Surrogate markers and predictors of insulin resistance in Nigeria patients with Type 2 diabetes mellitus: A cross sectional study

Background: This study set out to identify and compare surrogate markers of insulin resistance (IR) in males and females and compare the prevalence of IR using different surrogate markers. Methods: The study was an analytical cross-sectional hospital-based study among Nigerians with Type 2 diabetes mellitus (T2DM). A total of 234 (131 T2DM and 103 healthy) persons were invited to participate in the study. One hundred and ninety-nine persons completed the study. The following anthropometric measurements were taken (height [m], weight [kg], waist circumference [cm], and hip circumference [cm]). IR score (IRS) was derived using these six measurements: fasting basal insulin, fasting C-peptide, glucose-insulin ratio, quantitative insulin sensitivity check index, homeostasis model assessment (HOMA-IR), HOMA-c-peptide. Results: Using an IRS of >11 as criteria for IR, 52 (41.6%) of T2DM, and 21 (28.4%) of the control group were found to have IR. Forty-five percent of the DM females and 36.4% of DM males had IR, respectively, whereas 31.8% of the control females and 23.3% of control males had IR, respectively. Visceral Adiposity Index (VAI) had the best predictive value with the highest area under the receiver operating characteristic curve (0.648). Conclusion: The prevalence of IR is nonsignificantly higher in females than males. VAI is the best surrogate marker to predict the presence of IR among the male study participants, while waist circumference is the best surrogate marker to predict the presence of IR among the female study participants.