A new insulin sensitivity index derived from fat mass index and quantitative insulin sensitivity check index

Year 2015, Volume: 3 Issue: 1, 26 - 36, 21.04.2016

Metin Donma , Orkide Donma Birol Topçu , Murat Aydın , Feti Tülübaş , Burçin Nalbantoğlu , Muhammet Demirkol Ahmet Gürel

Abstract

Objective: Obesity has recently become one of the most important health problems throughout the world. This fact led to the controversies on the clinical use of insulin sensitivity indices. Indices previously described or introduced in this study have been evaluated to choose one, which is capable of exhibiting significant distinctions between healthy children and those involved in the classes of childhood obesity.
Materials and Methods: A total of 179 girls; 81 morbidly obese(MO), 42 obese(O), 16 overweight(OW) and 40 normal(N) participated in the study. Groups were constituted based upon age- and sex-specific body mass index percentiles tabulated by World Health Organization. Homeostasis Model Assessment of Insulin Resistance(HOMA-IR), HOMA-IR/BMI, log HOMA-IR, fasting glucose/fasting insulin ratio(FGIR), quantitative insulin sensitivity check index(QUICKI), Raynaud, reciprocal insulin indices and also new indices HOMA-IR*BMI, HOMA-IR*fat mass index(FMI), QUICKI*BMI, QUICKI*FMI were calculated. The cut-offs 3.16 and 2.5 for HOMA-IR, 7 and 6 for FGIR, 0.357 and 0.328 for QUICKI were evaluated to estimate insulin resistance. Statistical analyses were performed with Predictive Analytics SoftWare(PASW) Statistics 18.
Results and Conclusion: QUICKI*FMI was able to make a clear-cut separation between the groups. A new trilogy for cut-offs (HOMA>2.5, FGIR<7, QUICKI<0.328); each giving the similar results, has been suggested. Multifaceted character of QUICKI was also introduced. QUICKI was capable of discriminating MO from O when 0.328 cut-off was used, and O from OW when 0.357 cut-off was used. QUICKI*FMI index, a new one, was unique in detecting the advanced level of differences(p≤0.005) between N-OW, OW-O and O-MO groups during childhood obesity.

Key words
Obesity, childhood, insulin sensitivity index

Keywords

Obezite, çocukluk çağı, insulin sensitivite indeksi

References

• Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA 2012; 307(5): 483–490.
• Childhood overweight and obesity. Available from: http://www.who.int/dietphysicalactivity/childhood/en/ {Last updated: 2014}
• Childhood obesity facts. Available from: http://www.cdc.gov/healthyyouth/obesity/facts.htm/201 2 {Last updated: July 10, 2013}
• National Center for Health Statistics. Health, United States, 2011: With Special Features on Socioeconomic Status and Health. Hyattsville, MD; U.S. Department of Health and Human Services; 2012.
• Brufani C, Grossi A, Fintini D et al. Cardiovascular fitness, insulin resistance and metabolic syndrome in severely obese prepubertal Italian children. Horm Res 2008; 70(6): 349-356.
• Rizzo AC, Goldberg TB, Silva CC, Kurokawa CS, Nunes HR, Corrente JE. Metabolic syndrome risk factors in overweight, obese, and extremely obese Brazilian adolescents. Nutr J 2013; 12: 19.
• Tobisch B, Blatniczky L, Barkai L. Cardiometabolic risk factors and insulin resistance in obese children and adolescents: relation to puberty. Pediatr Obes 2013 Nov 13. [Epub ahead of print]
• Adam TC, Tsao S, Page KA, Hu H, Hasson RE, Goran MI. Insulin sensitivity and brain reward activation in overweight Hispanic girls: a pilot study. Pediatr Obes 2013 Dec 20. [Epub ahead of print]
• Antuna-Puente B, Disse E, Rabasa-Lhoret R, Laville M, Capeau J, Bastard JP. How can we measure insulin sensitivity/resistance? Diabetes Metab 2011; 37(3): 179–188.
• Henderson M, Rabasa-Lhoret R, Bastard JP et al. Original article Measuring insulin sensitivity in youth: How do the different indices compare with the goldstandard method? Diabetes Metab 2011; 37(1): 72–78
• Borai A, Livingston C, Kaddam I, Ferns G. Selection of the appropriate method for the assessment of insulin resistance. BMC Med Res Methodol 2011;11:158.
• Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28(7): 412–419.
• Katz A, Nambi SS, Mather K et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab 2000; 85(7): 2402-2410.
• Rössner SM, Neovius M, Mattsson A, Marcus C, Norgren S. HOMA-IR and QUICKI: decide on a general standard instead of making further comparisons. Acta Pædiatr 2010; 99(11): 1735–1740.
• Growth reference 5-19 years. BMI-for-age (5-19 years) Available from: http://www.who.int/growthref/who2007_bmi_for_age/en/. {Last updated: 2014}
• Legro RS, Finegood D, Dunaif A. A fasting glucose to insulin ratio is a useful measure of insulin sensitivity in women with polycystic ovary syndrome. J Clin Endocrinol Metab 1998; 83(8): 2694-2698.
• Raynaud E, Perez-Martin A, Brun JF, Benhaddad AA, Mercier J. Revised concept for the estimation of insulin sensitivity from a single sample. Diabetes Care 1999; 22(6): 1003-1004.
• Hermans MP, Levy JC, Morris RJ, Turner RC. Comparison of insulin sensitivity tests across a range of glucose tolerance from normal to diabetes. Diabetologia 1999; 42(6): 678-687.
• Gunczler, P., Lanes, R. Relationship between different fasting-based insulin sensitivity indices in obese children and adolescents. J Pediatr Endocrinol Metab 2006; 19(3): 259-265.
• Hrebícek J, Janout V, Malincíková J, Horáková D, Cízek L. Detection of insulin resistance by simple quantitative insulin sensitivity check index QUICKI for epidemiological assessment and prevention. J Clin Endocrinol Metab 2002; 87(1): 144-147.
• Keskin M, Kurtoglu S, Kendirci M, Atabek ME, Yazici C. Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics 2005; 115(4): e500-503.
• Madeira IR, Carvalho CN, Gazolla FM, de Matos HJ, Borges MA, Bordallo MA. Cut-off point for homeostatic model assesment for insulin resistance (HOMA-IR) index established from receiver operating characteristic (ROC) curve in the detection of metabolic syndrome in overweight pre-pubertal children. Arq Bras Endocrinol Metabol 2008;52(9):1466-73
• Shalitin S, Phillip M. Frequency of cardiovascular risk factors in obese children and adolescents referred to a tertiary care center in Israel. Horm Res 2008; 69(3):152-159.
• Cotton B, Smith A, Hansen I, Davis C, Doyle A, Walsh A. Physician-directed primary care intervention to reduce risk factors for type 2 diabetes in high-risk youth. Am J Med Sci 2006; 332(3): 108-111.
• Atabek ME, Pirgon O. Assessment of insulin sensitivity from measurements in fasting state and during an oral glucose tolerance test in obese children. J Pediatr Endocrinol Metab 2007; 20(2): 187-195.
• Pastucha D, Filipčíková R, Horáková D et al. The incidence of metabolic syndrome in obese Czech children: the importance of early detection of insulin resistance using homeostatic indexes HOMA-IR and QUICKI. Physiol Res 2013; 62(3): 277-283.
• Lorenzo C, Haffner SM, Stancakova A, Laakso M. Relation of direct and surrogate measures of insulin resistance to cardiovascular risk factors in nondiabetic Finnish offspring of Type 2 diabetic individuals. J Clin Endocrinol Metab 2010; 95(11): 5082–5090.
• Gungor N, Saad R, Janosky J, Arslanian S. Validation of surrogate estimates of insulin sensitivity and insulin secretion in children and adolescents. J Pediatr 2004; 144(1): 47–55.
• Trikudanathan S, Raji A, Chamarthi B, Seely EW, Simonson DC. Comparison of insulin sensitivity measures in South Asians. Metabolism Clin Exp 2013; 62(10): 1448–1454.
• George L, Bacha F, Lee SJ, Tfayli H, Andreatta E, Arslanian S. Surrogate Estimates of Insulin Sensitivity in Obese Youth along the Spectrum of Glucose Tolerance from Normal to Prediabetes to Diabetes. J Clin Endocrinol Metab 2011; 96(7): 2136–2145.
• Schwartz B, Jacobs Jr DR, Moran A, Steinberger J, Hong CP, Sinaiko AR. Measurement of insulin sensitivity in children. Diabetes Care 2008;31(4):783–8
• Antuna-Puente B, Faraj M, Karelis AD et al. HOMA or QUICKI: Is it useful to test the reproducibility of formulas? Diabetes Metab 2008; 34(3) 294–6.
• Bastard JP, Lavoie ME, Messier V, Prud’homme D, Rabasa-Lhoret R. Evaluation of two new surrogate indices including parameters not using insulin to assess insulin sensitivity/resistance in non-diabetic postmenopausal women: A MONET group study. Diabetes Metab 2012; 38(3): 258–263.
• Sohn, K. Sufficiently good measures of obesity: The case of a developing country. J Biosoc Sci 2014; 46(6):797-817.