Diagnosing Insulin Resistance by Simple Quantitative Methods in Subjects With Normal Glucose Metabolism

Ascaso, Juan F.; Pardo, Susana; Real, José T.; Lorente, Rosario I.; Priego, Antonia; Carmena, Rafael

doi:10.2337/diacare.26.12.3320

Cited by 417 publications

(323 citation statements)

References 29 publications

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“…20 and a HOMA-IR value p1.5 was considered indicative of normal insulin sensitivity. 21 A blood sample for measurement of adiponectin was collected. Plasma samples were immediately separated and stored frozen at À80 1C until measurement.…”

Section: Patientsmentioning

confidence: 99%

Metformin versus dietary treatment in nonalcoholic hepatic steatosis: a randomized study

et al. 2010

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Objective: We aimed at evaluating whether the addition of low-dose metformin to dietary treatment could be an effective approach in nondiabetic patients with nonalcoholic fatty liver disease (NAFLD). Methods: We carried out a 6-month prospective study in a series of overweight or obese patients with ultrasonographic diagnosis of hepatic steatosis. In total, 50 patients were enrolled and randomized into two groups: the first group (n ¼ 25) was given metformin (1 g per day) plus dietary treatment and the second group (n ¼ 25) was given dietary treatment alone. Results: At the end of the study, the proportion of patients with echographic evidence of fatty liver was reduced in both the metformin (Po0.0001) and the diet group (P ¼ 0.029). Moreover, patient body mass index and waist circumference significantly decreased in both groups (Po0.001). Fasting glucose, insulin resistance (evaluated as homeostasis model assessment of insulin resistance (HOMA-IR)) and serum adiponectin decreased in both groups, although these changes reached statistical significance only in the metformin group. In this group, HOMA-IR decreased from 3.3±1.6 to 2.4±1.2 (P ¼ 0.003), whereas it decreased from 3.2 ± 1.6 to 2.8 ± 1.1 (not significant, NS) in the diet group. Similarly, the proportion of patients with impaired fasting glucose declined from 35 to 5% (P ¼ 0.04) in the metformin and from 32 to 12% (NS) in the diet group. At baseline, B40% of patients in both groups met the diagnostic criteria of metabolic syndrome. This proportion decreased to 20% in the metformin group (P ¼ 0.008) and to 32% in the diet group (NS). Conclusions: In our 6-month prospective study, both low-dose metformin and dietary treatment alone ameliorated liver steatosis and metabolic derangements in patients with NAFLD. However, metformin was more effective than dietary treatment alone in normalizing several metabolic parameters in these patients.

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Section: Patientsmentioning

confidence: 99%

Metformin versus dietary treatment in nonalcoholic hepatic steatosis: a randomized study

et al. 2010

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“…Women were classified as being insulin resistant (IR group) or not insulin resistant (non-IR group) in accordance with defined cutoff points for HOMA-IR R2.5 (25,26), QUICKI %0.33 (26,27), and ISI %5 (20,24).…”

Section: ðLogðfiþðmu=mlþclogðfgþðmg=dlþþmentioning

confidence: 99%

Low sex hormone-binding globulin as a predictive marker for insulin resistance in women with hyperandrogenic syndrome

Kajaia¹,

Binder²,

Dittrich³

et al. 2007

eur j endocrinol

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Background: The aim of the present study is to assess insulin resistance (IR) in women with hyperandrogenic syndrome, which was suggested to replace the term polycystic ovary syndrome by the Androgen Excess Society, and to evaluate whether sex hormone-binding globulin (SHBG) can be used as a predictive marker of IR in hyperandrogenic women. Methods: Clinical, metabolic, and endocrine parameters were measured, and an oral glucose tolerance test was carried out. The women were classified as IR group or non-IR group, in accordance with defined cutoff points for the homeostatic model assessment of IR (HOMA-IR) at R2.5, the quantitative insulin sensitivity check index at %0.33, and the Matsuda insulin sensitivity index (ISI) at %5. Results: The women classified as having IR had a significantly higher body mass index (BMI) and free androgen index (FAI) and showed significantly lower SHBG and high-density lipoprotein (HDL) levels, regardless of the indices used. However, with the Matsuda ISI, generally more women were diagnosed as having IR, and this group had significantly higher total testosterone and triglyceride values, as well as a higher incidence of hirsutism. Conclusions: Women who were classified as being insulin resistant using insulin sensitivity indices showed significantly higher BMI and FAI values and lower SHBG and HDL levels. However, the Matsuda ISI may be more favorable for identifying IR in hyperandrogenic women. SHBG may serve as a predictive marker of IR in these women, particularly in those who are obese.

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“…Therefore, there remains a need for a simple IR test for routine screening, prospective studies, risk assessment, and therapeutic monitoring. 21,22 We reported a nontargeted metabolomics study using fasting plasma samples obtained from a healthy, nondiabetic population [Relationship between Insulin Sensitivity and Cardiovascular Disease (RISC) Study], searching for novel biomarkers of insulin sensitivity. 23 A number of small molecule metabolites were identified that correlated with the M values derived from the hyperinsulinemic euglycemic clamp.…”

Section: Introductionmentioning

confidence: 99%

A Novel Fasting Blood Test for Insulin Resistance and Prediabetes

Cobb

Gall

Adam

et al. 2013

J Diabetes Sci Technol

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Background: Insulin resistance (IR) can precede the dysglycemic states of prediabetes and type 2 diabetes mellitus (T2DM) by a number of years and is an early marker of risk for metabolic and cardiovascular disease. There is an unmet need for a simple method to measure IR that can be used for routine screening, prospective study, risk assessment, and therapeutic monitoring. We have reported several metabolites whose fasting plasma levels correlated with insulin sensitivity. These metabolites were used in the development of a novel test for IR and prediabetes. Methods: Data from the Relationship between Insulin Sensitivity and Cardiovascular Disease Study were used in an iterative process of algorithm development to define the best combination of metabolites for predicting the M value derived from the hyperinsulinemic euglycemic clamp, the gold standard measure of IR. Subjects were divided into a training set and a test set for algorithm development and validation. The resulting calculated M score, MQ, was utilized to predict IR and the risk of progressing from normal glucose tolerance to impaired glucose tolerance (IGT) over a 3 year period. Results: MQ correlated with actual M values, with an r value of 0.66. In addition, the test detects IR and predicts 3 year IGT progression with areas under the curve of 0.79 and 0.70, respectively, outperforming other simple measures such as fasting insulin, fasting glucose, homeostatic model assessment of IR, or body mass index. Conclusions: The result, Quantose™, is a simple test for IR based on a single fasting blood sample and may have value as an early indicator of risk for the development of prediabetes and T2DM.

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Diagnosing Insulin Resistance by Simple Quantitative Methods in Subjects With Normal Glucose Metabolism

Cited by 417 publications

References 29 publications

Metformin versus dietary treatment in nonalcoholic hepatic steatosis: a randomized study

Metformin versus dietary treatment in nonalcoholic hepatic steatosis: a randomized study

Low sex hormone-binding globulin as a predictive marker for insulin resistance in women with hyperandrogenic syndrome

A Novel Fasting Blood Test for Insulin Resistance and Prediabetes

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