Correlation between glycosylated hemoglobin and insulin resistance in adult male obese patients in al-anbar province

Obese adults' subjects have a body mass index (BMI) of 30 kg/m2 or more. When excess fat accumulates in the body, it has a negative impact on general health. Insulin resistance (IR) is a disorder wherein the body's insulin production is impaired, sensitive tissues is less susceptible to its effects. Type 2 diabetes (T2DM) and obesity are relationship to IR. IR in Iraq has expanded in recent decades as a result of the huge changes in the lifestyle of Iraqis. Research on Iraqi population in this area seems to be limited at the moment. The goal of this study is to find out the relation IR as measured by the homeostasis model assessment (HOMA-IR) and a hemoglobin A1c (HbA1c) test levels in obese adults' subjects in the Anbar province area of Iraq. This research comprised 120 male obese adults subjects ranging in age from 18 to 55 years old who were chosen randomly. The participants have been classified into two categories as per their BMI [Group 1 consisted of 60 obese adults' subjects, whereas Group 2 consisted of 60 normal-weight healthy adults' subjects who acted as non-obese controls]. A series of anthropometric measures were taken, and the following biochemical tests were done on all subjects: fasting glucose, HbA1c, lipid profile, fasting insulin, C-peptide, and thyroid stimulating hormone (TSH) levels were all measured. The enzymatic colorimetric approach was used to determine the glucose levels and lipid profile in the blood. The levels of insulin, C-peptide, and TSH in the blood was measure by using an enzyme-linked immunosorbent testing (ELISA). The HOMA-IR index was used to test IR and a cut off level of 2.6 was judged to be adequate. Using a Tosoh G8 Glycohemoglobin Analyzer to determine the HbA1c level. SPSS 25 was used to conduct the statistical analysis. The Student's independent t-test was used to examine the statistical significance of the data. When comparing the two study groups (obese and healthy non-obese subjects groups), the results revealed that there is significantly higher mean of age and BMI in obese adults' subjects (44.15±8.3 years and 32.67±2.5 kg/m2), than non- obese control group (32.72±10.5 years and 23.17±1.5 kg/m2; P <0.0001). Obese adults' subjects group had significantly higher mean of HbA1c (4.99±0.576%) glucose (5.31±0.86 mmol/l), insulin (11.76±5.06 μIU/mL) and C-peptide (2.48±1.08 ng/mL) levels than non-obese control group (4.65±0.386%, 4.74±0.48 mmol/l, 6.94±3.29 μIU/mL, and 1.47±0.66 ng/mL) respectively; P <0.0001). The mean serum of total cholesterol (TC), triglyceride (TG), low-density density lipoprotein (LDL) and very low-density density lipoprotein (VLDL) level for obese adults' subjects (4.77±0.79 mmol/l, 2.24±0.64 mmol/l, 2.47±0.89 mmol/l and 0.49±0.13 mmol/l) was higher than the mean of non-obese control group (4.47±0.47 mmol/l; P = 0.056, 1.43±0.43 mmol/l; P <0.001, 2.18±0.55 mmol/l; P =0.039 and 0.19±0.08 mmol/l; P <0.001) respectively and HDL (1.39±0.27 mmol/l) was lower than the mean of non-obese control group (1.63±0.19 mmol/l; P =0.701). The mean TSH levels in obese adults' subjects (1.834±1.01 mIU/mL) was higher than non-obese control group (1.592±0.80 mIU/mL) (P = 0.149). The mean HOMA-IR values of obese adults' subjects (2.927±1.65) were significantly higher than the non-obese control group (1.497±0.82) (P < 0.0001). Subjects with mean HOMA-IR ≥2.6 levels had higher values of HbA1c, Insulin, c- peptide, glucose, TSH, TC, TG, LDL, VLDL, BMI and lower HDL values than those with HOMA-IR <2.6 in obese adults' subjects and the same results were founded in non-obese control group. Obese adults' subjects with mean HbA1c more than 5.5 were had a significantly higher level of HOMA-IR (4.23± 2.03) than those with HbA1c values less than 5.5 (2.98±1.77; p<0.001). IR was shown to be more prevalent in obese adults' subjects, and these findings indicate that obese Iraqi adults' subjects had a higher potential to be IR than non-obese subjects. It is possible that the high HbA1c levels in obese adults' subjects is related to the high HOMA-IR index levels, which suggest that these results may be related to a tendency toward diabetes (T2DM) in the obese adult population in Iraq. Elevated HbA1c values in obese adults' subjects may be used to measure insulin sensitivity and resistance, and this can be used as a diagnostic test.