COVID-19 may increase the risk of insulin resistance in adult patients without diabetes: A 6-month prospective study

Chen, Mochuan; Zhu, Bing; Chen, Dong; Hu, Xingzhong; Xu, Xueqin; Shen, Wen-Jun; Hu, Chenchan; Li, Jue; Qu, Shen

OBJECTIVE: During the coronavirus disease 2019 (COVID-19) pandemic, exploring insulin resistance and β-cell activity is important for understanding COVID-19-associated new-onset diabetes. This study aimed to assess insulin sensitivity and fasting insulin secretion in COVID-19 patients without diabetes on admission and at 3 and 6 months after discharge. METHODS: This 6-month prospective study assessed data from the records of 64 patients without diabetes diagnosed with COVID-19 at Wenzhou Central Hospital, China. Each patient was followed up for 3 and 6 months after discharge. Repeated measures analysis of variance was used to investigate differences in multiple measurements of the same variable at different times. Linear regression analysis was performed to analyze the contributor for changes in triglyceride-glucose (TyG) index. RESULTS: Fasting C-peptide levels in patients at baseline were lower than the normal range (1.1-4.4 μg/L). Compared with baseline, patients had significantly elevated fasting C-peptide levels (0.35±0.24 vs. 2.36±0.98 vs. 2.52±1.11 μg/L, P˂0.001), HOMA-CP (0.42, IQR 0.36–0.62 vs. 2.54, IQR 1.95-3.42 vs. 2.90, IQR 2.02-4.23, P˂0.001) and TyG indexes (8.57±0.47 vs. 8.73±0.60 vs. 8.82±0.62, P=0.006), and decreased fasting glucose levels (5.84±1.21 vs. 4.95±0.76 vs. 5.40±0.68 mmol/L, P=0.003) during the 3 and 6-month follow-up. Male gender [β (95%CI): -0.312 (-0.590, -0.034)], age [0.012 (0.001, 0.023)], interferon-alfa treatment during hospitalization [0.540 (0.029, 1.051)], and changes in TC [0.217 (0.069, 0.366)] and HDL [-0.477 (-0.881, -0.074)] levels were significantly associated with changes in the TyG index. CONCLUSIONS: Our study provided the first evidence that COVID-19 may increase the risk of insulin resistance in patients without diabetes.