Abstract
BackgroundInsulin resistance (IR) reduces reactivity of the target organ to blood insulin. Researchers have attempted to evaluate IR using various serum lipid concentration ratios. We aimed to determine the most strongly IR-predictive lipid profile ratios for each sex by studying associations between lipid concentration ratios and IR using data from the fifth Korea National Health and Nutrition Examination Survey (KNHANES V-1) 2010.MethodsOverall, 8958 individuals participated in health interview and examination surveys. Among them, 1910 individuals who completed physical examinations and 8-h fasting blood tests and were older than 20 years of age were enrolled (929 men and 981 women). The lipid-ratio-related study outcomes were the low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-C/HDL-C), triglyceride (TG)/HDL-C, and non-HDL-C (LDL-C + TG/5)/HDL-C ratios. We divided subjects into 4 groups according to lipid profile ratio quartiles for a comparison of homeostasis model assessment (HOMA)-IR values. Regression analyses were performed after adjusting for the confounding factors of age, body mass index, and diabetes mellitus history.ResultsHOMA-IR values tended to increase significantly along with LDL-C/HDL-C, TG/HDL-C, and non-HDL-C/HDL-C ratios in both sexes. In men, multiple linear regression analyses showed that after adjusting for confounding factors, a significant positive association remained only with the LDL-C/HDL-C ratio (p = 0.0238, R2 = 0.3605, root mean squared error [MSE] =0.3512). In women, multiple linear regression analyses showed that after adjusting for confounding factors, significant positive associations remained with the LDL-C/HDL-C (p < 0.0001, R-square = 0.2329, root MSE = 0.3776), TG/HDL-C (p = 0.0001, R2 = 0.2373, root MSE = 0.3766), and non-HDL-C/HDL-C ratios (p < 0.0001, R2 = 0.2456, root MSE = 0.3745).ConclusionThe LDL-C/HDL-C ratio in men and LDL-C/HDL-C, TG/HDL-C, and non-HDL-C/HDL-C ratios in women might be clinically significant predictors of IR in healthy Korean adults. However, additional large-scale studies are required to confirm these findings.
Highlights
Insulin resistance (IR) is a condition in which the reactivity of a target organ to blood insulin is reduced, and is known to be the strongest predictor of type 2 diabetes mellitus occurrence [1]
Several clinicians have researched these data and found homeostasis model assessment (HOMA)-IR to be a reliable marker of IR [9, 10]
This study was performed to evaluate sex-based associations between lipid concentration ratios (e.g., low-density lipoprotein cholesterol (LDL-C)/ high-density lipoprotein cholesterol (HDL-C), TG/HDL-C, and non-HDL-C/HDL-C) and homeostasis model assessment for IR (HOMA-IR) values in order to determine the strongest predictor of IR in each sex
Summary
Insulin resistance (IR) is a condition in which the reactivity of a target organ to blood insulin is reduced, and is known to be the strongest predictor of type 2 diabetes mellitus occurrence [1]. Researchers have actively attempted to evaluate IR using ratios of various serum lipid concentration levels, such as the total cholesterol/high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)/HDL-C, and triglyceride (TG)/HDL-C ratios [11,12,13,14]. Insulin resistance (IR) reduces reactivity of the target organ to blood insulin. Researchers have attempted to evaluate IR using various serum lipid concentration ratios. We aimed to determine the most strongly IR-predictive lipid profile ratios for each sex by studying associations between lipid concentration ratios and IR using data from the fifth Korea National Health and Nutrition Examination Survey (KNHANES V-1) 2010
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