Publication:

Adenosine deaminase as marker of insulin resistance

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.