Surrogate estimates of insulin sensitivity in subjects with hypertension

Abstract

The purpose of the study is to compare surrogate estimates of insulin sensitivity with a directly measured insulin sensitivity index, steady-state plasma glucose (SSPG) from insulin suppression test (IST), in subjects with hypertension. Two hundred and twenty-eight hypertensive patients who received IST for SSPG were included for analysis. Estimates from fasting measurements alone, homeostasis model assessment for insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI)), and indices from fasting and/or 2 h samples (ISI 0,120 and ISI TX ) were calculated. In addition to Pearson and partial correlations, variancecomponent models were used to test the relationship between surrogate estimates of insulin sensitivity and SSPG. A large proportion of variance owing to covariates in the variance-component models indicated the goodness of model fit, irrespective of the independence among variables. SSPG was positively correlated with logarithmic transformation (Log) (HOMA-IR) and negatively correlated with QUICKI, Log (ISI 0,120 ) and ISI TX (all Po0.0001). Log (ISI 0,120 ) seemed to have a better correlation with SSPG (r ¼ À0.72) than other measures in partial correlation. The proportion of variance owing to all covariates of Log (ISI 0,120 ) and ISI TX were larger than those of Log (HOMA-IR) and QUICKI in the variancecomponent models. After adjustments for demographic and obesity covariates, the proportion of variance explained by Log (ISI 0,120 ) were largest among the surrogate measures in the variance-component models. Our results showed that ISI 0,120 and ISI TX correlated better with SSPG than those used fasting measures alone (HOMA-IR and QUICKI). Log (ISI 0,120 ) currently showing the strongest association with SSPG than other estimates is adaptable for use in large studies of hypertension.

What Are the Determinants of Insulin Resistance (IR) and How Effective Is the Sub-Saharan Africa-Specific Threshold of Abdominal Obesity (AO-SSA) Identifying IR in Congolese Black Hypertensive Patients?

“…Indeed they are labor-intensive, time-consuming, expensive, and technically challenging [41] [42]. A number of surrogate indices have therefore been employed to simplify and improve the determination of insulin resistance [42] [43]. Thus, it is generally considered that subjects with metabolic syndrome (MetS) or abdominal obesity (AO) are carrying IR [44]- [47].…”

Diagnosis of insulin resistance in hypertensive patients by the metabolic syndrome: AHA vs. IDF definitions

“…However, these techniques are complicated and generally not suitable for routine clinical work. Surrogate estimates of insulin sensitivity in hypertension have been published (4). It was suggested that insulin sensitivity indices integrating postchallenge values surrogated insulin sensitivity in hypertension better than those that used fasting measures alone (4).…”

“…Surrogate estimates of insulin sensitivity in hypertension have been published (4). It was suggested that insulin sensitivity indices integrating postchallenge values surrogated insulin sensitivity in hypertension better than those that used fasting measures alone (4). When oral glucose tolerance test (OGTT) is not available, simple clinical markers are options to clinicians for the diagnosis of IR in hypertension.…”

Measurements of insulin resistance in hypertension: where are we now?

“…Of note, Hwu et al 9 recently reported that insulin sensitivity indices integrating post-challenge values (ISI 0,120 and ISI TX ) surrogated insulin sensitivity better than HOMA-IR and QUICKI for subjects with hypertension. The ISI 0,120 is a more complex assessment of insulin resistance, which directly assesses total body's response to glucose loading and accounts more for peripheral insulin resistance and glucose disposal.…”

“…Surrogate estimates of insulin sensitivity in hypertensives have recently been published. 9 However, for the quantitative assessment of insulin resistance in hypertension, the glucose clamp methods are considered to be the gold standard method for direct measurement of insulin sensitivity. 10 Insulin is then infused to increase plasma insulin levels to a new steady state.…”