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Chronic kidney disease (CKD) and obesity may differentially affect these measurements because of changes in insulin kinetics and organ-specific effects on insulin sensitivity. In a cross-sectional study of 59 subjects with nondiabetic CKD [estimated glomerular filtration rate: (GFR) &lt;60 ml\u00b7min<jats:sup>\u22121<\/jats:sup>\u00b71.73 m<jats:sup>2<\/jats:sup>] and 39 matched healthy controls, we quantified insulin sensitivity by clamp (SI<jats:sub>clamp<\/jats:sub>), oral glucose tolerance test, and fasting glucose and insulin. We compared surrogate insulin sensitivity indices to SI<jats:sub>clamp<\/jats:sub> using descriptive statistics, graphical analyses, correlation coefficients, and linear regression. Mean age was 62.6 yr; 48% of the participants were female, and 77% were Caucasian. Insulin sensitivity indices were 8\u201338% lower in participants with vs. without CKD and 13\u201359% lower in obese compared with nonobese participants. Correlations of surrogate indices with SI<jats:sub>clamp<\/jats:sub> did not differ significantly by CKD or obesity status. Adjusting for SI<jats:sub>clamp<\/jats:sub> in addition to demographic factors, Matsuda index was 15% lower in participants with vs. without CKD ( P = 0.09) and 36% lower in participants with vs. without obesity ( P = 0.0001), whereas 1\/HOMA-IR was 23% lower in participants with vs. without CKD ( P = 0.02) and 46% lower in participants with vs. without obesity ( P &lt; 0.0001). We conclude that CKD and obesity do not significantly alter correlations of surrogate insulin sensitivity indices with SI<jats:sub>clamp<\/jats:sub>, but they do bias surrogate measurements of insulin sensitivity toward lower values. This bias may be due to differences in insulin kinetics or organ-specific responses to insulin. <\/jats:p>","DOI":"10.1152\/ajpendo.00394.2016","type":"journal-article","created":{"date-parts":[[2017,1,10]],"date-time":"2017-01-10T22:10:30Z","timestamp":1484086230000},"page":"E175-E182","source":"Crossref","is-referenced-by-count":7,"title":["Chronic kidney disease and obesity bias surrogate estimates of insulin sensitivity compared with the hyperinsulinemic euglycemic clamp"],"prefix":"10.1152","volume":"312","author":[{"given":"Iram","family":"Ahmad","sequence":"first","affiliation":[{"name":"Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington, Seattle, Washington;"},{"name":"Division of Nephrology, Department of Medicine, Kidney Research Institute, University of Washington, Seattle, Washington;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leila R.","family":"Zelnick","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Kidney Research Institute, University of Washington, Seattle, Washington;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole R.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Kidney Research Institute, University of Washington, Seattle, Washington;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana M.","family":"Hung","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Vanderbilt University School of Medicine, Nashville, Tennessee; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan","family":"Kestenbaum","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Kidney Research Institute, University of Washington, Seattle, Washington;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina M.","family":"Utzschneider","sequence":"additional","affiliation":[{"name":"Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington, Seattle, Washington;"},{"name":"Veterans Affairs Puget Sound Health Care System, Seattle, Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven E.","family":"Kahn","sequence":"additional","affiliation":[{"name":"Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington, Seattle, Washington;"},{"name":"Veterans Affairs Puget Sound Health Care System, Seattle, Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian. 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