Welcome, guest.
Login or Sign up to edit.

Add an entry



Add a finding for this diagnosis

Add prevalence for this diagnosis

Switch to calculator mode to see positive predictive value

Switch to likelihood ratios

Sort findings by Accuracy

Sort findings by Differential Diagnosis

Jump To

Physical Exam


Insulin Resistance: Sensitivity and Specificity

Introduction: As opposed to overt Diabetes. Insulin resistance is a component of the metabolic syndrome, along with hypertension, obesity, and dyslipidemia.

Gold standard is euglycemic hyperinsulinemic clamp, where a constant insulin infusion is given and a separate glucose infusion is titrated to euglycemia. The lower the amount of glucose needed, the more insulin resistant a person is.

[Edit Diagnosis] [Merge dx] [Add prevalence]

Tags: Endocrine Tag this Diagnosis.

The sensitivity and specificity of findings for Insulin Resistance are listed below. See the left navigation bar to change the display.

Physical Exam

Finding SensitivitySpecificity Comments, Study
Acanthosis Nigricans Edit 50%83%

According to this paper the diagnostic effect of AN is superceded by increased body fat density as measured by DXA.

Study: J Pediatr. 2001 Apr;138(4):474-80 PMID: 11295708


Finding SensitivitySpecificity Comments, Study
ATP III Criteria Edit 52%85%

>= 3 of the following criteria:

  • waist circumference greater than 102 cm in men and greater than 88 cm in women
  • serum triglyceride concentration of 1.69 mmol/L (150 mg/dL) or more
  • serum HDL cholesterol concentration less than 1.03 mmol/L (40 mg/dL) in men and less than 1.29 mmol/L (50 mg/dL) in women, blood pressure of 130/85 mm Hg or greater or therapy with antihypertensive medication
  • fasting plasma glucose level of 6.11 mmol/L (110 mg/dL) or greater.
  • "Since we did not measure waist circumference for most of our participants, we substituted a BMI of 25 kg/m2 or greater for women and 29 kg/m2 or greater for men, values that provided the same prevalence of the metabolic syndrome in the third National Health and Nutrition Examination Survey as did use of waist circumference (Ford E. Personal communication)."

    Study: Ann Intern Med. 2003 Nov 18;139(10):802-9. PMID: 14623617

    Body Mass Index Edit 56%76%

    >=29.3 kg/m2

    Study: Diabetes Care. 2001 Mar;24(3):460-4. PMID: 11289468

    Elevated Triglycerides Edit 67%71%

    >= 130mg/dl

    Study: Ann Intern Med. 2003 Nov 18;139(10):802-9. PMID: 14623617

    Fasting Insulin Edit 57%85%

    >=15 mcU/ml

    Similar results in a separate paper with a cutoff of 12.2mU/l.

    Study: Ann Intern Med. 2003 Nov 18;139(10):802-9. PMID: 14623617

    alt: Diabetes Care. 2001 Mar;24(3):460-4. PMID: 11289468

    Triglyceride to HDL Ratio Edit 64%68%

    >= 1.8

    Study: Ann Intern Med. 2003 Nov 18;139(10):802-9. PMID: 14623617