Haffner S M, Kennedy E, Gonzalez C, Stern M P, Miettinen H
Division of Clinical Epidemiology, University of Texas Health Science Center at San Antomo 78284-7873, USA.
Diabetes Care. 1996 Oct;19(10):1138-41. doi: 10.2337/diacare.19.10.1138.
Both insulin resistance (IR) and decreased insulin secretion have been shown to predict the development of NIDDM. However, methods to assess insulin sensitivity and secretion are complicated and expensive to apply in epidemiological studies. The homeostasis model assessment (HOMA) has been suggested as a method to assess IR and secretion from the fasting glucose and insulin concentrations.
We applied the HOMA model in the 3.5-year follow-up of the Mexico City Diabetes Study.
Out of 1,449 subjects, 97 developed diabetes. When modeled separately insulin resistance but not insulin secretion predicted NIDDM. However, when both variables were entered into the same regression model, both increased IR and decreased beta-cell function significantly predicted NIDDM.
We conclude that the HOMA provides a useful model to assess beta-cell function in epidemiological studies and that it is important to take into account the degree of IR in assessing insulin secretion.
胰岛素抵抗（IR）和胰岛素分泌减少均已被证明可预测非胰岛素依赖型糖尿病（NIDDM）的发生。然而，在流行病学研究中，评估胰岛素敏感性和分泌的方法复杂且成本高昂。稳态模型评估（HOMA）已被提议作为一种从空腹血糖和胰岛素浓度评估IR和分泌的方法。
我们在墨西哥城糖尿病研究的3.5年随访中应用了HOMA模型。
在1449名受试者中，97人患糖尿病。单独建模时，胰岛素抵抗而非胰岛素分泌可预测NIDDM。然而，当将两个变量纳入同一回归模型时，IR增加和β细胞功能降低均显著预测NIDDM。
我们得出结论，HOMA为流行病学研究中评估β细胞功能提供了一个有用的模型，并且在评估胰岛素分泌时考虑IR程度很重要。
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