利用高胰岛素⁃正葡萄糖钳夹技术评估腰高比与胰岛素抵抗的相关性
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国家重点研发计划专项(2018YFA0506904);国家自然科学基金(91854122,81670723)


Assessing the correlation of waist⁃to⁃height ratio with insulin resistance by hyperinsulinemic⁃euglycemic clamp
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    摘要:

    目的:通过高胰岛素-正葡萄糖钳夹试验验证腰高比在评估胰岛素抵抗中的临床应用价值。方法:共纳入154例受试者,检测空腹血脂谱及其他重要生化指标。所有受试者均行高胰岛素-正葡萄糖钳夹试验,并计算葡萄糖代谢率、体重指数(body mass index,BMI)、腰围、腰臀比、腰高比及HOMA指数。比较各指数预测评估受试者胰岛素抵抗的能力。结果:相关分析结果显示,腰高比(r=-0.730,P < 0.001)、腰臀比(r=-0.651,P < 0.001)、BMI指数(r=-0.717,P < 0.001)、腰围(r=-0.716,P < 0.001)均与高胰岛素-正葡萄糖钳夹试验所得葡萄糖代谢率显著相关。以葡萄糖代谢率为标准绘制ROC曲线,不同指数曲线下面积为HOMA-IR(0.860)>腰高比(0.850)> BMI(0.846)>腰围(0.837)>腰臀比(0.749)。腰高比诊断胰岛素抵抗的最佳值为0.56,此值在ROC曲线中对应了最高的灵敏度(93.9%)和特异度(66.7%)。结论:腰高比与高胰岛素-正葡萄糖钳夹试验所得的葡萄糖代谢率有较好的相关性,相较于BMI、腰围、腰臀比等有较高的敏感度及特异度,是较好评估胰岛素抵抗的简易指数,可广泛应用于流行病学研究或大型临床试验。

    Abstract:

    Objective:This study aims to evaluate the clinical value of the anthropometric waist-to-height ratio(WHtR) through the hyperinsulinemic-euglycemic clamp. Methods:A total of 154 subjects was included in the study. Lipid profiles and other biochemical markers were measured from the fasting blood sample. All the patients underwent hyperinsulinemic-euglycemic clamp,and the glucose metabolic rate,body mass index(BMI),waist circumference(WC),waist-to-hip ratio(WHR),WHtR and HOMA index were calculated. The ability of each index to predict the assessment of insulin resistance was compared. Results:Correlation analysis showed that WHtR(r=-0.730,P < 0.001),WHR(r=-0.651,P < 0.001),BMI(r=-0.717,P < 0.001),WC(r=-0.716,P < 0.001)were all significantly correlated with the glucose metabolic rate obtained in the hyperinsulinemic-euglycemic clamp. The area under ROC curve was HOMA-IR(0.860)> WHtR(0.850)> BMI(0.846)> WC(0.837)> WHt(0.749). The best value of WHtR for the diagnosis of insulin resistance was 0.56,which showed the highest sensitivity(93.9%)and specificity(66.7%)in the ROC curve. Conclusion:WHtR has a significant correlation with the glucose metabolic rate obtained from the hyperinsulinemic-euglycemic clamp,and has a higher sensitivity and specificity than BMI,WC and WHR,suggesting that it could be widely used in epidemiological studies or some large-scale clinical trials.

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钱蕾行,付真真,蒋琬姿,周红文,王晓东.利用高胰岛素⁃正葡萄糖钳夹技术评估腰高比与胰岛素抵抗的相关性[J].南京医科大学学报(自然科学版),2020,(6):858-862

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  • 收稿日期:2020-01-17
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  • 在线发布日期: 2020-07-07
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