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
Masao Kanauchi,
Shigeru Yamano,
Kimiko Kanauchi and
Yoshihiko Saito
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 sensitivityin 306 nonobese and nondiabetic Japanese subjects with variousBP categories (optimal BP, normal BP, high-normal BP, and hypertension).Insulin sensitivity was measured from fasting plasma glucoseand insulin values and those during a 75-g oral glucose tolerancetest by five formulas: the homeostasis model assessment of insulinresistance (HOMA-R), the quantitative insulin sensitivity checkindex (QUICKI), the oral glucose insulin sensitivity (OGIS)index, and two insulin sensitivity indexes (ISI-composite andISI-stumvoll). The HOMA-R was significantly higher, and theQUICKI was significantly lower in subjects with hypertensionthan in subjects with optimal BP. Both HOMA-R and QUICKI valuesshowed that high-normal BP patients had a higher (but not significant)degree of insulin resistance than optimal BP patients. The OGISindex was significantly lower in subjects with high-normal BPor hypertension than in subjects with optimal BP. The ISI-compositewas significantly lower in subjects with high-normal BP or hypertensionthan in subjects with optimal BP, and it was also significantlylower in subjects with hypertension than in subjects with normalBP. The ISI-stumvoll was significantly lower in subjects withhigh-normal BP or hypertension than in subjects with optimalBP. The OGIS index, ISI-composite, and ISI-stumvoll significantlydecreased with increasing severity of BP status among the normotensivegroups (optimal BP, normal BP, and high-normal BP). These findingsindicate that insulin resistance is present even in the high-normalBP categories of nonobese and nondiabetic Japanese individuals.
Abbreviations: AUC, Area under the response curve; BMI, bodymass index; BP, blood pressure; DBP, diastolic BP; HOMA-R, homeostasismodel assessment of insulin resistance; ISI, insulin sensitivityindex; ISI-stumvoll, ISI proposed by Stumvoll; OGIS, oral glucoseinsulin sensitivity; OGTT, oral glucose tolerance test; QUICKI,quantitative insulin sensitivity check index; SBP, systolicBP.
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