Almeda-Valdés Paloma, Bello-Chavolla Omar Y, Caballeros-Barragán César R, Gómez-Velasco Donají V, Viveros-Ruiz Tania, Vargas-Vázquez Arsenio, Aguilar-Salinas Carlos A
Departamento de Endocrinología y Metabolismo, Ciudad de México, México.
Unidad de Investigación de Enfermedades Metabólicas. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
Gac Med Mex. 2018;154(Supp 2):S50-S55. doi: 10.24875/GMM.18004578.
To evaluate the correlation between subrogate index for the evaluation of insulin resistance with the M value obtained with the euglycemic-hyperinsulinemic clamp as well as their sensitivity, specificity, and positive and negative predictive values.
The euglycemic-hyperinsulinemic clamp was performed in subjects having both normal fasting glucose and glycated hemoglobin concentrations. HOMA-IR, QUICKI, HOMA2%S, TyG, TyG*body mass index (BMI) and triglyceride/HDL indexes were calculated. Correlations coefficients were estimated between indexes results and the M-value adjusted by fat-free mass. Areas under the ROC curve were constructed to evaluate overall performance, sensitivity, specificity and predictive values of the subrogate indexes.
57 subjects, 68.4% women, with a mean age of 32.9 ± 11 years-old were included. The subrogate index with the best correlation with the M value was HOMA2%S (r = 0.428), HOMA-IR had the greatest area under the ROC curve (0.683; 95 % confidence interval: 0.503-0.864) and TyG*BMI the best sensitivity (98.2 %) and specificity (51.1 %).
The surrogated indexes for the evaluation of insulin resistance show a significant correlation with the M value obtained with the gold standard. Additional studies are required to determine cut-off values in Mexican population.
评估用于评估胰岛素抵抗的替代指标与采用正常血糖高胰岛素钳夹技术测得的M值之间的相关性，以及它们的敏感性、特异性、阳性预测值和阴性预测值。
对空腹血糖和糖化血红蛋白浓度均正常的受试者进行正常血糖高胰岛素钳夹试验。计算稳态模型评估胰岛素抵抗指数（HOMA-IR）、定量胰岛素敏感性检查指数（QUICKI）、稳态模型评估胰岛素敏感性指数2（HOMA2%S）、甘油三酯与葡萄糖乘积指数（TyG）、TyG*体重指数（BMI）以及甘油三酯/高密度脂蛋白指数。估计各指标结果与经去脂体重校正的M值之间的相关系数。构建ROC曲线下面积以评估替代指标的整体性能、敏感性、特异性和预测值。
纳入57名受试者，其中68.4%为女性，平均年龄32.9±11岁。与M值相关性最佳的替代指标是HOMA2%S（r = 0.428），HOMA-IR的ROC曲线下面积最大（0.683；95%置信区间：0.503 - 0.864），TyG*BMI的敏感性最佳（98.2%），特异性为（51.1%）。
评估胰岛素抵抗的替代指标与采用金标准测得的M值显著相关。需要进一步研究以确定墨西哥人群的截断值。
