Identification of insulin resistance in subjects with normal glucose tolerance.
- Author:
Jiunn Diann LIN
1
;
Jin Biou CHANG
;
Chung Ze WU
;
Dee PEI
;
Chang Hsun HSIEH
;
An Tsz HSIEH
;
Yen Lin CHEN
;
Chun Hsien HSU
;
Chuan Chieh LIU
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Blood Glucose; Cross-Sectional Studies; Female; Glucose; metabolism; Glucose Tolerance Test; Humans; Insulin Resistance; Male; Metabolic Syndrome; metabolism; Middle Aged; Models, Statistical
- From:Annals of the Academy of Medicine, Singapore 2014;43(2):113-119
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTIONDecreased insulin action (insulin resistance) is crucial in the pathogenesis of type 2 diabetes. Decreased insulin action can even be found in normoglycaemic patients, and they still bear increased risks for cardiovascular disease. In this study, we built models using data from metabolic syndrome (Mets) components and the oral glucose tolerance test (OGTT) to detect insulin resistance in subjects with normal glucose tolerance (NGT).
MATERIALS AND METHODSIn total, 292 participants with NGT were enrolled. Both an insulin suppression test (IST) and a 75-g OGTT were administered. The steady-state plasma glucose (SSPG) level derived from the IST was the measurement of insulin action. Participants in the highest tertile were defined as insulin-resistant. Five models were built: (i) Model 0: body mass index (BMI); (ii) Model 1: BMI, systolic and diastolic blood pressure, triglyceride; (iii) Model 2: Model 1 + fasting plasma insulin (FPI); (iv) Model 3: Model 2 + plasma glucose level at 120 minutes of the OGTT; and (v) Model 4: Model 3 + plasma insulin level at 120 min of the OGTT.
RESULTSThe area under the receiver operating characteristic curve (aROC curve) was observed to determine the predictive power of these models. BMI demonstrated the greatest aROC curve (71.6%) of Mets components. The aROC curves of Models 2, 3, and 4 were all substantially greater than that of BMI (77.1%, 80.1%, and 85.1%, respectively).
CONCLUSIONA prediction equation using Mets components and FPI can be used to predict insulin resistance in a Chinese population with NGT. Further research is required to test the utility of the equation in other populations and its prediction of cardiovascular disease or diabetes mellitus.