Insulin Resistance Probability Scores for Apparently Healthy Individuals.

CONTEXT

Insulin resistance (IR) can progress to type 2 diabetes. Therefore, timely identification of IR could facilitate disease prevention efforts. However, direct measurement of IR is not feasible in a clinical setting.

OBJECTIVE

Develop a clinically practical probability score to assess IR in apparently healthy individuals based on levels of insulin, C-peptide, and other risk factors.

DESIGN

Cross-sectional study.

PARTICIPANTS

Apparently healthy individuals who volunteered to participate in studies of IR.

MAIN OUTCOME MEASURE

IR, defined as the top tertile of steady-state plasma glucose during an insulin-suppression test.

RESULTS

In a study of 535 participants, insulin, C-peptide, creatinine, body mass index (BMI), and triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL-C) were independently associated with IR (all < 0.05) in a model that included age, sex, ethnicity, BMI, blood pressure, insulin, C-peptide, fasting glucose, low-density lipoprotein cholesterol, TG/HDL-C, alanine aminotransferase, and creatinine. For an IR probability score based on a model that included insulin, C-peptide, creatinine, TG/HDL-C, and BMI, the odds ratio was 26.7 (95% CI 14.0 to 50.8) for those with scores >66% compared with those with scores <33%. When only insulin and C-peptide were included in the model, the odds ratio was 15.6 (95% CI 7.5 to 32.4) for those with scores >66% compared with those with scores <33%.

CONCLUSIONS

An IR probability score based on insulin, C-peptide, creatinine, TG/HDL-C, and BMI or a score based on only insulin and C-peptide may help assess IR in apparently healthy individuals.