Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
Cad Saude Publica. 2020 Sep 2;36(8):e00072120. doi: 10.1590/0102-311X00072120.
Homeostasis model assessment of insulin resistance (HOMA-IR) is a method to measure insulin resistance. HOMA-IR cut-offs for identifying metabolic syndrome might vary across populations and body mass index (BMI) levels. We aimed to investigate HOMA-insulin resistance cut-offs that best discriminate individuals with insulin resistance and with metabolic syndrome for each BMI category in a large sample of adults without diabetes in the baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Among the 12,313 participants with mean age of 51.2 (SD 8.9) years, the prevalence of metabolic syndrome was 34.6%, and 60.1% had overweight or obesity. The prevalence of metabolic syndrome among normal weight, overweight and obesity categories were, respectively, 13%, 43.2% and 60.7%. The point of maximum combined sensitivity and specificity of HOMA-IR to discriminate the metabolic syndrome was 2.35 in the whole sample, with increasing values at higher BMI categories. This investigation contributes to better understanding HOMA-IR values associated with insulin resistance and metabolic syndrome in a large Brazilian adult sample, and that use of cut-off points according to ROC curve may be the better strategy. It also suggests that different values might be appropriate across BMI categories.
胰岛素抵抗的稳态模型评估（HOMA-IR）是一种衡量胰岛素抵抗的方法。用于识别代谢综合征的 HOMA-IR 切点可能因人群和体重指数（BMI）水平而异。我们旨在研究 HOMA-胰岛素抵抗切点，以最佳区分在巴西成年人健康纵向研究（ELSA-Brasil）基线时无糖尿病的大量成年人样本中每个 BMI 类别中具有胰岛素抵抗和代谢综合征的个体。在 12313 名平均年龄为 51.2（8.9）岁的参与者中，代谢综合征的患病率为 34.6%，超重或肥胖者占 60.1%。正常体重、超重和肥胖类别的代谢综合征患病率分别为 13%、43.2%和 60.7%。在整个样本中，HOMA-IR 区分代谢综合征的最大联合敏感性和特异性的切点为 2.35，随着 BMI 类别较高而增加。本研究有助于更好地了解在大型巴西成年人群中与胰岛素抵抗和代谢综合征相关的 HOMA-IR 值，根据 ROC 曲线使用切点可能是更好的策略。它还表明，BMI 类别之间可能需要不同的值。
