Significance of visceral adipose index on evaluating insulin resistance in Chinese adult patients with growth hormone deficiency / 解放军医学杂志

ABSTRACT

[Abstract] Objective To investigate the significance of Chinese visceral adipose index (CVAI) on predicting insulin resistance (IR) in Chinese adult patients with growth hormone deficiency (AGHD). Methods Seventy-seven AGHD patients, admitted from Jun. 2016 to Jun. 2017 in the First Affiliated Hospital of Chongqing Medical University, and 77 healthy people matched with age and gender were enrolled as the subjects. The cut-off point for judging IR was 2.69 that was at the upper quartile of the homeostasis model assessment of insulin resistance (HAMA-IR) value of 10 147 subjects aged 25-74 with normal glucose tolerance in the National Diabetes Prevention and Treatment Cooperative Group Survey Bank in 1994. Based on the cut-off point, AGHD patients were divided into IR group and insulin sensitivity (IS) group. Based on CVAI quartile, the AGHD patients were divided into 4 groups. The general anthropometric parameters and glycolipid biochemical index were measured, and waist hip index (WHR), body mass index (BMI), HOMA-IR, lipid accumulation product (LAP), visceral adipose index (VAI) and CVAI were calculated. The calculated area under curve (AUC) of receiver operating characteristic (ROC) curve was used to evaluate the significance of BMI, WHR, waist circumference (WC), LAP, VAI and CVAI in the prediction of IR among AGHD patients. Results The levels of BMI, WC, hip circumference (HC), diastolic blood pressure (DBP), fasting insulin (FINS), HOMA-IR, LAP, VAI and CVAI were obviously higher (P<0.05), and of high density lipoprotein cholesterol (HDL-C) was markedly lower (P<0.05) in AGHD group than those in control group. The weight, DBP, fasting plasma glucose (FPG), FINS, HOMA-IR, triglyceride (TG), CVAI, LAP and VAI were significantly higher (P<0.05) and insulin-like growth factor 1 (IGF-1), HDL-C were significantly lower (P<0.05) in IR group than those in IS group. The age, height, weight, BMI, WC, HC, WHR, FINS, HOMA-IR, TG, LAP and VAI were increased (P<0.05) and HDL-C and IGF-1 decreased (P<0.05) along with the CVAI increase. The ROC curve showed the largest area under the CVAI curve (0.899), the optimal critical value of CVAI was 89.26, which showed higher sensitivity and specificity. Conclusion Compared with the other body adipose index, CVAI may be more accurately able to screen and evaluate IR in Chinese patients with AGHD diseases.