title: [Reliability of HOMA-IR for evaluation of insulin resistance during perioperative period].
abstract: BACKGROUND
  Hyperglycemia due to increase in insulin resistance (IR) is often observed after surgery in spite of normal insulin secretion. To evaluate the degree of IR, the golden standard method is the normoglycemic hyperinsulinemic clamp technique (glucose clamp: GC). The GC using the artificial pancreas, STG-22 (Nikkiso, Tokyo, Japan), was established as a more reliable method, since it was evaluated during steady-state period under constant insulin infusion. Homeostasis model assessment insulin resistance (HOMA-IR), however, is frequently employed in daily practice because of its convenience. We, therefore, investigated the reliability of HOMA-IR in comparison with the glucose clamp using the STG-22.
  
  
  METHODS
  Eight healthy patients undergoing maxillofacial surgery were employed in this study after obtaining written informed consent. Their insulin resistance was evaluated by HOMA-IR and the GC using the STG-22 before and after surgery.
  
  
  RESULTS
  HOMA-IR increased from 0.81 +/- 0.48 to 1.17 +/- 0.50, although there were no significant differences between before and after surgery. On the other hand, M-value by GC significantly decreased after surgery from 8.82 +/- 2.49 mg x kg(-1) x min(-1) to 3.84 +/- 0.79 mg x kg(-1) x min(-1) (P = 0.0003). In addition, no significant correlation was found between the values of HOMA-IR and the M-value by GC.
  
  
  CONCLUSIONS
  HOMA-IR may not be reliable to evaluate IR for perioperative period.
authors.affiliation: Department of Dental Anesthesiology, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Fujino
authors.forename: Shoko
authors.initials: S
authors.lastname: Itoda
authors.forename: Saori
authors.initials: S
authors.lastname: Sako
authors.forename: Kazuki
authors.initials: K
authors.lastname: Matsuo
authors.forename: Eiji
authors.initials: E
authors.lastname: Sakamoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yokoyama
mesh_terms: D000328:Adult; D005260:Female; D015309:Glucose Clamp Technique; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D019397:Pancreas, Artificial; D059035:Perioperative Period; D015203:Reproducibility of Results