title: The HOMA-Adiponectin (HOMA-AD) Closely Mirrors the HOMA-IR Index in the Screening of Insulin Resistance in the Brazilian Metabolic Syndrome Study (BRAMS).
abstract: BACKGROUND
  The major adverse consequences of obesity are associated with the development of insulin resistance (IR) and adiposopathy. The Homeostasis Model Assessment-Adiponectin (HOMA-AD) was proposed as a modified version of the HOMA1-IR, which incorporates adiponectin in the denominator of the index.
  
  
  OBJECTIVE
  To evaluate the performance of the HOMA-AD index compared with the HOMA1-IR index as a surrogate marker of IR in women, and to establish the cutoff value of the HOMA-AD.
  
  
  METHODS
  The Brazilian Metabolic Syndrome Study (BRAMS) is a cross-sectional multicenter survey. The data from 1,061 subjects met the desired criteria: 18-65 years old, BMI: 18.5-49.9 Kg/m² and without diabetes. The IR was assessed by the indexes HOMA1-IR and HOMA-AD (total sample) and by the hyperglycemic clamp (n = 49). Metabolic syndrome was defined using the IDF criteria.
  
  
  RESULTS
  For the IR assessed by the clamp, the HOMA-AD demonstrated a stronger coefficient of correlation (r = -0.64) compared with the HOMA1-IR (r = -0.56); p < 0.0001. In the ROC analysis, compared with the HOMA1-IR, the HOMA-AD showed higher values of the AUC for the identification of IR based on the clamp test (AUC: 0.844 vs. AUC: 0.804) and on the metabolic syndrome (AUC: 0.703 vs. AUC: 0.689), respectively; p < 0.001 for all. However, the pairwise comparison did not show evidence of superiority for the HOMA-AD in comparison with the HOMA1-IR in the diagnosis of IR and metabolic syndrome (p > 0.05). The optimal cutoff identified for the HOMA-AD for the diagnosis of IR was 0.95.
  
  
  CONCLUSIONS
  The HOMA-AD index was demonstrated to be a useful surrogate marker for detecting IR among adult women and presented a similar performance compared with the HOMA1-IR index. These results may assist physicians and researchers in determining which method to use to evaluate IR in light of the available facilities.
authors.affiliation: LIMED - Laboratory of Investigation on Metabolism and Diabetes, Gastrocentro, University of Campinas, Campinas, Sao Paulo, Brazil.
authors.forename: Brunna Sullara
authors.identifier: http://orcid.org/0000-0002-4096-8337
authors.initials: BS
authors.lastname: Vilela
authors.affiliation: LIMED - Laboratory of Investigation on Metabolism and Diabetes, Gastrocentro, University of Campinas, Campinas, Sao Paulo, Brazil.|School of Applied Sciences, University of Campinas, Limeira, Sao Paulo, Brazil.
authors.forename: Ana Carolina Junqueira
authors.initials: AC
authors.lastname: Vasques
authors.affiliation: LIMED - Laboratory of Investigation on Metabolism and Diabetes, Gastrocentro, University of Campinas, Campinas, Sao Paulo, Brazil.
authors.forename: Roberta Soares Lara
authors.initials: RS
authors.lastname: Cassani
authors.affiliation: Department of Endocrinology, Federal University of Ceara, Fortaleza, Brazil.
authors.forename: Adriana Costa E
authors.initials: AC
authors.lastname: Forti
authors.affiliation: LIMED - Laboratory of Investigation on Metabolism and Diabetes, Gastrocentro, University of Campinas, Campinas, Sao Paulo, Brazil.
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Pareja
authors.affiliation: Department of Endocrinology, University of Campinas, Sao Paulo, Brazil.
authors.forename: Marcos Antonio
authors.initials: MA
authors.lastname: Tambascia
authors.affiliation: LIMED - Laboratory of Investigation on Metabolism and Diabetes, Gastrocentro, University of Campinas, Campinas, Sao Paulo, Brazil.
authors.forename: Bruno
authors.initials: B
authors.lastname: Geloneze
mesh_terms: D052242:Adiponectin / Q000378:metabolism*; D000328:Adult; D000886:Anthropometry; D019540:Area Under Curve; D001823:Body Composition; D015992:Body Mass Index; D001938:Brazil; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000150:complications / Q000473:pathology*; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D012372:ROC Curve; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D052242:Adiponectin; D008076:Cholesterol, HDL; D002784:Cholesterol; D005723:gamma-Glutamyltransferase