Introduction and Objective: Decreased insulin sensitivity (resistance) is associated with higher T2D risk. Identifying reliable surrogate indexes that are convenient and that use standard clinical assays might improve prevention of T2D. We compared the ability of 15 indexes to predict future T2D in Southwest US American Indians.Methods: We calculated indexes obtained from oral glucose tolerance tests (OGTTs) using fasting and 2-hr glucose and insulin measures. We estimated correlation coefficients (r) of all indexes with sensitivity (M) measured by hyperinsulinemic-euglycemic clamp in 305 persons. We studied T2D risk in 2604 people followed for up to 14.5 years (544 cases of T2D). Predictive performance was assessed by the hazard ratio (HR) per SD and by the change in the area under the receiver operating curve (AUC) compared with a model without insulin/glucose measures.Results: Table 1 shows r with M, HRs for T2D risk, and AUCs for all indexes. Indexes calculated from OGTTs performed best; Matsuda had the highest r with M; Gutt had the highest AUC. In indexes that only needed fasting insulin (I0), QUICKI and HOMA-IR had equal r and AUC. Among the indexes that did not require insulin measurement: triglycerides and glucose index had the highest r and AUC.Conclusion: Surrogate measures based on OGTTs are best for predicting T2D, while measures based on I0 perform better than those that do not measure insulin.
L. Vazquez: None. E. Vazquez Arreola: None. M. Nagul: None. J. Krakoff: None. R.L. Hanson: None.
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