This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rabasa-Lhoret, R. Articles by Laville, M. Search for Related Content PubMed PubMed Citation Articles by Rabasa-Lhoret, R. Articles by Laville, M.

Modified Quantitative Insulin Sensitivity Check Index Is Better Correlated to Hyperinsulinemic Glucose Clamp than Other Fasting-Based Index of Insulin Sensitivity in Different Insulin-Resistant States

Human Nutrition Research Centre of Lyon (R.R.-L., P.-H.D., F.A., F.G., J.B., C.L.-P., C.M., J.P., J.C., M.L.), Hôpital Edouard-Herriot, Lyon 69003, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U449 (R.R.-L., H.V., M.L.), Laennec Faculty of Medicine, Université Claude Bernard, Lyon 69372, France; Centre de Recherche (R.R.-L.), Centre Hospitalier de l’Université de Montréal Hôtel-Dieu, Montréal, Québec, Canada H2W 1T7; Department of Biochemistry and Hormonology (V.J.), Hôpital Tenon, Paris 75970 Cedex 20, France; and INSERM U402 (J.-P.B.), Saint-Antoine Faculty of Medicine, Université Pierre et Marie Curie, Paris 75571 Cedex 12, France

Address all correspondence and requests for reprints to: Rémi Rabasa-Lhoret, M.D., Ph.D., Division of Endocrinology Research Centre, Centre Hospitalier de l’Université de Montréal Hôtel-Dieu 3850, Saint-Urbain St. Montréal, Québec, Canada H2W 1T7. E-mail: remi.rabasa-lhoret{at}umontreal.ca.

Fasting-based index estimates of insulin sensitivity were compared with euglycemic hyperinsulinemic clamp (IS clamp) measurements in 148 subjects: normal controls (n = 46), and obese (n = 12), polycystic ovary syndrome (n = 16), first-degree relatives of type 2 diabetic (n = 17), impaired glucose tolerance (n = 28), and type 2 diabetic (n = 29) patients. The fasting-based indexes tested included log homeostasis model assessment (HOMA), the quantitative insulin sensitivity check index (QUICKI), the revised QUICKI, and a new revised QUICKI using fasting plasma glycerol.

In the population studied, at 40 mU/m²·min (n = 30) revised QUICKI (r = 0.86; P < 0.0001) and QUICKI-glycerol (r = 0.87; P < 0.0001) gave higher correlations with the IS clamp than QUICKI and log HOMA (r = 0.78 and r = -0.78; P < 0.001). For subjects tested at 75 mU/m²·min (n = 118), comparable correlations were found for all indexes (r > 0.80; P < 0.0001). When studied in subgroups, revised QUICKI and QUICKI-glycerol give significantly higher correlations with the IS clamp than other indexes for lean control subjects studied at 40mU/m²·min and impaired glucose tolerance subjects.

We confirmed, in a large patient population with a wide range of insulin sensitivities, that no single test is superior in all groups of patients. However, QUICKI and revised QUICKI are good indexes that offer correlations similar to or higher than values obtained with log HOMA. Such indexes are simple tools to estimate insulin sensitivity appropriate for epidemiological studies.

This work was supported by a postdoctoral fellowship from the French Diabetes Association (ALFEDIAM-Servier grant; to R.R.-L.) and a postdoctoral award from the Information, Educational and Research Centre in Nutrition (CERIN, Paris, France; to R.R.-L.).

Abbreviations: BMI, Body mass index; FFA, free fatty acid(s); GIR, glucose infusion rate; HOMA, homeostasis model assessment; IGT, impaired glucose tolerance; IS clamp, euglycemic hyperinsulinemic clamp; PCOS, polycystic ovary syndrome; QUICKI, quantitative insulin sensitivity check index.

This article has been cited by other articles:

				R. Muniyappa, S. Lee, H. Chen, and M. J. Quon Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage Am J Physiol Endocrinol Metab, January 1, 2008; 294(1): E15 - E26. [Abstract] [Full Text] [PDF]

				J. V. Silha, B.L. G. Nyomba, W. D. Leslie, and L. J. Murphy Ethnicity, Insulin Resistance, and Inflammatory Adipokines in Women at High and Low Risk for Vascular Disease Diabetes Care, February 1, 2007; 30(2): 286 - 291. [Abstract] [Full Text] [PDF]

				M. Faraj, G. Beauregard, E. Loizon, M. Moldes, K. Clement, Y. Tahiri, K. Cianflone, H. Vidal, and R. Rabasa-Lhoret Insulin regulation of gene expression and concentrations of white adipose tissue-derived proteins in vivo in healthy men: relation to adiponutrin. J. Endocrinol., November 1, 2006; 191(2): 427 - 435. [Abstract] [Full Text] [PDF]

				M. Moldes, G. Beauregard, M. Faraj, N. Peretti, P.-H. Ducluzeau, M. Laville, R. Rabasa-Lhoret, H. Vidal, and K. Clement Adiponutrin gene is regulated by insulin and glucose in human adipose tissue Eur. J. Endocrinol., September 1, 2006; 155(3): 461 - 468. [Abstract] [Full Text] [PDF]

				R. J. Karne, H. Chen, G. Sullivan, and M. J. Quon Letter re: Limited Accuracy of Surrogates of Insulin Resistance during Puberty in Obese and Lean Children at Risk for Altered Glucoregulation J. Clin. Endocrinol. Metab., July 1, 2005; 90(7): 4418 - 4419. [Full Text] [PDF]

				H. Chen, G. Sullivan, and M. J. Quon Assessing the Predictive Accuracy of QUICKI as a Surrogate Index for Insulin Sensitivity Using a Calibration Model Diabetes, July 1, 2005; 54(7): 1914 - 1925. [Abstract] [Full Text] [PDF]

				A. Brehm, G. Pfeiler, G. Pacini, H. Vierhapper, and M. Roden Relationship between Serum Lipoprotein Ratios and Insulin Resistance in Obesity Clin. Chem., December 1, 2004; 50(12): 2316 - 2322. [Abstract] [Full Text] [PDF]

				F. Conus, D. B. Allison, R. Rabasa-Lhoret, M. St-Onge, D. H. St-Pierre, A. Tremblay-Lebeau, and E. T. Poehlman Metabolic and Behavioral Characteristics of Metabolically Obese but Normal-Weight Women J. Clin. Endocrinol. Metab., October 1, 2004; 89(10): 5013 - 5020. [Abstract] [Full Text] [PDF]

				S. H. Kim, F. Abbasi, and G. M. Reaven Impact of Degree of Obesity on Surrogate Estimates of Insulin Resistance Diabetes Care, August 1, 2004; 27(8): 1998 - 2002. [Abstract] [Full Text] [PDF]

				J. F. Ascaso, S. Pardo, J. T. Real, R. I. Lorente, A. Priego, and R. Carmena Diagnosing Insulin Resistance by Simple Quantitative Methods in Subjects With Normal Glucose Metabolism: Response to Karne, Chen, and Quon Diabetes Care, May 1, 2004; 27(5): 1249 - 1249. [Full Text] [PDF]

				R. J. Karne, H. Chen, and M. J. Quon Diagnosing Insulin Resistance by Simple Quantitative Methods in Subjects With Normal Glucose Metabolism: Response to Ascaso et al. Diabetes Care, May 1, 2004; 27(5): 1247 - 1248. [Full Text] [PDF]