Table 3.
Methods to measure insulin resistance.
| Technique | Notes | Reference |
|---|---|---|
| Reference methods | ||
| Hyperinsulinemic euglycemic clamp | Gold standard, highly invasive | [114] |
| Frequently sampled intravenous glucose tolerance test | Silver standard, invasive | [132] |
| Oral glucose tolerance test | ||
| Insulin sensitivity glycemic index = 1 + 2/INSp × GLYp) | Most commonly used, little invasive | [133] |
| Whole body insulin sensitivity | Little invasive | [133] |
| Muscle IS = (Δglucose/Δtime)/mean plasma insulina | Little invasive | [134] |
| Hepatic IS = glucose0-30 minutes[AUC] × insulin0-30 minutes[AUC]b | Little invasive | [134] |
| Fasting simple indices | ||
| Homeostasis model assessment insulin resistance (HOMA-IR) | Non-invasive | [133] |
| Newer version of the HOMA-IR (HOMA2-S) | Non-invasive | [133] |
| FGIR = fasting glucose (mg/dl)/fasting insulin (mU/l) | Non-invasive | [133] |
| Quicki = 1/(log fasting insulin (mU/l) + log fasting glucose (mg/dl)) | Non-invasive | [133] |
| Biochemical markers of insulin resistance | ||
| Sex hormone binding globulin | Non-invasive | [133] |
| Insulin-like growth factor binding protein 1 | Non-invasive | [133] |
| Other markers: YKL-40, alpha-hydroxybutyrate, soluble CD36, leptin, resistin, interleukin-18, retinol binding protein-4, and chemerin | Non-invasive | [135] |
AUC, area under the curve; GLYp, area under glucose curve; INSp, area under the insulin curve; IS, insulin sensitivity. aThe rate of decay of plasma glucose concentration from its peak value to its nadir (Δglucose/Δtime) during the oral glucose tolerance test. bThe product of the total AUC for glucose and insulin during the first 30 minutes of the oral glucose tolerance test.