M K Garg1, Nikhil Tandon, R K Marwaha, Yashpal Singh. 1. Department of Endocrinology, Command Hospital (Southern Command), Pune;* Department of Endocrinology, All India Institute of Medical Sciences, and #International Life Sciences; New Delhi, India. Correspondence to: Dr RK Marwaha, Flat No 17, Gautam Apartments, Gautam Nagar, New Delhi 110 049, India. marwaha_ramank@hotmail.com.
Abstract
OBJECTIVE: To compare parameters of insulin resistance, with special reference to McAuley index, in urban Indian adolescents, and to establish their cut-off values for defining metabolic syndrome. DESIGN: Cross-sectional study. SETTING: Schools located in four different geographical zones of Delhi, India. PARTICIPANTS: 695 apparently healthy adolescents grouped as normal weight (298), overweight (205) and obese (192). OUTCOME MEASURES: Cut-off point for indices of insulin resistance was assessed by fasting insulin, insulin glucose ratio, and other methods (HOMA model, QUICKI, McAuley index) to define metabolic syndrome. RESULTS: The McAuley index increased progressively from normal weight to obese adolescents in both sexes. McAuley index was significantly lower in adolescents with metabolic syndrome (5.36 ± 1.28 vs. 7.05 ± 1.88; P<0.001). McAuley index had the highest area under curve of receiver operator characteristics [0.82 (0.02)] as compared to other indices of insulin resistance. McAuley index of 6.23 had the highest specificity (88%) with sensitivity of 63.3% for diagnosing metabolic syndrome, whereas insulin glucose ratio had the highest sensitivity (79.7%) but low (55.5%) specificity. McAuley index was negatively correlated with height (r= -0.257, P=<0.001), weight (r= -0.537, P=<0.001), body mass index (r= -0.579, P<0.001), waist circumference (r= -0.542, p<0.001), and waist hip ratio (r= -0.268, P<0.001). CONCLUSIONS: Among various parameters of insulin resistance, McAuley index had the highest specificity, and insulin glucose ratio had the highest sensitivity in diagnosing metabolic syndrome in urban Indian adolescents.
OBJECTIVE: To compare parameters of insulin resistance, with special reference to McAuley index, in urban Indian adolescents, and to establish their cut-off values for defining metabolic syndrome. DESIGN: Cross-sectional study. SETTING: Schools located in four different geographical zones of Delhi, India. PARTICIPANTS: 695 apparently healthy adolescents grouped as normal weight (298), overweight (205) and obese (192). OUTCOME MEASURES: Cut-off point for indices of insulin resistance was assessed by fasting insulin, insulin glucose ratio, and other methods (HOMA model, QUICKI, McAuley index) to define metabolic syndrome. RESULTS: The McAuley index increased progressively from normal weight to obese adolescents in both sexes. McAuley index was significantly lower in adolescents with metabolic syndrome (5.36 ± 1.28 vs. 7.05 ± 1.88; P<0.001). McAuley index had the highest area under curve of receiver operator characteristics [0.82 (0.02)] as compared to other indices of insulin resistance. McAuley index of 6.23 had the highest specificity (88%) with sensitivity of 63.3% for diagnosing metabolic syndrome, whereas insulin glucose ratio had the highest sensitivity (79.7%) but low (55.5%) specificity. McAuley index was negatively correlated with height (r= -0.257, P=<0.001), weight (r= -0.537, P=<0.001), body mass index (r= -0.579, P<0.001), waist circumference (r= -0.542, p<0.001), and waist hip ratio (r= -0.268, P<0.001). CONCLUSIONS: Among various parameters of insulin resistance, McAuley index had the highest specificity, and insulin glucose ratio had the highest sensitivity in diagnosing metabolic syndrome in urban Indian adolescents.
Authors: Krzysztof C Lewandowski; Justyna Płusajska; Wojciech Horzelski; Ewa Bieniek; Andrzej Lewiński Journal: Endocr Connect Date: 2018-02-07 Impact factor: 3.335