Predicting insulin resistance using the triglyceride-to-high-density lipoprotein cholesterol ratio in Taiwanese adults.
Predicting insulin resistance using the triglyceride-to-high-density lipoprotein cholesterol ratio in Taiwanese adults.
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DOI：
10.1186/1475-2840-10-93
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发表时间：
2011-10-17
影响因子：
9.3
通讯作者：
Koo M
中科院分区：
文献类型：
--
作者：
Chiang JK;Lai NS;Chang JK;Koo M
甘油三酯与高密度脂蛋白胆固醇的比率（TG/HDL-C）被提倡作为胰岛素抵抗的简单临床指标。 TG/HDL-C 的阈值似乎取决于种族。然而，尚无研究专门比较 TG/HDL-C 与其他临床和人口统计学因素在预测台湾成年人胰岛素抵抗方面的准确性。本研究的目的是利用 TG/HDL-C 和其他临床可用因素来预测台湾成年人的胰岛素抵抗。总共812名受试者是在台湾佛教大林慈济总医院进行全身健康检查时招募的。获得了人口统计信息和临床特征。胰岛素抵抗是通过胰岛素抵抗稳态模型评估（HOMA-IR）来定义的。使用简单和多重 Logistic 回归分析，使用 TG/HDL-C 和（模型 2）和不使用（模型 1）其他临床变量来获得胰岛素抵抗 (HOMA-IR > 2) 的概率。进行受试者工作特征 (ROC) 分析，以评估两种模型正确区分低 HOMA-IR 和高 HOMA-IR 受试者的能力。在多重 Logistic 回归中，除了 TG/HDL-C 之外，女性、较大的腰围和较高的 ALT 水平也与 HOMA-IR 升高的风险显着相关（模型 2）。模型 2 的 ROC 曲线下面积 (AUC) 为 0.71 [95% CI = 0.67-0.75]，显着高于 (P = 0.007) 模型 1 的 AUC 0.66 [95% CI = 0.62-0.71]。通过纳入三个额外的临床可用因素，可显着提高由 HOMA-IR 定义的使用 TG/HDL-C 的胰岛素抵抗的诊断准确性- 性别、腰围和 ALT 水平。
The triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) has been advocated as a simple clinical indicator of insulin resistance. Thresholds of TG/HDL-C appeared to depend on ethnicity. However, no studies have specifically compared the accuracy of TG/HDL-C with and without other clinical and demographic factors in predicting insulin resistance in Taiwanese adults. The aim of the present investigation was to use TG/HDL-C and other clinical available factors to predict insulin resistance in Taiwanese adults. A total of 812 subjects were recruited from at the time of their general health examination at the Buddhist Dalin Tzu Chi General Hospital, Taiwan. Demographic information and clinical characteristics were obtained. Insulin resistance was defined by the homeostasis model assessment for insulin resistance (HOMA-IR). Simple and multiple logistic regression analyses were used to obtain probabilities of insulin resistance (HOMA-IR > 2) using TG/HDL-C with (Model 2) and without (Model 1) other clinical variables. A receiver operating characteristic (ROC) analysis was conducted to evaluate the ability of the two models to correctly discriminate between subjects of low and elevated HOMA-IR. Female sex, greater waist circumferences, and higher ALT levels were significantly associated with the risk of elevated HOMA-IR in addition to TG/HDL-C in the multiple logistic regression (Model 2). The area under the ROC curve (AUC) of Model 2 was 0.71 [95% CI = 0.67-0.75] and was significantly higher (P = 0.007) than the AUC 0.66 [95% CI = 0.62-0.71] of Model 1. The diagnostic accuracy of insulin resistance, defined by HOMA-IR, using TG/HDL-C can be significantly enhanced by including three additional clinically available factors - sex, waist circumferences, and ALT levels.
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