Misclassification of subjects with insulin resistance and associated cardiovascular risk factors by homeostasis model assessment index. Utility of a postprandial method based on oral glucose tolerance test.

Misclassification of subjects with insulin resistance and associated cardiovascular risk factors by homeostasis model assessment index. Utility of a postprandial method based on oral glucose tolerance test.

MedLine Citation:	PMID: 20850158 Owner: NLM Status: In-Data-Review
Abstract/OtherAbstract:	Different methods are available for assessing insulin sensitivity in the fasting state. However, insulin resistance (IR) is initially a postprandial disturbance; and usually, when basal (fasting) disturbance appears, the process has been in progress for some time. Our aim was to investigate if a postprandial measurement, performing an oral glucose tolerance test (OGTT), is more sensitive than fasting values. We wished to identify early IR states in healthy, nonobese individuals and ascertain if this situation was associated with other cardiovascular risk factors. A total of 90 nonobese, nondiabetic, and nonsmoker individuals were studied. They were divided into 3 groups according to IR state-group 1: non-IR-homeostasis model assessment of IR (HOMA(IR)) and insulin sensitivity index of Matsuda-De Fronzo (ISI-Mat) were normal (HOMA(IR) <3.2 and ISI-Mat >4.0); group 2: with IR post-OGTT (ISI-Mat ≤4.0 and HOMA(IR) <3.2); and group 3: subjects with IR in basal conditions (HOMA(IR) ≥3.2). An intravenous glucose tolerance test to compare both indices was also performed. In 14.4% of subjects, the fasting HOMA(IR) values failed to identify IR (false-negative results). The ISI-Mat values were better correlated than HOMA(IR) (r = 0.875, P = .0001 and r = -0.631, P = .0001, respectively) with insulin sensitivity index obtained with intravenous glucose tolerance test. Subjects with IR had higher prevalence of a cluster of cardiovascular risk factors than non-IR subjects. These data show that that a significant percentage of subjects were misclassified with HOMA(IR). Early identification of IR by OGTT was associated with other cardiovascular risk factors. The OGTT is a simple method that could be applied to accurately identify IR subjects in the general population.

Authors:	Sergio Martinez-Hervas; Carlos Argente; Javier Garcia-Jodar; Antonia Priego; Jose T Real; Arturo Carratala; Rafael Carmena; Juan F Ascaso
Related Documents :	20827028 - Addition of losartan to angiotensin-converting enzyme inhibitors improves insulin resis... 15913658 - Low ethanol consumption induces enhancement of insulin sensitivity in liver of normal r... 15936468 - Efficacy of glimepiride in japanese type 2 diabetic subjects. 11788638 - Detection of insulin resistance by simple quantitative insulin sensitivity check index ... 1629198 - Iodophenylarsine oxide and arsenical affinity chromatography: new probes for dithiol pr... 10857968 - Trends in persistent proteinuria in adult-onset diabetes: a population-based study.
Publication Detail:	Type: Journal Article Date: 2010-09-17
Journal Detail:	Title: Metabolism: clinical and experimental Volume: 60 ISSN: 1532-8600 ISO Abbreviation: Metab. Clin. Exp. Publication Date: 2011 May
Date Detail:	Created Date: 2011-04-19 Completed Date: - Revised Date: -
Medline Journal Info:	Nlm Unique ID: 0375267 Medline TA: Metabolism Country: United States
Other Details:	Languages: eng Pagination: 740-6 Citation Subset: IM
Copyright Information:	Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:	Department of Medicine, Service of Endocrinology and Nutrition, Hospital Clínico Universitario, University of Valencia, E-46010 Valencia, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), E-08036 Barcelona, Spain; Fundación Investigación, Hospital Clínico Universitario de Valencia. Instituto de Investigación INCLIVA, E-46010 Valencia, Spain.
Export Citation:	APA/MLA Format Download EndNote Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document: Application of bioassays in toxicological hazard, risk and impact assessments of dredged sediments.
Next Document: Resveratrol and genistein as adenosine triphosphate-depleting agents in fat cells.