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. 2008 May;31(5):977-9.
doi: 10.2337/dc07-2194. Epub 2008 Feb 25.

Plasma adiponectin as a marker of insulin receptor dysfunction: clinical utility in severe insulin resistance

Robert K Semple  1 , Elaine K Cochran, Maria A Soos, Keith A Burling, David B Savage, Phillip Gorden, Stephen O'Rahilly
Affiliations

Plasma adiponectin as a marker of insulin receptor dysfunction: clinical utility in severe insulin resistance

Robert K Semple et al. Diabetes Care. 2008 May.

Abstract

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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