Horm Metab Res 2003; 35(1): 13-17
DOI: 10.1055/s-2003-38385
Original Basic
© Georg Thieme Verlag Stuttgart · New York

Comparison of Several Insulin Sensitivity Indices Derived from Basal Plasma Insulin and Glucose Levels with Minimal Model Indices

D.  A.  García-Estévez 1 , D.  Araújo-Vilar 1 , G.  Fiestras-Janeiro 2 , Á.  Saavedra-González 2 , J.  Cabezas-Cerrato 1
  • 1Service of Endocrinology and Nutrition, Department of Medicine, Hospital Clínico Universitario de Santiago, Faculty of Medicine. University of Santiago de Compostela, Spain
  • 2Department of Statistics and Operational Research, Faculty of Economic Science, University of Vigo, Spain
Further Information

Publication History

Received 5 November 2001

Accepted after revision 19 August 2002

Publication Date:
01 April 2003 (online)

Abstract

Some techniques for the evaluation of insulin resistance (IR), such as the clamp technique, are not viable for the study of large populations; and for this reason, alternative approaches based on fasting plasma glucose (FPG) and plasma insulin (FPI) have been proposed. The aim of this study was to compare the IR calculations obtained from FPI and FPG values with the insulin sensitivity (IS) index derived from the minimal model. Eighty-seven healthy subjects with a wide range of body mass index (18 - 44 kg × m-2) and 16 DM2 non-obese patients were included in the study. All of the patients underwent a frequently sampled intravenous glucose tolerance test (FSIGTT), and the minimal model of glucose was used for the estimation of insulin sensitivity (ISMINIMAL). The HOMA-IR index, the Avignon index, and the quotient FPG/FPI were used to calculate basal steady-state IR. The basal IR value that best correlated with IS was Log (1/HOMA-IR) (r = 0.70, p < 0.001). All of the basal indices showed a high correlation with each other. In conclusions, insulin sensitivity indices as determined from the basal glycaemia and insulinemia values are not good estimators for metabolic reality from the perspective of the minimal model. Nevertheless, they might well have an IR screening value for epidemiological studies, as long as there is no pancreatic β-cell dysfunction.

References

  • 1 DeFronzo R A. The triumvirate: B-cell, muscle, liver. A collusion responsible for NIDDM.  Diabetes. 1987;  37 667-687
  • 2 Bonadonna R C, de Fronzo R A. Glucose metabolism in obesity and type 2 diabetes.  Diabete Metab. 1991;  17 112-135
  • 3 Felber J P. From obesity to diabetes. Pathophysiological considerations.  Int J Obes. 1992;  16 937-952
  • 4 Bergman R N, Finegood D T, Ader M. Assessment of insulin sensitivity in vivo.  Endocrine Reviews. 1985;  6 45-86
  • 5 Matthews D R, Hosker J P, Rudenski A S, Naylor B A, Treacher D F, Turner R C. Homeostais model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man.  Diabetologia. 1985;  28 412-419
  • 6 Avignon A, Boegner C, Mariano-Goulart D, Colette C, Monnier L. Assessment of insulin sensitivity from plasma insulin and glucose in the fasting or post oral glucose-load state.  Int J Obes. 1999;  23 512-517
  • 7 Haffner S M, Miettinen H, Stern M P. The homeostasis model in the San Antonio Heart Stady.  Diabetes Care. 1997;  20 1087-1092
  • 8 Bavdekar A, Yajnik C S, Fall C H, Bapat S, Pandit A N, Deshpande V, Bhave S, Kellingray S D, Joglekar C. Insulin resistance syndrome in 8-year-old Indian children: small at birth, big at 8 years, or both?.  Diabetes. 1999;  48 2422-2429
  • 9 Tripathy D, Carlsson M, Almgren P, Isomaa B, Taskinen M R, Tuomi T, Groop L C. Insulin secretion and insulin sensitivity in relation to glucose tolerance. Lessons from the Botnia Study.  Diabetes. 2000;  49 975-980
  • 10 Snehalata C, Satyavani K, Sivansakari S, Vijay V, Ramachandran A. Insulin secretion and action in different stages of glucose tolerance in Asian Indians.  Diabet Med. 1999;  16 408-414
  • 11 Haffner S M, Mykkanen L, Festa A, Burke J P, Stern M P. Insulin-resistant prediabetic subjects have more atherogenic risk factors than insulin-sensitive prediabetic subjects: implications for preventing coronary heart disease during the prediabetic state.  Circulation. 2000;  7 975-980
  • 12 Kashiwabara H, Inaba M, Maruno Y. et al . Insulin levels during fasting and the glucose tolerance test and the Homa’s index predict subsequent development of hypertension.  J Hypertens. 2000;  18 83-88
  • 13 The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the diagnosis and classification of Diabetes. Diabetes Care 1997 20: 1183-1197
  • 14 Araújo-Vilar D, García-Estévez D A, Cabezas-Cerrato J. Both a reduced acute insulin response to glucose and lower glucose effectiveness are responsible for the worsening of intravenous glucose tolerance in healthy subjects independently of the degree of obesity.  Metabolism. 1998;  47 313-320
  • 15 García-Estévez D A, Araújo-Vilar D, Cabezas-Cerrato J. Non-insulin-mediated glucose uptake in several insulin-resistant states in the postabsorptive period.  Diabetes Res Clin Pract. 1998;  39 107-113
  • 16 Cabezas-Cerrato J, García-Estévez D A, Araújo D, Iglesias M. Insulin sensitivity, glucose effectiveness and β-cell function in obese males with essential hypertension: Investigation of the effects of treatment with a calcium channel blocker (diltiazem) or an angiotensin-converting enzyme inhibitor (quinapril).  Metabolism. 1997;  46 173-178
  • 17 Cabezas-Cerrato J, García-Estévez D A, Araújo-Vilar D. Insulin sensitivity and beta-cell function in essential hypertension and normotensive first-degree relatives of hypertensive subjects.  Diabetes Metab. 1997;  23 402-408
  • 18 Araújo-Vilar D, García-Estévez D A, Cabezas-Cerrato J. Insulin sensitivity, glucose effectiveness, and insulin secretion in nondiabetic offspring of patients with non-insulin-dependent diabetes mellitus: A cross-sectional study.  Metabolism. 1999;  48 978-983
  • 19 World Medical Association Declaration of Helsinki .Ethical principles for medical research involving human subjects. Bull. WHO 2001 79: 373-374
  • 20 Bergman R N, Ider Y Z, Bowden C R, Cobelli C. Quantitative estimation of insulin sensitivity.  Am J Phisiol. 1979;  236 E667-E677
  • 21 Bergman R N. Toward physiological understanding of glucose tolerance: Minimal model approach.  Diabetes. 1989;  38 1512-1527
  • 22 Araújo-Vilar D, Rega-Liste C A, García-Estévez D A, Sarmiento-Escalona F, Mosquera-Tallon V, Cabezas-Cerrato J. Minimal model of glucose metabolism: Modified equations and its application in the study of insulin sensitivity in obese subjects.  Diabetes Res Clin Pract. 1998;  39 129-141
  • 23 Toffolo G, Bergman R N, Finegood D T, Bowden C R, Cobelli C. Quantitative estimation of beta cell sensitivity to glucose in the intact organism. A minimal model of insulin kinectics in the dog.  Diabetes. 1980;  29 979-990
  • 24 Ferrari P, Alleman Y, Shaw S, Riesen W, Weidmann P. Reproducibility of insulin sensitivity measured by the minimal model method.  Diabetologia. 1991;  34 527-530
  • 25 Steil G M, Murray J, Bergman R N, Buchanan T A. Repeatability of insulin sensitivity and glucose effectiveness from the minimal model. Implications for study design.  Diabetes. 1994;  43 1365-1371
  • 26 Bergman R N, Prager R, Volund A, Olefsky J M. Equivalence of the insulin sensitivity index in man derived by the minimal model method and the euglycemic glucose clamp.  J Clin Invest. 1987;  79 790-800
  • 27 van Haeften T W. Glucose tolerance, insulin sensitivity, and the homeostasis model assessment method.  Diabetes Care. 1998;  21 673
  • 28 Kahn S E, Pringeon R L, Mcculloch D K. et al . Quantification of the relationship between insulin sensitivity and β-cell function in human subjects.  Diabetes. 1993;  42 1663-1672
  • 29 Hermans M P, Levy J C, Morris R J, Turner R C. Comparison of insulin sensitivity tests across a range of glucose tolerance from normal to diabetes.  Diabetologia. 1999;  42 678-687
  • 30 Bonora E, Targher G, Bonadonna R C. et al . Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity. Studies in subjects with various degrees of glucose tolerance and insulin sensitivity.  Diabetes Care. 2000;  23 57-63
  • 31 Mari A, Pacini G, Murphy E, Ludvik B, Nolan J J. A model-based method for assessing insulin sensitivity from the oral glucose tolerance test.  Diabetes Care. 2001;  24 539-548
  • 32 Pérez-Martín A, Raynaud E, Hentgen C, Bringer J, Mercier J, Brun J F. Simplified measurement of insulin sensitivity with the minimal model procedure in type 2 diabetic patients without measurement of insulinemia.  Horm Metab Res. 2002;  34 102-106
  • 33 Stumvoll M, Mitrakou A, Pimenta W. et al . Use of the oral glucose tolerance test to assess insulin release and insulin sensitivity.  Diabetes Care. 2000;  23 295-301
  • 34 Bruce D G, Chisholm D J, Storlein L H, Kraegen E W. Physiological importance of deficiency in early prandial insulin secretion in non-insulin-dependent diabetes.  Diabetes. 1988;  37 735-744
  • 35 Luzi L, DeFronzo R A. Effect of loss of first-phase insulin secretion on hepatic glucose production and tissue glucose disposal in humans.  Am J Physiol. 1989;  257 241-246
  • 36 Araúxo D, Camarero E, Iglesias-Guerrero M, Cabezas-Cerrato J. Insulin sensitivity in non insulin dependent diabetes mellitus and obesity using the minimal model approach. In: Crepaldi G, Tiengo A, Enzy G (eds) Importance of early insulin secretion on the carbohydrate tolerance, in diabetes, obesity, and hyperlipidedemias IV. Elsevier Science Publisher BV Amsterdam; 1990: 211-213
  • 37 Haffner S M, Miettinen H, Gaskill S P, Stern M P. Decreased insulin action and insulin secretion predict the development of impaired glucose tolerance.  Diabetologia. 1996;  39 1201-1207
  • 38 Bergman R N, Phillips L S, Cobelli C. Physiologic evaluation of factors controlling glucose tolerance in man. Measurement of insulin sensitivity and b-cell glucose sensitivity from the response to intravenous glucose.  J Clin Invest. 1981;  68 1456-1467

Prof. Dr. J. Cabezas-Cerrato

Service of Endocrinology and Nutrition · Hospital Clínico Universitario de Santiago

Tv Choupana s/n · 15706 Santiago de Compostela · Spain

Phone: + 34 (981) 951 246

Fax: + 34 (981) 520 410

Email: me836jcc@usc.es

    >