title: Cut-off values of anthropometric indices to determine insulin resistance in Pakistani adults.
abstract: OBJECTIVE
  To determine the cut-off values of anthropometric indices to indicate insulin resistance and correlation of these indices with insulin resistance in Pakistani adults.
  
  
  METHODS
  The cross-sectional study was conducted at the Military Hospital and Army Medical College, Rawalpindi, Pakistan, from June 2010 to November 2011. The study measured 209 adults for body mass index, waist circumference, waist-to-hip ratio, waist-to-height ratio and conicity index. Receiver operating characteristics curve analyses were done to determine the predictive values of these anthropometric measures and their cut-off values for insulin resistance by triglyceride/high density lipoprotein ratio.
  
  
  RESULTS
  Overall mean age was 51.5 +/- 1.16 years (range: 28-73) and there were 136 (65%) males and 73 (35%) females. Body mass index had the maximum predictive value for insulin resistance followed by waist circumference and waist-to-height ratio in males (p < 0.0001), sensitivity and specificity being 68% and 62% respectively with cut-off value of 25.04 kg/m2. ROC curve analyses showed the maximum predictive value of conicity index for insulin resistance followed by waist circumference and waist-to-height ratio in females (p < 0.08), sensitivity and specificity being 65% and 50% respectively with cut-off value of 1.39.
  
  
  CONCLUSIONS
  In Pakistani male adults, BMI is the best indicator of insulin resistance, while in female adults, conicity index is the best indicator.This is the first study in Pakistan reporting predictive values of anthropometric indices as a non-invasive method in determining insulin resistance.
authors.affiliation: Department of Physiology, Army Medical College, National University of Sciences and Technology, Islamabad, Pakistan. nadeemamina@yahoo.com
authors.forename: Amina
authors.initials: A
authors.lastname: Nadeem
authors.affiliation: Department of Biochemistry and Dean, Army Medical College, National University of Sciences and Technology, Islamabad, Pakistan.
authors.forename: Abdul Khaliq
authors.initials: AK
authors.lastname: Naveed
authors.affiliation: Department of Physiology, Army Medical College, National University of Sciences and Technology, Islamabad, Pakistan.
authors.forename: Muhammad Mazhar
authors.initials: MM
authors.lastname: Hussain
authors.affiliation: Department of Biochemistry and Molecular Biology, Army Medical College, National University of Sciences and Technology, Islamabad, Pakistan.
authors.forename: Syed Irfan
authors.initials: SI
authors.lastname: Raza
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D012372:ROC Curve; D012680:Sensitivity and Specificity; D055105:Waist Circumference; D049629:Waist-Hip Ratio