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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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				T. M. Cho, N. Peng, J. T. Clark, L. Novak, S. Roysommuti, J. Prasain, and J. M. Wyss Genistein Attenuates the Hypertensive Effects of Dietary NaCl in Hypertensive Male Rats Endocrinology, November 1, 2007; 148(11): 5396 - 5402. [Abstract] [Full Text] [PDF]

				Z. Liu Insulin at physiological concentrations increases microvascular perfusion in human myocardium Am J Physiol Endocrinol Metab, November 1, 2007; 293(5): E1250 - E1255. [Abstract] [Full Text] [PDF]

				P. Velasquez-Mieyer, C. P. Neira, R. Nieto, and P. A. Cowan Review: Obesity and cardiometabolic syndrome in children Therapeutic Advances in Cardiovascular Disease, October 1, 2007; 1(1): 61 - 81. [Abstract] [PDF]

				N. Kajaia, H. Binder, R. Dittrich, P. G Oppelt, B. Flor, S. Cupisti, M. W Beckmann, and A. Mueller Low sex hormone-binding globulin as a predictive marker for insulin resistance in women with hyperandrogenic syndrome Eur. J. Endocrinol., October 1, 2007; 157(4): 499 - 507. [Abstract] [Full Text] [PDF]

				E. J. Boyko and C. C. Jensen Do We Know What Homeostasis Model Assessment Measures?: If not, does it matter? Diabetes Care, October 1, 2007; 30(10): 2725 - 2728. [Full Text] [PDF]

				N. H. Cho, H. C. Jang, S. H. Choi, H. R. Kim, H. K. Lee, J. C.N. Chan, and S. Lim Abnormal Liver Function Test Predicts Type 2 Diabetes: A community-based prospective study Diabetes Care, October 1, 2007; 30(10): 2566 - 2568. [Full Text] [PDF]

				N. Tsuchiyama, T. Takamura, H. Ando, M. Sakurai, A. Shimizu, K.-i. Kato, S. Kurita, and S. Kaneko Possible Role of {alpha}-Cell Insulin Resistance in Exaggerated Glucagon Responses to Arginine in Type 2 Diabetes Diabetes Care, October 1, 2007; 30(10): 2583 - 2587. [Abstract] [Full Text] [PDF]

				Y. Seng Lee, L. Kok Seng Poh, B. Lay Kee Kek, and K. Yin Loke The Role of Melanocortin 3 Receptor Gene in Childhood Obesity Diabetes, October 1, 2007; 56(10): 2622 - 2630. [Abstract] [Full Text] [PDF]

				J. Gomez-Ambrosi, V. Catalan, B. Ramirez, A. Rodriguez, I. Colina, C. Silva, F. Rotellar, C. Mugueta, M. J. Gil, J. A. Cienfuegos, et al. Plasma Osteopontin Levels and Expression in Adipose Tissue Are Increased in Obesity J. Clin. Endocrinol. Metab., September 1, 2007; 92(9): 3719 - 3727. [Abstract] [Full Text] [PDF]

				G Svegliati-Baroni, E Bugianesi, T Bouserhal, F Marini, F Ridolfi, F Tarsetti, F Ancarani, E Petrelli, E Peruzzi, M L. Cascio, et al. Post-load insulin resistance is an independent predictor of hepatic fibrosis in virus C chronic hepatitis and in non-alcoholic fatty liver disease Gut, September 1, 2007; 56(9): 1296 - 1301. [Abstract] [Full Text] [PDF]

				Y. J. Cheng, E. W. Gregg, N. De Rekeneire, D. E. Williams, G. Imperatore, C. J. Caspersen, and H. S. Kahn Muscle-Strengthening Activity and Its Association With Insulin Sensitivity Diabetes Care, September 1, 2007; 30(9): 2264 - 2270. [Abstract] [Full Text] [PDF]

				C. Anderwald, M. Anderwald-Stadler, M. Promintzer, G. Prager, M. Mandl, P. Nowotny, M. G. Bischof, M. Wolzt, B. Ludvik, T. Kastenbauer, et al. The Clamp-Like Index: A novel and highly sensitive insulin sensitivity index to calculate hyperinsulinemic clamp glucose infusion rates from oral glucose tolerance tests in nondiabetic subjects Diabetes Care, September 1, 2007; 30(9): 2374 - 2380. [Abstract] [Full Text] [PDF]

				S. Gilliam-Davis, V. S. Payne, S. O. Kasper, E. N. Tommasi, M. E. Robbins, and D. I. Diz Long-term AT1 receptor blockade improves metabolic function and provides renoprotection in Fischer-344 rats Am J Physiol Heart Circ Physiol, September 1, 2007; 293(3): H1327 - H1333. [Abstract] [Full Text] [PDF]

				V. F. Panoulas, H. J. Milionis, K. M. J. Douglas, P. Nightingale, M. D. Kita, R. Klocke, M. S. Elisaf, and G. D. Kitas Association of serum uric acid with cardiovascular disease in rheumatoid arthritis Rheumatology, September 1, 2007; 46(9): 1466 - 1470. [Abstract] [Full Text] [PDF]

				V. F. Panoulas, K. M. J. Douglas, H. J. Milionis, A. Stavropoulos-Kalinglou, P. Nightingale, M. D. Kita, A. L. Tselios, G. S. Metsios, M. S. Elisaf, and G. D. Kitas Prevalence and associations of hypertension and its control in patients with rheumatoid arthritis Rheumatology, September 1, 2007; 46(9): 1477 - 1482. [Abstract] [Full Text] [PDF]

				S. Hahn, M. Backhaus, M. Broecker-Preuss, S. Tan, T. Dietz, R. Kimmig, M. Schmidt, K. Mann, and O. E Janssen Retinol-binding protein 4 levels are elevated in polycystic ovary syndrome women with obesity and impaired glucose metabolism Eur. J. Endocrinol., August 1, 2007; 157(2): 201 - 207. [Abstract] [Full Text] [PDF]

				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]