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Journal of Medical Sciences 2011;14(2):56-60 (108.46±12.93 vs 76.93±6.9 mmHg, p <0.0001) were significantly higher in cases as compared to controls. Insulin resistance, measured by HOMA-IR, was higher in cases in comparison to controls (10.47±8.6 vs 2.67±0.8, p <0.0001). Fasting plasma active ghrelin levels were significantly lower in cases as compared to controls (11.34±6.4 vs 34.46±5.4 fmol/ml, p <0.0001). Plasma active Ghrelin levels are negatively associated with SBP (r = -0.71, p <0.001) and DBP (r = -0.64, p <0.001) in hypertensive patients. There is also an inverse association between ghrelin and fasting insulin concentrations (r = -0.40, p <0.01). Plasma active ghrelin levels were lower in patients with having insulin resistance (HOMA-IR >3.8). These findings were independent of type 2 diabetes status (15.22±4.05 vs 20.98±0.83 fmol/ml, p <0.01). Also insulin resistance is negatively correlated to ghrelin (r=0.32, p <0.05). Plasma active ghrelin levels were lower in obese subjects when compared to non obese subjects (4.96±1.76 vs Materials and Methods This Case–Control study was conducted in the Department of Medicine and Pathology, CSM Medical University, Lucknow between Jan 2009 to Feb 2010. Patients having type 2 diabetes mellitus, attending diabetes clinic and admitted in medical wards of Gandhi Memorial and Associated Hospitals of CSM Medical University, Lucknow were studied after taking their informed consent. A total of 81 patients were enrolled for the study. 50 of these were cases and 31 were controls, (controls were selected from general population not having history of diabetes and hypertension). Those in the diabetic group were divided into four subgroups which included 8 patients having type 2 diabetes only (group 1), 10 patients were having type 2 diabetes and insulin resistance (group 2), 12 patients were having type 2 diabetes, insulin resistance and hypertension (group 3) and last subgroup included 20 patients having type 2 diabetes , insulin resistance, hypertension and obesity (group 4). In our study population of 50 diabetic patients and 31 11 controls, we measured Fasting blood sugars (FBS), Postpran11 dial blood sugars (PPBS), lipid profile, weight, height, BMI, 125 fasting insulin level was measured by I -radio immunoassay (RIA) technique using RIAK-1 kit (BARC Vashi complex, 12 Turbhe, Mumbai), fasting active Ghrelin was measured by Active Ghrelin ELISA kit (Mitsubishi Chemical Medience Corporation, TOKYO) which measures the active form of Ghrelin based on the principle of 2 site sandwich enzyme 13 linked immuno-sorbent assay (ELISA), insulin resistance by 14 HOMA-IR, HbA1c was measured by using ion exchange 15 resin method. Circulating ghrelin includes active (acylated) and inactive (desacylated) form. In our study we estimated active form of ghrelin. Patients with type-II diabetes mellitus for the last three years in age group 25-70 years with or without treatment. Patients with Type-I diabetes mellitus and Hyperthyroidism patients were excluded from the study. Statistical Analysis: Data analysis was done using STRATA 10.1 (College Station, Tx, USA), Two sample t-test used, if data met normally assumption otherwise, Mann Whitney U test is used. Normally all data tested by using Shapiro Wilk’s test. Data were presented as mean + SD, median (IQR) and p value. p value <0.05 was considered as significant.

journal of medical sciences/journal of medical sciences  (srinagar. online)

Plasma Active Ghrelin Level in Patients with Type 2 Diabetes Mellitus and its Interrelationship with Insulin resistance, Hypertension, Dyslipidemia and Obesity