Relation between HOMA-IR and insulin sensitivity index determined by hyperinsulinemic-euglycemic clamp analysis during treatment with a sodium-glucose cotransporter 2 inhibitor

• Published in: Endocrine Journal Vol. 67; no. 5; pp. 501 - 507
• Main Authors: So, Anna, Sakaguchi, Kazuhiko, Okada, Yuko, Morita, Yasuko, Yamada, Tomoko, Miura, Hiroshi, Otowa-Suematsu, Natsu, Nakamura, Tomoaki, Komada, Hisako, Hirota, Yushi, Tamori, Yoshikazu, Ogawa, Wataru
• Format: Journal Article
• Language: English
• Published: Japan The Japan Endocrine Society 01.01.2020; Japan Science and Technology Agency
• Subjects: Adult; Aged; Benzhydryl Compounds - therapeutic use; Blood Glucose - analysis; Body mass index; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Female; Glucose; Glucose Clamp Technique; Glucosides - therapeutic use; Homeostasis; Homeostasis model assessment–insulin resistance (HOMA-IR); Humans; Hyperinsulinemic-euglycemic clamp; Insulin; Insulin - blood; Insulin - pharmacology; Insulin resistance; Insulin Resistance - physiology; Insulin sensitivity; Male; Middle Aged; Multivariate analysis; Na+/glucose cotransporter; Sodium-glucose cotransporter 2 (SGLT2) inhibitor; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; Sodium-glucose cotransporter 2 (SGLT2) inhibitor; Insulin resistance; Homeostasis model assessment–insulin resistance (HOMA-IR); Hyperinsulinemic-euglycemic clamp; Insulin sensitivity
• ISSN: 0918-8959; 1348-4540; 1348-4540
• DOI: 10.1507/endocrj.EJ19-0445

We had aimed to determine whether homeostasis model assessment–insulin resistance (HOMA-IR) reflects insulin resistance-sensitivity during treatment with a sodium-glucose cotransporter 2 inhibitor (SGLT2i). Hyperinsulinemic-euglycemic clamp analysis was performed in 22 patients with type 2 diabetic patients taking dapagliflozin (5 mg/day before or after breakfast). Propensity score matching of these individuals (SGLT2i group) for age, sex, body mass index, and clamp-derived tissue glucose uptake rate with 44 type 2 diabetic patients who had undergone clamp analysis without SGLT2i treatment (control group) identified 17 paired subjects in each group for further analysis of the relation between HOMA-IR and a clamp-derived insulin sensitivity index (ISI). Natural log–transformed HOMA-IR was negatively correlated with ISI in both SGLT2i (r = –0.527, p = 0.030) and control (r = –0.534, p = 0.027) groups. The simple regression lines for log-transformed HOMA-IR and ISI in the two groups showed similar slopes but differed in their intercepts. Multivariate analysis revealed that HOMA-IR for patients with the same ISI in the two groups was related by the formula: HOMA-IRcontrol = HOMA-IRSGLT2i × 2.45. In conclusion, HOMA-IR was well correlated with ISI during SGLT2i treatment, but values corresponding to the same ISI were lower in the SGLT2i group than in the control group.