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Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage.

Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage. Research Abstract Details 

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  • Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage. Abstract Text:

    ranganath muniyappaRanganath Muniyappa,sihoon leeSihoon Lee,hui chenHui Chen,michael j quonMichael J Quon,ranganath muniyappaRanganath Muniyappa,sihoon leeSihoon Lee,hui chenHui Chen,michael j quonMichael J Quon,

    Insulin resistance contributes to the pathophysiology of diabetes and is a hallmark of obesity, metabolic syndrome, and many cardiovascular diseases. Therefore, quantifying insulin sensitivity/resistance in humans and animal models is of great importance for epidemiological studies, clinical and basic science investigations, and eventual use in clinical practice. Direct and indirect methods of varying complexity are currently employed for these purposes. Some methods rely on steady-state analysis of glucose and insulin, whereas others rely on dynamic testing. Each of these methods has distinct advantages and limitations. Thus, optimal choice and employment of a specific method depends on the nature of the studies being performed. Established direct methods for measuring insulin sensitivity in vivo are relatively complex. The hyperinsulinemic euglycemic glucose clamp and the insulin suppression test directly assess insulin-mediated glucose utilization under steady-state conditions that are both labor and time intensive. A slightly less complex indirect method relies on minimal model analysis of a frequently sampled intravenous glucose tolerance test. Finally, simple surrogate indexes for insulin sensitivity/resistance are available (e.g., QUICKI, HOMA, 1/insulin, Matusda index) that are derived from blood insulin and glucose concentrations under fasting conditions (steady state) or after an oral glucose load (dynamic). In particular, the quantitative insulin sensitivity check index (QUICKI) has been validated extensively against the reference standard glucose clamp method. QUICKI is a simple, robust, accurate, reproducible method that appropriately predicts changes in insulin sensitivity after therapeutic interventions as well as the onset of diabetes. In this Frontiers article, we highlight merits, limitations, and appropriate use of current in vivo measures of insulin sensitivity/resistance.

    Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage. Publishing Authors By Initials

    r muniyappaR Muniyappa,s leeS Lee,h chenH Chen,mj quonMJ Quon,r muniyappaR Muniyappa,s leeS Lee,h chenH Chen,mj quonMJ Quon,

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    Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage. Journal Published:

    PUBLICATION TYPE: Journal Article

    Journal: American journal of physiology. Endocrinology and

    VOLUME: 294

    Page Numbers: E15-26

    Journal Abbreviation: Am. J. Physiol. Endocrinol. Me

    ISSN: 0193-1849

    DAY: 23

    MONTH: 10

    YEAR: 2007

    Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage. Information

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    LANGUAGE: eng

    NlmUniqueID: 100901226

    Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage. Keywords Mesh Terms:

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    AFFILIATION: Diabetes Unit, NCCAM, NIH, 9 Memorial Drive, Bldg. 9, Rm. 1N-105 MSC 0920, Bethesda, MD 20892. quonm@nih.gov).

    Country: United States

    United States Research PublicationUnited States Research Publication

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    MEDLINETA: Am J Physiol Endocrinol Metab

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