Correlation of anthropometric indicators for identifying insulin sensitivity and resistance

CONTEXT AND OBJECTIVES: Early detection of reduced insulin sensitivity (IS) and insulin resistance (IR) is desirable. The aim here was to evaluate correlations of anthropometric indicators for identifying IR or IS and determine the cutoff points of the most effective indicators. DESIGN AND SETTING: Cross-sectional study in the city of São Paulo. METHODS: Sixty-one individuals with normal fasting plasma glucose (NFPG) and 43 overweight women were analyzed. Body mass index (BMI), waist circumference (WC), waist-to-hip ratio, waist-to-height ratio (WHtR), conicity index and the HOMA-IS and HOMA-IR indices were determined. The correlations between the anthropometric indices and IS and IR were determined. ROC analysis was used to determine the areas under the curve (AUC) and cutoff points. RESULTS: Among the NFPG individuals, BMI (r = -0.50; P = 0.002) and WHtR (r = -0.45; P = 0.007) showed correlations with HOMA-IS (homeostasis model assessment of insulin sensitivity). The ROC curve demonstrated statistical significance for BMI (AUC = 0.769; P = 0.005), WHtR (AUC = 0.764; P = 0.01) and WC (AUC = 0.702; P = 0.04), and the best cutoff points were 33.3 kg/m², 0.67 and 100 cm, respectively. Among the overweight women, the best correlation with HOMA-IR was demonstrated by WHtR (r = 0.37; P = 0.01), and the best cutoff point was 0.70 (AUC = 0.61; P = 0.25). CONCLUSION: The most promising indicators for showing IS among the NFPG individuals were BMI, WHtR and WC. Among the overweight women, WHtR demonstrated greater correlation with I

Prevalence of prediabetes in patients with metabolic risk

CONTEXT AND OBJECTIVE: Early diagnosis of prediabetes should be done to avoid complications relating to diabetes mellitus (DM). The aim here was to assess the prevalence of prediabetes among individuals at high risk of developing DM, and to seek variables relating to glucose intolerance (GI) among individuals with normal fasting plasma glucose (FPG). DESIGN AND SETTING: Cross-sectional study at Hospital do Servidor Público Estadual, São Paulo. METHODS: The FPG and glucose tolerance test (GTT) were analyzed, from which the subjects were divided as follows: group 1 (FPG and GTT both normal), group 2 (normal FPG but abnormal GTT), group 3 (abnormal FPG but normal GTT), and group 4 (FPG and GTT both abnormal). The subjects' clinical, laboratory and anthropometric profile was determined. RESULTS: 138 subjects were studied: 44 in group 1, 11 in group 2, 33 in group 3 and 50 in group 4. The prevalence of prediabetes was 68.0%. Group 4 individuals were older than group 1 individuals [69.0 (55.5-74.0) versus 58.9 ± 11.8 years; P < 0.05], with greater prevalence of risk conditions for DM [5.0 (4.0-5.0) versus 4.0 (3.0-5.0); P < 0.05]. Among individuals with normal FPG, GI prevalence was 20.0%. No variables analyzed correlated with GTT. CONCLUSION: The prevalence of prediabetes was 68.0%, and 20.0% of subjects with normal FPG had GI. Although some anthropometric, clinical and laboratory variables have been correlated with DM and prediabetes, none, except for GTT, was able to screen for GI among subjects with normal FPG in the present stud

No association between 25-hydroxyvitamin D levels and prediabetes in Brazilian patients. A cross-sectional study

CONTEXT AND OBJECTIVE: Several studies have evaluated the role of low 25-hydroxyvitamin D (25OHD3) in the pathogenesis of type 2 diabetes (T2DM) and have presented controversial results. The metabolic processes that culminate in T2DM begin under prediabetic conditions. Our aim was to analyze the association between 25OHD3 and glucose metabolism in individuals who were free from but at elevated risk of diabetes. DESIGN AND SETTING: Cross-sectional study at a tertiary hospital. METHODS: Anthropometric and laboratory profiles were determined in patients with one or more of the following risk factors: hypertension; body mass index (BMI) ≥ 25 kg/m2; waist circumference > 80 cm for women and > 94 cm for men; first-degree relatives with diabetes; women with large-for-gestational-age newborns or with gestational T2DM; HDL-cholesterol (high density lipoprotein) 250 mg/dl. The patients were divided into two groups: one with prediabetes (abnormal fasting plasma glucose or oral glucose tolerance test) and the other with normal glucose (euglycemic). RESULTS: There was no statistically significant difference between the prediabetic group (n = 38) and euglycemic group (n = 15) regarding age (66.4 ± 10.6 versus 62.6 ± 9.1 years), gender (52.6 versus 73.3% female) and BMI (30.1 ± 4.61 versus 27.9 ± 4.7 kg/m2). Low serum levels of 25OHD3 were found in both groups, without any statistically significant difference between them (29.1 ± 11.8 versus 26.87 ± 9.2 ng/dl). CONCLUSION: There was no association between 25OHD3 levels and the clinical or laboratorial variables analyzed