Abstract
Background: Insulin resistance is recognized as impairment subjacent in many metabolic disorders, most of them conditioning the development of diabetes mellitus type II. Cut-off points for clinical parameters such as glucose or HDL cholesterol have been established; however there is no consensus for cut-off points for two of the most used parameters to detect insulin resistance: insulin and homeostasis model assessment of insulin resistance (HOMA-IR). The aim of this study is to propose cut-off points for normal blood levels of insulin and HOMA-IR for young Mexicans. Methods: A sample of 1,359 young Mexicans (17-24 years old) was studied. The set of metabolic alterations related to metabolic syndrome (MetS) was identified, forming two groups of young: ‘Healthy’ and ‘Non-Healthy’, whether or not they presented one or more of the five alterations according to an international definition of MetS. The cut-off points were calculated using two statistical methods, applying sensitivity analysis, and calculating the percentile 95 of ‘Healthy’ young to obtain normal ranges, and the ‘probability of a correct diagnosis’ was used to assess its efficacy. Results: The cut-off point values proposed for young Mexicans are, for insulin 14.0 μU/ml for women and 11.0 μU/ml for men and for HOMA-IR 2.9 for women and 2.3 for men. Conclusions: These upper limits could be useful to detect high risk or presence of metabolic alterations related to the MetS in young Mexicans. Conclusions: These upper limits could be useful to detect high risk or presence of metabolic alterations related to the MetS in young Mexicans.
Highlights
Insulin resistance (IR) is a metabolic alteration related to metabolic syndrome (MetS), it has been argued that IR has a stronger relation to MetS than even obesity [1,2]
Parameter values of ‘Healthy’ and ‘Non-Healthy’ young: Overall, 32.8% (446/1359) of the students are ‘Healthy’, i.e., they presented no alterations related to MetS; the proportion are unbalanced between women and men, since 26.8% (254/949) of women were in the ‘Healthy’ group, whereas 46.8% (192/410) of men were ‘Healthy’, i.e., the prevalence of ‘Non-Healthy’ young was 73.2% (695/949) for women, and 53.2% (218/410) for men
The average values are higher for women compared with men, for all the six groups, for both, insulin and homeostasis model assessment of insulin resistance (HOMA-IR), from zero to five altered parameters
Summary
Insulin resistance (IR) is a metabolic alteration related to metabolic syndrome (MetS), it has been argued that IR has a stronger relation to MetS than even obesity [1,2]. To prevent the epidemic of degenerative diseases that MetS intend to predict, such as diabetes type II (DM2), cardiovascular diseases (CVD), and atherosclerosis, IR is a valuable tool to predict or even prevent MetS, and those impairments putatively related to it In this regard, several methods have been developed to measure IR ranging from very complex, like the hyperinsulinemic-euglycemic glucose clamp (involving many considerations and highly trained personnel to perform the measurement), to a more simple like homeostasis model assessment (HOMA) [3], or the oral glucose tolerance test (OGTT) [4]; the OGTT involves at least 2 hours of measurements and is not affordable for large number of individuals.
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