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Increased C-Peptide and Insulin Resistance are Important in the Development of Paralysis in Patients with Idiopathic Peripheral Facial Paralysis

ABS TRACT Objective: To investigate the possible predictive role of the effects of insulin resistance (IR), connecting peptide (C-peptide) and glucose metabolism on paralysis in patients with nondiabetic “Bell’s palsy (BP)”. Material and Methods: The prospective-con-trolled study included 40 patients (mean age 39.95±11.74 years) and 22 healthy volunteers (average age 36.95±9.8 years). Clinical severity of BP was assessed using the House-Brackmann Facial Nerve Grading System. In addition to routine examinations, glucose, insulin, hemoglobin A1c (HbA1c), HbA1c-Système International (HbA1c-SI), and C-peptide levels were measured after at least 8 hours of fasting. IR was evaluated using homeostatic model assessment for IR (HOMA-IR) at a cut-off value of 2.7. Results: Fasting glucose, fasting insulin, fasting C-peptide, HbA1c, HbA1c-SI, and HOMA-IR values were signif- icantly higher in the BP group (p<0.05 for all). Additionally, all blood parameters were positively correlated and mean fasting insulin, fasting C-peptide, and HOMA-IR values were significantly correlated with each other. Mean HOMA-IR value was significantly higher in the BP group compared to the control group (4.2±2.39 vs. 2.61±1.13) (p=0.004). Conclusion: The significant increase in HOMA-IR values in BP patients suggests that IR is a facilitative risk factor for BP. In addition, we consider that there may be a strong relationship between BP and increased all values. We also propose that these values can be highly useful and indispensable parameters in the pathophysiology of BP, administration of prophylactic precautions for prediabetes.