Fasting insulin sensitivity indices are not better than routine clinical variables at predicting insulin sensitivity among Black Africans: a clamp study in sub-Saharan Africans
Identifieur interne : 003983 ( Main/Merge ); précédent : 003982; suivant : 003984Fasting insulin sensitivity indices are not better than routine clinical variables at predicting insulin sensitivity among Black Africans: a clamp study in sub-Saharan Africans
Auteurs : Eugene Sobngwi [Cameroun] ; Andre-Pascal Kengne [Afrique du Sud, Australie] ; Justin B. Echouffo-Tcheugui [États-Unis] ; Simeon Choukem [Cameroun] ; Joelle Sobngwi-Tambekou [Cameroun] ; Eric V. Balti [Cameroun, Belgique] ; Mark S. Pearce [Royaume-Uni] ; Valentin Siaha [Cameroun] ; Aissa S. Mamdjokam [Cameroun] ; Valery Effoe [Cameroun, États-Unis] ; Eric Lontchi-Yimagou [Cameroun] ; Oliver T. Donfack [Cameroun] ; Barbara Atogho-Tiedeu [Cameroun] ; Philippe Boudou [France] ; Jean-Francois Gautier [France] ; Jean-Claude Mbanya [Cameroun]Source :
- BMC Endocrine Disorders [ 1472-6823 ] ; 2014.
Abstract
We aimed to evaluate the predictive utility of common fasting insulin sensitivity indices, and non-laboratory surrogates [BMI, waist circumference (WC) and waist-to-height ratio (WHtR)] in sub-Saharan Africans without diabetes.
We measured fasting glucose and insulin, and glucose uptake during 80/mU/m2/min euglycemic clamp in 87 Cameroonians (51 men) aged (SD) 34.6 (11.4) years. We derived insulin sensitivity indices including HOMA-IR, quantitative insulin sensitivity check index (QUICKI), fasting insulin resistance index (FIRI) and glucose-to-insulin ratio (GIR). Indices and clinical predictors were compared to clamp using correlation tests, robust linear regressions and agreement of classification by sex-specific thirds.
The mean insulin sensitivity was M = 10.5 ± 3.2 mg/kg/min. Classification across thirds of insulin sensitivity by clamp matched with non-laboratory surrogates in 30-48% of participants, and with fasting indices in 27-51%, with kappa statistics ranging from −0.10 to 0.26. Fasting indices correlated significantly with clamp (/r/=0.23-0.30), with GIR performing less well than fasting insulin and HOMA-IR (both p < 0.02). BMI, WC and WHtR were equal or superior to fasting indices (/r/=0.38-0.43). Combinations of fasting indices and clinical predictors explained 25-27% of variation in clamp values.
Fasting insulin sensitivity indices are modest predictors of insulin sensitivity measured by euglycemic clamp, and do not perform better than clinical surrogates in this population.
Url:
DOI: 10.1186/1472-6823-14-65
PubMed: 25106496
PubMed Central: 4130121
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<author><name sortKey="Sobngwi, Eugene" sort="Sobngwi, Eugene" uniqKey="Sobngwi E" first="Eugene" last="Sobngwi">Eugene Sobngwi</name>
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<author><name sortKey="Kengne, Andre Pascal" sort="Kengne, Andre Pascal" uniqKey="Kengne A" first="Andre-Pascal" last="Kengne">Andre-Pascal Kengne</name>
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<author><name sortKey="Choukem, Simeon" sort="Choukem, Simeon" uniqKey="Choukem S" first="Simeon" last="Choukem">Simeon Choukem</name>
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<affiliation wicri:level="1"><nlm:aff id="I7">Department of Internal Medicine, Douala General Hospital, Douala, Cameroon</nlm:aff>
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<author><name sortKey="Sobngwi Tambekou, Joelle" sort="Sobngwi Tambekou, Joelle" uniqKey="Sobngwi Tambekou J" first="Joelle" last="Sobngwi-Tambekou">Joelle Sobngwi-Tambekou</name>
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<author><name sortKey="Balti, Eric V" sort="Balti, Eric V" uniqKey="Balti E" first="Eric V" last="Balti">Eric V. Balti</name>
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<country xml:lang="fr">Cameroun</country>
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<wicri:noRegion>Yaounde</wicri:noRegion>
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<affiliation wicri:level="3"><nlm:aff id="I9">Diabetes Research Center, Brussels Free University-(VUB), Brussels, Belgium</nlm:aff>
<country xml:lang="fr">Belgique</country>
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<author><name sortKey="Pearce, Mark S" sort="Pearce, Mark S" uniqKey="Pearce M" first="Mark S" last="Pearce">Mark S. Pearce</name>
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<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Institute of Health & Society, Newcastle University, Newcastle upon Tyne</wicri:regionArea>
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<author><name sortKey="Siaha, Valentin" sort="Siaha, Valentin" uniqKey="Siaha V" first="Valentin" last="Siaha">Valentin Siaha</name>
<affiliation wicri:level="1"><nlm:aff id="I2">National Obesity Centre, Yaounde Central Hospital, Yaounde, Cameroon</nlm:aff>
<country xml:lang="fr">Cameroun</country>
<wicri:regionArea>National Obesity Centre, Yaounde Central Hospital, Yaounde</wicri:regionArea>
<wicri:noRegion>Yaounde</wicri:noRegion>
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<author><name sortKey="Mamdjokam, Aissa S" sort="Mamdjokam, Aissa S" uniqKey="Mamdjokam A" first="Aissa S" last="Mamdjokam">Aissa S. Mamdjokam</name>
<affiliation wicri:level="1"><nlm:aff id="I2">National Obesity Centre, Yaounde Central Hospital, Yaounde, Cameroon</nlm:aff>
<country xml:lang="fr">Cameroun</country>
<wicri:regionArea>National Obesity Centre, Yaounde Central Hospital, Yaounde</wicri:regionArea>
<wicri:noRegion>Yaounde</wicri:noRegion>
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<author><name sortKey="Effoe, Valery" sort="Effoe, Valery" uniqKey="Effoe V" first="Valery" last="Effoe">Valery Effoe</name>
<affiliation wicri:level="1"><nlm:aff id="I2">National Obesity Centre, Yaounde Central Hospital, Yaounde, Cameroon</nlm:aff>
<country xml:lang="fr">Cameroun</country>
<wicri:regionArea>National Obesity Centre, Yaounde Central Hospital, Yaounde</wicri:regionArea>
<wicri:noRegion>Yaounde</wicri:noRegion>
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<affiliation wicri:level="2"><nlm:aff id="I11">Wake Forest Institute for Regenerative Medicine, Wake Forest University, Winston-Salem, North Carolina, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Wake Forest Institute for Regenerative Medicine, Wake Forest University, Winston-Salem, North Carolina</wicri:regionArea>
<placeName><region type="state">Caroline du Nord</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lontchi Yimagou, Eric" sort="Lontchi Yimagou, Eric" uniqKey="Lontchi Yimagou E" first="Eric" last="Lontchi-Yimagou">Eric Lontchi-Yimagou</name>
<affiliation wicri:level="1"><nlm:aff id="I12">Laboratory of Molecular Medicine and Metabolism, Biotechnology Centre, Nkolbisson, University of Yaounde 1, Yaounde, Cameroon</nlm:aff>
<country xml:lang="fr">Cameroun</country>
<wicri:regionArea>Laboratory of Molecular Medicine and Metabolism, Biotechnology Centre, Nkolbisson, University of Yaounde 1, Yaounde</wicri:regionArea>
<wicri:noRegion>Yaounde</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Donfack, Oliver T" sort="Donfack, Oliver T" uniqKey="Donfack O" first="Oliver T" last="Donfack">Oliver T. Donfack</name>
<affiliation wicri:level="1"><nlm:aff id="I12">Laboratory of Molecular Medicine and Metabolism, Biotechnology Centre, Nkolbisson, University of Yaounde 1, Yaounde, Cameroon</nlm:aff>
<country xml:lang="fr">Cameroun</country>
<wicri:regionArea>Laboratory of Molecular Medicine and Metabolism, Biotechnology Centre, Nkolbisson, University of Yaounde 1, Yaounde</wicri:regionArea>
<wicri:noRegion>Yaounde</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Atogho Tiedeu, Barbara" sort="Atogho Tiedeu, Barbara" uniqKey="Atogho Tiedeu B" first="Barbara" last="Atogho-Tiedeu">Barbara Atogho-Tiedeu</name>
<affiliation wicri:level="1"><nlm:aff id="I12">Laboratory of Molecular Medicine and Metabolism, Biotechnology Centre, Nkolbisson, University of Yaounde 1, Yaounde, Cameroon</nlm:aff>
<country xml:lang="fr">Cameroun</country>
<wicri:regionArea>Laboratory of Molecular Medicine and Metabolism, Biotechnology Centre, Nkolbisson, University of Yaounde 1, Yaounde</wicri:regionArea>
<wicri:noRegion>Yaounde</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Boudou, Philippe" sort="Boudou, Philippe" uniqKey="Boudou P" first="Philippe" last="Boudou">Philippe Boudou</name>
<affiliation wicri:level="3"><nlm:aff id="I13">Unit of Transfer in Molecular Oncology and Hormonology, Saint-Louis University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Unit of Transfer in Molecular Oncology and Hormonology, Saint-Louis University Hospital, Assistance Publique - Hôpitaux de Paris, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Gautier, Jean Francois" sort="Gautier, Jean Francois" uniqKey="Gautier J" first="Jean-Francois" last="Gautier">Jean-Francois Gautier</name>
<affiliation wicri:level="3"><nlm:aff id="I14">Department of Diabetes and Endocrinology, Saint-Louis University Hospital, Assistance Publique - Hôpitaux de Paris, University Paris-Diderot Paris-7, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Department of Diabetes and Endocrinology, Saint-Louis University Hospital, Assistance Publique - Hôpitaux de Paris, University Paris-Diderot Paris-7, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mbanya, Jean Claude" sort="Mbanya, Jean Claude" uniqKey="Mbanya J" first="Jean-Claude" last="Mbanya">Jean-Claude Mbanya</name>
<affiliation wicri:level="1"><nlm:aff id="I1">Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon</nlm:aff>
<country xml:lang="fr">Cameroun</country>
<wicri:regionArea>Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde</wicri:regionArea>
<wicri:noRegion>Yaounde</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="I2">National Obesity Centre, Yaounde Central Hospital, Yaounde, Cameroon</nlm:aff>
<country xml:lang="fr">Cameroun</country>
<wicri:regionArea>National Obesity Centre, Yaounde Central Hospital, Yaounde</wicri:regionArea>
<wicri:noRegion>Yaounde</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j">BMC Endocrine Disorders</title>
<idno type="eISSN">1472-6823</idno>
<imprint><date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>We aimed to evaluate the predictive utility of common fasting insulin sensitivity indices, and non-laboratory surrogates [BMI, waist circumference (WC) and waist-to-height ratio (WHtR)] in sub-Saharan Africans without diabetes.</p>
</sec>
<sec><title>Methods</title>
<p>We measured fasting glucose and insulin, and glucose uptake during 80/mU/m<sup>2</sup>
/min euglycemic clamp in 87 Cameroonians (51 men) aged (SD) 34.6 (11.4) years. We derived insulin sensitivity indices including HOMA-IR, quantitative insulin sensitivity check index (QUICKI), fasting insulin resistance index (FIRI) and glucose-to-insulin ratio (GIR). Indices and clinical predictors were compared to clamp using correlation tests, robust linear regressions and agreement of classification by sex-specific thirds.</p>
</sec>
<sec><title>Results</title>
<p>The mean insulin sensitivity was M = 10.5 ± 3.2 mg/kg/min. Classification across thirds of insulin sensitivity by clamp matched with non-laboratory surrogates in 30-48% of participants, and with fasting indices in 27-51%, with kappa statistics ranging from −0.10 to 0.26. Fasting indices correlated significantly with clamp (/r/=0.23-0.30), with GIR performing less well than fasting insulin and HOMA-IR (both p < 0.02). BMI, WC and WHtR were equal or superior to fasting indices (/r/=0.38-0.43). Combinations of fasting indices and clinical predictors explained 25-27% of variation in clamp values.</p>
</sec>
<sec><title>Conclusion</title>
<p>Fasting insulin sensitivity indices are modest predictors of insulin sensitivity measured by euglycemic clamp, and do not perform better than clinical surrogates in this population.</p>
</sec>
</div>
</front>
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