Relationship between the hyperinsulinemic–euglycaemic clamp and a new simple index assessing insulin sensitivity in overweight and obese postmenopausal women

Abstract

Objective The purpose of this study was to compare assessment of insulin sensitivity from hyperinsulinemic euglycaemic (HIEG) clamp with indexes derived from fasting and oral glucose tolerance test (OGTT). Subjects and methods Cross-sectional study with 107 sedentary non-diabetic overweight and obese postmenopausal (BMI = 32.4 ± 0.4 kg/m 2) women undergoing both HIEG clamp and OGTT. Pairs of data were analyzed using Pearson correlation and Bland–Altman graphs analysis. Comparison between correlations was made using the method reported by Zar. Results All the indexes derived from either the OGTT or surrogate indexes were highly correlated with all the clamp-derived formulas ( P < 0.0001). However, HOMA and QUICKI were generally less correlated than OGTT-derived indexes. Analogically to QUICKI, we calculated a new formula derived from the OGTT measurements of glucose and insulin named simple index assessing insulin sensitivity (SI isOGTT) = 1/[log(sum glucose t 0–30–90–120) (mmol/l) + log(sum insulin t 0–30–90–120) (μUI/ml)]. By using this formula, we found high significant correlations ( r's = 0.61–0.65; P < 0.0001) with the clamp results. Moreover, the correlations of SI isOGTT with the clamp data were higher than for other previously published indexes. Conclusion In that large group of non-diabetic overweight and obese postmenopausal women insulin sensitivity index derived from OGTT provided more accurate information than fasting based formula. We propose a new simple index for the assessment of insulin sensitivity from the OGTT data (SI isOGTT). The advantage of this new formula over all previously published OGTT-derived indexes of insulin sensitivity is that it is 1) easy to calculate 2) better correlated than other indexes of insulin sensitivity and 3) not affected by the way clamp results are expressed. Further studies are needed to validate SI isOGTT index in other populations.