Comparison of Measured and Estimated Indices of Insulin Sensitivity and β Cell Function: Impact of Ethnicity on Insulin Sensitivity and β Cell Function in Glucose-Tolerant and Normotensive Subjects1

Type 2 diabetes mellitus is the result of an imbalance between insulin sensitivity and beta cell function. Although the assessment of these 2 parameters is critical for various studies, the current methods are time consuming and labor intensive. Recently, new estimated indices have been proposed. We examined the impact of ethnicity on the indices of insulin sensitivity and beta cell function measured from the hyperglycemic clamp and compared the results to the estimated indices, proposed by Matsuda and DeFronzo and Stumvoll et al., from a standard oral glucose tolerance test in 105 healthy, glucose-tolerant, and normotensive subjects from 4 ethnic groups. Among the ethnic groups, differences were noted in the measured insulin sensitivity (P = 0.0006) and beta cell function (P = 0.006 for the first phase insulin response, P = 0.0002 for the second phase insulin response). Although the estimated indices correlated with the measured indices (r(2) = 0.5184--0.3014), the estimated indices barely detected the differences among the ethnic groups. Multivariate analysis confirmed that ethnicity had an independent impact for the measured indices, but had only a modest impact on the estimated insulin sensitivity indices and had no impact on the estimated indices of beta cell function. We conclude that although the estimated indices of insulin sensitivity and beta cell function from the oral glucose tolerance test correlated with the measured ones in a wide spectrum of healthy, glucose-tolerant, and normotensive subjects, they were much less likely to detect the differences than measured ones among the ethnic groups.