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1 Diabetes Unit, Laboratory of Clinical Investigation, National Center for Complementary and Alternative Medicine, National Institutes of Health, Bethesda, 20892; and 2 Division of Biostatistics, Center for Devices and Radiological Health, US Food and Drug Administration, Rockville, Maryland 20850
Insulin resistance may link disorders of
metabolic homeostasis such as diabetes and obesity with disorders of
hemodynamic homeostasis such as hypertension. Thus it is of interest to
validate simple methods for quantifying insulin sensitivity in
hypertensive patients. The quantitative insulin-sensitivity check index
(QUICKI) is a novel mathematical transformation of fasting blood
glucose and insulin levels. In obese and diabetic subjects, QUICKI has a significantly better linear correlation with glucose clamp
determinations of insulin sensitivity than minimal-model estimates. To
determine whether QUICKI is also useful in hypertensive subjects, we
performed glucose clamps and frequently sampled intravenous glucose
tolerance tests (FSIVGTT) on 27 hypertensive subjects taken off
antihypertensive medication. Indexes of insulin sensitivity derived
from glucose clamp studies (SIClamp) were compared with
QUICKI, minimal-model analysis of FSIVGTTs (SIMM), and
homeostasis model assessment (HOMA). The correlation between QUICKI and
SIClamp (r = 0.84) was significantly better
than that between SIMM and SIClamp
(r = 0.65; P < 0.028). The correlation
between QUICKI and SIClamp was comparable to that between
1/HOMA and SIClamp (r = 0.82). When studies
were repeated in 14 subjects who had resumed antihypertensive medications, the percent changes in SIClamp for each of
these patients were significantly correlated with percent changes
in QUICKI (r = 0.61) and HOMA (r = 
0.54) but not SIMM (r = 0.18). We
conclude that QUICKI is a simple, robust index of insulin sensitivity that is useful for evaluating and following the insulin resistance of
hypertensive subjects in both research studies and clinical practice.
insulin resistance; diabetes; glucose clamp
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