Use of markers of dyslipidemia to identify overweight youth with insulin resistance.
BACKGROUND
Markers to identify overweight youth with insulin resistance are of clinical importance.


OBJECTIVE
To determine if markers of dyslipidemia could identify overweight adolescents with insulin resistance. SETTING, PARTICIPANTS, AND STUDY DESIGN: We retrospectively examined the association between markers of dyslipidemia and insulin resistance in 35 overweight [body mass index (BMI) of > or =95th percentile], white adolescents [mean age 13.5 +/- (SD) 1.6 yr] who had participated in hyperinsulinemic-euglycemic clamp studies to evaluate insulin action. Total body fat was measured by dual-energy X-ray absorptiometry and abdominal fat with computed tomography. Using receiver-operating curves, cut-points for triglyceride (TG)/high-density lipoprotein (HDL) and TG level to identify overweight individuals in the lowest tertile for insulin sensitivity were determined.


METHODS
Difference in the values for insulin sensitivity among the groups.


RESULTS
Of the markers examined (TG, TG/HDL, adiponectin, measures of adiposity and fasting insulin), fasting insulin was the strongest correlate of insulin sensitivity (r = 0.87, p < 0.001). Youth with TG/HDL level > or =3 had lower insulin sensitivity (50% lower median values, p < 0.01) and higher visceral fat (p < 0.05) despite BMI comparable to that of youth with TG/HDL level <3. Youth with TG/HDL > or =3 had a sensitivity of 61% and specificity of 82% for identifying participants with the greatest degree of insulin resistance.


CONCLUSIONS
TG and TG/HDL are easily obtained markers associated with insulin resistance. Further research is needed to determine if a constellation of clinical findings, such as components of the metabolic syndrome along with other metabolic markers including adiponectin, better predicts insulin resistance in overweight youth.
Hannon
Tamara S
TS
Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. tamara.hannon@chp.edu
Bacha
Fida
F
Lee
So Jung
SJ
Janosky
Janine
J
Arslanian
Silva A
SA
D050153:Abdominal Fat / Q000000981:diagnostic imaging; D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000000981:diagnostic imaging; D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D050171:Dyslipidemias / Q000097:blood*; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D050177:Overweight / Q000502:physiology*; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014280:Triglycerides / Q000097:blood*
D015415:Biomarkers; D007328:Insulin; D008075:Lipoproteins, HDL; D014280:Triglycerides