Optimal threshold of homeostasis model assessment for insulin resistance in an Iranian population: the implication of metabolic syndrome to detect insulin resistance.
We assessed the threshold of homeostasis model assessment (HOMA) values to determine insulin resistance (IR) in a sample of Iranians and examined the associations of IR with metabolic syndrome (MetS). Study comprised 1327 non-diabetic and non-hypertensive subjects (438 men, 838 women; aged 20-77 years) incurred in four different locations (Tehran, Iran), 2005-2008. Lower limit of the top quintile of HOMA values in subjects without any metabolic abnormality was considered as the threshold of IR. This threshold was 1.8 (1.7 men; 1.8 women). Overall, 41.1% (36.3% men; 41.5% women) of subjects had IR. HOMA cut-off to determine MetS was 1.95 for ATPIII definition, and 1.85 for IDF. IR associated MetS (ATPIII: odds ratio (OR)=2.9, 95% CI=2.2-3.9, p<0.05; IDF: OR=2.94, 95% CI: 2.3-3.8, p<0.05). Sensitivity of MetS to detect IR was 22.4% for IDF and 36.2% for ATPIII criteria. In multivariate models, HOMA was predicted by waist circumference, and inversely by age and serum HDL-cholesterol. In this study, the cut point of HOMA to detect IR was lower than other populations. IR is an unyielding correlate of MetS; but definitions of MetS are insensitive measures of IR in our population.
Endocrinology and Metabolism Research Center, Vali-asr Hospital, Tehran University of Medical Sciences, Tehran, Iran. esteghamati@tums.ac.ir
Alireza
A
Esteghamati
Haleh
H
Ashraf
Abdoul-Reza
AR
Esteghamati
Alipasha
A
Meysamie
Omid
O
Khalilzadeh
Manouchehr
M
Nakhjavani
Mehrshad
M
Abbasi
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D005260:Female; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D007492:Iran / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D008487:Medical History Taking; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D008875:Middle Aged; D008954:Models, Biological; D016017:Odds Ratio; D018579:Patient Selection; D015203:Reproducibility of Results; D055815:Young Adult
D001786:Blood Glucose; D007328:Insulin; D008055:Lipids