Insulin resistance in drug naive patients with multiple sclerosis
Background/Aim. Due to the fact that there is a relatively small number of data related to systemic insulin abnormalities in the multiple sclerosis (MS), the main objective of our study was to determine whether a dysbalance of glucose and insulin metabolism exist in patients with natural co...
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| Format: | Article |
| Language: | English |
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2017-01-01
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| Series: | Vojnosanitetski Pregled |
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| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2017/0042-84501600082K.pdf |
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| author | Kostić Smiljana Kolić Ivana Raičević Ranko Stojanović Zvezdana Kostić Dejan Dinčić Evica |
| author_facet | Kostić Smiljana Kolić Ivana Raičević Ranko Stojanović Zvezdana Kostić Dejan Dinčić Evica |
| author_sort | Kostić Smiljana |
| collection | DOAJ |
| description | Background/Aim. Due to the fact that there is a relatively small number of
data related to systemic insulin abnormalities in the multiple sclerosis
(MS), the main objective of our study was to determine whether a dysbalance
of glucose and insulin metabolism exist in patients with natural course of
MS. Our hypothesis was that the metabolic disorder that characterizes state
of the insulin resistance (IR) and reduced insulin sensitivity (IS) in
untreated patients with MS could play a role in disease progression and
degree of functional disability. Methods. The study included 31 patients with
relapsing-remitting (RR) MS and 14 healthy controls from the same geographic
area matched by age, ethnicity and number of smokers. The glucose tolerance,
IS, and IR were examined using an oral glucose tolerance test (OGTT) and
using basal plasma glucose and insulin levels. The functional disability and
disease progression were evaluated by the Expanded Disability Status Scale
(EDSS) and Multiple Sclerosis Severity Score (MSSS). Results. The MS patients
tolerated glucose equally well as the healthy controls. Basal concentrations
of insulin were significantly higher in the MS group (p < 0.05), as well as
insulin plasma level 30 min after oral glucose load (p < 0.01). The patients
with MS had significantly higher values of homeostasis model assessment
indexes of IR (HOMA-IR) (p = 0.027; p = 0.028). The percentage of IS (HOMA2
%S) and whole body IS index (ISI Matsuda) showed significantly lower values
in the MS patients than in the controls (p = 0.005; p = 0.001). The
insulinogenic index in the first 30 min of OGTT was significantly higher in
MS patients (p = 0.005). The measures of functional disability and MS
progression did not correlate significantly with the investigated parameters
of IR and IS indexes. Conclusion. This study demonstrates for the first time
the existence of hyperinsulinemia, reduced insulin sensitivity and normal
glucose tolerance that indicate the initial phase of IR in the natural course
of MS. Additional research is necessary in order to define the mechanisms of
occurrence and the impact of IR on the complex pathophysiological processes
in MS. |
| format | Article |
| id | doaj-art-761fc0207a1a49e79896f3beab7baec5 |
| institution | DOAJ |
| issn | 0042-8450 2406-0720 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj-art-761fc0207a1a49e79896f3beab7baec52025-08-20T03:19:11ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202017-01-0174656357010.2298/VSP160218082K0042-84501600082KInsulin resistance in drug naive patients with multiple sclerosisKostić Smiljana0Kolić Ivana1Raičević Ranko2Stojanović Zvezdana3Kostić Dejan4Dinčić Evica5Military Medical Academy, Clinic of Neurology, BelgradeInstitute of Nuclear Sciences „Vinča“, Laboratory for Radiobiology and Molecular Genetics, BelgradeMilitary Medical Academy, Clinic of Neurology, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade + Institute of Nuclear Sciences „Vinča“, Laboratory for Radiobiology and Molecular Genetics, BelgradeMilitary Medical Academy, Institute of Radiology, BelgradeMilitary Medical Academy, Clinic of Neurology, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeBackground/Aim. Due to the fact that there is a relatively small number of data related to systemic insulin abnormalities in the multiple sclerosis (MS), the main objective of our study was to determine whether a dysbalance of glucose and insulin metabolism exist in patients with natural course of MS. Our hypothesis was that the metabolic disorder that characterizes state of the insulin resistance (IR) and reduced insulin sensitivity (IS) in untreated patients with MS could play a role in disease progression and degree of functional disability. Methods. The study included 31 patients with relapsing-remitting (RR) MS and 14 healthy controls from the same geographic area matched by age, ethnicity and number of smokers. The glucose tolerance, IS, and IR were examined using an oral glucose tolerance test (OGTT) and using basal plasma glucose and insulin levels. The functional disability and disease progression were evaluated by the Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Severity Score (MSSS). Results. The MS patients tolerated glucose equally well as the healthy controls. Basal concentrations of insulin were significantly higher in the MS group (p < 0.05), as well as insulin plasma level 30 min after oral glucose load (p < 0.01). The patients with MS had significantly higher values of homeostasis model assessment indexes of IR (HOMA-IR) (p = 0.027; p = 0.028). The percentage of IS (HOMA2 %S) and whole body IS index (ISI Matsuda) showed significantly lower values in the MS patients than in the controls (p = 0.005; p = 0.001). The insulinogenic index in the first 30 min of OGTT was significantly higher in MS patients (p = 0.005). The measures of functional disability and MS progression did not correlate significantly with the investigated parameters of IR and IS indexes. Conclusion. This study demonstrates for the first time the existence of hyperinsulinemia, reduced insulin sensitivity and normal glucose tolerance that indicate the initial phase of IR in the natural course of MS. Additional research is necessary in order to define the mechanisms of occurrence and the impact of IR on the complex pathophysiological processes in MS.http://www.doiserbia.nb.rs/img/doi/0042-8450/2017/0042-84501600082K.pdfmultiple sclerosisinsulin resistanceglucose tolerance testquestionnaires |
| spellingShingle | Kostić Smiljana Kolić Ivana Raičević Ranko Stojanović Zvezdana Kostić Dejan Dinčić Evica Insulin resistance in drug naive patients with multiple sclerosis Vojnosanitetski Pregled multiple sclerosis insulin resistance glucose tolerance test questionnaires |
| title | Insulin resistance in drug naive patients with multiple sclerosis |
| title_full | Insulin resistance in drug naive patients with multiple sclerosis |
| title_fullStr | Insulin resistance in drug naive patients with multiple sclerosis |
| title_full_unstemmed | Insulin resistance in drug naive patients with multiple sclerosis |
| title_short | Insulin resistance in drug naive patients with multiple sclerosis |
| title_sort | insulin resistance in drug naive patients with multiple sclerosis |
| topic | multiple sclerosis insulin resistance glucose tolerance test questionnaires |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2017/0042-84501600082K.pdf |
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