Adaptation of five indirect insulin sensitivity evaluation methods to three populations: Metabolic syndrome, athletic and normal subjects

Abstract

Insulin sensitivity is determined using direct or indirect methods. Indirect methods are less invasive than direct methods, but have lower accuracy. The accuracy is set through the Spearman's rank correlation coefficient between the indirect method and a direct method. Since the set of parameters of each indirect method has been set empirically, different values of insulin sensitivity have been reported when they are applied on different populations. In this paper, five indirect methods (Avignon, HOMA-IR, QUICKI, Raynaud, and Matsuda) used to determine insulin sensitivity were adapted to three different populations: athletics, metabolic syndrome and normal subjects. The parameters of each method were varied in a range of values until the optimal value that gives the best correlation coefficient with a gold standard was obtained. Results show that the adaptation procedure led to an improved correlation coefficient. Additionally, the method of Matsuda was the most accurate, followed by the method of Avignon. We have confirmed that each indirect method needs a different set of parameters when it is applied to a specific population in order to obtain an accurate value of insulin sensitivity.

Leveraging the future of diagnosis and management of diabetes: From old indexes to new technologies

“…In fact, the advantage of surrogates based on dynamic testing is that information about insulin secretion can be obtained at the same time as information about insulin action. However, if the main goal is to estimate insulin sensitivity/resistance, fasting surrogate indexes are preferable to dynamic ones as they are simpler to obtain and do not require multiple timepoints of blood sampling 47 . Although indirect methods were mostly used in fundamental research, their application has been increasing both in clinical and epidemiological studies, as well as in clinical practice, due to the abovementioned advantages.…”

“…Nonetheless, as it is calculated from blood samples taken before and during the OGTT, there is an uncomfortable need for successive blood sampling 73 . On the contrary, by using five timepoints, Matsuda becomes more accurate when compared to other surrogate indexes that use less timepoints 47 …”