Dietary insulin load and insulin index are associated with the risk of insulin resistance: a prospective approach in tehran lipid and glucose study

BACKGROUND The aim of this study was to investigate the relationship between dietary insulin load (DIL) and insulin index (DII) and the risk of insulin resistance in Tehranian adults. METHODS In this study, 927 men and women, aged 22-80 years, participated in Tehran Lipid and Glucose Study were included. Fasting serum insulin and glucose were measured at baseline and again after a 3-year of follow-up. Usual dietary intakes were measured using a validated 168 item semi-quantitative food frequency questionnaire and DIL and DII were calculated. Logistic regression models were used to estimate the occurrence of the IR across tertile categories of DIL and DII with adjustment for potential confounding variables. RESULT Mean age of participants was 40.71 ± 12.14 y, and mean body mass index (BMI) was 27.23 ± 4.9 kg/m(2), at baseline. Mean of DIL and DII was 937 ± 254 and 84.0 ± 6.3. Participants with higher DIL had higher weight and waist circumference at baseline (P < 0.05). A borderline positive association was observed between DII and the risk of insulin resistance in fully adjusted model (odds ratio = 1.66, 95 % confidence interval = 0.96-2.86, P for trend = 0.06). After adjustment of potential confounders, highest compared to the lowest tertile of DIL was also significantly associated with increased risk of insulin resistance (odds ratio = 1.69, 95 % confidence interval = 1.01-2.89, P for trend = 0.06). CONCLUSION Dietary insulin load and DII could be considered as independent dietary risk factors for development of insulin resistance.