Plasma Adiponectin as a Marker of Insulin Receptor Dysfunction : Clinical utility in severe insulin resistance  

Oleh:

Semple, Robert K. ; Cochran, Elaine K. ; Soos, Maria A. ; Burling, Keith A.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Diabetes Care vol. 31 no. 05 (May 2008), page 977-979.
Topik: Plasma Adiponectin; insulin resistance

Ketersediaan

Perpustakaan FK Nomor Panggil: D05.K.2008.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

Lihat Detail Induk

Isi artikel

OBJECTIVE—Severe insulin resistance is associated with high morbidity. Identification of severely insulin-resistant patients who have genetic or acquired insulin receptor dysfunction may aid therapeutic decision making; however, onerous diagnostic tests allied to a low frequency of insulin receptor dysfunction often preclude formal diagnosis. Our previous observation of paradoxical hyperadiponectinemia in insulin receptoropathy provides a possible basis for a simpler and cheaper screening test. RESEARCH DESIGN AND METHODS—Receiver operating characteristics analysis was used to determine diagnostic thresholds for insulin receptoropathy in severe insulin resistance for adiponectin and for the insulin-regulated hepatic proteins sex hormone–binding globulin (SHBG) and IGF binding protein-1 (IGFBP-1). RESULTS—Adiponectin >7 mg/l in severe insulin resistance had a 97% positive predictive value for insulin receptoropathy and <5 mg/l a 97% negative predictive value. IGFBP-1 and SHBG had lesser, though still significant, utility. CONCLUSIONS—Use of these markers is likely to have significant value in accelerating the diagnosis of insulin receptoropathies.

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