@article{3085870,
    title = "Modification and validation of the triglyceride-to-HDL cholesterol ratio as a surrogate of insulin sensitivity in white juveniles and adults without diabetes mellitus: The single point insulin sensitivity estimator (SPISE)",
    author = "Paulmichl, K. and Hatunic, M. and Højlund, K. and Jotic, A. and Krebs, M. and Mitrakou, A. and Porcellati, F. and Tura, A. and Bergsten, P. and Forslund, A. and Manell, H. and Widhalm, K. and Weghuber, D. and Anderwald, C.-H.",
    journal = "Advances in Clinical Chemistry",
    year = "2016",
    volume = "62",
    number = "9",
    pages = "1211-1219",
    publisher = "American Association for Clinical Chemistry Inc.",
    doi = "10.1373/clinchem.2016.257436",
    keywords = "high density lipoprotein cholesterol;  insulin;  low density lipoprotein cholesterol;  triacylglycerol;  high density lipoprotein cholesterol;  insulin;  triacylglycerol, adolescent;  adult;  Article;  body mass;  cardiovascular parameters;  cohort analysis;  comparative study;  diabetes mellitus;  diet restriction;  disease assessment;  female;  homeostasis model assessment insulin resistance;  human;  insulin resistance;  insulin sensitivity;  male;  mathematical model;  normal human;  oral glucose tolerance test;  Quantitative Insulin Sensitivity Check Index;  receiver operating characteristic;  triglyceride high density lipoprotein cholesterol ratio;  validation study;  blood;  diabetes mellitus;  glucose tolerance test;  middle aged;  obesity, Adolescent;  Adult;  Cholesterol, HDL;  Cohort Studies;  Diabetes Mellitus;  Female;  Glucose Tolerance Test;  Humans;  Insulin;  Male;  Middle Aged;  Obesity;  Triglycerides",
    abstract = "BACKGROUND: The triglyceride-to-HDL cholesterol (TG/HDL-C) ratio was introduced as a tool to estimate insulin resistance, because circulating lipid measurements are available in routine settings. Insulin, Cpeptide, and free fatty acids are components of other insulin-sensitivity indices but their measurement is expensive. Easier and more affordable tools are of interest for both pediatric and adult patients. METHODS: Study participants from the Relationship Between Insulin Sensitivity and Cardiovascular Disease [43.9 (8.3) years, n 1260] as well as the Beta-Cell Function in Juvenile Diabetes and Obesity study cohorts [15 (1.9) years, n 29] underwent oral-glucosetolerance tests and euglycemic clamp tests for estimation of whole-body insulin sensitivity and calculation of insulin sensitivity indices. To refine the TG/HDL ratio, mathematical modeling was applied including body mass index (BMI), fasting TG, andHDLcholesterol and compared to the clamp-derived M-value as an estimate of insulin sensitivity. Each modeling result was scored by identifying insulin resistance and correlation coefficient. The Single Point Insulin Sensitivity Estimator (SPISE) was compared to traditional insulin sensitivity indices using area under the ROC curve (aROC) analysis and 2 test. RESULTS: The novel formula for SPISE was computed as follows: SPISE 600 HDL-C0.185/(TG0.2 BMI1.338), with fasting HDL-C (mg/dL), fasting TG concentrations (mg/dL), and BMI (kg/m2). A cutoff value of 6.61 corresponds to an M-value smaller than 4.7 mg kg1 min1 (aROC, M:0.797). SPISE showed a significantly better aROC than the TG/HDL-C ratio. SPISE aROC was comparable to the Matsuda ISI (insulin sensitivity index) and equal to the QUICKI (quantitative insulin sensitivity check index) and HOMA-IR (homeostasis model assessment-insulin resistance) when calculated with M-values. CONCLUSIONS: The SPISE seems well suited to surrogate whole-body insulin sensitivity from inexpensive fasting single-point blood draw and BMI in white adolescents and adults. © 2016 American Association for Clinical Chemistry.0."
}