Optimal reference values for insulin sensitivity indices in Iranian healthy females: a population-based study
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ORIGINAL ARTICLE
Optimal reference values for insulin sensitivity indices in Iranian healthy females: a population-based study Fahimeh Ramezani Tehrani 1 & Nazanin Hashemi 1 & Seyed Ali Montazeri 1 & Maryam Rahmati 1 & Hossein Hatami 2 Received: 3 July 2019 / Accepted: 27 February 2020 # Research Society for Study of Diabetes in India 2020
Abstract Purpose To define reference values for various insulin sensitivity (IS) indices in healthy women in a population-based study of the five provinces in Iran Methods In this cross-sectional study, 250 normal-weighted women without hypertension, diabetes, polycystic ovary syndrome, hormonal disorders, pregnancy, or menopause were evaluated in this study. After a 12-h fasting, blood samples were obtained from all participants, levels of metabolic markers (fasting plasma glucose, lipid profile, insulin, etc.) were measured using enzymatic colorimetric and ultrasensitive enzyme-linked radioimmunoassay methods. Multiple insulin sensitivity indices were calculated using well-known predetermined formulas. K-means cluster analysis was used to determine reference values for each insulin sensitivity index. Results The threshold values of homeostasis model assessment (HOMA-%β, HOMA-βcell) and fasting insulin resistance index (FIRI) were 400.41, 198.55, and 2.57 corresponding to 97th, 93rd, and 92nd percentiles, respectively. Reference values of quantitative insulin sensitivity check index (QUICKI) and TG/HDL-c were 0.44 and 4.40, both of which relate to 92nd percentile. The recently introduced single-point insulin sensitivity estimator (SPISE) was analyzed and showed a threshold of 10.10 (87th percentile) in this study. Threshold values of reciprocal insulin (1/Insulin) and glucose-to-insulin ratio (G/I) were 0.51 (95th percentile) and 76.91 (99th percentile), respectively. Conclusion This study determined reference values for various insulin sensitivity indices in healthy Iranian women. These values can be used to define insulin sensitivity in women in epidemiological and clinical studies. Keywords Insulin sensitivity . Cluster analysis . Reference value . Population study
Introduction Insulin sensitivity/resistance plays an important role in the pathophysiology of obesity, diabetes mellitus, and polycystic ovary syndrome [1–3]. Increased risk of cardiovascular diseases (CVD), including coronary heart disease and stroke, and hypertension has been shown to be associated with high
* Nazanin Hashemi [email protected] 1
Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2
Department of Public Health, School of Public Health and Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
insulin levels [4]. Insulin sensitivity (IS) is closely associated with insulin secretion, which corresponds significantly in glucose dysregulation and obesity [5, 6]. Therefore, knowledge of the insulin sensitivity/resistance pr
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