20/(fasting C-peptide × fasting plasma glucose) is a simple and effective index of insulin resistance in patients with type 2 diabetes mellitus: a preliminary report

Abstract

BackgroundWe developed a simple and new insulin resistance index derived from a glucose clamp and a meal tolerance test (MTT) in Japanese patients with type 2 diabetes mellitus.MethodsFifteen patients [mean age: 53 years, fasting plasma glucose (FPG) 7.7 mmol/L, HbA1c 7.1% (54 mmol/mol), body mass index 26.8 kg/m2] underwent a MTT and a glucose clamp. Participants were given a test meal (450 kcal). Plasma glucose and insulin were measured at 0 (fasting), 30, 60, 120, and 180 min. Serum C-peptide immunoreactivity (CPR) was measured at 0 (fasting; F-CPR) and 120 min. Homeostasis model assessment of insulin resistance (HOMA-IR) and insulin sensitivity indices (ISI) were calculated from the MTT results. The glucose infusion rate (GIR) was measured during hyperinsulinemic–euglycemic glucose clamps.ResultsThe mean GIR in all patients was 5.8 mg·kg–1·min–1. The index 20/(F-CPR × FPG) was correlated strongly with GIR (r = 0.83, P < 0.0005). HOMA-IR (r = −0.74, P < 0.005) and ISI (r = 0.66, P < 0.01) were also correlated with GIR. In 10 patients with mild insulin resistance (GIR 5.0–10.0 mg·kg–1·min–1), 20/(F-CPR × FPG) was very strongly correlated with GIR (r = 0.90, P < 0.0005), but not with HOMA-IR and ISI (r = −0.49, P = 0.15; r = 0.20, P = 0.56, respectively). In patients with mild insulin resistance, plasma adiponectin (r = 0.65, P < 0.05), but not BMI or waist circumstance, was correlated with GIR.Conclusions20/(F-CPR × FPG) is a simple and effective index of insulin resistance, and performs better than HOMA-IR and ISI in Japanese patients with type 2 diabetes mellitus. Our results suggest that 20/(F-CPR × FPG) is a more effective index than HOMA-IR in Japanese patients with mild insulin resistance.

Assessment of Insulin Producing Function of the Pancreas and the Marker of Insulin Resistance in Low-Progressive Autoimmune Diabetes in Adults (Lada) Patients

“…Насамперед, було використано коефiцiєнт, який розрахо-вується як спiввiдношення ТГ та ХС ЛПВЩ (ТГ/ХС ЛПВЩ) (табл. 2) [12,17].…”

“…Остан-нє значно обмежує їх застосування, оскiльки є неможливим у хворих на тлi iнсулiнотера-пiї. В лiтературних джерелах пропонуються iншi способи верифiкацiї IР, зокрема з вико-ристанням рiвня С-пептиду або лiпiдiв в си-роватцi кровi [12,13].…”

Korelasi Indeks 20/(C-Peptide Puasa×glukosa Darah Puasa) Dengan Homa-Ir Untuk Menilai Resistensi Insulin Diabetes Melitus Tipe 2

“…Indeks 20/ (C-peptide puasa x glukosa darah puasa) merupakan indeks baru yang diajukan oleh penelitian Ohkura et al (2013). Keunggulan lain selain yang telah disebutkan sebelumnya adalah dimasukannya pemeriksaan C-peptide ke dalam rumus tersebut.…”

“…Hasil ini menunjukkan subjek penelitian ini mempunyai resistensi insulin yang lebih tinggi jika dibandingkan dengan subjek penelitian Ohkura et al (2013). Hal ini didukung oleh data kadar C-peptide pada penelitian ini lebih tinggi jika dibandingkan dengan kadar Cpeptide pada penelitian Ohkura et al Penyebab terjadinya resistensi insulin dan gangguan fungsi sel beta pankreas merupakan multifaktorial seperti penurunan massa sel beta, peningkatan apoptosis/penurunan regenerasi sel, kelelahan sel beta karena resistensi insulin yang lama, toksisitas glukosa, toksisitas lipid pada sel beta, inflamasi, dan deposisi amiloid atau kondisi lain yang dapat menurunkan massa sel beta.…”

Comparative effect of vildagliptin and teneligliptin on HbA1c, glycemic efficacy and insulin sensitivity

“…7 However, the usage of these indexes might not be accurate in patients with a low body mass index (BMI), decreased beta-cell cell function and high FBG levels. 8,9 As a matter of fact, Asian populations including Indians often represent such features. Furthermore, in patients with impaired hepatic and/or renal functions where insulin metabolism may be distorted, HOMA indexes might not be accurate.…”