PLoS ONE (Jan 2018)

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

  • Tsuyoshi Okura,
  • Risa Nakamura,
  • Yohei Fujioka,
  • Sonoko Kawamoto-Kitao,
  • Yuichi Ito,
  • Kazuhisa Matsumoto,
  • Kyoko Shoji,
  • Keisuke Sumi,
  • Kazuhiko Matsuzawa,
  • Shoichiro Izawa,
  • Etsuko Ueta,
  • Masahiko Kato,
  • Takeshi Imamura,
  • Shin-Ichi Taniguchi,
  • Kazuhiro Yamamoto

DOI
https://doi.org/10.1371/journal.pone.0197663
Journal volume & issue
Vol. 13, no. 5
p. e0197663

Abstract

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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.