Highlights
- •Lipoprotein Insulin Resistance Index (LP-IR) is associated with insulin resistance.
- •Elevated LP-IR levels are associated with an increased type II diabetes mellitus risk.
- •LP-IR allowed to reclassify 27% of the patients from lower to higher type II diabetes mellitus risk.
- •LP-IR score ≥ 68 improved the Framingham Offspring prediction algorithm
Background
Early assessment of insulin resistance may be a way of identifying patients at risk
as well as monitoring treatments that increase insulin sensitivity and reduce the
risk of developing type II diabetes mellitus (T2DM).
Objective
The objective of the study was to evaluate the ability of the Lipoprotein Insulin
Resistance Index (LP-IR) to predict incident T2DM in a large cohort.
Methods
LP-IR scores were calculated using 6 lipoprotein particle concentrations and sizes
measured by nuclear magnetic resonance spectroscopy. In total, 5977 nondiabetic men
and women were included. Cox proportional hazards regression was used to evaluate
the association of LP-IR scores with incident T2DM.
Results
LP-IR scores were closely associated with insulin resistance, assessed by homeostatic
model assessment of insulin resistance (r = 0.51; P < .0001). During a median follow-up for 7.5 years, 278 new T2DM cases were ascertained.
The Kaplan–Meier plot with log-rank test (P < .001) demonstrated that elevated LP-IR levels are associated with an increased
T2DM risk. In analyses adjusted for age and sex, LP-IR was associated with incident
T2DM; hazard ratio (HR) for the highest versus lowest quartile was 10.18 (95% confidence
interval: 6.24–16.61), P < .0001. After adjustment for clinical risk factors, the HR was attenuated but remained
significant (HR 3.02 [1.73–5.25], P < .0001). LP-IR scores added significantly to the performance of the Framingham Offspring
prediction algorithm; C-index (95% confidence interval) for the Framingham Offspring
score without and with LP-IR (0.863 [0.863–0.864] and 0.868 [0.867–0.86], P < .0001). Similar results were observed when LP-IR was analyzed as a categorical
variable with a clinical cut-point of 68.
Conclusion
LP-IR may be a convenient way to assess insulin resistance and T2DM risk, as well
as to monitor preventative treatments.
Keywords
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Article info
Publication history
Published online: December 01, 2018
Accepted:
November 27,
2018
Received:
August 10,
2018
Identification
Copyright
© 2018 National Lipid Association. All rights reserved.
