Lee Sihoon, Choi Sunghee, Kim Hae Jin, Chung Yoon-Sok, Lee Kwan Woo, Lee Hyun Chul, Huh Kap Bum, Kim Dae Jung
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2006 Aug;21(4):695-700. doi: 10.3346/jkms.2006.21.4.695.
We investigated the cutoff values of surrogate of insulin resistance for diagnosing metabolic syndrome in Korean adults. The data from 976 non-diabetic individuals (484 men and 492 women) aged 30-79 yr were analyzed. We determined the odds ratios for the prevalence of metabolic syndrome according to the quartiles of fasting insulin, homeostasis model for insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) as independent variables, while adjusting for age, sex, and body mass index. The cutoff values of fasting insulin, HOMA-IR, and QUICKI were estimated by the areas under the receiver-operating characteristic (ROC) curves. The cutoff points for defining insulin resistance are a fasting insulin level of 12.94 microU/mL, HOMA-IR=3.04 as the 75th percentile value, and QUICKI=0.32 as the 25th percentile value. Compared with the lowest quartile, the adjusted odds ratios for the prevalence of metabolic syndrome in the highest quartiles of fasting insulin, HOMA-IR, and QUICKI were 1.95 (1.26-3.01), 2.27 (1.45-3.56), and 2.27 (1.45-3.56), respectively. The respective cutoff values for fasting serum insulin, HOMA-IR, and QUIC-KI by ROC analysis were 10.57 microU/mL (sensitivity 58.5%, specificity 66.8%), 2.34 (sensitivity 62.8%, specificity 65.7%), and 0.33 (sensitivity 61.2%, specificity 66.8%). Fasting insulin, HOMA-IR, and QUICKI can be used as surrogate measures of insulin resistance in Korean non-diabetic adults.
我们研究了韩国成年人中用于诊断代谢综合征的胰岛素抵抗替代指标的临界值。分析了976名年龄在30 - 79岁的非糖尿病个体(484名男性和492名女性)的数据。我们将空腹胰岛素、胰岛素抵抗稳态模型(HOMA-IR)和定量胰岛素敏感性检查指数(QUICKI)的四分位数作为自变量,同时对年龄、性别和体重指数进行校正,确定代谢综合征患病率的比值比。通过受试者操作特征(ROC)曲线下面积估计空腹胰岛素、HOMA-IR和QUICKI的临界值。定义胰岛素抵抗的临界点为空腹胰岛素水平12.94微单位/毫升、HOMA-IR = 3.04(第75百分位数)和QUICKI = 0.32(第25百分位数)。与最低四分位数相比,空腹胰岛素、HOMA-IR和QUICKI最高四分位数中代谢综合征患病率的校正比值比分别为1.95(1.26 - 3.01)、2.27(1.45 - 3.56)和2.27(1.45 - 3.56)。通过ROC分析,空腹血清胰岛素、HOMA-IR和QUICKI的各自临界值分别为10.57微单位/毫升(敏感性58.5%,特异性66.8%)、2.34(敏感性62.8%,特异性65.7%)和0.33(敏感性61.2%,特异性66.8%)。空腹胰岛素、HOMA-IR和QUICKI可作为韩国非糖尿病成年人胰岛素抵抗的替代指标。