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. 2019 Aug 10;9(8):e028652.
doi: 10.1136/bmjopen-2018-028652.

Association between normal triglyceride and insulin resistance in US adults without other risk factors: a cross-sectional study from the US National Health and Nutrition Examination Survey, 2007-2014

Chunli Bi  1 , Lijuan Wang  2 , Chong Sun  1 , Mengzi Sun  1 , Pingping Zheng  1 , Zhiqiang Xue  1 , Li Shen  1 , Pan Pan  1 , Jiagen Li  1 , Yaogai Lv  1 , Anning Zhang  1 , Bo Li  1 , Xinyao Zhang  3 , Yan Yao  4 , Lina Jin  4
Affiliations

Association between normal triglyceride and insulin resistance in US adults without other risk factors: a cross-sectional study from the US National Health and Nutrition Examination Survey, 2007-2014

Chunli Bi et al. BMJ Open. .

Abstract

Objective: Traditionally, the absence of insulin resistance risk factors (IRRFs) was considered a low risk for insulin resistance (IR). However, IR also existed in certain individuals without IRRFs; thus this study aims to explore predictors of IR targeted at the population without IRRFs.

Design: Cross-sectional survey.

Setting: National Health and Nutrition Examination Survey.

Participants: Participants without regular IRRFs (IRRF-Free, n=2478) and a subgroup without optimal IRRFs (IRRF-Optimal, n=1414) were involved in this study.

Primary and secondary outcome measure: IRRFs and the optimal cut-off value of triglyceride (TG) to predict IR.

Results: Overall, the prevalence of IR was 6.9% and 5.7% in the IRRF-Free group and the IRRF-Optimal group, respectively. TG and waist circumference were independently associated with the prevalence of IR in both the groups (OR=1.010 to 10.20; p<0.05 for all), where TG was positively associated with IR. The area under the receiver operating characteristic curve of TG was 0.7016 (95% CI: 0.7013 to 0.7018) and 0.7219 (95% CI: 0.7215 to 0.7222), and the optimal cut-off value of TG to predict IR was 79.5 mg/dL and 81.5 mg/dL in the IRRF-Free group and the IRRF-Optimal group, respectively.

Conclusion: There is an association between TG and IR even in the normal range of TG concentration. Therefore, normal TG could be used as an important indicator to predict the prevalence of IR in the absence of IRRFs.

Keywords: NHANES; ROC curve; insulin resistance; risk factors; triglyceride.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Study design and participant flow diagram for the present study. IRRF, insulin resistance risk factor; NHANES, National Health and Nutrition Examination Survey.
Figure 2
Figure 2
Relation between TG and IR in IRRF-Free and IRRF-Optimal groups. IR, insulin resistance; IRRF, IR risk factor; TG, triglyceride.
Figure 3
Figure 3
Area under ROC curves of triglyceride to predict IR in IRRF-Free and IRRF-Optimal groups. IR, insulin resistance; IRRF, IR risk factor; ROC, receiver operating characteristic.
See this image and copyright information in PMC

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