PMID- 20850158
OWN - NLM
STAT- MEDLINE
DCOM- 20110711
LR  - 20111117
IS  - 1532-8600 (Electronic)
IS  - 0026-0495 (Linking)
VI  - 60
IP  - 5
DP  - 2011 May
TI  - Misclassification of subjects with insulin resistance and associated 
      cardiovascular risk factors by homeostasis model assessment index. Utility of a 
      postprandial method based on oral glucose tolerance test.
PG  - 740-6
LID - 10.1016/j.metabol.2010.07.024 [doi]
AB  - Different methods are available for assessing insulin sensitivity in the fasting 
      state. However, insulin resistance (IR) is initially a postprandial disturbance; 
      and usually, when basal (fasting) disturbance appears, the process has been in 
      progress for some time. Our aim was to investigate if a postprandial measurement, 
      performing an oral glucose tolerance test (OGTT), is more sensitive than fasting 
      values. We wished to identify early IR states in healthy, nonobese individuals 
      and ascertain if this situation was associated with other cardiovascular risk 
      factors. A total of 90 nonobese, nondiabetic, and nonsmoker individuals were 
      studied. They were divided into 3 groups according to IR state--group 1: 
      non-IR--homeostasis model assessment of IR (HOMA(IR)) and insulin sensitivity 
      index of Matsuda-De Fronzo (ISI-Mat) were normal (HOMA(IR) <3.2 and ISI-Mat 
      >4.0); group 2: with IR post-OGTT (ISI-Mat </=4.0 and HOMA(IR) <3.2); and group 3: 
      subjects with IR in basal conditions (HOMA(IR) >/=3.2). An intravenous glucose 
      tolerance test to compare both indices was also performed. In 14.4% of subjects, 
      the fasting HOMA(IR) values failed to identify IR (false-negative results). The 
      ISI-Mat values were better correlated than HOMA(IR) (r = 0.875, P = .0001 and r = 
      -0.631, P = .0001, respectively) with insulin sensitivity index obtained with 
      intravenous glucose tolerance test. Subjects with IR had higher prevalence of a 
      cluster of cardiovascular risk factors than non-IR subjects. These data show that 
      that a significant percentage of subjects were misclassified with HOMA(IR). Early 
      identification of IR by OGTT was associated with other cardiovascular risk 
      factors. The OGTT is a simple method that could be applied to accurately identify 
      IR subjects in the general population.
CI  - Copyright (c) 2011 Elsevier Inc. All rights reserved.
FAU - Martinez-Hervas, Sergio
AU  - Martinez-Hervas S
AD  - Department of Medicine, Service of Endocrinology and Nutrition, Hospital Clinico 
      Universitario, University of Valencia, E-46010 Valencia, Spain.
FAU - Argente, Carlos
AU  - Argente C
FAU - Garcia-Jodar, Javier
AU  - Garcia-Jodar J
FAU - Priego, Antonia
AU  - Priego A
FAU - Real, Jose T
AU  - Real JT
FAU - Carratala, Arturo
AU  - Carratala A
FAU - Carmena, Rafael
AU  - Carmena R
FAU - Ascaso, Juan F
AU  - Ascaso JF
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100917
PL  - United States
TA  - Metabolism
JT  - Metabolism: clinical and experimental
JID - 0375267
RN  - 0 (Insulin)
SB  - IM
MH  - Adult
MH  - Blood Pressure
MH  - Body Mass Index
MH  - Cardiovascular Diseases/*etiology
MH  - *Diagnostic Errors
MH  - Female
MH  - Glucose Tolerance Test/*methods
MH  - Homeostasis
MH  - Humans
MH  - Insulin/blood
MH  - *Insulin Resistance
MH  - Male
MH  - Middle Aged
MH  - *Models, Biological
MH  - Postprandial Period
MH  - Sensitivity and Specificity
MH  - Waist Circumference
EDAT- 2010/09/21 06:00
MHDA- 2011/07/12 06:00
CRDT- 2010/09/21 06:00
PHST- 2009/12/14 00:00 [received]
PHST- 2010/05/26 00:00 [revised]
PHST- 2010/07/14 00:00 [accepted]
PHST- 2010/09/21 06:00 [entrez]
PHST- 2010/09/21 06:00 [pubmed]
PHST- 2011/07/12 06:00 [medline]
AID - S0026-0495(10)00252-0 [pii]
AID - 10.1016/j.metabol.2010.07.024 [doi]
PST - ppublish
SO  - Metabolism. 2011 May;60(5):740-6. doi: 10.1016/j.metabol.2010.07.024. Epub 2010 
      Sep 17.