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Modification and Validation of the Triglyceride-to-HDL Cholesterol Ratio as a Surrogate of Insulin Sensitivity in White Juveniles and Adults without Diabetes Mellitus: The Single Point Insulin Sensitivity Estimator (SPISE)
Paracelsus Med Univ, Dept Pediat, Div Pediat Gastroenterol Hepatol & Nutr, Mullner Hauptstr 48, A-5020 Salzburg, Austria.;Paracelsus Med Univ, Obes Res Unit, Salzburg, Austria..
Mater Misericordiae Univ Hosp, Dublin, Ireland..
Odense Univ Hosp, Dept Endocrinol, Odense, Denmark.;Univ Southern Denmark, Dept Clin Res, Odense, Denmark.;Univ Southern Denmark, Inst Mol Med, Odense, Denmark..
Univ Belgrade, Fac Med, Clin Ctr Serbia, Clin Endocrinol Diabet & Metab Disorders, Belgrade, Serbia..
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2016 (English)In: Clinical Chemistry, ISSN 0009-9147, E-ISSN 1530-8561, Vol. 62, no 9, 1211-1219 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The triglyceride-to-HDL cholesterol (TG/HDL-C) ratio was introduced as a tool to estimate insulin resistance; because circulating lipid measurements are available in routine settings. Insulin, C-peptide, and free fatty acids are components of other insulin-sensitivity indices but their measurement is expensive. Easier and more affordable tools are of interest for both pediatric and adult patients. METHODS: Study participants from the Relationship Between Insulin Sensitivity and Cardiovascular Disease [43.9 (8.3) years, n = 1260] as well as the Beta-Cell Function in Juvenile Diabetes and Obesity study cohorts [15 (1.9) years, n = 29] underwent oral-glucose-tolerance tests and euglycemic clamp tests for estimation of whole-body insulin sensitivity and calculation of insulin sensitivity indices. To refine the TG/HDL ratio, mathematical modeling was applied including body mass index (BMI), fasting TG, and HDL cholesterol and compared to the clamp-derived M-value as an estimate of insulin sensitivity. Each modeling result was scored by identifying insulin resistance and correlation coefficient. The Single Point Insulin Sensitivity Estimator (SPISE) was compared to traditional insulin sensitivity indices using area under the ROC curve (aROC) analysis and chi(2) test. RESULTS: The novel formula for SPISE was computed as follows: SPISE = 600 X HDL-C-0.185/(TG(0.2) X BMI1.338), with fasting HDL-C (mg/dL), fasting TG concentrations (mg/dL), and BMI (kg/m(2)). A cutoff value of 6.61 corresponds to an M-value smaller than 4.7 mg . kg(-1) . min(-1) (aROC, M:0.797). SPISE showed a significantly better aROC than the TG/HDL-C ratio. SPISE aROC was comparable to the Matsuda ISI (insulin sensitivity index) and equal to the QUICKI (quantitative insulin sensitivity check index) and HOMA-IR (homeostasis model assessment insulin resistance) when calculated with M-values. CONCLUSIONS: The SPISE seems well suited to surrogate whole-body insulin sensitivity from inexpensive fasting single-point blood draw and BMI in white adolescents and adults.

Place, publisher, year, edition, pages
2016. Vol. 62, no 9, 1211-1219 p.
National Category
Endocrinology and Diabetes
URN: urn:nbn:se:uu:diva-303731DOI: 10.1373/clinchem.2016.257436ISI: 000382422200010PubMedID: 27471037OAI: oai:DiVA.org:uu-303731DiVA: diva2:973948
EU, FP7, Seventh Framework Programme, 279153; 359742EU, European Research Council, QLG1-CT-2001-01252
Available from: 2016-09-23 Created: 2016-09-23 Last updated: 2016-09-23Bibliographically approved

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Bergsten, PeterForslund, AndersManell, Hannes
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Department of Medical Cell BiologyPediatricsDepartment of Women's and Children's Health
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