Relation between HOMA-IR and insulin sensitivity index determined by hyperinsulinemic-euglycemic clamp analysis during treatment with a sodium-glucose cotransporter 2 inhibitor
Relation between HOMA-IR and insulin sensitivity index determined by hyperinsulinemic-euglycemic clamp analysis during treatment with a sodium-glucose cotransporter 2 inhibitor
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DOI：
10.1507/endocrj.ej19-0445
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发表时间：
2020-01-01
影响因子：
2
通讯作者：
Ogawa, Wataru
中科院分区：
文献类型：
--
作者：
So, Anna;Sakaguchi, Kazuhiko;Ogawa, Wataru
我们的目的是确定稳态模型评估胰岛素抵抗 (HOMA-IR) 是否反映了钠-葡萄糖协同转运蛋白 2 抑制剂 (SGLT2i) 治疗期间的胰岛素抵抗敏感性。对 22 名服用达格列净（5 mg/天，早餐前或早餐后）的 2 型糖尿病患者进行高胰岛素-正常血糖钳夹分析。这些个体（SGLT2i 组）的年龄、性别、体重指数和钳夹衍生组织葡萄糖摄取率倾向评分与 44 名接受钳夹分析但未接受 SGLT2i 治疗的 2 型糖尿病患者（对照组）进行倾向评分匹配，确定每组 17 名配对受试者，以进一步分析 HOMA-IR 和钳夹衍生胰岛素敏感性指数 (ISI) 之间的关系。在 SGLT2i 组（r = -0.527，p = 0.030）和对照组（r = -0.534，p = 0.027）中，自然对数转换的 HOMA-IR 与 ISI 呈负相关。两组中对数转换的 HOMA-IR 和 ISI 的简单回归线显示相似的斜率，但截距不同。多变量分析显示，两组中具有相同ISI的患者的HOMA-IR通过以下公式相关：HOMA-IRcontrol = HOMA-IRSGLT2i x 2.45。总之，SGLT2i治疗期间HOMA-IR与ISI良好相关，但SGLT2i组中与相同ISI对应的值低于对照组。
We had aimed to determine whether homeostasis model assessment-insulin resistance (HOMA-IR) reflects insulin resistance-sensitivity during treatment with a sodium-glucose cotransporter 2 inhibitor (SGLT2i). Hyperinsulinemic-euglycemic clamp analysis was performed in 22 patients with type 2 diabetic patients taking dapagliflozin (5 mg/day before or after breakfast). Propensity score matching of these individuals (SGLT2i group) for age, sex, body mass index, and clamp -derived tissue glucose uptake rate with 44 type 2 diabetic patients who had undergone clamp analysis without SGLT2i treatment (control group) identified 17 paired subjects in each group for further analysis of the relation between HOMA-IR and a clamp-derived insulin sensitivity index (ISI). Natural log-transformed HOMA-IR was negatively correlated with ISI in both SGLT2i (r = -0.527, p = 0.030) and control (r = -0.534, p = 0.027) groups. The simple regression lines for log -transformed HOMA-IR and ISI in the two groups showed similar slopes but differed in their intercepts. Multivariate analysis revealed that HOMA-IR for patients with the same ISI in the two groups was related by the formula: HOMA-IRcontrol = HOMA-IRSGLT2i x 2.45. In conclusion, HOMA-IR was well correlated with ISI during SGLT2i treatment, but values corresponding to the same ISI were lower in the SGLT2i group than in the control group.