OBJECTIVE: Severe insulin resistance is associated with high morbidity. Identification of severely insulin-resistant patients who have genetic or acquired insulin receptor dysfunction may aid therapeutic decision making; however, onerous diagnostic tests allied to a low frequency of insulin receptor dysfunction often preclude formal diagnosis. Our previous observation of paradoxical hyperadiponectinemia in insulin receptoropathy provides a possible basis for a simpler and cheaper screening test. RESEARCH DESIGN AND METHODS: Receiver operating characteristics analysis was used to determine diagnostic thresholds for insulin receptoropathy in severe insulin resistance for adiponectin and for the insulin-regulated hepatic proteins sex hormone-binding globulin (SHBG) and IGF binding protein-1 (IGFBP-1). RESULTS: Adiponectin >7 mg/l in severe insulin resistance had a 97% positive predictive value for insulin receptoropathy and <5 mg/l a 97% negative predictive value. IGFBP-1 and SHBG had lesser, though still significant, utility. CONCLUSIONS: Use of these markers is likely to have significant value in accelerating the diagnosis of insulin receptoropathies.
OBJECTIVE: Severe insulin resistance is associated with high morbidity. Identification of severely insulin-resistant patients who have genetic or acquired insulin receptor dysfunction may aid therapeutic decision making; however, onerous diagnostic tests allied to a low frequency of insulin receptor dysfunction often preclude formal diagnosis. Our previous observation of paradoxical hyperadiponectinemia in insulin receptoropathy provides a possible basis for a simpler and cheaper screening test. RESEARCH DESIGN AND METHODS: Receiver operating characteristics analysis was used to determine diagnostic thresholds for insulin receptoropathy in severe insulin resistance for adiponectin and for the insulin-regulated hepatic proteins sex hormone-binding globulin (SHBG) and IGF binding protein-1 (IGFBP-1). RESULTS:Adiponectin >7 mg/l in severe insulin resistance had a 97% positive predictive value for insulin receptoropathy and <5 mg/l a 97% negative predictive value. IGFBP-1 and SHBG had lesser, though still significant, utility. CONCLUSIONS: Use of these markers is likely to have significant value in accelerating the diagnosis of insulin receptoropathies.
Authors: David R Weber; Diana E Stanescu; Robert Semple; Cheryl Holland; Sheela N Magge Journal: J Pediatr Endocrinol Metab Date: 2014-11 Impact factor: 1.634
Authors: R Krishnapuram; E J Dhurandhar; O Dubuisson; H Kirk-Ballard; S Bajpeyi; N Butte; M S Sothern; E Larsen-Meyer; S Chalew; B Bennett; A K Gupta; F L Greenway; W Johnson; M Brashear; G Reinhart; T Rankinen; C Bouchard; W T Cefalu; J Ye; R Javier; A Zuberi; N V Dhurandhar Journal: Am J Physiol Endocrinol Metab Date: 2011-01-25 Impact factor: 4.310
Authors: Robert K Semple; Alison Sleigh; Peter R Murgatroyd; Claire A Adams; Les Bluck; Sarah Jackson; Alessandra Vottero; Dipak Kanabar; Valentine Charlton-Menys; Paul Durrington; Maria A Soos; T Adrian Carpenter; David J Lomas; Elaine K Cochran; Phillip Gorden; Stephen O'Rahilly; David B Savage Journal: J Clin Invest Date: 2009-01-26 Impact factor: 14.808
Authors: Ajay Thankamony; Donatella Capalbo; M Loredana Marcovecchio; Alison Sleigh; Sine Wanda Jørgensen; Nathan R Hill; Katrin Mooslehner; Giles S H Yeo; Les Bluck; Anders Juul; Allan Vaag; David B Dunger Journal: J Clin Endocrinol Metab Date: 2014-03-11 Impact factor: 5.958