Validity and reproducibility of HOMA-IR, 1/HOMA-IR, QUICKI and McAuley's indices in patients with hypertension and type II diabetes

Abstract

The aim of this study was to evaluate the validity and reliability of homeostasis model assessment-insulin resistance (HOMA-IR) index, its reciprocal (1/HOMA-IR), quantitative insulin sensitivity check index (QUICKI) and McAuley's index in hypertensive diabetic patients. In 78 patients with hypertension and type II diabetes glucose, insulin and triglyceride levels were determined after a 12-h fast to calculate these indices, and insulin sensitivity (IS) was measured with the hyperinsulinemic euglycemic clamp technique. Two weeks later, subjects had again their glucose, insulin and triglycerides measured. Simple and multiple linear regression analysis were applied to assess the validity of these indices compared to clamp IS and coefficients of variation between the two visits were estimated to assess their reproducibility. HOMA-IR index was strongly and inversely correlated with the basic IS clamp index, the Mvalue (r ¼ À0.572, Po0.001), M-value normalized with subjects' body weight or fat-free mass and every other clamp-derived index. 1/HOMA-IR and QUICKI indices were positively correlated with the M-value (r ¼ 0.342, Po0.05 and r ¼ 0.456, Po0.01, respectively) and the rest clamp indices. McAuley's index generally presented less strong correlations (r ¼ 0.317, Po0.05 with M-value). In multivariate analysis, HOMA-IR was the best fit of clampderived IS. Coefficients of variation between the two visits were 23.5% for HOMA-IR, 19.2% for 1/HOMA-IR, 7.8% for QUICKI and 15.1% for McAuley's index. In conclusion, HOMA-IR, 1/HOMA-IR and QUICKI are valid estimates of clamp-derived IS in patients with hypertension and type II diabetes, whereas the validity of McAuley's index needs further evaluation. QUICKI displayed better reproducibility than the other indices.

The relationship between lipoprotein-associated phospholipase A2 with cardiovascular risk factors in testosterone deficiency

“…[8] Free and bioavailable testosterone were calculated from the web address "http://www.issam.ch/freetesto.htm" by using total testosterone, SHBG and albumin levels [9] , HOMA-IR index and QUICKI index were calculated from the web addresses https://sasl.unibas.ch/11calculators-HOMA.php [10] and "https://sasl.unibas.ch/11calculators-QUICKI.php [11] , respectively.…”

Salt and insulin sensitivity after short and prolonged high salt intake in elderly subjects

“…The HOMA method was chosen to evaluate insulin sensitivity in this study because it is simple, easily applied, and has good reproducibility (34). The HOMA estimate of insulin sensitivity significantly correlates with data derived from forearm metabolic studies involving direct measurements of insulin action on muscle glucose metabolism (35).…”

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

“…Therefore, the diagnosis of DM itself represents a good marker of insulin resistance and the HOMA-IR levels in subjects with DM seem to reach a saturation point of insulin resistance. Although the relationship between DM and hypertension is still not fully understood, readers of the paper by Sarafidis et al 19 may appreciate it much more if the current study was carried out in a study cohort of non-diabetic hypertensive subjects instead of those with type 2 DM.…”

“…In the current issue of the Journal of Human Hypertension, Sarafidis et al 19 evaluate the performance of several mathematical manipulations of the fasting insulin and/or glucose concentrations to surrogate insulin resistance in a cohort of subjects with both hypertension and DM. Their data show that HOMA-IR was the best fit of Mvalues from the clamps.…”

“…In the paper by Sarafidis et al, 19 the authors recruited a group of patients who had hypertension before type 2 DM for the study. New-onset DM is an important clinical problem that occurs in nearly 2% of treated hypertensive subjects a year, and results in a threefold risk for subsequent cardiovascular disease compared with those who remained free of DM.…”