Validation of surrogate indexes of insulin sensitivity in acute phase of myocardial infarction based on euglycemic-hyperinsulinemic clamp

dc.creatorMoura, FA
dc.creatorCarvalho, LSF
dc.creatorCintra, RMR
dc.creatorMartins, NV
dc.creatorFigueiredo, VN
dc.creatorSilva, JCQE
dc.creatorAlmeida, OLR
dc.creatorCoelho, OR
dc.creatorSposito, AC
dc.date2014
dc.dateFEB
dc.date2014-07-30T19:07:40Z
dc.date2015-11-26T17:50:49Z
dc.date2014-07-30T19:07:40Z
dc.date2015-11-26T17:50:49Z
dc.date.accessioned2018-03-29T00:34:08Z
dc.date.available2018-03-29T00:34:08Z
dc.identifierAmerican Journal Of Physiology-endocrinology And Metabolism. Amer Physiological Soc, v. 306, n. 4, n. E399, n. E403, 2014.
dc.identifier0193-1849
dc.identifier1522-1555
dc.identifierWOS:000331896600005
dc.identifier10.1152/ajpendo.00566.2013
dc.identifierhttp://www.repositorio.unicamp.br/jspui/handle/REPOSIP/73129
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/73129
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1289803
dc.descriptionConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.descriptionThe decrease in insulin sensitivity (IS) during myocardial infarction (MI) is recognized as a possible contributor to poor patient outcomes. Despite its potential relevance, a standardized and convenient IS assessment tool has yet to be established for said clinical scenarios. This study aimed to validate the accuracy of surrogate indexes in determining IS in acute MI patients by comparison with the gold standard reference method for measuring IS, the euglycemic-hyperinsulinemic clamp (EHC). We performed EHCs in 31 consecutive nondiabetic patients who were admitted within the first 24 h of symptoms of ST-segment elevation MI. Patients with prior diagnosis of diabetes, use of hypoglycemic agents, or a glycosylated hemoglobin >= 6.5% were excluded. EHCs were performed at the second day (D2) and sixth day (D6) post-MI. Basal (12-h fasting) blood samples from D2 and D6 were used to evaluate patient blood glucose and insulin levels. We then calculated the following surrogate indexes: homeostatic model assessment of insulin sensitivity (HOMA2S), homeostatic model assessment of insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI). The IS index measured by EHC (ISiclamp) was correlated to HOMA2S, HOMA-IR, and QUICKI at D2 (r = 0.485, P = 0.009; r = -0.384, P = 0.048; r = 0.479, P = 0.01, respectively) and D6 (r = 0.621, P = 0.002; r = -0.576, P = 0.006; r = 0.626, P = 0.002, respectively). Receiver operator characteristic curves made for discrimination of ISiclamp above the median in D2 and D6 depicted areas under the curve of 0.740, 0.734, and 0.760 for HOMA2S, HOMA-IR, and QUICKI, respectively. Bland-Altman plots displayed no apparent systematic error for indexes, but a propensity for proportional error, particularly with HOMA-IR. Thus, based on EHC, these simple surrogate indexes are feasible for assessing IS during MI.
dc.descriptiono TEXTO COMPLETO DESTE ARTIGO, ESTARÁ DISPONÍVEL À PARTIR DE AGOSTO DE 2015.
dc.description306
dc.description4
dc.descriptionE399
dc.descriptionE403
dc.descriptionConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.descriptionFoundation for Research Support of the State of Sao Paulo [2012/18044-1]
dc.descriptionConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.descriptionCNPq [151900/2011-6]
dc.descriptionFoundation for Research Support of the State of Sao Paulo [2012/18044-1]
dc.languageen
dc.publisherAmer Physiological Soc
dc.publisherBethesda
dc.publisherEUA
dc.relationAmerican Journal Of Physiology-endocrinology And Metabolism
dc.relationAm. J. Physiol.-Endocrinol. Metab.
dc.rightsembargo
dc.sourceWeb of Science
dc.subjecthomeostatic model assessment
dc.subjectinsulin sensitivity
dc.subjecteuglycemic hyperinsulinemic clamp
dc.subjectmyocardial infarction
dc.subjectHomeostasis Model Assessment
dc.subjectGlucose Clamp
dc.subjectCheck Index
dc.subjectResistance
dc.subjectHyperglycemia
dc.titleValidation of surrogate indexes of insulin sensitivity in acute phase of myocardial infarction based on euglycemic-hyperinsulinemic clamp
dc.typeArtículos de revistas


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