Diagnostic value of surrogate markers of insulin resistance in patients with stable coronary artery disease with obesity and normal fasting glucose
Keywords:інсулін натще, інсулінорезистентність, індекси НОМА, QUICKI та McAuley., fasting insulin, insulin resistance, HOMA-IR, QUICKI and McAuley indices.
Obesity has reached epidemic proportions in the worldwide and is associated with numerous comorbidities, including coronary artery disease(CAD) and Type 2 Diabetes Mellitus(T2DM). Insulin resistance is a condition that is a precursor to developing T2DM. The euglycaemic hyperinsulinaemic clamp technique remains the gold standard for estimating insulin resistance in patients, but it is invasive and impractical for routine use. Various surrogate methods for the quantification of insulin sensitivity have been proposed. Early identification of insulin resistant individuals is important for the management strategies of T2DM.
The aim of the present study was to investigate sensitivity and specificity of simple indices HOMA-IR, QUICKI and McAuley in obese patient with CAD and normal fasting glucose level.
Method: It was examined 52 patients with stable CAD and obesity aged 45-79 years. Fasting glucose, fasting insulin, glycated hemoglobin and lipids were measured. Insulin resistance was calculated by HOMA-IR, QUICKI and McAuley indices. We analyzed the sensitivity and specificity of HOMA-IR, QUICKI and McAuley indices as diagnostic tests compared to fasting insulin calculated by confusion matrix.
Results: 23,1 % of patients were insulin resistant by fasting insulin and 28,8 % by HOMA in our study group. 36,5 % were detected as insulin resistant by QUICKI and 34,6 % by McAuley. Analysis showed that the sensitivity was identical for QUICKI and HOMA-IR (100 %), while McAuley had a slight lower sensitivity (81,8 %). But QUICKI had highest specificity 95,1 %.
Conclusion: QUICKI index may be recommended for the insulin resistance estimation due to its high sensitivity and specificity among other indices in patients with stable coronary artery disease and obesity.
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