Detection of insulin resistance by simple quantitative insulin sensitivity check index QUICKI for epidemiological assessment and prevention.
Detection of insulin resistance by simple quantitative insulin sensitivity check index QUICKI for epidemiological assessment and prevention.
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DOI：
10.1210/jc.87.1.144
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发表时间：
2002-01-01
影响因子：
5.8
通讯作者：
Cízek, L
中科院分区：
文献类型：
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作者：
Hrebícek, J;Janout, V;Cízek, L
本研究的目的是评价最近定义的简单胰岛素敏感性检查指数QUICKI（Katz et al. 2000）在常见临床和流行病学实践中用于胰岛素抵抗诊断。根据259名健康成人志愿者和患者以及47名青春期前年龄的健康和肥胖儿童的空腹值计算QUICKI（1/log胰岛素+ log胰岛素，单位为mg/dL）和HOMA（胰岛素 * log胰岛素，单位为mumol/L/22.5）指数。在成人中，QUICKI指数的下降（健康受试者的平均值+/- SEM = 0.366 +/- 0.029）以及HOMA指数的增加（健康受试者为1.57 +/- 0.87）对应于不同门诊患者组中胰岛素抵抗的代谢和临床表现。QUICKI指数具有较低的分散方差和95%的置信限显示出较高的区分能力。葡萄糖耐受不良或糖尿病、胰岛素抵抗的典型高脂血症或这些代谢紊乱的组合患者的QUICKI指数值显著低于健康志愿者。青春期前健康儿童的QUICKI指数表明，与成人相比，其胰岛素抵抗程度更高（平均值为0.339 +/- 0.020）; BMI超过25的肥胖儿童QUICKI指数的增加并不显著，尽管肥胖儿童的血清瘦素和甘油三酯显著增加，HDL-胆固醇降低。QUICKI指数低于0.357（处于健康人95%置信限的下限）的成人患者代表具有典型代谢综合征表现的组，这些参数与QUICKI指数大于0.357的年龄相当的患者组显著不同。本研究表明QUICKI指数在临床和流行病学实践中诊断胰岛素抵抗的适用性。然而，由于胰岛素测定的显著实验室间差异和/或不同人群中的可能差异，需要为每个实验室建立一个正常的QUICKI指数范围，并有适当的对照组。
The aim of the present study was to evaluate the recently defined simple insulin sensitivity check index QUICKI (Katz et al. 2000) for insulin resistance diagnostics in common clinical and epidemiological practice. Both the QUICKI (1/log insulin + log glycemia in mg/dL) and HOMA (insulin * glycemia in mumol/L/22.5) indexes were calculated from fasting values in 259 adult healthy volunteers and patients, and in 47 healthy and obese children of prepubertal age of both sexes. In adults, a fall in the QUICKI index (mean +/- SEM in healthy subjects = 0.366 +/- 0.029) as well as an increase in the HOMA, index (in healthy subjectss 1.57 +/- 0.87) corresponded to metabolic and clinical manifestations of insulin resistance in various groups of outpatients. The QUICKI index had lower dispersion variances and the 95% confidence limits displayed a higher discrimination capacity. Patients with glucose intolerance or diabetes, hyperlipidemia typical for insulin resistance, or with combination of these metabolic disorders were characterized by QUICKI index values that were significantly lower than those of healthy volunteers. The QUICKI index in healthy prepubertal children indicated a higher insulin resistance compared to adults (mean 0.339 +/- 0.020); an increase in the QUICKI index in obese children with BMI over 25 was not significant, although obese children showed a significant increase of serum leptin and triglycerides and a decrease of HDL-cholesterol. Adult patients with QUICKI index below 0.357 (which is at the lower limit of 95% confidence limits in healthy persons) represented a group with typical manifestations of metabolic syndrome, differing in these parameters significantly from the group of patients of comparable age with a QUICKI index greater than 0.357. The present study suggests suitability of the QUICKI index for diagnosis of insulin resistance in clinical and epidemiological practice. However, a normal QUICKI index range needs to be established for each laboratory with an appropriate control group because of significant inter-laboratory variations in insulin determinations and/or possible differences in various populations.