The Use and Effectiveness of Selected Alternative Markers for Insulin Sensitivity and Secretion Compared with Gold Standard Markers in Dietary Intervention Studies in Individuals without Diabetes: Results of a Systematic Review

Nutrients. 2022 May 12;14(10):2036. doi: 10.3390/nu14102036.

Abstract

Background: The gold-standard techniques for measuring insulin sensitivity and secretion are well established. However, they may be perceived as invasive and expensive for use in dietary intervention studies. Thus, surrogate markers have been proposed as alternative markers for insulin sensitivity and secretion. This systematic review aimed to identify markers of insulin sensitivity and secretion in response to dietary intervention and assess their suitability as surrogates for the gold-standard methodology.

Methods: Three databases, PubMed, Scopus, and Cochrane were searched, intervention studies and randomised controlled trials reporting data on dietary intake, a gold standard of analysis of insulin sensitivity (either euglycaemic-hyperinsulinaemic clamp or intravenous glucose tolerance test and secretion (acute insulin response to glucose), as well as surrogate markers for insulin sensitivity (either fasting insulin, area under the curve oral glucose tolerance tests and HOMA-IR) and insulin secretion (disposition index), were selected.

Results: We identified thirty-five studies that were eligible for inclusion. We found insufficient evidence to predict insulin sensitivity and secretion with surrogate markers when compared to gold standards in nutritional intervention studies.

Conclusions: Future research is needed to investigate if surrogate measures of insulin sensitivity and secretion can be repeatable and reproducible in the same way as gold standards.

Keywords: dietary intervention studies; gold standard; insulin secretion; insulin sensitivity; surrogate markers.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Biomarkers
  • Blood Glucose
  • Diabetes Mellitus*
  • Glucose Clamp Technique
  • Humans
  • Insulin
  • Insulin Resistance* / physiology

Substances

  • Biomarkers
  • Blood Glucose
  • Insulin

Grants and funding

This work was conducted by an expert group of the European branch of the International Life Sciences Institute (ILSI Europe). The research question addressed in this publication and potential contributing experts in the field were identified by the Obesity and Diabetes Task Force. The composition of the task force is listed on the ILSI Europe website at https://ilsi.eu/task-forces/nutrition/obesity-and-diabetes/ (accessed on 2 April 2022). Registration number: CRD42017037411. According to ILSI Europe policies, the EG is composed of at least 50% of external non-industry members. Once the expert group was formed, the research project was handed over to them to independently refine the research question. Consequently, the expert group carried out the work, that is, collecting/analysing data/information and writing the scientific paper independently of other activities of the task force. The research report is the result of a scientific evaluation in line with ILSI Europe’s framework to provide a pre-competitive setting for public-private partnerships. ILSI Europe (Adam Coventry) facilitated scientific meetings and coordinated the overall project management and administrative tasks relating to the completion of this work. For further information about ILSI Europe, please email info@ilsieurope.be or call +3227710014. The opinions expressed herein, and the conclusions of this publication are those of the authors and do not necessarily represent the views of ILSI Europe nor those of its member companies. Experts are not paid for the time spent on this work; however, the non-industry members within the expert group were offered support for travel and accommodation costs from the Obesity and Diabetes Task Force to attend meetings to discuss the manuscript. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.