THU251 Diagnostic Performance For Predicting Hepatic And Peripheral Tissue Insulin Resistance In Young Adult Men Using 1Hour Post Load Serum Glucose And Insulin Levels A Pilot Study
Authors: Julian Ledezma Andrés , Espinel Pachón Cristian Felipe , sthefany Perea Sussan , Eduardo Caminos Jorge 
Published: October 2023

Disclosure: A.J. Ledezma: None. C.F. Espinel Pachón: None. S.S. Perea: None. J.E. Caminos: None.

Insulin resistance (RI) is a risk factor for prediabetes and DM2, and other non communicable diseases. Different studies have demonstrated that 1h post load serum glucose levels during an oral glucose test tolerance OGTT seem to be a better predictor of peripheral RI than 2h post load serum glucose among individuals without DM2. On the other hand, HOMA IR reflects primarily hepatic sensitivity/resistance, meanwhile, Matsuda index, may reflect both hepatic and peripheral tissue insulin sensitivity/resistance. Thus, this study aimed to evaluate the diagnostic performance, to identify hepatic and peripheral RI, of 1h post load serum glucose and insulin levels during an OGTT in young adult men, using ROC AUC analysis. This cross-sectional study was conducted on a total of 91 young adult men (18-31-year-olds), 47 healthy lean (BMI &lt;25 kg/m2), and 44 obese nondiabetic subjects (BMI ≥30 kg/m2). Subjects underwent a standard 75g OGTT and blood samples were drawn at 0, 30, 60, and 120 min to obtain serum glucose and insulin levels. Clinical and anthropometric and biochemical variables were determined. Participants were classified as RI based on a predefined Matsuda index cutoff 4.3 value. Cut-offs, sensitivity, and specificity for glucose, insulin, and anthropometrics parameters were determined by AUC ROC analysis for predicting RI diagnosis, and Spearman´s correlation was established between biochemical variables and waist/height ratio and Delong test analysis. Our results showed that 1h post load glucose levels had higher sensitivity 84.1% vs 47.7% and AUC 83.9% [CI 95% 75.6; 92.1%] vs 72.4% [CI 95% 61.8%; 83.0%] than 2h post load during OGTT, however lower specificity was found 70.2% vs 89.4%. Additionally, 1h post load insulin levels had higher sensitivity 90.9% vs 77% and AUC 97.1% [CI 95% 94; 100%] vs 91.9% [CI 95% 86.3; 97.5%] than 2h post load during OGTT, without changes in specificity 97.9% vs 97.8%. It is important to highlight that waist/height ratio reached a 100% AUC 95% CI diagnostic performance for RI in our sample. Additionally, HOMA IR index 99.8% [CI 95% 99.1; 100%], 1/fasting insulin 100% [CI 95% 0.99; 100%], and fasting glucose/insulin ratio 99.7% [CI 95% 99.2; 100%], showed a high diagnostic performance for RI. In the Spearman correlation, Waist/height ratio presented a high correlation with respect to Matsuda -0.8672; p&lt;0.01 G/I1H -0.7454; p&lt;0.01, 1/I1H -0.7783; p&lt; 0.01; Delong test, the best performance comparing 1H vs 2H, G1H/G2H with Z value 2.0668 and P 0.03 In conclusion, 1h post load glucose and insulin levels and the waist/height ratio show greater diagnostic performance than 2h post load for detecting peripheral tissue and hepatic RI in young men. Therefore, Cut-offs values of glucose and insulin levels 1h post load provide simple but useful test for early detection of different prevalent diseases related to RI.

Presentation: Thursday, June 15, 2023