Validation of surrogate estimates of insulin sensitivity and insulin secretion in children and adolescents.
OBJECTIVE
To compare insulin sensitivity and pancreatic beta-cell function measured by the euglycemic and the hyperglycemic clamp, with simple estimates of insulin sensitivity and pancreatic beta-cell function in youth. Study design We measured insulin sensitivity with a euglycemic clamp and first- and second-phase insulin secretion with a hyperglycemic clamp in 156 AA and white youths. Estimates of insulin sensitivity (fasting insulin level [I(F)], the ratio of fasting glucose [G(F)] to I(F) [G(F)/I(F)], homeostasis model assessment estimate of insulin sensitivity [HOMA IS], and quantitative insulin sensitivity check index [QUICKI]) and estimates of pancreatic beta-cell function (I(F), the ratio of I(F) to G(F) [I(F)/G(F)], and homeostasis model assessment estimate of pancreatic beta-cell function [HOMA %B]) were derived from fasting measurements.


RESULTS
In the total group, IS(Eu) correlated strongly with I(F) (r=-0.92), G(F)/I(F) (r=0.92), HOMA IS (r=0.91), and QUICKI (r=0.91) (P<.01). First-phase and second-phase insulin secretion correlated with I(F), I(F)/G(F), and HOMA %B (first-phase insulin secretion: r=0.76, 0.79, 0.82; second-phase insulin secretion: r=0.83, 0.86, 0.86, respectively; P<.01).


CONCLUSIONS
Simple estimates of insulin sensitivity and pancreatic beta-cell function using fasting insulin and glucose levels serve as surrogate measures of insulin sensitivity and secretion in nondiabetic youths. The validity of these conclusions in children with impaired glucose tolerance and type 2 diabetes mellitus remains to be determined.
Gungor
Neslihan
N
Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children's Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
Saad
Rola
R
Janosky
Janine
J
Arslanian
Silva
S
D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D002648:Child; D005215:Fasting; D005260:Female; D015309:Glucose Clamp Technique; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance / Q000502:physiology*; D007515:Islets of Langerhans / Q000502:physiology; D016014:Linear Models; D008297:Male; D009765:Obesity / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000097:blood; D015203:Reproducibility of Results
D001786:Blood Glucose; D007328:Insulin