Yang Yumei, Wang Baomin, Yuan Haoyue, Li Xiaomu
Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Shanghai 200032, China.
Int J Endocrinol. 2021 Apr 30;2021:6676569. doi: 10.1155/2021/6676569. eCollection 2021.
Insulin resistance (IR) is closely associated with metabolic profiles, including obesity and dyslipidemia. The aim of the present study was to examine how lipid profiles were associated with IR in nonobese middle-aged and elderly Chinese population.
This cross-sectional study included 1608 subjects. IR was defined by homeostasis model assessment of insulin resistance (HOMA-IR) of at least 2.5.
In nonobese subjects (body mass index (BMI) < 25 kg/m, = 996), triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio (odds ratio (OR) = 1.43, 95% confidence interval (CI) 1.13-1.81, =0.003) was an independent risk factor for IR. The best marker for predicting IR in nonobese subjects was TG/HDL-C ratio with the areas under the receiver operating characteristic curves (AUC) of 0.73 ( < 0.001). The optimal cut-off point to identifying IR for TG/HDL-C ratio was ≥1.50 in the nonobese population. Other markers like BMI, TG, and total cholesterol (TC)/HDL-C also had acceptable discriminatory power for predicting IR in nonobese population (AUC ≥ 0.7 and < 0.001). BMI had the highest AUC of 0.647 ( < 0.001) after being adjusted, but it was not effective enough to predict IR in obese subjects (BMI ≥ 25.0, = 612).
The TG/HDL-C ratio may be the best reliable marker for predicting IR in the nonobese middle-aged and elderly Chinese population.
胰岛素抵抗（IR）与包括肥胖和血脂异常在内的代谢状况密切相关。本研究旨在探讨非肥胖的中老年中国人群中血脂谱与IR之间的关联。
这项横断面研究纳入了1608名受试者。IR通过胰岛素抵抗稳态模型评估（HOMA-IR）定义，即至少为2.5。
在非肥胖受试者（体重指数（BMI）<25 kg/m²，n = 996）中，甘油三酯（TG）与高密度脂蛋白胆固醇（HDL-C）的比值（优势比（OR）= 1.43，95%置信区间（CI）1.13 - 1.81，P = 0.003）是IR的独立危险因素。预测非肥胖受试者IR的最佳指标是TG/HDL-C比值，其受试者工作特征曲线下面积（AUC）为0.73（P < 0.001）。在非肥胖人群中，识别IR的TG/HDL-C比值的最佳截断点为≥1.50。其他指标如BMI、TG和总胆固醇（TC）/HDL-C在预测非肥胖人群的IR方面也具有可接受的鉴别能力（AUC≥0.7且P < 0.001）。调整后，BMI的AUC最高，为0.647（P < 0.001），但在肥胖受试者（BMI≥25.0，n = 612）中，其预测IR的效果不够理想。
TG/HDL-C比值可能是预测非肥胖的中老年中国人群IR的最佳可靠指标。
