title: Diagnosing insulin resistance in the general population.
abstract: OBJECTIVE
  Difficulties in measuring insulin sensitivity prevent the identification of insulin-resistant individuals in the general population. Therefore, we compared fasting insulin, homeostasis model assessment (HOMA), insulin-to-glucose ratio, Bennett index, and a score based on weighted combinations of fasting insulin, BMI, and fasting triglycerides with the euglycemic insulin clamp to determine the most appropriate method for assessing insulin resistance in the general population.
  
  
  METHODS
  Family history of diabetes, BMI, blood pressure, waist and hip circumference, fasting lipids, glucose, insulin, liver enzymes, and insulin sensitivity index (ISI) using the euglycemic insulin clamp were obtained for 178 normoglycemic individuals aged 25-68 years. Product-moment correlations were used to examine the association between ISI and various surrogate measurements of insulin sensitivity. Regression models were used to devise weights for each variable and to identify cutoff points for individual components of the score. A bootstrap procedure was used to identify the most useful predictors of ISI.
  
  
  RESULTS
  Correlation coefficients between ISI and fasting insulin, HOMA, insulin-to-glucose ratio, and the Bennett index were similar in magnitude. The variables that best predicted insulin sensitivity were fasting insulin and fasting triglycerides. The use of a score based on Mffm/I = exp[2.63 - 0.28ln(insulin) - 0.31ln(TAG)] rather than the use of fasting insulin alone resulted in a higher sensitivity and a maintained specificity when predicting insulin sensitivity.
  
  
  CONCLUSIONS
  A weighted combination of two routine laboratory measurements, i.e., fasting insulin and triglycerides, provides a simple means of screening for insulin resistance in the general population.
authors: Department of Human Nutrition, Otago University, Dunedin, New Zealand. kirsten.mcauley@stonebow.otago.ac.nz
authors: K A
authors: KA
authors: McAuley
authors: S M
authors: SM
authors: Williams
authors: J I
authors: JI
authors: Mann
authors: R J
authors: RJ
authors: Walker
authors: N J
authors: NJ
authors: Lewis-Barned
authors: L A
authors: LA
authors: Temple
authors: A W
authors: AW
authors: Duncan
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D001824:Body Constitution; D015992:Body Mass Index; D005260:Female; D015309:Glucose Clamp Technique; D006706:Homeostasis; D006801:Humans; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage / Q000097:blood* / Q000494:pharmacology; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D007328:Insulin; D014280:Triglycerides