Abbasi Fahim, Shiffman Dov, Tong Carmen H, Devlin James J, McPhaul Michael J
Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California.
Quest Diagnostics Nichols Institute, San Juan Capistrano, California.
J Endocr Soc. 2018 Aug 9;2(9):1050-1057. doi: 10.1210/js.2018-00107. eCollection 2018 Sep 1.
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.
Develop a clinically practical probability score to assess IR in apparently healthy individuals based on levels of insulin, C-peptide, and other risk factors.
Cross-sectional study.
Apparently healthy individuals who volunteered to participate in studies of IR.
IR, defined as the top tertile of steady-state plasma glucose during an insulin-suppression test.
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%.
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.
胰岛素抵抗（IR）可进展为2型糖尿病。因此，及时识别IR有助于疾病预防工作。然而，在临床环境中直接测量IR并不可行。
基于胰岛素、C肽和其他危险因素的水平，开发一种临床实用的概率评分，以评估看似健康个体的IR。
横断面研究。
自愿参与IR研究的看似健康的个体。
IR，定义为胰岛素抑制试验期间稳态血浆葡萄糖的最高三分位数。
在一项对535名参与者的研究中，在一个包括年龄、性别、种族、体重指数（BMI）、血压、胰岛素、C肽、空腹血糖、低密度脂蛋白胆固醇、甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL-C）、丙氨酸转氨酶和肌酐的模型中，胰岛素、C肽、肌酐、体重指数（BMI）以及甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL-C）与IR独立相关（均P<0.05）。对于基于包括胰岛素、C肽、肌酐、TG/HDL-C和BMI的模型的IR概率评分，评分>66%的人群与评分<33%的人群相比比值比为26.7（95%CI 14.0至50.8）。当模型中仅包括胰岛素和C肽时，评分>66%的人群与评分<33%的人群相比比值比为15.6（95%CI 7.5至32.4）。
基于胰岛素、C肽、肌酐、TG/HDL-C和BMI的IR概率评分或仅基于胰岛素和C肽的评分可能有助于评估看似健康个体的IR。
