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

• Lee S
• Choi S
• Kim HJ
• Chung YS
• Lee KW
• Lee HC
• Huh KB
• Kim DJ

• KMID: 2157823
• DOI: http://doi.org/10.3346/jkms.2006.21.4.695

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

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

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  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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