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Evaluation of insulin sensitivity with a new lipid-based index in non-diabetic postmenopausal overweight and obese women before and after a weight loss intervention

¹ Inserm, CDR 893, équipe 7, Paris F-75012, France² Université Pierre et Marie Curie-Paris 6, Faculté de Médecine, UMRS680, Paris F-75005, France³ Centre de Recherche en Nutrition Humaine Rhône-Alpes, Université Claude Bernard Lyon1, Hospices Civils de Lyon, Lyon, France⁴ Department of Nutrition, Université de Montréal, Montréal, Québec, Canada⁵ Institut de Recherches Cliniques de Montréal, Montréal, Québec, Canada⁶ Centre de Recherche sur le Diabète de Montréal (MDRC), Centre de Recherche du Centre Hospitalier de L'Université de Montréal, Montréal, Québec, Canada⁷ AP-HP, Hôpital Hôpital Tenon, Service de Biochimie et Hormonologie, Paris F-75020, France

(Correspondence should be addressed to R Rabasa-Lhoret at Institut de Recherches Cliniques de Montréal; Email: remi.rabasa-lhoret{at}ircm.qc.ca)

^* (B Antuna-Puente and E Disse contributed equally to this work)

Objective: To evaluate the validity of a new lipid-based index (Disse index) in assessing insulin sensitivity (IS) compared with the hyperinsulinemic-euglycemic (HIEG) clamp in overweight and obese, non-diabetic, postmenopausal women, before and after a weight loss intervention.

Research design and methods: Association between Disse index and the HIEG clamp was evaluated in 86 non-diabetic postmenopausal overweight and obese women before and after weight loss. Percentage changes (%) were calculated for several fasting indices and compared with % of HIEG clamp.

Results: We observed a strong correlation between Disse index and HIEG clamp (r=0.69, P<0.001). This association was higher than those of homeostasis model assessment (HOMA), quantitative insulin sensitivity check index (QUICKI), and McAuley indices while no significant difference was observed with Revised-QUICKI. Percent change of Disse index (pre- versus post-weight loss program) was significantly correlated with % of HIEG clamp (r=0.34, P<0.01). This correlation was similar to those observed for the other indices tested.

Conclusions: We validated the reliability of Disse index in assessing IS in non-diabetic post-menopausal overweight and obese women, before and after weight loss intervention. Disse index may be useful not only for insulin resistant diagnostics in this type of population, but also for the IS follow-up after a weight-loss program and weight stabilization. The presence of lipid elements in this fasting index improves the estimation of IS in overweight and obese non-diabetic post-menopausal women and could add more information about peripheral IS.