title: Correlation of body muscle/fat ratio with insulin sensitivity using hyperinsulinemic-euglycemic clamp in treatment-naïve type 2 diabetes mellitus.
abstract: OBJECTIVE
  Fat deposition and obesity are crucial pathological components of diabetes mellitus (DM). In clinical practice, assessment of insulin resistance is important. We hypothesized that body muscle and fat composition might be a key factor for insulin resistance in patients with type 2 DM.
  
  
  METHODS
  Subjects included 61 untreated DM patients. Hyperinsulinemic-euglycemic clamp examination was performed to calculate the M/I value as the insulin resistance reference indicator. Elementary body composition was measured by impedance analysis using InBody770.
  
  
  RESULTS
  Simple regression analysis showed that total muscle quantity/total fat quantity ratio (muscle/fat) was significantly correlated with M/I value (B=0.806, P<0.001). The regression equation was M/I value=3.6934×(muscle/fat ratio)+0.0347 (R(2)=0.6503, P<0.001). Multivariate logistic regression analysis showed that muscle/fat ratio was independently and significantly associated with insulin resistance, defined by M/I value <9 (odds ratio, 0.89; 95% confidence interval, 0.80-0.99, P=0.04). With receiver operating curve analysis, the cutoff value of muscle/fat ratio for insulin resistance was 2.40 and area under the curve was 0.87 (sensitivity 91% and specificity 76%, P<0.001), indicating that muscle/fat ratio was significantly effective for predicting insulin resistance in treatment-naïve DM. The result could provide a possible estimation of the M/I value using the regression equation M/I value=2.5438×(muscle/fat ratio)+48.6194×QUICKI-13.6522 (R(2)=0.7012).
  
  
  CONCLUSIONS
  In treatment-naïve DM, the muscle/fat ratio, assessed by InBody770 is clinically useful for evaluating the presence of insulin resistance in daily clinical practice.
authors: Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.
authors: Noboru
authors: N
authors: Kurinami
authors: Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan; Division of Cardiovascular Medicine, Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.
authors: Seigo
authors: S
authors: Sugiyama
authors: Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.
authors: Akira
authors: A
authors: Yoshida
authors: Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.
authors: Kunio
authors: K
authors: Hieshima
authors: Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.
authors: Fumio
authors: F
authors: Miyamoto
authors: Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.
authors: Keizo
authors: K
authors: Kajiwara
authors: Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.
authors: Tomio
authors: T
authors: Jinnouchi
authors: Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan. Electronic address: hideaki@jinnouchi.or.jp.
authors: Hideaki
authors: H
authors: Jinnouchi
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects / Q000378:metabolism*; D001823:Body Composition; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D015309:Glucose Clamp Technique / Q000379:methods*; D018149:Glucose Intolerance / Q000209:etiology*; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000187:drug effects / Q000378:metabolism*; D009765:Obesity / Q000150:complications / Q000503:physiopathology*
keywords: Body fat; Body muscle; Diabetes mellitus; Insulin resistance; Obesity