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胰岛素抵抗评估的迷你综述:替代指标及临床应用的进展

Mini-review on insulin resistance assessment: Advances in surrogate indices and clinical applications.

作者信息

Moriyama Kengo

机构信息

Department of Clinical Health Science, Tokai University School of Medicine, Hachioji 1920032, Tokyo, Japan.

出版信息

World J Clin Cases. 2025 Oct 16;13(29):108380. doi: 10.12998/wjcc.v13.i29.108380.

Abstract

Insulin resistance (IR) is widely recognized as a key contributor to metabolic disorders, and various surrogate indices have been developed to estimate IR in clinical and research settings. The hyperinsulinemic-euglycemic clamp is considered the gold standard method for assessing insulin resistance due to its precision; however, its complexity limits its widespread clinical application. Consequently, surrogate indices derived from fasting and post-load glucose and insulin levels have been developed to estimate IR, facilitating early detection and risk stratification in metabolic disorders. This mini-review discusses the clinical utility, strengths, and limitations of key IR indices, including the homeostasis model assessment of IR, quantitative insulin sensitivity check index, Matsuda index, and triglyceride-glucose index. Overall, the evidence presented to date suggests that these indices provide valuable estimates of IR in various populations. Yet, their applicability varies depending on ethnic background, disease status, and clinical setting. Integrating these indices into routine clinical practice and research could improve metabolic risk assessment and guide preventive interventions. Further investigations are necessary to refine their accuracy and determine optimal cut-off values for various populations.

摘要

胰岛素抵抗(IR)被广泛认为是代谢紊乱的关键因素,并且已经开发了各种替代指标来在临床和研究环境中评估IR。高胰岛素正葡萄糖钳夹技术因其精确性而被认为是评估胰岛素抵抗的金标准方法;然而,其复杂性限制了它在临床上的广泛应用。因此,已经开发了从空腹和负荷后血糖及胰岛素水平得出的替代指标来估计IR,这有助于在代谢紊乱中进行早期检测和风险分层。这篇小型综述讨论了关键IR指标的临床效用、优点和局限性,包括胰岛素抵抗的稳态模型评估、定量胰岛素敏感性检查指数、松田指数和甘油三酯-葡萄糖指数。总体而言,迄今为止所呈现的证据表明,这些指标为不同人群的IR提供了有价值的估计。然而,它们的适用性因种族背景、疾病状态和临床环境而异。将这些指标纳入常规临床实践和研究中可以改善代谢风险评估并指导预防干预措施。需要进一步研究以提高其准确性并确定不同人群的最佳临界值。

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