The role of the body mass index and triglyceride levels in identifying insulin-sensitive and insulin-resistant variants in Japanese non-insulin-dependent diabetic patients

Taniguchi, Ataru; Fukushima, Mitsuo; Sakai, Masahiko; Kataoka, Kiyoshi; Nagata, I; Doi, Kentaro; Arakawa, Hiroaki; Nagasaka, Shoichiro; Tokuyama, Kumpei; Nakai, Yoshikatsu

doi:10.1053/meta.2000.7735

Cited by 81 publications

(69 citation statements)

References 19 publications

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“…Studies have correlated the isolated anthropometric measures and the anthropometric indexes with IR [5][6][7][8][9] . The anthropometric indicators arise as an alternative for IR's evaluation with lower cost and higher easiness of application in epidemiological studies and in health basic attention services.…”

mentioning

confidence: 99%

Indicadores antropométricos de resistência à insulina

Vasques¹,

Rosado²,

Rosado³

et al. 2010

Arq. Bras. Cardiol.

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standardization deficiencies for its execution, limiting the comparison between different laboratories results' and its application in clinical practice 4 .Studies have correlated the isolated anthropometric measures and the anthropometric indexes with IR [5][6][7][8][9] . The anthropometric indicators arise as an alternative for IR's evaluation with lower cost and higher easiness of application in epidemiological studies and in health basic attention services. Because of the importance of this theme, the objective was to discuss about the main measures and the anthropometric indexes that have been associated with IR. MethodologyA bibliographic review was performed on available periodics in scientific bases, such as Scielo, Science Direct and Pubmed. The keywords used for the search of articles were: insulin resistance; anthropometry; body mass index; waist circumference; sagittal abdominal diameter; waist-hip ratio; conicity index; waist-thigh ratio; neck circumference; and waiststature ratio. Published articles were selected between 1990 and 2007, besides of the incorporation of classic previously published papers concerning the theme. Most of the studies included in this review were transversal. Some case-control and cohorts works were also discussed. Articles characterized by scientific rigidity, concerning the sample's size and statistical analysis appropriate to the objectives of the study. Insulin resistance Laboratorial determinationIR can be determined directly from the management of a predetermined quantity of exogenous insulin, or indirectly, based on the concentrations of endogenous insulin 10 .The euglycemic hyperinsulinemic clamp is an example of a direct technique that allows the determination of a metabolized insulin quantity, by the peripheric tissues during the stimulation with insulin. Although nowadays it is the golden standard technique for evaluating the IR in vivo, it is costly, slowly and of high complexity, being feasible its application in population studies, and especially in clinical practice AbstractSome studies have analyzed the efficacy of anthropometric indicators in predicting insulin resistance (IR), for they are more economic and accessible. In this study, the objective was to discuss the measures and anthropometric indices that have been associated with IR. A bibliographic review was done, based on Scielo, Science Direct and Pubmed. Among these studies, waist and sagittal abdominal diameter presented better predictive capacity for IR, with more consistent results. The waist-to-thigh, waist-to-size, neck-to-thigh ratios, the conicity and the sagittal index have showed positive results; nevertheless, more studies are necessary to consolidate them as predictors to IR. The obtained results, with the use of body mass index and of the waist-to-hip ratio, were inconsistent. In the Brazilian population, the realization of studies evaluating the performance of these indicators in predicting IR is suggested, since the results of the studies conducted in other populations are not always...

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mentioning

confidence: 99%

Indicadores antropométricos de resistência à insulina

Vasques¹,

Rosado²,

Rosado³

et al. 2010

Arq. Bras. Cardiol.

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“…In that regard, it is preferable to use the percentile 95 and not the percentile 84 (as it is mean+SD). While Aguilar-Salinas et al [16] used the percentile 90 of HOMA-IR to establish a cut-off point of 2.4, based on a sample of 2,256 Mexican adults (20-69 years old); they argued that this value is quite similar to the 2.5 used by Taniguchi et al [15] Clearly both values were set based on non-compatible premises and populations: first, the age group in the Japanese sample were older than in the Mexican sample; second, the study of Taniguchi et al [15] set the cut-off point based on percentile 84, whereas the study of AguilarSalinas et al [16] set the cut-off point based on percentile 90; and third, the Japanese population was selected based in a healthy condition, i.e., within normal BMI and fasting blood glucose, whereas in the Mexican sample of this study no restriction was imposed on clinical parameters. Comparing the cut-off point used by Aguilar-Salinas et al [16] for Mexican population and the one proposed in this study, two issues can be discussed: (1) Our study is centered to detect early (i.e., before the evolution of MetS) the metabolic alterations related to MetS, then the cut-off points should be used in this context; whereas the cited study was framed in a very wide context: Mexican adults with no restrictions in clinical parameters, and hence the HOMA-IR threshold is biased a) b) by the insulin resistance prevalence.…”

Section: Discussionmentioning

confidence: 98%

“…In other study [14], using a machine learning algorithm involving several parameters related to MetS, including among them the serum aminotransferases, proposed a HOMA-IR cut-off point of 2.6 (and hence with 83% sensitivity, 54% specificity) for Americans of Mexican ascent. Furthermore, in one study [15] based on a sample population of 22 Japanese of 22-24 years old, set an upper threshold of 2.5 for HOMA-IR. They used the criteria of the mean plus one standard deviation, that could be interpreted (when applying the empirical rule) as the specificity of such cut-off point is 84% (mean+SD, implies, according to the empirical rule, an area under the normal curve of 68%+(32%/2)), i.e., 16% (100-84%) of healthy young will be misclassified when evaluated with HOMA-IR.…”

Section: Discussionmentioning

confidence: 99%

Insulin and HOMA-IR in Healthy Young Mexicans: A Cut-off Points Proposal

Murguía‐Romero

Jiménez-Flores²,

Méndez-Cruz³

et al. 2014

Intern Med

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“…36 , 37 Studies in adults have defined a value ≥2.5 as the cut-off for IR. 38-40 Studies in different geographic populations, however, have proposed a higher or lower cut-off. 41 In order to allow comparisons with other regions with the most accepted normal value and, in keeping with a similar value proposed in a previous study in our country, we used a value of 2.5.…”

Section: Discussionmentioning

confidence: 99%

Acanthosis nigricans in the knuckles: An early, accessible, straightforward, and sensitive clinical tool to predict insulin resistance

González-Saldivar

Rodríguez-Gutiérrez

Treviño-Alvarez

et al. 2018

Dermato-Endocrinology

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Any clinical/biochemical marker revealing obesity or diabetes before their appearance is valuable. Insulin resistance (IR) is present in both disorders many years before occurrence. Accordingly, we determined whether acanthosis nigricans (AN) in the knuckles is associated to higher insulin and homeostasis model assessment for estimated insulin resistance (HOMA-IR) index values, and assessed the influence of body-mass index (BMI) and the diagnostic performance of AN in the knuckles to detect IR. In this cross-sectional controlled study, we included men or women, 18 to 23 years old, with or without AN in the knuckles. In 149 cases with AN in the knuckles and 145 controls, fasting insulin was higher in cases (13.45 µU/mL ± 7.8 vs. 8.59 µU/mL ± 3.63, P < .001, respectively). Mean HOMA-IR index was also higher (2.86 ± 1.68 vs. 1.78 ± 0.77, P < .001). A significant increase in fasting insulin and HOMA-IR values between and within BMI groups from normal through obese category was identified in controls and cases. By multivariate regression analysis, cases with normal BMI were significantly associated to a HOMA-IR ≥2.5 (OR = 3.09, CI95% = 1.75–5.48, P = .001). A model of AN in the knuckles, normal BMI, and increased waist circumference allowed identifying 2 out of 3 cases with HOMA-IR index ≥2.5. AN in the knuckles could be addressed with two aims: as an easy, accessible, and costless diagnostic tool suggesting hyperinsulinemia secondary to IR, and, an early marker of IR even in the absence of overweight or obesity.

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The role of the body mass index and triglyceride levels in identifying insulin-sensitive and insulin-resistant variants in Japanese non-insulin-dependent diabetic patients

Cited by 81 publications

References 19 publications

Indicadores antropométricos de resistência à insulina

Indicadores antropométricos de resistência à insulina

Insulin and HOMA-IR in Healthy Young Mexicans: A Cut-off Points Proposal

Acanthosis nigricans in the knuckles: An early, accessible, straightforward, and sensitive clinical tool to predict insulin resistance

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