CPR-IR is an insulin resistance index that is minimally affected by hepatic insulin clearance-A preliminary research

PLoS One. 2018 May 23;13(5):e0197663. doi: 10.1371/journal.pone.0197663. eCollection 2018.

Abstract

Background: Increased hepatic insulin clearance (HIC) is important in the pathophysiology of type 2 diabetes mellitus (T2DM). The aim of this study is to analyze an effective insulin resistance (IR) index that is minimally affected by HIC.

Methods: Our study involved 20 participants with T2DM and 21 healthy participants without diabetes (Non-DM). Participants underwent a meal tolerance test from which plasma glucose, insulin and serum C-peptide immunoreactivity (CPR) were measured, and HOMA-IR and HIC were calculated. Participants then underwent a hyperinsulinemic-euglycemic clamp from which the glucose disposal rate (GDR) was measured.

Results: The index CPR-IR = 20/(fasting CPR × fasting plasma glucose) was correlated more strongly with GDR, than was HOMA-IR, and CPR-IR could be used to estimate GDR. In T2DM participants with HIC below the median, HOMA-IR and CPR-IR were equally well correlated with GDR. In T2DM with high HIC, CPR-IR correlated with GDR while HOMA-IR did not. In Non-DM, CPR-IR and HOMA-IR were equally well correlated with GDR regardless of HIC. The mean HIC value in T2DM was significantly higher than that of Non-DM.

Conclusions: CPR-IR could be a simple and effective index of insulin resistance for patients with type 2 diabetes that is minimally affected by HIC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • C-Peptide / blood*
  • Diabetes Mellitus, Type 2 / metabolism*
  • Eating
  • Fasting
  • Female
  • Glucose Clamp Technique
  • Humans
  • Insulin / metabolism*
  • Insulin Resistance*
  • Liver / metabolism*
  • Male
  • Middle Aged
  • Severity of Illness Index

Substances

  • C-Peptide
  • Insulin

Grants and funding

This work was supported by a JSPS KAKENHI Grant-in-Aid for Scientific Research (C) grant number 16K08935 (2016-2019), JSPS KAKENHI Grant-in-Aid for Young Scientists (B) grant number 26870373 (2014–2015), the Japan Diabetes Foundation (2013), grants for young researchers from the Japan Association for Diabetes Education and Care (2013, 2014), Tottori University Faculty of Medicine Research Grant (2013) and Tottori University Hospital Research Grant (2013). This work also supported by the MSD research grant (2013, 2015).