title: Prediction of insulin resistance in type 2 diabetes mellitus using routinely available clinical parameters.
abstract: OBJECTIVE
  To determine if insulin resistance (IR), an important predictor of cardiovascular risk in the general population and in type 2 diabetes mellitus, can be assessed using simple parameters which are readily available in clinical practice.
  
  
  METHODS
  This cross-sectional study included 194 patients with type 2 diabetes. Body mass index, waist index (WI), triglyceride levels, 1/HDL, triglyceride/HDL, uric acid and urine albumin:creatinine ratio were investigated as possible predictors of IR.
  
  
  RESULTS
  WI correlated more strongly than any other parameter with log insulin levels, log fasting glucose to insulin ratio (FGIR), log fasting glucose to insulin product (FGIP), homeostatic model assessment (HOMA-IR) and quantitative insulin check index (QUICKI). WI also emerged as the strongest independent predictor of IR indices studied in regression as well as in ROC analyses. At a cut-off of 1.115, WI had a 78% sensitivity and 65% specificity for predicting IR when HOMA-IR was used as indicator of IR, and 74% sensitivity and specificity when QUICKI was used as indicator of IR. Combining WI with other variables did not improve performance significantly.
  
  
  CONCLUSIONS
  In our cohort of patients with type 2 diabetes, WI was the parameter with the strongest association with, and the best predictor of, IR.
authors.affiliation: Department of Cardiology, Mater Dei Hospital, Tal-Qroqq, Msida MSD 2090, Malta; University of Malta Medical School, University of Malta, Tal-Qroqq, Msida MSD 2090, Malta. Electronic address: caroline.j.magri@gmail.com.
authors.forename: Caroline J
authors.initials: CJ
authors.lastname: Magri
authors.affiliation: University of Malta Medical School, University of Malta, Tal-Qroqq, Msida MSD 2090, Malta; Diabetes & Endocrine Centre, Mater Dei Hospital, Tal-Qroqq, Msida MSD 2090, Malta.
authors.forename: Stephen
authors.initials: S
authors.lastname: Fava
authors.affiliation: University of Malta Medical School, University of Malta, Tal-Qroqq, Msida MSD 2090, Malta; Department of Cardiac Services, Mater Dei Hospital, Tal-Qroqq, Msida MSD 2090, Malta.
authors.forename: Joseph
authors.initials: J
authors.lastname: Galea
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001786:Blood Glucose; D015992:Body Mass Index; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D014280:Triglycerides; D003404:Creatinine
keywords: HOMA-IR; Insulin resistance; QUICKI; Type 2 diabetes; Waist index