title: Limitation of the validity of the homeostasis model assessment as an index of insulin resistance in Korea.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Institute of Endocrine Research, Yonsei University College of Medicine, Seoul 120-752, Korea.
authors.forename: Eun Seok
authors.initials: ES
authors.lastname: Kang
authors.forename: Yong Seok
authors.initials: YS
authors.lastname: Yun
authors.forename: Seok Won
authors.initials: SW
authors.lastname: Park
authors.forename: Hyeung Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Ahn
authors.forename: Young Duk
authors.initials: YD
authors.lastname: Song
authors.forename: Bong Soo
authors.initials: BS
authors.lastname: Cha
authors.forename: Sung Kil
authors.initials: SK
authors.lastname: Lim
authors.forename: Kyung Rae
authors.initials: KR
authors.lastname: Kim
authors.forename: Hyun Chul
authors.initials: HC
authors.lastname: Lee
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D007328:Insulin