Spectrum of lipid and lipoprotein indices in human subjects with insulin resistance syndrome.
BACKGROUND
Insulin resistance syndrome or metabolic syndrome is one of the major metabolic threats our recently urbanized society is going to face in near future. The management of this syndrome requires a very effective biochemical marker for screening. The objective of this cross sectional study were to compare various lipid and lipoprotein indices in human subjects with insulin resistance syndrome This study was carried out between April 2004 to January 2006 at the department of chemical pathology and endocrinology, Armed Forces Institute of Pathology, Rawalpindi.


METHODS
A total of forty-seven subjects with metabolic syndrome were selected as per the criteria of National Cholesterol Education Program, Adult Treatment Panel III (NCEP, ATP III) from a target population diagnosed to have impaired glucose regulation at AFIP. Forty-seven age and sex-matched healthy controls were also included in the study. Insulin resistance was calculated by the method of HOMA-IR, using the formula of Mathew's et al. The various lipid and lipoproteins, their ratios and log-transformed versions were evaluated for differences between subjects with metabolic syndrome and controls. Finally the diagnostic performances of these candidate lipid markers were evaluated.


RESULTS
Results between subjects with metabolic syndrome and controls were found to be significant for serum triglyceride (p < 0.05), HDL-C (p < 0.05), triglyceride/HDL-C (p < 0.01), Log triglyceride/HDL-C (p < 0.01), total cholesterol/HDL-C (p < 0.01), LDL-C/HDL-C (p < 0.01O). However there was weak correlation between these lipid based markers and HOMA-IR [(serum triglyceride: r = 0.225), (HDL-C: r = -0.235), (triglyceride/HDL-C: r = 0.333), (total cholesterol/HDL-C: r = 0.239)]. The AUCs for the diagnosis of metabolic syndrome remained highest for HOMA-IR [0.727 (95% CI: 0.642-0.812)], followed by triglyceride/HDL-C [0.669 (95%CI: 0.572-0.766)] and LDL-C/HDL-C [0.639 (95% CI: 0.537-0.742)].


CONCLUSIONS
The differences for lipids and lipoproteins between subjects with metabolic syndrome and controls remained significant. However, these markers have shown poor correlations with HOMA-IR along-with weaker diagnostic accuracy for the diagnosis of metabolic syndrome. Recommended cut-offs must be used, once these markers are employed in the diagnosis of metabolic syndrome.
Khan
Sikandar Hayat
SH
Armed Forces Institute of Pathology, Rawalpindi, Pakistan. sik_cpsp@yahoo.com
Khan
Farooq Ahmad
FA
Ijaz
Amir
A
Sattar
Abdus
A
Dilawar
Mohammad
M
Hashim
Rizwan
R
D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood*; D008875:Middle Aged; D055105:Waist Circumference
D015415:Biomarkers; D008055:Lipids; D008074:Lipoproteins