Centre de recherche, hôpital Laval, Québec, Canada.
Diabetes Metab. 2009 Nov;35(5):398-403. doi: 10.1016/j.diabet.2009.04.007. Epub 2009 Sep 5.
The ongoing obesity epidemic is associated with numerous health problems related to altered metabolic function. Among these is type 2 diabetes, characterized by lowered insulin sensitivity (IS). Consequently, the development of simple indices to assess IS has research and clinical importance. The SI(is)OGTT, a new index of IS, was recently described by Bastard et al. (Diabetes & Metabolism 2007;33:261-8), and validated in sedentary, non-diabetic, overweight and obese postmenopausal women. The aim of the present study was to validate the index in men.
The data used in this project came from sedentary men (n=36), aged 34-53 years, all of whom underwent a hyperinsulinaemic-euglycaemic clamp and 2-hour oral glucose tolerance test (OGTT). Correlations with M/I (glucose infusion rate [GIR] divided by insulin concentration), GIR and GIR divided by fat-free mass (FFM) were obtained by four well-known indices (HOMA, QUICKI, Cederholm and Matsuda) as well as with the new SI(is)OGTT index. Pearson correlations and Bland-Altman analyses were obtained for every index versus clamp value.
The best correlate of IS in the present study was the SI(is)OGTT (r=0.84, P<0.0001). The agreement of this method with the hyperinsulinaemic-euglycaemic clamp, as assessed by Bland-Altman plots, was similar to those of the other indices and to those previously described in postmenopausal women.
The new index proposed by Bastard et al. is as good a predictor of IS in sedentary men as the other commonly used indices, and appears to be as reliable in this population as it was in the original study of postmenopausal women.
目前肥胖症的流行与多种代谢功能改变相关的健康问题有关。其中包括 2 型糖尿病,其特征是胰岛素敏感性(IS)降低。因此,开发简单的指标来评估 IS 具有研究和临床意义。Bastard 等人最近描述了一种新的 IS 指数,即 SI(is)OGTT(糖尿病与代谢 2007;33:261-8),并在久坐、非糖尿病、超重和肥胖绝经后妇女中进行了验证。本研究的目的是验证该指数在男性中的适用性。
本项目使用的数据来自 36 名年龄在 34-53 岁之间、久坐的男性,他们均接受了高胰岛素-正常血糖钳夹和 2 小时口服葡萄糖耐量试验(OGTT)。通过四个著名的指数(HOMA、QUICKI、Cederholm 和 Matsuda)以及新的 SI(is)OGTT 指数,获得了与 M/I(葡萄糖输注率[GIR]除以胰岛素浓度)、GIR 和 GIR 除以去脂体重(FFM)的相关性。为每个指数与钳夹值之间的相关性进行了 Pearson 相关分析和 Bland-Altman 分析。
本研究中 IS 的最佳相关指标是 SI(is)OGTT(r=0.84,P<0.0001)。通过 Bland-Altman 图评估,该方法与高胰岛素-正常血糖钳夹的一致性与其他常用指数相似,与绝经后妇女的研究结果相似。
Bastard 等人提出的新指数在预测久坐男性 IS 方面与其他常用指数一样好,并且在该人群中的可靠性与原始绝经后妇女研究中的可靠性相似。