title: Plasma chloride concentration as a new diagnostic indicator of insulin insufficiency.
abstract: The medical criteria for initiating insulin therapy, based on clinical profiles of type 2 diabetic patients, have not yet been clearly established. We explored various parameters with 48 type 2 diabetic patients who were taking oral hypoglycemic medication. Among parameters, body mass index (BMI), the fasting plasma glucose level (FPG), and plasma chloride concentration were identified by forward-stepwise discriminant analysis as parameters that can discriminate between patients who were and those who were not undergoing insulin therapy. In combination, these parameters correctly diagnosed 86.4% of the patients who were undergoing insulin therapy, and 84.6% of those who were not undergoing insulin therapy. Further, we observed significant correlations between plasma chloride concentrations and either plasma sodium or organic acid concentrations, suggesting that impaired insulin action may reduce plasma chloride concentrations through changes in plasma sodium and organic acid metabolism. Our results suggest that plasma chloride concentration is a possible new indicator of insulin insufficiency.
authors.affiliation: Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba City, Ibaraki 305-8575, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Kikuchi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kawakami
authors.forename: Kyoko
authors.initials: K
authors.lastname: Kakihana
authors.forename: Koichi
authors.initials: K
authors.lastname: Kawai
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Murayama
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Iizuka
authors.forename: Seiji
authors.initials: S
authors.lastname: Suzuki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Suzuki
authors.forename: Hirohito
authors.initials: H
authors.lastname: Sone
authors.forename: Hideo
authors.initials: H
authors.lastname: Toyoshima
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Shimano
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Yamada
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002712:Chlorides / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D005215:Fasting; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012964:Sodium / Q000097:blood
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D002712:Chlorides; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D012964:Sodium