Fasting blood sample-based assessment of insulin sensitivity in kidney-pancreas-transplanted patients.
OBJECTIVE
To ascertain whether simple indexes of insulin sensitivity based on a fasting blood sample may be reliable measures of insulin sensitivity in combined kidney-pancreas- transplanted patients.


METHODS
Estimates of insulin sensitivity based on fasting plasma glucose, insulin (homeostasis model assessment of insulin sensitivity [HOMA-IS], Quantitative Insulin Sensitivity Check Index [QUICKI]), and free fatty acid (revised QUICKI) concentrations were compared with insulin sensitivity as assessed with the gold standard technique (euglycemic-hyperinsulinemic clamp) in 22 patients who had undergone kidney-pancreas transplantation (KP-Tx) and 18 matched healthy subjects (NOR).


RESULTS
In KP-Tx patients, indexes based on the glucose-insulin product, HOMA-IS (r = 0.47, P = 0.03) and QUICKI (r = 0.47, P = 0.03), were shown to be reliable measures of insulin sensitivity. The introduction of fasting plasma free fatty acid concentration in the revised QUICKI (r = 0.76, P < 0.0001) considerably improved the power of prediction of the clamp-based measure of insulin sensitivity as observed in the healthy control subjects (r = 0.83, P < 0.0001).


CONCLUSIONS
This study shows that in KP-Tx patients, HOMA-IS and QUICKI are reliable measures of insulin sensitivity; the additional incorporation of fasting plasma free fatty acid concentration into the glucose-insulin product (revised QUICKI) resulted in a considerably more powerful index.
Perseghin
Gianluca
G
Nutrition/Metabolism, Istituto Scientifico H San Raffaele, Milan, Italy. perseghin.gianluca@hsr.it
Caumo
Andrea
A
Sereni
Lucia Piceni
LP
Battezzati
Alberto
A
Luzi
Livio
L
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D005215:Fasting; D005260:Female; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood / Q000378:metabolism / Q000494:pharmacology*; D000078790:Insulin Secretion; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D016035:Pancreas Transplantation / Q000502:physiology*; D012016:Reference Values
D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin