Abstract
There is a steady increase in the number of overweight and obese people worldwide and increasingly, younger people. Excess adipose tissue impairs the action of insulin, leading to insulin resistance (IR). Tissue IR is a major factor in relation to cardiovascular disease, metabolic syndrome and diabetes. Thus, it is important to recognize at the pre-disease stage with the possibility of therapeutic intervention. IR is assessed using indicators of epidemiological significance, most often calculated from fasting and postprandial glucose and insulin values, so-called indirect indicators of insulin resistance. The most commonly used parameter is the Homeostatic Model Assessment (HOMA). Although the Quantitative Insulin Sensitivity Check Index (QUICKI), Matsuda Index and the Insulin Secretion-Sensitivity Index-2 (ISSI-2) are also used, the values of these indices established for IR vary for different age, sex, populations and ethnic groups. Thus, appropriate reference values of indirect indices should be determined for such groups, and when this is precluded, data from published studies carried out on the most ethnically, socio-economically and age-matched populations should be applied.
Highlights
Insulin resistance (IR) is a pathological state of disturbance between insulin synthesis and its action in the tissues
Different indirect indices are applied for the purpose of insulin resistance recognition, among them those calculated from fasting glucose and insulin concentration, as well as those derived from its measurement during the oral glucose tolerance test (OGTT)
According to our research results for young Caucasian the reference intervals for indirect insulin resistance indices which we examined according to Clinical and Laboratory Standards Institute (CLSI) protocol were: ≤4.00, ≤2.27, ≤4.10, ≥0.31 for HOMA1IR, HOMA2, HOMA2 C-pep., and Quantitative Insulin Sensitivity Check Index (QUICKI) respectively
Summary
Insulin resistance (IR) is a pathological state of disturbance between insulin synthesis and its action in the tissues. Establishing reference intervals or decision limits could facilitate the use of indirect insulin resistance indices in routine clinical practice, due to accurate identification of individuals at risk for metabolic diseases and the introduction of personalised therapeutic interventions[12,13]. It is especially important for the practices of primary care physicians and family doctors, with regard to the increased prevalence of insulin resistance in the world population[14]. Polish adults with NGT and Insulin – immunoradiometric method (IRMA, al., (2005)
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