This study examined the correlation between four different methods of measuring insulin sensitivity (IS) in a group of children: the hyperinsulinemic-euglycemic (EUG) clamp, the frequently sampled intravenous glucose tolerance test (FSIVGTT), various indices derived from the OGTT, as well as fasting indices (HOMA-IR, QUICKI, and fasting insulin [INS0]). Twenty healthy children (mean (SD) age: 9(2) years) were studied: 9 boys and 11 girls. Their mean (SD) BMI z-score was 1.5 (0.8). No participant had impaired fasting glucose, glucose intolerance or diabetes. Each child underwent a 3-hour EUG clamp, an insulin modified minimal model FSIVGTT, and a 3-hour OGTT. Correlations were established using Spearman's rank correlations. The two clamp derived formulas considered were highly correlated (r=0.85). IS measured from the FSIVGTT was highly correlated with both clamp measures (r=0.69, 0.74). Of the 9 different indices derived from the OGTT considered, 4 showed high correlation with clamp results: ISI Matsuda (r=0.63, 0.69), ISI Belfiore (r=0.62, 0.64), SIisOGTT (r=0.62, 0.62) and Log sum insulin, the most closely correlated index (r=−0.67,-0.80). Fasting indices of IS had slightly lower correlations with clamp results: HOMA-IR (r=−0.55, -0.56), QUICKI (r=0.55, 0.57), and INS0 (r=−0.59, -0.63). Measurement of IS using the clamp, the FSIVGTT, and OGTT derived indices were highly correlated in this group of children. In particular, the Log sum insulin index was the most strongly correlated with clamp results, and appears to provide more valid information than either HOMA-IR or QUICKI. This suggests that OGTT derived indices provide valid, clinically feasible methods of estimating IS in youth.
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© 2008 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.