title: Utility of a surrogate measure of insulin resistance in American Indians: the Strong Heart Study.
abstract: OBJECTIVE
  1) Determine in a sample of American Indians (AI) how well insulin sensitivity (SI) measured by the frequently sampled intravenous glucose test (FSIGT) correlates with a simpler measure of insulin resistance (IR) measured by the homeostasis assessment (HOMA) model; (2) compare insulin sensitivity in a sample of diabetic and non-diabetic Al in the Strong Heart Study (SHS) with that of White, Black, and Hispanic Americans in the Insulin Resistance Atherosclerosis Study (IRAS).
  
  
  METHODS
  Cross sectional
  
  
  METHODS
  Community
  
  
  METHODS
  Sixty-one Al participants in SHS MAIN OUTCOME MEASURES: Mean SI measured by FSIGT, a complex protocol to evaluate insulin sensitivity, and mean IR measured by the HOMA model, a method based on measures of fasting glucose and fasting insulin.
  
  
  RESULTS
  Although 70% of sample participants were non-diabetic, only 18% were insulin sensitive by SI. Diabetes status strongly confounded Si among Al in SHS. At non-diabetic levels of fasting glucose (< 126 mg/dL), SI correlated well with HOMA IR (rho = -0.49, P = .0009), but SI did not reflect HOMA IR at levels of fasting glucose that are diagnostic of diabetes (> or = 126 mg/dL; rho = -0.13, P = n.s.). With the exception of some Hispanic participants in IRAS, mean SI of non-diabetic Al in SHS was lower than that of their non-diabetic IRAS counterparts. Diabetic Al participants in SHS had markedly lower mean SI than all diabetic participants in IRAS.
  
  
  CONCLUSIONS
  The HOMA model may be a useful tool to identify non-diabetic American Indians who might benefit from early CVD risk factor modification.
authors.affiliation: MedStar Research Institute, Washington, DC, USA. helaine.e.resnick@medstar.net
authors.forename: Helaine E
authors.initials: HE
authors.lastname: Resnick
authors.forename: Richard N
authors.initials: RN
authors.lastname: Bergman
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Henderson
authors.forename: Patricia
authors.initials: P
authors.lastname: Nez-Henderson
authors.forename: Barbara V
authors.initials: BV
authors.lastname: Howard
mesh_terms: D002318:Cardiovascular Diseases / Q000208:ethnology* / Q000209:etiology / Q000517:prevention & control; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000208:ethnology* / Q000378:metabolism*; D005260:Female; D005947:Glucose; D005951:Glucose Tolerance Test; D006801:Humans; D007198:Indians, North American; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D015205:Northwestern United States / Q000453:epidemiology; D015206:Southwestern United States / Q000453:epidemiology
chemical_list: D005947:Glucose