Abstract
Aim:to determine cut off points for The Homeostatic Model Assessment Index 1 and 2 (HOMA-1 and HOMA-2) for identifying insulin resistance and metabolic syndrome among a Cuban-American population.Study Design:Cross sectional.Place and Duration of Study:Florida International University, Robert Stempel School of Public Health and Social Work, Department of Dietetics and Nutrition, Miami, FL from July 2010 to December 2011.Methodology:Subjects without diabetes residing in South Florida were enrolled (N=146, aged 37 to 83 years). The HOMA1-IR and HOMA2-IR 90th percentile in the healthy group (n=75) was used as the cut-off point for insulin resistance. A ROC curve was constructed to determine the cut-off point for metabolic syndrome.Results:HOMA1-IR was associated with BMI, central obesity, and triglycerides (P<0.05). HOMA2-IR was associated with BMI, central obesity, total cholesterol, HDL-cholesterol and LDL-cholesterol (P<0.05). The cut-off points for insulin resistance for HOMA-1 and HOMA-2 were >3.95 and >2.20 and for metabolic syndrome were >2.98 (63.4% sensitivity and 73.3% specificity) and >1.55 (60.6% sensitivity and 66.7% specificity), respectively.Conclusion:HOMA cut-off points may be used as a screening tool to identify insulin resistance and metabolic syndrome among Cuban-Americans living in South Florida.
Highlights
Insulin resistance (IR) is the decrease in the capacity of several tissues to respond to insulin, failing to transport glucose into the cell [1]
Homeostatic model assessment (HOMA) cut-off points may be used as a screening tool to identify insulin resistance and metabolic syndrome among Cuban-Americans living in South Florida
The Homeostatic model assessment (HOMA) is a secondary measure of insulin resistance based on fasting plasma glucose and fasting insulin that has been validated against the hyperinsulinemic euglycemic clamp
Summary
Insulin resistance (IR) is the decrease in the capacity of several tissues to respond to insulin, failing to transport glucose into the cell [1]. Metabolic syndrome (MS) is a condition that encompasses several metabolic disorders related to insulin resistance including abdominal obesity, hypertension, hyperlipidemia, low HDL cholesterol, and impaired fasting plasma glucose [2]. Both conditions are risk factors for type 2 diabetes (T2D) and cardiovascular disease and its prevalence has increased notably in the recent years [3,4]. The Homeostatic model assessment (HOMA) is a secondary measure of insulin resistance based on fasting plasma glucose and fasting insulin that has been validated against the hyperinsulinemic euglycemic clamp. The first version of HOMA1-IR was published in 1985 assuming a linear relationship in the feedback glucose-insulin. The second version of the model (HOMA2-IR) established a nonlinear relationship that better reflect the real physiologic interaction among plasma glucose and insulin and corrects for peripheral and hepatic glucose resistance, as well as renal glucose loss, making this model appropriate for subjects with hyperglycemia [7]
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