Quantitative Insulin Sensitivity Check Index and the Reciprocal Index of Homeostasis Model Assessment in Normal Range Weight and Moderately Obese Type 2 Diabetic Patients

Abstract

OBJECTIVE -To investigate whether the quantitative insulin sensitivity check index (QUICKI) and the reciprocal index of homeostasis model assessment (1/HOMA-IR) derived from fasting plasma glucose and insulin level are excellent surrogate indices of insulin resistance in both normal range-weight and moderately obese type 2 diabetic and healthy subjects. RESEARCH DESIGN AND METHODS -The association between QUICKI or 1/HOMA-IR and insulin resistance index assessed by euglycemic-hyperinsulinemic clamp (clamp-IR) was investigated in 121 type 2 diabetic and 29 healthy subjects recruited from among 120 (age 55 Ϯ 11, 48 Ϯ 15, and 52 Ϯ 15 years [means Ϯ SD], respectively). Type 2 diabetic subjects were divided into groups of 76 normal range-weight and 45 moderately obese subjects (BMI 21.4 Ϯ 2.3 vs. 27.2 Ϯ 2.2 kg/m 2 , P Ͻ 0.0001).RESULTS -QUICKI and 1/HOMA-IR were significantly lower in the moderately obese group than in the normal range-weight type 2 diabetic and healthy groups (n ϭ 120) (QUICKI, 0.338 Ϯ 0.030, 0.371 Ϯ 0.037, and 0.389 Ϯ 0.041, respectively, P Ͻ 0.0001; 1/HOMA-IR, 0.50 Ϯ 0.33, 0.92 Ϯ 0.55, and 1.24 Ϯ 0.82, P Ͻ 0.0001). QUICKI was strongly correlated with clamp-IR in normal range-weight, moderately obese type 2 diabetic, and healthy subjects (r ϭ 0.641, 0.570, and 0.502, respectively; all subjects, r ϭ 0.608, P Ͻ 0.01) and 1/HOMA-IR exhibited correlations comparable to those of QUICKI with clamp-IR (r ϭ 0.637, 0.530, and 0.461, respectively; all subjects, r ϭ 0.589, P Ͻ 0.001). In multiple regression models including QUICKI or 1/HOMA-IR as an independent variable, the estimation formula accounted for 55% of the variability of clamp-IR for the group of all type 2 diabetic subjects (R 2 ϭ 0.547 and 0.551, respectively, P Յ 0.0001).CONCLUSIONS -QUICKI and 1/HOMA-IR were highly correlated with clamp-IR, with comparable coefficients in both normal range-weight and moderately obese type 2 diabetic patients and nondiabetic subjects. The latter can probably be applied clinically in view of its convenience. Diabetes Care 26:2426 -2432, 2003I nsulin resistance might play an important role in hyperglycemia in type 2 diabetes, which eventually induces the development of diabetic microangiopathy (1). To achieve excellent glycemic control to prevent these complications, several oral hypoglycemic agents (OHAs) that improve insulin resistance (such as thiazolidinediones and biguanides) have been developed and are available clinically (2,3). Furthermore, insulin resistance is proposed to play important roles in the pathogenesis of cardiovascular diseases (4), the most common cause of death in diabetic patients. Therefore, it is important clinically and epidemiologically to evaluate insulin resistance simply and accurately in individual diabetic patients.The euglycemic-hyperinsulinemic clamp, the gold standard technique for estimation of insulin resistance, is accurate but complex and laborious enough that it is not practical for evaluation of a large number of type 2 diabetic patients or populations at risk for insulin...

Gonadal Hormones and Gonadal Function in Type 2 Diabetes Model OLETF (Otsuka Long Evans Tokushima Fatty) Rats

“…Also, a statistically significant negative correlation was noted between testis weight and the HOMA index in diabetic rats. The HOMA index is generally used as an indicator of insulin resistance in both human and rodents [15,16,24]. Our studies suggest that hyperglycemia or insulin resistance may primarily induce testis atrophy, subsequently causing a reduction in spermatogenesis, which was more remarkably observed in diabetic rats than in non-diabetic rats.…”

Predictive clinical parameters for therapeutic efficacy of rosiglitazone in Korean type 2 diabetes mellitus

“…First, more strict criteria for defining rosiglitazone-responder could not be adopted because of short planned duration of rosiglitazone treatment. Second, although it has been shown that both HOMA IR and QUICKI provide strong correlations with insulin resistance index assessed by euglycemic-hyperinsulinemic clamp [28,29], these parameters must be interpreted with caution because of the wide degree of variability compared with euglycemic-hyperinsulinemic clamp, the gold standard method for assessing insulin resistance and of a limited value of HOMA IR and QUICKI for elderly patients with poorly controlled T2DM [30]. Lastly, as few studies have been conducted in the Asian populations with regard to racial differences in body composition, regional fat distribution, and insulin resistance [31][32][33][34][35][36], more results on the change of body composition or fat redistribution and the comparison of regional fat distribution between the responder and nonresponder might be useful to verify the TZDs effect on body fat and to predict and classify rosiglitazone-responders by fat distribution when applicating TZD in non-obese or obese Asian diabetic patients.…”

Different mechanisms in weight loss-induced blood pressure reduction between a calorie-restricted diet and exercise

“…The homeostasis model assessment of insulin resistance (HOMA-IR): fasting glucose (mg dl À1 ) Â fasting insulin (mU ml À1 )/405. 25 Plasma NE, insulin and leptin were measured as previously reported. 23 …”