Triglycerides and glycated hemoglobin for screening insulin resistance in obese patients

Guilaine Boursier (1, 2) , Ariane Sultan (1, 2) , Nicolas Molinari (3) , Laurent Maïmoun (1, 2) , Catherine Boegner , Marion Picandet , Nils Kuster (1, 2) , Anne-Sophie Bargnoux (1, 2) , Stéphanie Badiou (1, 2) , Anne-Marie Dupuy (4, 2) , Jean-Paul Cristol (1, 2) , Antoine Avignon (2, 1)

1 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
2 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
3 MISTEA - Mathématiques, Informatique et STatistique pour l'Environnement et l'Agronomie
4 PSNREC - Neuropsychiatrie : recherche épidémiologique et clinique

Objective: Assessment of insulin resistance (IR) is essential in non-diabetic patients with obesity. Thus study aims to identify the best determinants of IR and to propose an original approach for routine assessment of IR in obesity. Design and patients: All adult with obesity defined by a body mass index >= 30 kg/m(2), evaluated in the Nutrition Department between January 2010 and January 2015 were included in this cross-sectional study. Patients with diabetes were excluded. IR was diagnosed according to the HOMA-IR. Based on a logistic regression, we determined a composite score of IR. We then tested the variables with a principal component analysis and a hierarchical clustering analysis. Results: A total of 498 patients with obesity were included. IR was associated with grade III obesity (OR = 2.6[1.6-4.4], p < 0.001), HbA1c >= 5.7% (OR = 2.6[ 1.7-4.0], p < 0.001), hypertriglyceridemia > 1.7 mmol/l (OR = 3.0[ 2.0-4.5], p < 0.001) and age (OR = 0.98[ 0.96-0.99], p = 0.002). Exploratory visual analysis using factor map and clustering analysis revealed that lipid and carbohydrates metabolism abnormalities were correlated with insulin resistance but not with excessive fat accumulation and low-grade inflammation. Conclusions: Our results highlight the interest of simple blood tests such as HbA1c and triglyceride determination, which associated with BMI, may be widely available tools for screening IR in obese patients.

Mots clés: Glycated hemoglobin; Insulin resistance; Triglycerides; Dyslipidemias; Lipids; Obesity

Domaines: Médecine humaine et pathologie

Guilaine Boursier, Ariane Sultan, Nicolas Molinari, Laurent Maïmoun, Catherine Boegner, et al.. Triglycerides and glycated hemoglobin for screening insulin resistance in obese patients. Clinical Biochemistry, 2017, 53, pp.8-12. ⟨10.1016/j.clinbiochem.2017.12.002⟩. ⟨hal-01723736⟩