title: Evaluation of two new surrogate indices including parameters not using insulin to assess insulin sensitivity/resistance in non-diabetic postmenopausal women: a MONET group study.
abstract: OBJECTIVE
  The study evaluated and compared, with other surrogate indices of insulin sensitivity/resistance (IS/R), the relevance of the TyG index, a product of fasting glucose and triglyceride (TG) levels, and the EGIR index, which includes TG, high-density lipoprotein cholesterol (HDL-c) and waist circumference in its formula to estimate IS/R, in non-diabetic postmenopausal women.
  
  
  METHODS
  A secondary analysis was performed using the baseline data for 163 non-diabetic postmenopausal women from the Montreal-Ottawa New Emerging Team (MONET) population database. The subjects participated in hyperinsulinaemic-euglycaemic (HIEG) clamp and oral glucose tolerance (OGTT) tests. Correlations and comparisons between surrogate indices were performed in addition to inter-rater agreement tests. The optimal value of surrogate indices for diagnosis of IS/R was established on a receiver operating characteristic (ROC) scatter plot.
  
  
  RESULTS
  A significant correlation was found between the HIEG clamp and all IS/R surrogate indices tested [r=-0.370 (TyG index) to 0.608 (SIisOGTT index); P<0.001]. On ROC curve analysis, a higher AUROC was found for SIisOGTT (0.791) than for TyG and EGIR (0.706 and 0.675, respectively; P=0.07 and P<0.05, respectively).
  
  
  CONCLUSIONS
  The TyG and EGIR IS/R indices were only relatively modestly related to the HIEG clamp. In contrast, both fasting- and OGTT-derived IS/R surrogate indices, which include insulin values in their formulae, appeared to be more accurate in estimating IS/R in our study population. Thus, the TyG and EGIR IS/R indices need to be tested and validated more extensively in different populations before being put to large-scale clinical use.
authors.affiliation: Service de Biochimie et Hormonologie, Hôpital Tenon, AP-HP, 75020 Paris, France. jean-philippe.bastard@tnn.aphp.fr
authors.forename: J-P
authors.initials: JP
authors.lastname: Bastard
authors.forename: M-E
authors.initials: ME
authors.lastname: Lavoie
authors.forename: V
authors.initials: V
authors.lastname: Messier
authors.forename: D
authors.initials: D
authors.lastname: Prud'homme
authors.forename: R
authors.initials: R
authors.lastname: Rabasa-Lhoret
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D008076:Cholesterol, HDL / Q000097:blood*; D003430:Cross-Sectional Studies; D005215:Fasting; D005260:Female; D015309:Glucose Clamp Technique; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood* / Q000502:physiology; D007333:Insulin Resistance / Q000502:physiology*; D008875:Middle Aged; D017698:Postmenopause / Q000097:blood*; D012016:Reference Values; D014280:Triglycerides / Q000097:blood*; D049629:Waist-Hip Ratio
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides