Comparison of Surrogate Markers as Measures of Uncomplicated Insulin Resistance in Korean Adults.
BACKGROUND
Metabolic syndrome (MS) is known to increase the risk of various cardiometabolic diseases and in-sulin resistance (IR) has known to have central role in the development of MS. Many surrogate indices of IR have been proposed and the detection of MS might be a suitable model for assessing the accuracy of surrogate indices. The aims of our study are to invest the most appropriate index by assessment of the diagnostic capacity of IR among each surrogate index and identifying cut-off values for discriminating uncomplicated MS in Korean adults.


METHODS
A cross-sectional study was performed, assessing 294 Korean adults, 85 of whom were diagnosed with uncomplicated MS. The sensitivities and specificities of five surrogate IR indices were compared to discriminate MS from healthy subjects; these included fasting serum insulin, homeostasis model assessment-insulin resistance index, quantitative insulin sensitivity check index, McAuley index, and Disse index. Correlations between each index value were assessed using Pearson's and Spearman's correlation methods.


RESULTS
The McAuley index showed the highest area under the curve (0.85), specificity (86.12%), accuracy (82.31%), positive predictive value (68.13%), and negative predictive value (88.67%) to distinguish MS, with a cut-off point of 5.3 defined. Correlation coefficients of the five indices showed that the McAuley index had the strongest correlation with IR.


CONCLUSIONS
The McAuley index showed the best accuracy in the detection of MS as a surrogate marker of IR. To establish more effective and accurate standards of measuring IR, comprehensive and multi-scaled studies are required.
Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Tae Jong
TJ
Kim
Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Hye Jung
HJ
Kim
Department of Family Medicine, Seoul Red Cross Hospital, Seoul, Korea.
Young Bae
YB
Kim
Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Jee Yon
JY
Lee
Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Korea.
Hye Sun
HS
Lee
Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Korea.
Jung Hwa
JH
Hong
Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Ji Won
JW
Lee
Insulin Resistance; Koreans; McAuley Index; Metabolic Syndrome