Good agreement between hyperinsulinemic‐euglycemic clamp and 2 hours oral minimal model assessed insulin sensitivity in adolescents

Abstract

Background/objective: Rates of dysglycemia are increasing in youth, secondary to obesity and decreased insulin sensitivity (IS) in puberty. The oral minimal model (OMM) has been developed in order to measure IS using an easy oral glucose load, such as an oral glucose tolerance test (OGTT), instead of an hyperinsulinemiceuglycemic clamp (HE-clamp), a more invasive and time-consuming procedure. However, this model, following a standard 2 hour-OGTT has never been validated in youth, a population known for a different physiologic response to OGTT than adults. Thus, we compared IS measurements obtained from OMM following a 2-hour OGTT to HE-clamp and isotope tracer-assessed tissue IS in adolescents. We also compared the liver/muscle-specific IS from HE-clamp with other liver/muscle-specific IS surrogates following an OGTT previously validated in adults. Methods: Secondary analysis of a cross-sectional study. Adolescent girls with (n = 26) and without (n = 7) polycystic ovary syndrome (PCOS) (14.6 ± 1.7 years; BMI percentile 23.3%-98.2%) underwent a 2-hour 75 g OGTT and a 4-phase HE-clamp. OMM IS (Si), dynamic Si (Si d) and other OGTT-derived muscle and liver IS indices were correlated with HE-clamp tissue-specific IS.

Hyperprolactinemia and insulin resistance

“…The hyperinsulinaemic-euglycaemic clamp is considered the gold standard method for assessing insulin sensitivity [9,[13][14][15]. The test consists of an intravenous infusion with insulin, which allows its concentration in the serum to be maintained at about 100 mIU/L, and an intravenous infusion with glucose to provide specific blood glucose levels [5,9,14,16].…”

Biochemical and Anthropometric Indices of Insulin Resistance in Obese and Overweight Children with Metabolic Dysfunction-Associated Fatty Liver Disease

“…It is widely accepted that hyperinsulinemic-euglycemic clamp (HEC) is the criterion standard for measuring insulin action in vivo [10], but it is invasive, time-consuming (requiring 6 or more hours of continuous bedside monitoring and infusion adjustments), expensive, and difficult to apply in everyday clinical practice in children [11]. Moreover, the homeostatic model assessment of insulin resistance (HOMA-IR), which is widely used in adults, does not have standardized values in children and seems not to correlate with IR in this group of patients [4].…”

Oral minimal model-based estimates of insulin sensitivity in obese youth depend on oral glucose tolerance test protocol duration

“…The OMM was developed in healthy adults and validated against the HE clamp using data from a 7-h OGTT, but some implementations of OMM have been applied in adults with type 2 diabetes and adolescent cohorts [ 30 , [38] , [39] , [40] , [41] , [42] , [43] ]. estimates from shorter OGTT/OMM protocols have been validated in adult populations without type 2 diabetes [ 30 , 38 ], lean to obese adolescents [ 40 ], and adolescent girls [ 42 , 43 ]. However, insulin resistance (IR) alters the glucose-insulin dynamics represented by OMM, and protocol duration dependence of OMM estimates has not been rigorously assessed in populations expressing diverse metabolic phenotypes.…”