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Homeostasis Model Assessment of Insulin Resistance, Quantitative Insulin Sensitivity Check Index, and Oral Glucose Insulin Sensitivity Index in Nonobese, Nondiabetic Subjects with High-Normal Blood Pressure

First Department of Internal Medicine (M.K., S.Y., Y.S.), Nara Medical University, Nara 634-0813, Japan; and Medical Center for Employers’ Health (K.K.), SHARP Corporation, Shinjo 639-2198, Japan

Address all correspondence and requests for reprints to: Dr. Masao Kanauchi, First Department of Internal Medicine, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-0813, Japan. E-mail: kanauchi{at}nmu-gw.naramed-u.ac.jp.

To investigate the relationships between high-normal blood pressure (BP) and insulin resistance, we examined insulin sensitivity in 306 nonobese and nondiabetic Japanese subjects with various BP categories (optimal BP, normal BP, high-normal BP, and hypertension). Insulin sensitivity was measured from fasting plasma glucose and insulin values and those during a 75-g oral glucose tolerance test by five formulas: the homeostasis model assessment of insulin resistance (HOMA-R), the quantitative insulin sensitivity check index (QUICKI), the oral glucose insulin sensitivity (OGIS) index, and two insulin sensitivity indexes (ISI-composite and ISI-stumvoll). The HOMA-R was significantly higher, and the QUICKI was significantly lower in subjects with hypertension than in subjects with optimal BP. Both HOMA-R and QUICKI values showed that high-normal BP patients had a higher (but not significant) degree of insulin resistance than optimal BP patients. The OGIS index was significantly lower in subjects with high-normal BP or hypertension than in subjects with optimal BP. The ISI-composite was significantly lower in subjects with high-normal BP or hypertension than in subjects with optimal BP, and it was also significantly lower in subjects with hypertension than in subjects with normal BP. The ISI-stumvoll was significantly lower in subjects with high-normal BP or hypertension than in subjects with optimal BP. The OGIS index, ISI-composite, and ISI-stumvoll significantly decreased with increasing severity of BP status among the normotensive groups (optimal BP, normal BP, and high-normal BP). These findings indicate that insulin resistance is present even in the high-normal BP categories of nonobese and nondiabetic Japanese individuals.

Abbreviations: AUC, Area under the response curve; BMI, body mass index; BP, blood pressure; DBP, diastolic BP; HOMA-R, homeostasis model assessment of insulin resistance; ISI, insulin sensitivity index; ISI-stumvoll, ISI proposed by Stumvoll; OGIS, oral glucose insulin sensitivity; OGTT, oral glucose tolerance test; QUICKI, quantitative insulin sensitivity check index; SBP, systolic BP.

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