TY - JOUR
T1 - Reliability of HOMA-IR for evaluation of insulin resistance during perioperative period
AU - Flfjino, Hiroko
AU - Itoda, Shoko
AU - Sako, Saori
AU - Matsuo, Kazuki
AU - Sakamoto, Eiji
AU - Yokoyama, Takeshi
PY - 2013/2
Y1 - 2013/2
N2 - Background : Hyperglycemia due to increase in insulin resistance (IR) is often observed after surgery in spite of normal insulin secretion. To evaluate the degree of IR, the golden standard method is the normoglycemic hyperinsulinemic clamp technique (glucose clamp GC). The GC using the artificial pancreas, STG®-22 (Nikkiso, Tokyo, Japan), was established as a more reliable method, since it was evaluated during steady-state period under constant insulin infusion. Homeostasis model assessment insulin resistance (HOMA-IR), however, is frequently employed in daily practice because of its convenience. We1 therefore, investigated the reliability of HOMA-IR in comparison with the glucose clamp using the STG® Methods : Eight healthy patients undergoing maxillofacial surgery were employed in this study after obtaining written informed consent. Their insulin resistance was evaluated by HOMA-IR and the GC using the STG®before and after surgery. Results : HOMA-IR increased from 0.81 ±0.48 to 1.17±0.50, although there were no significant differences between before and after surgery. On the other hand, M-value by GC significantly decreased after surgery from 8.82±2.49mg • kg-1 • min-1 to 3.84±0.79 mg • kg-1 • min-1 (P=0.0003). In addition, no significant correlation was found between the values of HOMA-IR and the M-value by GC. Conclusions : HOMA-IR may not be reliable to evaluate IR for perioperative period.
AB - Background : Hyperglycemia due to increase in insulin resistance (IR) is often observed after surgery in spite of normal insulin secretion. To evaluate the degree of IR, the golden standard method is the normoglycemic hyperinsulinemic clamp technique (glucose clamp GC). The GC using the artificial pancreas, STG®-22 (Nikkiso, Tokyo, Japan), was established as a more reliable method, since it was evaluated during steady-state period under constant insulin infusion. Homeostasis model assessment insulin resistance (HOMA-IR), however, is frequently employed in daily practice because of its convenience. We1 therefore, investigated the reliability of HOMA-IR in comparison with the glucose clamp using the STG® Methods : Eight healthy patients undergoing maxillofacial surgery were employed in this study after obtaining written informed consent. Their insulin resistance was evaluated by HOMA-IR and the GC using the STG®before and after surgery. Results : HOMA-IR increased from 0.81 ±0.48 to 1.17±0.50, although there were no significant differences between before and after surgery. On the other hand, M-value by GC significantly decreased after surgery from 8.82±2.49mg • kg-1 • min-1 to 3.84±0.79 mg • kg-1 • min-1 (P=0.0003). In addition, no significant correlation was found between the values of HOMA-IR and the M-value by GC. Conclusions : HOMA-IR may not be reliable to evaluate IR for perioperative period.
UR - http://www.scopus.com/inward/record.url?scp=84874155560&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84874155560&partnerID=8YFLogxK
M3 - Article
C2 - 23479912
AN - SCOPUS:84874155560
VL - 62
SP - 140
EP - 146
JO - Japanese Journal of Anesthesiology
JF - Japanese Journal of Anesthesiology
SN - 0021-4892
IS - 2
ER -