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The correlation of BMI and insulin resistance in moderately burned patients

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Surowiecka A., Korzeniowski T., Korulczyk P., Budzyńska J., Leśniewska M., Kozioł I., Górecka Z., Łączyk M., Wilhelm G., Staśkiewicz M., Torres K., Strużyna J.
Polish Journal of Surgery
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2024
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vol. 96
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issue 6
39-46
EN
Introduction: 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. Aim: The aim of the study was to verify the correlation of BMI and insulin resistance with clinical parameters of moderately burned patients. Materials and methods: 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. Results: 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. Discussion: 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. Conclusions and significance of the study: 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.
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