Symbiosis School of Biological Sciences, Symbiosis International (Deemed University), Lavale, Pune, India.
Exp Clin Endocrinol Diabetes. 2021 Jun;129(6):449-456. doi: 10.1055/a-1120-8163. Epub 2020 Mar 18.
Unhealthy dietary habits and sedentary lifestyles have raised alarming concerns for the rising prevalence of metabolic syndrome (MetS) and associated cardiometabolic risk among Indians at an early age. Insulin resistance and adiposity are the important risk factors associated with MetS. The present study aimed to investigate the relationship between a modified marker of insulin resistance (homeostatic model assessment-adiponectin (HOMA-AD)) and cardiometabolic risk among middle-aged Indians.
The study comprised of 144 subjects of age-group 31-50 years, where 83 subjects were diagnosed for MetS according to the guidelines given by the International Diabetes Federation. We measured cardiometabolic risk indicators such as fasting blood glucose (FPG), fasting plasma insulin (FPI), homeostatic model assessment- insulin resistance (HOMA-IR), adiponectin, high sensitivity C-reactive protein (hs-CRP), oxidized LDL (oxLDL), monocyte chemoattractant protein-1 (MCP-1), and atherogenic index, among others. We calculated HOMA-AD by the formula: [FPG (mmol/l) × FPI (µIU/ml)] / [22.5 × Adiponectin (µg/ml)].
HOMA-IR and HOMA-AD were highly increased (p<0.001) in the MetS subjects than controls. Adiponectin was significantly (p<0.01) lower whereas cardiac risk markers such as atherogenic index, hs-CRP, oxLDL, and MCP-1 were significantly (p<0.01) elevated in MetS group than controls. Linear regression showed positive and significant associations (p<0.01) of HOMA-AD with all the cardiometabolic risk markers except MCP-1. HOMA-AD showed higher AUC (0.806) than HOMA-IR (0.791) for predicting MetS.
HOMA-AD could be a surrogate adipokine-based marker correlated significantly with components of MetS and cardiometabolic risk indicators. It appeared to be a better predictor of MetS among middle-aged Indians than HOMA-IR.
不健康的饮食习惯和久坐的生活方式导致代谢综合征（MetS）和相关心血管代谢风险在印度人中的发病率上升，令人担忧。胰岛素抵抗和肥胖是与 MetS 相关的重要危险因素。本研究旨在探讨中年印度人中改良的胰岛素抵抗标志物（稳态模型评估-脂联素（HOMA-AD））与心血管代谢风险之间的关系。
该研究包括年龄在 31-50 岁的 144 名受试者，其中 83 名根据国际糖尿病联合会的指南诊断为 MetS。我们测量了心血管代谢风险指标，如空腹血糖（FPG）、空腹血浆胰岛素（FPI）、稳态模型评估-胰岛素抵抗（HOMA-IR）、脂联素、高敏 C 反应蛋白（hs-CRP）、氧化 LDL（oxLDL）、单核细胞趋化蛋白-1（MCP-1）和致动脉粥样硬化指数等。我们通过公式计算 HOMA-AD：[FPG（mmol/l）×FPI（µIU/ml）] / [22.5 × 脂联素（µg/ml）]。
MetS 组的 HOMA-IR 和 HOMA-AD 明显高于对照组（p<0.001）。脂联素明显降低（p<0.01），而心脏风险标志物如致动脉粥样硬化指数、hs-CRP、oxLDL 和 MCP-1 在 MetS 组明显高于对照组（p<0.01）。线性回归显示 HOMA-AD 与所有心血管代谢风险标志物均呈正相关（p<0.01），除 MCP-1 外。HOMA-AD 对 MetS 的预测 AUC（0.806）高于 HOMA-IR（0.791）。
HOMA-AD 可以作为一种替代的脂肪因子标志物，与 MetS 成分和心血管代谢风险标志物显著相关。它似乎是预测中年印度人 MetS 的更好指标，优于 HOMA-IR。
