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Use of Metabolic Markers To Identify Overweight Individuals Who Are Insulin Resistant

Tracey McLaughlin, MD; Fahim Abbasi, MD; Karen Cheal, MPH; James Chu, MD; Cindy Lamendola, MSN; and Gerald Reaven, MD
[+] Article and Author Information

From Stanford University School of Medicine, Stanford, California.


Grant Support: By National Institutes of Health grants RR000070-40 and RR16071-01.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Gerald Reaven, MD, Division of Cardiovascular Medicine, Falk Cardiovascular Research Center, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305.

Current Author Addresses: Drs. McLaughlin and Chu: Division of Endocrinology, Stanford University School of Medicine, Room S005, Stanford, CA 94305-5103.

Drs. Reaven, Abbasi, and Ms. Lamendola: Division of Cardiovascular Medicine, Falk Cardiovascular Research Center, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305.

Ms. Cheal: Department of Psychiatry, Brigham and Women's Hospital, 350 Longwood Avenue, Suite 201, Boston, MA 02115.

Author Contributions: Conception and design: T. McLaughlin, K. Cheal, J. Chu, G. Reaven.

Analysis and interpretation of the data: T. McLaughlin, G. Reaven.

Drafting of the article: T. McLaughlin, G. Reaven.

Critical revision of the article for important intellectual content: T. McLaughlin, G. Reaven.

Final approval of the article: T. McLaughlin, G. Reaven.

Provision of study materials or patients: T. McLaughlin, F. Abbasi, C. Lamendola, G. Reaven.

Statistical expertise: T. McLaughlin, K. Cheal, G. Reaven.

Obtaining of funding: T. McLaughlin, G. Reaven.

Administrative, technical, or logistic support: T. McLaughlin, F. Abbasi, C. Lamendola.

Collection and assembly of data: T. McLaughlin, F. Abbasi.


Ann Intern Med. 2003;139(10):802-809. doi:10.7326/0003-4819-139-10-200311180-00007
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The study sample consisted of 258 persons with a BMI of 25 kg/m2 or greater, classified as overweight or obese by National Institutes of Health (24) and World Health Organization criteria (25). Participants were drawn from a large database of 490 healthy volunteers who have participated in research studies in the past 10 years. These studies typically used newspaper advertisements to identify persons without known disease to participate in our efforts to define the relationship between insulin resistance and metabolic abnormalities. According to their medical histories, study participants did not have major chronic medical illnesses, including CVD, and were not taking any medication known to influence insulin resistance or lipid metabolism (such as corticosteroids and lipid-lowering drugs). No clinically significant abnormalities were found during physical examination; participants were not anemic, had normal liver and kidney function, and were nondiabetic on the basis of plasma glucose concentrations in response to a standard oral glucose challenge (26).

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Figure.
Receiver-operating characteristic curves for metabolic markers of insulin resistance.BMI2HDL

Comparison, in individuals with body mass index ( ) of 25 kg/m or greater, of relationships between rates of true-positive test results (sensitivity) and false-positive test results (1 − specificity) for plasma concentrations of fasting triglyceride–high-density lipoprotein ( ) cholesterol ratio, triglyceride, insulin, cholesterol–HDL cholesterol ratio, BMI, HDL cholesterol, glucose, and total cholesterol.

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Summary for Patients

Use of Common Laboratory Tests To Identify People with Insulin Resistance

The summary below is from the full report titled “Use of Metabolic Markers To Identify Overweight Individuals Who Are Insulin Resistant.” It is in the 18 November 2003 issue of Annals of Internal Medicine (volume 139, pages 802-809). The authors are T. McLaughlin, F. Abbasi, K. Cheal, J. Chu, C. Lamendola, and G. Reaven.

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