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Journal of Diabetology | Volume 3
May 16-17, 2019 | Prague, Czech Republic
Diabetes and Endocrinology
27
th
International Conference on
J Diabetol, Volume 3
Serum IRAP, a novel direct biomarker of prediabetes
Serge P Bottari
Alps University School of Medicine and Hospital, France
I
nsulin resistance (IR), currently called prediabetes, affects
more than half of the adult population worldwide. Type
2 diabetes (T2D), which often follows in the absence of
treatment, affects more than 400 million people and
represents more than 10 % of the health budget in
industrialized countries. A preventive public health policy is
urgently needed in order to stop this constantly progressing
epidemic. Indeed, early management of prediabetes does
not only strongly reduce its evolution towards T2D but
also strongly reduces the appearance of cardiovascular
comorbidity as well as that of associated cancers. There is
however currently no simple and reliable test available for
the diagnosis or screening of prediabetes and it is generally
estimated that 20 to 60 % of diabetics are not diagnosed.
We therefore developed an ELISA for the quantitative
determination of a novel circulating biomarker of IR, IRAP
(Insulin-Regulated AminoPeptidase, EC 3.4.11.3). IRAP is
associated with and translocated in a stoechiometric fashion
to the plasma membrane together with GLUT4 in response to
insulin in skeletal muscle and adipose tissue. Its extracellular
domain (IRAPs) is subsequently cleaved and secreted in
the blood stream. In T2D, IRAP translocation in response to
insulin is strongly decreased.
Our patented sandwich ELISA is highly sensitive (≥ 10.000-fold
"normal" fasting concentrations) and specific, robust and very
cost-effective. Dispersion of fasting plasma concentration
values in a healthy population is very low (101,4 ± 15,9µg/ml)
as compared to insulin and C-peptide. Results of pilot studies
indicate an excellent correlation between IRAPs levels and
insulin sensitivity. We therefore think that plasma IRAPs is a
direct marker of insulin sensitivity and that the quantitative
determination of its plasma levels should allow large-scale
screening of populations at risk for prediabetes and T2D,
thereby allow the enforcement of a preventive health policy
aiming at efficiently reducing this epidemic.
e
:
serge.bottari@univ-grenoble-alpes.fr