ArticleJournal of clinical medicine2023
Indirect Insulin Resistance Indices and Their Cut-Off Values for the Prediction of Post-Transplantation Diabetes Mellitus in Kidney Transplant Recipients.
Article in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 4 citations in OpenAlex.
- Article
- Bayesian Youden index for algorithmic evaluation under class imbalance: mathematical foundations with applications to insulin resistance and diabetes progression.Frontiers in epidemiology · 2026Article
- Triglyceride-glucose index and risk of renal function decline and death-censored renal allograft loss in kidney transplant recipients.Kidney research and clinical practice · 2025Article
- Diabetes Mellitus in Kidney Transplant Recipients: New Horizons in Treatment.Journal of clinical medicine · 2025Review
- "Effect of post-kidney transplant diabetes mellitus on long-term outcomes in a cohort of pediatric kidney transplant recipients from 2005 to 2022." Survival analysis.BMJ paediatrics open · 2024Article
- Association between insulin resistance indices and kidney stones: results from the 2015-2018 National Health and Nutrition Examination Survey.Frontiers in nutrition · 2024Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundInsulin resistance plays an important role in the development of post-transplantation diabetes mellitus (PTDM) in kidney transplant recipients (KTRs). Current methods for the direct determination of insulin resistance are complicated and invasive. Therefore, this study aimed to investigate the relevance of indirect insulin resistance indices in relation to the development of PTDM in KTRs.
methodsWe included 472 stable outpatient KTRs without diabetes at baseline from a prospective cohort study. Four indirect insulin resistance indices, namely homeostasis model assessment-insulin resistance (HOMA-IR), visceral adiposity index (VAI), lipid accumulation product (LAP), and triglycerides-glucose (TyG) index, were assessed. We analyzed each measure using the receiver operating characteristic (ROC) curve for PTDM development. The optimal cut-off value for each parameter was determined using the Youden index.
resultsAfter a median of 9.6 years (interquartile range (IQR) 6.6-10.2) of follow-up, 68 (14%) KTRs developed PTDM. In Cox regression analyses, all indirect insulin resistance indices associated with incident PTDM were independent of potential confounders. ROC curve was 0.764 (95% CI, 0.703-0.826) for HOMA-IR, 0.685 (95% CI, 0.615-0.757) for VAI, 0.743 (95% CI, 0.678-0.808) for LAP, and 0.698 (95% CI, 0.629-0.766) for TyG index, with respective optimal cut-off values of 2.47, 4.01, 87.0, and 4.94.
conclusionsIndirect insulin resistance indices can be used to predict incident PTDM in KTRs. In addition to HOMA-IR, insulin-free surrogates of insulin resistance might serve as useful methods to identify KTRs at risk of PTDM, thus obviating the necessity to measure insulin.
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