Measuring and Estimating Insulin Resistance in Clinical and Research Settings

Overview

Journal Obesity (Silver Spring)

Specialties Endocrinology
Nutritional Sciences
Physiology

Date 2022 Jul 27

PMID 35894085

Authors

Amalia Gastaldelli

Affiliations

Soon will be listed here.

Abstract

The article discusses how to measure insulin resistance in muscle, liver, and adipose tissue in human participants. The most frequently used methodologies to evaluate insulin resistance are described in detail starting from the gold standard, that is, the euglycemic hyperinsulinemic clamp, to the intravenous glucose tolerance test, surrogate indices based on fasting measurements, or dynamic tests (such as oral glucose or mixed meal tolerance tests). The accuracy, precision, and reproducibility of the tests as well as cutoff values are reported.

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References

Stumvoll M, Mitrakou A, Pimenta W, Jenssen T, Yki-Jarvinen H, van Haeften T . Use of the oral glucose tolerance test to assess insulin release and insulin sensitivity. Diabetes Care. 2000; 23(3):295-301. DOI: 10.2337/diacare.23.3.295. View

Cherrington A . Banting Lecture 1997. Control of glucose uptake and release by the liver in vivo. Diabetes. 1999; 48(5):1198-214. DOI: 10.2337/diabetes.48.5.1198. View

Rabkin R, Simon N, Steiner S, Colwell J . Effect of renal disease on renal uptake and excretion of insulin in man. N Engl J Med. 1970; 282(4):182-7. DOI: 10.1056/NEJM197001222820402. View

Gayoso-Diz P, Otero-Gonzalez A, Rodriguez-Alvarez M, Gude F, Garcia F, de Francisco A . Insulin resistance (HOMA-IR) cut-off values and the metabolic syndrome in a general adult population: effect of gender and age: EPIRCE cross-sectional study. BMC Endocr Disord. 2013; 13:47. PMC: 4016563. DOI: 10.1186/1472-6823-13-47. View

Denti P, Bertoldo A, Vicini P, Cobelli C . IVGTT glucose minimal model covariate selection by nonlinear mixed-effects approach. Am J Physiol Endocrinol Metab. 2010; 298(5):E950-60. PMC: 2867373. DOI: 10.1152/ajpendo.00656.2009. View

Otten J, Ahren B, Olsson T . Surrogate measures of insulin sensitivity vs the hyperinsulinaemic-euglycaemic clamp: a meta-analysis. Diabetologia. 2014; 57(9):1781-8. DOI: 10.1007/s00125-014-3285-x. View

Abdul-Ghani M, Matsuda M, Balas B, DeFronzo R . Muscle and liver insulin resistance indexes derived from the oral glucose tolerance test. Diabetes Care. 2006; 30(1):89-94. DOI: 10.2337/dc06-1519. View

Mittendorfer B, Patterson B, Smith G, Yoshino M, Klein S . β Cell function and plasma insulin clearance in people with obesity and different glycemic status. J Clin Invest. 2021; 132(3). PMC: 8803344. DOI: 10.1172/JCI154068. View

Gastaldelli A, DeFronzo R, Salehi M . Comment on Piccinini and Bergman. The Measurement of Insulin Clearance. Diabetes Care 2020;43:2296-2302. Diabetes Care. 2021; 44(5):e98-e99. PMC: 8132326. DOI: 10.2337/dc20-2911. View

10.

Bonadonna R, Groop L, Kraemer N, Ferrannini E, Del Prato S, DeFronzo R . Obesity and insulin resistance in humans: a dose-response study. Metabolism. 1990; 39(5):452-9. DOI: 10.1016/0026-0495(90)90002-t. View

11.

Tam C, Xie W, Johnson W, Cefalu W, Redman L, Ravussin E . Defining insulin resistance from hyperinsulinemic-euglycemic clamps. Diabetes Care. 2012; 35(7):1605-10. PMC: 3379600. DOI: 10.2337/dc11-2339. View

12.

Gastaldelli A, Miyazaki Y, Mahankali A, Berria R, Pettiti M, Buzzigoli E . The effect of pioglitazone on the liver: role of adiponectin. Diabetes Care. 2006; 29(10):2275-81. DOI: 10.2337/dc05-2445. View

13.

Karpe F, Dickmann J, Frayn K . Fatty acids, obesity, and insulin resistance: time for a reevaluation. Diabetes. 2011; 60(10):2441-9. PMC: 3178283. DOI: 10.2337/db11-0425. View

14.

Pacini G, Tonolo G, Sambataro M, Maioli M, Ciccarese M, Brocco E . Insulin sensitivity and glucose effectiveness: minimal model analysis of regular and insulin-modified FSIGT. Am J Physiol. 1998; 274(4):E592-9. DOI: 10.1152/ajpendo.1998.274.4.E592. View

15.

Amato M, Giordano C, Galia M, Criscimanna A, Vitabile S, Midiri M . Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care. 2010; 33(4):920-2. PMC: 2845052. DOI: 10.2337/dc09-1825. View

16.

Bastard J, Vandernotte J, Faraj M, Karelis A, Messier L, Malita F . Relationship between the hyperinsulinemic-euglycaemic clamp and a new simple index assessing insulin sensitivity in overweight and obese postmenopausal women. Diabetes Metab. 2007; 33(4):261-8. DOI: 10.1016/j.diabet.2007.02.004. View

17.

Stern S, Williams K, Ferrannini E, DeFronzo R, Bogardus C, Stern M . Identification of individuals with insulin resistance using routine clinical measurements. Diabetes. 2005; 54(2):333-9. DOI: 10.2337/diabetes.54.2.333. View

18.

Perseghin G, Caumo A, CALONI M, Testolin G, Luzi L . Incorporation of the fasting plasma FFA concentration into QUICKI improves its association with insulin sensitivity in nonobese individuals. J Clin Endocrinol Metab. 2001; 86(10):4776-81. DOI: 10.1210/jcem.86.10.7902. View

19.

Groop L, Bonadonna R, DelPrato S, Ratheiser K, Zyck K, Ferrannini E . Glucose and free fatty acid metabolism in non-insulin-dependent diabetes mellitus. Evidence for multiple sites of insulin resistance. J Clin Invest. 1989; 84(1):205-13. PMC: 303971. DOI: 10.1172/JCI114142. View

20.

Heilbronn L, Rood J, Janderova L, Albu J, Kelley D, Ravussin E . Relationship between serum resistin concentrations and insulin resistance in nonobese, obese, and obese diabetic subjects. J Clin Endocrinol Metab. 2004; 89(4):1844-8. DOI: 10.1210/jc.2003-031410. View