Optimal cutoff for the evaluation of insulin resistance through triglyceride-glucose index: A cross-sectional study in a Venezuelan population [version 1; referees: awaiting peer review]
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Fecha
2017-08-07
Autores
Salazar, Juan
Bermúdez, Valmore
Calvo, María
Olivar, Luis
Luzardo, Eliana
Navarro, Carla
Mencia, Heysa
Martínez, María
Rivas-Ríos, José
Wilches-Durán, Sandra
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F1000 Research Ltd.
Resumen
Background: Insulin resistance (IR) evaluation is a fundamental goal in clinical
and epidemiological research. However, the most widely used methods are
difficult to apply to populations with low incomes. The triglyceride-glucose index
(TGI) emerges as an alternative to use in daily clinical practice. Therefore the
objective of this study was to determine an optimal cutoff point for the TGI in an
adult population from Maracaibo, Venezuela.
Methods: This is a sub-study of Maracaibo City Metabolic Syndrome
Prevalence Study, a descriptive, cross-sectional study with random and
multi-stage sampling. For this analysis, 2004 individuals of both genders ≥18
years old with basal insulin determination and triglycerides < 500 mg/dl were
evaluated.. A reference population was selected according to clinical and
metabolic criteria to plot ROC Curves specific for gender and age groups to
determine the optimal cutoff point according to sensitivity and specificity.The
TGI was calculated according to the equation: ln [Fasting triglyceride (mg / dl) x
Fasting glucose (mg / dl)] / 2.
Results: The TGI in the general population was 4.6±0.3 (male: 4.66±0.34 vs.
female: 4.56±0.33, p=8.93x10 ). The optimal cutoff point was 4.49, with a
sensitivity of 82.6% and specificity of 82.1% (AUC=0.889, 95% CI:
0.854-0.924). There were no significant differences in the predictive capacity of
the index when evaluated according to gender and age groups. Those
individuals with TGI≥4.5 had higher HOMA2-IR averages than those with TGI
<4.5 (2.48 vs 1.74, respectively, p<0.001).
Conclusions: The TGI is a measure of interest to identify IR in the general
population. We propose a single cutoff point of 4.5 to classify individuals with
IR. Future studies should evaluate the predictive capacity of this index to
determine atypical metabolic phenotypes, type 2 diabetes mellitus and even
cardiovascular risk in our population.
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Palabras clave
Blood pressure, Body mass index, Cholesterol, Diabetes mellitus, Glucose metabolism, Insulin resistance, Obesity, Type 2 diabetes