Abstract
BackgroundWe sought to identify the distribution and cut-off value of the ‘homeostasis model assessment of insulin resistance’ (HOMA-IR) according to gender and menopausal status for metabolic syndrome in Koreans.MethodsData were from the Korean National Health and Nutrition Examination Survey in 2008–2010. The subjects included adults aged 20 years or older. We excluded participants who had diabetes or fasting serum glucose ≥ 7 mmol/L. Finally, 11,121 subjects (4,911 men, 3,597 premenopausal women, 2,613 postmenopausal women) were enrolled. The modified Adult Treatment Panel III criteria were used to define metabolic syndrome.ResultsThe mean HOMA-IR was 2.11 (2.07–2.15) for men, 2.0 (1.97–2.04) for premenopausal women, and 2.14 (2.2–2.19) for postmenopausal women. The first cut-off values in men, premenopausal women, and postmenopausal women were 2.23 (sensitivity 70.6%, specificity 66.9%), 2.39 (sensitivity 72.3%, specificity 76.4%), and 2.48 (sensitivity 51.9%, specificity 80.2%), respectively. Based on the first HOMA-IR cut-off value, the prevalence of metabolic syndrome was 22.9% in men, 13.7% in premenopausal women, and 51.6% in postmenopausal women. The second cut-off value was around 3.2 in all three groups. Based on the second HOMA-IR cut-off value, the prevalence of metabolic syndrome was 50.8% in men, 42.5% in premenopausal women, and 71.6% in postmenopausal women.ConclusionIn conclusion, the first cut-off values for HOMA-IR were 2.2–2.5 and the second cut-off value was 3.2 in Korea. The distribution of HOMA-IR showed differences according to gender and menopausal status. When we apply HOMA-IR, we should consider gender, menopausal status, and the prevalence of metabolic syndrome.
Highlights
Insulin resistance (IR) is closely associated with cardiovascular risk factors, including diabetes mellitus, dyslipidemia, and hypertension [1]
The distribution of homeostasis model assessment of insulin resistance’ (HOMA-IR) showed differences according to gender and menopausal status
We identified the proportion of the five components of metabolic syndrome according to each group
Summary
Insulin resistance (IR) is closely associated with cardiovascular risk factors, including diabetes mellitus, dyslipidemia, and hypertension [1]. The gold standard method for insulin sensitivity and resistance is the hyperinsulinemic-euglycemic glucose clamp technique [2]. This is not readily applied in large-scale investigations because of its complex process. Alternative and simpler methods of measuring insulin resistance include the fasting insulin level, the ‘homeostasis model assessment of insulin resistance’ (HOMA-IR), and the quantitative insulin sensitivity check index (QUICKI) [3, 4]. The cut-off values of HOMA-IR for metabolic syndrome in Korean nondiabetic adults were 2.34 (sensitivity 62.8%, specificity 65.7%) [12]. We sought to identify the distribution and cut-off value of the ‘homeostasis model assessment of insulin resistance’ (HOMA-IR) according to gender and menopausal status for metabolic syndrome in Koreans
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