title: [Identification of cutoff points for Homeostatic Model Assessment for Insulin Resistance index in adolescents: systematic review].
abstract: OBJECTIVE
  To identify cutoff points of the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index established for adolescents and discuss their applicability for the diagnosis of insulin resistance in Brazilian adolescents.
  
  
  METHODS
  A systematic review was performed in the PubMed, Lilacs and SciELO databases, using the following descriptors: "Adolescents", "insulin resistance" and "ROC curve". Original articles carried out with adolescents published between 2005 and 2015 in Portuguese, English or Spanish languages, which included the statistical analysis using ROC curve to determine the index cutoff (HOMA-IR) were included.
  
  
  RESULTS
  A total of 184 articles were identified and after the study phases were applied, seven articles were selected for the review. All selected studies established their cutoffs using a ROC curve, with the lowest observed cutoff of 1.65 for girls and 1.95 for boys and the highest of 3.82 for girls and 5.22 for boys. Of the studies analyzed, one proposed external validity, recommending the use of the HOMA-IR cutoff >2.5 for both genders.
  
  
  CONCLUSIONS
  The HOMA-IR index constitutes a reliable method for the detection of insulin resistance in adolescents, as long as it uses cutoffs that are more adequate for the reality of the study population, allowing early diagnosis of insulin resistance and enabling multidisciplinary interventions aiming at health promotion of this population.
authors.affiliation: Universidade Federal de Pernambuco (UFPE), Recife, PE, Brasil. Electronic address: izabelandradee@hotmail.com.
authors.forename: Maria Izabel Siqueira de
authors.initials: MI
authors.lastname: Andrade
authors.affiliation: Universidade Federal de Pernambuco (UFPE), Recife, PE, Brasil.
authors.forename: Juliana Souza
authors.initials: JS
authors.lastname: Oliveira
authors.affiliation: Universidade Federal de Pernambuco (UFPE), Recife, PE, Brasil.
authors.forename: Vanessa Sá
authors.initials: VS
authors.lastname: Leal
authors.affiliation: Universidade Federal de Pernambuco (UFPE), Recife, PE, Brasil.
authors.forename: Niedja Maria da Silva
authors.initials: NM
authors.lastname: Lima
authors.affiliation: Universidade Federal de Pernambuco (UFPE), Recife, PE, Brasil.
authors.forename: Emília Chagas
authors.initials: EC
authors.lastname: Costa
authors.affiliation: Universidade Federal de Pernambuco (UFPE), Recife, PE, Brasil.
authors.forename: Nathalia Barbosa de
authors.initials: NB
authors.lastname: Aquino
authors.affiliation: Universidade Federal de Pernambuco (UFPE), Recife, PE, Brasil.
authors.forename: Pedro Israel Cabral de
authors.initials: PI
authors.lastname: Lira
mesh_terms: D000293:Adolescent; D001938:Brazil; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008954:Models, Biological; D012372:ROC Curve
keywords: Adolescent; Adolescente; Curva ROC; Insulin resistance; ROC curve; Resistência à insulina; Review; Revisão