Modified quantitative insulin sensitivity check index is better correlated to hyperinsulinemic glucose clamp than other fasting-based index of insulin sensitivity in different insulin-resistant states.
Fasting-based index estimates of insulin sensitivity were compared with euglycemic hyperinsulinemic clamp (IS clamp) measurements in 148 subjects: normal controls (n = 46), and obese (n = 12), polycystic ovary syndrome (n = 16), first-degree relatives of type 2 diabetic (n = 17), impaired glucose tolerance (n = 28), and type 2 diabetic (n = 29) patients. The fasting-based indexes tested included log homeostasis model assessment (HOMA), the quantitative insulin sensitivity check index (QUICKI), the revised QUICKI, and a new revised QUICKI using fasting plasma glycerol. In the population studied, at 40 mU/m(2).min (n = 30) revised QUICKI (r = 0.86; P < 0.0001) and QUICKI-glycerol (r = 0.87; P < 0.0001) gave higher correlations with the IS clamp than QUICKI and log HOMA (r = 0.78 and r = -0.78; P < 0.001). For subjects tested at 75 mU/m(2).min (n = 118), comparable correlations were found for all indexes (r > 0.80; P < 0.0001). When studied in subgroups, revised QUICKI and QUICKI-glycerol give significantly higher correlations with the IS clamp than other indexes for lean control subjects studied at 40mU/m(2).min and impaired glucose tolerance subjects. We confirmed, in a large patient population with a wide range of insulin sensitivities, that no single test is superior in all groups of patients. However, QUICKI and revised QUICKI are good indexes that offer correlations similar to or higher than values obtained with log HOMA. Such indexes are simple tools to estimate insulin sensitivity appropriate for epidemiological studies.
Rabasa-Lhoret
Rémi
R
Human Nutrition Research Centre of Lyon, Hôpital Edouard-Herriot, Lyon 69003, France. remi.rabasalhoret@umontreal.ca
Bastard
Jean-Philippe
JP
Jan
Véronique
V
Ducluzeau
Pierre-Henri
PH
Andreelli
Fabrizio
F
Guebre
Fitsum
F
Bruzeau
Joëlle
J
Louche-Pellissier
Corinne
C
MaItrepierre
Christine
C
Peyrat
Jocelyne
J
Chagné
Jérôme
J
Vidal
Hubert
H
Laville
Martine
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis; D005215:Fasting; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D015309:Glucose Clamp Technique / Q000379:methods*; D018149:Glucose Intolerance / Q000175:diagnosis*; D005990:Glycerol / Q000097:blood; D006801:Humans; D006946:Hyperinsulinism; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity
D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D005990:Glycerol