Good agreement between hyperinsulinemic-euglycemic clamp and 2h oral minimal model assessed insulin sensitivity in adolescents.

BACKGROUND/OBJECTIVE Rates of dysglycemia are increasing in youth, secondary to obesity and decreased insulin sensitivity (IS) in puberty. The Oral Minimal Model (OMM) has been developed in order to measure insulin sensitivity using an easy oral glucose load such as an oral glucose tolerance test (OGTT), instead of an hyperinsulinemic-euglycemic clamp (HE-Clamp), a more invasive and time-consuming procedure. However, this model, following a standard 2h- OGTT has never been validated in youth, a population known for a different physiologic response to OGTT than adults. Thus, we compared IS measurements obtained from OMM following a 2h OGTT to HE-Clamp and isotope tracer-assessed tissue IS in adolescents. We also compared the liver/muscle-specific IS from HE-Clamp with other liver/muscle-specific IS surrogates following an OGTT previously validated in adults. METHODS Secondary analysis of a cross-sectional study. Adolescent girls with (n=26) and without (n=7) Polycystic Ovary Syndrome (PCOS) (14.6±1.7 years; BMI %ile 23.3%-98.2%) underwent a 2-hour 75g OGTT and a 4-phase HE-Clamp. OMM IS (Si), dynamic Si (Sid ) and other OGTT-derived muscle and liver IS indices were correlated with HE-Clamp tissue-specific IS. RESULTS OMM Si and Sid correlated with HE-clamp-measured peripheral IS (r=0.64, p<0.0001 and r=0.73; p<0.0001, respectively) and the correlation co-efficient trended higher than the Matsuda index (r=0.59; p=0.003). The other tissue specific indices were poorly correlated with their HE-Clamp measurements. CONCLUSION In adolescent girls, the 2h OMM provided the best estimate of peripheral IS. Additional surrogates for hepatic IS are needed for youth. This article is protected by copyright. All rights reserved.