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Insulin resistance (IR) plays an important role as a major determinant of Metabolic syndrome (MetS). Various methods are available for measuring insulin resistance but they are laborious, time-consuming, and costly. Therefore various surrogate markers and indices have been devised to simplify and improve the determination of insulin resistance. Recently, a new index, single point insulin sensitivity estimator (SPISE) was proposed in the European population and was found comparable to the gold standard test (hyperinsulinemic euglycemic glucose clamp).This study was planned to evaluate whether SPISE could be a useful potential low-cost indicator for predicting MetS with IR patients in Indian population. Eighty-three participants from outpatient care of AIIMS Rishikesh were evaluated after informed consent. They were divided into Metabolic syndrome (n = 56) and Non Metabolic Syndrome(n = 27), using South Asian Modified National Cholesterol Education Program- ATP-III criteria for metabolic syndrome. SPISE index, HOMA-IR, Insulin Resistance Index, Triglycerides to high-density lipoproteins cholesterol ratio (TG/HDL-C) were calculated for all the subjects. Receiver operating characteristic (ROC) curve was plotted to assess discriminatory ability of SPISE, HOMA-IR, TG/HDL-C ratio, IRI and hs-CRP to differentiate between IR(Metabolic syndrome) and non-IR (Non-Metabolic syndrome) subjects. SPISE has greater area under curve with better sensitivity and specificity compared to HOMA-IR, IRI, TG/HDL-C ratio and hs CRP. So, SPISE has better predictive ability than HOMA-IR, IRI, TG/HDL-C ratio and hs CRP to discriminate IR from non-IR cases. SPISE could be a useful potential low-cost indicator with high sensitivity and specificity for predicting IR in MetS patients.

Background Vitamin B12 is an essential coenzyme for homocysteine remethylation. So, its deficiency could lead to homocysteine accumulation, a modifiable risk factor for coronary artery disease, deep vein thrombosis and stroke. Transcobalamin II (TCN2) protein responsible for intracellular delivery of vitamin B12 levels, might have change in structure due to genetic variation leading to the altered delivery of vitamin B12. TCN2 gene polymorphism has been associated with increased risk of coronary artery disease, however to the best of our knowledge, no previous study has documented its effect in stroke in India. Aim To explore TCN2 gene polymorphisms status and its association with risk of stroke in North Indian population. Methods An observational study including 154 subjects (84 stroke cases and 70 healthy) was conducted. Genotyping of TCN2 gene SNP 776C > G was done by PCR-RFLP and that of 1196G > A and 1043C > T by allele-specific PCR. Serum level of vitamin B12, and homocysteine were measured by ELISA, and Enzymatic Cycling method respectively. Results Subjects with 776GG genotype had 2.5 times higher risk of developing stroke as compared to 776CC genotype (OR = 2.5, 95%CI = 1.06–5.88; P = .04). Moreover, 776GG had a significantly lower vitamin B12 (P = .04) and a significantly higher homocysteine (P = .004) as compared to 776CC. SNP 1196G > A did not show a significant association with risk of stroke, vitamin B12 and homocysteine levels. 1043CT genotype showed significantly lower risk of stroke (OR = 0.34, 95%CI = 0.13–0.90; P = .03), though had no significant association with vitamin B12 and homocysteine levels. Conclusion SNP 776C > G may be used as a genetic marker for predicting increased risk of stroke. Whereas, 1043CT genotype may have a protective association against the risk of stroke.