Strategy to establish a cut-off point for hyperinsulinemia

Autores: Loría Alvar, Arroyo Acevedo Pedro, Fernández Victoria, Laviada Molina Hugo A

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The Fasting Plasma Insulin (FPI) is often used in clinical medicine to classify subjects in a binary categorization of normal versus hyperinsulinemic patients. The cut-off point for hyperinsulinemia in the literature is variable and has led to the proposal that each laboratory should establish its own cut-off point. Or as proposed by WHO, to use an arbitrary percentile value of the FPI distribution as a cut-off point. We offer here a strategy that could prove useful to others, to establish hyperinsulinemia in a population group. To illustrate the procedure we shall use insulin values seen in 443 adults (253 women, 190 men) living in the Mexican State of Yucatan. Some subjects (N = 183) were urbanites living in the State Capital of Merida, and others (N = 260) were rural subjects living in two small communities (Uci and San Rafael with populations < 12 hundred). Blood pressure, height and weight, and circumferences of waist and hip were measured at the time of blood sampling. The blood was collected in vaccum tubes containing sodium fluoride to prevent glycolisis, and stored on ice during its transportation to the laboratory of the Hospital O‘Horan in Merida run by personnel of the University of Yucatan. The urban samples were delivered to the laboratory 1-3 hours after sampling whereas the rural ones took 3-5 hours. Upon arrival, plasma was separated, refrig-erated, and the biochemical assays (FPI = fasting plasma insulin, FPG = fasting plasma glucose, cholesterol, triglycerides, LDL and HDL) were per-formed on the following day in an automated analyzer (Boehringer Mannheim, Germany). Two indices (BMI = body mass index and WHR = waist to hip ratio) were calculated with the anthropometric data. The personnel that measured blood pressure and anthropometry had been trained and standardized by us prior to the start of the study. The Ethics Committe of the O‘Horan Hospital approved the study and written consent was obtained from the urban subjects and from the municipal authorities of the rural communities.

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2010-07-20   |   1,316 visitas   |   Evalua este artículo 0 valoraciones

Vol. 62 Núm.3. Mayo-Junio 2010 Pags. 276-278 Rev Invest Clin 2010; 62(3)