Korean J Med > Volume 73(6); 2007 > Article
The Korean Journal of Medicine 2007;73(6):611-617.
Best surrogate marker for insulin resistance in middle aged non-diabetic Korean ; Chungju metabolic syndrome study
Ji-Hyun Kim, Hyuk-Sang Kwon, Yong-Moon Park, Sun-Young Lim, Jin-Hee Lee, Seung-Hwan Lee, Dong-Joon Lim, Soon-Hwa Hong, Jae-Hyoung Cho, Sung-Rae Kim, Dong-Suk Kim, Kun-Ho Yoon
Department of Pulmonology and Critical Care Medicine, Chonnam National University Medical School, Gwangju, Korea
원저 : 당뇨병이 없는 한국 성인에서 인슐린 저항성의 임상지표
김지현&#;권혁상&#;박용문&#;임선영&#;이진희&#;이승환&#;임동준&#;홍순화&#;조재, Hyuk-Sang Kwon, Yong-Moon Park, Sun-Young Lim, Jin-Hee Lee, Seung-Hwan Lee, Dong-Joon Lim, Soon-Hwa Hong, Jae-Hyoung Cho, Sung-Rae Kim, Dong-Suk Kim, Kun-Ho Yoon
Abstract
Background : To investigate the best surrogate marker for insulin resistance in the non-diabetic middle-aged population in Korea. Methods : This study was performed from February to April 2003-2005 in adults over 40 years of age living in Chungju City, South Korea, selected by stratified random cluster sampling. We analyzed the data from a total 6,149 non-diabetic subjects that completed a survey consisting of anthropometric measurement and blood chemistry. We defined the highest quartile of the homeostasis model for insulin resistance (HOMA-IR) as the insulin resistant group in our study population. We also analyzed the correlation of various anthropometric (body mass index, waist circumference, waist to hip ratio, waist to height ratio) and biochemical parameters (total cholesterol to HDL cholesterol ratio, non-HDL cholesterol level, triglycerides to HDL cholesterol ratio and level of triglycerides) with insulin resistance using simple and multiple regression analysis for detecting the insulin resistance group. Results : By simple regression analysis, among the anthropometric parameters including the body mass index, waist circumference, waist to hip ratio, waist to height ratio, and the biochemical parameters, including the total cholesterol to HDL cholesterol ratio, non-HDL cholesterol level, triglyceride to HDL cholesterol ratio and triglycerides level, the body mass index was the best surrogate marker for insulin resistance (95% CI 1.215-1.262). The cut-off value of the body mass index was 24.6 kg/m2 (male; 24.7, female; 24.6 kg/m2), with a sensitivity of 62.6% and specificity of 66.9%. Multiple logistic regression analysis for insulin resistance also gave the same results. Furthermore, the cut-off value of the body mass index for the metabolic syndrome as defined by NCEP-ATP III was also 24.1 kg/m2 (male; 24.0, female; 24.2 kg/m2). Conclusions : Our study results suggest that the body mass index was the best surrogate marker for insulin resistance of a non-diabetic population and its cut-off value was approximately 24 kg/m2. (Korean J Med 73:611-617, 2007)
Key Words: Insulin resistance, Metabolic syndrome


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