Incorporation of the fasting free fatty acid concentration into quantitative insulin sensitivity check index improves its association with insulin sensitivity in adults, but not in children

Abstract

Objective: Based on fasting insulin and glucose, several indices of insulin sensitivity have been developed in adults. Recently, it has been demonstrated that incorporation of the fasting free fatty acid (FFA) concentration improves the association with insulin sensitivity in adults. We investigated the association of clamp-derived insulin sensitivity with indices of insulin sensitivity derived from fasting blood in prepubertal children and adults, with and without incorporation of FFAs. Design and methods: We studied 59 healthy adults and 29 of them are prepubertal children. We measured insulin sensitivity with the euglycemic-hyperinsulinemic clamp. Based on fasting insulin and glucose, we estimated insulin sensitivity with the homeostasis model assessment (HOMA), the quantitative insulin sensitivity check index (QUICKI), and the revised QUICKI after the incorporation of FFAs. Results: The associations of HOMA and QUICKI with clamp-derived insulin sensitivity in children (rZK0.55 and 0.54 respectively; P!0.01) were similar to those in adults (rZK0.54 and 0.53 respectively; P!0.01). However, incorporation of FFAs into the QUICKI model resulted in an increase in the association in adults, but not in children (rZ0.68 and 0.48 respectively; P!0.01). Adding FFA levels to a regression model with glucose and insulin as independent variables resulted in an increase in the explained variance in clamp-derived insulin sensitivity in adults, but not in children (P value 0.004 in adults and 0.3 in children). Conclusions: HOMA and QUICKI are associated with clamp-derived insulin sensitivity in both children and adults. Incorporating fasting levels of FFAs into the QUICKI model improves the association with clamp-derived insulin sensitivity in adults, but not in children.

METS‐IR, a novel simple insulin resistance indexes, is associated with hypertension in normal‐weight Chinese adults

“…The HEC technique is the gold standard and frequently sampled intravenous glucose tolerance (FSIVGTT) the silver standard in estimating IR However, because they are costly, time‐consuming, invasive, and unphysiological methods, HEC and FSIVGTT are not appropriate in epidemiological studies. Some simple indexes of IR, such as HOMA‐IR and the quantitative insulin sensitivity check index, do not need the intravenous administration of exogenous insulin or glucose and are the most commonly used tools in clinical and epidemiological studies . However, the calculation of these simple indexes requires an insulin assay, which is likely to cause significant bias.…”

“…20 The HEC technique is the gold standard and frequently sampled intravenous glucose tolerance (FSIVGTT) the silver standard in estimating IR 21 ical studies. 22,23 However, the calculation of these simple indexes requires an insulin assay, which is likely to cause significant bias.…”

Relation Between Serum Free Fatty Acids and Adiposity, Insulin Resistance, and Cardiovascular Risk Factors From Adolescence to Adulthood

“…In contrast to adults, fasting FFAs in prepubertal children were not associated with IR as measured by the euglycemic-hyperinsulinemic clamp (24). Although an inverse relation between FFAs and fasting insulin has been reported in prepubertal children, other studies showed no relation of FFAs with fasting insulin in both prepubertal and pubertal children (24–28). Lipid infusion, which results in elevated FFA levels, increased IR in pubertal but not in prepubertal children (29).…”

Adverse effects on insulin secretion of replacing saturated fat with refined carbohydrate but not with monounsaturated fat: A randomized controlled trial in centrally obese subjects

“…RQUICKI was calculated as 1/(log fasting insulin (mU/mL) 1 log fasting glucose (mg/dL) 1 log fasting NEFA (mmol/L)). 20 Incremental AUCs (iAUCs) were calculated by the conventional trapezoid rule after the subtraction of baseline reading. Insulin response corrected for glucose was defined as iAUC insulin/glucose (0-120 min) .…”