A biomarker concept for assessment of insulin resistance, beta-cell function and chronic systemic inflammation in type 2 diabetes mellitus.
The classification of patients with type 2 diabetes by means of the classical clinical and laboratory markers (HbA1c, glucose, lipids, BMI and blood pressure) is a classification by symptoms and does not provide an insight into the underlying pathophysiological disorders, insulin resistance, beta-cell dysfunction and adipogenesis. However, a better understanding of these disorders may be helpful for the selection of appropriate and successful therapeutic interventions. The assessment of beta-cell dysfunction has become of special interest as more drugs have been developed that are supposed to protect these cells or preserve their functional capacity, such as GLP-1 analogs or DPPIV-inhibitors. Next to conventional means of beta-cell function assessment, HOMA-score and meal related functional parameters, the determination of fasting intact proinsulin or the proinsulin/insulin ratio have become popular methods to describe the impact of new drugs on the insulin secreting cells. They have been investigated and validated in multiple cross-sectional and interventional controlled clinical studies. Routine assessment of these markers in addition to adiponectin and hsCRP may allow for a better understanding of the underlying disease conditions and optimization of the anti-diabetic and anti-atherosclerotic therapy targeting beyond simple glucose control.
Pfützner
Andreas
A
IKFE - Institute for Clinical Research and Development, Mainz, Germany. andreasp@ikfe.de
Weber
Matthias M
MM
Forst
Thomas
T
D052242:Adiponectin / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D006706:Homeostasis; D006801:Humans; D007249:Inflammation / Q000175:diagnosis*; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000378:metabolism* / Q000502:physiology*; D011384:Proinsulin / Q000097:blood; D015203:Reproducibility of Results
D052242:Adiponectin; D015415:Biomarkers; D002097:C-Reactive Protein; D011384:Proinsulin