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Fasting-based estimates of insulin sensitivity in overweight and obesity: a critical appraisal.
Obesity (Silver Spring). 2006 Jul; 14(7):1250-6.O

Abstract

OBJECTIVE

To identify simple methods to estimate the degree of insulin resistance.

RESEARCH METHODS AND PROCEDURES

The performance of a wide range of fasting-based index estimates of insulin sensitivity was compared by receiver operating characteristic analysis (area under curves and their 95% confidence intervals) against the M value from euglycemic insulin clamp studies collected in the San Antonio (non-Hispanic whites and Hispanic residents of San Antonio, TX) and European Group for the Study of Insulin Resistance (non-diabetic white Europeans) databases (n = 638).

RESULTS

Insulin resistance differed substantially between lean (BMI < 25 kg/m2), overweight or obese (BMI > or = 25 kg/m2), and type 2 diabetic individuals. Estimates of insulin resistance were, therefore, assessed in each group separately. In the overweight and obese subgroup (n = 302), the receiver operating characteristic performance of fasting-based indices varied from 0.72 (0.62 to 0.82), in the case of the insulin/glucose ratio, to 0.80 (0.72 to 0.88) in the case of Belfiore free fatty acids. One superior method could not be identified; the confidence intervals overlapped, and no statistically significant differences emerged. All indices performed better when using the whole study population, with fasting plasma insulin, homeostatic model assessment, insulin/glucose ratio, quantitative insulin sensitivity check index, glucose/insulin ratio, Belfiore glycemia, revised quantitative insulin sensitivity check index, McAuley index, and Belfiore free fatty acids showing area under curves of 0.83, 0.90, 0.66, 0.90, 0.66, 0.90, 0.85, 0.83, and 0.86, respectively, because of the inclusion of very insulin sensitive (lean) and very insulin resistant cases (diabetic subjects).

DISCUSSION

In conclusion, a superior fasting-based index estimate to distinguish between the presence and absence of insulin resistance in overweight and obesity could not be identified despite the use of the large datasets.

Authors+Show Affiliations

Department of Diabetology, Metabolism and Clinical Nutrition, Faculty of Medicine, University Hospital Antwerp, Wilrijkstraat 10, B-2650 Edegem, Antwerp, Belgium.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16899806

Citation

Ruige, Johannes B., et al. "Fasting-based Estimates of Insulin Sensitivity in Overweight and Obesity: a Critical Appraisal." Obesity (Silver Spring, Md.), vol. 14, no. 7, 2006, pp. 1250-6.
Ruige JB, Mertens IL, Bartholomeeusen E, et al. Fasting-based estimates of insulin sensitivity in overweight and obesity: a critical appraisal. Obesity (Silver Spring). 2006;14(7):1250-6.
Ruige, J. B., Mertens, I. L., Bartholomeeusen, E., Dirinck, E., Ferrannini, E., & Van Gaal, L. F. (2006). Fasting-based estimates of insulin sensitivity in overweight and obesity: a critical appraisal. Obesity (Silver Spring, Md.), 14(7), 1250-6.
Ruige JB, et al. Fasting-based Estimates of Insulin Sensitivity in Overweight and Obesity: a Critical Appraisal. Obesity (Silver Spring). 2006;14(7):1250-6. PubMed PMID: 16899806.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fasting-based estimates of insulin sensitivity in overweight and obesity: a critical appraisal. AU - Ruige,Johannes B, AU - Mertens,Ilse L, AU - Bartholomeeusen,Ellen, AU - Dirinck,Eveline, AU - Ferrannini,Ele, AU - Van Gaal,Luc F, PY - 2006/8/11/pubmed PY - 2006/12/9/medline PY - 2006/8/11/entrez SP - 1250 EP - 6 JF - Obesity (Silver Spring, Md.) JO - Obesity (Silver Spring) VL - 14 IS - 7 N2 - OBJECTIVE: To identify simple methods to estimate the degree of insulin resistance. RESEARCH METHODS AND PROCEDURES: The performance of a wide range of fasting-based index estimates of insulin sensitivity was compared by receiver operating characteristic analysis (area under curves and their 95% confidence intervals) against the M value from euglycemic insulin clamp studies collected in the San Antonio (non-Hispanic whites and Hispanic residents of San Antonio, TX) and European Group for the Study of Insulin Resistance (non-diabetic white Europeans) databases (n = 638). RESULTS: Insulin resistance differed substantially between lean (BMI < 25 kg/m2), overweight or obese (BMI > or = 25 kg/m2), and type 2 diabetic individuals. Estimates of insulin resistance were, therefore, assessed in each group separately. In the overweight and obese subgroup (n = 302), the receiver operating characteristic performance of fasting-based indices varied from 0.72 (0.62 to 0.82), in the case of the insulin/glucose ratio, to 0.80 (0.72 to 0.88) in the case of Belfiore free fatty acids. One superior method could not be identified; the confidence intervals overlapped, and no statistically significant differences emerged. All indices performed better when using the whole study population, with fasting plasma insulin, homeostatic model assessment, insulin/glucose ratio, quantitative insulin sensitivity check index, glucose/insulin ratio, Belfiore glycemia, revised quantitative insulin sensitivity check index, McAuley index, and Belfiore free fatty acids showing area under curves of 0.83, 0.90, 0.66, 0.90, 0.66, 0.90, 0.85, 0.83, and 0.86, respectively, because of the inclusion of very insulin sensitive (lean) and very insulin resistant cases (diabetic subjects). DISCUSSION: In conclusion, a superior fasting-based index estimate to distinguish between the presence and absence of insulin resistance in overweight and obesity could not be identified despite the use of the large datasets. SN - 1930-7381 UR - https://www.unboundmedicine.com/medline/citation/16899806/Fasting_based_estimates_of_insulin_sensitivity_in_overweight_and_obesity:_a_critical_appraisal_ L2 - https://doi.org/10.1038/oby.2006.142 DB - PRIME DP - Unbound Medicine ER -