Another insulin resistance test: Insulin Resistance Panel With Score

Alzheimer's, cardiovascular, and other chronic diseases; biomarkers, lifestyle, supplements, drugs, and health care.
circular
Senior Contributor
Senior Contributor
Posts: 5565
Joined: Sun Nov 03, 2013 10:43 am

Another insulin resistance test: Insulin Resistance Panel With Score

Post by circular »

This appears to be an improvement over just testing insulin. I wonder how it would stack up against post-prandial insulin tests:
Clinical Significance: Proinsulin is processed to insulin and C-peptide as it passes through pancreatic beta cells, which are then released together in response to increased glucose levels. A steady-state plasma glucose test, in individuals undergoing an insulin suppression test to assess insulin resistance, found that the combination of insulin and C-peptide was a better indicator of insulin resistance than either one individually. The Insulin Resistance Panel with Score combines fasting insulin and C-peptide measurements to evaluate the likelihood that an individual has insulin resistance. [Link]
ApoE 3/4 > Thanks in advance for any responses made to my posts.
User avatar
Tincup
Mod
Mod
Posts: 3558
Joined: Fri Aug 08, 2014 2:57 pm
Location: Front Range, CO

Re: Another insulin resistance test: Insulin Resistance Panel With Score

Post by Tincup »

circular wrote:This appears to be an improvement over just testing insulin. I wonder how it would stack up against post-prandial insulin tests:
Turns out this was tested on me in a November Salveo (lab) test. My insulin was 3 (which was considered low by the lab - ideal listed as 4-9) and proinsulin was 6 with ideal listed as <= 13. The ratio was considered mildly high at 4.4, with ideal being <3.6. Most in the field don't think that insulin at 3 is low, also Catherine Crofts has said insulin values are extremely pulsatile. Gundry did not comment on this. My SHBG was 160, which is very high. Turns out that high SHBG is associated with low insulin. I still think a Kraft test, which is essentially a pancreatic "stress test." Is a much better indicator of IR. It does require more time than a single time blood draw. A Kraft test is an oral glucose tolerance test with an insulin assay with a glucose assay at time 0, 30, 60, 120, 180 minutes, some go all the way to 5 hours. A low carb and/or keto diet can also skew the results for either test. Kraft suggested eating at least 150g/day of carbs for 14 days before doing his test. Kraft and his test has been discussed before here.
Tincup
E3,E4
User avatar
Julie G
Mod
Mod
Posts: 9187
Joined: Sat Oct 26, 2013 6:36 pm

Re: Another insulin resistance test: Insulin Resistance Panel With Score

Post by Julie G »

Thanks for bringing this to our attention, Circ. I tested this back in 2016 and also got a 6 with fasting insulin of 2. My C-peptide on that same test was also very low; both supposedly indicating no IR. Startlingly, my proinsulin: C-peptide ratio was flagged as high at 5.6. I tried to look up the significance and all I could find was that this indicated emerging T1D in children. Huh? Like Tincup, I suspect that our even mildly LC diets are throwing off the reference ranges. FWIW, my recent NMR showed an LPIR <25. I think I’ll go with that one. :D
circular
Senior Contributor
Senior Contributor
Posts: 5565
Joined: Sun Nov 03, 2013 10:43 am

Re: Another insulin resistance test: Insulin Resistance Panel With Score

Post by circular »

Thanks Tincup and Julie. Why wouldn’t the LPIR also get messy with a low carb dieter? Just curious. Every insulin test I’ve ever done, including in my OP here, but not including Kraft’s or Croft’s methods, has shown me to be insulin sensitive. On the other hand I have a history of PCOS. But really, for brain insulin sensitivity wouldn’t we really need a PET scan showing glucose uptake?
ApoE 3/4 > Thanks in advance for any responses made to my posts.
circular
Senior Contributor
Senior Contributor
Posts: 5565
Joined: Sun Nov 03, 2013 10:43 am

Re: Another insulin resistance test: Insulin Resistance Panel With Score

Post by circular »

This indicates the Insulin Resistance Panel with Score was tested against the conventional gold standard IR test, as far as that goes. https://blog.questdiagnostics.com/2018/ ... esistance/
this new method has been validated against a gold-standard measurement of IR, which requires intravenous infusion, making it unsuitable for primary care settings.
It links to the 2018 paper on it, making me wonder how Julie got it in 2016?
ApoE 3/4 > Thanks in advance for any responses made to my posts.
User avatar
Tincup
Mod
Mod
Posts: 3558
Joined: Fri Aug 08, 2014 2:57 pm
Location: Front Range, CO

Re: Another insulin resistance test: Insulin Resistance Panel With Score

Post by Tincup »

circular wrote:This indicates the Insulin Resistance Panel with Score was tested against the conventional gold standard IR test, as far as that goes. https://blog.questdiagnostics.com/2018/ ... esistance/
this new method has been validated against a gold-standard measurement of IR, which requires intravenous infusion, making it unsuitable for primary care settings.
I'm guessing it is the Hyperinsulinemic-euglycemic clamp technique.. " The plasma insulin concentration is acutely raised and maintained at 100 μU/ml by a continuous infusion of insulin. Meanwhile, the plasma glucose concentration is held constant at basal levels by a variable glucose infusion. When the steady-state is achieved, the glucose infusion rate equals glucose uptake by all the tissues in the body and is therefore a measure of tissue insulin sensitivity. The hyperinsulinemic clamps are often used to measure insulin resistance."

For my preference, I'd still rather get a Kraft test, as it will tell you how the pancreas and the whole system responds to a glucose load. When Dr. Crofts did her thesis using Kraft's data, she determined that a reasonable approximation was to get an insulin test exactly two hours after your carbiest meal of the day. If insulin was <= 30, then you were good, >50 bad and inbetween you need further testing. As I recall, Stavia did this and her insulin was 20 (all in mIU/L units).

Julie's NMR LPIR is another proxy test, based on lipids. I've had this test and done well (<25) on it, but I would still rather actually stress test the insulin system.

In this recently released podcast, Ivor Cummins interviews Dr. Arthur Agaston. Dr. Agatston (who developed a widely used scoring technique for CAC calcium heart scans) started using the Kraft test on his patients and describes what he's learned.
Tincup
E3,E4
User avatar
Julie G
Mod
Mod
Posts: 9187
Joined: Sat Oct 26, 2013 6:36 pm

Re: Another insulin resistance test: Insulin Resistance Panel With Score

Post by Julie G »

It links to the 2018 paper on it, making me wonder how Julie got it in 2016?
Mine wasn’t a Quest panel but rather a huge battery performed by True Health Diagnostics in July of 2016. Kinda funny how Quest claims to be the first to offer it. ;)
circular
Senior Contributor
Senior Contributor
Posts: 5565
Joined: Sun Nov 03, 2013 10:43 am

Re: Another insulin resistance test: Insulin Resistance Panel With Score

Post by circular »

Julie G wrote:
It links to the 2018 paper on it, making me wonder how Julie got it in 2016?
Mine wasn’t a Quest panel but rather a huge battery performed by True Health Diagnostics in July of 2016. Kinda funny how Quest claims to be the first to offer it. ;)
Lots of 'strange' things happen in the laboratory testing world. Here's some shady background on THD that is now bankrupt and no one seems to want to buy. Even after THD bought the Health Diagnostics Laboratory (remember that, after HDL was in legal trouble, discussed here a long while back?):
In July 2016 a post in CardiBrief called out several sales practices of True Health as examples of "a wide variety of new scams to gain new business...that emerged in the wake of the collapse and bankruptcy of Health Diagnostics Laboratory." These practices included setting up labs that would be majority-owned by the testing company and minority-owned by individual doctors, who could then financially benefit without owning the lab to which he or she would send tests, which would be illegal; another was offering management services through blood-drawing service providers. [WikiP]
Here's the CardiBrief article. One avenue it describes that facilitates new scams involves phlebotomy companies. There are lots of comments there, which naturally point to issues with Quest and LabCorps too. I'd forgotten about those, but they brought me full circle...

I've been getting great DTC deals on tests through an enormous local (statewide) collaboration between Quest and a massive, big name health care organization, a 'joint venture' doing business as a phlebotomy company! They claim to be 'ethical', 'honorable', 'truthful', 'fair', and 'decent' and have garnered prominent business awards, but I wonder if there's a backstory there anyway. To their credit, the IR Resistance Score with Panel is just $59 (compared with the DTC 'sale' price of $199 here [instead of $655!)), and TMAO is just $36 (compared with the sale price of $139 here [instead of $360]). (Note those last two examples from True Health Labs are not from True Health Diagnostics :roll: ) This gives us an idea of what the markups often must be like when we order DTC labs. Even sale prices are, at least sometimes, a gauge.

I didn't know about this subsequent history with THD until just now, when I tried to sort out who developed the Insulin Resistance Panel with Score ... for no terribly influential civic reason :lol:
ApoE 3/4 > Thanks in advance for any responses made to my posts.
circular
Senior Contributor
Senior Contributor
Posts: 5565
Joined: Sun Nov 03, 2013 10:43 am

Re: Another insulin resistance test: Insulin Resistance Panel With Score

Post by circular »

I've copied this post and sent this topic to a thread it belongs in better.

I also added at the end of the copied post the example where a toxicology lab company required a saliva sample for 'compliance', opening the door to patients' whole genomes being bought and sold outside of disclosures and patient use agreements.
ApoE 3/4 > Thanks in advance for any responses made to my posts.
circular
Senior Contributor
Senior Contributor
Posts: 5565
Joined: Sun Nov 03, 2013 10:43 am

Re: Another insulin resistance test: Insulin Resistance Panel With Score

Post by circular »

Back to the IR panel with score, they couldn't calculate mine:

Insulin, Intact <3* ... < OR = 16 uIU/mL
C-Peptide 0.74 ... 0.68­ - 2.16 ng/mL

Insulin Resistance Score NOTCALC *

'Unable to calculate the Insulin Resistance Score, as one or more
analytes were outside of the reportable range.'

Oh well, doesn't look to bad.
ApoE 3/4 > Thanks in advance for any responses made to my posts.
Post Reply