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- Title
Quantifying the Improvement of Surrogate Indices of Hepatic Insulin Resistance Using Complex Measurement Techniques.
- Authors
Hattersley, John G.; Mö hlig, Matthias; Roden, Michael; Arafat, Ayman M.; Loeffelholz, Christian v.; Nowotny, Peter; Machann, Jü rgen; Hierholzer, Johannes; Osterhoff, Martin; Khan, Michael; Pfeiffer, Andreas F. H.; Weickert, Martin O.
- Abstract
We evaluated the ability of simple and complex surrogate-indices to identify individuals from an overweight/obese cohort with hepatic insulin-resistance (HEP-IR). Five indices, one previously defined and four newly generated through step-wise linear regression, were created against a single-cohort sample of 77 extensively characterised participants with the metabolic syndrome (age 55.6±1.0 years, BMI 31.5±0.4 kg/m2; 30 males). HEP-IR was defined by measuring endogenous-glucose- production (EGP) with [6-62H2] glucose during fasting and euglycemic-hyperinsulinemic clamps and expressed as EGP*fasting plasma insulin. Complex measures were incorporated into the model, including various non-standard biomarkers and the measurement of body-fat distribution and liver-fat, to further improve the predictive capability of the index. Validation was performed against a data set of the same subjects after an isoenergetic dietary intervention (4 arms, diets varying in protein and fiber content versus control). All five indices produced comparable prediction of HEP-IR, explaining 39-56% of the variance, depending on regression variable combination. The validation of the regression equations showed little variation between the different proposed indices (r2 = 27-32%) on a matched dataset. New complex indices encompassing advanced measurement techniques offered an improved correlation (r = 0.75, P<0.001). However, when validated against the alternative dataset all indices performed comparably with the standard homeostasis model assessment for insulin resistance (HOMA-IR) (r = 0.54, P<0.001). Thus, simple estimates of HEP-IR performed comparable to more complex indices and could be an efficient and cost effective approach in large epidemiological investigations.
- Subjects
COST analysis; COST; ENGINEERING economy; INDUSTRIAL costs; COST control
- Publication
PLoS ONE, 2012, Vol 7, Issue 6, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0039029