Background
Methods
Subjects
Evaluation of confounding factors
Statistical analysis
Results
Background factors of subjects categorized by BMI
Body mass index† characteristics | Total | Non-obese | Overweight | P-value* |
---|---|---|---|---|
All N = 1,342 | <25.0 kg/m2 N = 998 | ≥25.0 kg/m2 N = 344 | ||
Male sex,% | 43.7 | 42.8 | 46.5 | 0.232 |
Age (years) | 59 ± 13 | 60 ± 13 | 57 ± 12 | 0.012 |
Body mass index (kg/m2) | 23.1 ± 3.1 | 21.7 ± 2.0 | 27.1 ± 2.2 | <0.001 |
Smoking status {never/ex/light/heavy (%)} | 71.2/9.6/9.1/10.1 | 72.6/8.3/8.9/10.1 | 66.9/13.4/9.6/10.2 | 0.043 |
Alcohol consumption {never/light/moderate/heavy (%)} | 38.8/31.8/18.6/10.8 | 40.5/30.5/18.9/10.1 | 34.0/35.8/17.4/12.8 | 0.072 |
Cardiovascular disease,% | 4.5 | 4.7 | 4.1 | 0.764 |
Systolic blood pressure (mmHg) | 134 ± 21 | 132 ± 21 | 139 ± 19 | <0.001 |
Diastolic blood pressure (mmHg) | 80 ± 11 | 79 ± 11 | 84 ± 10 | <0.001 |
Total cholesterol (mg/dL) | 201 ± 35 | 200 ± 34 | 205 ± 35 | 0.024 |
Triglycerides (mg/dL) | 90 (67–126) | 85 (64–117) | 108 (81–152) | <0.001 |
HDL cholesterol (mg/dL) | 63 ± 15 | 65 ± 16 | 57 ± 13 | <0.001 |
LDL cholesterol (mg/dL) | 118 ± 32 | 116 ± 31 | 123 ± 32 | <0.001 |
Uric acid (mg/dL) | 5.0 ± 1.4 | 4.8 ± 1.4 | 5.5 ± 1.4 | <0.001 |
High sensitivity CRP (mg/dL) | 0.04 (0.02-0.09) | 0.04 (0.02-0.07) | 0.07 (0.04-0.15) | <0.001 |
Serum HMW adiponectin (μg/mL) | 4.89 (2.98-7.99) | 5.37 (3.21-8.69) | 3.95 (2.24-5.82) | <0.001 |
GGT (IU/L) | 25 (18–43) | 32 (21–63) | <0.001 | |
ALT (IU/L) | <0.001 | |||
AST (IU/L) | 0.013 | |||
ALT/AST ratio | 0.79 (0.65-1.0) | 0.74 (0.63-0.91) | 0.96 (0.72-1.2) | <0.001 |
Insulin resistance of subjects categorized by BMI
Body mass index characteristics | Total | Non-obese | Overweight | P-value* |
---|---|---|---|---|
All N = 1,342 | <25.0 kg/m2 N = 998 | ≥25.0 kg/m2 N = 344 | ||
Fasting blood glucose (mg/dL) | 92 (87–99) | 91 (86–98) | 96 (89–103) | <0.001 |
Immunoreactive insulin (mU/mL) | 5.2 (3.4-7.7) | 4.5 (3.0-6.6) | 8.0 (5.4-11.2) | <0.001 |
HOMA-IR† | 1.20 (0.76-1.84) | 1.03 (0.67-1.54) | 1.93 (1.23-2.81) | <0.001 |
HOMA-IR† <1.6,% | 67.5 | 77.5 | 38.7 | |
HOMA-IR† ≥1.6 and <2.5,% | 20.0 | 16.3 | 30.8 | <0.001 |
HOMA-IR† ≥2.5,% | 12.4 | 6.2 | 30.5 | <0.001 |
Comparison of areas under ROC curves [95% confidence interval] for potential markers of insulin resistance of subjects categorized by BMI
Body mass index characteristics | AUC (95% CI) | |||||
---|---|---|---|---|---|---|
Total | P-value | Non-obese | P-value | Overweight | P-value | |
All N = 1,342 | <25.0 kg/m2 N = 998 | ≥25.0 kg/m2 N = 344 | ||||
Triglycerides (mg/dL) | 0.69 (0.65-0.73) | <0.001 | 0.66 (0.59-0.73) | <0.001 | 0.65 (0.58-0.71) | <0.001 |
High sensitivity CRP (mg/dL) | 0.68 (0.64-0.72) | <0.001 | 0.61 (0.55-0.68) | 0.003 | 0.63 (0.57-0.70) | <0.001 |
Serum HMW adiponectin (μg/mL) | 0.32 (0.28-0.36) | <0.001 | 0.32 (0.25-0.39) | <0.001 | 0.40 (0.33-0.46) | 0.003 |
GGT (IU/L) | 0.63 (0.58-0.67) | <0.001 | 0.61 (0.54-0.67) | 0.005 | 0.54 (0.48-0.61) | 0.211 |
ALT (IU/L) | 0.69 (0.64-0.73) | <0.001 | 0.62 (0.55-0.69) | 0.002 | 0.66 (0.59-0.72) | <0.001 |
AST (IU/L) | 0.56 (0.51-0.61) | 0.013 | 0.49 (0.41-0.57) | 0.818 | 0.59 (0.52-0.66) | 0.007 |
ALT/AST ratio | 0.74 (0.70-0.78) | <0.001 | 0.70 (0.63-0.77) | <0.001 | 0.66 (0.59-0.72) | <0.001 |
Relationship between various confounding factors and HOMA-I of subjects categorized by body mass index
Body mass index† characteristics | β(P-value) | ||
---|---|---|---|
Total | Non-obese | Overweight | |
All N = 1,342 | <25.0 kg/m2 N = 998 | ≥25.0 kg/m2 N = 344 | |
Male sex,% | 0.247 (<0.001) | 0.281 (<0.001) | 0.219 (0.005) |
Age (years) | −0.064 (0.020) | −0.116 (0.001) | 0.094 (0.135) |
Body mass index (kg/m2) | 0.320 (<0.001) | 0.206 (<0.001) | 0.262 (<0.001) |
Smoking status {never/ex/light/heavy (%)} | −0.065 (0.014) | −0.060 (0.075) | −0.103 (0.073) |
Alcohol consumption {never/light/moderate/heavy(%)} | −0.114 (<0.001) | −0.137 (<0.001) | −0.081 (0.222) |
Cardiovascular disease,% | 0.032 (0.140) | 0.055 (0.046) | −0.024 (0.610) |
Systolic blood pressure (mmHg) | 0.093 (<0.001) | 0.126 (<0.001) | 0.032 (0.543) |
Triglycerides (mg/dL) | 0.138 (<0.001) | 0.145 (<0.001) | 0.164 (0.005) |
HDL cholesterol (mg/dL) | −0.033 (0.215) | −0.038 (0.249) | −0.028 (0.645) |
LDL cholesterol (mg/dL) | 0.041 (0.079) | 0.063 (0.034) | 0.010 (0.848) |
Uric acid (mg/dL) | 0.021 (0.451) | 0.049 (0.153) | −0.052 (0.400) |
High sensitivity CRP (mg/dL) | 0.049 (0.035) | 0.048 (0.095) | 0.074 (0.149) |
Serum HMW adiponectin (μg/mL) | −0.164 (<0.001) | −0.162 (<0.001) | −0.231 (0.001) |
GGT (IU/L) | 0.097 (0.001) | 0.079 (0.031) | 0.149 (0.038) |
ALT/AST ratio | 0.122 (<0.001) | 0.129 (<0.001) | 0.143 (0.038) |
R2 | 0.417 (<0.001) | 0.315 (<0.001) | 0.290 (<0.001) |
Optimal cut-off point of ALT/AST ratio for predicting insulin resistance of subjects categorized by BMI
Characteristics cut-off point | HOMA-IR§ | ||||||
---|---|---|---|---|---|---|---|
<2.5 | ≥2.5 | Sensitivity | Specificity | Positive LR | Negative LR | Accuracy | |
Body mass index <25.0 kg/m2 | N = 936 | N = 62 | % | ||||
ALT/AST ratio <0.82 | 612 | 22 | 0.67 | 0.65 | 1.91 | 0.51 | 65.3 |
ALT/AST ratio ≥0.82 | 324 | 40 | |||||
Body mass index ≥25.0 kg/m2 | N = 239 | N = 105 | |||||
ALT/AST ratio <1.02 | 158 | 41 | 0.66 | 0.61 | 1.69 | 0.56 | 64.5 |
ALT/AST ratio ≥1.02 | 81 | 64 |
Relationship between ALT/AST ratio and insulin resistance of subjects within selected subgroups
Stratified subgroups | N | HOMA-IR ≥2.5,% | ALT/AST ratio | ||
---|---|---|---|---|---|
ROC curves AUC (95%CI) | BMI-adjusted β (P-value) | Multivariate-adjusted β (P-value) | |||
Men Body mass index (kg/m2) | |||||
Total | 587 | 66 (11.2) | 0.75 (0.68-0.81 | 0.253 (<0.001) | 0.104 (0.016) |
<22.0 | 202 | 7 (3.5) | 0.67 (0.44-0.89) | 0.257 (<0.001) | 0.141 (0.051) |
22.0-25.0 | 225 | 19 (8.4) | 0.64 (0.51-0.77) | 0.317 (<0.001) | 0.166 (0.030) |
<25.0 | 427 | 26 (6.1) | 0.67 (0.56-0.77) | 0.274 (<0.001) | 0.143 (0.004) |
≥25.0 | 160 | 40 (25.0) | 0.73 (0.63-0.82) | 0.215 (0.005) | 0.052 (0.600) |
Women Body mass index (kg/m2) | |||||
Total | 755 | 101 (13.4) | 0.75 (0.70-0.81) | 0.197 (<0.001) | 0.104 (0.002) |
<22.0 | 308 | 10 (3.2) | 0.74 (0.62-0.87) | 0.149 (0.008) | 0.055 (0.334) |
22.0-25.0 | 263 | 26 (9.9) | 0.71 (0.60-0.82) | 0.250 (<0.001) | 0.136 (0.039) |
<25.0 | 571 | 36 (6.3) | 0.74 (0.65-0.82) | 0.194 (<0.001) | 0.092 (0.026) |
≥25.0 | 184 | 65 (35.3) | 0.68 (0.60-0.76) | 0.231 (0.001) | 0.176 (0.019) |