Your browser doesn't support javascript.
loading
Lipoprotein heterogeneity may help to detect individuals with insulin resistance.
Lorenzo, Carlos; Hanley, Anthony J; Rewers, Marian J; Festa, Andreas; Haffner, Steven M.
Afiliación
  • Lorenzo C; Department of Medicine, Division of Clinical Epidemiology, University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA. lorenzo@uthscsa.edu.
  • Hanley AJ; Department of Nutritional Sciences, and the Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
  • Rewers MJ; Department of Medicine, and the Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
  • Festa A; Barbara Davis Center for Childhood Diabetes, University Colorado School of Medicine, Aurora, CO, USA.
  • Haffner SM; Elli Lilly and Co., Vienna, Austria.
Diabetologia ; 58(12): 2765-73, 2015 Dec.
Article en En | MEDLINE | ID: mdl-26341113
AIMS/HYPOTHESIS: The triacylglycerol (TG)-to-HDL-cholesterol ratio has been shown to detect insulin resistance. However, the added predictive value of a more comprehensive assessment of lipoprotein composition is unknown. METHODS: We analysed cross-sectional data from 882 non-diabetic participants in the Insulin Resistance Atherosclerosis Study (IRAS). Lipoproteins were measured by nuclear magnetic resonance (NMR) spectroscopy. Determined by the frequently sampled intravenous glucose tolerance test, insulin resistance was defined as the lowest sex-specific quartile of insulin sensitivity. RESULTS: The AUC of the receiver operating characteristic curve of HDL-cholesterol and TG levels for detecting insulin resistance was similar to that of the TG-to-HDL-cholesterol ratio (0.676 vs 0.673; p = 0.685), but smaller than the AUC of NMR-detected lipoproteins (0.676 vs 0.745; p < 0.001). NMR lipoproteins added discriminative value to HDL-cholesterol and TG levels (net reclassification improvement of 40.0%; p < 0.001; and integrated discrimination improvement of 9.5%; p < 0.001), with net benefit within predicted probabilities of between 10% and 50% by Vickers' decision-curve analysis. We also demonstrated additive value to demographic variables, BMI and levels of fasting glucose, TG, and HDL-cholesterol (net reclassification improvement of 14.0%; p < 0.001; and integrated discrimination improvement of 4.5%; p < 0.001). CONCLUSIONS/INTERPRETATION: NMR lipoproteins, which can be measured in the fasting state, add information to the TG and HDL-cholesterol ratio across a broad range on insulin resistance. Depending on the other risk factors of insulin resistance that are incorporated, NMR lipoproteins permit the correct reclassification of an additional 14-40% of individuals.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Resistencia a la Insulina / Lipoproteínas Tipo de estudio: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Diabetologia Año: 2015 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Resistencia a la Insulina / Lipoproteínas Tipo de estudio: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Diabetologia Año: 2015 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania