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Title: New Measure of Insulin Sensitivity Predicts Cardiovascular Disease Better than HOMA Estimated Insulin Resistance
Authors: Venkataraman, K.
Khoo, C.M.
Leow, M.K.S.
Khoo, E.Y.H.
Isaac, A.V.
Zagorodnov, V.
Sadananthan, S.A.
Velan, S.S.
Chong, Y.S.
Gluckman, P.
Lee, J. 
Salim, A. 
Tai, E.S.
Seng Lee, Y.
Issue Date: 30-Sep-2013
Citation: Venkataraman, K., Khoo, C.M., Leow, M.K.S., Khoo, E.Y.H., Isaac, A.V., Zagorodnov, V., Sadananthan, S.A., Velan, S.S., Chong, Y.S., Gluckman, P., Lee, J., Salim, A., Tai, E.S., Seng Lee, Y. (2013-09-30). New Measure of Insulin Sensitivity Predicts Cardiovascular Disease Better than HOMA Estimated Insulin Resistance. PLoS ONE 8 (9) : -. ScholarBank@NUS Repository.
Abstract: Context:Accurate assessment of insulin sensitivity may better identify individuals at increased risk of cardio-metabolic diseases.Objectives:To examine whether a combination of anthropometric, biochemical and imaging measures can better estimate insulin sensitivity index (ISI) and provide improved prediction of cardio-metabolic risk, in comparison to HOMA-IR.Design and participants:Healthy male volunteers (96 Chinese, 80 Malay, 77 Indian), 21 to 40 years, body mass index 18-30 kg/m2. Predicted ISI (ISI-cal) was generated using 45 randomly selected Chinese through stepwise multiple linear regression, and validated in the rest using non-parametric correlation (Kendall's tau τ). In an independent longitudinal cohort, ISI-cal and HOMA-IR were compared for prediction of diabetes and cardiovascular disease (CVD), using ROC curves.Setting:The study was conducted in a university academic medical centre.Outcome measures:ISI measured by hyperinsulinemic euglycemic glucose clamp, along with anthropometric measurements, biochemical assessment and imaging; incident diabetes and CVD.Results:A combination of fasting insulin, serum triglycerides and waist-to-hip ratio (WHR) provided the best estimate of clamp-derived ISI (adjusted R2 0.58 versus 0.32 HOMA-IR). In an independent cohort, ROC areas under the curve were 0.77±0.02 ISI-cal versus 0.76±0.02 HOMA-IR (p>0.05) for incident diabetes, and 0.74±0.03 ISI-cal versus 0.61±0.03 HOMA-IR (p
Source Title: PLoS ONE
ISSN: 19326203
DOI: 10.1371/journal.pone.0074410
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