Method of Treating a Subject According to Biomarkers for Insulin Resistance

Abstract

The invention provides compositions and methods for determining insulin resistance and/or pancreatic β-cell dysfunction in a subject. The invention also provides compositions and methods for treating a subject according to the insulin resistance and/or pancreatic β-cell dysfunction in the subject.

1 . A composition comprising a solid support comprising:
 (a) a capture binding ligand selective for adiponectin,   (b) a capture binding ligand selective for C-peptide,   (c) a capture binding ligand selective for insulin, and   (d) a capture binding ligand selective for intact proinsulin.   
     
     
         2 . The composition of  claim 1  wherein one of the capture binding ligands comprises an antibody. 
     
     
         3 . The composition of  claim 1  wherein the composition further comprises:
 (a) a soluble capture ligand selective for adiponectin, 
 (b) a soluble capture ligand selective for C-peptide, 
 (c) a soluble capture ligand selective for insulin, and 
 (d) a soluble capture ligand selective for intact proinsulin. 
 
     
     
         4 . The composition of  claim 3  wherein each of the soluble capture ligands comprises a detectable marker. 
     
     
         5 . The composition of  claim 4  wherein a detectable marker is a fluorophore. 
     
     
         6 . The composition of  claim 4  wherein a detectable marker is biotin. 
     
     
         7 . The composition of  claim 6  further comprising a streptavidin/enzyme complex comprising horseradish peroxidase. 
     
     
         8 . The composition of  claim 1  further comprising a detector. 
     
     
         9 . A method of treating insulin resistance in a subject comprising
 (a) measuring the concentration of a biomarker panel in a sample from the subject, the biomarker panel consisting of adiponectin, C-peptide, insulin and intact proinsulin; and   (b) effecting a therapy with respect to the subject.   
     
     
         10 .- 17 . (canceled) 
     
     
         18 . The method of  claim 9  wherein the subject is not administered a drug or combination of drugs selected from a sulfonylurea and a glinide. 
     
     
         19 . The method of  claim 9  wherein the subject is further administered one or more additional drugs comprising one or more glucose lowering drugs. 
     
     
         20 . The method of  claim 9  wherein the sample comprises blood. 
     
     
         21 . The method of  claim 9  further comprising taking a measurement of at least one additional biomarker. 
     
     
         22 . The method of  claim 21  wherein the additional biomarker is selected from the group consisting of leptin, mRNAx, NFκB, IL-6, MMP-9, TNFα, NFκB, eNOS, PPARγ, MCP-1, PAI-1, ICAM/VCAM, E-selectin, P-selectin, von Willebrand factor, sCD40L, insulin, glucose, HbA1c, free fatty acids, triglycerides, VLDL, small dense LDL, oxidized LDL, resistin, HDL, NO, IκB-α, IκB-β, p105, RelA, TNFα, MIF, inflammatory cytokines and molecules involved in signaling pathways. 
     
     
         23 . (canceled) 
     
     
         24 . A method of diagnosing insulin resistance in a subject comprising:
 (a) contacting a sample from the subject with the composition of  claim 1 ; and   (b) measuring the concentration of a biomarker panel in the sample from the subject, the biomarker panel consisting of adiponectin, C-peptide, insulin and intact proinsulin.