title: Epidemiologic Behavior and Estimation of an Optimal Cut-Off Point for Homeostasis Model Assessment-2 Insulin Resistance: A Report from a Venezuelan Population.
abstract: Background. Mathematical models such as Homeostasis Model Assessment have gained popularity in the evaluation of insulin resistance (IR). The purpose of this study was to estimate the optimal cut-off point for Homeostasis Model Assessment-2 Insulin Resistance (HOMA2-IR) in an adult population of Maracaibo, Venezuela. Methods. Descriptive, cross-sectional study with randomized, multistaged sampling included 2,026 adult individuals. IR was evaluated through HOMA2-IR calculation in 602 metabolically healthy individuals. For cut-off point estimation, two approaches were applied: HOMA2-IR percentile distribution and construction of ROC curves using sensitivity and specificity for selection. Results. HOMA2-IR arithmetic mean for the general population was 2.21 ± 1.42, with 2.18 ± 1.37 for women and 2.23 ± 1.47 for men (P = 0.466). When calculating HOMA2-IR for the healthy reference population, the resulting p75 was 2.00. Using ROC curves, the selected cut-off point was 1.95, with an area under the curve of 0.801, sensibility of 75.3%, and specificity of 72.8%. Conclusions. We propose an optimal cut-off point of 2.00 for HOMA2-IR, offering high sensitivity and specificity, sufficient for proper assessment of IR in the adult population of our city, Maracaibo. The determination of population-specific cut-off points is needed to evaluate risk for public health problems, such as obesity and metabolic syndrome.
authors.affiliation: Endocrine and Metabolic Diseases Research Center, University of Zulia, Maracaibo 4001, Venezuela.
authors.forename: Valmore
authors.initials: V
authors.lastname: Bermúdez
authors.affiliation: Endocrine and Metabolic Diseases Research Center, University of Zulia, Maracaibo 4001, Venezuela; Institute of Clinical Immunology, University of Los Andes, Mérida 5101, Venezuela.
authors.forename: Joselyn
authors.identifier: 0000-0003-4994-075X
authors.initials: J
authors.lastname: Rojas
authors.affiliation: Endocrine and Metabolic Diseases Research Center, University of Zulia, Maracaibo 4001, Venezuela.
authors.forename: María Sofía
authors.initials: MS
authors.lastname: Martínez
authors.affiliation: Endocrine and Metabolic Diseases Research Center, University of Zulia, Maracaibo 4001, Venezuela.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Apruzzese
authors.affiliation: Endocrine and Metabolic Diseases Research Center, University of Zulia, Maracaibo 4001, Venezuela.
authors.forename: Mervin
authors.initials: M
authors.lastname: Chávez-Castillo
authors.affiliation: Endocrine and Metabolic Diseases Research Center, University of Zulia, Maracaibo 4001, Venezuela.
authors.forename: Robys
authors.initials: R
authors.lastname: Gonzalez
authors.affiliation: Endocrine and Metabolic Diseases Research Center, University of Zulia, Maracaibo 4001, Venezuela.
authors.forename: Yaquelín
authors.initials: Y
authors.lastname: Torres
authors.affiliation: Endocrine and Metabolic Diseases Research Center, University of Zulia, Maracaibo 4001, Venezuela.
authors.forename: Juan
authors.identifier: 0000-0003-4211-528X
authors.initials: J
authors.lastname: Salazar
authors.affiliation: Endocrine and Metabolic Diseases Research Center, University of Zulia, Maracaibo 4001, Venezuela.
authors.forename: Luis
authors.initials: L
authors.lastname: Bello
authors.affiliation: Endocrine and Metabolic Diseases Research Center, University of Zulia, Maracaibo 4001, Venezuela.
authors.forename: Roberto
authors.initials: R
authors.lastname: Añez
authors.affiliation: Endocrine and Metabolic Diseases Research Center, University of Zulia, Maracaibo 4001, Venezuela.
authors.forename: Maricarmen
authors.initials: M
authors.lastname: Chacín
authors.affiliation: Endocrine and Metabolic Diseases Research Center, University of Zulia, Maracaibo 4001, Venezuela.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Toledo
authors.affiliation: Endocrine and Metabolic Diseases Research Center, University of Zulia, Maracaibo 4001, Venezuela.
authors.forename: Mayela
authors.initials: M
authors.lastname: Cabrera
authors.affiliation: Endocrine and Metabolic Diseases Research Center, University of Zulia, Maracaibo 4001, Venezuela; Institute of Biological Investigations, University of Zulia, Maracaibo 4001, Venezuela.
authors.forename: Edgardo
authors.initials: E
authors.lastname: Mengual
authors.affiliation: Pharmacology Department, Physiological Sciences Unit, University of Zulia, Maracaibo 4001, Venezuela.
authors.forename: Raquel
authors.initials: R
authors.lastname: Ávila
authors.affiliation: Morphological Sciences Department, University of Zulia, Maracaibo 4001, Venezuela.
authors.forename: Freddy
authors.identifier: 0000-0003-0427-0465
authors.initials: F
authors.lastname: Pachano
authors.affiliation: Lipid and Atherosclerosis Unit, Department of Medicine, IMIBIC/Reina Sofia University Hospital/University of Cordoba and CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Institute of Health Carlos III, Córdova 14004, Spain.
authors.forename: José
authors.initials: J
authors.lastname: López-Miranda