due to sedentary life and nutritional abundance, influenced by genetic factors. It is continuing to rise at an alarming rate even in developing countries like India where hunger is also at the other side. According to known Prevalence rate of overweight and obese in India is 12.8 percent and 10.3 percent respectively.¹ Florentine had also estimated that more than 300 million people in the world are obese.² Obesity, especially class III³, or morbid obesity (BMI > 40 kg/m², 5% of obese individuals), has been recognized as an etiologic or contributing factor for health problems such as coronary heart disease ⁴, dyslipidemia, insulin resistance, hyperinsulinemia, type 2 diabetes^5, 6, and sleep apnea⁷, So we have studied the is there is any difference of fasting insulin level in the Obese and non obese individuals .

METHODOLOGY

This was a cross-sectional study carried out in the department of Medicine of a tertiary health care centre during the one year period i.e. May 2016 to May 2017, all the patients at the Outpatient department were screened for Obesity by Body Mass Index and those having BMI >30 were classified as Obese and those Below 25 were classified as non obese, so during the one year period 35 in each such Obese and Non obese were selected randomly. All details of the patients like age, sex were noted, All the patients undergone fasting Insulin level. The statistical analysis done by unpaired t-test, analyzed by SPSS 19 version.

RESULT

Table 1: Distribution of the patients as per age and sex in two different group

The average age of the patients in both the groups was 45 ± 5.76 and 47 ± 7.12 (p p>0.05, df=68, unpaired -t=2.34 ) was comparable to each other .

Table 2: Distribution of the patients as per the sex

The Male: Female sex ratio was 2.33 and 3.44 was comparable to each other (X²>0.05, df=1,p>0.05)

 

Table 3: Distribution of the patients as per the Fasting Insulin level

The average Fasting Insulin level (µIU/L) was 19.23 ± 5.65 in the Obese individuals and 10.12 ± 3.45 in the non-obese individuals, this observed difference was statistically significant (t=8.1413, df=68,p<0.0001)

 

DISCUSSION

Identifying individuals with increased fasting insulin level is crucial as it increases the risk of developing type 2 diabetes by fivefold and CVD by two-fold along with consequences of metabolic syndrome ⁸. The prevalence of overweight and obesity is rapidly increasing in developing as well as industrialized countries.⁹ Some studies from urban populations have shown that overweight and obesity are increasingly common^10,11 Several studies have shown that obesity is associated with chronic diseases, including diabetes, hypertension, and metabolic syndrome, which are the accompanying metabolic abnormalities of insulin resistance (IR).¹⁰ IR is a state in which a given amount of insulin produces a subnormal biological response.¹² Furthermore, it is characterized by a decrease in the ability of insulin to stimulate the use of glucose by muscles and adipose tissue and to suppress hepatic glucose production and output.¹³ Furthermore, it accounts for a resistance to insulin action on protein and lipid metabolism as well as on vascular endothelial function and gene expression.¹⁴ Adipose tissue seems to play a key role in the pathogenesis of IR through several released metabolites, hormones, and adipocytokins that can affect different steps in insulin action.¹⁵ Adipocytes produce nonesterified fatty acids, which inhibit carbohydrate metabolism via substrate competition and impaired intracellular insulin signaling.^15,16 The euglycemic insulin clamp¹⁷ and the intravenous glucose tolerance tests¹⁸ are gold standard methods for measurement of IR in research, but they are cumbersome in clinical practice and are difficult to perform in population-based research studies. Fasting insulin (FI)¹⁹ is accurate at predicting IR so we have taken Fasting Insulin for measuring insulin resistance In our study we have seen that the average age of the patients in both the groups was 45 ± 5.76 and 47 ± 7.12 (p p>0.05, df=68, unpaired -t=2.34 ) was comparable to each other. The Male: Female sex ratio was 2.33 and 3.44 was comparable to each other (X²>0.05, df=1, p>0.05). The average Fasting Insulin level (µIU/L) was 19.23 ± 5.65 in the Obese individuals and 10.12 ± 3.45 in the non-obese individuals, this observed difference was statistically significant (t=8.1413, df=68,p<0.0001) These findings are similar with Mahmudul Haque ²⁰ they found : Result showed that serum insulin values were significantly higher in cases (Overweight and obese) than in controls of same age and sex (p=<0.001)

 

CONCLUSION

It can be concluded from our study that Fasting Insulin level were significantly higher in Obese patients as compared to Non obese patients indicating that obese patients are having insulin resistance as compared to non obese.

 

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