In quest for method of insulin resistance assessment in everyday clinical practice-Insulin resistance indices.

Summary Insulin resistance (IR) a state of decreased sensitivity of target tissues to insulin is suspected usually in obese so can be overlooked in normal weight subjects thus it is important to find optimal method of IR assessment in clinical practice. Aims (1) Assessment if IR can be reliably and easily diagnosed by any of surrogate methods: HOMA, HOMA 2, QUICKI and Matsuda index, using data from routinely performed tests. (2) Retrospective estimation of IR resistance incidence among female patients with various BMI, hospitalized for various reasons, in order to confirm need for IR assessment. Methods HOMA, HOMA2, QUICKI, Matsuda index were calculated using data obtained from medical history of 130 female subjects – patients of the Department of Endocrinology and Metabolic Diseases, in whom oral glucose tolerance test (OGTT) with parallel insulin concentrations assessment was performed. Results IR correlated positively with body mass index (BMI) in the entire study group, regardless which of four analyzed IR indices was used. Insulin resistance occurred in the obese as well as in normal weight and underweight subjects. The incidences of IR in the study group varied, depending upon chosen method and adopted cut-off values. Conclusions The need for quantitative assessment of IR in clinical practice is apparent. Proper selection of the best method of IR assessment remains a problem. HOMA appears the method of first choice for clinical use. There is an urgent need to establish universal or, at least, national standard cut-off values for IR, to introduce IR assessment in clinical practice.