J Korean Med Sci.  2006 Aug;21(4):695-700. 10.3346/jkms.2006.21.4.695.

Cutoff Values of Surrogate Measures of Insulin Resistance for Metabolic Syndrome in Korean Non-diabetic Adults

Affiliations
  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • 3Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea. djkim@ajou.ac.kr
  • 4Huh's Diabetes Center and the 21 Century Diabetes and Vascular Research Institute, Seoul, Korea.

Abstract

We investigated the cutoff values of surrogate of insulin resistance for diagnosing metabolic syndrome in Korean adults. The data from 976 non-diabetic individuals (484 men and 492 women) aged 30-79 yr were analyzed. We determined the odds ratios for the prevalence of metabolic syndrome according to the quartiles of fasting insulin, homeostasis model for insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) as independent variables, while adjusting for age, sex, and body mass index. The cutoff values of fasting insulin, HOMA-IR, and QUICKI were estimated by the areas under the receiver-operating characteristic (ROC) curves. The cutoff points for defining insulin resistance are a fasting insulin level of 12.94 micro U/mL, HOMA-IR=3.04 as the 75th percentile value, and QUICKI=0.32 as the 25th percentile value. Compared with the lowest quartile, the adjusted odds ratios for the prevalence of metabolic syndrome in the highest quartiles of fasting insulin, HOMA-IR, and QUICKI were 1.95 (1.26-3.01), 2.27 (1.45-3.56), and 2.27 (1.45-3.56), respectively. The respective cutoff values for fasting serum insulin, HOMA-IR, and QUIC-KI by ROC analysis were 10.57 micro U/mL (sensitivity 58.5%, specificity 66.8%), 2.34 (sensitivity 62.8%, specificity 65.7%), and 0.33 (sensitivity 61.2%, specificity 66.8%). Fasting insulin, HOMA-IR, and QUICKI can be used as surrogate measures of insulin resistance in Korean non-diabetic adults.

Keyword

Insulin Resistance; Metabolic Syndrome X

MeSH Terms

Triglycerides/blood
Predictive Value of Tests
Multivariate Analysis
Middle Aged
Metabolic Syndrome X/*blood/diagnosis/physiopathology
Male
Korea
*Insulin Resistance
Insulin/*blood
Humans
Female
Fasting/blood
Diabetes Mellitus/blood/physiopathology
Cholesterol, HDL/blood
Cholesterol/blood
Blood Pressure/physiology
Blood Glucose/analysis
Aged
Adult

Figure

  • Fig. 1 Distribution of age, body mass index, fasting glucose and fasting insulin of study subjects.

  • Fig. 2 Receiver-operating characteristic (ROC) curves for fasting serum insulin, HOMA-IR, and QUICKI for increased metabolic syndrome. The cutoff values for fasting serum insulin, HOMA-IR, and QUICKI are 10.57 µU/mL (sensitivity 58.5%, specificity 66.8 %), 2.34 (sensitivity 62.8%, specificity 65.7%), and 0.33 (sensitivity 61.2%, specificity 66.8%) (p<0.001, respectively). The areas under the ROC curves (95% CI) for the parameters are 0.656 (0.625-0.685), 0.672 (0.641-0.701), and 0.671 (0.641-0.701), respectively.


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