Just Read: Estimating Insulin Sensitivity using common lab values (HDL, TG, BMI) – The Single Point Insulin Sensitivity Estimator (SPISE)

This paper, written by european researchers, describes a newer way to estimate insulin sensitivity (or it’s unhealthy opposite, insulin resistance) using commonly obtained lab values. Here’s the equation they came up with:

The novel formula for SPISE was computed as follows: SPISE = 600 X HDL-0.185/(TG0.2 x BMI1.338, with fasting HDL-C (mg/dL), fasting TG concentrations (mg/dL), and BMI (kg/m2)Paulmichl K, Hatunic M, Højlund K, Jotic A, Krebs M, Mitrakou A, et al. Modification and Validation of the Triglyceride-to-HDL Cholesterol Ratio as a Surrogate of Insulin Sensitivity in White Juveniles and Adults without Diabetes Mellitus: The Single Point Insulin Sensitivity Estimator (SPISE). Clin Chem [Internet]. Clinical Chemistry; 2016 Sep 1 [cited 2018 Oct 24];62(9):1211–9

This is important because other methods are either less accurate (a common method is to compute TG/HDL, with a cutoff of below 2.0 for insulin sensitivity) or much more intensive (ingesting glucose in a lab and monitoring its disappearance and measured insulin levels).

There’s a breakdown in the article of the common methods and their sensitivities and specificities.

The cutoff for this calculation is 6.61. A value higher than this means “insulin sensitive,” a value lower than this means “insulin resistant”

This calculation, the Single Point Insulin Sensitivity Estimator (SPISE) was used in this paper to demonstrate that individuals who progressed to pre-diabetes or diabetes showed impaired insulin sensitivity much earlier than their diagnosis, maybe up to 20 years:

2018.10.24 Low Carb and Low Carbon 572
2018.10.24 Low Carb and Low Carbon 572 (View on Flickr.com)

This calculation may be able to help patients and doctors see progress as they engage in dietary approaches to prevent or reverse diabetes. I created a spreadsheet for myself with the equation and am happy to punch in values for people, or share the spreadsheet.

The reason these numbers put together in this way give a measure of insulin sensitivity is beyond the scope of this post, however, it’s known that the biochemical adjustments that happen in the setting of a body overwhelmed with insulin that cannot do its job versus one that isn’t have an impact on measured HDL and triglycerides.

Check My Work Please

I am not an endocrinologist or a basic scientist, so I’d welcome anyone checking my work on this and letting me know if this is something useful clinically.

Reference

Paulmichl K, Hatunic M, Højlund K, Jotic A, Krebs M, Mitrakou A, et al. Modification and Validation of the Triglyceride-to-HDL Cholesterol Ratio as a Surrogate of Insulin Sensitivity in White Juveniles and Adults without Diabetes Mellitus: The Single Point Insulin Sensitivity Estimator (SPISE). Clin Chem [Internet]. Clinical Chemistry; 2016 Sep 1 [cited 2018 Oct 24];62(9):1211–9

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