Association Of Insulin Resistance And Serum Advance Glycation End Product With Nerve Conduction Velocity In Type Pre-Diabetics

Background – Studies have shown that insulin resistance contributes to the development of peripheral neuropathy. However, there is very limited data about the association of insulin resistance with nerve conduction velocity in prediabetics. Objective - To establish any existing association of Insulin resistance (IR) and serum advance glycation end products (AGE) with nerve conduction velocity in prediabetics. Method - Hundred subjects (diagnosed as per 2010 ADA guidelines) between 40 to 65 years of age and ninety controls (age, gender matched) were enrolled for the study. Insulin resistance was determined by Homeostatic model assessment for insulin resistance (HOMA-IR) using the following formula: plasma insulin (μIU/mL) ×plasma glucose (mg/dL)/405. The serum levels of AGEs was determined using commercially available ELISA kits. Nerve conduction studies were performed on right Tibial nerve and right Sural in lower limb, with surface recording, using the standardized technique.Result- : There was a significant reduction in NCV of bilateral peroneal nerve (p<0.001) and sural nerve (p<0.001) in prediabetics as compared to controls. Serum AGE levels were found significantly elevated in prediabetic group. In univariate analysis AGE was seen to be significantly associated with insulin resistance (P < 0.001, r = 0.281). A significant negative association was obtained between HOMA-IR and Nerve conduction velocity of peroneal & sural nerve. HOMA-IR was significantly associated with body weight, BMI, WC, and with body fat % (p<0.001).Conclusion- : Insulin resistance delays nerve conduction in motor and sensory nerves in prediabetics and as such nerve conduction study can serve as an important diagnostic modality for early detection of diabetic neuropathy