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QUICKI Does Not Accurately Reflect Changes in Insulin Sensitivity with Exercise Training

Departments of Medicine (Division of Endocrinology and Metabolism) (G.E.D., P.W.S.), Biostatistics (A.D.H.), and Biochemistry and Molecular Biology (P.W.S.), University of Florida, Gainesville, Florida 32610

Address all correspondence and requests for reprints to: Glen E. Duncan, Ph.D., Box 100226 JHMHSC, University of Florida, Gainesville, Florida 32610-0226. E-mail: gduncan{at}ufl.edu

Abstract

A novel index of insulin sensitivity, the quick insulin sensitivity check index, termed QUICKI (1/[log (insulin) + log (glucose)]), was recently developed. We examined whether QUICKI accurately reflects changes in insulin sensitivity after exercise training, a perturbation known to improve insulin sensitivity. Sedentary, nondiabetic adults underwent a frequently sampled iv glucose tolerance test before and after 6 months of training. Insulin sensitivity was estimated from the glucose tolerance test using Bergman’s minimal model (insulin sensitivity–minimal model), and QUICKI was calculated from basal insulin and glucose. Exercise increased (P = 0.003) insulin sensitivity–minimal model but did not change (P = 0.12) QUICKI. Before and after training, the rank-correlation between QUICKI and insulin sensitivity–minimal model was significant (r = 0.79, P = 0.0005; r = 0.56, P = 0.03, respectively). However, the rank-correlation between fasting insulin alone with insulin sensitivity–minimal model was as good (before training r = -0.77, P = 0.0009; after training r = -0.55, P = 0.03) as that between QUICKI and insulin sensitivity–minimal model. Fasting glucose was not related to insulin sensitivity–minimal model at either time. When difference scores (i.e. after pretraining values) were examined, neither QUICKI nor fasting insulin correlated with insulin sensitivity–minimal model (QUICKI vs. insulin sensitivity–minimal model r = 0.24, P = 0.39; fasting insulin vs. insulin sensitivity–minimal model r = -0.40, P = 0.14). We conclude that fasting insulin is equivalent to fasting insulin plus glucose (i.e. QUICKI) at estimating basal insulin sensitivity in nondiabetic adults. However, QUICKI does not accurately reflect exercise-induced changes in insulin sensitivity within individual subjects.

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