A prospective analysis of the HOMA model. The Mexico City Diabetes Study.
OBJECTIVE
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.


METHODS
We applied the HOMA model in the 3.5-year follow-up of the Mexico City Diabetes Study.


RESULTS
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.


CONCLUSIONS
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.
Haffner
S M
SM
Division of Clinical Epidemiology, University of Texas Health Science Center at San Antomo 78284-7873, USA.
Kennedy
E
E
Gonzalez
C
C
Stern
M P
MP
Miettinen
H
H
D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D007515:Islets of Langerhans / Q000378:metabolism*; D008297:Male; D008800:Mexico; D008875:Middle Aged; D019518:Postprandial Period; D011446:Prospective Studies; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D012737:Sex Factors; D013997:Time Factors
D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin