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

Eugene Sobngwi, Andre Pascal Kengne, Justin B. Echouffo-Tcheugui, Simeon Choukem, Joelle Sobngwi-Tambekou, Eric V. Balti, Mark S. Pearce, Valentin Siaha, Aissa S. Mamdjokam, Valery Effoe, Eric Lontchi-Yimagou, Oliver T. Donfack, Barbara Atogho-Tiedeu, Philippe Boudou, Jean Francois Gautier, Jean Claude Mbanya

Research output: Contribution to journalArticlepeer-review

Abstract

Background: 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.Methods: 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.Results: 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.Conclusion: 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.

Original languageEnglish (US)
Article number65
JournalBMC Endocrine Disorders
Volume14
Issue number1
DOIs
StatePublished - Aug 9 2014

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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