Departamento de Endocrinología y Metabolismo Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán 14000 México DF, México.
Cardiovasc Diabetol. 2010 Jun 23;9:26. doi: 10.1186/1475-2840-9-26.
Insulin resistance (IR) and related metabolic disturbances are characterized by low levels of adiponectin. High molecular weight adiponectin (HMWA) is considered the active form of adiponectin and a better marker of IR than total adiponectin. The objective of this study is to compare the utility of total adiponectin, HMWA and the HMWA/total adiponectin index (SA index) for the identification of IR and related metabolic conditions.
A cross-sectional analysis was performed in a group of ambulatory subjects, aged 20 to 70 years, in Mexico City. Areas under the receiver operator characteristic (ROC) curve for total, HMWA and the SA index were plotted for the identification of metabolic disturbances. Sensitivity and specificity, positive and negative predictive values, and accuracy for the identification of IR were calculated.
The study included 101 men and 168 women. The areas under the ROC curve for total and HMWA for the identification of IR (0.664 vs. 0.669, P = 0.74), obesity (0.592 vs. 0.610, P = 0.32), hypertriglyceridemia (0.661 vs. 0.671, P = 0.50) and hypoalphalipoproteinemia (0.624 vs. 0.633, P = 0.58) were similar. A total adiponectin level of 8.03 mug/ml was associated with a sensitivity of 57.6%, a specificity of 65.9%, a positive predictive value of 50.0%, a negative predictive value of 72.4%, and an accuracy of 62.7% for the diagnosis of IR. The corresponding figures for a HMWA value of 4.25 mug/dl were 59.6%, 67.1%, 51.8%, 73.7% and 64.2%.The area under the ROC curve of the SA index for the identification of IR was 0.622 [95% CI 0.554-0.691], obesity 0.613 [95% CI 0.536-0.689], hypertriglyceridemia 0.616 [95% CI 0.549-0.683], and hypoalphalipoproteinemia 0.606 [95% CI 0.535-0.677].
Total adiponectin, HMWA and the SA index had similar utility for the identification of IR and metabolic disturbances.
胰岛素抵抗（IR）和相关代谢紊乱的特征是脂联素水平低。高分子量脂联素（HMWA）被认为是脂联素的活性形式，是 IR 的比总脂联素更好的标志物。本研究的目的是比较总脂联素、HMWA 和 HMWA/总脂联素指数（SA 指数）在识别 IR 和相关代谢状况方面的效用。
在墨西哥城的一组门诊患者中进行了横断面分析，年龄在 20 至 70 岁之间。为了识别代谢紊乱，绘制了总脂联素、HMWA 和 SA 指数的接收器操作特征（ROC）曲线下面积。计算了识别 IR 的敏感性、特异性、阳性和阴性预测值以及准确性。
该研究包括 101 名男性和 168 名女性。总脂联素和 HMWA 识别 IR 的 ROC 曲线下面积（0.664 对 0.669，P=0.74）、肥胖（0.592 对 0.610，P=0.32）、高甘油三酯血症（0.661 对 0.671，P=0.50）和低α脂蛋白血症（0.624 对 0.633，P=0.58）相似。总脂联素水平为 8.03 mcg/ml 与 IR 诊断的敏感性为 57.6%、特异性为 65.9%、阳性预测值为 50.0%、阴性预测值为 72.4%和准确性为 62.7%相关。HMWA 值为 4.25 mcg/dl 时的相应数值分别为 59.6%、67.1%、51.8%、73.7%和 64.2%。SA 指数识别 IR 的 ROC 曲线下面积为 0.622[95%CI 0.554-0.691]、肥胖症 0.613[95%CI 0.536-0.689]、高甘油三酯血症 0.616[95%CI 0.549-0.683]和低α脂蛋白血症 0.606[95%CI 0.535-0.677]。
总脂联素、HMWA 和 SA 指数在识别 IR 和代谢紊乱方面具有相似的效用。
