Insulin like growth factor-binding protein-1 as a marker for hyperinsulinemia in obese menopausal women.
Insulin like growth factor-binding protein-1 as a marker for hyperinsulinemia in obese menopausal women.
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DOI：
10.1210/jcem.81.12.8954066
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发表时间：
1996-12
期刊：
影响因子：
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通讯作者：
H. Mogul;M. Marshall;M. Frey;H. Burke;P. S. Wynn;S. Wilker;A. Southern;S. Gambert
中科院分区：
文献类型：
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作者：
H. Mogul;M. Marshall;M. Frey;H. Burke;P. S. Wynn;S. Wilker;A. Southern;S. Gambert
高胰岛素血症是胰岛素抵抗的一种表现，是非胰岛素依赖型糖尿病（NIDDM）的前兆，也是X综合征的标志。胰岛素样生长因子结合蛋白-1 (IGFBP-1)，先前在动物和人类研究中被证明与胰岛素呈负相关，被评估为异常葡萄糖刺激曲线下面积（AUC）胰岛素的诊断标志物（先验定义为>或= 100微u /ml）。我们进行了方差分析和逻辑回归来评估IGFBP-1和其他研究协变量，包括体重指数、血压、血脂、血糖和胰岛素测量，并评估了高胰岛素血症女性与正常女性的表现特征（敏感性、特异性、阳性和阴性预测值和准确率）。高胰岛素血症妇女的平均IGFBP-1为6.1 ng/ml(95%可信区间（CI） 3.1至8.9)，而正常妇女的平均IGFBP-1为33.5 ng/ml (CI 15.8至51.2)（P = 0.0027）。在临界值为15ng/ml时，13名高胰岛素血症妇女和4名胰岛素水平正常妇女的IGFBP-1均异常（敏感性100%，特异性69%；阳性预测值76%，阴性预测值100%，诊断准确率85%），该临界值对应正常研究人群的95%置信下限。Logistic回归模型显示，在所有研究协变量中，IGFBP-1作为二元因变量是auc -胰岛素的最佳预测变量。这些结果表明IGFBP-1可能是肥胖绝经妇女亚群中高胰岛素血症的简单血清标志物。
Hyperinsulinemia, a manifestation of insulin resistance, precursor of non-insulin dependent diabetes mellitus (NIDDM) and the hallmark of Syndrome X was assessed in 27 obese post-menopausal women. Insulin-like growth factor binding protein-1 (IGFBP-1), which had been shown previously to correlate inversely with insulin in animal and human studies, was evaluated as a diagnostic marker for abnormal glucose stimulated area under the curve (AUC) insulin (defined a priori as > or = 100 microU/ml). We performed analysis of variance and logistic regression to assess IGFBP-1 and other study covariates, including body mass index, blood pressure, lipids and measures of glucose and insulin in hyperinsulinemic vs. normal women and evaluated performance characteristics (sensitivity, specificity, positive and negative predictive values and accuracy rates). The mean IGFBP-1 was 6.1 ng/ml (95% confidence interval (CI) 3.1 to 8.9) for the hyper-insulinemic women compared to 33.5 ng/ml (CI 15.8 to 51.2) for normal women (P = .0027). At a cutoff point of 15ng/ml, which was selected to correspond to the lower 95% confidence limit for the normal study population, IGFBP-1 was abnormal in all 13 women with hyperinsulinemia and 4 women with normal insulin levels (sensitivity 100%, specificity 69%; positive predictive value 76%, negative predictive value 100%, diagnostic accuracy rate 85%). Logistic regression models indicated that, of all study covariates, IGFBP-1 was the best predictor variable for AUC-insulin as a binary dependent variable. These results suggest that IGFBP-1 may be a simple serum marker for hyperinsulinemia in a subpopulation of obese menopausal women.