С–peptide and modifi ed HOMA–index in different carbohydrate metabolism disturbances during glucocorticoid therapy
https://doi.org/10.21886/2219-8075-2018-9-1-23-31
Abstract
Objective: the evaluation of the role of C–peptide and modified HOMA–index in different carbohydrate metabolism disturbances (CMD) during glucocorticoid therapy. Materials and methods: 193 patients were included: 63 patients with systemic lupus erythematosus (LE), 45 – with systemic vasculitis (SV); 76 – with chronic glomerulonephritis (CGN). 98 patients received glucocorticoid pulse–therapy (GC–PT) (1 course of 3 sessions) and 95 received oral GC. All patients underwent standard clinical and laboratory tests, glucose tolerance test (GTT), С–peptide evaluation, also HOMA–IR and HOMA–islet indices were calculated. Results: oral GCT revealed increased prevalence of CMG (impaired fasting glucose (IFG), impaired glucose tolerance (IGT), diabetes mellitus (DM)) in patients receiving oral GC compared to patients receiving GC–PT. Patients in both groups with DM and IFG demonstrated higher levels of C–peptide, OGTT and HOMA–IR index before treatment compared to patients without CMD and IFG, which confirms the presence of insulin resistance in that group of patients. Patients with DM had a decreased secretory beta–cell function, which was characterized by a decrease of HOMA–islet index. Conclusion: CMD occur more oft en in patients, receiving oral GC compared to GC–PT. HOMA–IR index can be utilized as a prognostic marker of CMD in patients receiving intensive GC therapy and prolonged oral GC therapy.
About the Authors
F. V. Valeeva
Kazan State Medical University, Kazan
Russian Federation
professor, doctor of Medicine, Head of the Endocrinology department
Russian Federation
professor, doctor of Medicine, Head of the Endocrinology department
G. I. Nurullina
Kazan State Medical University, Kazan
Russian Federation
assistant of the department of Hospital therapy
Russian Federation
assistant of the department of Hospital therapy
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Review
For citations:
Valeeva F.V., Nurullina G.I. С–peptide and modifi ed HOMA–index in different carbohydrate metabolism disturbances during glucocorticoid therapy. Medical Herald of the South of Russia. 2018;9(1):23-31. (In Russ.) https://doi.org/10.21886/2219-8075-2018-9-1-23-31
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