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How good a marker is insulin level for insulin resistance?
1Department of Genetics, University of Washington, Seattle 98195.
American Journal of Epidemiology
|May 1, 1993
Summary
Fasting insulin levels are reliable markers for insulin resistance in population studies, especially for those with normal glucose tolerance. Postload insulin levels are less reliable, particularly in individuals with impaired glucose tolerance or diabetes.
Area of Science:
- Endocrinology
- Metabolic Syndrome
- Cardiovascular Disease Epidemiology
Background:
- Epidemiologic studies often use fasting and postload insulin levels as markers for insulin resistance to assess coronary heart disease risk.
- The reliability of insulin levels as markers for insulin resistance has not been systematically validated across different glucose tolerance statuses.
Purpose of the Study:
- To evaluate the correlation between measured insulin levels and quantified insulin resistance using the euglycemic hyperinsulinemic clamp technique.
- To assess the validity of insulin levels as markers for insulin resistance in individuals with normal glucose tolerance, impaired glucose tolerance, and non-insulin-dependent diabetes mellitus.
Main Methods:
- Insulin resistance was quantified using the gold-standard euglycemic hyperinsulinemic clamp technique, measuring whole-body glucose uptake.
- Insulin response to an oral glucose load was measured in 132 subjects (50 normal glucose tolerance, 28 impaired glucose tolerance, 54 non-insulin-dependent diabetes mellitus).
- Subjects were randomly selected from population studies conducted in Kuopio, Finland.
Main Results:
- In subjects with normoglycemia, insulin resistance showed strong correlations with both fasting (-0.58 to -0.74) and postload insulin levels (p < 0.01).
- Correlations between insulin resistance and insulin levels were significantly weaker in subjects with impaired glucose tolerance and non-insulin-dependent diabetes mellitus.
- Among subjects with abnormal glucose tolerance, only fasting insulin levels correlated significantly with insulin resistance (-0.47 to -0.48, p < 0.05).
Conclusions:
- Fasting insulin levels are a more reliable marker of insulin resistance than postload insulin levels, particularly in population studies.
- The use of fasting insulin levels as a marker for insulin resistance is especially recommended for individuals with abnormal glucose tolerance or diabetes.