Low insulin sensitivity measured by both quantitative insulin sensitivity check index and homeostasis model assessment method as a risk factor of increased intima-media thickness of the carotid artery

J Clin Endocrinol Metab. 2002 Nov;87(11):5092-7. doi: 10.1210/jc.2002-020703.


The present study evaluated the association of ultrasonographic manifestations of carotid atherosclerosis with glucose status, various components of the insulin resistance syndrome, and insulin sensitivity measured by a novel quantitative insulin sensitivity check index (QUICKI = 1/[log(I0) + log (G0)]). Carotid ultrasonographic measurements were performed on 54 diabetic subjects, 97 subjects with impaired glucose tolerance and 57 normoglycemic subjects. QUICKI and insulin resistance measured by a HOMA (homeostasis model assessment) method had a high negative correlation (r = -0.995, P < 0.001). QUICKI was lower in diabetic subjects (0.319 +/- 0.022) than in subjects with impaired glucose tolerance (0.334 +/- 0.027) or normoglycemia (0.335 +/- 0.022, P = 0.002). There was an increasing trend in the mean and maximal intima-media thickness (IMT) of the common carotid artery (CCA) with worsening of glucose status. The maximal IMT of the CCA correlated inversely with QUICKI (r = -0.158, P = 0.027). The prevalence of severe CCA atherosclerosis (maximal IMT of the CCA > or = 1.2 mm) was 41% in men and 16% in women (P < 0.001). It was also associated with a long (> or =26 yr) smoking history. The prevalence of severe CCA atherosclerosis was 11% in the highest QUICKI tertile, 36% in the middle tertile, and 33% in the lowest tertile (P = 0.002). Systolic blood pressure was higher and high-density lipoprotein cholesterol lower in subjects with severe CCA atherosclerosis, compared with those without it. In multiple regression analysis, the adjusted odds ratio for severe CCA atherosclerosis was 5.7 (95% confidence interval, 2.2-15.1) in subjects in the two lowest tertiles of QUICKI, compared with those in the highest tertile.

MeSH terms

  • Blood Glucose / metabolism
  • Blood Pressure
  • Carotid Arteries / diagnostic imaging*
  • Carotid Artery Diseases / diagnostic imaging*
  • Carotid Artery Diseases / epidemiology
  • Cholesterol, HDL / blood
  • Fasting
  • Female
  • Glucose Intolerance / epidemiology
  • Homeostasis*
  • Humans
  • Hypertension / epidemiology
  • Insulin / blood
  • Insulin / pharmacology*
  • Insulin Resistance
  • Male
  • Middle Aged
  • Odds Ratio
  • Regression Analysis
  • Risk Factors
  • Sex Characteristics
  • Smoking / epidemiology
  • Triglycerides / blood
  • Ultrasonography


  • Blood Glucose
  • Cholesterol, HDL
  • Insulin
  • Triglycerides