Surrogate markers of insulin resistance in assessing individuals with new categories "prehypertension" and "prediabetes".
BACKGROUND
There are few data on the impact of insulin resistance on the recently defined categories of prehypertension (PHT) and prediabetes (PDM). The aim of this study was to examine associations of surrogate markers of insulin resistance with PHT/PDM.


METHODS
Subjects included 554 individuals who underwent a 75-g oral glucose tolerance test (OGTT). They were classified into four groups using a severity score for high blood pressure and glucose tolerance. Insulin resistance was measured using the homeostasis model assessment of insulin resistance (HOMA-R) and three surrogate markers obtained from 75-g OGTT values (ISI-composite, Stumvoll index, and OGIS index).


RESULTS
HOMA-R increased significantly, but the other three surrogate indices decreased with increasing severity score. Of these markers, the OGIS index was mostly associated with prevalent PHT/PDM and the odds ratio for insulin resistance was 3.61 (95% CI 1.68-7.76, p=0.001) for subjects with either PHT or PDM and 29.98 (12.81-70.18, p<0.001) for subjects with both PHT and PDM.


CONCLUSIONS
PHT and PDM frequently coexist in relatively lean Japanese subjects. Decreased insulin sensitivity may contribute to the underlying status of PHT/PDM. Among the surrogate markers of insulin resistance, the OGIS index is the most sensitive for assessment of PHT/PDM status.
Kanauchi
Masao
M
First Department of Internal Medicine, Nara Medical University, Kashihara, Japan. kanauchi@nmu-gw.naramed-u.ac.jp
Kanauchi
Kimiko
K
Inoue
Tomoko
T
Kimura
Kuniko
K
Saito
Yoshihiko
Y
D000328:Adult; D000368:Aged; D015415:Biomarkers; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D005260:Female; D005951:Glucose Tolerance Test; D006706:Homeostasis; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000503:physiopathology; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000175:diagnosis* / Q000503:physiopathology
D015415:Biomarkers; D001786:Blood Glucose