Clinical Significance of the Insulin Resistance Index as Assessed by Homeostasis Model Assessment.

Ikeda, Yukio; Suehiro, Tadashi; Nakamura, Toshihiro; Kumon, Yoshitaka; Hashimoto, Kozo

doi:10.1507/endocrj.48.81

Cited by 117 publications

(87 citation statements)

References 10 publications

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“…15 Previously, fasting insulin has been reported to be as accurate as HOMA IR, Bennetts index and the insulin-to-glucose ratio, for prediction of insulin resistance in normoglycaemic subjects. [19][20][21] In the present study, correlations between Si and the insulin-to-glucose ratio and Bennetts index were weaker than other surrogate markers and did not reach significance. However, fasting insulin did show a significant moderate relationship with Si and may be useful in situations where fasting glucose concentrations are unavailable.…”

Section: Discussioncontrasting

confidence: 83%

“…15 Other surrogate methods, including fasting insulin, 16 Bennetts index 17 and the insulin-to-glucose ratio, 18 also demonstrate good concordance with values obtained using the more invasive techniques. [19][20][21] The recently developed quantitative insulin-sensitivity check index (QUICKI), 22 which takes the product of both the reciprocal and the logarithm of fasted insulin and glucose concentrations, gives values that correlate well with the glucose-clamp and minimal model techniques and may provide a better surrogate measure of insulin resistance compared to HOMA IR. 22 The revised version of QUICKI (revised QUICKI) 23 that incorporates a value for fasting nonesterified fatty acids (NEFA) into the QUICKI formula is reported to have a stronger relationship with the glucose clamp than QUICKI alone and therefore may provide an adequate substitute for more sophisticated measures of insulin sensitivity.…”

Section: Introductionmentioning

confidence: 99%

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Revised QUICKI provides a strong surrogate estimate of insulin sensitivity when compared with the minimal model

et al. 2004

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OBJECTIVE:To compare insulin sensitivity (Si) from a frequently sampled intravenous glucose tolerance test (FSIGT) and subsequent minimal model analyses with surrogate measures of insulin sensitivity and resistance and to compare features of the metabolic syndrome between Caucasians and Indian Asians living in the UK. SUBJECTS: In all, 27 healthy male volunteers (14 UK Caucasians and 13 UK Indian Asians), with a mean age of 51.271.5 y, BMI of 25.870.6 kg/m 2 and Si of 2.8570.37. MEASUREMENTS: Si was determined from an FSIGT with subsequent minimal model analysis. The concentrations of insulin, glucose and nonesterified fatty acids (NEFA) were analysed in fasting plasma and used to calculate surrogate measure of insulin sensitivity (quantitative insulin sensitivity check index (QUICKI), revised QUICKI) and resistance (homeostasis for insulin resistance (HOMA IR), fasting insulin resistance index (FIRI), Bennetts index, fasting insulin, insulin-to-glucose ratio). Plasma concentrations of triacylglycerol (TAG), total cholesterol, high density cholesterol, (HDL-C) and low density cholesterol, (LDL-C) were also measured in the fasted state. Anthropometric measurements were conducted to determine body-fat distribution. RESULTS: Correlation analysis identified the strongest relationship between Si and the revised QUICKI (r ¼ 0.67; P ¼ 0.000). Significant associations were also observed between Si and QUICKI (r ¼ 0.51; P ¼ 0.007), HOMA IR (r ¼ À0.50; P ¼ 0.009), FIRI and fasting insulin. The Indian Asian group had lower HDL-C (P ¼ 0.001), a higher waist-hip ratio (P ¼ 0.01) and were significantly less insulin sensitive (Si) than the Caucasian group (P ¼ 0.02). CONCLUSION:The revised QUICKI demonstrated a statistically strong relationship with the minimal model. However, it was unable to differentiate between insulin-sensitive and -resistant groups in this study. Future larger studies in population groups with varying degrees of insulin sensitivity are recommended to investigate the general applicability of the revised QUICKI surrogate technique.

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Section: Discussioncontrasting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Revised QUICKI provides a strong surrogate estimate of insulin sensitivity when compared with the minimal model

et al. 2004

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“…The validity of these estimates in relation to the clamp technique has been examined in several studies, in a wide variety of populations. [13][14][15][16][17][18][19][20] However, data on their validity in hypertensive populations are generally limited. Recently, McAuley et al 21 proposed another index, which uses fasting insulin and triglyceride values, to be a strong predictor of clamp-derived IS, but this index was not adequately further investigated.…”

Section: Introductionmentioning

confidence: 99%

Validity and reproducibility of HOMA-IR, 1/HOMA-IR, QUICKI and McAuley's indices in patients with hypertension and type II diabetes

et al. 2007

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The aim of this study was to evaluate the validity and reliability of homeostasis model assessment-insulin resistance (HOMA-IR) index, its reciprocal (1/HOMA-IR), quantitative insulin sensitivity check index (QUICKI) and McAuley's index in hypertensive diabetic patients. In 78 patients with hypertension and type II diabetes glucose, insulin and triglyceride levels were determined after a 12-h fast to calculate these indices, and insulin sensitivity (IS) was measured with the hyperinsulinemic euglycemic clamp technique. Two weeks later, subjects had again their glucose, insulin and triglycerides measured. Simple and multiple linear regression analysis were applied to assess the validity of these indices compared to clamp IS and coefficients of variation between the two visits were estimated to assess their reproducibility. HOMA-IR index was strongly and inversely correlated with the basic IS clamp index, the Mvalue (r ¼ À0.572, Po0.001), M-value normalized with subjects' body weight or fat-free mass and every other clamp-derived index. 1/HOMA-IR and QUICKI indices were positively correlated with the M-value (r ¼ 0.342, Po0.05 and r ¼ 0.456, Po0.01, respectively) and the rest clamp indices. McAuley's index generally presented less strong correlations (r ¼ 0.317, Po0.05 with M-value). In multivariate analysis, HOMA-IR was the best fit of clampderived IS. Coefficients of variation between the two visits were 23.5% for HOMA-IR, 19.2% for 1/HOMA-IR, 7.8% for QUICKI and 15.1% for McAuley's index. In conclusion, HOMA-IR, 1/HOMA-IR and QUICKI are valid estimates of clamp-derived IS in patients with hypertension and type II diabetes, whereas the validity of McAuley's index needs further evaluation. QUICKI displayed better reproducibility than the other indices.

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“…O índice HOMA -Homeostasis Assesment Model, descrito por Matthews et al, (1985), é um modelo matemático que tem sido validado diante do padrão ouro, o clamp euglicêmico hiperinsulinêmico, e vem sendo utilizado por vários autores dando sustentação ao seu uso principalmente em estudos epidemiológicos (Bonora et al, 2000;Haffner et al, 1996;Ikeda et al, 2001;Straczkowski et al, 2003;Yokoyama, et al, 2004;Straczkowski et al, 2004). O HOMA pode ser usado com os pacientes em jejum como em estudos fi siológicos onde esses parâmetros são avaliados mediante prova funcional como o TOTG (Wallace et al, 2004).…”

Section: Resultsunclassified

Avaliação do efeito hipoglicemiante de Cissus sicyoides em estudos clínicos fase II

Santos¹,

Modesto-Filho²,

Diniz³

et al. 2008

Rev. bras. farmacogn.

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RESUMO: O estudo objetivou realizar ensaios clínicos de fase II com o infuso das folhas deCissus sicyoides L (Vitaceae) para investigar a efi cácia terapêutica desse vegetal em voluntárias intolerantes à glicose (GIG n = 14) e diabéticas (GD n = 12) entre 30 e 59 anos de idade no Hospital Universitário Lauro Wanderley/UFPB. O chá foi preparado com 1g do pó das folhas secas, diluído em 150 mL de água quente por 10 minutos (uso popular), dose única, por um período de 7 dias (fase aguda). No GIG verifi cou-se a interação entre a glicemia e a insulina através do Teste Oral de Tolerância à Glicose, sem e com a ingestão do infuso. A glicemia e insulinemia foram determinadas nos tempos 0, 1, 2 e 3 h. Para o GD avaliou-se a variação espontânea da glicemia (em jejum e em repouso nos tempos 0, 1, 2 e 3 h) e o perfi l glicêmico (antes e 2 h após as refeições) na ausência e na presença do chá. No GIG, o chá das folhas teve atividade hipoglicemiante signifi cativa aos 120 minutos, porém, não houve aumento da insulinemia, além da fi siológica, sugerindo que esse efeito não ocorreu por liberação ou secreção da mesma. No GD o infuso não apresentou efeito hipoglicemiante signifi cativo. Unitermos:Cissus sicyoides, Vitaceae, estudos clínicos, atividade hipoglicemiante.ABSTRACT: "Evaluation of the hypoglycemic effect of Cissus sicyoides in phase II clinical trials". This study aimed to perform Phase II clinical trials with the infusion of the leaves of Cissus sicyoides L to investigate its therapeutic effectiveness in glucose-intolerant (GIG n = 14) and in type 2 diabetic (GD n = 12) volunteers, 30 to 59 years old, at Hospital Universitário Lauro Wanderley/UFPB. The tea was prepared with 1g of dust falling leaves diluted in 150 mL of hot water for 10 minutes (popular usage), in single doses, for 7 days (acute phase). In the GIG, the interaction between the glicemy and the insulin was verifi ed through two oral tests of glucose tolerance, with and without infusion's ingestion. The glicemy and the insulinemy were determined at 0, 1, 2, and 3 hours. For GD, the spontaneous variation of glicemy (during fasting and resting periods, at 0, 1, 2, and 3 hours), and the glicemic profi le (before and 2 hours after meals) were evaluated in the absence and in the presence of the tea. For GIG, the tea of the leaves revealed considerable hypoglycemic activity at 120 minutes; however there was no insulinemy increase, beyond the physiological, suggesting that this effect did not happen because of insulinemy's liberation or secretion. For GD, the tea did not demonstrate considerable hypoglycemic activity.

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Clinical Significance of the Insulin Resistance Index as Assessed by Homeostasis Model Assessment.

Cited by 117 publications

References 10 publications

Revised QUICKI provides a strong surrogate estimate of insulin sensitivity when compared with the minimal model

Revised QUICKI provides a strong surrogate estimate of insulin sensitivity when compared with the minimal model

Validity and reproducibility of HOMA-IR, 1/HOMA-IR, QUICKI and McAuley's indices in patients with hypertension and type II diabetes

Avaliação do efeito hipoglicemiante de Cissus sicyoides em estudos clínicos fase II

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