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Copyright ©2010 Baishideng.
World J Diabetes. May 15, 2010; 1(2): 36-47
Published online May 15, 2010. doi: 10.4239/wjd.v1.i2.36
Table 1 Various methods to measure insulin resistance
S NoMethodCommentsAdvantagesDisadvantages
1Hyperinsulinemic euglycemic glucose clampGold standard method for quantifying insulin sensitivityDirect measure of insulin under steady-state conditionsLaborious, involves intra venous infusion of insulin, frequent blood sampling
2Oral glucose tolerance testClinically used to detect glucose intoleranceHelps in estimating other surrogate indicesUseful for glucose tolerance but not for IR
3Fasting insulinMost practical method to measure IRDetects insulin resistance before clinical disease appearsLack of standardization of the insulin assay procedure
4Glucose/insulin ratio (G/I ratio)comparable to insulin sensitivity measured by the FSIVGTTTHighly sensitive & specific for insulin sensitivityDoes not aptly reveal the physiology of insulin sensitivity
5Insulinogenic index (IGI)index of β-cell function δI (0-30 min)/δG (0-30 min)Measure of first-phase insulin response to glucose challengeNot broadly validated
6Homeostasis model assessmentAssesses inherent β-cell function and insulin sensitivity HOMA-IR = (G × I)/22.5Simple, minimally invasive, predicts fasting steady-state G and I levelsInsulin sensitivity in subjects treated with insulin needs further validation
7Quantitative insulin sensitivity check index (QUICKI)Mathematical transformation of FBG and insulin QUICKI = 1/[log (IμU/mL) + log(G mg/dL)]Consistent, precise index of insulin sensitivity, minimally invasiveNormal range to be established for each laboratory due to significant inter laboratory variations in insulin assay
8Minimal model analysis of frequently sampled intravenous glucose tolerance testIndirect measure of insulin sensitivity/resistanceAnalysis using the computer program MINMODMultiple blood sampling
9Glucose insulin (GI) productIndex of whole-body insulin sensitivity
10Fasting insulin resistance index (FIRI)(fasting G × fasting I)/25
Table 2 Various derived surrogate markers of insulin resistance
S NoMethodMeasurementComments
1Matsuda index10 000/√ (fasting G × fasting I) (mean G × mean I)Represents both hepatic and peripheral tissue sensitivity to insulin
2Gutt index75 000 + (G0 - G120) (mg/dL) × 0.19 × BW/120 × Gmean(0, 120) (mmol/L) × Log [Imean(0, 120)] (mU/L)Good to predict onset of type 2 diabetes
3Stumvoll index0.156 - 0.0000459 × I120 (pmol/L) – 0.000321 × I0 (pmol/L) – 0.00541 × G120 (mmol/L)Utilizes demographic data like age, sex and BMI along with plasma glucose and insulin to predict insulin sensitivity
4Avignon indexSib = 108/[I0 (mU/L) × G0 (mmol/L) × VD) Si2h = 108/(I120 (mU/L) × G120 (mmol/L) × VD]Determines glucose tolerance and insulin sensitivity in single test
5Oral glucose insulin sensitivity indexG and I concentrations from a 75 g OGTT at 0, 2, and 3 h (3 h OGTT) or at 0, 1.5, and 2 h (2 h OGTT). The formula includes six constants
6Log (HOMA-IR)Evaluates insulin resistance in insulin-resistant states like glucose intolerance and mild to moderate diabetes
Table 3 Imminent markers of insulin resistance
S NoMarker
1Insulin growth factor binding protein-1 (IGFBP-1)
2sCD36 (solubleCD36)
3C-reactive protein (CRP)
6Tumour necrosis factor (TNF alpha)
8C3 complement
9Glycosylated hemoglobin (Hb)A1c
10Protein kinase C (PKC) in microangiopathy
11Sex hormone-binding globulin (SHBG) in hyperandrogenic syndrome