title: The difference in correlation between insulin resistance index and chronic inflammation in type 2 diabetes with and without metabolic syndrome.
abstract: BACKGROUND
  Insulin resistance (IR) is associated with low-grade systemic inflammation. It plays an important role in the pathogenesis of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) in patients with metabolic syndrome (MetS). It is unclear whether diabetic patients with MetS confer elevated CVD risk and outcomes beyond the impact of individual's components of MetS. The aim of this study is to highlight the central role of IR, inflammation, triglyceride/high-density lipoprotein- cholesterol (TG/HDL-C) ratio, and atherogenic index of plasma (AIP) in T2DM with MetS.
  
  
  METHODS
  This cross-sectional study comprised 130 men distributed into three groups, namely Controls: 40 nondiabetic healthy volunteers; Group I: 40 T2DM patients without MetS, and Group II: 50 T2DM patients with MetS. Fasting blood samples were collected for the measurement of blood lipid profile, glucose, insulin, hemoglobin A1c, and high-sensitivity C-reactive protein (hs-CRP). TG/HDL-C ratio, AIP, and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated.
  
  
  RESULTS
  Significant positive association was observed between HOMA-IR and hs-CRP only in Group II and between HOMA-IR and TG/HDL-C ratio in all subjects. Significant differences were seen in waist and hip circumferences, waist/hip ratio, body mass index, systolic blood pressure, fasting blood glucose, TGs, HDL-C, insulin, hs-CRP, HOMA-IR, TG/HDL ratio, and AIP between Controls and Group I with Group II.
  
  
  CONCLUSIONS
  In T2DM with MetS, coexistence of elevated atherogenic indices, systemic inflammation, and association between HOMA-IR and TG/HDL-C ratio were seen. These factors are considered having important role in elevated CVD risk beyond MetS components in these patients.
authors.affiliation: Department of Clinical Biochemistry, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Morteza
authors.initials: M
authors.lastname: Pourfarzam
authors.affiliation: Department of Clinical Biochemistry, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Fouzieh
authors.initials: F
authors.lastname: Zadhoush
authors.affiliation: Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Sadeghi
keywords: Atherogenic index of plasma; inflammation; insulin resistance index; metabolic syndrome; triglyceride/high-density lipoprotein -cholesterol ratio; type 2 diabetes mellitus