A novel index of insulin resistance determined from the homeostasis model assessment index and adiponectin levels in Japanese subjects.
Insulin resistance is the principal cause of glucose intolerance and type 2 diabetes and induces progression of severe atherosclerosis in these patients. Adiponectin, the adipose-specific proteins, is known to correlate negatively with insulin resistance in patients with obesity and type 2 diabetes. The purpose of this study was to evaluate the potential of using serum adiponectin levels as a marker of insulin resistance in various states of insulin resistance. Furthermore, we attempted to establish a modified index of the homeostasis model assessment index (HOMA-IR), calculated from the product of serum insulin and plasma glucose levels divided by serum adiponectin levels (HOMA-AD). We recruited 117 Japanese subjects with various degrees of glucose tolerance and determined serum adiponectin levels and insulin sensitivity (M-value) by using the euglycemic hyperinsulinemic clamp technique. M-value, the gold standard index of insulin resistance, correlates significantly and independently with fasting insulin (r=-0.313, P<0.001), glucose (r=-0.319, P<0.001), and adiponectin (r=0.241, P<0.002) levels. M-values were more significantly correlated with HOMA-AD (r=-0.643, P<0.001) than HOMA-IR values (r=-0.591, P<0.001). In subjects with moderate hyperglycemia (fasting glucose levels>8.0mmol/L, n=30), HOMA-AD showed a more significant correlation with the M-value than HOMA-IR (r=-0.535, P=0.005 versus r=-0.461, P=0.010). We would therefore like to propose a novel index, HOMA-AD, as a simple and adequate index for determining insulin resistance even in diabetic patients with overt hyperglycemia.
Matsuhisa
Munehide
M
Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, Osaka, 2-2 Yamadaoka, Suita City, Japan. matuhisa@medone.med.osaka-u.ac.jp
Yamasaki
Yoshimitsu
Y
Emoto
Masanori
M
Shimabukuro
Michio
M
Ueda
Shinichiro
S
Funahashi
Tohru
T
Matsuzawa
Yuji
Y
D052242:Adiponectin / Q000097:blood; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005215:Fasting; D015309:Glucose Clamp Technique; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D007564:Japan; D008875:Middle Aged; D008954:Models, Biological; D011237:Predictive Value of Tests
C499918:ADIPOQ protein, human; D052242:Adiponectin; D001786:Blood Glucose