Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2018 Jun 5;33(29):e197. doi: 10.3346/jkms.2018.33.e197. eCollection 2018 Jul 16.
This study aimed to identify the gender-specific characteristics of the surrogate measures of insulin resistance and to establish valid cut-off values for metabolic abnormalities in a representative sample in Korea.
Data were collected from the datasets of the Korean National Health and Nutrition Examination Survey between 2007 and 2010. The total number of eligible participants was 10,997. We used three measures of insulin resistance: the homeostasis model assessment-insulin resistance (HOMA-IR), McAuley index, and triglyceride and glucose (TyG) index. The estimated cut-off values were determined using the highest score of the Youden index.
The area under the curve (AUC) of the HOMA-IR, McAuley index, and TyG index were 0.737 (95% confidence interval [CI], 0.725-0.750), 0.861 (95% CI, 0.853-0.870), and 0.877 (95% CI, 0.868-0.885), respectively. The cut-off values of the HOMA-IR were 2.20 in men, 2.55 in premenopausal women, and 2.03 in postmenopausal women, and those of the McAuley index were 6.4 in men and 6.6 in premenopausal and postmenopausal women. For the TyG index, the cut-off values were 4.76 in men and 4.71 in premenopausal and postmenopausal women.
In conclusion, the present study provides the valid cut-off values of the indirect surrogate measures of insulin sensitivity. These values may be used as reference for insulin sensitivity in a clinical setting and may provide a simple and supplementary method for identifying populations at risk of insulin resistance.
本研究旨在确定胰岛素抵抗的替代指标在韩国代表性样本中的性别特异性特征,并为代谢异常建立有效的截断值。
数据来自于 2007 年至 2010 年韩国国家健康和营养检查调查的数据集。合格参与者总数为 10997 人。我们使用三种胰岛素抵抗指标:稳态模型评估-胰岛素抵抗(HOMA-IR)、麦考利指数和甘油三酯与葡萄糖(TyG)指数。使用约登指数的最高得分来确定估计的截断值。
HOMA-IR、麦考利指数和 TyG 指数的曲线下面积(AUC)分别为 0.737(95%置信区间[CI],0.725-0.750)、0.861(95% CI,0.853-0.870)和 0.877(95% CI,0.868-0.885)。HOMA-IR 的截断值在男性为 2.20,在绝经前女性为 2.55,在绝经后女性为 2.03,麦考利指数的截断值在男性为 6.4,在绝经前和绝经后女性均为 6.6。对于 TyG 指数,截断值在男性为 4.76,在绝经前和绝经后女性均为 4.71。
总之,本研究提供了胰岛素敏感性间接替代指标的有效截断值。这些值可用于临床实践中胰岛素敏感性的参考,并为识别胰岛素抵抗风险人群提供了一种简单而补充的方法。