Mets-Ir as a Useful Tool for the Diagnosis of Insulin Resistance in Non-Diabetic Euthyroid Adults from Lima, Peru

Abstract

Abstract Background: The prevalence of insulin resistance (IR) has increased in the last decades, especially in low- and middle-income countries. However, the gold standard for its diagnosis is not accessible and insulin dosing cannot be performed routinely. A non-insulin-based tool is required for an early diagnosis and prevention of complications. Objective:Evaluate the METS-IR diagnostic utility compared to the TyG index and the TG/HDL-c in a sample of non-diabetic euthyroid adults. Methods: We included adults of both sexes, with no history of diabetes mellitus or thyroid disorders, who attended the outpatient service of a private clinic in Lima-Peru. The exposure variable was METS-IR and it was defined as follows: Ln((2*fasting glucose)+Triglycerides)*BMI)/(Ln(HDL-c)). We considered the HOMA-IR as the gold standard for IR using a cut-off of 2.8. We elaborated Receiver operating characteristic (ROC) curves and calculated the area under the curves (AUC) with their 95% confidence intervals (95%CI). Results: We analyzed 619 adults, 69.5% were female, the mean age was 38.9 years, the mean BMI was 29.2 kg/m2. The METS-IR mean was 2.4, while the HOMA-IR mean was 3.58 and the IR prevalence was 49.1%. The METS-IR AUC was 0.79(95%CI: 0.75-0.82), while the TyG AUC was 0.76(95%CI: 0.72-0.80) and TG/HDL-c AUC was 0.76(95%CI: 0.72-0.79), p<0.001. We estimated an empirical cutpoint of 2.30 with a sensitivity of 78% and a specificity of 68%. Conclusion:Using the METS-IR to diagnose IR seems to be better than TyG and TG/HDL-c. The METS-IR could be a useful non-insulin based tool to identify people at risk of IR in non-diabetic euthyroid adults. Keywords: Insulin resistance, METS-IR, Anthropometry, Latin America. Abbreviations: METS-IR: Metabolic Score for Insulin Resistance; BMI: Body mass index; HOMA-IR: Homeostatic model assessment. Funding and Conflicts of Interest: None.