The ratio of adiponectin to homeostasis model assessment of insulin resistance is a powerful index of each component of metabolic syndrome in an aged Japanese population: Results from the KING Study

Abstract

We evaluated the ratio of adiponectin level to homeostasis model assessment of insulin resistance (A/H ratio) as a risk marker for metabolic syndrome (MetS) and each of its components. The A/H ratio may prove to be a powerful index for evaluation of risk for MetS and each of its components.

Introduction

Metabolic syndrome (MetS) is characterized by a clustering of metabolic abnormalities, including central obesity, insulin resistance (IR), dyslipidemia, and hypertension, and it has been identified as a common precursor to the development of cardiovascular disease [1]. The prevalence of MetS is increasing in Japan as a result of changes in diet and physical activity during recent decades [2]. There is therefore an urgent need to establish an appropriate and sensitive screening marker to identify individuals at high risk for the development of MetS and thereby to prevent a further increase in its incidence.

Insulin resistance with compensatory hyperinsulinemia is thought to play a prominent role in MetS [3]. Adiponectin is thought to contribute to the regulation of insulin sensitivity [4], [5]. Homeostasis model assessment (HOMA) provides a useful index of IR in epidemiological studies [6], [7]. Adiponectin and HOMA thus represent two different aspects of IR with opposite relations to this condition. The combination of these two markers in the form of the ratio of the serum adiponectin concentration to HOMA-IR (A/H ratio) would potentiate this difference and might therefore be expected to be more sensitive than either parameter alone for evaluation of MetS risk. We have now examined this hypothesis in a population-based cross-sectional study of aged Japanese.