Evaluation of simple indices of insulin sensitivity and insulin secretion for use in epidemiologic studies.
Evaluation of simple indices of insulin sensitivity and insulin secretion for use in epidemiologic studies.
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DOI：
10.1093/oxfordjournals.aje.a010187
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发表时间：
2000-01
影响因子：
5
通讯作者：
R. Hanson;R. Pratley;C. Bogardus;K. Narayan;J. Roumain;G. Imperatore;A. Fagot-Campagna;D. Pettitt;Peter H. Bennett;W. Knowler
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文献类型：
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作者：
R. Hanson;R. Pratley;C. Bogardus;K. Narayan;J. Roumain;G. Imperatore;A. Fagot-Campagna;D. Pettitt;Peter H. Bennett;W. Knowler
直接测量 2 型糖尿病的代谢特征、胰岛素抵抗和胰岛素分泌减少的成本很高。为了评估源自胰岛素和葡萄糖测量的几个简单指数的效用，从 1982 年到 1997 年，对这些指数与亚利桑那州希拉河印第安社区皮马印第安人胰岛素敏感性和分泌的更复杂测量的相关性进行了检查。还对 1,731 人预测糖尿病发病率的能力进行了检查。指数是根据口服葡萄糖耐量试验期间获得的空腹和 2 小时血糖（G0、G120）和胰岛素（I0、I120）浓度计算的。空腹血清胰岛素浓度和胰岛素敏感性指数（10(4)/(I0 x G0)）均与高胰岛素-正常血糖钳夹得出的胰岛素敏感性估计值呈中等相关性（绝对值r约0.60）。他们还强烈预测了糖尿病的发病率（胰岛素抵抗最多和最少的三分位数组的发病率比约为 3.0）。校正的胰岛素反应 (I120/(G120 x (G120 - 70))) 与静脉内葡萄糖耐量试验测得的胰岛素分泌适度相关 (r = 0.35)。通过该指数评估的胰岛素分泌受损可预测糖尿病的发病率，特别是在控制胰岛素敏感性指数后（发病率比 = 1.6）。因此，简单的胰岛素敏感性和分泌指数可能是流行病学研究中更复杂措施的合理替代指标。
The metabolic characteristics of type 2 diabetes, insulin resistance, and diminished insulin secretion are costly to measure directly. To evaluate the utility of several simple indices derived from insulin and glucose measurements, the indices were examined from 1982 to 1997 with respect to correlation with more sophisticated measures of insulin sensitivity and secretion in Pima Indians in the Gila River Indian Community of Arizona. Ability to predict the incidence of diabetes in 1,731 persons was also examined. Indices were calculated from fasting and 2-hour glucose (G0, G120) and insulin (I0, I120) concentrations obtained during an oral glucose tolerance test. Fasting serum insulin concentration and the insulin sensitivity index (10(4)/(I0 x G0)) each showed a moderate correlation with the estimate of insulin sensitivity derived from the hyperinsulinemic-euglycemic clamp (absolute value r approximately 0.60). They also strongly predicted the incidence of diabetes (incidence rate ratio comparing the most and least insulin-resistant tertile groups approximately 3.0). Corrected insulin response (I120/(G120 x (G120 - 70))) was modestly correlated with insulin secretion as measured by an intravenous glucose tolerance test (r = 0.35). Impaired insulin secretion assessed by this index predicted incidence of diabetes, particularly after control for insulin sensitivity index (incidence rate ratio = 1.6). Thus, simple indices of insulin sensitivity and secretion may be reasonable surrogates for more sophisticated measures in epidemiologic studies.