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 The application value of serum 25(OH)D3, uric acid, triglyceride, and homeostasis model assessment of insulin resistance in male patients with hyperuricemia combined with hypogonadism

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qun Zhang ◽  
Wei Chen ◽  
Canqin Yun ◽  
Juan Wang
Keyword(s):  
Insulin Resistance ◽  
Logistic Regression ◽  
Uric Acid ◽  
Free Testosterone ◽  
Normal Group ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Alcoholic Fatty Liver ◽  
Male Patients ◽  
Function Group

Abstract Background The purpose of this study was to investigate the application value of serum 25(OH)D3, uric acid, triglyceride (TG), and homeostasis model assessment of insulin resistance (HOMA-IR) in male patients with hyperuricemia combined with hypogonadism. Methods From August 2018 to August 2020, a total of 198 male patients with primary hyperuricemia were prospectively enrolled in our hospital for inpatient treatment in the department of Metabolism and Endocrinology. They are divided into normal gonadal function group (normal group, n = 117) and hypogonadal function group (hypogonadism group, n = 81), according to free testosterone (FT) level, International Index of Erectile Function (IIEF-5), and androgen deficiency in the aging male (ADAM) questionnaires. Laboratory indexes were compared between two groups. Multivariate logistic regression was applied to analyze the influencing factors of hypogonadism. Results Among the 198 hyperuricemia patients, 40.91 % were hypogonadism. Compared with the normal group, the BMI, waist circumference (WC), and the prevalence of non-alcoholic fatty liver disease (NAFLD), hyperlipidemia (HLP), and obesity (OB) in the hypogonadism group were higher, and the difference was statistically significant (P < 0.05, respectively). The levels of fasting plasma glucose (FPG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), triacylglycerol (TG), serum uric acid (SUA), alanine transaminase (ALT) of hypogonadism group were higher than those of normal group, while the levels of TT, FT, E2, 25(OH)D3 of hypogonadism group were lower than those of normal group (P < 0.05, respectively). Pearson’s linear correlation was used to analyze the correlation between the indicators with significant differences in general data and laboratory indicators and hypogonadism. BMI, WC, HOMA-IR, TG, SUA, TT, FT, 25(OH)D3, E2 were positively correlated with hypogonadism (r = 0.556, 0.139, 0.473, 0.143, 0.134, 0.462, 0.419, 0.572, 0.601, P = 0.012, 0.027, 0.018, 0.019, 0.028, 0.029, 0.030, 0.009, 0.003, respectively). Taking the above indicators as independent variables and hypogonadism as the dependent variable, logistic regression analysis found that the risk factors for hypogonadism were SUA, WC, BMI, HOMA-IR, TG, TT, FT, E2, and 25(OH) D3. Conclusions Serum 25(OH)D3, SUA, HOMA-IR, TG levels were positively correlated with male hyperuricemia patients with hypogonadism. They have important application value in the diagnosis of male hyperuricemia patients with hypogonadism.

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 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.

scholarly journals Low-Grade Inflammation, Obesity, and Insulin Resistance in Adolescents

2007 ◽  
Vol 92 (12) ◽  
pp. 4569-4574 ◽  
Author(s):  
Christian Herder ◽  
Sophie Schneitler ◽  
Wolfgang Rathmann ◽  
Burkhard Haastert ◽  
Heiko Schneitler ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Immune Activation ◽  
Interferon Γ ◽  
Considerable Proportion ◽  
Low Grade ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Cross Sectional ◽  
Monocyte Chemoattractant Protein 1 ◽  
Low Grade Inflammation

Abstract Context: Low-grade inflammation is associated with insulin resistance and precedes the onset of type 2 diabetes mellitus in adults, but there are no comparable data in youth. Objective: The objective of the study was to characterize the pattern of subclinical immune activation that is associated with indices of obesity and insulin resistance in youth and analyze whether this association is explained by obesity. Design: This was a cross-sectional study. Setting: Medical check-up of schoolchildren was conducted by the Public Health Office in Düsseldorf (Germany). Participants: Participants included 519 adolescents (mean age 15.5 ± 0.8 yr). Main Outcome Measures: Measures included body mass index (BMI) and waist circumference (WC) as indices of obesity; fasting glucose, insulin, and homeostasis model assessment of insulin resistance; serum concentrations of TNFα, IL-6, IL-8, IL-18, monocyte chemoattractant protein-1, interferon-γ-inducible protein (IP)-10 and adiponectin as immunological variables. Results: In age-, sex-, and lipid-adjusted analyses, IL-6, IL-18, IP-10, and adiponectin (inversely) were associated with both BMI and WC (all P ≤ 0.002). None of the immune markers was related to glucose, but IL-6, IL-18, and adiponectin (inversely) were associated with insulin and homeostasis model assessment of insulin resistance in age- and sex-adjusted models. Adjustment for BMI or WC indicated that a considerable proportion of these associations may be mediated by obesity. Conclusions: We found that a differential low-grade immune activation is associated with parameters of obesity in adolescents. Moreover, there is evidence that IL-6, IL-18, IP-10, and adiponectin (inversely) are associated with insulin resistance and that these associations can mainly be attributed to obesity.

scholarly journals Circulating vaspin is unrelated to insulin sensitivity in a cohort of nondiabetic humans

2010 ◽  
Vol 162 (3) ◽  
pp. 507-513 ◽  
Author(s):  
Christian von Loeffelholz ◽  
Matthias Möhlig ◽  
Ayman M Arafat ◽  
Frank Isken ◽  
Joachim Spranger ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Sexual Dimorphism ◽  
Insulin Sensitivity ◽  
Intervention Study ◽  
Cross Sectional Study ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Short Term ◽  
Cross Sectional ◽  
Glucose Tolerance Status

ObjectiveTo study the association of vaspin with glucose metabolism.DesignCross-sectional and intervention study.Subjects and methodsThe association of serum vaspin with metabolic and anthropometric characteristics was investigated in 108 volunteers. Euglycemic–hyperinsulinemic clamps (EHC) were performed in 83 of the participants. Changes of circulating vaspin levels were additionally studied in a crossover study using 300 min EHC with lipid versus saline infusion (n=10).ResultsNeither glucose tolerance status nor insulin sensitivity, both as measured using EHCs and using homeostasis model assessment for insulin resistance (HOMA-IR), was significantly associated with serum vaspin in the cross-sectional study. Furthermore, there was no effect of short-term lipid-induced insulin resistance due to a 300 min intravenous lipid challenge on circulating vaspin. However, circulating vaspin levels were significantly elevated in women using oral contraceptives (OC), both compared to women without OC intake (1.17±0.26 vs 0.52±0.09 ng/ml, P=0.02) and males (1.17±0.26 vs 0.29±0.04 ng/ml, P=0.01). After exclusion of OC using females and stratification according to body mass index (BMI), a significant sexual dimorphism in subjects with a BMI <25 kg/m2 was observed (males 0.21±0.04 ng/ml versus females 0.70±0.16 ng/ml, P=0.009).ConclusionOur results support the existence of a sexual dimorphism regarding circulating vaspin. The lack of an association of serum vaspin with HOMA-IR and M value indicates, however, no major role for vaspin concerning insulin sensitivity in nondiabetic humans.

scholarly journals The Combination of High Levels of Adiponectin and Insulin Resistance Are Affected by Aging in Non-Obese Old Peoples

2022 ◽  
Vol 12 ◽  
Author(s):  
Jun Muratsu ◽  
Kei Kamide ◽  
Takashi Fujimoto ◽  
Yasushi Takeya ◽  
Ken Sugimoto ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Logistic Regression ◽  
Missing Data ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Multivariable Logistic Regression Analysis ◽  
Model Assessment ◽  
Cross Sectional ◽  
Low Bmi ◽  
Energy Deprivation

BackgroundAdipokine dysregulation is a key feature of insulin resistance and a metabolic syndrome associated with obesity. Low adiponectin levels are associated with higher risks of cardiovascular diseases (CVD). However, high adiponectin levels have also been associated with increased all-cause and cardiovascular mortality in the elderly. This adiponectin paradox has yet to be clarified, which has hindered our understanding of the biological role of adiponectin. Adipokine dysregulation and insulin resistance are also associated with energy-deprivation conditions, such as frailty in old age. The objective of this study was to investigate the association between plasma adiponectin and insulin resistance using the homeostasis model assessment for insulin resistance (HOMA-IR) classified by age. In particular, we sought to determine the factors of the subjects associated with both high adiponectin levels and HOMA-IR (H-adiponectin/H-HOMA) and high adiponectin levels and low HOMA-IR (H-adiponectin/L-HOMA).MethodsThe eligible subjects in this cross-sectional study were 33,216 individuals who had undergone health checkups at the Physical Checkup Center of Sumitomo Hospital between April 2008 and December 2018. After excluding 26,371 individuals who were under 60 years old, 529 who had been taking medications for diabetes mellitus, and 690 with missing data, the present study included 5,673 (3,467 males, 2,206 females) subjects with no missing data. The relationship between serum adiponectin levels and HOMA-IR was assessed using logistic regression models adjusted by clinically relevant factors.ResultsIn the multivariable logistic regression analysis, age and low BMI were shown to positively correlate with the characteristics of H-adiponectin/H-HOMA. In females, systolic blood pressure was also shown to be an associated factor.ConclusionIn conclusion, this study showed that aging or a low BMI may contribute to high adiponectin levels and insulin resistance.

scholarly journals Ορμόνες του λιπώδους ιστού και χρόνια νεφρική ανεπάρκεια

2014 ◽  
Author(s):  
Άννα Μαρούγκα
Keyword(s):  
Insulin Resistance ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Assessment Score ◽  
Reactive Protein ◽  
Factor Α

ΣΚΟΠΟΣ: Ο στόχος της παρούσας μελέτης ήταν να ερευνηθεί ο ρόλος της ρεζιστίνης στους ηλικιωμένους μη διαβητικούς σε διαφορετικά στάδια της χρόνιας πάθησης νεφρών (CKD) συμπεριλαμβανομένης της αιμοδιάλυσης. ΥΛΙΚΟ ΚΑΙ ΜΕΘΟΔΟΙ: Εξετάσαμε τα επίπεδα της ρεζιστίνης ορού σε σχέση με τα δημογραφικά και κλινικά στοιχεία, τις μεταβολικές παραμέτρους και τους δείκτες φλεγμονής σε μια διατομική (cross-sectional) μελέτη 80 ηλικιωμένων ασθενών διαχωρισμένων σε τέσσερις ομάδες 20 ασθενών κάθε μια, σύμφωνα με το eGFR (glomerular ποσοστό διήθησης) και ταιριασμένους για την ηλικία (± 5 χρόνια) και το φύλο. Ασθενείς με eGFR περισσότερο από 90 mL/min χρησίμευσαν ως ομάδα ελέγχου. Πραγματοποιήθηκαν αιματολογικές, βιοχημικές και ανοσοχημικές αναλύσεις από εμπορικά διαθέσιμες ανοσολογικές δοκιμασίες ενζύμων (ELISA). ΑΠΟΤΕΛΕΣΜΑΤΑ: Τα αποτελέσματά μας έδειξαν: 1) τα επίπεδα της ρεζιστίνης ορού ήταν δύο φορές πιο υψηλά στους ασθενείς με προηγμένη CKD ειδικά σε εκείνους που υποβάλλονται στην αιμοδιάλυση έναντι των ασθενών ελέγχου, 2) τα επίπεδα της ρεζιστίνης ορού αφορούσαν άμεσα τους δείκτες φλεγμονής (TumorNecrosis Factor-α και την C-Reactive Protein) και τα επίπεδα φωσφορικού άλατοςορού, και 3) τα επίπεδα της ρεζιστίνης ορού αφορούσαν αντιστρόφως τη λευκωματίνη, το eGFR, και τα επίπεδα του αιματοκρίτη. Αποτύχαμε να αποκαλύψουμε οποιαδήποτε σχέση μεταξύ των επιπέδων της ρεζιστίνης και του ομοιοστατικού πρότυπου αποτελέσματος αξιολόγησης της αντίστασης ινσουλίνης(Homeostasis Model Assessment Score of Insulin Resistance (HOMA-IR)), τον δείκτη μάζας σώματος, την χοληστερίνη και τα επίπεδα της λεπτίνης. ΣΥΜΠΕΡΑΣΜΑ: Τελικά, τα αποτελέσματα αυτής της μελέτης προτείνουν ότι υπάρχει μια συσχέτιση της ρεζιστίνης και των δεικτών κατάστασης υποσιτισμού-φλεγμονής σε ηλικιωμένους μη διαβητικούς ασθενείς με χρόνια πάθηση νεφρών.

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