Triglycerides and ratio of triglycerides to high-density lipoprotein cholesterol are better than liver enzymes to identify insulin resistance in urban middle-aged and older non-obese Chinese without diabetes.
BACKGROUND
Insulin resistance (IR) plays an important pathophysiological role in the development of diabetes, dyslipidemia, hypertension, and cardiovascular disease. Moreover, IR can occur even in non-obese people without diabetes. However, direct detection of IR is complicated. In order to find a simple surrogate marker of IR early in non-obese people, we investigate the association of commonly-used biochemical markers (liver enzymes and lipid profiles) with IR in urban middle-aged and older non-obese Chinese without diabetes.


METHODS
This cross-sectional study included 1 987 subjects (1 473 women). Fasting blood samples were collected for measurement of glucose, insulin, liver enzymes, lipid profiles and creatinine. Subjects whose homeostasis model of assessment-IR (HOMA-IR) index values exceeded the 75th percentile (2.67 for women and 2.48 for men) of the population were considered to have IR. The area under the receiver operating characteristic curve (ROC) was used to compare the power of potential markers in identifying IR.


RESULTS
Triglycerides (TG) and ratio of TG to high-density lipoprotein cholesterol (TG/HDL-C) discriminated IR better than other indexes for both sexes; areas under the receiver operating characteristic (ROC) curves (AUC) values were 0.770 (95% confidence interval 0.733-0.807) and 0.772 (0.736-0.809), respectively, for women and 0.754 (0.664-0.844) and 0.756 (0.672-0.840), respectively, for men. To identify IR, the optimal cut-offs for TG and TG/HDL-C ratio were 1.315 mmol/L (sensitivity 74.3%, specificity 71.0%) and 0.873 (sensitivity 70.1%, specificity 73.4%), respectively, for women, and 1.275 mmol/L (sensitivity 66.7%, specificity 74.4%) and 0.812 (sensitivity 75.8%, specificity 69.2%), respectively, for men.


CONCLUSIONS
TG and TG/HDL-C ratio could be used to identify IR in urban middle-aged and older non-obese Chinese without diabetes.
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Yu
Y
Sun
College of Medicine, Shandong University, Jinan, Shandong 250012, China.
Wenjuan
W
Li
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Xinguo
X
Hou
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Chuan
C
Wang
Department of Endocrinology, Second People's Hospital of Jining, Jining, Shandong 272049, China.
Chengqiao
C
Li
Shantui Community Health Center, Jining, Shandong 272000, China.
Xiuping
X
Zhang
Lukang Hospital of Jining, Jining, Shandong 272141, China.
Weifang
W
Yang
China National Heavy Duty Truck Group Corporation Hospital, Jinan, Shandong 250116, China.
Zeqiang
Z
Ma
Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Weiqing
W
Wang
Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Guang
G
Ning
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Huizhen
H
Zheng
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Aixia
A
Ma
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Jun
J
Song
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Peng
P
Lin
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Kai
K
Liang
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Fuqiang
F
Liu
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Lei
L
Gong
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Meijian
M
Wang
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Juan
J
Xiao
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Fei
F
Yan
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Junpeng
J
Yang
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Lingshu
L
Wang
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Meng
M
Tian
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Jidong
J
Liu
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Ruxing
R
Zhao
Department of Ophthalmology, College of Medicine, University of Florida, Gainesville, 32610-0284, FL, USA.
Ping
P
Zhu
Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China. Email: chenli3@medmail.com.cn.
Li
L
Chen
D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood*; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008099:Liver / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood*
D008076:Cholesterol, HDL; D014280:Triglycerides; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase