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Cut-off Values and Clinical Utility of Surrogate Markers for Insulin Resistance and Beta-Cell Function to Identify Metabolic Syndrome and Its Components among Southern Indian Adults

Journal of Obesity & Metabolic Syndrome 2020년 29권 4호 p.281 ~ 291
Endukuru Chiranjeevi Kumar, Gaur Girwar Singh, Yerrabelli Dhanalakshmi, Sahoo Jayaprakash, Vairappan Balasubramaniyan,
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 ( Endukuru Chiranjeevi Kumar ) - Jawaharlal Institute of Postgraduate Medical Education and Research Department of Physiology
 ( Gaur Girwar Singh ) - Jawaharlal Institute of Postgraduate Medical Education and Research Department of Physiology
 ( Yerrabelli Dhanalakshmi ) - Jawaharlal Institute of Postgraduate Medical Education and Research Department of Physiology
 ( Sahoo Jayaprakash ) - Jawaharlal Institute of Postgraduate Medical Education and Research Department of Endocrinology
 ( Vairappan Balasubramaniyan ) - Jawaharlal Institute of Postgraduate Medical Education and Research Department of Biochemistry

Abstract


Background: Insulin resistance (IR) is a collective clinical entity that exacerbates metabolic syndrome (MetS). As the gold-standard test to quantify IR involves intravenous insulin loading and repeated blood glucose monitoring, many indices have been developed for IR assessment for convenience. This study tested the ideal cut-off values and clinical utility of IR indices in identifying MetS.

Methods: We recruited 150 subjects, 75 MetS patients and 75 healthy controls, then obtained written informed consent to participate in this study. We collected fasting blood samples for glucose and lipid profiles and calculated nineteen indices of IR and insulin secretion using validated formulae. We determined the precision of these IR indices using the area under the curve (AUC) in a receiver operating characteristic analysis.

Results: Subjects with MetS have significantly higher IR coupled with lower insulin sensitivity and beta-cell function than controls. Among the surrogate markers of IR tested, the homeostatic model assessment of insulin resistance (HOMA-IR), HOMA-adiponectin (HOMA-AD), triglyceride-glucose (TyG) index, HOMA-1%S (insulin sensitivity), quantitative insulin sensitivity check index (QUICKI), McAuley index, single-point insulin sensitivity estimator (SPISE), and HOMA-2%B (beta-cell function) showed the highest AUC values for detecting MetS.

Conclusion: Our study results suggest that the ideal cut-off and AUC values identified for HOMA-IR, HOMA-AD, the TyG index, HOMA-1%S, QUICKI, the McAuley index, SPISE, and HOMA-2%B offer a clinical approach to the early detection and risk stratification for MetS among people in southern India.

키워드

Beta-cell function; Homeostatic model assessment of insulin resistance; Insulin sensitivity; Homeostatic model assessment-adiponectin; McAuley index; Single-point insulin sensitivity estimator

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