October 17, 2013

Accurately Measure Insulin Sensitivity and CVD Risk

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measurement insulin sensitivityThe HOMA-IR measurement has traditionally been used to assess insulin sensitivity but there’s a new sheriff in town to fill the shoes. The study published in PLoS One zones in on the true measurements that tell the story of insulin sensitivity and insulin resistance.

The measurement of insulin sensitivity may help identify people at increased risk of cardio-metabolic diseases. The use of this particular combination evaluation of insulin sensitivity may increase the accuracy and better determine if a person is at increased risk of cardio-metabolic diseases.

This ombination of anthropometric, biochemical and imaging measures is used to estimate insulin sensitivity index (ISI) and provide improved prediction of cardio-metabolic risk, in comparison to HOMA-IR.

HOMA-IR is the homeostasis model assessment that estimates beta cell function and insulin sensitivity. These measures correspond well, but are not necessarily equivalent, to non-steady state estimates of beta cell function and insulin sensitivity derived from other tests.

For this reason, this study shines in providing a more accurate measurement of insulin sensitivity. The evaluation assessed healthy men, between the ages of 32 to 40 year old. Their HOMA-IR measurements were taken, as well as their ISI or insulin sensitivity index.

The insulin sensitivity index is calculated using  glucose intake, circulating insulin, and postprandial glucose readings. Imaging tests and incident of diabetes and cardiovascular disease are also taken into consideration for this test.

Fasting insulin, triglycerides and waist-to-hip ratio provided the best estimate of clamp-derived ISI compared to HOMA-IR. ISI also had greater sensitivity than defined metabolic syndrome in predicting CVD, with a four-fold increase in the risk of CVD independent of metabolic syndrome.

Triglycerides and waist-to-hip ratio, combined with fasting insulin levels, provide a better estimate of current insulin resistance state and improved identification of individuals with future risk of CVD, compared to HOMA-IR. This may be useful for estimating insulin sensitivity and cardio-metabolic risk in clinical and epidemiological settings.

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