American Journal of Epidemiology Vol. 151, No. 2: 190-198
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health
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Evaluation of Simple Indices of Insulin Sensitivity and Insulin Secretion for Use in Epidemioiogic Studies
From the Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases Phoenix, AZ
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 (104/(I0 x G0)) each showed a moderate correlation with the estimate of insulin sensitivity derived from the hyperinsulinemiceuglycemic clamp (|r| 
0.60). They also strongly predicted the incidence of diabetes (incidence rate ratio comparing the most and least insulin-resistant tertile groups 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 responsible surrogates for more sophisticated measures in epidemiologic studies. Am J Epidemiol 2000; 151:190-8.
diabetes mellitus; non-insulin-dependent; epidemiologic studies; incidence; insulin resistance
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V. Jayagopal, E. S. Kilpatrick, S. Holding, P. E. Jennings, and S. L. Atkin The Biological Variation of Insulin Resistance in Polycystic Ovarian Syndrome J. Clin. Endocrinol. Metab., April 1, 2002; 87(4): 1560 - 1562. [Abstract] [Full Text] [PDF]
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S. Del Prato, P. Marchetti, and R. C. Bonadonna Phasic Insulin Release and Metabolic Regulation in Type 2 Diabetes Diabetes, February 1, 2002; 51(90001): S109 - 116. [Abstract] [Full Text] [PDF]
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B. Ahren and H. Larsson Quantification of Insulin Secretion in Relation to Insulin Sensitivity in Nondiabetic Postmenopausal Women Diabetes, February 1, 2002; 51(90001): S202 - 211. [Abstract] [Full Text] [PDF]
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P. Vague and L. Nguyen Rationale and Methods for the Estimation of Insulin Secretion in a Given Patient: From Research to Clinical Practice Diabetes, February 1, 2002; 51(90001): S240 - 244. [Abstract] [Full Text] [PDF]
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K. J. Mather, A. E. Hunt, H. O. Steinberg, G. Paradisi, G. Hook, A. Katz, M. J. Quon, and A. D. Baron Repeatability Characteristics of Simple Indices of Insulin Resistance: Implications for Research Applications J. Clin. Endocrinol. Metab., November 1, 2001; 86(11): 5457 - 5464. [Abstract] [Full Text] [PDF]
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A. Fritsche, A. Madaus, W. Renn, O. Tschritter, A. Teigeler, M. Weisser, E. Maerker, F. Machicao, H. Haring, and M. Stumvoll The Prevalent Gly1057Asp Polymorphism in the Insulin Receptor Substrate-2 Gene Is Not Associated with Impaired Insulin Secretion J. Clin. Endocrinol. Metab., October 1, 2001; 86(10): 4822 - 4825. [Abstract] [Full Text] [PDF]
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 L. S.-C. Cheng, R. C. Davis, L. J. Raffel, A. H. Xiang, N. Wang, M. Quinones, P.-Z. Wen, E. Toscano, J. Diaz, S. Pressman, et al. Coincident Linkage of Fasting Plasma Insulin and Blood Pressure to Chromosome 7q in Hypertensive Hispanic Families Circulation, September 11, 2001; 104(11): 1255 - 1260. [Abstract] [Full Text] [PDF]
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A. M. Kriska, M. A. Pereira, R. L. Hanson, M. P. de Courten, P. Z. Zimmet, K. G. M.M. Alberti, P. Chitson, P. H. Bennett, K.M. V. Narayan, and W. C. Knowler Association of Physical Activity and Serum Insulin Concentrations in Two Populations at High Risk for Type 2 Diabetes but Differing by BMI Diabetes Care, July 1, 2001; 24(7): 1175 - 1180. [Abstract] [Full Text] [PDF]
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 J Forsblad, A Gottsater, T Matzsch, and F Lindgarde Predictors of carotid endarterectomy in middle-aged individuals Vascular Medicine, May 1, 2001; 6(2): 81 - 85. [Abstract] [PDF]
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M. Stumvoll, A. Fritsche, A. Volk, N. Stefan, A. Madaus, E. Maerker, A. Teigeler, M. Koch, F. Machicao, and H. Häring The Gly972Arg Polymorphism in the Insulin Receptor Substrate-1 Gene Contributes to the Variation in insulin Secretion in Normal Glucose-Tolerant Humans Diabetes, April 1, 2001; 50(4): 882 - 885. [Abstract] [Full Text]
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A. Katsuki, Y. Sumida, E. C. Gabazza, S. Murashima, M. Furuta, R. Araki-Sasaki, Y. Hori, Y. Yano, and Y. Adachi Homeostasis Model Assessment Is a Reliable Indicator of Insulin Resistance During Follow-up of Patients With Type 2 Diabetes Diabetes Care, February 1, 2001; 24(2): 362 - 365. [Abstract] [Full Text]
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C. Weyer, P. A. Tataranni, C. Bogardus, and R. E. Pratley Insulin Resistance and Insulin Secretory Dysfunction Are Independent Predictors of Worsening of Glucose Tolerance During Each Stage of Type 2 Diabetes Development Diabetes Care, January 1, 2001; 24(1): 89 - 94. [Abstract] [Full Text]
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