ESTIMATED GLUCOSE DISPOSAL RATE, A SIMPLE AND NOVEL INDEX TO ACCESS CARDIOMETABOLIC RISK AMONG TYPE 2 DIABETES MELLITUS PATIENTS. A CROSS-SECTIONAL STUDY.
Abstract
Objective: Insulin resistance is the common soil for Cardio vascular diseases (CVD’s) and diabetes. Insulin resistance (IR) leads to atherogenic dyslipidemia characterized by increased Triglycerides, decreased HDL-C, and increased sd-LDL. Dyslipidemia leads to early predisposition of T2DM patients to CVD’s. Hence, we aimed to identify and analyse the relationship between surrogate markers of IR and cardiometabolic risk biomarkers among T2DM patients.
Methods: This cross-sectional study recruited 82 T2DM without any established liver and cardiac disorders. Routine biochemical parameters were analyzed by an autoanalyzer. Index parameters like lipid pentad index, HOMA, eGDR etc. were calculated using the established formulas. HbA1C was estimated using Biorad D10 autoanalyzer. Apo-B, Apo-A, lipoprotein (a), insulin, were analyzed using ELISA.
Results: HOMA1-IR, HOMA2-IR showed a significant positive correlation with the cardiometabolic risk biomarkers. Significant negative correlation between eGDR, a surrogate of IR with the cardiometabolic risk markers in T2DM patients was observed. The median levels of CLTI, MLTI, LPI, TyG index, AIP were highest in the lowest tertile of eGDR (eGDR <4) and low in the highest tertile of eGDR (eGDR >7). We did not observe any gender specific differences in the correlation of eGDR with cardiometabolic risk biomarkers.
Conclusion: Our study was the first to demonstrate the significant negative correlation between eGDR, a surrogate of IR with the cardiometabolic risk markers in T2DM patients. These findings are important as evaluating eGDR in the routine clinical set up is easy and will help in catching the T2DM at its early phase, thus curtailing the incidences of associated comorbidities.
Keywords: Cardiometabolic risk, Estimated glucose disposal rate (eGDR), HOMA, Insulin resistance, Lipid Pentad Index, Type 2 Diabetes Mellitus.
