ABSI is a poor predictor of insulin resistance in Chinese adults and elderly without diabetes

ABSTRACT Objective: Recently, a new obesity index (A Body Shape Index, ABSI) based on waist circumference (WC) was developed, and high ABSI corresponds to a more central concentration of body volume. It is well known that central obesity is closely linked with insulin resistance (IR). Therefore, our study aimed to examine the discriminatory power of ABSI for IR in Chinese adults and elderly without diabetes. Subjects and methods: In 2007, a cross-sectional study was made. In this study, 570 individuals without diabetes were available for analysis (male: 56.1%, mean age: 62.3 ± 6.5 years). Insulin resistance was assessed by homeostasis model assessment (HOMA-IR). Areas under the receiver operating characteristic (ROC) curves were determined to identify variables/models that could predict insulin resistance. Results: ABSI was associated with IR, the cut-off points was 0.0785 m11/6kg-2/3 to identifying IR and the area under the ROC (AUC) curve was 0.618 (95%CI: 0.561-0.675), which was not better than body mass index BMI (AUC = 0.753; 95%CI: 0.706-0.801), WC (AUC = 0.749; 95%CI: 0.700-0.797), and fasting plasma glucose (FPG, AUC = 0.752; 95%CI: 0.705-0.799). Furthermore, combination with ABSI could improve the discriminatory power of other variables for IR. The AUC curve increased from 0.753 to 0.771for BMI, 0.749 to 0.754 for WC, 0.752 to 0.769 for FPG, respectively. Conclusions: ABSI is associated with IR in the general Chinese adults and elderly without diabetes, but the discriminatory power for IR is poor. It is recommended that ABSI be used in combination with other variables.

Blood Mercury and Insulin Resistance in Nondiabetic Koreans (KNHANES 2008-2010)

PURPOSE: Blood mercury levels are associated with inflammation, and chronic low-grade inflammation is a cause of insulin resistance. This study aimed to investigate the association between serum mercury and insulin resistance. MATERIALS AND METHODS: Subjects from the 2008-2010 Korean National Health and Nutrition Examination Survey were selected (n=29235) and the relevant data of 5388 subjects (2643 males and 2745 females) were analyzed cross-sectionally. Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) was compared according to blood mercury quartiles, and the odds ratio (OR) of having the highest quartile of HOMA-IR according to blood mercury quartiles was calculated. RESULTS: Blood mercury levels in men and women were 29.4 nmol/L and 20.5 nmol/L, respectively, and fasting blood sugar (FBS), insulin, and HOMA-IR were significantly correlated with blood mercury levels. The correlation was stronger in men than in women. In men, FBS and HOMA-IR showed step-wise increases as the quartiles of blood mercury increased; only HOMA-IR differed significantly in the third and fourth blood mercury quartiles, compared to the first quartile. In women, however, both FBS and HOMA-IR differed significantly in the third and fourth blood mercury quartiles, compared to the first quartile. Among men, the OR of being in the highest HOMA-IR quartile was greatest for the highest blood mercury quartile (OR=1.720, 95% CI; 1.172-2.526), compared with the lowest quartile. CONCLUSION: In this large population-based study, blood mercury levels were weakly correlated with HOMA-IR and may be a risk factor for insulin resistance in nondiabetic Koreans.

Triglyceride Is a Useful Surrogate Marker for Insulin Resistance in Korean Women with Polycystic Ovary Syndrome

PURPOSE: To evaluate lipid profiles and liver enzymes as surrogate markers used for recognizing insulin resistance in Korean women with polycystic ovary syndrome (PCOS). MATERIALS AND METHODS: 458 women with PCOS were divided into two groups: non-obese with a body mass index (BMI) or =25.0 kg/m2. Anthropometric measures and blood sampling for hormone assay, liver enzymes, lipid profiles and 75 g oral glucose tolerance test were performed. Insulin resistance was defined as homeostasis model assessment of insulin resistance (HOMA-IR)> or =2.5. Areas under the receiver operating characteristic (ROC) curves were used to compare the power of serum markers. Multiple linear regression analysis was used to evaluate the contribution of each confounding factor for HOMA-IR. RESULTS: In non-obese and obese groups, the ROC curve analyses demonstrated that the best marker for insulin resistance was triglyceride (TG), with the areas under the ROC curve of 0.617 and 0.837, respectively. Low-density lipoprotein cholesterol (LDL-C) was the significant marker for insulin resistance with areas under the ROC curve of 0.698 in obese group, but not significant in non-obese group. TG and LDL-C were significantly associated with HOMA-IR in both non-obese and obese PCOS women by multiple linear regression analysis. The optimal cut-off points of TG> or =68.5 was a marker for predicting insulin resistance in non-obese PCOS patients and TG> or =100.5 in obese group. CONCLUSION: TG can be used as a useful marker for insulin resistance in Korean women with PCOS, especially for obese patients.

Assessment of the ability of the triglyceride to high density lipoprotein cholesterol ratio to discriminate insulin resistance among Caribbean-born black persons with and without Hispanic ethnicity / Evaluación de la capacidad de la proporción de los triglicéridos en relación con el colesterol de las lipoproteínas de alta densidad para identificar la resistencia a la insulina entre personas negras nacidad en el Caribe con o sin etnicidad Hispánica

OBJECTIVE: The objective of this research was to determine if the triglyceride (TG) to high density lipoprotein (HDL) cholesterol (TG/HDL) ratio has similar utility for discriminating insulin resistance in Caribbean-born black persons with and without Hispanic ethnicity. METHODS: Serum lipids, glucose and insulin were determined and compared for 144 Hispanic blacks and 655 non-Hispanic blacks living in the US Virgin Islands. Area under the receiver operating characteristics (AUROC) curve statistics were used to evaluate the ability of the TG/HDL ratio to discriminate insulin resistance in the two ethnic groups. RESULTS: Hispanic blacks had significantly higher levels of triglycerides and insulin resistance and a lower level of HDL cholesterol than non-Hispanic blacks. The AUROC curve for the ability of the TG/HDL to discriminate insulin resistance was 0.71 (95% CI = 0.62, 0.79) for Hispanic blacks and 0.64 (95% CI = 0.59, 0.69) for non-Hispanic blacks. CONCLUSIONS: Among Caribbean-born black persons living in the US Virgin Islands, the TG/HDL ratio is a useful screening measure for discriminating insulin resistance in those with Hispanic ethnicity but not in those without Hispanic ethnicity.

OBJETIVO: El objetivo de esta investigación fue determinar si la proporción (TG/HDL) de los triglicéridos (TG) con respecto al colesterol de las lipoproteínas de alta densidad (HDL) tiene una utilidad similar a la hora de identificar la resistencia a la insulina en personas negras nacidas en el Caribe, con o sin etnicidad hispánica. MÉTODOS: Se determinaron y compararon la insulina, la glucosa y los lípidos séricos de 144 negros hispánicos y 655 negros no hispánicos residentes en Islas Vírgenes, USA. Las estadísticas del área bajo la curva de las características operativas del receptor (AUROC) se utilizaron para evaluar la capacidad de la proporción TG/HDL para establecer la resistencia a la insulina en los dos grupos étnicos. RESULTADOS: Los negros hispánicos tenían niveles significativamente más altos de triglicéridos y resistencia a la insulina y un menor nivel de colesterol HDL que los negros no hispánicos. La curva AUROC para la capacidad del TG/HDL para establecer la resistencia a la insulina fue 0.71 (95% CI = 0.62, 0.79) para los negros hispánicos y 0.64 (95% CI = 0.59, 0.69) para los negros no hispánicos. CONCLUSIONES: Entre las personas negras que viven en las Islas Vírgenes, la proporción de TG/HDL es una medida útil de tamizaje pata establecer la resistencia a la insulina en las personas de etnia hispana, pero no en las personas de etnicidad no hispánica.

Associations among Body Mass Index, Insulin Resistance, and Pancreatic beta-Cell Function in Korean Patients with New-Onset Type 2 Diabetes

BACKGROUND/AIMS: We investigated the associations among body mass index (BMI), insulin resistance, and beta-cell function in Korean patients newly presenting with type 2 diabetes. METHODS: In total, 132 patients with new-onset type 2 diabetes mellitus were investigated. A standard 75-g oral glucose tolerance test was performed, and the indices of insulin secretion and insulin resistance were calculated. RESULTS: A higher BMI was associated with higher homeostasis model assessment values for insulin resistance (HOMA-IR), homeostasis model assessment of beta-cell function (HOMA-beta), and insulinogenic index as well as lower levels of insulin sensitivity index composite (ISIcomp) and disposition index (DI). In multiple regression models, BMI had independent positive associations with HOMA-IR, ISIcomp, and HOMA-beta and inverse associations with the DI. CONCLUSIONS: Our results showed that BMI had independent positive associations with indices of insulin resistance and an inverse association with beta-cell function adjusted for insulin resistance in Korean patients newly presenting with type 2 diabetes.

Insulin Resistance as a Risk Factor for Gallbladder Stone Formation in Korean Postmenopausal Women

BACKGROUND/AIMS: The objective of this study was to determine whether insulin resistance is associated with gallbladder stone formation in Korean women based on menopausal status. METHODS: The study included 4,125 consecutive Korean subjects (30-79 years of age). Subjects who had a medical history of diabetes, hypertension, dyslipidemia, other cardiovascular disorders, or hormone replacement therapy were excluded. The women were subdivided into two groups according to their menopausal status. RESULTS: Analysis of premenopausal women showed no significant differences in the homeostasis model of assessment-insulin resistance (HOMA-IR) index between the two groups in terms of gallstone disease. The associations between the occurrence of gallbladder stones and age, obesity, abdominal obesity, hyperinsulinemia, and high HOMA-IR index were statistically significant in the analysis with postmenopausal women. In a multiple logistic regression analysis, low high density lipoprotein-cholesterol was an independent predictor of gallbladder stone formation in premenopausal women. However, the multiple logistic regression analysis also showed that age and HOMA-IR were significantly associated with gallbladder stone formation in postmenopausal women. In an additional analysis stratified by obesity, insulin resistance was a significant risk factor for gallbladder stone formation only in the abdominally obese premenopausal group. CONCLUSIONS: Insulin resistance may be associated with gallbladder stone formation in Korean postmenopausal women with abdominal obesity.

Distribution and cutoff points of fasting insulin in Asian Indian adolescents and their association with metabolic syndrome.

AIM: To evaluate the levels and appropriate cutoff points of fasting insulin, and their association with the metabolic syndrome (MS) in Asian Indian adolescents. METHODS: This cross-sectional, population based study included 948 (527 males & 421 females) adolescent subjects aged 14-19 years selected randomly from New Delhi, India. Cutoff points of fasting insulin were defined using Receiver Operating Characteristics curve analysis against overweight, abdominal obesity and high subscapular skinfold thickness. The MS was defined according to NCEP, ATP III and IDF criteria using age-, gender- and ethnicity-specific cutoff points. RESULTS: Fasting insulin levels peaked at 16 y and reduced subsequently in both genders. The derived cutoff points for fasting insulin (pmol/L) were: 14-15 y- 128.5 and 164.8; 16-17 y- 126.1 and 152.8; 18-19 y- 121.2 and 162.4 in males and females, respectively. Prevalence of fasting hyperinsulinemia (39.1%) and MS (NCEP 2.2%, IDF 1.5%) was highest in age group 16-17 years. CONCLUSION: The data from this first study describing the distribution and cutoff points of fasting insulin in Asian Indian adolescents may be helpful for detection of and application of primary prevention strategies for fasting hyperinsulinemia and the metabolic syndrome in this population.

Dyslipidemia in Asian Indians: determinants and significance.

Data suggest that lipid fractions other than total cholesterol, i.e. serum triglycerides (TG) and high-density lipoprotein (HDL) cholesterol are important for the pathogenesis of atherosclerosis. A combination of hypertriglyceridemia, low levels of HDL-cholesterol and high levels of small dense low-density lipoprotein, termed as "atherogenic dyslipidemia', is particularly seen in Asian Indians. Although precise reason for such dyslipidemia is unknown, genetic predisposition and characteristic body composition (excess truncal subcutaneous fat and intraabdominal fat) may be important contributors. A common interface between such body composition and dyslipidemia in Asian Indians is high tendency to develop insulin resistance, more than the other ethnic groups. The general guidelines for the management of dyslipidemia in Asian Indians should be according to National Cholesterol Education Program, Adult Treatment Panel III. However, optimal management requires consideration of ethnic-specific dietary, lifestyle and management factors to formulate individual treatment guidelines.