Case control study of insulin resistance and  cell function as prognostic indicator of septicemia patients admitted to tertiary care teaching hospital

Chitresh Chahar, Parmendra Sirohi, Prashant Bishnoi, Rajendra Prasad Agrawal

Abstract


The study was aimed to evaluate insulin resistance and b cell function as prognostic indicator in multi organ dysfunction in septicemia. A case control follow up study consisting of 50 non diabetic patients of septicemia with multi organ dysfunction (MODS) and 50 control participants were enrolled by simple random sampling, excluding the ones not met inclusion criteria. The eligible individuals were evaluated for haematological investigation, renal function tests, serum bicarbonate, fasting blood glucose and serum insulin levels at the point of entry, 3rd day and 7th day of admission. Homa IR and Homab cell function were computed using fasting blood glucose and insulin levels. These prognostic dependent variables were compared with independent variables by the student t-test and odds ratio for assessing the mortality and severity among study participants. Study cases had a statistically significant (p<0.001) high mean values of Homa IR at the time of entry, on Day 3rd and 7thwhereas Homab cell function had statistically(p<0.001) low values, compared to control group. In sepsis patients mortality (6 cases) was higher in study groups where patients had more insulin resistance (IR) (6.55±1.44) and less b cell dysfunction (37.17±25.59) compared to control group (with 2 mortality cases) which had less IR (2.77±0.33) and more b cell dysfunction (152.37±5.06) in study and control group respectively, (p<0.05).Both insulin resistance and b cell dysfunction are reliable indicators of the state of severity and mortality in critically ill patients with multi-organ dysfunction syndrome (MODS).

 

Keywords: Septicemia, MODS, Insulin resistance, b cell function, Prognosis

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References


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