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      Evaluación y comparación de la Sensibilidad Insulínica por dos modelos matemáticos: Homeostasis Model Assessment (Homa) y Quantitative Insulin-Sensitivity Check Index (Quicki)

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          Abstract

          RESUMEN. En los diabéticos la aterosclerosis ocurre más temprano y con mayor severidad, por lo que la evaluación de los parámetros que puedan interactuar en este proceso, son de importancia. Muchos han sido los métodos empleados para valorar la resistencia a la insulina, como el del Clamp Euglicémico-Hiperinsulinémico, sin embargo es un método poco practico y costoso para estudios poblacionales, por lo que se han desarrollado nuevas alternativas para su estimación, a través de modelos matemáticos como el Homeostasis Model Assessment (HOMA) y el Quantitative Insulin-Sensitivity Check Index (QUICKI). El presente trabajo fue conducido con la finalidad de establecer valores de referencia para resistencia a la insulina mediante HOMA y QUICKI, en dos poblaciones, una sana (n=30) y una con diabetes (n=25). Se encontró que estos índices están significativamente más elevados en los pacientes diabéticos, y permiten evaluar de forma rápida y sencilla la resistencia a la insulina en estudios poblacionales.

          Translated abstract

          ABSTRACT: Atherosclerosis process in diabetic patients occurs early and with severity, and for this reason is important to evalute those parameters, that could interact in this process. Many methods have been used to evalute the insulin resistance, such as; the Clamp Euglicémico-Hiperinsulinémico. However, it is not a practical and cheap method for population studies. Then, it has been developments new alternative methods for their estimation, using mathematical models such as; Homeostasis Model Assessment (HOMA) and Quantitative Insulin-Sensitivity Check Index (QUICKI). This research was lead in order to establish reference values of insulin resistance of HOMA and QUICKI, in two populations. First one, with normal population (n=30) between 25-30 years old and the second was a diabetic patients population (n=25) between 25-50 years old. These indexes (HOMA and QUICKI) are significantly high in the diabetic patients, and they allow to evaluate simple and quikly the resistance to the insulin in population studies.

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          Most cited references19

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          Role of Insulin Resistance in Human Disease

          G M Reaven (1988)
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            Role of insulin resistance in human disease

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              Assessment of insulin sensitivity and beta-cell function from measurements in the fasting state and during an oral glucose tolerance test.

              We aimed to find if the relation between insulin sensitivity and beta-cell function assessed from fasting and OGTT measurements has a physiological shape (hyperbolic with the reference methods). Healthy women without diabetic first-degree relatives underwent a 75 g OGTT with plasma glucose and insulin (n = 35) concentrations being measured at 0, 30, 60 and 120 min. Beta-cell function and insulin sensitivity were estimated using previously described indices from fasting (1 for beta-cell function, 6 for insulin sensitivity) and OGTT measurements (3 for beta-cell function and 5 for insulin sensitivity). A hyperbolic relation was tested for the 21 beta-cell function-insulin sensitivity pairs using a non-lineal regression method. The assessment of beta-cell function from OGTT was impossible in seven women and one had outlier indices. For the remaining 27 women, only 8 combinations adjusted to a hyperbolic relation. The best adjustment was achieved using the fasting glucose to insulin ratio as the estimation of insulin sensitivity and the homeostasis model assessment (HOMA) index (single fasting sample) as the estimation of beta-cell function (r2 0.802, k 869.71, p < 0.001). In this group of healthy women, the estimation of insulin sensitivity and beta-cell function by most methods using OGTT-derived glucose and insulin measurements did not adjust to a hyperbolic relation but all fasting indices combinations did. Beta-cell function estimated with the HOMA index and insulin sensitivity with fasting glucose to insulin ratio had the best adjustment.
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                Author and article information

                Journal
                rfm
                Revista de la Facultad de Medicina
                RFM
                Universidad Central de Venezuela. Facultad de Medicina. Comisión de Publicaciones de la Facultad de Medicina (Caracas, Distrito Capital, Venezuela )
                0798-0469
                January 2004
                : 27
                : 1
                : 54-57
                Affiliations
                [01] orgnameInstituto Venezolano de los Seguros de Sociales orgdiv1Coordinador de Docencia e Investigacion orgdiv2Hospital Militar Dr. Carlos Arvelo
                [03] orgnameHospital Militar Dr. Carlos Arvelo orgdiv1Biologo del Laboratorio de Investigaciones de Endocrinología y Enfermedades Metabolicas orgdiv2Escuela de Nutricion y Dietetica oswaldobregon@ 123456hotmail.com
                [02] orgnameHospital Militar Dr. Carlos Arvelo orgdiv1Biologo del Laboratorio de Investigaciones de Endocrinología y Enfermedades Metabolicas orgdiv2Prof. Post-grado de Endocrinologia
                Article
                S0798-04692004000100010 S0798-0469(04)02700110
                237e0b2d-dfef-4701-9df4-608e3fcddd9a

                http://creativecommons.org/licenses/by/4.0/

                History
                : 01 December 2003
                : 13 April 2004
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 16, Pages: 4
                Product

                SciELO Venezuela

                Categories
                Trabajos Originales

                Mathematical models,Diabetes,Resistencia a la insulina,Modelos matemáticos,Insulin resistance

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