Quantitative Insulin Sensitivity Check Index and the Reciprocal Index of Homeostasis Model Assessment in Normal Range Weight and Moderately Obese Type 2 Diabetic Patients
- Hisayo Yokoyama, MD1,
- Masanori Emoto, MD, PHD1,
- Shigehiko Fujiwara, MD1,
- Koka Motoyama, MD1,
- Tomoaki Morioka, MD1,
- Miyoko Komatsu, MD, PHD1,
- Hideki Tahara, MD, PHD1,
- Tetsuo Shoji, MD, PHD1,
- Yasuhisa Okuno, MD, PHD2 and
- Yoshiki Nishizawa, MD, PHD1
- 1Osaka City University Graduate School of Medicine, Metabolism, Endocrinology and Molecular Medicine, Osaka, Japan
- 2Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Institute of Geriatrics and Medical Science, Osaka, Japan
- 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.
- FIRI, fasting immunoreactive insulin
- FPG, fasting plasma glucose
- HOMA, homeostasis model assessment
- HOMA-IR, HOMA of insulin resistance
- 1/HOMA-IR, reciprocal of HOMA-IR
- OHA, oral hypoglycemic agent
- QUICKI, quantitative insulin sensitivity check index
- SSPI, steady-state plasma insulin
Footnotes
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A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
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- Accepted May 12, 2003.
- Received September 19, 2002.
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