Limitations of fasting indices in the measurement of insulin sensitivity in Afro-Caribbean adults

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Title: Limitations of fasting indices in the measurement of insulin sensitivity in Afro-Caribbean adults
Author: Thompson, Debbie S; Boyne, Michael S; Osmond, Clive; Ferguson, Trevor S; Tulloch-Reid, Marshall K; Wilks, Rainford J; Barnett, Alan T; Forrester, Terrence E
Abstract: Abstract Background Insulin sensitivity can be estimated using glucose disposal rate (M) measured during a hyperinsulinemic euglycemic clamp (HEC) or insulin sensitivity index (SI) derived from a frequently sampled intravenous glucose tolerance test (FSIVGTT). The commonly used homeostatic model assessment of insulin resistance (HOMA-IR) which utilizes fasting glucose and insulin has been validated against M across several populations (rand#8201;=and#8201;0.5-0.8). This study sought to validate HOMA-IR against SI and M in an Afro-Caribbean population. Findings Sixty participants completed a 180-minute FSIVGTT and another 50 completed a 150-minute hyperinsulinemic euglycemic clamp. In both groups, HOMA-IR was calculated and anthropometry and body composition using dual energy x-ray absorptiometry (DEXA) were measured.FSIVGTT: The participants were 55% male, age 23.1and#8201;and#177;and#8201;0.05and#160;years, BMI 24.8and#8201;and#177;and#8201;6.3and#160;kg/m2 and % body fat 25.0and#8201;and#177;and#8201;15.2 (meanand#8201;and#177;and#8201;SD). HEC: The participants were 44% male, age 27.3and#8201;and#177;and#8201;8.1and#160;years, BMI 23.6and#8201;and#177;and#8201;5.0and#160;kg/m2 and % body fat 24.7and#8201;and#177;and#8201;14.2 (meanand#8201;and#177;and#8201;SD). While HOMA-IR, SI and M correlated with waist, BMI and % body fat (P-valuesand#8201;andlt;and#8201;0.01) there were no significant correlations between HOMA-IR with either SI or M-value (P-valuesand#8201;andgt;and#8201;0.2). Conclusions In young Afro-Caribbean adults, HOMA-IR compared poorly with other measures of insulin sensitivity. It remains important to determine whether similar findings occur in a more insulin resistant population. However, HOMA-IR correlated with clinical measures of insulin sensitivity (i.e. adiposity), so it may still be useful in epidemiological studies.
URI: http://dx.doi.org/10.1186/1756-0500-7-98
http://hdl.handle.net/2139/38043
Date: 2014-02-20


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