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Quantitative Insulin Sensitivity Check Index: A Simple, Accurate Method for Assessing Insulin Sensitivity In Humans

Hypertension-Endocrine Branch and Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, National Institutes of Health (D.A.F.), Bethesda, Maryland 20892; and Division of Endocrinology and Metabolism, Indiana University School of Medicine (K.M., A.D.B.), Indianapolis, Indiana 46202

Address all correspondence and requests for reprints to: Michael J. Quon, M.D., Ph.D., Hypertension-Endocrine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Building 10, Room 8C-218, 10 Center Drive, MSC 1755, Bethesda, Maryland 20892-1755. E-mail: quonm{at}nih.gov

Insulin resistance plays an important role in the pathophysiology of diabetes and is associated with obesity and other cardiovascular risk factors. The "gold standard" glucose clamp and minimal model analysis are two established methods for determining insulin sensitivity in vivo, but neither is easily implemented in large studies. Thus, it is of interest to develop a simple, accurate method for assessing insulin sensitivity that is useful for clinical investigations. We performed both hyperinsulinemic isoglycemic glucose clamp and insulin-modified frequently sampled iv glucose tolerance tests on 28 non-obese, 13 obese, and 15 type 2 diabetic subjects. We obtained correlations between indexes of insulin sensitivity from glucose clamp studies (SI_Clamp) and minimal model analysis (SI_MM) that were comparable to previous reports (r = 0.57). We performed a sensitivity analysis on our data and discovered that physiological steady state values [i.e. fasting insulin (I₀) and glucose (G₀)] contain critical information about insulin sensitivity. We defined a quantitative insulin sensitivity check index (QUICKI = 1/[log(I₀) + log(G₀)]) that has substantially better correlation with SI_Clamp (r = 0.78) than the correlation we observed between SI_MM and SI_Clamp. Moreover, we observed a comparable overall correlation between QUICKI and SI_Clamp in a totally independent group of 21 obese and 14 nonobese subjects from another institution. We conclude that QUICKI is an index of insulin sensitivity obtained from a fasting blood sample that may be useful for clinical research.

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				E M Delemarre, J Rotteveel, and H A D.-v. de Waal Metabolic implications of GH treatment in small for gestational age Eur. J. Endocrinol., August 1, 2007; 157(suppl_1): S47 - S50. [Abstract] [Full Text] [PDF]

				B. J. Goldstein, M. N. Feinglos, J. K. Lunceford, J. Johnson, D. E. Williams-Herman, and for the Sitagliptin 036 Study Group Effect of Initial Combination Therapy With Sitagliptin, a Dipeptidyl Peptidase-4 Inhibitor, and Metformin on Glycemic Control in Patients With Type 2 Diabetes Diabetes Care, August 1, 2007; 30(8): 1979 - 1987. [Abstract] [Full Text] [PDF]

				J. Beltrand, M. Beregszaszi, D. Chevenne, G. Sebag, M. De Kerdanet, F. Huet, M. Polak, N. Tubiana-Rufi, D. Lacombe, A. M. De Paoli, et al. Metabolic Correction Induced by Leptin Replacement Treatment in Young Children With Berardinelli-Seip Congenital Lipoatrophy Pediatrics, August 1, 2007; 120(2): e291 - e296. [Abstract] [Full Text] [PDF]

				R. S. Rector, S. O. Warner, Y. Liu, P. S. Hinton, G. Y. Sun, R. H. Cox, C. S. Stump, M. H. Laughlin, K. C. Dellsperger, and T. R. Thomas Exercise and diet induced weight loss improves measures of oxidative stress and insulin sensitivity in adults with characteristics of the metabolic syndrome Am J Physiol Endocrinol Metab, August 1, 2007; 293(2): E500 - E506. [Abstract] [Full Text] [PDF]

				E. Carmina, S. Bucchieri, A. Esposito, A. Del Puente, P. Mansueto, F. Orio, G. Di Fede, and G. Rini Abdominal Fat Quantity and Distribution in Women with Polycystic Ovary Syndrome and Extent of Its Relation to Insulin Resistance J. Clin. Endocrinol. Metab., July 1, 2007; 92(7): 2500 - 2505. [Abstract] [Full Text] [PDF]

				K. K. Miller, B. M. K. Biller, A. Schaub, K. Pulaski-Liebert, G. Bradwin, N. Rifai, and A. Klibanski Effects of Testosterone Therapy on Cardiovascular Risk Markers in Androgen-Deficient Women with Hypopituitarism J. Clin. Endocrinol. Metab., July 1, 2007; 92(7): 2474 - 2479. [Abstract] [Full Text] [PDF]

				C. Cobelli, G. M. Toffolo, C. D. Man, M. Campioni, P. Denti, A. Caumo, P. Butler, and R. Rizza Assessment of beta-cell function in humans, simultaneously with insulin sensitivity and hepatic extraction, from intravenous and oral glucose tests Am J Physiol Endocrinol Metab, July 1, 2007; 293(1): E1 - E15. [Abstract] [Full Text] [PDF]

				M. F. Crutchlow, B. Robinson, B. Pappachen, N. Wimmer, A. J. Cucchiara, D. Cohen, and R. Townsend Validation of Steady-State Insulin Sensitivity Indices in Chronic Kidney Disease Diabetes Care, July 1, 2007; 30(7): 1813 - 1818. [Abstract] [Full Text] [PDF]

				G. Li, Y. Zhang, E. Rodrigues, D. Zheng, M. Matheny, K.-Y. Cheng, and P. J. Scarpace Melanocortin activation of nucleus of the solitary tract avoids anorectic tachyphylaxis and induces prolonged weight loss Am J Physiol Endocrinol Metab, July 1, 2007; 293(1): E252 - E258. [Abstract] [Full Text] [PDF]

				K. K. Koh, M. J. Quon, Y. Lee, S. H. Han, J. Y. Ahn, W.-J. Chung, J.-a Kim, and E. K. Shin Additive beneficial cardiovascular and metabolic effects of combination therapy with ramipril and candesartan in hypertensive patients Eur. Heart J., June 2, 2007; 28(12): 1440 - 1447. [Abstract] [Full Text] [PDF]

				E. Debing, E. Peeters, W. Duquet, K. Poppe, B. Velkeniers, and P. Van den Brande Endogenous sex hormone levels in postmenopausal women undergoing carotid artery endarterectomy Eur. J. Endocrinol., June 1, 2007; 156(6): 687 - 693. [Abstract] [Full Text] [PDF]

				K. K. Koh, M. J. Quon, S. J. Lee, S. H. Han, J. Y. Ahn, J.-a Kim, W.-J. Chung, Y. Lee, and E. K. Shin Efonidipine Simultaneously Improves Blood Pressure, Endothelial Function, and Metabolic Parameters in Nondiabetic Patients With Hypertension Diabetes Care, June 1, 2007; 30(6): 1605 - 1607. [Full Text] [PDF]

				J.-P. del Rincon, K. Iida, B. D. Gaylinn, C. E. McCurdy, J. W. Leitner, L. A. Barbour, J. J. Kopchick, J. E. Friedman, B. Draznin, and M. O. Thorner Growth Hormone Regulation of p85{alpha} Expression and Phosphoinositide 3-Kinase Activity in Adipose Tissue: Mechanism for Growth Hormone-Mediated Insulin Resistance Diabetes, June 1, 2007; 56(6): 1638 - 1646. [Abstract] [Full Text] [PDF]

				P. Kallio, M. Kolehmainen, D. E Laaksonen, J. Kekalainen, T. Salopuro, K. Sivenius, L. Pulkkinen, H. M Mykkanen, L. Niskanen, M. Uusitupa, et al. Dietary carbohydrate modification induces alterations in gene expression in abdominal subcutaneous adipose tissue in persons with the metabolic syndrome: the FUNGENUT Study Am. J. Clinical Nutrition, May 1, 2007; 85(5): 1417 - 1427. [Abstract] [Full Text] [PDF]

				C. Beysen, E. J. Murphy, T. McLaughlin, T. Riiff, C. Lamendola, H. C. Turner, M. Awada, S. M. Turner, G. Reaven, and M. K. Hellerstein Whole-Body Glycolysis Measured by the Deuterated-Glucose Disposal Test Correlates Highly With Insulin Resistance In Vivo Diabetes Care, May 1, 2007; 30(5): 1143 - 1149. [Abstract] [Full Text] [PDF]

				M. A. Potenza, F. L. Marasciulo, M. Tarquinio, E. Tiravanti, G. Colantuono, A. Federici, J.-a Kim, M. J. Quon, and M. Montagnani EGCG, a green tea polyphenol, improves endothelial function and insulin sensitivity, reduces blood pressure, and protects against myocardial I/R injury in SHR Am J Physiol Endocrinol Metab, May 1, 2007; 292(5): E1378 - E1387. [Abstract] [Full Text] [PDF]

				K. K. Trout, C. Homko, and N. C. Tkacs Methods of Measuring Insulin Sensitivity Biol Res Nurs, April 1, 2007; 8(4): 305 - 318. [Abstract] [PDF]

				B. Banaszewska, L. Pawelczyk, R. Z. Spaczynski, J. Dziura, and A. J. Duleba Effects of Simvastatin and Oral Contraceptive Agent on Polycystic Ovary Syndrome: Prospective, Randomized, Crossover Trial J. Clin. Endocrinol. Metab., February 1, 2007; 92(2): 456 - 461. [Abstract] [Full Text] [PDF]

				H. Yamaza, T. Komatsu, K. To, H. Toyama, T. Chiba, Y. Higami, and I. Shimokawa Involvement of Insulin-Like Growth Factor-1 in the Effect of Caloric Restriction: Regulation of Plasma Adiponectin and Leptin J. Gerontol. A Biol. Sci. Med. Sci., January 1, 2007; 62(1): 27 - 33. [Abstract] [Full Text] [PDF]

				M. A. Abdul-Ghani, M. Matsuda, B. Balas, and R. A. DeFronzo Muscle and Liver Insulin Resistance Indexes Derived From the Oral Glucose Tolerance Test Diabetes Care, January 1, 2007; 30(1): 89 - 94. [Abstract] [Full Text] [PDF]

				G. Radetti, A. Fanolla, L. Pappalardo, and E. Gottardi Prematurity May Be a Risk Factor for Thyroid Dysfunction in Childhood J. Clin. Endocrinol. Metab., January 1, 2007; 92(1): 155 - 159. [Abstract] [Full Text] [PDF]

				L. D. Yee, N. Williams, P. Wen, D. C. Young, J. Lester, M. V. Johnson, W. B. Farrar, M. J. Walker, S. P. Povoski, S. Suster, et al. Pilot Study of Rosiglitazone Therapy in Women with Breast Cancer: Effects of Short-term Therapy on Tumor Tissue and Serum Markers Clin. Cancer Res., January 1, 2007; 13(1): 246 - 252. [Abstract] [Full Text] [PDF]

				P. Aschner, M. S. Kipnes, J. K. Lunceford, M. Sanchez, C. Mickel, D. E. Williams-Herman, and for the Sitagliptin Study 021 Group Effect of the Dipeptidyl Peptidase-4 Inhibitor Sitagliptin as Monotherapy on Glycemic Control in Patients With Type 2 Diabetes Diabetes Care, December 1, 2006; 29(12): 2632 - 2637. [Abstract] [Full Text] [PDF]