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

  1. Hisayo Yokoyama, MD1,
  2. Masanori Emoto, MD, PHD1,
  3. Shigehiko Fujiwara, MD1,
  4. Koka Motoyama, MD1,
  5. Tomoaki Morioka, MD1,
  6. Miyoko Komatsu, MD, PHD1,
  7. Hideki Tahara, MD, PHD1,
  8. Tetsuo Shoji, MD, PHD1,
  9. Yasuhisa Okuno, MD, PHD2 and
  10. Yoshiki Nishizawa, MD, PHD1
  1. 1Osaka City University Graduate School of Medicine, Metabolism, Endocrinology and Molecular Medicine, Osaka, Japan
  2. 2Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Institute of Geriatrics and Medical Science, Osaka, Japan
  1. Address correspondence and reprint requests to Masanori Emoto, Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, Japan, 545-8585. E-mail: memoto{at}med.osaka-cu.ac.jp

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 ± 11, 48 ± 15, and 52 ± 15 years [means ± SD], respectively). Type 2 diabetic subjects were divided into groups of 76 normal range-weight and 45 moderately obese subjects (BMI 21.4 ± 2.3 vs. 27.2 ± 2.2 kg/m2, P < 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 = 120) (QUICKI, 0.338 ± 0.030, 0.371 ± 0.037, and 0.389 ± 0.041, respectively, P < 0.0001; 1/HOMA-IR, 0.50 ± 0.33, 0.92 ± 0.55, and 1.24 ± 0.82, P < 0.0001). QUICKI was strongly correlated with clamp-IR in normal range-weight, moderately obese type 2 diabetic, and healthy subjects (r = 0.641, 0.570, and 0.502, respectively; all subjects, r = 0.608, P < 0.01) and 1/HOMA-IR exhibited correlations comparable to those of QUICKI with clamp-IR (r = 0.637, 0.530, and 0.461, respectively; all subjects, r = 0.589, P < 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 (R2 = 0.547 and 0.551, respectively, P ≤ 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.

Footnotes

  • A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    • Accepted May 12, 2003.
    • Received September 19, 2002.
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