Table 3—

Effect of adding CRP or ALT to models testing the association of metabolic risk definitions with directly measured insulin sensitivity

ModelIndependent variablePrevalence (%)OR (95% CI)P valueAROC
Individual components
    1Elevated waist circumference31.16.13 (4.44–8.45)<0.00010.74
    2Elevated triglyceride30.61.68 (1.23–2.25)0.00040.61
    3Low HDL50.52.60 (1.97–3.44)<0.00010.66
    4Elevated blood pressure46.52.37 (1.78–3.14)<0.00010.65
    5IFG15.02.23 (1.69–2.94)<0.00010.64
    6CRP >3 mg/l29.82.49 (1.84–3.36)<0.00010.65
    7ALT (upper quartile)26.53.00 (2.19–4.12)<0.00010.66
Waist and ALT
    8Elevated waist circumference5.73 (4.14–7.95)<0.0001
ALT (upper quartile)2.64 (1.88–3.70)<0.00010.76*
Hypertriglyceridemic waist models
    9Hypertriglyceridemic waist17.92.73 (1.94–3.84)<0.00010.64
    10Hypertriglyceridemic waist2.56 (1.80–3.63)<0.0001
CRP >3 mg/l2.37 (1.74–3.21)<0.00010.68
    11Hypertriglyceridemic waist2.55 (1.79–3.62)<0.0001
ALT (upper quartile)2.88 (2.08–3.97)<0.00010.68††
    12Hypertriglyceridemic waist2.37 (1.65–3.39)<0.0001
CRP >3 mg/l2.42 (1.77–3.31)<0.0001
ALT (upper quartile)2.94 (2.12–4.09)<0.00010.72†††
EWET models
    13EWET23.14.61 (3.32–6.41)<0.00010.69
    14EWET4.15 (2.97–5.80)<0.0001
CRP >3 mg/l2.09 (1.52–2.86)<0.00010.72
    15EWET4.27 (3.05–5.97)<0.0001
ALT (upper quartile)2.71 (1.95–3.78)<0.00010.72‡‡
    16EWET2.15 (1.56–2.96)<0.0001
CRP >3 mg/l2.77 (1.98–3.88)<0.0001
ALT (upper quartile)3.80 (2.70–5.35)<0.00010.74‡‡‡
TG-to-HDL ratio models
    17TG/HDL (≥3)40.72.44 (1.84–3.23)<0.00010.65
    18TG/HDL (≥3)2.37 (1.78–3.16)<0.0001
CRP >3 mg/l2.45 (1.80–3.33)<0.00010.69§
    19TG/HDL (≥3)2.29 (1.72–3.05)<0.0001
ALT (upper quartile)2.83 (2.05–3.91)<0.00010.69§§
    20TG/HDL (≥3)2.22 (1.66–2.98)<0.0001
CRP >3 mg/l2.51 (1.84–3.44)<0.0001
ALT (upper quartile)2.90 (2.08–4.03)<0.00010.72§§§
HOMA-IR models
    21HOMA-IR (upper quartile)32.711.72 (8.45–16.23)<0.00010.79
    22HOMA-IR (upper quartile)11.01 (7.92–15.30)<0.0001
CRP >3 mg/l1.99 (1.40–2.82)0.00010.81
    23HOMA-IR (upper quartile)10.46 (7.51–14.58)<0.0001
ALT (upper quartile)1.84 (1.27–2.66)0.00130.79¶¶
    24HOMA-IR (upper quartile)9.75 (6.98–13.63)<0.0001
CRP >3 mg/l2.04 (1.44–2.90)<0.0001
ALT (upper quartile)1.90 (1.31–2.77)0.00080.81¶¶¶
Metabolic syndrome models
    25NCEP metabolic syndrome26.84.44 (3.25–6.07)<0.00010.70
    26NCEP metabolic syndrome3.99 (2.90–5.48)<0.0001
CRP >3 mg/l2.04 (1.48–2.79)<0.00010.72#
    27NCEP metabolic syndrome4.01 (2.91–5.51)<0.0001
ALT (upper quartile)2.55 (1.83–3.56)<0.00010.73##
    28NCEP metabolic syndrome3.56 (2.57–4.93)<0.0001
CRP >3 mg/l2.11 (1.53–2.91)<0.0001
ALT (upper quartile)2.62 (1.87–3.67)<0.00010.75###
    29NCEP metabolic syndrome2.01 (1.38–2.91)0.0002
CRP >3 mg/l1.87 (1.31–2.67)0.0006
HOMA-IR (upper quartile)8.17 (5.78–11.54)<0.0001
ALT (upper quartile)1.80 (1.23–2.64)0.00240.82####
  • Logistic regression models were adjusted for age, sex, and ethnicity; rows 1–5 are NCEP-defined traits. The dependent variable is the lowest quartile of Si measured by an FSIVGTT. Models 8, 10–12, 14–16, 18–20, 22–24, and 26–29 show multivariate results with ORs for risk definitions adjusted for other variables in the model. Independent variables are elevated waist (waist circumference >102 cm [men] or >88 cm [women]), elevated triglyceride level (triglycerides ≥150 mg/dl), low HDL (HDL cholesterol <40 mg/dl [men] or <50 mg/dl [women]), elevated blood pressure (blood pressure ≥130/≥85 mmHg), IFG (fasting glucose ≥110 mg/dl), ALT (upper quartile [≥23 units/l]), hypertriglyceridemic waist (waist circumference ≥90 cm [men] or ≥80 cm [women] and triglycerides ≥175 mg/dl), EWET, (waist circumference ≥95 cm [men] or ≥88 cm [women] and triglycerides ≥128 mg/dl); HOMA [(insulin × glucose [millimoles per liter])/22.5, with elevated HOMA ≥4.02], and NCEP metabolic syndrome (≥3 of the disorders listed in the first 5 rows of this table). P values for AROC comparisons:

  • *

    * Adding ALT to waist circumference, P = 0.01;

  • Adding CRP to hypertriglyceridemic waist, P = 0.001;

  • ††

    †† Adding ALT to hypertriglyceridemic waist, P = 0.003;

  • †††

    ††† Adding CRP and ALT to hypertriglyceridemic waist, P < 0.0001;

  • Adding CRP to EWET, P = 0.002;

  • ‡‡

    ‡‡ Adding ALT to EWET, P = 0.01;

  • ‡‡‡

    ‡‡‡ Adding CRP and ALT to EWET, P < 0.0001;

  • §

    § Adding CRP to elevated triglycerides-to-HDL (Tg/HDL) ratio, P = 0.004;

  • §§

    §§ Adding ALT to elevated triglycerides-to-HDL ratio, P = 0.005;

  • §§§

    §§§ Adding CRP and ALT to elevated triglycerides-to-HDL ratio, P < 0.0001;

  • Adding CRP to HOMA-IR, P = 0.02;

  • ¶¶

    ¶¶ Adding ALT to HOMA-IR, P = 0.21;

  • ¶¶¶

    ¶¶¶ Adding CRP and ALT to HOMA-IR, P = 0.004;

  • #

    # Adding CRP to NCEP metabolic syndrome, P = 0.03;

  • ##

    ## Adding ALT to NCEP metabolic syndrome, P = 0.005;

  • ###

    ### Adding CRP and ALT to NCEP metabolic syndrome, P < 0.0001;

  • ####

    #### Adding CRP, ALT, and HOMA-IR to NCEP metabolic syndrome, P < 0.0001.