20/(fasting C-peptide × fasting plasma glucose) is a simple and effective index of insulin resistance in patients with type 2 diabetes mellitus: a preliminary report

Cardiovascular Diabetology

Original Investigation

Kazuhiko Matsuzawa¹  Hiroko Ohkura¹  Shin-ichi Taniguchi¹  Keisuke Sumi²  Naoya Yamamoto²  Kazuhiro Yamamoto²  Hideki Shiochi²  Hiroshi Kinoshita²  Tsuyoshi Ohkura²  Youhei Fujioka²  Masahiko Kato²  Shoichiro Izawa² 

[1] Department of Regional Medicine, Tottori University Faculty of Medicine, Yonago, Tottori, Japan;Division of Cardiovascular Medicine, Endocrinology and Metabolism, Department of Molecular Medicine and Therapeutics, Tottori University Faculty of Medicine, Yonago, Tottori, Japan;

关键词: Glucose clamp;    Meal tolerance test;    Japanese patients;    Insulin resistance;    C-peptide;    Type 2 diabetes mellitus;   

DOI  :  10.1186/1475-2840-12-21

 received in 2012-12-31, accepted in 2013-01-16,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundWe developed a simple and new insulin resistance index derived from a glucose clamp and a meal tolerance test (MTT) in Japanese patients with type 2 diabetes mellitus.MethodsFifteen patients [mean age: 53 years, fasting plasma glucose (FPG) 7.7 mmol/L, HbA1c 7.1% (54 mmol/mol), body mass index 26.8 kg/m2] underwent a MTT and a glucose clamp. Participants were given a test meal (450 kcal). Plasma glucose and insulin were measured at 0 (fasting), 30, 60, 120, and 180 min. Serum C-peptide immunoreactivity (CPR) was measured at 0 (fasting; F-CPR) and 120 min. Homeostasis model assessment of insulin resistance (HOMA-IR) and insulin sensitivity indices (ISI) were calculated from the MTT results. The glucose infusion rate (GIR) was measured during hyperinsulinemic–euglycemic glucose clamps.ResultsThe mean GIR in all patients was 5.8 mg·kg–1·min–1. The index 20/(F-CPR × FPG) was correlated strongly with GIR (r = 0.83, P < 0.0005). HOMA-IR (r = −0.74, P < 0.005) and ISI (r = 0.66, P < 0.01) were also correlated with GIR. In 10 patients with mild insulin resistance (GIR 5.0–10.0 mg·kg–1·min–1), 20/(F-CPR × FPG) was very strongly correlated with GIR (r = 0.90, P < 0.0005), but not with HOMA-IR and ISI (r = − 0.49, P = 0.15; r = 0.20, P = 0.56, respectively). In patients with mild insulin resistance, plasma adiponectin (r = 0.65, P < 0.05), but not BMI or waist circumstance, was correlated with GIR.Conclusions20/(F-CPR × FPG) is a simple and effective index of insulin resistance, and performs better than HOMA-IR and ISI in Japanese patients with type 2 diabetes mellitus. Our results suggest that 20/(F-CPR × FPG) is a more effective index than HOMA-IR in Japanese patients with mild insulin resistance.

【 授权许可】

CC BY   
© Ohkura et al.; licensee BioMed Central Ltd. 2013