Estimation of insulin resistance in non-diabetic normotensive Saudi adults by QUICKI, HOMA-IR and modified QUICKI: a comparative study

ABSTRACT

Identification of insulin resistance [IR] in the general population is important for developing strategies to reduce the prevalence of non-insulin-dependent diabetes mellitus [NIDDM]. We used the original and a modified version of the Quantitative Insulin Sensitivity Check Index [QUICKI, M-QUICKI], and the Homeostasis Model Assessment of Insulin Resistance [HOMA-IR] to divide non-diabetic normotensive adults into high-[HIR] and low-insulin-resistant [LIR] subgroups to investigate similarities and differences in their characteristics. Three hundred fifty-seven healthy adults aged 18-50 years were recruited randomly from health centers in Jeddah in a cross-sectional study design. Anthropometric and demographic information was taken. Insulin, glucose, lipid profile and free fatty acid were determined in fasting blood samples. M-QUICKI, HOMA-IR and QUICKI were calculated. Reported cut-off points were used to identify HIR subjects, who were then matched for age and sex to others in the study population, resulting in 3 HIR and 3 LIR subgroups. Two hundred nine subjects satisfied the selection criteria. M-QUICKI correlated significantly [P=.01] with HOMA-IR and QUICKI values. Increased adiposity was the common characteristic of the three HIR subgroups. HIR subgroups identified using M-QUICKI [97 subjects] and HOMA [25 subjects], but not QUICKI [135 subjects], had statistically different biochemical characteristics compared to corresponding LIR sub-groups. Adiposity, but not sex, is a risk factor for IR in the studied population. Further studies are needed to choose the most appropriate index for detecting IR in community-based surveys