Clinical And Experimental Study On The Insulin Resistance In MODS Patients

Purpose:To elucidate the role of insulin resistance and secretion in clinical MODS patients and the changes of density and affinity of insulin receptor in erythrocytes and the tyrosine protein kinase activity of insulin receptor in MODS patients .Methods:The patients in the ICU were randomly collected,coincided with diagnostic code of multiorgan dysfunction syndrome(MODS),without diabetes before morbidity. additionally, some good-health people were selected as a normal control group. The Indexes of HOMA - IR , HOMA -β, FGLU ,FINS have been determined ,and The correlations and regression - equations between the HOMA - IR and the indexs related to MODS in patients have been analyzed. The indexes of fasting blood glucose were determinded by glucose oxidase method,insulin were determinded by radio-immunity method .The density and affinity of insulin receptor on erythrocytes surface were determined by the radioreceptor assay in MODS patients. The autophosphorylation of insulin receptor were determined by enzyme-linked immunosorbent assay.Results:The levels of HOMA - IR , FGLU , FINS in MODS patients are significant higher than that of the controls. There is a significant correlations between the HOMA - IR and the indexs related to MODS patients. The levels of fasting blood glucose,insulin in MODS patients were significant higher than that of the controls.The density and affinity of insulin receptor in erythrocytes in MODS patients were significantly reduced than that of the controls. The autophosphorylation of insulin receptor were reduced correspond with the rise of glucose in MODS patients.Conclusions:The estimation of index of HOMA - IR and HOMA–βwould contribute to the diagnosis for the MODS patients.Down regulation of insulin receptors and the change of TPK activity might be a key factor in the mechanism by which the MODS patients developed insulin resistance.