title: Neither homeostasis model assessment nor quantitative insulin sensitivity check index can predict insulin resistance in elderly patients with poorly controlled type 2 diabetes mellitus.
abstract: To clarify whether homeostasis model assessment (HOMA IR) and quantitative insulin sensitivity check index (QUICKI) may be indicators of insulin resistance in elderly patients with type 2 diabetes mellitus, their relationship with the glucose infusion rate during the euglycemic hyperinsulinemic clamp study (clamp IR) was assessed. This study comprised 56 Japanese patients with type 2 diabetes mellitus; of these, 28 were 70 yr of age or older (group 1) and 28 were less than 70 yr of age (group 2). Their blood sugars were in poor control (fasting plasma glucose levels: group 1, 9.0 +/- 2.6 mmol/liter; group 2, 8.9 +/- 2.3 mmol/liter; hemoglobin A1c: group 1, 9.5 +/- 2.0%; group 2, 9.2 +/- 1.7%). Log-transformed HOMA IR was significantly correlated with the clamp IR in group 2 patients (r = -0.51, P < 0.01), but not in group 1 patients (r = -0.28, P = 0.15). There was a significant positive correlation between QUICKI and clamp IR in group 2 patients (r = 0.50, P < 0.01). However, no significant correlation was observed between QUICKI and clamp IR in group 1 patients (r = 0.31, P = 0.12). There was a significant correlation between log-transformed HOMA IR (r = -0.37, P < 0.01) or QUICKI (r = 0.37, P < 0.01) and clamp IR when both groups were combined. In conclusion, neither HOMA IR nor QUICKI should be used as an index of insulin resistance in elderly patients with poorly controlled type 2 diabetes mellitus. The results of this study suggest the need for developing a new noninvasive method for evaluating insulin resistance in those patients.
authors.affiliation: Third Department of Internal Medicine, Mie University School of Medicine, 2-174 Edobashi, Tsu, 514-8507 Mie, Japan. katuki-a@clin.medic.mie-u.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Katsuki
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Sumida
authors.forename: Hideki
authors.initials: H
authors.lastname: Urakawa
authors.forename: Esteban C
authors.initials: EC
authors.lastname: Gabazza
authors.forename: Shuichi
authors.initials: S
authors.lastname: Murashima
authors.forename: Kohei
authors.initials: K
authors.lastname: Morioka
authors.forename: Nagako
authors.initials: N
authors.lastname: Kitagawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanaka
authors.forename: Rika
authors.initials: R
authors.lastname: Araki-Sasaki
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Hori
authors.forename: Kaname
authors.initials: K
authors.lastname: Nakatani
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yano
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Adachi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000628:therapy; D005260:Female; D015309:Glucose Clamp Technique; D006442:Glycated Hemoglobin / Q000032:analysis; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood / Q000494:pharmacology*; D007333:Insulin Resistance; D008297:Male; D008954:Models, Biological
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin