Assessment of the relationship between insulin resistance, atherogenic index of plasma and white blood cell count: A data mining study

Amaç: Hiperglisemik öglisemik klemp testi insülin direncinin (İD) değerlendirilmesinde altın standart olarak kabul edilmektedir. Bununla birlikte bu testin geniş gruplarda uygulanması zor ve pratik değildir. Bu nedenle klinisyenler İD'nin değerlendirilmesinde hesaplamalı parametrelere ihtiyaç duymaktadır. Bu çalışmada insulin direncinin değerlendirilebilmesinde plazma aterojenik indeks (PAİ) ve beyaz küre (WBC) değerinin kullanılıp kullanılamayacağı tespit edilmeye çalışılmıştır. Yöntem: Bu amaçla Mart 2015- 2016 yılları arasında Cumhuriyet Üniversitesi Sağlık Hizmetleri Araştırma ve Uygulama Hastanesi'ne başvuran 138.934 kişinin bilgileri incelendi ve 474 kişi çalışmaya dahil edildi. Çalışma populasyonuna ait yaş, cinsiyet, WBC sayısı, açlık glukoz, trigliserid, total kolesterol, yüksek dansiteli lipoprotein kolesterol ve insulin düzeyi bilgileri hastane bilgi işlem sisteminden alındı. Bulgular: İD'nin varlığının gösterilmesinde PAİ için elde edilen eğri altında kalan alan (AUC) değerleri homeostatic model assessment-insuline resistance (HOMA-IR) ve quantitative insulin sensitivity check index (QUICKI) için sırasıyla 0.670 ve 0.690 olarak tespit edildi. Bu değerler WBC için sırasıyla 0.649 ve 0.652 olarak bulundu. Ayrıca HOMA-IR değeri baz alındığında PAİ ve WBC'nin negatif prediktif değerinin pozitif prediktif değerinden daha yüksek olduğu görüldü. Sonuç: İnsulin direncinin tespitinde WBC ve AIP'in tek başına kullanılabilecek güvenilir bir belirteç olmadığı ancak bu parametrelerin HOMA-IR ve QUICKI ile birlikte insulin direncinin dışlanmasına katkı sağlayabileceği düşünülmektedir.

İnsülin direncinin plazma aterojenik indeks ve beyaz küre sayısı ile ilişkisinin değerlendirilmesi: Bir veri madenciliği çalışması

Objective: The hyperinsulinemic-euglycemic clamp tests considered as a gold standard method for assessing the insulin sensitivity, whereas the application of this test in large groups is both difficult and not practical, therefore clinicians need calculating parameters to evaluate the insulin sensitivity. In the study we evaluated the prediction of insulin resistance (IR) by atherogenic index of plasma (AIP) and WBC count. Method: We retrospectively reviewed the records of 139.934 individuals admitted to our hospital from March 2015 to March 2016. 474 individuals were enrolled in our study. Study population's records such as age, gender, white blood cell (WBC) count and the concentrations of overnight fasting blood glucose, triglyceride (TG), total cholesterol (TCHOL), HDL-C, low density lipoprotein cholesterol (LDL-C) and insulin were recorded from our hospital information system. Results: The receiver operating characteristic curves (AUC) of AIP for predicting IR were 0.670 and 0.690 as measured by homeostatic model assessment-insulin resistance (HOMA-IR) and insulin sensitivity check index (QUICKI), respectively. The area under the curve (AUC) values for predicting IR with WBC count were 0.649 and 0.652 as measured by HOMA-IR and QUICKI, respectively. Conlusions: Negative predictive values of AIP and WBC were found higher than positive predictive values as measured HOMA-IR. AIP and WBC may not serve as a predictor of IR lonely but these markers might be used as surrogate markers may contribute to excluding IR when used in combination with HOMA-IR and QUICKI.

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