Utility of the C-Peptide/Insulin Molar Ratio for Distinguishing Type A Insulin Resistance Syndrome From Type 2 Diabetes
Authors' conclusion
The CPR/IRI molar ratio, both at baseline and during OGTT, exhibited higher sensitivity and specificity than IRI levels alone for distinguishing type A IRS from type 2 diabetes. This ratio may serve as a reliable clinical marker for early and accurate diagnosis of type A IRS.
Study context
- Population
- Individuals with type A insulin resistance syndrome (IRS) or T2D with C-peptide reactivity (CPR) and immunoreactive insulin (IRI) measured during a 75-g oral glucose tolerance test (OGTT)
- Participants
- 18 vs 126
- Comparison
- CPR/IRI molar ratio vs IRI levels for distinguishing type A IRS from T2D
- Type A IRSn = 18
- T2Dn = 126reference
- Outcome
- Diagnostic performance (ROC analysis) of the CPR/IRI molar ratio and IRI levels for distinguishing type A IRS from T2D
Methodological detailsretrospective
- Retrospective
Performance
As reported in the abstract
CPR/IRI molar ratio diagnostic performance (AUC) · baseline, 1 h and 2 h after OGTT initiation
AUC at baseline (sensitivity 100%, specificity 99.2%)
0.997
AUC at 1 h (sensitivity 100%, specificity 97.6%)
0.999
AUC at 2 h (sensitivity 100%, specificity 95.1%)
0.997
Further findings
IRI levels and CPR/IRI molar ratio
- IRI significantly higher and CPR/IRI molar ratio significantly lower in type A IRS vs T2D
Subgroups by BMI and hyperinsulinemia severity
- CPR/IRI molar ratio showed robust diagnostic performance regardless of BMI or hyperinsulinemia severity
Original publication
Utility of the C-Peptide/Insulin Molar Ratio for Distinguishing Type A Insulin Resistance Syndrome From Type 2 Diabetes. J Clin Endocrinol Metab. Published 28 January 2025. doi:10.
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