ABSTRACT
BACKGROUND:
Insulin resistance (IR) and progressive pancreatic β-cell dysfunction have been identified as the two fundamental features in the pathogenesis of obesity and non-insulin-dependent diabetes mellitus. We aimed to investigate correlations between anthropometric indices of obesity and IR in non-diabetic obese individuals, and the cutoff value from receiver operating characteristic (ROC) curve analysis.
DESIGN AND SETTING:
Cross-sectional study conducted in a private clinic.
METHODS:
We included obese individuals (body mass index, BMI ≥ 30 kg/m22. Carneiro IBP, Sampaio HAC, Carioca AAF, Pinto FJM, Damasceno NRT. Antigos e novos Indicadores antropométricos como preditores de resistência à Insulina em adolescentes [Old and new anthropometric Indices as Insulin resistance predictors In adolescentes]. Arq Bras Endocrinol Metabol. 2014;58(8):838-43.) with no diabetes mellitus (fasting glucose levels ≤ 126 mg/dl). The participants were evaluated for the presence of cardiovascular risk factors and through anthropometric measurements and biochemical tests. Furthermore, IR was assessed indirectly using the homeostatic model assessment (HOMA)-IR and HOMA-β indexes. The area underthe curve (AUC) of the variables was compared.The sensitivity, specificity and cutoff of each variable for diagnosing IR were calculated.
RESULTS:
The most promising anthropometric parameters for indicating IR in non-diabetic obese individuals were waist-to-height ratio (WHtR), waist circumference (WC) and BMI. WHtR proved to be an independent predictor of IR, with risk increased by 0.53% in HOMA-IR, 5.3% in HOMA-β and 1.14% in insulin. For HOMA-IR, WHtR had the highest AUC value (0.98), followed by WC (0.93) and BMI (0.81). For HOMA-β, WHtR also had the highest AUC value (0.83), followed by WC (0.75) and BMI (0.73).The optimal WHtR cutoff was 0.65 for HOMA-IR and 0.67 for HOMA-β.
CONCLUSION:
Among anthropometric obesity indicators, WHtR was most closely associated with occurrences of IR and predicted the onset of diabetes in obese individuals.
KEY WORDS:
Anthropometry; Obesity; Diabetes mellitus