SPINA-GR
Reference range1.41–9.00 mol/s
Calculatorhttps://doi.org/10.5281/zenodo.7479856
PurposeMedical diagnosis, research
Test ofInsulin sensitivity

SPINA-GR is a calculated biomarker for insulin sensitivity.[1][lower-alpha 1] It represents insulin receptor gain.

How to determine GR

The index is derived from a mathematical model of insulin-glucose homeostasis.[2] For diagnostic purposes, it is calculated from fasting insulin and glucose concentrations with:

.[1]

[I](∞): Fasting Insulin plasma concentration (μU/mL)
[G](∞): Fasting blood glucose concentration (mg/dL)
G1: Parameter for pharmacokinetics (154.93 s/L)
DR: EC50 of insulin at its receptor (1,6 nmol/L)
GE: Effector gain (50 s/moL)
P(∞): Constitutive endogenous glucose production (150 µmol/s)

Clinical significance

Validity

Compared to healthy volunteers, SPINA-GR is significantly reduced in persons with prediabetes and diabetes mellitus, and it correlates with the M value in glucose clamp studies, triceps skinfold, subscapular skinfold and (better than HOMA-IR and QUICKI) with the two-hour value in oral glucose tolerance testing (OGTT), glucose rise in OGTT, waist-to-hip ratio, body fat content (measured via DXA) and the HbA1c fraction.[1]

Clinical utility

Both in the FAST study, an observational case-control sequencing study including 300 persons from Germany, and in a large sample from the NHANES study, SPINA-GR differed more clearly between subjects with and without diabetes than the corresponding HOMA-IR, HOMA-IS and QUICKI indices.[3]

Other uses

Together with the secretory capacity of pancreatic beta cells (SPINA-GBeta), SPINA-GR provides the foundation for the definition of a fasting based disposition index of insulin-glucose homeostasis (SPINA-DI).[3]

Pathophysiological implications

In lean subjects it is significantly higher than in a population with obese persons.[1] In several populations, SPINA-GR correlated with the area under the glucose curve and 2-hour concentrations of glucose, insulin and proinsulin in oral glucose tolerance testing, concentrations of free fatty acids, ghrelin and adiponectin, and the HbA1c fraction.[3]

See also

Notes

  1. ↑ SPINA is an acronym for "structure parameter inference approach".

References

  1. 1 2 3 4 Dietrich, JW; Dasgupta, R; Anoop, S; Jebasingh, F; Kurian, ME; Inbakumari, M; Boehm, BO; Thomas, N (21 October 2022). "SPINA Carb: a simple mathematical model supporting fast in-vivo estimation of insulin sensitivity and beta cell function". Scientific Reports. 12 (1): 17659. Bibcode:2022NatSR..1217659D. doi:10.1038/s41598-022-22531-3. PMC 9587026. PMID 36271244.
  2. ↑ Dietrich, Johannes W.; Böhm, Bernhard (27 August 2015). "Die MiMe-NoCoDI-Plattform: Ein Ansatz für die Modellierung biologischer Regelkreise". GMDS 2015; 60. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik: Biometrie und Epidemiologie e.V. (GMDS). doi:10.3205/15gmds058.
  3. 1 2 3 Dietrich, Johannes W.; Abood, Assjana; Dasgupta, Riddhi; Anoop, Shajith; Jebasingh, Felix K.; Spurgeon, R.; Thomas, Nihal; Boehm, Bernhard O. (2 January 2024). "A novel simple disposition index ( SPINA‐DI ) from fasting insulin and glucose concentration as a robust measure of carbohydrate homeostasis". Journal of Diabetes. doi:10.1111/1753-0407.13525. PMID 38169110.
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