Surrogate measures of insulin sensitivity vs the hyperinsulinaemic-euglycaemic clamp: a meta-analysis
Surrogate measures of insulin sensitivity vs the hyperinsulinaemic-euglycaemic clamp: a meta-analysis
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DOI：
10.1007/s00125-014-3285-x
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发表时间：
2014-09-01
期刊：
影响因子：
8.2
通讯作者：
Olsson, Tommy
中科院分区：
文献类型：
--
作者：
Otten, Julia;Ahren, Bo;Olsson, Tommy
目的/假设我们旨在确定胰岛素敏感性的哪个替代指标与参考指标高胰岛素血症-血糖钳（HEC）相关性最强，以确定哪种替代指标应推荐用于大规模研究。方法检索文献（1979-2012），检索所有报告HEC与胰岛素敏感性替代指标（空腹样本或OGTT期间）之间双变量相关性的文章。我们对每个替代测量进行了随机效应荟萃分析，以整合不同研究的相关系数。结果与HEC合并相关性最强(r)的ogtt替代指标为Stumvoll代谢清除率（Stumvoll MCR; r=0.70 [95% CI 0.61, 0.77], n=5）、口服葡萄糖胰岛素敏感性（OGIS; r=0.70 [0.57, 0.80], n=6）、Matsuda指数（r=0.67 [0.61, 0.73], n=19）、Stumvoll胰岛素敏感性指数（Stumvoll ISI; r=0.67 [0.60, 0.72], n=8）和Gutt指数（r=0.65 [0.60, 0.69], n=6）。与HEC相关性最强且95% ci较窄的空腹替代指标为修正后的QUICKI （r=0.68 [0.58, 0.77], n=7）、QUICKI （r=0.61 [0.55, 0.65], n=35）、log HOMA- ir （r=-0.60 [-0.66, -0.53], n=22）和计算机生成的胰岛素敏感性HOMA （HOMA-%S; r=0.57 [0.46, 0.67], n=5）。在估计胰岛素敏感性方面，修订后的QUICKI禁食替代指标似乎与基于ogtt的Stumvoll MCR、OGIS、Matsuda、Stumvoll ISI和Gutt指标一样好。因此，它可以被推荐为在大规模临床研究中使用的最合适的索引。
Aims/hypothesis We aimed to identify which surrogate index of insulin sensitivity has the strongest correlation with the reference measurement, the hyperinsulinaemic-euglycaemic clamp (HEC), to determine which surrogate measure should be recommended for use in large-scale studies.Methods A literature search (1979-2012) was conducted to retrieve all articles reporting bivariate correlations between the HEC and surrogate measures of insulin sensitivity (in fasting samples or during the OGTT). We performed a random effects meta-analysis for each surrogate measure to integrate the correlation coefficients of the different studies.Results The OGTT-based surrogate measures with the strongest pooled correlations (r) to the HEC were the Stumvoll metabolic clearance rate (Stumvoll MCR; r=0.70 [95% CI 0.61, 0.77], n=5), oral glucose insulin sensitivity (OGIS; r=0.70 [0.57, 0.80], n=6), the Matsuda index (r=0.67 [0.61, 0.73], n=19), the Stumvoll insulin sensitivity index (Stumvoll ISI; r=0.67 [0.60, 0.72], n=8) and the Gutt index (r=0.65 [0.60, 0.69], n=6). The fasting surrogate indices that correlated most strongly with the HEC and had narrow 95% CIs were the revised QUICKI (r=0.68 [0.58, 0.77], n=7), the QUICKI (r=0.61 [0.55, 0.65], n=35), the log HOMA-IR (r=-0.60 [-0.66, -0.53], n=22) and the computer generated HOMA of insulin sensitivity (HOMA-%S; r=0.57 [0.46, 0.67], n=5).Conclusions/interpretation The revised QUICKI fasting surrogate measure appears to be as good as the OGTT-based Stumvoll MCR, OGIS, Matsuda, Stumvoll ISI and Gutt indices for estimating insulin sensitivity. It can therefore be recommended as the most appropriate index for use in large-scale clinical studies.