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[A methodological study on the evaluation of insulin resistance in vivo].

OBJECTIVE
To investigate the advantage and disadvantage of several methods often used to evaluate insulin resistance and to attempt to modify the disadvantage.


METHODS
Three protocols of minimal model technique (MMT), three protocols of basal state approach and four protocols of oral glucose tolerance test (OGTT) were used respectively to calculate insulin sensitivity index (ISI) in 16 subjects with normal glucose tolerance (NGT) and 13 patients with non-insulin-dependent diabetes mellitus (NIDDM). ISI of classical MMT was regarded as standard; ISI of other protocols were analyzed, assessed and compared with that of classical MMT.


RESULTS
Except the ISI expressed by the ratio of fasting serum glucose to insulin concentration (FSG/FIns) and the ratio between area under curve (AUC) of glucose and insulin (AUCg/AUCi) in OGTT, ISI of other protocols was significantly higher in NGT group than in NIDDM group (P < 0.05, ISI relative values were 1 and 0.44 - 0.70 respectively) and had stronger relationships as compared with ISI of classical MMT (r = 0.45 - 0.92, P < 0.05).


CONCLUSION
The modifications that reduce the samples to 12 or 10 and shorten the time to 120 min for MMT are feasible. Both the homeostasis model assessment and the basal state method designed by LI Guangwei are very simple; they can roughly evaluate insulin sensitivity. OGTT designed by Cederholm is a relatively simple and precise method of measuring IR. Two protocols of OGTT designed by the authors may be accurate methods for evaluating IR. Both FSG/FIns and AUCg/AUCi can not reliably evaluate insulin sensitivity.