Limitations in the Use of Indices Using Glucose and Insulin Levels to Predict Insulin Sensitivity
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OBJECTIVE: To examine the utility of commonly used insulin sensitivity indices in nondiabetic European Americans (EAs) and African Americans (AAs). RESEARCH DESIGN AND METHODS: Two-hundred forty nondiabetic participants were studied. Euglycemic-hyperinsulinemic clamp was the gold standard approach to assess glucose disposal rates (GDR) normalized by lean body mass. The homeostatic model assessment for insulin resistance (HOMA-IR) and the quantitative insulin sensitivity check index (QUICKI) were calculated from fasting plasma glucose and insulin (FIL). Oral glucose tolerance test (OGTT) was performed to determine Matsuda index, the simple index assessing insulin sensitivity (SIisOGTT), Avignon index, and Stomvoll index. Relationships among these indices with GDR were analyzed by multiple regression. RESULTS: GDR values were similar in EA and AA subgroups; even so, AA exhibited higher FIL and were insulin-resistant compared with EA, as assessed by HOMA-IR, QUICKI, Matsuda index, SIisOGTT, Avignon index, and Stumvoll index. In the overall study population, GDR was significantly correlated with all studied insulin sensitivity indices (/r/ = 0.381–0.513); however, these indices were not superior to FIL in predicting GDR. Race and gender affected the strength of this relationship. In AA males, FIL and HOMA-IR were not correlated with GDR. In contrast, Matsuda index and SIisOGTT were significantly correlated with GDR in AA males, and Matsuda index was superior to HOMA-IR and QUICKI in AAs overall. CONCLUSIONS: Insulin sensitivity indices based on glucose and insulin levels should be used cautiously as measures of peripheral insulin sensitivity when comparing mixed gender and mixed race populations. Matsuda index and SIisOGTT are reliable in studies that include AA males.
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Studies assessing the relationship between indices based on fasting plasma glucose and insulin levels and clamp measures could reflect falsely inflated slopes and correlation coefficients when data from nondiabetic and diabetic subjects are included in the same regression analyses.
“Consequently, studies assessing the relationship between indices based on fasting plasma glucose (FPG) and insulin levels and clamp measures could reflect falsely inflated slopes and correlation coefficients in regression equations when data from nondiabetic and diabetic subjects are included in the same regression analyses [6].”
From Optimal Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) Cut-Offs: A Cross-Sectional Study in the Czech Population (2019) · cites this paper as [6]
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“Consequently, studies assessing the relationship between indices based on fasting plasma glucose (FPG) and insulin levels and clamp measures could reflect falsely inflated slopes and correlation coefficients in regression equations when data from nondiabetic and diabetic subjects are included in the same regression an…”
BackgroundThe Effects of Soy Isoflavones on Metabolic Status of Patients With Polycystic Ovary Syndrome
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- Authors
- Pisprasert, V., Ingram, K. H., Lopez-Davila, M. F., Munoz, A. J., & Garvey, W. T.
- Affiliations
- University of Alabama at Birmingham (US)
- Kennesaw State University (US)
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama
- University of South Carolina (US)
- Corresponding author
- Pisprasert, Veeradej
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2013-03-14
- Volume
- 36
- Issue
- 4
- Pages
- 845-853
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3609485
- OpenAlex
- W2168987890
- Cited by
- 302
- References
- 41
- Citations by year
- 2026: 5 · 2025: 14 · 2024: 11 · 2023: 11 · 2022: 23 · 2021: 18 · 2020: 31 · 2019: 30 · 2018: 33 · 2017: 32 · 2016: 32 · 2015: 31 · 2014: 23 · 2013: 8
- FWCI
- 15.91
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DigitalCommons - Kennesaw State University (Kennesaw State University) (submittedVersion)
- Funders
- National Institutes of Health (5p60dk079626-05)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK-038764, P60-DK-079626, DK-083562, R01DK083562, P30DK056336)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- insulin sensitivity index, insulin resistance, Matsuda index, HOMA-IR, QUICKI, glucose disposal rate, hyperinsulinemic-euglycemic clamp, fasting insulin, racial differences, African American men, European Americans, oral glucose tolerance test, peripheral insulin sensitivity
- MeSH terms
- Adult, Black or African American, Blood Glucose, Female, Glucose Tolerance Test, Humans, Immunoassay, Insulin, Insulin Resistance, Male, Middle Aged, Glucose Clamp Technique, Absorptiometry, Photon, White People
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