Open AccessCPR-IR is an insulin resistance index that is minimally affected by hepatic insulin clearance—A preliminary research
Author(s) -
Tomohiro Okura,
Ryô Nakamura,
Yohei Fujioka,
Sonoko Kawamoto-Kitao,
Y. Ito,
Kazuhisa Matsumoto,
Kyoko Shoji,
Keisuke Sumi,
Kazuhiko Matsuzawa,
Shoichiro Izawa,
Etsuko Ueta,
Masahiko Kato,
Teruhiko Imamura,
Shinichi Taniguchi,
Kazuhide Yamamoto
Publication year - 2018
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0197663
Subject(s) - insulin resistance , medicine , insulin , type 2 diabetes mellitus , diabetes mellitus , endocrinology , glucose clamp technique , pathophysiology , type 2 diabetes , pancreatic hormone
Background Increased hepatic insulin clearance (HIC) is important in the pathophysiology of type 2 diabetes mellitus (T2DM). The aim of this study is to analyze an effective insulin resistance (IR) index that is minimally affected by HIC. Methods Our study involved 20 participants with T2DM and 21 healthy participants without diabetes (Non-DM). Participants underwent a meal tolerance test from which plasma glucose, insulin and serum C-peptide immunoreactivity (CPR) were measured, and HOMA-IR and HIC were calculated. Participants then underwent a hyperinsulinemic-euglycemic clamp from which the glucose disposal rate (GDR) was measured. Results The index CPR-IR = 20/(fasting CPR × fasting plasma glucose) was correlated more strongly with GDR, than was HOMA-IR, and CPR-IR could be used to estimate GDR. In T2DM participants with HIC below the median, HOMA-IR and CPR-IR were equally well correlated with GDR. In T2DM with high HIC, CPR-IR correlated with GDR while HOMA-IR did not. In Non-DM, CPR-IR and HOMA-IR were equally well correlated with GDR regardless of HIC. The mean HIC value in T2DM was significantly higher than that of Non-DM. Conclusions CPR-IR could be a simple and effective index of insulin resistance for patients with type 2 diabetes that is minimally affected by HIC.