Abstract
BackgroundThe triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) has been advocated as a simple clinical indicator of insulin resistance. Thresholds of TG/HDL-C appeared to depend on ethnicity. However, no studies have specifically compared the accuracy of TG/HDL-C with and without other clinical and demographic factors in predicting insulin resistance in Taiwanese adults. The aim of the present investigation was to use TG/HDL-C and other clinical available factors to predict insulin resistance in Taiwanese adults.MethodsA total of 812 subjects were recruited from at the time of their general health examination at the Buddhist Dalin Tzu Chi General Hospital, Taiwan. Demographic information and clinical characteristics were obtained. Insulin resistance was defined by the homeostasis model assessment for insulin resistance (HOMA-IR). Simple and multiple logistic regression analyses were used to obtain probabilities of insulin resistance (HOMA-IR > 2) using TG/HDL-C with (Model 2) and without (Model 1) other clinical variables. A receiver operating characteristic (ROC) analysis was conducted to evaluate the ability of the two models to correctly discriminate between subjects of low and elevated HOMA-IR.ResultsFemale sex, greater waist circumferences, and higher ALT levels were significantly associated with the risk of elevated HOMA-IR in addition to TG/HDL-C in the multiple logistic regression (Model 2). The area under the ROC curve (AUC) of Model 2 was 0.71 [95% CI = 0.67-0.75] and was significantly higher (P = 0.007) than the AUC 0.66 [95% CI = 0.62-0.71] of Model 1.ConclusionsThe diagnostic accuracy of insulin resistance, defined by HOMA-IR, using TG/HDL-C can be significantly enhanced by including three additional clinically available factors - sex, waist circumferences, and ALT levels.
Highlights
The triglyceride to high-density lipoprotein cholesterol ratio (TG/high density lipoprotein-cholesterol (HDL-C)) has been advocated as a simple clinical indicator of insulin resistance
Previous studies have shown that insulin resistance scores based on the homeostasis model assessment (HOMA) method was strongly correlated with glucose clamp-assessed insulin resistance [5,6]
There were no significant differences in age, sex, location of residence, body height, total cholesterol levels, low-density lipoprotein-cholesterol (LDL-C) levels, and daily energy expenditure between the two homeostasis model assessment for insulin resistance (HOMA-IR) groups
Summary
The triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) has been advocated as a simple clinical indicator of insulin resistance. No studies have compared the accuracy of TG/HDL-C with and without other clinical and demographic factors in predicting insulin resistance in Taiwanese adults. The aim of the present investigation was to use TG/ HDL-C and other clinical available factors to predict insulin resistance in Taiwanese adults. The pathophysiology of the metabolic syndrome remains a subject of controversy but many of its features are associated with insulin resistance. It is typically defined as decreased sensitivity or responsiveness to metabolic actions of insulin. Previous studies have shown that insulin resistance scores based on the homeostasis model assessment (HOMA) method was strongly correlated with glucose clamp-assessed insulin resistance [5,6]. The model utilize a set of empirically derived nonlinear equations to predict the homeostatic concentrations of fasting insulin and glucose, which reflect the varying degrees of pancreatic b-cell function and insulin resistance [7]
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