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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

Lookup NU author(s): Dr Eugene Sobngwi, Professor Mark PearceORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


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/m(2)/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.

Publication metadata

Author(s): Sobngwi E, Kengne AP, Echouffo-Tcheugui JB, Choukem S, Sobngwi-Tambekou J, Balti EV, Pearce MS, Siaha V, Mamdjokam AS, Effoe V, Lontchi-Yimagou E, Donfack OT, Atogho-Tiedeu B, Boudou P, Gautier JF, Mbanya JC

Publication type: Article

Publication status: Published

Journal: BMC Endocrine Disorders

Year: 2014

Volume: 14

Online publication date: 09/08/2014

Acceptance date: 01/08/2014

Date deposited: 15/10/2014

ISSN (electronic): 1472-6823

Publisher: BioMed Central Ltd


DOI: 10.1186/1472-6823-14-65


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