Tuo Xiu, Yuan Jing, Wang Xu-Hong, Xin Zhong
Department of Endocrinology, Beijing Tongren Hospital.
Beijing key Laboratory of Diabetes Prevention and Research, Dong Jiao Min Xiang.
Medicine (Baltimore). 2020 Jan;99(5):e19023. doi: 10.1097/MD.0000000000019023.
In the present study, the performance of anthropometric parameters, lipid and glucose indexes, and the combination of anthropometric parameters with the TyG (triglycerides × fasting plasma glucose) metabolic index, was compared in detecting insulin resistance (IR) to evaluate the optimal cut-off points in nondiabetic Chinese individuals. A total of 1067 nondiabetics underwent oral glucose tolerance test, blood lipid, and fasting insulin measurements. The clinical usefulness of various parameters- body mass index (BMI), waist circumference (WC), TyG, triglycerides/ high density lipoprotein cholesterol ratio, and TyG with adiposity status (TyG-BMI [TyG × BMI] and TyG-WC)-was analyzed to identify IR. Spearman correlation and receiver-operating characteristic curve analyses were used to compare the predictive efficacy of different indicators. All indicators showed a positive correlation with IR in both normal glucose and all subjects. However, the correlation between BMI and homeostasis model assessment of IR index was higher than other indicators as assessed by Spearman correlation test (P < .05). Furthermore, BMI and TyG-BMI were better indicators than others as determined by comparing the area under the receiver-operating characteristics curves (P < .05) in detecting IR. BMI is a simple and accurate measure for detecting IR in Chinese subjects. The 27 kg/m threshold was the optimal BMI cut-off point for detecting IR in both normal glucose and all glucose categories subjects.
在本研究中，比较了人体测量参数、脂质和血糖指标，以及人体测量参数与TyG（甘油三酯×空腹血糖）代谢指数的组合在检测胰岛素抵抗（IR）方面的表现，以评估非糖尿病中国人群的最佳切点。共有1067名非糖尿病患者接受了口服葡萄糖耐量试验、血脂和空腹胰岛素测量。分析了各种参数——体重指数（BMI）、腰围（WC）、TyG、甘油三酯/高密度脂蛋白胆固醇比值，以及结合肥胖状态的TyG（TyG-BMI [TyG×BMI]和TyG-WC）——的临床实用性以识别IR。采用Spearman相关性分析和受试者工作特征曲线分析来比较不同指标的预测效能。在正常血糖人群和所有受试者中，所有指标均与IR呈正相关。然而，通过Spearman相关性检验评估，BMI与IR指数的稳态模型评估之间的相关性高于其他指标（P<0.05）。此外，通过比较受试者工作特征曲线下面积（P<0.05）确定，BMI和TyG-BMI在检测IR方面比其他指标更好。BMI是检测中国受试者IR的一种简单而准确的指标。27kg/m²的阈值是检测正常血糖人群和所有血糖类别受试者IR的最佳BMI切点。
