Proforma for Registration of Topic for Dissertation

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE , KARNATAKA

PROFORMA FOR REGISTRATION OF TOPIC FOR DISSERTATION

1. Name of the Dr. Gurucharan A candidate Department of Medicine Address of the candidate Vydehi Institute of medical sciences & research center , Whitefield , Bangalore 560066 2. Name of the VYDEHI INSTITUTE OF MEDICAL SCIENCES Institution AND RESEARCH CENTRE,

BANGALORE - 560066 3. Course of study & M.D IN GENERAL MEDICINE subject 4. Date of Admission to 7th MAY, 2009 course 5. Title of the topic STUDY OF ROLE OF INSULIN ASSAY IN ESTABLISHING METABOLIC SYNDROME

6. Brief resume of intended work 6.1Need for the study

METABOLIC SYNDROME is charecterised by a cluster of related biochemical and anthropometric features

The National cholesterol education panel, Adult treatment panel Ш 2001 and International Diabetes Foundation have laid own a simple pragmatic criteria which has made it easier in establishing the diagnosis of Metabolic syndrome

There have been multiple factors that are attributed to the evolution of Metabolic syndrome however the most accepted unifying identified factor is insulin resistance as a pathophysiologic trigger of this disorder ..

Though insulin resistance is well established , few Indian studies are available with Insulin assay . This study aims to find out the presence of Hyperinsulinemia in patients with Metabolic syndrome which would thereby reflect the presence of insulin resistance

6.2Review of literature

There is a relationship between the number of components of metabolic syndrome and the increasing levels of fasting insulin1

44 patients with metabolic syndrome of the 76 individuals in the study had high fasting and 2-hour insulin levels 2

Insulin resistance is fundamental to the Metabolic syndrome and the measurement of insulin sensitivity is desirable but may be difficult by using technically demanding tests 3

Emphasis is laid on the study of insulin resistance in metabolic syndrome and the association of the two 4

The sensitive chemiluminescent detection method is simple to perform and should be readily adaptable for ELISAs of therapeutic proteins5

Objectives of the study : 6.3  To study the serum insulin levels in patients with metabolic syndrome

 To establish a relation between Serum insulin levels and metabolic syndrome

Materials and methods

7. Source of Data :

Patients presenting to OPD ,Diabetic clinic and in-patients of our hospital .

STASTICAL METHODS

7.1b It will be a duration based study for a period of 1 year and a minimum of 50 patients will be taken

7.2 Method of collection data :

Patients presenting to OPD ,Diabetic clinic and in-patients of our hospital will be included. Informed consent will be taken. A pre structured proforma will be used to collect the baseline data.

Patients satisfying the inclusion criteria will undergo relevant

investigations which includes serum insulin assay using standard

chemiluminescent method . b . INCLUSION CRITERIA

1)Central obeisity - Waist circumference more than 102cm in men and 88 cms in women

2)Fasting Triglycerides more than or equal to 150mg/dl

3)HDL Levels less than or equal to 40mg/dl and 50mg/dl in men and women respectively

4)Systolic blood pressure more than or equal to 130mmhg and diastolic blood pressure more than or equal to 85mmhg

5)Fasting plasma glucose more than or equal to 100mg/dl or previously diagnosed Type2 diabetes

Patients should satisfy 3 of the above 5 criteria as per National cholesterol education panel, Adult treatment panel Ш 2001

c. Exclusion criteria

1. polycystic ovarian disease

2. Hyper parathyroidism

3 acute liver failure

4. Lipodystrophy in association with HIV

5. diffuse idiopathic skeletal hyperostosis

6.Type 1 diabetes

7. Simple obeisity

METHODS OF STATISTICAL ANALYSIS – The data collected will be analysed by mean standard deviation and t- Test

7.3 Does the study require any investigation or intervention to be conducted on patients?

 YES

7.4 Has ethical clearance been obtained from your institution?

 YES 8. List of references :

1. FM Adam, MG Nara, and JM Adam. Fasting insulin, adiponectin, hs-CRP levels, and the components of metabolic syndrome. Acta Med Indones, October 1, 2006; 38(4): 179-84

2. Fernando F. Ribeiro-Filho, Alessandra N. Faria, , Narcia E.B. Kohlmann, Maria-Teresa Zanella, and Sandra R.G. Ferreira . Two-Hour Insulin Determination Improves the Ability of Abdominal Fat Measurement to Identify Risk for the Metabolic Syndrome . FF Ribeiro-Filho, AN Faria, NE Kohlmann, MT Zanella, and SR Ferreira Diabetes Care, Jun 2003; 26: 1725-30.

3. R Olufadi , C D Byrne , Clinical and laboratory diagnosis of metabolic syndrome .J Clin Pathol 2008 ;61:697-706

4. Jeffrey S. Flier, Insulin Resistance: The metabolic syndrome X N Engl J Med 341:1402, October 28, 1999 Book Review

5. Ying Cao, Wendell C. Smith and Ronald R. A Sensitive chemiluminescent enzyme immunoassay for the bioanalysis of carboxyl-terminal B-chain analogues of human insulin, Journal of Pharmaceutical and Biomedical Analysis, August 2001

9. Signature of the candidate 10. Remarks of the Guide : This topic is well defined clinically with lab support. Since not many studies with insulin assay are available this study would be useful The Post Graduate will clinically assess Metabolic syndrome and correlate with the lab data . It is a feasible study in our hospital as plenty of clinical material and facility for insulin assay is available . The results expected are good in correlation with the available literature

11. Name and designation of

11.1 Guide : DR.RAJA PONNAMBALAM , MD PROFESSOR DEPARTMENT OF MEDICINE VIMS & RC, Bangalore

11.2 Signature :

11.3 Co-Guide

11.4 Signature : 11.5 Head of Department : DR. SOMASEKAR.D.S , MD PROFESSOR & HOD

DEPARTMENT OF MEDICINE VIMS & RC, BANGALORE.

11.6 Signature :

12.1 Remarks of Principal :

12.2 Signature :