Shalaurova Irina, Connelly Margery A, Garvey W Timothy, Otvos James D
1 LipoScience Inc. , Raleigh, North Carolina.
Metab Syndr Relat Disord. 2014 Oct;12(8):422-9. doi: 10.1089/met.2014.0050. Epub 2014 Jun 24.
Abstract Background: Lipoprotein particle sizes and concentrations are characteristically altered in patients with insulin resistance (IR) or type 2 diabetes mellitus (T2DM). This study assessed the ability of an IR score, based on nuclear magnetic resonance (NMR)-derived lipoprotein information, to detect IR in otherwise healthy individuals.
Lipoprotein subclass and size information were evaluated for strength of association with IR, as measured by homeostasis model assessment of insulin resistance (HOMA-IR) in the Multi-Ethnic Study of Atherosclerosis (MESA). To increase the likelihood of identifying subjects with IR, six lipoprotein measures were combined into a single algorithm. The resulting assay [Lipoprotein Insulin Resistance Index (LP-IR)] was developed using HOMA-IR in 4972 nondiabetic subjects from MESA and verified independently using glucose disposal rates (GDRs) measured during hyperinsulinemic-euglycemic clamps in 56 insulin-sensitive, 46 insulin-resistant, and 46 untreated subjects with T2DM.
LP-IR exhibited stronger associations with HOMA-IR (r=0.51) and GDR (r=-0.53) than each of the individual lipoprotein parameters as well as the triglycerides/high-density lipoprotein cholesterol (TGs/HDL-C) ratio (r=0.41 and -0.44, respectively). In MESA, associations between the LP-IR score and HOMA-IR were strong in men (r=0.51), women (r=0.52), European Americans (r=0.58), African Americans (r=0.48), Chinese Americans (r=0.49), and Hispanic Americans (r=0.45). When LP-IR was categorized by HOMA-IR and either body mass index (BMI) or fasting plasma glucose (FPG), subgroups were revealed whose LP-IR scores were high (≥ 50), despite having normal BMIs (<24 kg/m(2)) or FPG (<100 mg/dL).
LP-IR scores had strong associations with multiple measures, HOMA-IR, and GDR, the former being more reflective of hepatic and the latter of peripheral insulin sensitivity, and may represent a simple means to identify individuals with IR.
摘要 背景：胰岛素抵抗（IR）或2型糖尿病（T2DM）患者的脂蛋白颗粒大小和浓度会发生特征性改变。本研究评估了基于核磁共振（NMR）衍生的脂蛋白信息的IR评分检测健康个体中IR的能力。
在动脉粥样硬化多族裔研究（MESA）中，评估脂蛋白亚类和大小信息与IR的关联强度，IR通过胰岛素抵抗稳态模型评估（HOMA-IR）来衡量。为增加识别IR受试者的可能性，将六项脂蛋白测量值合并为单一算法。使用来自MESA的4972名非糖尿病受试者的HOMA-IR开发了所得检测方法[脂蛋白胰岛素抵抗指数（LP-IR）]，并在56名胰岛素敏感、46名胰岛素抵抗和46名未治疗的T2DM受试者的高胰岛素-正常血糖钳夹期间测量的葡萄糖处置率（GDR）进行独立验证。
LP-IR与HOMA-IR（r = 0.51）和GDR（r = -0.53）的关联比每个单独的脂蛋白参数以及甘油三酯/高密度脂蛋白胆固醇（TGs/HDL-C）比值（分别为r = 0.41和 -0.44）更强。在MESA中，LP-IR评分与HOMA-IR之间的关联在男性（r = 0.51）、女性（r = 0.52）、欧洲裔美国人（r = 0.58）、非裔美国人（r =
