DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20161988

Adenosine deaminase as marker of insulin resistance

Bhanukumar Muthiah, Adarsh L. S., Naveen Krishna Peddi, Vineetha Bharathan Menon

Abstract


Background:Type-2 diabetes complications contribute to increased morbidity and mortality and hence early diagnosis and control of diabetes is necessary. Adenosine deaminase activity is present in almost all human tissues, but the highest levels are found in lymphoid system. Aim of the study was to identify the correlation between adenosine deaminase levels and insulin resistance in type-2 diabetics and serum adenosine deaminase levels and glycemic control.

Methods: In this case control study, patients with type-2 diabetes mellitus, attending out-patient department or admitted in the hospital during the study period, fulfilling the study criteria were taken up.

Results: 200 patients were included in the study, with 100 patients in the case and controls group respectively. The mean body mass index, waist circumference, fasting blood sugar, post prandial blood sugar, glycosylated hemoglobin, fasting serum insulin levels, quantitative insulin sensitivity check index values were found to be significantly elevated (p<0.0001) in case group compared to controls. Quantitative insulin sensitivity check index was significantly reduced (p<0.0001) in study group compared to controls. Adenosine deaminase  levels were significantly high (p<0.0001) in the study group compared to the control group, with a mean value of 22.35 U/L against 4.38 U/L. Adenosine deaminase levels were found to have a linear association with elevated fasting blood sugar and post prandial blood sugar, with a statistical significance (p<0.0001).

Conclusions: We identified that the highest Adenosine deaminase levels were detected in poorly controlled type-2 diabetes mellitus. Adenosine deaminase levels were found to have positive correlation with body mass index, fasting blood sugar and post prandial blood sugar levels. Adenosine deaminase levels were also positively correlated with insulin resistance, as calculated by homeostasis model assessment of insulin resistance. Adenosine deaminase levels were found to have an inversely proportional correlation with quantitative insulin sensitivity check index.

 


Keywords


Adenosine deaminase, Diabetes mellitus, HOMA-INR, Insulin resistance, Insulin sensitivity, QUICKI

Full Text:

PDF

References


Longo DL, Fauci AS, Kasper DS, Hauser SL, Jameson J, Loscalzo J. Criteria of diagnosis of diabetes mellitus, American Diabetes Association Guidelines. Harrison’s Principles of Internal Medicine, 18th edition, McGraw and Hill Publications; New York. 2012:2970.

Global burden of diabetes. International Diabetes federation. Diabetic atlas. 5th edition 2011, Brussels. Available at: http://www.idf.org/diabetesatlas. Accessed on 22nd November 2014.

Chamnan P, Simmons RK, Forouhi NG, Luben R. Khaw KY, Wareham NJ, et al. Incidence of type 2 diabetes using proposed HbA1c diagnostic criteria in the EPIC-Norflok cohort: Implication for preventive strategies. Available at http://care.diabetesjournal.org. Accessed on 22nd November 2014.

Longo DL, Fauci AS, Kasper DS, Hauser SL, Jameson JL, Loscalzo J. Complications of Diabetes. Harrison’s Principles of Internal Medicine, 18th edition, McGraw and Hill Publications; New York. 2012:2976-80.

Longo DL, Fauci AS, Kasper DS, Hauser SL, Jameson JL, Loscalzo J. Treatment goals for adults with diabetes. American Diabetes Association Guidelines. Harrison’s Principles of Internal Medicine, 18th edition, McGraw and Hill Publicationsl New York. 2012:2990.

Hirschhorn R, Ratech H. Isozymes of adenosine deaminase. In: Ratazzi MC, Scandalia JG, Whitt GS, eds. Current topics in biological and medical research, 1st Edition. Saunders publication; New York. 1980:132-57.

Mc Lane MP, Black PR, Law WR, Raymond RM. Adenosine induced reversal of in vivo hepatic responsiveness to insulin. Diabetes. 1990;39:62-9.

Hashemi DM, Karami TF, Gavami S, Sirati SM. Adenosine deaminase activities in the estrogen receptor positive and negative human breast cancer cell lines. Med J Islamic Rep Iran. 2005;19:53-6.

Lann D, LeRoith D. Insulin resistance as the underlying cause for the metabolic syndrome. Med Clin North Am. 2007;91:1063-77.

Antuna-Puente B, Disse E, Rabasa-Lhoret R, Laville M, Capeau J, Bastard JP. How can we measure insulin sensitivity/resistance? Diabetes Metab. 2011;37:179-88.

Hedblad B, Nilsson P, Janzon L, Berglund G. Relation between insulin resistance and carotid intima-media thickness and stenosis in non-diabetic subjects. Results from a cross-sectional study in Malmo, Sweden. Diabet Med. 2000;17:299-307.

Summer AE, Cowie CC. Ethnic differences in the ability of triglyceride levels to identify insulin resistance. Atherosclerosis. 2008;196:696-703.

Geloneze B, Repetto EM, Geloneze SR, Tambascia MA, Ermetice MN. The threshold value for insulin resistance (HOMA-IR) in an admixture population. IR in the Brazilian metabolic syndrome study. Diabetes Res Clin Pract. 2006;72:219-20.

Esteghamati A, Ashraf H, Esteghamati AR, Meysamie A, Khalizadeh O, Nakhjavani M, et al. Optimal threshold of homeostasis model assessment for insulin resistance in an Iranian population: the implication of metabolic syndrome to detect insulin resistance. Diabetes Res Clin Pract. 2009;84:279-87.

Marques-Vidal P, Mazoyer E, Bongard V, Gourdy P, Ruidavets JB, Drouet L, et al: Prevalence of insulin resistance syndrome in Southwestern France and its relationship with inflammatory and haemostatic markers. Diabetes Care. 2002;25:1371-7.

Do HD, Lohsoosthorn V, Jiamjarasrangsi W, Lertmaharit S, Williams MA. Prevalence of insulin resistance and its relationship with cardiovascular disease risk factors among Thai adults over 35 years old. Diabetes Res Clin Pract. 2010;89:303-8.

Bonora E, Kiechl S, Willeit J, Oberhollenzer F, Egger G, Targher G, et al: Prevalence of insulin resistance in metabolic disorders. Diabetes. 1995;47:1643-9.

Nakai Y, Fukushima M, Nakaishi S, Kishimoto H, Seino Y, Nagasaka S, et al. The threshold value for insulin resistance on homeostasis model assessment of insulin sensitivity. Diabet Med. 2002;19:346-7.

Pepe MS. The statistical evaluation of medical tests for classification and prediction. New York: Oxford. University Press; 2003.

Gayoso-Diz P, Otero-González A, Rodriguez-Alvarez MX, Gude F, Cadarso-Suarez C, García F, et al. IR index (HOMA-IR) levels in a general adult population: curves percentile by gender and age. The EPIRCE study. Diabetes Res Clin Pract. 2011;94:146-55.

Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, et al. Global burden of metabolic risk factors of chronic diseases collaborating group (Blood Glucose). National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet. 2011;378:31-40.

Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, et al. Global burden of metabolic risk factors of chronic diseases collaborating group (Body mass index). National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet. 2011;377:557-67.

Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G, et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000;85(7):2402-10.

Kurtul N, Pence S, Akarsu E, Kocoglu H, Aksoy Y, Aksoy H. Adenosine deaminase activity in the serum of type 2 diabetic patients. Acta Medica. 2004;47:33-5.

Sangeetha K, Dharamveer S. Adenosine deaminase activity in Type 2 diabetes mellitus patients. Indian Medical Gazette. 2011;3:110-3.

Jae-Geun L, Dong Gu K, Jung Re Y, Young Ree K, JinSoek K, GwanPyo K, Dae Ho L. Adenosine deaminase activity in patients with type 2 diabetes mellitus and effect of DPP-4 inhibitor treatment on ADA activity. Diabetes Metab J. 2011;35:149-58.

Nisha SR, Krishnamurthy N, Raghavendra PBN, Ashakiran S, Sumathi ME, Harish R. Role of adenosine deaminase to predict glycemic status in type 2 diabetes mellitus. J Clin Biomed Sci. 2012;2(3):123-32.

Amandeep K, Sahiba K, Naresh M, Neha. Adenosine deaminase activity and its correlation with glycated haemoglobin levels in patients of type 2 diabetes mellitus. JCDR. 2012;6(2):252-6.

Bottini E, Gloria BF. Adenosine deaminase and body mass index in non-insulin-dependent diabetes mellitus. Metabolism. 1999;48(8):949-51.

Ashish AJ, Anuradha J. Elevated serum adenosine deaminase activity in obese subjects. Arch Physiol Biochem. 2001;118(1):1-5.

Amrita K, Chanchal KJ, Jayanta KR, Harendra ND. Adenosine deaminase activity among newly diagnosed patients with type 2 diabetes mellitus and its correlation with insulin resistance. http://webcache.googleusercontent.com/search?q=cache:xPQkFH53fX0J:apjor.com/files/1404803755.docx+&cd=1&hl=en&ct=clnk&gl=in&client=opera(Accessed 22nd November 2014).

Gowda VMN, Vasudha KC, Reshma S, Sujatha KJ. Serum ADA activity in type-2 diabetes patients. Int J Diabetes Dev Ctries. 2012;32(3):176-81.