A lipid-parameter-based index for estimating insulin sensitivity and identifying insulin resistance in a healthy population
A lipid-parameter-based index for estimating insulin sensitivity and identifying insulin resistance in a healthy population
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DOI：
10.1016/j.diabet.2008.02.009
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发表时间：
2008-11-01
影响因子：
7.2
通讯作者：
Laville, M.
中科院分区：
文献类型：
--
作者：
Disse, E.;Bastard, J. P.;Laville, M.
的目标。-胰岛素抵抗需要在发展过程中尽早发现，以便制定有针对性的预防规划。因此，我们采用血糖胰岛素钳法比较不同的空腹胰岛素敏感性替代指标，试图建立最合适的方法来评估健康人群的胰岛素抵抗。- 70例血糖正常的非肥胖者使用血糖钳获得葡萄糖、胰岛素、胰岛素原、胰高血糖素、葡萄糖耐量、空腹血脂、肝酶、血压、人体测量参数和胰岛素敏感性（Mffm/I）。使用Spearman秩相关来检查Mffm/I与胰岛素敏感性的各种禁食替代指标之间的关系。使用回归模型确定每个变量的权重，并推导出估计胰岛素抵抗的公式。采用受试者工作特征（ROC）曲线评价替代指标和新公式对胰岛素抵抗个体的临床价值。-最能预测胰岛素敏感性的变量是高密度脂蛋白与总胆固醇的比值、空腹NEFA和空腹胰岛素。使用基于脂质参数的公式Mffm/I = 12 × [2.5 × （HDL-c/总胆固醇）- NEFA]空腹胰岛素在预测胰岛素抵抗方面具有很高的临床价值。Mffm/I与新空腹指标的相关系数高于最常用的胰岛素敏感性空腹替代指标。基于空腹样本的脂质参数指数为筛查健康人群中的胰岛素抵抗提供了一种简单的方法。(C) 2008 Elsevier Masson SAS。版权所有。
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.