Comparison of composite whole body insulin sensitivity index derived from mixed meal test and oral glucose tolerance test in insulin resistant obese subjects

Abstract

Apart from fasting blood glucose (FBG) and insulin (FBI), oral glucose tolerance test (OGTT) is also used in calculating insulin sensitivity. During OGTT, insulin secretion may not reflect normal physiological insulin secretion. Based on this idea, hepatic and whole body insulin sensitivity rates were tested during OGTT and mixed meal test (MMT) in obese subjects. Thirty-one women with Quantitative Insulin Sensitivity Check Index (QUICKI) values below 0.350 and body mass index (BMI) >or=30 were included into the study. OGTT with 75-g glucose and MMT 300 kcal were applied to all cases. Data obtained from OGTT and MMT were used in the assessment of insulin sensitivity with Hemostasis of Model Assessment-Insulin Resistance (HOMA-IR) and Matsuda's Composite Whole Body Insulin Sensitivity Index (Matsuda's ISI). Mean BMI, FBG, and FBI were 36.8 +/- 3.9 kg/m(2), 100.5 +/- 0.10 mg/dl, 16.2 +/- 5.3 microg/ml, respectively. QUICKI was 0.31 +/- 0.01 and HOMA-IR was 3.71 +/- 0.88. Matsuda's ISI derived from OGTT was 6.96 +/- 3.35 and from MMT was 11.32 +/- 6.61. In analysis, it was demonstrated that there was a correlation between HOMA-IR, QUICKI, and Matsuda's ISIs derived from OGTT and MMT. Comparing the time periods separately, it was detected that despite similar increment in insulin levels, glucose levels were higher in OGTT than MMT at 15 and 30 min. Consequently, Matsuda's ISI was demonstrated to be effectively used with the data of MMT, as used with OGTT. Moreover, MMT was shown to be in parallel to physiologic insulin secretion and reflect pancreatic functions better compared to OGTT.

Early beta-cell dysfunction characterizes males with type 2 diabetes of Yemenite origin

“…This difference was due to a significant 30 % reduction in the insulin response in males of Yemenite origin (p = 0.03), while women of Yemenite origin had similar early insulin response. In contrast, there was no difference in insulin sensitivity between the two groups indicated by similar Matsuda index that was found previously, to be highly correlated with the gold-standard euglycemic clamp [12,13] (Fig. 1c).…”

“…The usage of meal tolerance test as an alternative method to determine indices of insulin secretion and insulin sensitivity is supported by previous studies that have shown it to be highly correlated with the results provided by the oral glucose tolerance test (OGTT) with the advantage of being a more physiologic stimulus [13][14][15].…”

“…Insulin sensitivity was estimated using the insulin sensitivity index (ISI) of Matsuda and De Fronzo [12,13]: ISI = 10,000/square root of (Ins 0 9 Glu 0) 9 (mean glucose 9 mean insulin during MTT), and by the mathematical homeostasis model assessment (HOMA). The HOMA2-IR index was calculated using the updated version of the HOMA calculator (www.dtu.ox.ac.uk/homa calculator/index.php).…”

Short-term sleep deprivation with nocturnal light exposure alters time-dependent glucagon-like peptide-1 and insulin secretion in male volunteers

“…Insulin resistance was estimated by two different surrogate measuresments: the homeostatic model assessment (HOMA-IR) index, calculated from fasting plasma insulin (FPI) and fasting plasma glucose (FPG) concentrations [FPI (mU/l) ϫ FPG (mmol/l)/22.5], and Matsuda's composite index, calculated using both fasting and postprandial concentrations of insulin and glucose [10,000/(FPI ϫ FPG ϫ mean insulin levels during MTT ϫ mean glucose levels during MTT)1/2]. Because the relationship between insulin and glucose concentrations during the fasting state reflects mainly the balance between hepatic glucose output and insulin secretion, it is generally accepted that the HOMA-IR is an indicator of hepatic insulin resistance (28,29,39,46). However, during the postabsorptive state, insulin sensitivity equally reflects both suppression of hepatic glucose production and glucose disposal by all tissues in the body, and therefore, Matsuda's composite index is generally considered an indicator of whole body insulin sensitivity (28,39).…”

“…Because the relationship between insulin and glucose concentrations during the fasting state reflects mainly the balance between hepatic glucose output and insulin secretion, it is generally accepted that the HOMA-IR is an indicator of hepatic insulin resistance (28,29,39,46). However, during the postabsorptive state, insulin sensitivity equally reflects both suppression of hepatic glucose production and glucose disposal by all tissues in the body, and therefore, Matsuda's composite index is generally considered an indicator of whole body insulin sensitivity (28,39). Accordingly, whole body insulin resistance is estimated by calculating the inverse number of Matsuda's composite index.…”