Limitation of the validity of the homeostasis model assessment as an index of insulin resistance in Korea.
Homeostasis model assessment of insulin resistance (HOMA-IR) is a less invasive, inexpensive, and less labor-intensive method to measure insulin resistance (IR) as compared with the glucose clamp test. The aim of this study was to evaluate the validity of HOMA-IR by comparing it with the euglycemic clamp test in determining IR. We assessed the validity of HOMA-IR by comparing it with the total glucose disposal rate measured by the 3-hour euglycemic-hyperinsulinemic clamp in subjects with type 2 diabetes (n = 47), impaired glucose tolerance (n = 21), and normal glucose tolerance (n = 22). There was a strong inverse correlation (r = -0.558; P < .001) between the log-transformed HOMA-IR and the total glucose disposal rate. There was moderate agreement between the 2 methods in the categorization according to the IR (weighted kappa = 0.294). The magnitude of the correlation coefficients was smaller in the subjects with a lower body mass index (BMI <25.0 kg/m2 , r = -0.441 vs BMI > or =25.0 kg/m2 , r = -0.615; P = .032), a lower HOMA-beta cell function (HOMA- beta <60.0, r = -0.527 vs HOMA- beta > or =60.0, r = -0.686; P = .016), and higher fasting glucose levels (fasting glucose < or =5.66 mmol/L, r = -0.556 vs fasting glucose >5.66 mmol/L, r = -0.520; P = .039). The limitation of the validity of the HOMA-IR should be carefully considered in subjects with a lower BMI, a lower beta cell function, and high fasting glucose levels such as lean type 2 diabetes mellitus with insulin secretory defects.
Kang
Eun Seok
ES
Department of Internal Medicine, Institute of Endocrine Research, Yonsei University College of Medicine, Seoul 120-752, Korea.
Yun
Yong Seok
YS
Park
Seok Won
SW
Kim
Hyeung Jin
HJ
Ahn
Chul Woo
CW
Song
Young Duk
YD
Cha
Bong Soo
BS
Lim
Sung Kil
SK
Kim
Kyung Rae
KR
Lee
Hyun Chul
HC
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D005260:Female; D015309:Glucose Clamp Technique; D018149:Glucose Intolerance / Q000097:blood; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D007515:Islets of Langerhans / Q000502:physiology; D007700:Kinetics; D007723:Korea; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010186:Pancreatic Function Tests; D015203:Reproducibility of Results
D001786:Blood Glucose; D007328:Insulin