title: Dietary insulin load and insulin index are associated with the risk of insulin resistance: a prospective approach in tehran lipid and glucose study.
abstract: BACKGROUND
  The aim of this study was to investigate the relationship between dietary insulin load (DIL) and insulin index (DII) and the risk of insulin resistance in Tehranian adults.
  
  
  METHODS
  In this study, 927 men and women, aged 22-80 years, participated in Tehran Lipid and Glucose Study were included. Fasting serum insulin and glucose were measured at baseline and again after a 3-year of follow-up. Usual dietary intakes were measured using a validated 168 item semi-quantitative food frequency questionnaire and DIL and DII were calculated. Logistic regression models were used to estimate the occurrence of the IR across tertile categories of DIL and DII with adjustment for potential confounding variables.
  
  
  RESULTS
  Mean age of participants was 40.71 ± 12.14 y, and mean body mass index (BMI) was 27.23 ± 4.9 kg/m(2), at baseline. Mean of DIL and DII was 937 ± 254 and 84.0 ± 6.3. Participants with higher DIL had higher weight and waist circumference at baseline (P < 0.05). A borderline positive association was observed between DII and the risk of insulin resistance in fully adjusted model (odds ratio = 1.66, 95 % confidence interval = 0.96-2.86, P for trend = 0.06). After adjustment of potential confounders, highest compared to the lowest tertile of DIL was also significantly associated with increased risk of insulin resistance (odds ratio = 1.69, 95 % confidence interval = 1.01-2.89, P for trend = 0.06).
  
  
  CONCLUSIONS
  Dietary insulin load and DII could be considered as independent dietary risk factors for development of insulin resistance.
authors.affiliation: Nutrition and Endocrine Research Center, and Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Parvin
authors.initials: P
authors.lastname: Mirmiran
authors.affiliation: Nutrition and Endocrine Research Center, and Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Saeed
authors.initials: S
authors.lastname: Esfandiari
authors.affiliation: Nutrition and Endocrine Research Center, and Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; No. 24., Shahid Erabi St., Yeman St., P.O. Box: 19395-4763, Velenjak, Tehran Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Bahadoran
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Tohidi
authors.affiliation: Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Fereidoun
authors.initials: F
authors.lastname: Azizi
keywords: Dietary insulin index; Dietary insulin load; Insulin resistance