Department of Pathology, Faculty of Medicine, Kuwait University, Safat, Kuwait.
Clin Chem Lab Med. 2010 Nov;48(11):1629-34. doi: 10.1515/CCLM.2010.303. Epub 2010 Aug 13.
Homeostasis model assessment (HOMA) is a surrogate index widely used to study the role of insulin sensitivity or resistance in associated disease states. However, reported values for the definition of insulin resistance (the top 25% of the distribution in non-diabetic subjects) vary widely. This study evaluates the effect of HOMA computational methods [original HOMA model formula (HOMA1) and online calculator computer model (HOMA2)] on the associations and cut-off limits for insulin resistance.
Anthropometric measurements, fasting adiponectin, leptin, leptin receptor, insulin, glucose, high-sensitivity C-reactive protein and a lipid profile were measured in type 2 diabetic patients (n=226) and their normoglycemic first degree relatives (n=319). HOMA1 and HOMA2 were used to estimate insulin resistance, β-cell function and insulin sensitivity. Subjects were classified as metabolic syndrome positive or negative (International Diabetes Federation criteria). Bland-Altmann analysis was used to evaluate agreement between the computational methods. Univariate and multivariate logistic regression analyses were used to relate the HOMA computational methods with metabolic variables and metabolic syndrome status.
The two computational methods had different cut-offs for the definition of insulin resistance: HOMA1 formula ≥2.5; HOMA2 calculator ≥1.4. Correlations of the two HOMA computational methods with anthropometric and metabolic variables showed some degree of variation. The odds ratios of the associations with the metabolic syndrome for the HOMA1 formula and HOMA2 calculator computational methods were 2.04 and 1.43, respectively. Receiver operating characteristic analysis for diagnosis of the metabolic syndrome showed that areas under the receiver operating characteristic curves for the HOMA1 formula and HOMA2 calculator computational methods were 0.741 and 0.680, respectively.
The HOMA computational method is a significant determinant of the associations and classification of insulin resistance.
稳态模型评估（HOMA）是一种广泛用于研究胰岛素敏感性或抵抗在相关疾病状态中作用的替代指标。然而，胰岛素抵抗的定义值（非糖尿病患者分布的前 25%）差异很大。本研究评估了 HOMA 计算方法[原始 HOMA 模型公式（HOMA1）和在线计算器计算机模型（HOMA2）]对胰岛素抵抗的相关性和截止值的影响。
在 226 例 2 型糖尿病患者和 319 例其血糖正常的一级亲属中测量了人体测量学指标、空腹脂联素、瘦素、瘦素受体、胰岛素、血糖、高敏 C 反应蛋白和血脂谱。使用 HOMA1 和 HOMA2 来估计胰岛素抵抗、β细胞功能和胰岛素敏感性。根据国际糖尿病联合会标准，将受试者分为代谢综合征阳性或阴性。Bland-Altman 分析用于评估两种计算方法之间的一致性。使用单变量和多变量逻辑回归分析将 HOMA 计算方法与代谢变量和代谢综合征状态相关联。
两种计算方法对胰岛素抵抗的定义有不同的截止值：HOMA1 公式≥2.5；HOMA2 计算器≥1.4。两种 HOMA 计算方法与人体测量和代谢变量的相关性存在一定程度的差异。HOMA1 公式和 HOMA2 计算器计算方法与代谢综合征的关联的比值比分别为 2.04 和 1.43。用于诊断代谢综合征的受试者工作特征分析显示，HOMA1 公式和 HOMA2 计算器计算方法的受试者工作特征曲线下面积分别为 0.741 和 0.680。
HOMA 计算方法是胰岛素抵抗相关性和分类的重要决定因素。
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