Validity assessment of the single-point insulin sensitivity estimator (spise) for diagnosis of cardiometabolic risk in post-pubertal hispanic adolescents

Paulina Correa-Burrows,Sheila Gahagan,Raquel Burrows,Estela Blanco

doi:10.1038/s41598-020-71074-y

Paulina Correa-Burrows, Sheila Gahagan + Show 2 more

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https://doi.org/10.1038/s41598-020-71074-y

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Abstract

Insulin measurements are not advised for cardiometabolic risk screening in large groups. Here we assessed the accuracy of the single-point insulin sensitivity estimator (SPISE) to diagnose cardiometabolic risk in Chilean adolescents. In 678 post-pubertal adolescents (52% males, M(SD) age = 16.8 (0.2) years), height, weight, waist circumference, blood lipids, glucose, insulin, and blood pressure were measured. BMI, HOMA-IR, and SPISE were estimated; HOMA-IR values ≥ 2.6 were considered insulin resistance (IR). Metabolic syndrome (MetS) was defined with the joint IDF/AHA/NHBLI standard. Using receiver operating characteristic curves, we obtained optimal SPISE cutpoints for IR and MetS diagnosis. The prevalence of MetS and IR was 8.2% and 17.1%, respectively. In males, the optimal cutoff for MetS diagnosis was 5.0 (sensitivity: 97%; specificity: 82%), and the optimal cutoff for IR diagnosis was 5.9 (sensitivity: 71%; specificity: 83%). In females, a SPISE of 6.0 had the highest sensitivity (90%) and specificity (74%) for MetS diagnosis. A SPISE of 6.4 was the optimal cutoff for IR diagnosis; however, sensitivity and specificity were 61% and 75%. In males and female post-pubertal adolescents, SPISE had a very good and good diagnostic performance, respectively, in predicting MetS. It was an accurate diagnostic tool for IR prediction in males, but not necessarily in females.

Highlights

Insulin resistance (IR), reduced responsiveness of a target cell or a whole organism to the insulin concentration to which it is exposed, is the prelude of major cardiometabolic disorders, such as coronary heart disease, stroke, Metabolic Syndrome (MetS), non-alcoholic fatty liver disease (NAFLD) and type-2 diabetes (T2D)[1,2]
Paulmichl et al found that Single-Point Insulin Sensitivity Estimator (SPISE) was comparable to the Matsuda Index in assessments of insulin resistance (IR) in Caucasian adolescents with obesity and adults, and, performed as well as HOMA-IR and QUICKI, suggesting it was well suited as a surrogate of insulin sensitivity in these g roups[8]
No sex differences were found in the prevalence of obesity, IR, and Metabolic syndrome (MetS)

Summary

Introduction

Insulin resistance (IR), reduced responsiveness of a target cell or a whole organism to the insulin concentration to which it is exposed, is the prelude of major cardiometabolic disorders, such as coronary heart disease, stroke, Metabolic Syndrome (MetS), non-alcoholic fatty liver disease (NAFLD) and type-2 diabetes (T2D)[1,2]. Paulmichl et al found that SPISE was comparable to the Matsuda Index in assessments of IR in Caucasian adolescents with obesity and adults, and, performed as well as HOMA-IR and QUICKI, suggesting it was well suited as a surrogate of insulin sensitivity in these g roups[8]. With the rising prevalence of obesity among younger age populations, the need for early screening and management of IR-related cardiometabolic risk becomes urgent, mainly when the road back to optimal blood sugar control is still possible without medication. This may help to avoid the premature emergence of hyperinsulinemia, inflammation, atherogenic dyslipidemia, and endothelial dysfunction, which are responsible for the significantly increased cardiovascular risk in individuals with impaired glucose metabolism. We determined the optimal cutoff point for the diagnosis of insulin resistance (IR) and MetS in this population

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