A lipid-parameter-based index for estimating insulin sensitivity and identifying insulin resistance in a healthy population

被引:25
作者
Disse, E. [1 ,2 ,3 ,4 ]
Bastard, J. P. [5 ,6 ]
Bonnet, F. [1 ,2 ,3 ,4 ]
Maitrepierre, C. [1 ,2 ,3 ,4 ]
Peyrat, J. [1 ,2 ,3 ,4 ]
Louche-Pelissier, C. [1 ,2 ,3 ,4 ]
Laville, M. [1 ,2 ,3 ,4 ]
机构
[1] Univ Lyon 1, Human Nutr Res Ctr Rhone Alpes, Hop Edouard Herriot, Fac Med, F-69003 Lyon, France
[2] INSERM, U870, IFR62, F-69008 Lyon, France
[3] INRA, UMR 1235, F-69008 Lyon, France
[4] Inst Natl Sci Appl, RMND, F-69621 Villeurbanne, France
[5] Tenon Hosp, Dept Biochem, AP HP, F-75020 Paris, France
[6] Univ Paris 06, U893, CDR St Antoine Inserm, Fac Med,UPMC, F-75012 Paris, France
关键词
Insulin resistance; Surrogate markers; Fatty acids; Diabetes; ROC curve;
D O I
10.1016/j.diabet.2008.02.009
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aim. - Insulin resistance needs to be identified as early as possible in its development to allow targeted prevention programmes. Therefore, we compared various fasting surrogate indices for insulin sensitivity using the euglycaemic insulin clamp in ail attempt to develop the most appropriate method for assessing insulin resistance in a healthy population. Methods. - Glucose, insulin, proinsulin, glucagon, glucose tolerance, fasting lipids, liver enzymes, blood pressure, anthropometric parameters and insulin sensitivity (Mffm/I) using the euglycaemic insulin clamp were obtained for 70 normoglycaemic non-obese individuals. Spearman's rank correlations were used to examine the association between Mffm/I and various fasting surrogate indices of insulin sensitivity. A regression model Was used to determine the weighting for each variable and to derive a formula for estimating insulin resistance. The clinical value of the Surrogate indices and the new formula for identifying insulin-resistant individuals was evaluated by the use of receiver operating characteristic (ROC) Curves. Results. -The variables that best predicted insulin sensitivity were the HDL-to-total cholesterol ratio, the fasting NEFA and fasting insulin. The use of the lipid-parameter-based formula Mffm/I = 12 x [2.5 x (HDL-c/total cholesterol) - NEFA] fasting insulin appeared to have high clinical Value in predicting insulin resistance. The correlation coefficient between Mffm/I and the new fasting index was higher than those with the most commonly used fasting surrogate indices for insulin Sensitivity. Conclusion. - A lipid-parameter-based index using fasting samples provides a simple means of screening for insulin resistance in the healthy population. (C) 2008 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:457 / 463
页数:7
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