Association Of Adenosine Deaminase With Insulin Resistance And Pancreatic Enzymes In Type 2 Diabetes Mellitus

Abstract

Background: Adenosine deaminase(ADA) is a key regulating enzyme of adenosine levels and ADA gives a promising result as a common inflammatory marker for glycemic control, insulin resistance and pathogenesis of diabetes. Chronic inflammation of pancreas in type 2 diabetes mellitus (T2DM) leads to fibrosis and exocrine pancreatic insufficiency. The present study was undertaken to evaluate association of adenosine deaminase with insulin resistance and pancreatic enzymes in type 2 diabetes mellitus.

Materials and Methods: This case-control study was conducted in Department of

Biochemistry, LN Medical College & JK Hospital, Bhopal, Madhya Pradesh, India. Relevant

history was taken, clinical examination and laboratory investigations was done in 200

subjects including 100 type 2 diabetes mellitus subjects & 100 nondiabetic healthy controls. Under fasting condition, 4 ml blood sample and 2 ml post-prandial blood was collected and serum was separated. The separated serum was used for the estimation of FBS, PPBS, insulin, pancreatic enzymes (amylase and lipase) and Adenosine deaminase levels by using autoanalyzer kits. 2 ml whole blood sample was used for estimation of HbA1c.

Results: Among 100 type 2 diabetic subjects, 43 were males and 57were females. In non- diabetic subjects, 54 were males and 46 were females. Age (49.3 ± 7.6yrs) and BMI (26.2 ±

1.2Kg/m²) was significantly more in T2DM cases than non-diabetic subjects. Mean levels of

fasting glucose (148.0 ± 18.0 mg/dl), post prandial glucose (219.3 ± 33.8 mg/dl), HbA1C (7.0

± 0.6g%), insulin (15.2 ± 4.6µIU/ml), HOMA-IR (5.6 ± 2.2), ADA (21.4 ± 5.8 IU/L) were

significantly higher and serum amylase (43.4 ± 10.3IU/L), lipase (30.5 ± 8.4IU/L) levels

were significantly lower in T2DM cases compared to nondiabetic subjects (P < 0.001). ADA showed positive correlation with fasting Insulin &HOMA-IR and negative correlation with pancreatic enzymes. Further, serum ADA levels are significantly higher in fairly controlled than in controlled diabetics.

Conclusion: ADA levels are linearly associated with severity of type 2 diabetes mellitus. So, that serum ADA levels may be used as an alternative surrogate marker for insulin resistance, assessing glycemic control and assessing pancreatic enzymes serum amylase and lipase in pathogenesis of type 2 diabetes mellitus.