Evaluation of routine laboratory markers for identifying insulin resistance in normal-weight adults
DOI:
https://doi.org/10.55629/pakjpathol.v37i2.1043Abstract
Objective: To determine the frequency of insulin resistance in normal-weight adults and evaluate the ability of routine laboratory markers to identify insulin resistance.
Material and Methods: This Cross-sectional analytical study was conducted at the Department of Pathology, Quaid-e-Azam Medical College, Bahawalpur, from June to December 2025. Adults aged 18–60 years with BMI 18.5–24.9 kg/m² were included. Fasting glucose, insulin, HbA1c, triglycerides, HDL-C, ALT, AST and uric acid were measured. HOMA-IR, triglyceride-glucose (TyG) index and TG/HDL-C ratio were calculated. Insulin resistance was defined as HOMA-IR ≥2.5. Receiver operating characteristic analysis assessed discrimination.
Results: Among 246 adults, mean age was 36.2 (SD 8.6) years and 48 (19.5%) had insulin resistance. Compared with insulin-sensitive participants, those with insulin resistance had higher BMI, fasting glucose, HbA1c, triglycerides, ALT, AST, uric acid, TyG index and TG/HDL-C ratio, with lower HDL-C. TyG had the numerically highest AUC (0.815; 95% CI 0.752–0.878), with a cutoff of 8.481 providing 83.3% sensitivity and 65.7% specificity. TG/HDL-C had an AUC of 0.805. Each one-standard-deviation increase in TyG was associated with 4.26-fold higher adjusted odds of insulin resistance.
Conclusion: Insulin resistance was present in about one fifth of normal-weight adults. TyG and TG/HDL-C may offer simple, inexpensive screening tools for identifying individuals who require closer metabolic assessment, but population-specific validation is needed before routine clinical use.
Keywords: HDL cholesterol, HOMA-IR, Insulin resistance, Normal weight, Triglyceride-glucose index, Triglycerides
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