Accuracy of insulin resistance indices for metabolic syndrome : a cross-sectional study in adults

Abstract

Background: This study aimed to determine the ability of commonly used insulin resistance indices to identify the metabolic syndrome. Methods: 183 people referred for outpatient care at the Metabolism Unit of Hospital de Clínicas de Porto Alegre were evaluated with anthropometric, blood pressure, lipid profle, and adiponectin measurements. Glucose tolerance status was determined by 2-h 75-g oral glucose tolerance test and glycosylated hemoglobin. Defnition of metabolic syndrome was based on the Joint Interim Statement of diferent medical associations. Twenty-one indices of insulin resistance were estimated from published equations. The accuracy of these indices was determined by area under the ROC curve (AUC) analysis. In addition, we determined an optimal cut point for each index and its performance as a diagnostic test. Results: The study population was comprised of 183 people (73.2% women; 78.7% white; age 52.6±12.0 years, mean±standard deviation), of whom 140 (76.5%) had metabolic syndrome. The reciprocal of the Gutt index provided the greatest AUC for identifcation of metabolic syndrome, but there were no statistical diferences between Gutt and 11 AUC indices. Gutt presented 86.4% sensitivity and 76.7% specifcity to identify metabolic syndrome. Conclusions: A number of commonly employed indices of insulin resistance are capable of identifying individuals with the metabolic syndrome.