title: Comparison of insulin sensitivity measures in South Asians.
abstract: OBJECTIVE
  South Asians have increased visceral adiposity, insulin resistance and greater prevalence of type 2 diabetes and cardiovascular disease when compared to Caucasians of European origin. Surrogate markers of insulin resistance such as the composite insulin sensitivity (Matsuda) index correlate with glucose clamps in other populations, but ethnicity can affect these indices. We compared the Matsuda index, homeostasis model assessment (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and triglyceride/HDL ratio to insulin sensitivity derived from euglycemic clamps in healthy South Asians and Caucasians.
  
  
  METHODS
  Twenty-three healthy South Asians and 18 Caucasians matched for age (mean±SE=33.6±2.1 vs. 36.0±3.0 years) and BMI (25.2±1.1 vs. 24.6±0.9 kg/m(2)) underwent 75 g oral glucose tolerance test (OGTT), 2-h euglycemic hyperinsulinemic clamp (240 pmol·m(-2)·min(-1)), fasting lipid profile, and anthropometric measures.
  
  
  RESULTS
  South Asians had higher fasting insulin (41±5 vs. 21±2 pmol/l; p=0.002) and lower HDL-C (1.25±0.06 vs. 1.56±0.10 mmol/l; p=0.010), but similar fasting glucose (5.0±0.1 vs. 4.9±0.1 mmol/l) levels vs. Caucasians. South Asians had significantly decreased measures of insulin sensitivity derived from both the euglycemic clamp (24.9±1.3 vs. 41.4±1.9 μmol·kg(-1)·min(-1); p<0.0001) and OGTT (Matsuda Index 7.60±0.99 vs. 13.60±1.79; p=0.004). The Matsuda index correlated highly with clamp insulin sensitivity in South Asians (r=0.50; p=0.014) and Caucasians (r=0.47; p=0.046). HOMA-IR, QUICKI, and triglyceride/HDL ratio correlated with clamp values in South Asians, but not in Caucasians.
  
  
  CONCLUSIONS
  In South Asians, Matsuda index, HOMA-IR, QUICKI, and triglyceride/HDL ratio offer simple and valid surrogate measures of insulin sensitivity that can be employed in larger clinical or epidemiological studies in this ethnic group.
authors.affiliation: Division of Endocrinology, Diabetes Hypertension Department of Medicine Brigham Women's Hospital Harvard Medical School, Boston, MA.
authors.forename: Subbulaxmi
authors.initials: S
authors.lastname: Trikudanathan
authors.forename: Annaswamy
authors.initials: A
authors.lastname: Raji
authors.forename: Bindu
authors.initials: B
authors.lastname: Chamarthi
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Seely
authors.forename: Donald C
authors.initials: DC
authors.lastname: Simonson
mesh_terms: D000328:Adult; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism; D005215:Fasting / Q000097:blood / Q000378:metabolism; D005260:Female; D005951:Glucose Tolerance Test / Q000379:methods; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance / Q000502:physiology*; D050356:Lipid Metabolism / Q000502:physiology; D008055:Lipids / Q000097:blood; D008075:Lipoproteins, HDL / Q000378:metabolism*; D008297:Male; D014280:Triglycerides / Q000378:metabolism*
chemical_list: D001786:Blood Glucose; C034396:HDL-triglyceride; D007328:Insulin; D008055:Lipids; D008075:Lipoproteins, HDL; D014280:Triglycerides
keywords: Composite insulin sensitivity index; Euglycemic clamp; HOMA-IR; Matsuda index; QUICKI
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