Key result
SPISE yields a near-perfect 0.99 AUC for discriminating BMI-defined obesity in type 2 diabetes.
Why the study?
Non-insulin-based markers as alternatives to conventional insulin-based indices for assessing insulin sensitivity in anthropometry specified type 2 diabetes mellitus were evaluated.
Does the Single Point Insulin Sensitivity Estimator (SPISE) accurately predict insulin sensitivity and discriminate BMI-defined obesity in adults with type 2 diabetes mellitus?
Cross-Sectional (n=100)
No
Does the Single Point Insulin Sensitivity Estimator (SPISE) accurately predict insulin sensitivity and discriminate BMI-defined obesity in adults with type 2 diabetes mellitus?
Effect estimate: AUC 0.99 (95% CI 0.97-1.00)
p-value: p=<0.0001
SPISE is a highly sensitive and specific non-insulin-based marker for discriminating BMI-defined obesity in patients with type 2 diabetes, though its reliance on BMI warrants cautious interpretation.
Non-insulin markers may aid IR assessment in T2DM; hypothesis-generating and requires prospective validation before clinical adoption.
Purpose The study was aimed at the assessment of non-insulin-based markers as alternatives to the conventional insulin-based indices in anthropometry specified type 2 Diabetes mellitus. The outcome was targeted towards the utility of such indices in diabetes mellitus and associated metabolic derangements centering around insulin resistance. Methods Fasting venous blood samples were utilized for biochemical analyses. The parameters included plasma glucose, insulin, lipid profile [triglycerides, HDL cholesterol, total cholesterol and LDL cholesterol (Friedewald equation)]. Uric acid, liver enzymes, renal profile, electrolytes, and thyroid function tests were also evaluated. Appropriate statistical analysis, as deemed fit for normal and skewed data were undertaken. Results Across the BMI categories, significant differences were observed in several insulin-resistance indices. Quantitative Insulin Sensitivity Check Index (QUICKI) values were lowest in the obese group and highest in the normal-weight group ( p < 0.0001). Single Point Insulin Sensitivity Estimator (SPISE) values also showed reduction across normal, overweight, and obese groups ( p < 0.0001). The TyG index demonstrated a significant increase with rising BMI ( p = 0.0002). With reference to utility of SPISE as a predictor in anthropometry specified groups, it demonstrated a near-perfect discriminatory performance with an AUC of 0.99 (95% CI: 0.97–1.00, p < 0.0001). A cut-off value of < 5.55 yielded a sensitivity of 92.5% and specificity of 93.3%. Conclusions SPISE, independent of insulin, showed high discrimination of BMI-defined obesity in this T2DM cohort, although its performance should be interpreted cautiously because BMI is incorporated into the SPISE equation.
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K. et al. (2026) conducted a cross-sectional in Type 2 Diabetes Mellitus (n=100). Single Point Insulin Sensitivity Estimator (SPISE) vs. Normal BMI group was evaluated on Discrimination of BMI-defined obesity (AUC 0.99, 95% CI 0.97-1.00, p=<0.0001). The Single Point Insulin Sensitivity Estimator (SPISE) demonstrated near-perfect discrimination of BMI-defined obesity in adults with type 2 diabetes, yielding an AUC of 0.99.
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