Insulin Sensitivity Indexes Cutoff Points As Surrogates for Metabolic Syndrome Diagnosis in Chilean Adolescents

Presentation Number: SAT 506
Date of Presentation: April 1st, 2017

Christian Alvarado Araiza*1, Lluvia Vianey Fajardo2, Paulina Correa3, Estela Blanco4, Sheila Gahagan4 and Raquel Burrows5
1Instituto Nacional de Pediatría, Mexico DF, Mexico, 2Instituto Nacional de Pediatría, Mexico City, Mexico, 3Institute of Nutrition and Food Technology, University of Chile, Santiago Chile, 4Division of Child Development and Community Health, University of California San Diego, CA, 5Instituto Nacional de Tecnología en Alimentos, Chile

Abstract

Insulin resistance (IR) is the main metabolic disturbance associated with obesity, and it is related with the development of Diabetes Mellitus type 2 and Metabolic Syndrome (MetS). The final stage of IR is beta cell dysfunction, however the lipid metabolism disruption which develops first is strongly related with cardiovascular risk. Different insulin sensitivity markers (ISM) have been proposed for the diagnosis of IR, but there is limited evidence regarding the sensitivity of these indicators to diagnose biological risk. The aim of this study was to establish the validity of different ISM to identify adolescents with MetS. In 667 adolescents (16.8 ± 0.3 y), BMI, waist circumference, blood arterial pressure, glucose, insulin, cholesterol profile, adiponectin and leptin were measured after a 12-hour overnight fast. The optimal cut-off of the Homeostatic Model (HOMA), the Quantitative Insulin Sensitivity Check Index (QUICKI), the Single Point Insulin Sensitivity Estimator (SPISE) and the Leptin/Adiponectin ratio (LAR) for MetS diagnosis were determined by ROC analysis and the best combination for specificity and sensibility was stablished using Youden’s index. MetS was diagnosed according to the AHA/IDF/ATP 2009. SPICE showed the best sensitivity and specificity for diagnosing MetS with a cut-off point of 5.89 in males (aROC: 0.95, Sens: 96% and Spec: 84%)and 6.27 in females (aROC: 0.89, Sens: 89% and Spec: 77%). LAR was the second best index with an optimal cut-off point of 0.88 in males (aROC: 0.88, Sens: 88% and Spec: 80%) and 2.0 in females (aROC: 0.79, Sens: 79% and Spec: 70%). We observed a strong correlation between the ISM and MetS, even in lower cut-off levels as the ones proposed to diagnose insulin resistance in the general population. This suggests that the lipid disorders appear even before the biochemical insulin resistance is observed.

 

Nothing to Disclose: CA, LVF, PC, EB, SG, RB