Dataset Information

Evaluation of surrogate measures of insulin sensitivity - correlation with gold standard is not enough.

ABSTRACT: Impaired insulin sensitivity is a key abnormality underlying the development of type 2 diabetes. Measuring insulin sensitivity is therefore of importance in identifying individuals at risk of developing diabetes and for the evaluation of diabetes-focused interventions. A number of measures have been proposed for this purpose. Among these the hyperinsulinemic euglycemic clamp (HEC) is considered the gold standard. However, as the HEC is a costly, time consuming and invasive method requiring trained staff, there is a need for simpler so called surrogate measures.A frequently used approach to evaluate surrogate measures is through correlation with the HEC. We discuss limitations with this method. We suggest other aspects to take into consideration, such as repeatability, reproducibility, systematic biases and discrimination ability. In addition, we focus on three frequently used surrogate measures. We argue that they are one-to-one transformations of each other, and therefore question the benefits of further comparison between them. They give the same results in all rank-based methods, for instance Spearman correlations, Mann-Whitney tests and receiver operating characteristic (ROC) analysis.We suggest investigating further aspects than correlation alone when evaluating a surrogate measure of insulin sensitivity. We recommend choosing one of the three surrogate measures HOMA-IR, QUICKI and FIRI for analysis of a clinical study.

SUBMITTER: Rudvik A

PROVIDER: S-EPMC6019831 | biostudies-other | 2018 Jun

REPOSITORIES: biostudies-other

ACCESS DATA

Publications

Evaluation of surrogate measures of insulin sensitivity - correlation with gold standard is not enough.

Rudvik Anna A Månsson Marianne M

BMC medical research methodology 20180626 1

<h4>Background</h4>Impaired insulin sensitivity is a key abnormality underlying the development of type 2 diabetes. Measuring insulin sensitivity is therefore of importance in identifying individuals at risk of developing diabetes and for the evaluation of diabetes-focused interventions. A number of measures have been proposed for this purpose. Among these the hyperinsulinemic euglycemic clamp (HEC) is considered the gold standard. However, as the HEC is a costly, time consuming and invasive met ...[more]

PMID: 29940866

Similar Datasets

Project description:BackgroundWith the rising prevalence of obesity and type 2 diabetes (T2D) in obese children, it is becoming imperative to detect disturbed glucose metabolism as early as possible in order to prevent T2D development.Subjects/methodsCross-sectional study of 92 obese children (median age 11.7 years, 51% female) and 7 lean children (median age 11.4 years, 57% female) who underwent an oral glucose tolerance test (OGTT) in a tertiary pediatric care center. Glucose tolerance was assessed and different indices for β-cell function, insulin sensitivity and insulin secretion were calculated.ResultsNineteen obese children were identified with prediabetes (PD, 12 impaired glucose tolerance, 4 increased fasting glucose and 3 combined). Compared with the 73 obese children with normal glucose tolerance (nGT), subjects with PD had higher insulin resistance, but lower insulin sensitivity and β-cell function, although their glycated hemoglobin (HbA1c) levels were comparable. The Whole Body Insulin Sensitivity Index (WBISI) and β-cell function by Insulin Secretion-Sensitivity Index-2 (ISSI-2) strongly correlated with the OGTT glucose area under the curve 0-120 min (r = 0.392, p < 0.0002; r = 0.547, p < 0.0001, respectively). When testing the relation between early insulin response during OGTT by insulinogenic index and insulin sensitivity assessed by WBISI, a hyperbolic relationship between insulin secretion and insulin sensitivity was found. The calculated disposition index was lower in subjects with PD vs. nGT (median 459 vs. 792, p = 0.004). We identified the OGTT 30-min/120-min insulin ratio as a simple marker, which is significantly lower in obese children with vs. without PD (median 0.87 vs. 1.29, p = 0.021) and which has a better sensitivity and specificity for detecting PD than HbA1c among obese children.ConclusionsChildren with identified PD had changes of several markers for β-cell function, insulin sensitivity and resistance before changes in HbA1c occurred. The lower disposition index indicates that these children have already inadequate β-cell compensation for the degree of insulin resistance.

Dataset Information

Evaluation of surrogate measures of insulin sensitivity - correlation with gold standard is not enough.

Publications

Evaluation of surrogate measures of insulin sensitivity - correlation with gold standard is not enough.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets