scholarly journals Epidemiologic Behavior and Estimation of an Optimal Cut-Off Point for Homeostasis Model Assessment-2 Insulin Resistance: A Report from a Venezuelan Population

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Valmore Bermúdez ◽  
Joselyn Rojas ◽  
María Sofía Martínez ◽  
Vanessa Apruzzese ◽  
Mervin Chávez-Castillo ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Sensitivity And Specificity ◽  
Adult Population ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Reference Population ◽  
Point Estimation ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Cross Sectional

Background. Mathematical models such as Homeostasis Model Assessment have gained popularity in the evaluation of insulin resistance (IR). The purpose of this study was to estimate the optimal cut-off point for Homeostasis Model Assessment-2 Insulin Resistance (HOMA2-IR) in an adult population of Maracaibo, Venezuela. Methods. Descriptive, cross-sectional study with randomized, multistaged sampling included 2,026 adult individuals. IR was evaluated through HOMA2-IR calculation in 602 metabolically healthy individuals. For cut-off point estimation, two approaches were applied: HOMA2-IR percentile distribution and construction of ROC curves using sensitivity and specificity for selection. Results. HOMA2-IR arithmetic mean for the general population was 2.21±1.42, with 2.18±1.37 for women and 2.23±1.47 for men (P=0.466). When calculating HOMA2-IR for the healthy reference population, the resulting p75 was 2.00. Using ROC curves, the selected cut-off point was 1.95, with an area under the curve of 0.801, sensibility of 75.3%, and specificity of 72.8%. Conclusions. We propose an optimal cut-off point of 2.00 for HOMA2-IR, offering high sensitivity and specificity, sufficient for proper assessment of IR in the adult population of our city, Maracaibo. The determination of population-specific cut-off points is needed to evaluate risk for public health problems, such as obesity and metabolic syndrome.

scholarly journals Development and Validation of Two Self-Reported Tools for Insulin Resistance and Hypertension Risk Assessment in A European Cohort: The Feel4Diabetes-Study

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 960
Author(s):  
Spyridon Kanellakis ◽  
Christina Mavrogianni ◽  
Kalliopi Karatzi ◽  
Jaana Lindstrom ◽  
Greet Cardon ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Risk Assessment ◽  
High Risk ◽  
Sensitivity And Specificity ◽  
Low Cost ◽  
Area Under The Curve ◽  
Assessment Tools ◽  
Screening Tools ◽  
Model Assessment ◽  
Sugary Drinks

Early identification of type 2 diabetes mellitus (T2DM) and hypertension (HTN) risk may improve prevention and promote public health. Implementation of self-reported scores for risk assessment provides an alternative cost-effective tool. The study aimed to develop and validate two easy-to-apply screening tools identifying high-risk individuals for insulin resistance (IR) and HTN in a European cohort. Sociodemographic, lifestyle, anthropometric and clinical data obtained from 1581 and 1350 adults (baseline data from the Feel4Diabetes-study) were used for the European IR and the European HTN risk assessment index respectively. Body mass index, waist circumference, sex, age, breakfast consumption, alcohol, legumes and sugary drinks intake, physical activity and sedentary behavior were significantly correlated with Homeostatic Model Assessment of IR (HOMA-IR) and/or HTN and incorporated in the two models. For the IR index, the Area Under the Curve (AUC), sensitivity and specificity for identifying individuals above the 75th and 95th of HOMA-IR percentiles were 0.768 (95%CI: 0.721–0.815), 0.720 and 0.691 and 0.828 (95%CI: 0.766–0.890), 0.696 and 0.778 respectively. For the HTN index, the AUC, sensitivity and specificity were 0.778 (95%CI: 0.680–0.876), 0.667 and 0.797. The developed risk assessment tools are easy-to-apply, valid, and low-cost, identifying European adults at high risk for developing T2DM or having HTN.

scholarly journals Distribution of the homeostasis model assessment of insulin resistance in Mexican children and adolescents

2012 ◽  
Vol 166 (2) ◽  
pp. 301-306 ◽  
Author(s):  
Celia Aradillas-García ◽  
Martha Rodríguez-Morán ◽  
María Eugenia Garay-Sevilla ◽  
Juan Manuel Malacara ◽  
Ramón Alberto Rascon-Pacheco ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Children And Adolescents ◽  
Fasting Glucose ◽  
Population Based ◽  
Healthy Children ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Cross Sectional ◽  
Glucose Levels ◽  
Mexican Children

ObjectiveSeveral cutoff points of the homeostasis model assessment of insulin resistance (HOMA-IR; varying from 2.5 to 4.0) have been suggested for diagnosing IR in youth. In this study, we determined the distribution of the HOMA-IR in Mexican children and adolescents.Design and methodsA total of 6132 children and adolescents from San Luis Potosi, León, Queretaro, and Durango, which are cities in central and northern Mexico, were enrolled in a population-based cross-sectional study. Eligible participants were apparently healthy children and adolescents aged 6–18 years. Pregnancy and the presence of chronic illnesses were exclusion criteria.ResultsA total of 3701 (60.3%) girls and 2431 (39.7%) boys were included in this study. In the overall population, the mean body mass index, insulin levels, and fasting glucose levels were 21.8±1.3 kg/m2, 7.1±3.2 μU/ml, and 86.2±10.0 mg/dl respectively. The concentrations of insulin and fasting glucose gradually increased from 6 to 12 years of age, whereas the concentrations tended to plateau in the 13- to 18-year-old population. The absolute mean of the HOMA-IR was 2.89±0.7. The HOMA-IR gradually increased with age and reached a plateau at 13 years of age.ConclusionsBecause the insulin concentrations, glucose levels, and HOMA-IR exhibited a gradual increase with age that was not related to obesity, our results suggested that the evaluation of IR in children should be based on percentiles of the HOMA-IR rather than a dichotomous value derived from a single cutoff point.

scholarly journals Decreased plasma adiponectin concentrations in nondiabetic women with elevated homeostasis model assessment ratios

2003 ◽  
pp. 343-350 ◽  
Author(s):  
M Matsubara ◽  
S Katayose ◽  
S Maruoka
Keyword(s):  
Insulin Resistance ◽  
Multiple Regression ◽  
Serum Insulin ◽  
Sandwich Elisa ◽  
Serum Triglyceride ◽  
Model Assessment ◽  
Continuous Variables ◽  
Homeostasis Model Assessment ◽  
Cross Sectional ◽  
Plasma Adiponectin

OBJECTIVE: Whether the adipocyte-derived protein adiponectin is associated with insulin resistance independently of the effects of adiposity and the diabetic state is an important question. We explored, in a cross-sectional study of 486 Japanese nondiabetic women, the relationship between the calculated insulin resistance (homeostasis model assessment ratio (HOMA-R)) and adiponectin levels determined using a validated sandwich ELISA. DESIGN AND METHODS: All participants were stratified into tertiles for HOMA-R (approximately <1.5, 1.5< or = approximately <3.0, 3.0< or = approximately ) and the differences across tertiles of continuous variables were tested with ANOVA. Two-way ANOVA was used to determine possible relationships for plasma adiponectin between tertiles of HOMA-R and several stratified parameters. Multiple regression analyses were performed with HOMA-R or fasting serum insulin as dependent variable, and diastolic blood pressure (BP), body mass index (BMI), serum triglyceride (TG), leptin and adiponectin as independent determinants. RESULTS: Mean plasma adiponectin in the high HOMA-R group decreased compared with that in the low HOMA-R group both before (mean+/-s.e.m. 6.2+/-0.6 vs 9.2+/-0.3 microg/ml, P<0.001) and after adjustment for body fat mass (BFM) as kg or percent (0.31+/-0.04 vs 0.69+/-0.03, 0.18+/-0.02 vs 0.34+/-0.01, both P<0.001). HOMA-R was inversely associated with adiponectin levels both before (r=-0.37, P<0.001) and after adjustment for BFM (r=-0.49, -0.46, both P<0.001). After covariate adjustment for age, diastolic BP, BMI and serum TG, HOMA-R retained a significant correlation with adiponectin/BFM (kg). Both adiponectin and leptin were the significant determinants of HOMA-R or fasting insulin in multiple regression models. CONCLUSIONS: Adiponectin was inversely associated with insulin resistance in nondiabetic subjects, independently from age, BP, adiposity and serum lipids. Because adiponectin is thought to have an anti-atherogenic action, the presence of hypoadiponectinemia may predispose subjects to atherosclerosis, and may progress the atherogenesis in insulin resistance.

scholarly journals High HOMA-IR Index in Healthcare Shift Workers

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 186 ◽  
Author(s):  
Caterina Ledda ◽  
Diana Cinà ◽  
Serena Matera ◽  
Nicola Mucci ◽  
Massimo Bracci ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Shift Work ◽  
Healthcare Workers ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Significant Positive Association ◽  
Cross Sectional ◽  
Shift Workers

Background and objectives: Evidence shows that shift work may be correlated with insulin resistance (IR). Therefore its estimation in clinical and prevention practice is of great significance. A cross-sectional study was performed to examine the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) Index among healthcare shift workers (HCSW). Materials and Methods: A total of 272 healthcare workers (HCWs) were invited to participate in the study within an occupational surveillance framework, 137 were HCSW while 135 were healthcare non-shift workers (HCNSW). Fasting glucose, insulin, and HOMA-IR Index were evaluated in each participant and correlated with shift workers. Results: Indicators of glucose metabolism were significantly higher in HCSW p < 0.001, and logistic regression analysis confirmed a significant positive association between increased values of HOMA-IR Index and shift workers (p < 0.05). Conclusions: Shift work could be a risk factor in developing insulin resistance and metabolic syndrome.

scholarly journals Optimal Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) Cut-Offs: A Cross-Sectional Study in the Czech Population

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 158 ◽  
Author(s):  
Dagmar Horáková ◽  
Ladislav Štěpánek ◽  
Vladimír Janout ◽  
Jana Janoutová ◽  
Dalibor Pastucha ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Logistic Regression ◽  
Clinical Practice ◽  
Predictive Accuracy ◽  
Predictive Ability ◽  
Glucose Metabolism Disorders ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Cross Sectional ◽  
Czech Population

Background and Objectives: The key pathogenetic mechanism of glucose metabolism disorders, insulin resistance (IR), can be assessed using the Homeostasis Model Assessment of IR (HOMA-IR). However, its application in clinical practice is limited due to the absence of cut-offs. In this study, we aimed to define the cut-offs for the Czech population. Methods: After undergoing anthropometric and biochemical studies, the sample of 3539 individuals was divided into either nondiabetics, including both subjects with normal glucose tolerance (NGT, n = 1947) and prediabetics (n = 1459), or diabetics (n = 133). The optimal HOMA-IR cut-offs between subgroups were determined to maximize the sum of the sensitivity and specificity for diagnosing type 2 diabetes mellitus (T2DM) or prediabetes. The predictive accuracy was illustrated using receiver operating characteristic (ROC) curves. Logistic regression was performed to assess the association between a target variable (presence/absence of T2DM) depending on the HOMA-IR score as well as on the age and sex. Results: The HOMA-IR cut-off between nondiabetics and diabetics for both sexes together was 3.63, with a sensitivity of 0.56 and a specificity of 0.86. The area under the ROC curve was 0.73 for T2DM diagnosing in both sexes. The HOMA-IR cut-off between the NGT subjects and prediabetics was 1.82, with a sensitivity of 0.60 and a specificity of 0.66. Logistic regression showed that increased HOMA-IR is a risk factor for the presence of T2DM (odds ratio (OR) 1.2, 95% confidence interval (CI) 1.14–1.28, p < 0.0001). The predictive ability of HOMA-IR in diagnosing T2DM is statistically significantly lower in females (OR 0.66, 95% CI 0.44–0.98). The results are valid for middle-aged European adults. Conclusions: The results suggest the existence of HOMA-IR cut-offs signaling established IR. Introduction of the instrument into common clinical practice, together with the known cut-offs, may contribute to preventing T2DM.

scholarly journals Association of Metabolic Syndrome with the Adiponectin to Homeostasis Model Assessment of Insulin Resistance Ratio

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Yu-Song Ding ◽  
Shu-Xia Guo ◽  
Ru-Lin Ma ◽  
Shu-Gang Li ◽  
Heng Guo ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Operating Characteristic ◽  
Diagnostic Marker ◽  
Roc Curves ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Middle Aged ◽  
Diagnostic Efficacy ◽  
Increased Risk

This study aimed at determining whether the adiponectin to HOMA-IR (A/H) ratio is associated with MetS and MetS components and comparing the diagnostic efficacy of adiponectin, HOMA-IR, and the A/H ratio in healthy, middle-aged participants. MetS was assessed in 1628 Kazakh participants (men, 768; women, 860). The associations between adiponectin, HOMA-IR, and the A/H ratio with the components of MetS and MetS were examined using logistic regression analysis and receiver operating characteristic (ROC) curves. Our results show that A/H ratio may be a better diagnostic marker for MetS than either HOMA-IR or adiponectin alone, and it may serve as an important biomarker to determine an increased risk for MetS in healthy middle-aged population.

scholarly journals Hubungan Kadar Plasma Chemerin dengan Homeostasis Model Assessment Insulin Resistance pada Remaja Obesitas

Sari Pediatri ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. 24
Author(s):  
Silvy Dioni ◽  
Eka Agustia Rini ◽  
Eti Yerizel
Keyword(s):  
Insulin Resistance ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Cross Sectional ◽  
Elisa Data

Latar belakang. Obesitas pada anak berhubungan dengan meningkatnya risiko sindrom metabolik, seperti resistensi insulin. HOMA-IR merupakan marker yang sering digunakan untuk menilai resistensi insulin. Chemerin merupakan protein 18 kDa yang dihasilkan jaringan adiposa, berfungsi sebagai chemoatractant memegang peran penting berkontribusi terhadap perkembangan inflamasi dan resistensi insulin. Tujuan. Untuk mengetahui hubungan kadar chemerin dengan HOMA-IR pada remaja obesitas.Metode. Penelitian ini merupakan penelitian cross sectional yang dilakukan pada 3 sekolah menengah umum (SMU) di kota Padang. Jumlah sampel berjumlah 28 remaja obesitas dan 28 remaja dengan IMT normal. Obesitas ditentukan berdasarkan nilai IMT, HOMA-IR dihitung berdasarkan rumus yang menggunakan nilai glukosa dan insulin puasa. Glukosa diukur dengan metode glucose hexokinase fotometrik, insulin diperiksa dengan metode chemiluminessence immunoassay dan kadar plasma chemerin dengan metode ELISA. Data dianalisis dengan sistem komputerisasi dengan uji korelasi.Hasil. Kadar plasma chemerin lebih tinggi pada kelompok obesitas dibandingkan kontrol 121,52 (SD 2,09) ng/ml vs 97,23(SD 2,41) ng/ml, p: 0,001 dan pada kelompok obesitas dengan resistensi insulin dibandingkan non resistensi insulin 133,1(SD 19,24) vs 115,09 (SD 19,52), p=0,001. Terdapat hubungan lemah kadar chemerin dengan nilai HOMA-IR pada obesitas(r=0,382;p=0,045) dan hubungan lemah kadar chemerin dengan nilai HOMA-IR pada obesitas resistensi insulin (r=0,297;p=0,405).Kesimpulan. Terdapat hubungan lemah kadar chemerin dengan nilai HOMA-IR pada remaja obesitas, dan hubungan lemah kadar chemerin dengan nilai HOMA-IR pada obesitas resistensi insulin.

Waist Circumference as a Simple and Meaningful Means to Assess Insulin Resistance Among Outpatients with Bipolar Disorder

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
F.A. Gomes ◽  
P.V.d.S. Magalhães ◽  
M. Kunz ◽  
A. Andreazza ◽  
L. Silveira ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Bipolar Disorder ◽  
Waist Circumference ◽  
International Diabetes Federation ◽  
Roc Curves ◽  
Clinical Parameter ◽  
Cross Sectional Study ◽  
Model Assessment ◽  
Cross Sectional ◽  
Homeostatic Model Assessment

Aims:To evaluate insulin resistance (IR) among outpatients with bipolar disorder (BD) in order to determine clinical correlates of IR in this patient population.Method:We performed a cross-sectional study in sixty-five DSM-IV-TR BD patients consecutively assessed from January to August 2007 at the Bipolar Disorder Program, Hospital de Clínicas de Porto Alegre, Brazil. IR was diagnosed using the homeostatic model assessment - insulin resistance (HOMA-IR). Metabolic syndrome (MS) diagnosis and metabolic variables were assessed using three definitions: National Cholesterol Educational Program - Adult Treatment Panel III (NCEP-ATP III); NCEP-ATP III modified criteria and International Diabetes Federation (IDF).Results:IR was present in 43.1% of the sample (women 40%, men 44.4%). The prevalence of MS defined by the NCEP-ATP III criteria was 32.3%, NCEP-ATP III modified was 40% and IDF was 41.5%. NCEP-ATP III modified criteria showed the best trade-off between sensitivity (78.6%) and specificity (89.2%) to detect insulin resistance. Waist circumference was the best clinical parameter associated with IR in the linear regression model (B=0.014, SE 0.002, t=6.18, p< 0.001). Areas under ROC curves were similar for waist circumference and different MS definitions (chi2=2.98, df=3, p=0.39).Conclusion:Currently MS criteria may provide reasonable sensitivity and specificity for the detection of insulin resistance in patients with bipolar disorder. Waist circumference may be a simple and inexpensive means to predict insulin resistance in this population.

scholarly journals Plasma metabolites associated with homeostatic model assessment of insulin resistance: metabolite-model design and external validation

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Pablo Hernández-Alonso ◽  
Jesús García-Gavilán ◽  
Lucía Camacho-Barcia ◽  
Anders Sjödin ◽  
Thea T. Hansen ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
External Validation ◽  
Area Under The Curve ◽  
Validation Dataset ◽  
Plasma Metabolites ◽  
Model Assessment ◽  
Cross Sectional ◽  
Lipid Species ◽  
Homeostatic Model Assessment ◽  
Homeostatic Model

Abstract Different plasma metabolites have been related to insulin resistance (IR). However, there is a lack of metabolite models predicting IR with external validation. The aim of this study is to identify a multi-metabolite model associated to the homeostatic model assessment (HOMA)-IR values. We performed a cross-sectional metabolomics analysis of samples collected from overweight and obese subjects from two independent studies. The training step was performed in 236 subjects from the SATIN study and validated in 102 subjects from the GLYNDIET study. Plasma metabolomics profile was analyzed using three different approaches: GC/quadrupole-TOF, LC/quadrupole-TOF, and nuclear magnetic resonance (NMR). Associations between metabolites and HOMA-IR were assessed using elastic net regression analysis with a leave-one-out cross validation (CV) and 100 CV runs. HOMA-IR was analyzed both as linear and categorical (median or lower versus higher than the median). Receiver operating characteristic curves were constructed based on metabolites’ weighted models. A set of 30 metabolites discriminating extremes of HOMA-IR were consistently selected. These metabolites comprised some amino acids, lipid species and different organic acids. The area under the curve (AUC) for the discrimination between HOMA-IR extreme categories was 0.82 (95% CI: 0.74–0.90), based on the multi-metabolite model weighted with the regression coefficients of metabolites in the validation dataset. We identified a set of metabolites discriminating between extremes of HOMA-IR and able to predict HOMA-IR with high accuracy.

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