Waist-to-height ratio and metabolic phenotype compared to the Matsuda index for the prediction of insulin resistance

Abstract Current screening algorithms for type 2 diabetes (T2D) rely on fasting plasma glucose (FPG) and/or HbA1c. This fails to identify a sizeable subgroup of individuals in early stages of metabolic dysregulation who are at high risk for developing diabetes or cardiovascular disease. The Matsuda...

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Autores principales:	Katharina Lechner, Benjamin Lechner, Alexander Crispin, Peter E. H. Schwarz, Helene von Bibra
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/20a7e7f932a1443b80cf5487ad6a8c55
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spelling	oai:doaj.org-article:20a7e7f932a1443b80cf5487ad6a8c552021-12-02T18:03:46ZWaist-to-height ratio and metabolic phenotype compared to the Matsuda index for the prediction of insulin resistance10.1038/s41598-021-87266-z2045-2322https://doaj.org/article/20a7e7f932a1443b80cf5487ad6a8c552021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-87266-zhttps://doaj.org/toc/2045-2322Abstract Current screening algorithms for type 2 diabetes (T2D) rely on fasting plasma glucose (FPG) and/or HbA1c. This fails to identify a sizeable subgroup of individuals in early stages of metabolic dysregulation who are at high risk for developing diabetes or cardiovascular disease. The Matsuda index, a combination of parameters derived from a fasting and postprandial insulin assay, is an early biomarker for metabolic dysregulation (i.e. insulin resistance/compensatory hyperinsulinemia). The aim of this analysis was to compare four widely available anthropometric and biochemical markers indicative of this condition [waist-to-height ratio (WHtR), hypertriglyceridemic-waist phenotype (HTW), triglycerides-to-HDL-C ratio (TG/HDL-C) and FPG] to the Matsuda index. This cross-sectional analysis included 2231 individuals with normal fasting glucose (NFG, n = 1333), impaired fasting glucose (IFG, n = 599) and T2D (n = 299) from an outpatient diabetes clinic in Germany and thus extended a prior analysis from our group done on the first two subgroups. We analyzed correlations of the Matsuda index with WHtR, HTW, TG/HDL-C and FPG and their predictive accuracies by correlation and logistic regression analyses and receiver operating characteristics. In the entire group and in NFG, IFG and T2D, the best associations were observed between the Matsuda index and the WHtR (r = − 0.458), followed by HTW phenotype (r = − 0.438). As for prediction accuracy, WHtR was superior to HTW, TG/HDL-C and FPG in the entire group (AUC 0.801) and NFG, IFG and T2D. A multivariable risk score for the prediction of insulin resistance was tested and demonstrated an area under the ROC curve of 0.765 for WHtR and its interaction with sex as predictor controlled by age and sex. The predictive power increased to 0.845 when FPG and TG/HDL-C were included. Using as a comparator the Matsuda index, WHtR, compared to HTW, TG/HDL-C and FPG, showed the best predictive value for detecting metabolic dysregulation. We conclude that WHtR, a widely available anthropometric index, could refine phenotypic screening for insulin resistance/hyperinsulinemia. This may ameliorate early identification of individuals who are candidates for appropriate therapeutic interventions aimed at addressing the twin epidemic of metabolic and cardiovascular disease in settings where more extended testing such as insulin assays are not feasible.Katharina LechnerBenjamin LechnerAlexander CrispinPeter E. H. SchwarzHelene von BibraNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Katharina Lechner Benjamin Lechner Alexander Crispin Peter E. H. Schwarz Helene von Bibra Waist-to-height ratio and metabolic phenotype compared to the Matsuda index for the prediction of insulin resistance
description	Abstract Current screening algorithms for type 2 diabetes (T2D) rely on fasting plasma glucose (FPG) and/or HbA1c. This fails to identify a sizeable subgroup of individuals in early stages of metabolic dysregulation who are at high risk for developing diabetes or cardiovascular disease. The Matsuda index, a combination of parameters derived from a fasting and postprandial insulin assay, is an early biomarker for metabolic dysregulation (i.e. insulin resistance/compensatory hyperinsulinemia). The aim of this analysis was to compare four widely available anthropometric and biochemical markers indicative of this condition [waist-to-height ratio (WHtR), hypertriglyceridemic-waist phenotype (HTW), triglycerides-to-HDL-C ratio (TG/HDL-C) and FPG] to the Matsuda index. This cross-sectional analysis included 2231 individuals with normal fasting glucose (NFG, n = 1333), impaired fasting glucose (IFG, n = 599) and T2D (n = 299) from an outpatient diabetes clinic in Germany and thus extended a prior analysis from our group done on the first two subgroups. We analyzed correlations of the Matsuda index with WHtR, HTW, TG/HDL-C and FPG and their predictive accuracies by correlation and logistic regression analyses and receiver operating characteristics. In the entire group and in NFG, IFG and T2D, the best associations were observed between the Matsuda index and the WHtR (r = − 0.458), followed by HTW phenotype (r = − 0.438). As for prediction accuracy, WHtR was superior to HTW, TG/HDL-C and FPG in the entire group (AUC 0.801) and NFG, IFG and T2D. A multivariable risk score for the prediction of insulin resistance was tested and demonstrated an area under the ROC curve of 0.765 for WHtR and its interaction with sex as predictor controlled by age and sex. The predictive power increased to 0.845 when FPG and TG/HDL-C were included. Using as a comparator the Matsuda index, WHtR, compared to HTW, TG/HDL-C and FPG, showed the best predictive value for detecting metabolic dysregulation. We conclude that WHtR, a widely available anthropometric index, could refine phenotypic screening for insulin resistance/hyperinsulinemia. This may ameliorate early identification of individuals who are candidates for appropriate therapeutic interventions aimed at addressing the twin epidemic of metabolic and cardiovascular disease in settings where more extended testing such as insulin assays are not feasible.
format	article
author	Katharina Lechner Benjamin Lechner Alexander Crispin Peter E. H. Schwarz Helene von Bibra
author_facet	Katharina Lechner Benjamin Lechner Alexander Crispin Peter E. H. Schwarz Helene von Bibra
author_sort	Katharina Lechner
title	Waist-to-height ratio and metabolic phenotype compared to the Matsuda index for the prediction of insulin resistance
title_short	Waist-to-height ratio and metabolic phenotype compared to the Matsuda index for the prediction of insulin resistance
title_full	Waist-to-height ratio and metabolic phenotype compared to the Matsuda index for the prediction of insulin resistance
title_fullStr	Waist-to-height ratio and metabolic phenotype compared to the Matsuda index for the prediction of insulin resistance
title_full_unstemmed	Waist-to-height ratio and metabolic phenotype compared to the Matsuda index for the prediction of insulin resistance
title_sort	waist-to-height ratio and metabolic phenotype compared to the matsuda index for the prediction of insulin resistance
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/20a7e7f932a1443b80cf5487ad6a8c55
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Waist-to-height ratio and metabolic phenotype compared to the Matsuda index for the prediction of insulin resistance

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