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Background: Insulin resistance (IR) is a collective clinical entity that exacerbates metabolic syndrome (MetS). As the gold-standard test to quantify IR involves intravenous insulin loading and repeated blood glucose monitoring, many indices have been developed for IR assessment for convenience. This study tested the ideal cut-off values and clinical utility of IR indices in identifying MetS. Methods: We recruited 150 subjects, 75 MetS patients and 75 healthy controls, then obtained written informed consent to participate in this study. We collected fasting blood samples for glucose and lipid profiles and calculated nineteen indices of IR and insulin secretion using validated formulae. We determined the precision of these IR indices using the area under the curve (AUC) in a receiver operating characteristic analysis. Results: Subjects with MetS have significantly higher IR coupled with lower insulin sensitivity and beta-cell function than controls. Among the surrogate markers of IR tested, the homeostatic model assessment of insulin resistance (HOMA-IR), HOMA-adiponectin (HOMA-AD), triglyceride-glucose (TyG) index, HOMA-1%S (insulin sensitivity), quantitative insulin sensitivity check index (QUICKI), McAuley index, single-point insulin sensitivity estimator (SPISE), and HOMA-2%B (beta-cell function) showed the highest AUC values for detecting MetS. Conclusion: Our study results suggest that the ideal cut-off and AUC values identified for HOMA-IR, HOMA-AD, the TyG index, HOMA-1%S, QUICKI, the McAuley index, SPISE, and HOMA-2%B offer a clinical approach to the early detection and risk stratification for MetS among people in southern India. [ABSTRACT FROM AUTHOR]

Aims The study aim was to determine the correlation of several surrogate estimates of insulin resistance with a direct measure of insulin action and the ability of these estimates to identify insulin resistant persons. Methods Retrospective analysis of 454 apparently healthy individuals studied in a clinical research center. The correlations between 11 surrogate estimates of insulin resistance, using either fasting or post-oral glucose challenge values, and a direct measure of insulin-mediated glucose uptake (SSPG concentration during the Insulin Suppression Test) were determined as well as the ability of the surrogate estimates to identify insulin resistant individuals. Results All surrogate estimates were significantly (P < .001) correlated with SSPG concentrations and successfully identified insulin resistant persons. These relationships were of lesser magnitude when estimates were based on fasting data, with the exception of the McAuley index—derived from fasting data, but resembling post-glucose challenge estimates. Moreover, correlation with SSPG concentration, and positive identification of insulin resistance, varied considerably among estimates. Conclusion All 11 surrogate estimates of insulin resistance significantly correlated with insulin-mediated glucose disposal and identified insulin resistant persons with a reasonable degree of sensitivity and specificity. For identification of insulin resistant individuals, indices based on post-glucose challenge measurements performed better than those based on fasting measurements, with the exception of McAuley index. The quantitative information derived from this analysis should help investigators select the surrogate marker of insulin resistance best suited for their study. [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence of insulin resistant syndrome (IRS) among newly diagnosed patients with type 2 diabetes and to test their validity against two indices of insulin resistance (IR). Materials and Methods: Prevalence of IRS was estimated according to the criteria used by ATP III in newly diagnosed type 2 diabetic patients. Sensitivity and specifi city of the ACE criteria were calculated against two indices of IR namely fasting insulin (FI) level > 12 mU/l and McAuley index (McA) < 5.8. [McA= exp [2.63--0.28 ln(insulin in mU/l) -- 0.31 ln(triglycerides in mmol/l)]. Results: 35.7% of patients had IRS by ATP III criteria. 64.3% of patients were insulin resistant by FI and McA in each index. In patients who had IRS with ATP criteria, 80% and 86.6% were found to have McA and FI in the insulin resistant range. Out of the patients who were resistant by McA, only 40.6% had IR by ACE criteria and 93% had shown IR by FI. Out of all patients who did not fulfi ll the ATP III for IR, 74% and 59% were detected as having IR by fasting insulin and McA respectively. Sensitivity of the ACE criteria when tested against the FI and McA were 37.5% and 40.6%, specifi city were 70% and 80%, respectively. Conclusions: IRS was common among the newly diagnosed patients with type 2 diabetes. ACE criteria showed an acceptable specifi city but lack adequate sensitivity when compared with the two Indices of insulin resistance. More valid and clinically useful criteria should be available for the accurate diagnosis of IRS in clinical practice. [ABSTRACT FROM AUTHOR]

Objective To observe the accuracy of several indices in assessing insulin resistance (IR) in the overweight/ obesity population and to find more desirable cut-off point of IR. Methods This study involved 406 overweight obesity participants without overt diabetes. Homeostasis model assessment of insulin resistance ( HOMA-IR) index, Quantitative insulin sensitivity check index (QUICKI) and McAuley index ( McA index) were calculated and compared with fasting insulin levels (FINS) (⩾ 12 mIU/L, which was the reference criteria for determined IR) . Results Of the 406 participants, 114 cases of IR and 292 cases of non-IR were found. When using HOMA-IR⩾2.6 as the cut-off point of IR, there were 138 cases of IR and 268 cases of non-IR. The sensitivity was 94. 74% and the specificity was 89. 73%. Youden index was 0. 84. When using HOMA-IR⩾2.68 as the cut-off point, the sensitivity and specificity was 93.3% and 92.9% , respectively. Youden index was elevated to 0. 86. When using QUICKI⩽0.339 as the cut-off point of IR, there were 210 cases of IR and 196 cases of non-IR. The sensitivity was 100% and the specificity was 67.12%. Youden index was 0.67. When using QUICKI⩽0.335 as the cut-off point, the sensitivity and specificity was 79. 8% and 99. 0%, respectively. Youden index was increased to 0. 79. When using McA⩽5.8 as the cut-off point of IR, there were 403 cases of IR and 3 cases of non-IR. The sensitivity was 98.25% and the specificity was only 0.34% . Youden index was -1.41. When using McA⩽4.29 as the cut-off point, the sensitivity and specificity was 78.0% and 82.9%, respectively. Youden index was ｉｎｃｒｅａｓｅｄ ｔｏ ０．６１． Ｃｏｎｃｌｕｓｉｏｎｓ　ＨＯＭＡ-ＩＲ ｉｓ ｍｏｒｅ ａｃｃｕｒａｔｅ ｉｎ ｄｅｔｅｃｔｉｎｇ ＩＲ ｉｎ ｏｖｅｒｗｅｉｇｈｔ／ｏｂｅｓｅ ｐｏｐｕｌａｔｉｏｎ. Ｔｈｅ ｔｈｒｅｓｈｏｌｄｓ ｏｆ ｔｈｅｓｅ ｔｈｒｅｅ ｉｎｄｉｃｅｓ ｉｎ ｏｖｅｒｗｅｉｇｈｔ／ｏｂｅｓｅ ｐｏｐｕｌａｔｉｏｎ ｓｈｏｕｌｄ ｂｅ ａｄｊｕｓｔｅｄ ａｐｐｒｏｐｒｉａｔｅｌｙ ｃｏｎｓｉｄｅｒｉｎｇ ｔｈｅ ｉｎｆｌｕｅｎｃｅ ｏｆ ｏｂｅｓｉｔｙ ａｎｄ ｌｉｐｉｄ ｍｅｔａｂｏｌｉsｍ ｏｎ ｉｎｓｕｌｉｎ ｌｅｖｅｌｓ ｔｏ ｉｎｃｒｅａｓｅ ｔｈｅ ａｃｃｕｒａｃｙ ｉｎ ｅｖａｌｕａｔｉｎｇ ＩＲ. [ABSTRACT FROM AUTHOR]