Armin Van Buuren
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August 29, ; Accepted date: September 19, ; Published date: J Diabetes Metab 5: This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Many reports have demonstrated that anthropometric indices can detect IS and IR, however ethnic variations can influence the optimal cutoff value. Insulin resistance; Insulin sensitivity; Waist circumference; Body-mass index, Waist-to-height ratio; Percent body fat; Receiver-operating characteristic curve. The prevalence of Type 2 Diabetes T2D is a major health concern in Mexico, as well as the rest of the world [ 1 - 3 ]. According to Mexican Ministry of Health, current estimates suggest that, bythe cases of T2D will increase to Moreover, IS and IR can be present five years before the development of pre-diabetes, a stage preceding T2D characterized by impaired glucose function [ 5 ].
Obesity and increased central adiposity are two risk factors associated with T2D [ 6 - 8 ]. Healthy subjects and without a T2D diagnosis were asked to participate. Subjects were excluded from the study, if it was suspected they had an acute or chronic illness that would interfere with the analysis. All participants provided informed consent to participate in the study protocols, conducted in accordance with the Declaration of Helsinki.
Subjects were clinically evaluated according to a standardized protocol including personal and family medical history. WC was measured at the midpoint between the highest point of the iliac crest and the lowest point of the costal margin at the mid-axillary line using a non-stretching anthropometric measuring tape. Hip circumference was measured at the widest part of the buttocks. Measurements were performed at the end of a normal inhalation using minimal pressure with the tape to avoid compression of the skin.
Whole blood samples were collected from the antecubital vein following a h overnight fast. The samples were kept at room temperature for 2h to allow clotting. Samples were used for the following endpoints: Fasting plasma glucose and insulin.
Insulin levels were determined by automated immunoassay Access, Beckman. Receiver Operating Characteristic ROC curve was used to determine the sensitivity and specificity of each anthropometric index. Anthropometric indices correlate with insulin sensitivity and insulin resistance. More females were determined to have low IS than monero de alma cd 27 Next, we determined the association between the anthropometric indices and IS by calculating the Spearman correlation coefficients.
Clinical and Metabolic characteristics of subjects from central Mexico. Determination of the best anthropometric index to predict IS and IR in males and females. For males, the AUC was 0. For females, the AUC was 0. In males and females, all tests demonstrated similar efficiencies Table 3.
Determination of optimal anthropometric index cutoff value to predict IS and IR in males and females. The test with highest accuracy was considered the better test. The optimal cutoff value for each indices and their test performance for males and females are shown in Table 4 and Table 5respectively.
The optimal cutoff value for IS were always below the monero de alma cd 27 cutoff value for IR. Anthropometric indices are easy, rapid, and inexpensive measures that are utilized in rural and financially burden areas of Mexico and other parts of the world that can identify IS and IR. In agreement with others, we determined that WHR was not an acceptable test [ 2021 ]. Many reports have shown that BMI affectively correlates with IS in children and adults [ 622 - 24 ].
Unfortunately, these reports did not compare to alternative measures of obesity. To date and to best of our knowledge, there are no reports that examine anthropometric indices and IS in Mexican subjects. For males, our results are similar to reports on Pakistani and Iranian populations. Although these studies demonstrated a WC cutoff of In addition, Gomez-Garcia et al.
However, according monero de alma cd 27 Monero-Estrada et al. The optimal WC cutoff for Mexicans from Michoacan was determined to be These data confirms that WC is acceptable test to determine IR in males and different ethnic groups have different monero de alma cd 27 values. Overall, this does support the notion that in different regions of the world, different anthropometric indices are more efficient than others in determining IR.
Using the same population, we determined the cutoff values for IS and IR. For each monero de alma cd 27 indices, the IS cutoff value was lower than the IR cutoff value. This would suggest that IS precedes IR. We, as well as others, have demonstrated that IS does develop before IR [ 2930 ].
Since IS monero de alma cd 27 IR, it would be beneficial for general practitioners to start examining patients for IS to prevent the development of IR and pre-diabetes. We determined a few limitations for this study.
First, the study is a cross-sectional study and cannot determine any causal effects between the anthropometric indices and IS or IR. Upon further examination, selection of different cutoff monero de alma cd 27 resulted in higher test accuracies while altering the PPVs and NPVs Data not shown. These suggest that Youden index, even though gives the highest sensitivity and specificity pair, may not predict the optimal cutoff value. Further analyses are required.
Third, our cohorts contain a mixture of subject with and without a family history of T2D. Many subjects did not indicate or know if there was a family history of T2D. A family history increases the risk of T2D and its associated complications [ 31 ]. It is possible that the optimal cutoff values are different between subjects with family history of T2D and those without.
These cutoff values will aid clinicians monero de alma cd 27 the diagnosis of IS and IR and help design treatments to mitigate the development of T2D. We would like to express our gratitude to the participants of this study, Dr. The Summer of Scientific Investigation, who examined patient records. Please leave a message, monero de alma cd 27 will get back you shortly.
Home Publications Conferences Register Contact. Guidelines Upcoming Special Issues. Research Article Open Access. September 26, Citation: Significance was determined by Student T Test. Body Fat percent; FPG: Quantitative Insulin Sensitivity Check Index. Negative Predictive Value; IS: Select your language of interest to view the total content in your interested language. Can't read the image?
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