The correlation of BMI and insulin resistance in moderately burned patients.

Abstract

<b>Introduction:</b> Obesity is strongly related to serious comorbidities that might affect the healing process. Elevated Body Mass Index (BMI) and insulin resistance have a significant impact on the development of the metabolic syndrome often leading to lethal cardiovascular complications.<b>Aim:</b> The aim of the study was to verify the correlation of BMI and insulin resistance with clinical parameters of moderately burned patients.<b>Materials and methods:</b> There were 149 patients enrolled in the study and their clinical data was retrospectively analyzed. The laboratory tests, insulin demand, BMI, and surgical procedures were evaluated on admission and discharge.<b>Results:</b> Burned patients who required insulin were characterized by worse laboratory results on admission to the burn unit, they had lower hemoglobin (HGB) levels (P = 0.0001), higher creatinine levels by 0.323 units (P = 0.009), higher C-reactive protein (CRP) by approximately 94 units (P = 0.0001), as higher procalcitonin (PCT) by approximately 0.5 units (P = 0.001) as compared to non-insulin-treated patients. Moreover, burned patients who required insulin stayed in the hospital for an average of 10 days longer. All patients from the insulin-demand subgroup had elevated triglycerides (Tg) levels on admission with increased indexes of insulin resistance.<b>Discussion:</b> Our study suggests that the protective effect of a higher BMI in burned patients, known as the 'obesity paradox' may be compromised by insulin resistance.<b>Conclusions and significance of the study:</b> The results show that elevated Tg on admission to the burn unit coexisting with a BMI over 25 kg/m² may be used as an important prognostic factor and may help with prediction of insulin demand and worse outcome in moderately burned patients.