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Comparison of euglycemic clamp data with surrogate index measures of insulin sensitivity
Author(s) -
Hays Nicholas P.,
Starling Raymond D.,
Sullivan Dennis H.,
Coker Robert H.,
Evans William J.
Publication year - 2006
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.20.4.a594
Subject(s) - clamp , insulin , insulin sensitivity , glucose clamp technique , medicine , endocrinology , body mass index , sensitivity (control systems) , insulin resistance , clamping , electronic engineering , engineering , mechanical engineering
Equations to assess insulin sensitivity using fasting blood values or oral glucose tolerance data have been developed. We examined change in insulin sensitivity in response to a 12‐wk diet and exercise intervention in 31 older adults with impaired glucose tolerance using a euglycemic‐hyperinsulinemic clamp and 10 commonly used insulin sensitivity equations. Glucose disposal as calculated from clamp data was significantly higher following the intervention compared to baseline (5.9 ± 0.4 vs. 5.2 ± 0.3 mg · kg fat‐free mass −1 · min −1 , P = .01). In contrast, none of the examined indices indicated a significant change in insulin sensitivity over time (all P > .3). A 95% limits of agreement approach to compare insulin sensitivity calculated from each equation with the measure of glucose disposal from the clamp indicated imperfect agreement between measures (agreement limits ranged from ± 2.5 to 4.2 mg · kg FFM −1 · min −1 ), despite significant correlations between indices and clamp data. Correlations of changes in index values with changes in clamp data signify that these indices may have some practical utility. In terms of assessing improvements in insulin sensitivity, however, the wide variability in the prediction limits of agreement among indices suggests that these equations may be inadequate to assess change in insulin sensitivity, especially in comparison to the clamp technique. R01AG15385, F32AG21374, and M01RR14288.