Assessment of insulin sensitivity based on a fasting blood sample in men with liver cirrhosis before and after liver transplantation.
BACKGROUND
Insulin resistance is a key factor in the pathogenesis of hepatogenous diabetes and influences the prognosis of chronic liver diseases. In vivo assessment of insulin resistance in humans is expensive; therefore, surrogate indices based on a fasting plasma glucose and insulin concentrations (HOMA-IS, QUICKI) were proposed. This study aimed to test whether these simple indices are reliable measures of insulin sensitivity in patients with liver cirrhosis before and after liver transplantation (LTx).


METHODS
HOMA-IS and QUICKI were compared with insulin sensitivity as assessed with the gold standard technique (insulin clamp) in 20 patients with liver cirrhosis, in 36 patients after LTx, and in 25 matched healthy subjects (predominantly men). To test whether these indices may be applied also in prospective studies, 10 patients with liver cirrhosis were studied longitudinally before and 2 years after LTx.


RESULTS
Both HOMA-IS and QUICKI were associated with insulin sensitivity in patients with liver cirrhosis (r=0.63, P=0.005 and r=0.60, P=0.009) and in LTx patients (r=0.41, P=0.02 and r=0.46, P=0.05). Both were able to detect the improvement of insulin sensitivity after LTx in the patients studied prospectively.


CONCLUSIONS
HOMA-IS and QUICKI are simple reliable tools to assess insulin sensitivity in clinical and epidemiologic investigations of chronic liver disease before and after LTx.
Perseghin
Gianluca
G
Nutrition/Metabolism, Istituto Scientifico H San Raffaele, Milan, Italy. perseghin.gianluca@hsr.it.
Caumo
Andrea
A
Mazzaferro
Vincenzo
V
Pulvirenti
Andrea
A
Piceni Sereni
Lucia
L
Romito
Raffaele
R
Lattuada
Guido
G
Coppa
Jorgelina
J
Costantino
Federica
F
Regalia
Enrico
E
Luzi
Livio
L
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008103:Liver Cirrhosis / Q000378:metabolism* / Q000601:surgery*; D016031:Liver Transplantation; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose