Raised plasma insulin level and homeostasis model assessment (HOMA) score in cerebral malaria: evidence for insulin resistance and marker of virulence.
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| Abstract | OBJECTIVE: To study the glycaemic profile of patients with severe malaria (SM). METHODS: For this purpose, 110 SM patients were recruited. Pre-treatment random blood glucose and plasma insulin were measured in a subset of donors. An ex-vivo experiment was developed for estimation of glucose consumption by parasitized erythrocytes. RESULTS: Hyperglycaemia was frequent in SM but more commonly associated with cerebral malaria (CM), while hyperinsulinaemia was recognized in severe-malarial-hypotension (median, 25 %-75 %, 188.2, 93.8-336.8 pmol/L). The plasma insulin level was positively correlated with age (CC = 0.457, p < 0.001) and negatively with parasitaemia (CC = -0.368, p = 0.045). Importantly, fatal-CM was associated with hyperglycaemia (12.22, 6.5-14.6 mmol/L), hyperinsulinaemia (141.0, 54.0-186.8 pmol/L) and elevated homeostasis model assessment (HOMA) values. However, there was a trend of higher glucose consumption by parasites in CM compared with that in uncomplicated malaria (UM). CONCLUSION: Hyperglycaemia, hyperinsulinaemia and elevated HOMA are evidence for insulin resistance and possibly pancreatic B-cell dysfunction in fatal-CM.
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| Authors | Elrashid M Eltahir, Gehad El Ghazali, Thoraya M E A-Elgadir, Ishraga E A-Elbasit, Mustafa I Elbashir, Hayder A Giha |
| Journal | Acta biochimica Polonica (Acta Biochim Pol) Vol. 57 Issue 4 Pg. 513-20 ( 2010) ISSN: 1734-154X [Electronic] Poland |
| PMID | 21140005 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't) |
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