AIMS/HYPOTHESIS: The euglycaemic-hyperinsulinaemic clamp is the gold-standard method for measuring insulin sensitivity, but is less suitable for large clinical trials. Thus, several indices have been developed for evaluating insulin sensitivity from the oral glucose tolerance test (OGTT). However, most of them yield values different from those obtained by the clamp method. The aim of this study was to develop a new index to predict clamp-derived insulin sensitivity (M value) from the OGTT-derived oral glucose insulin sensitivity index (OGIS). METHODS: We analysed datasets of people that underwent both a clamp and an OGTT or meal test, thereby allowing calculation of both the M value and OGIS. The population was divided into a training and a validation cohort (n = 359 and n = 154, respectively). After a stepwise selection approach, the best model for M value prediction was applied to the validation cohort. This cohort was also divided into subgroups according to glucose tolerance, obesity category and age. RESULTS: The new index, called PREDIcted M (PREDIM), was based on OGIS, BMI, 2 h glucose during OGTT and fasting insulin. Bland-Altman analysis revealed a good relationship between the M value and PREDIM in the validation dataset (only 9 of 154 observations outside limits of agreement). Also, no significant differences were found between the M value and PREDIM (equivalence test: p < 0.0063). Subgroup stratification showed that measured M value and PREDIM have a similar ability to detect intergroup differences (p < 0.02, both M value and PREDIM). CONCLUSIONS/INTERPRETATION: The new index PREDIM provides excellent prediction of M values from OGTT or meal data, thereby allowing comparison of insulin sensitivity between studies using different tests.

CNR Institute of Clinical Physiology Pisa Italy

Department of Obstetrics and Gynecology Division of Obstetrics and Feto maternal Medicine Medical University of Vienna Vienna Austria

Division of Endocrinology and Diabetology Medical Faculty Heinrich Heine University Düsseldorf Germany

German Center for Diabetes Research München Neuherberg Germany

Institute for Clinical Diabetology German Diabetes Center Leibniz Center for Diabetes Research Düsseldorf Germany

Institute of Endocrinology Prague Czech Republic

Metabolic Unit CNR Institute of Neuroscience Corso Stati Uniti 4 35127 Padova Italy

Steno Diabetes Center Copenhagen Gentofte Denmark

Zobrazit více v PubMed

Proc Natl Acad Sci U S A. 2014 Jul 1;111(26):9597-602 PubMed

Diabetologia. 2005 Apr;48(4):748-51 PubMed

Diabetes Care. 2005 May;28(5):1132-8 PubMed

J Clin Endocrinol Metab. 2005 Jan;90(1):493-500 PubMed

Diabetes. 2009 Apr;58(4):773-95 PubMed

Lancet Oncol. 2009 Apr;10(4):341-50 PubMed

Diabetologia. 2008 May;51(5):853-61 PubMed

Diabetes Care. 2010 Jan;33 Suppl 1:S62-9 PubMed

Diabetes Care. 2001 Mar;24(3):539-48 PubMed

Diabetes Care. 2012 Jul;35(7):1605-10 PubMed

Ann Med. 2006;38(1):42-51 PubMed

Diabetes Care. 2014 Feb;37(2):468-74 PubMed

Best Pract Res Clin Endocrinol Metab. 2003 Sep;17(3):305-22 PubMed

Diabetologia. 2010 Jan;53(1):144-52 PubMed

Am J Physiol. 1979 Sep;237(3):E214-23 PubMed

Obes Surg. 2014 May;24(5):718-26 PubMed

Nat Rev Endocrinol. 2011 Sep 13;8(2):92-103 PubMed

J Clin Endocrinol Metab. 2004 Jun;89(6):2942-5 PubMed

The Glycemic Curve during the Oral Glucose Tolerance Test: Is It Only Indicative of Glycoregulation?

The rs10830963 Polymorphism of the MTNR1B Gene: Association With Abnormal Glucose, Insulin and C-peptide Kinetics

Effect of a Low-Fat Vegan Diet on Body Weight, Insulin Sensitivity, Postprandial Metabolism, and Intramyocellular and Hepatocellular Lipid Levels in Overweight Adults: A Randomized Clinical Trial

A Plant-Based Meal Stimulates Incretin and Insulin Secretion More Than an Energy- and Macronutrient-Matched Standard Meal in Type 2 Diabetes: A Randomized Crossover Study