title: Insulin sensitivity indices: a proposal of cut-off points for simple identification of insulin-resistant subjects.
abstract: Demanding measurement of insulin sensitivity using clamp methods does not simplify the identification of insulin resistant subjects in the general population. Other approaches such as fasting- or oral glucose tolerance test-derived insulin sensitivity indices were proposed and validated with the euglycemic clamp. Nevertheless, a lack of reference values for these indices prevents their wider use in epidemiological studies and clinical practice. The aim of our study was therefore to define the cut-off points of insulin resistance indices as well as the ranges of the most frequently obtained values for selected indices. A standard 75 g oral glucose tolerance test was carried out in 1156 subjects from a Caucasian rural population with no previous evidence of diabetes or other dysglycemias. Insulin resistance/sensitivity indices (HOMA-IR, HOMA-IR2, ISI Cederholm, and ISI Matsuda) were calculated. The 75th percentile value as the cut-off point to define IR corresponded with a HOMA-IR of 2.29, a HOMA-IR2 of 1.21, a 25th percentile for ISI Cederholm, and ISI Matsuda of 57 and 5.0, respectively. For the first time, the cut-off points for selected indices and their most frequently obtained values were established for groups of subjects as defined by glucose homeostasis and BMI. Thus, insulin-resistant subjects can be identified using this simple approach.
authors.affiliation: Laboratory of Human Endocrinology, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovak Republic.
authors.forename: Z
authors.initials: Z
authors.lastname: Radikova
authors.forename: J
authors.initials: J
authors.lastname: Koska
authors.forename: M
authors.initials: M
authors.lastname: Huckova
authors.forename: L
authors.initials: L
authors.lastname: Ksinantova
authors.forename: R
authors.initials: R
authors.lastname: Imrich
authors.forename: M
authors.initials: M
authors.lastname: Vigas
authors.forename: T
authors.initials: T
authors.lastname: Trnovec
authors.forename: P
authors.initials: P
authors.lastname: Langer
authors.forename: E
authors.initials: E
authors.lastname: Sebokova
authors.forename: I
authors.initials: I
authors.lastname: Klimes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012107:Research Design; D012680:Sensitivity and Specificity
chemical_list: D001786:Blood Glucose; D007328:Insulin