Research Article Details
| Article ID: | A12551 |
| PMID: | 30394863 |
| Source: | Metab Syndr Relat Disord |
| Title: | Prediction of Insulin Resistance with Anthropometric and Clinical Laboratory Measures in Nondiabetic Teenagers. |
| Abstract: | BACKGROUND: Adolescent obesity is an important risk factor for cardiovascular disease in part due to its relationship to type 2 diabetes. Therefore, screening for type 2 diabetes is recommended. However, since insulin resistance (IR) is an early precursor of diabetes, it would be beneficial if IR predictors from routine assessments could identify those at greatest metabolic risk before diabetes has developed. METHODS: Adolescents aged 14-18 years with normal fasting plasma glucose (n = 252) were selected from the National Health and Nutrition Examination Survey 2013-2014. IR was estimated with homeostatic model assessment (HOMA). Multivariable linear/logistic regressions with demographic covariates assessed HOMA Index (HI)-determined IR associations with common clinical measurements. RESULTS: The constellation of body mass index (BMI) percentile (P < 0.0001), diastolic blood pressure (DBP, P = 0.0056), and serum alanine aminotransferase (ALT, P = 0.0295) predicted log-transformed HI; cholesterol, triglycerides, and high- and low-density lipoprotein cholesterol were not predictive. Secondary gender analyses indicated significant associations in males (BMI percentile, P = 0.0008; DBP, P = 0.0003; ALT, P = 0.0436), but only BMI percentile in females (P = 0.0001). After stratifying predictors at clinical thresholds, logistic regressions had increased specificity at HI's 85th percentile compared with its 75th [85th: area under curve (AUC) = 0.87, 75th: AUC = 0.80]. At the 85th HI percentile, IR was associated with these components [BMI percentile: adjusted odds ratio (aOR) = 34.31, 95% confidence interval (CI): 8.5-139.3; ALT: aOR = 11.36, 95% CI: 3.0-43.7; DBP: aOR = 7.73, 95% CI: 2.4-24.6]. In males, IR was associated with elevated BMI percentile (aOR 24.0) and ALT (aOR 23.9) and in females with elevated BMI percentile (aOR 45.8) and DBP (aOR 17.9). CONCLUSIONS: Three routine clinical assessments, BMI percentile, DBP, and ALT, predicted IR at HI's 75th and 85th percentiles in nondiabetic adolescents. Prospective validation may yield simple gender-specific screening identifying nondiabetic adolescents at greatest need of treatment intervention. |
| DOI: | 10.1089/met.2018.0072 |
| Strategy ID | Therapy Strategy | Synonyms | Therapy Targets | Therapy Drugs | |
|---|---|---|---|---|---|
| S01 | Improve insulin resistance | insulin sensitizer; insulin resistance; glucose tolerance | Biguanide: increases 5-AMP activated protein kinase signaling; SGLT-2 inhibitor; Thiazalidinedione: selective PPAR-γ agonists; GLP-1 agonist | Metformin; Empagliflozin; Canagliflozin; Rosiglitazone; Pioglitazone; Liraglutide | Details |
| Diseases ID | DO ID | Disease Name | Definition | Class | |
|---|---|---|---|---|---|
| I13 | 3146 | Lipid metabolism disorder | An inherited metabolic disorder that involves the creation and degradation of lipids. http://en.wikipedia.org/wiki/Lipid_metabolism | disease of metabolism/ inherited metabolic disorder | Details |
| I12 | 10763 | Hypertension | An artery disease characterized by chronic elevated blood pressure in the arteries. https://en.wikipedia.org/wiki/Hypertension, https://www.ncbi.nlm.nih.gov/pubmed/24352797 | disease of anatomical entity/ cardiovascular system disease/vascular disease/ artery disease | Details |
| I05 | 9352 | Type 2 diabetes mellitus | A diabetes that is characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. A diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. http://en.wikipedia.org/wiki/Diabetes, http://en.wikipedia.org/wiki/Diabetes_mellitus_type_2 | disease of metabolism/inherited metabolic disorder/ carbohydrate metabolic disorder/glucose metabolism disease/diabetes/ diabetes mellitus | Details |
| I14 | 9970 | Obesity | An overnutrition that is characterized by excess body fat, traditionally defined as an elevated ratio of weight to height (specifically 30 kilograms per meter squared), has_material_basis_in a multifactorial etiology related to excess nutrition intake, decreased caloric utilization, and genetic susceptibility, and possibly medications and certain disorders of metabolism, endocrine function, and mental illness. https://en.wikipedia.org/wiki/Obesity | disease of metabolism/acquired metabolic disease/ nutrition disease/overnutrition | Details |
| Drug ID | Drug Name | Type | DrugBank ID | Targets | Category | Latest Progress | |
|---|---|---|---|---|---|---|---|
| D199 | L-alanine | Chemical drug | DB00160 | KYNU | -- | Failed in clinical trials | Details |
| D328 | Serine | Chemical drug | DB00133 | SRR | Improve insulin resistance | Under clinical trials | Details |
| D080 | Citrulline | Chemical drug | DB00155 | -- | -- | Under clinical trials | Details |
| D182 | Insulin | Biological drug | DB00030 | INSR agonist; CPE modulator&product of | -- | Under clinical trials | Details |
| D094 | Cysteamine | Chemical drug | DB00847 | GSS stimulant | Renal drug | Under clinical trials | Details |
| D095 | Cysteamine bitartrate | Chemical drug | DB00847 | -- | -- | Under clinical trials | Details |