The biochemical assessment of insulin resistance

Abstract

Addresses

Metabolic Effects of Darunavir/Ritonavir Versus Atazanavir/Ritonavir in Treatment-Naive, HIV Type 1-Infected Subjects over 48 Weeks

“…However, several studies have demonstrated that results obtained using HOMA-IR correlate well with results using the euglycemic, hyperinsulinemic clamp technique. 36,55 Slight reductions in creatinine clearance were seen from baseline to week 12 in both treatment arms of this study; however, these reductions were no longer apparent after 48 weeks of treatment. A previous study suggested an association between the use of ATV, TDF, or indinavir and creatinine clearance, as indicated by a persistent reduction in glomerular filtration rate over time.…”

“…36 The lower limits of quantification (laboratory variability; normal reference range) for the biomarker assays are as follows: IL-1 beta, 0.125 pg/ml (6.7%; < 0.201 pg/ml); IL-6, 0.2 pg/ml (4.3%; < 11.83 pg/ml); TNF RII, 1 pg/ml (2.6%-4.8%; 1003-3170 pg/ ml); hs-CRP, 0.15 mg/liter ( < 2%; < 5.00 mg/liter); fibrinogen, 42 mg/dl ( < 4%; 211-372 mg/dl); and d-dimer, 109 ng/ml ( < 4%; < 201 ng/ml; ICON Central Laboratories Inc., Farmingdale, NY). For the determination of LPS concentration, the QCL-1000 assay (Lonza Biologics Inc., Walkersville, MD), with a sensitivity range of 0.1-1.0 endotoxin units/ml (1 endotoxin unit = 100 pg), and low intraassay variability, was used.…”

Insulin resistance and obesity in childhood

“…Different methods to assess insulin resistance are currently available and they include fasting measurements of insulin and glucose, the OGTT, the insulin tolerance test, the hyperinsulinemic euglycemic clamp and the frequently sampled i.v. glucose tolerance test (FSIVGTT) (62).…”

“…The two most common tests to measure insulin sensitivity are the hyperinsulinemic euglycemic clamp and the FSIVGTT utilizing the minimal model (62). These methods are accurate and, when labelled glucose tracers are used, they also allow differentiation between hepatic and muscular insulin resistance (62).…”

“…These methods are accurate and, when labelled glucose tracers are used, they also allow differentiation between hepatic and muscular insulin resistance (62). Furthermore, the use of stable isotopes also permits the assessment of protein and lipid metabolism together with insulin sensitivity (62). However, both these tests are difficult to perform, time consuming, expensive and invasive (62).…”