Relation between HOMA-IR and insulin sensitivity index determined by hyperinsulinemic-euglycemic clamp analysis during treatment with a sodium-glucose cotransporter 2 inhibitor
Open accessAbstract
We had aimed to determine whether homeostasis model assessment–insulin resistance (HOMA-IR) reflects insulin resistance-sensitivity during treatment with a sodium-glucose cotransporter 2 inhibitor (SGLT2i). Hyperinsulinemic-euglycemic clamp analysis was performed in 22 patients with type 2 diabetic patients taking dapagliflozin (5 mg/day before or after breakfast). Propensity score matching of these individuals (SGLT2i group) for age, sex, body mass index, and clamp-derived tissue glucose uptake rate with 44 type 2 diabetic patients who had undergone clamp analysis without SGLT2i treatment (control group) identified 17 paired subjects in each group for further analysis of the relation between HOMA-IR and a clamp-derived insulin sensitivity index (ISI). Natural log–transformed HOMA-IR was negatively correlated with ISI in both SGLT2i (r = –0.527, p = 0.030) and control (r = –0.534, p = 0.027) groups. The simple regression lines for log-transformed HOMA-IR and ISI in the two groups showed similar slopes but differed in their intercepts. Multivariate analysis revealed that HOMA-IR for patients with the same ISI in the two groups was related by the formula: HOMA-IRcontrol = HOMA-IRSGLT2i × 2.45. In conclusion, HOMA-IR was well correlated with ISI during SGLT2i treatment, but values corresponding to the same ISI were lower in the SGLT2i group than in the control group.
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HOMA-IR is the most common test used in research studies to measure insulin resistance, as it has been shown to closely approximate the results of clamp studies over many years.
“In clinical practice, HOMA-IR is the most common test used in research studies to measure insulin resistance, as it has been shown to closely approximate the results of clamp studies over many years [41,42].”
From Controversies in the Pathogenesis, Diagnosis and Treatment of PCOS: Focus on Insulin Resistance, Inflammation, and Hyperandrogenism (2022) · cites this paper as [42]
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- Authors
- So, A., Sakaguchi, K., Okada, Y., Morita, Y., Yamada, T., Miura, H., Otowa-Suematsu, N., Nakamura, T., Komada, H., Hirota, Y., Tamori, Y., & Ogawa, W.
- Affiliations
- Kobe University (JP)
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
- Akashi Medical Center (JP)
- ORCID
- Venue
- Endocrine Journal
- Publisher
- Japan Endocrine Society
- Published
- 2020
- Volume
- 67
- Issue
- 5
- Pages
- 501-507
- ISSN
- 0918-8959 (ISSN-L)
- 1348-4540
- OpenAlex
- W3004531423
- Cited by
- 45
- References
- 30
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 17 · 2023: 7 · 2022: 8 · 2021: 5 · 2020: 2
- FWCI
- 4.16
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Endocrine Journal (publishedVersion)
- PubMed (publishedVersion)
- Institutional Repositories DataBase (IRDB) (acceptedVersion)
- Kobe University Repository Kernel (Kobe University) (submittedVersion, other-oa)
- Kobe University Repository Kernel (Kobe University) (submittedVersion)
- Funders
- Japan Society for the Promotion of Science (17K16148)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- HOMA-IR, insulin resistance, insulin sensitivity index, SGLT2 inhibitors, dapagliflozin, type 2 diabetes, hyperinsulinemic-euglycemic clamp
- MeSH terms
- Sodium-Glucose Transporter 2 Inhibitors, Adult, Aged, Benzhydryl Compounds, Blood Glucose, Diabetes Mellitus, Type 2, Female, Glucosides, Humans, Insulin, Insulin Resistance, Male, Middle Aged, Glucose Clamp Technique
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