Endocrinology and Metabolism Research Center, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Metab Syndr Relat Disord. 2012 Feb;10(1):63-9. doi: 10.1089/met.2011.0002. Epub 2011 Oct 19.
Dyslipidemia is a distinguishing characteristic of subjects with insulin resistance. Our aim was to determine the predictive abilities and appropriate cutoffs of different lipid variables for insulin resistance.
We used the data of the individuals without history of known diabetes mellitus, aged 25-64 years, from the third national Survey of Risk Factors of Non-Communicable Diseases (SuRFNCD-2007). Fasting blood was collected for lipids, glucose and insulin. Receiver operating characteristics (ROC) curves were used to evaluate the predictive abilities of lipid measures for insulin resistance reflected by a homeostasis model assessment value >1.775. The optimal cutoffs of the selected measures were determined using the maximum Youden index and the point closest to (0,1) on the ROC curve, and were compared with metabolic syndrome definitions to diagnose hyperinsulinemia (fasting insulin ≥10 in men and ≥11 U/L in women).
Among lipid measures, low-density lipoprotein cholesterol (LDL-C) was the most tenuously related parameter to insulin resistance. On the contrary, triglycerides and triglycerides to high-density lipoprotein cholesterol ratio (triglycerides/HDL-C) had the highest abilities to determine insulin resistance, regardless of sex and body mass index (BMI). The optimal triglycerides and triglycerides/HDL-C cutoffs were 145 mg/dL and 3.75 for men and 109 mg/dL and 3.00 for women, respectively, which had similar abilities to metabolic syndrome definitions in identifying hyperinsulinemia.
Among lipid measures, triglycerides and the triglycerides/HDL-C ratio have the highest predictive abilities for insulin resistance, and the diagnostic values of their appropriate cutoffs are similar to those of metabolic syndrome definitions.
血脂异常是胰岛素抵抗患者的一个显著特征。本研究旨在确定不同血脂变量对胰岛素抵抗的预测能力和合适切点。
我们使用了来自第三次全国慢性病及其危险因素监测（SuRFNCD-2007）的、无已知糖尿病病史且年龄在 25-64 岁的个体数据。采集空腹血样，用于检测血脂、血糖和胰岛素。采用受试者工作特征（ROC）曲线评估血脂指标对胰岛素抵抗（稳态模型评估值>1.775）的预测能力。采用最大 Youden 指数和 ROC 曲线上最接近（0,1）的点来确定所选指标的最佳切点，并与代谢综合征定义相比较，以诊断高胰岛素血症（男性空腹胰岛素≥10 mU/L，女性空腹胰岛素≥11 mU/L）。
在血脂指标中，低密度脂蛋白胆固醇（LDL-C）与胰岛素抵抗的相关性最弱。相反，甘油三酯和甘油三酯与高密度脂蛋白胆固醇比值（甘油三酯/HDL-C）具有最强的确定胰岛素抵抗的能力，无论性别和体重指数（BMI）如何。最佳甘油三酯和甘油三酯/HDL-C 切点分别为男性 145 mg/dL 和 3.75，女性 109 mg/dL 和 3.00，它们在识别高胰岛素血症方面与代谢综合征定义具有相似的能力。
在血脂指标中，甘油三酯和甘油三酯/HDL-C 比值对胰岛素抵抗具有最高的预测能力，其合适切点的诊断价值与代谢综合征定义相似。
