Skip to main content
Erschienen in: Acta Diabetologica 5/2015

01.10.2015 | Original Article

Cut-off points of homeostasis model assessment of insulin resistance, beta-cell function, and fasting serum insulin to identify future type 2 diabetes: Tehran Lipid and Glucose Study

verfasst von: Asghar Ghasemi, Maryam Tohidi, Arash Derakhshan, Mitra Hasheminia, Fereidoun Azizi, Farzad Hadaegh

Erschienen in: Acta Diabetologica | Ausgabe 5/2015

Einloggen, um Zugang zu erhalten

Abstract

Aims

To determine cut-off points of homeostasis model assessment of insulin resistance (HOMA-IR), β-cell function (HOMA-B), insulin sensitivity (HOMA-S), and fasting insulin for identifying the subjects with type 2 diabetes mellitus (T2DM) in Iranian adults using data from a prospective population-based study.

Methods

From participants of Tehran Lipid and Glucose Study, 4942 Iranian subjects, aged 20–86 years, were followed for incident T2DM. Fasting serum insulin was determined by the electrochemiluminescence immunoasaay. The associations between HOMA-IR, HOMA-B, HOMA-S, and fasting insulin and incident T2DM were evaluated using Cox proportional hazards models. The receiver operator characteristic curve analysis was used to determine the cut-off points of HOMA-IR, HOMA-B, HOMA-S, and fasting insulin.

Results

After 9.2 year follow-up, 346 (7.0 %) incident cases of T2DM were identified; the risk-factor-adjusted hazard ratios for HOMA1-IR, HOMA2-IR, HOMA1-B, HOMA2-B, HOMA1-S, HOMA2-S, and insulin were 1.15, 1.70, 0.732, 0.997, 0.974, 0.986, and 1.01 in women and 1.37, 1.67, 0.588, 0.993, 0.986, 0.991, and 1.06 in men, respectively (all p < 0.05 except for HOMA2-B in women). Optimal cut-off points for HOMA1-IR, HOMA2-IR, HOMA1-B, HOMA2-B, HOMA1-S, HOMA2-S, and insulin were 1.85, 1.41, 86.2, 72.5, 54.1, 63.7, and 11.13 µU/ml in women and 2.17, 1.18, 67.1, 74.6, 46.1, 74.1, and 9.16 µU/ml in men, respectively.

Conclusions

HOMA-IR, HOMA-B (except for HOMA2-B in women), HOMA-S, and fasting insulin were independent predictors of T2DM. Optimal cut-off points of HOMA-IR, HOMA-B, HOMA-S, and fasting serum insulin were determined from a population-based study for identifying incident T2DM.
Literatur
3.
Zurück zum Zitat Perseghin G, Calori G, Lattuada G, Ragogna F, Dugnani E, Garancini MP, Crosignani P, Villa M, Bosi E, Ruotolo G, Piemonti L (2012) Insulin resistance/hyperinsulinemia and cancer mortality: the Cremona study at the 15th year of follow-up. Acta Diabetol 49(6):421–428. doi:10.1007/s00592-011-0361-2 CrossRefPubMed Perseghin G, Calori G, Lattuada G, Ragogna F, Dugnani E, Garancini MP, Crosignani P, Villa M, Bosi E, Ruotolo G, Piemonti L (2012) Insulin resistance/hyperinsulinemia and cancer mortality: the Cremona study at the 15th year of follow-up. Acta Diabetol 49(6):421–428. doi:10.​1007/​s00592-011-0361-2 CrossRefPubMed
4.
Zurück zum Zitat Abbasi F, Okeke Q, Reaven GM (2014) Evaluation of fasting plasma insulin concentration as an estimate of insulin action in nondiabetic individuals: comparison with the homeostasis model assessment of insulin resistance (HOMA-IR). Acta Diabetol 51(2):193–197. doi:10.1007/s00592-013-0461-2 CrossRefPubMed Abbasi F, Okeke Q, Reaven GM (2014) Evaluation of fasting plasma insulin concentration as an estimate of insulin action in nondiabetic individuals: comparison with the homeostasis model assessment of insulin resistance (HOMA-IR). Acta Diabetol 51(2):193–197. doi:10.​1007/​s00592-013-0461-2 CrossRefPubMed
5.
Zurück zum Zitat Muniyappa R, Lee S, Chen H, Quon MJ (2008) Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage. Am J Physiol Endocrinol Metab 294(1):E15–E26. doi:10.1152/ajpendo.00645.2007 CrossRefPubMed Muniyappa R, Lee S, Chen H, Quon MJ (2008) Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage. Am J Physiol Endocrinol Metab 294(1):E15–E26. doi:10.​1152/​ajpendo.​00645.​2007 CrossRefPubMed
6.
Zurück zum Zitat Esteghamati A, Ashraf H, Khalilzadeh O, Zandieh A, Nakhjavani M, Rashidi A, Haghazali M, Asgari F (2010) Optimal cut-off of homeostasis model assessment of insulin resistance (HOMA-IR) for the diagnosis of metabolic syndrome: third national surveillance of risk factors of non-communicable diseases in Iran (SuRFNCD-2007). Nutr Metab (Lond) 7:26. doi:10.1186/1743-7075-7-26 CrossRef Esteghamati A, Ashraf H, Khalilzadeh O, Zandieh A, Nakhjavani M, Rashidi A, Haghazali M, Asgari F (2010) Optimal cut-off of homeostasis model assessment of insulin resistance (HOMA-IR) for the diagnosis of metabolic syndrome: third national surveillance of risk factors of non-communicable diseases in Iran (SuRFNCD-2007). Nutr Metab (Lond) 7:26. doi:10.​1186/​1743-7075-7-26 CrossRef
7.
Zurück zum Zitat Després J-P, Marette A (1999) Obesity and insulin resistance: epidemiologic, metabolic, and molecular aspects. In: Reaven GM, Laws A (eds) Insulin resistance: the metabolic syndrome X. Humana Press Inc., Totowa, pp 51–81CrossRef Després J-P, Marette A (1999) Obesity and insulin resistance: epidemiologic, metabolic, and molecular aspects. In: Reaven GM, Laws A (eds) Insulin resistance: the metabolic syndrome X. Humana Press Inc., Totowa, pp 51–81CrossRef
11.
Zurück zum Zitat Song Y, Manson JE, Tinker L, Howard BV, Kuller LH, Nathan L, Rifai N, Liu S (2007) Insulin sensitivity and insulin secretion determined by homeostasis model assessment and risk of diabetes in a multiethnic cohort of women: the Women’s Health Initiative Observational Study. Diabetes Care 30(7):1747–1752. doi:10.2337/dc07-0358 PubMedCentralCrossRefPubMed Song Y, Manson JE, Tinker L, Howard BV, Kuller LH, Nathan L, Rifai N, Liu S (2007) Insulin sensitivity and insulin secretion determined by homeostasis model assessment and risk of diabetes in a multiethnic cohort of women: the Women’s Health Initiative Observational Study. Diabetes Care 30(7):1747–1752. doi:10.​2337/​dc07-0358 PubMedCentralCrossRefPubMed
13.
Zurück zum Zitat Caumo A, Perseghin G, Brunani A, Luzi L (2006) New insights on the simultaneous assessment of insulin sensitivity and beta-cell function with the HOMA2 method. Diabetes Care 29(12):2733–2734. doi:10.2337/dc06-0070 CrossRefPubMed Caumo A, Perseghin G, Brunani A, Luzi L (2006) New insights on the simultaneous assessment of insulin sensitivity and beta-cell function with the HOMA2 method. Diabetes Care 29(12):2733–2734. doi:10.​2337/​dc06-0070 CrossRefPubMed
14.
Zurück zum Zitat Tohidi M, Ghasemi A, Hadaegh F, Derakhshan A, Chary A, Azizi F (2014) Age- and sex-specific reference values for fasting serum insulin levels and insulin resistance/sensitivity indices in healthy Iranian adults: Tehran Lipid and Glucose Study. Clin Biochem 47(6):432–438. doi:10.1016/j.clinbiochem.2014.02.007 CrossRefPubMed Tohidi M, Ghasemi A, Hadaegh F, Derakhshan A, Chary A, Azizi F (2014) Age- and sex-specific reference values for fasting serum insulin levels and insulin resistance/sensitivity indices in healthy Iranian adults: Tehran Lipid and Glucose Study. Clin Biochem 47(6):432–438. doi:10.​1016/​j.​clinbiochem.​2014.​02.​007 CrossRefPubMed
16.
Zurück zum Zitat Timoteo AT, Miranda F, Carmo MM, Ferreira RC (2014) Optimal cut-off value for homeostasis model assessment (HOMA) index of insulin-resistance in a population of patients admitted electively in a portuguese cardiology ward. Acta Med Port 27(4):473–479PubMed Timoteo AT, Miranda F, Carmo MM, Ferreira RC (2014) Optimal cut-off value for homeostasis model assessment (HOMA) index of insulin-resistance in a population of patients admitted electively in a portuguese cardiology ward. Acta Med Port 27(4):473–479PubMed
17.
Zurück zum Zitat Esteghamati A, Ashraf H, Esteghamati AR, Meysamie A, Khalilzadeh O, Nakhjavani M, Abbasi M (2009) Optimal threshold of homeostasis model assessment for insulin resistance in an Iranian population: the implication of metabolic syndrome to detect insulin resistance. Diabetes Res Clin Pract 84(3):279–287. doi:10.1016/j.diabres.2009.03.005 CrossRefPubMed Esteghamati A, Ashraf H, Esteghamati AR, Meysamie A, Khalilzadeh O, Nakhjavani M, Abbasi M (2009) Optimal threshold of homeostasis model assessment for insulin resistance in an Iranian population: the implication of metabolic syndrome to detect insulin resistance. Diabetes Res Clin Pract 84(3):279–287. doi:10.​1016/​j.​diabres.​2009.​03.​005 CrossRefPubMed
18.
Zurück zum Zitat Geloneze B, Vasques AC, Stabe CF, Pareja JC, Rosado LE, Queiroz EC, Tambascia MA (2009) HOMA1-IR and HOMA2-IR indexes in identifying insulin resistance and metabolic syndrome: Brazilian Metabolic Syndrome Study (BRAMS). Arq Bras Endocrinol Metabol 53(2):281–287CrossRefPubMed Geloneze B, Vasques AC, Stabe CF, Pareja JC, Rosado LE, Queiroz EC, Tambascia MA (2009) HOMA1-IR and HOMA2-IR indexes in identifying insulin resistance and metabolic syndrome: Brazilian Metabolic Syndrome Study (BRAMS). Arq Bras Endocrinol Metabol 53(2):281–287CrossRefPubMed
19.
Zurück zum Zitat Gayoso-Diz P, Otero-Gonzalez A, Rodriguez-Alvarez MX, Gude F, Garcia F, De Francisco A, Quintela AG (2013) Insulin resistance (HOMA-IR) cut-off values and the metabolic syndrome in a general adult population: effect of gender and age: EPIRCE cross-sectional study. BMC Endocr Disord 13:47. doi:10.1186/1472-6823-13-47 PubMedCentralCrossRefPubMed Gayoso-Diz P, Otero-Gonzalez A, Rodriguez-Alvarez MX, Gude F, Garcia F, De Francisco A, Quintela AG (2013) Insulin resistance (HOMA-IR) cut-off values and the metabolic syndrome in a general adult population: effect of gender and age: EPIRCE cross-sectional study. BMC Endocr Disord 13:47. doi:10.​1186/​1472-6823-13-47 PubMedCentralCrossRefPubMed
21.
Zurück zum Zitat Lee S, Choi S, Kim HJ, Chung YS, Lee KW, Lee HC, Huh KB, Kim DJ (2006) Cutoff values of surrogate measures of insulin resistance for metabolic syndrome in Korean non-diabetic adults. J Korean Med Sci 21(4):695–700PubMedCentralCrossRefPubMed Lee S, Choi S, Kim HJ, Chung YS, Lee KW, Lee HC, Huh KB, Kim DJ (2006) Cutoff values of surrogate measures of insulin resistance for metabolic syndrome in Korean non-diabetic adults. J Korean Med Sci 21(4):695–700PubMedCentralCrossRefPubMed
22.
Zurück zum Zitat Derakhshan A, Tohidi M, Arshi B, Khalili D, Azizi F, Hadaegh F (2014) Relationship of hyperinsulinaemia, insulin resistance and beta-cell dysfunction with incident diabetes and pre-diabetes: the Tehran Lipid and Glucose Study. Diabet Med. doi:10.1111/dme.12560 PubMed Derakhshan A, Tohidi M, Arshi B, Khalili D, Azizi F, Hadaegh F (2014) Relationship of hyperinsulinaemia, insulin resistance and beta-cell dysfunction with incident diabetes and pre-diabetes: the Tehran Lipid and Glucose Study. Diabet Med. doi:10.​1111/​dme.​12560 PubMed
24.
Zurück zum Zitat Ainsworth BE, Jacobs DR Jr, Leon AS (1993) Validity and reliability of self-reported physical activity status: the Lipid Research Clinics questionnaire. Med Sci Sports Exerc 25(1):92–98CrossRefPubMed Ainsworth BE, Jacobs DR Jr, Leon AS (1993) Validity and reliability of self-reported physical activity status: the Lipid Research Clinics questionnaire. Med Sci Sports Exerc 25(1):92–98CrossRefPubMed
25.
Zurück zum Zitat Kriska AM, Knowler WC, LaPorte RE, Drash AL, Wing RR, Blair SN, Bennett PH, Kuller LH (1990) Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians. Diabetes Care 13(4):401–411CrossRefPubMed Kriska AM, Knowler WC, LaPorte RE, Drash AL, Wing RR, Blair SN, Bennett PH, Kuller LH (1990) Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians. Diabetes Care 13(4):401–411CrossRefPubMed
26.
Zurück zum Zitat Committee IPAQR (2005) Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ). Retrieved 15 Nov 2010 Committee IPAQR (2005) Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ). Retrieved 15 Nov 2010
27.
Zurück zum Zitat Niemczyk S, Szamotulska K, Giers K, Jasik M, Bartoszewicz Z, Romejko-Ciepielewska K, Paklerska E, Gomolka M, Matuszkiewicz-Rowinska J (2013) Homeostatic model assessment indices in evaluation of insulin resistance and secretion in hemodialysis patients. Med Sci Monit 19:592–598. doi:10.12659/MSM.883978 PubMedCentralCrossRefPubMed Niemczyk S, Szamotulska K, Giers K, Jasik M, Bartoszewicz Z, Romejko-Ciepielewska K, Paklerska E, Gomolka M, Matuszkiewicz-Rowinska J (2013) Homeostatic model assessment indices in evaluation of insulin resistance and secretion in hemodialysis patients. Med Sci Monit 19:592–598. doi:10.​12659/​MSM.​883978 PubMedCentralCrossRefPubMed
29.
Zurück zum Zitat Glumer C, Carstensen B, Sandbaek A, Lauritzen T, Jorgensen T, Borch-Johnsen K (2004) A Danish diabetes risk score for targeted screening: the Inter99 study. Diabetes Care 27(3):727–733CrossRefPubMed Glumer C, Carstensen B, Sandbaek A, Lauritzen T, Jorgensen T, Borch-Johnsen K (2004) A Danish diabetes risk score for targeted screening: the Inter99 study. Diabetes Care 27(3):727–733CrossRefPubMed
32.
Zurück zum Zitat Hanley AJ, Wagenknecht LE, Norris JM, Bryer-Ash M, Chen YI, Anderson AM, Bergman R, Haffner SM (2009) Insulin resistance, beta cell dysfunction and visceral adiposity as predictors of incident diabetes: the Insulin Resistance Atherosclerosis Study (IRAS) Family study. Diabetologia 52(10):2079–2086. doi:10.1007/s00125-009-1464-y PubMedCentralCrossRefPubMed Hanley AJ, Wagenknecht LE, Norris JM, Bryer-Ash M, Chen YI, Anderson AM, Bergman R, Haffner SM (2009) Insulin resistance, beta cell dysfunction and visceral adiposity as predictors of incident diabetes: the Insulin Resistance Atherosclerosis Study (IRAS) Family study. Diabetologia 52(10):2079–2086. doi:10.​1007/​s00125-009-1464-y PubMedCentralCrossRefPubMed
33.
Zurück zum Zitat Soriguer F, Colomo N, Valdes S, Goday A, Rubio-Martin E, Esteva I, Castano L, Ruiz de Adana MS, Morcillo S, Calle A, Garcia-Fuentes E, Catala M, Gutierrez-Repiso C, Delgado E, Gomis R, Ortega E, Rojo-Martinez G (2014) Modifications of the homeostasis model assessment of insulin resistance index with age. Acta Diabetol 51(6):917–925. doi:10.1007/s00592-013-0523-5 CrossRefPubMed Soriguer F, Colomo N, Valdes S, Goday A, Rubio-Martin E, Esteva I, Castano L, Ruiz de Adana MS, Morcillo S, Calle A, Garcia-Fuentes E, Catala M, Gutierrez-Repiso C, Delgado E, Gomis R, Ortega E, Rojo-Martinez G (2014) Modifications of the homeostasis model assessment of insulin resistance index with age. Acta Diabetol 51(6):917–925. doi:10.​1007/​s00592-013-0523-5 CrossRefPubMed
35.
Zurück zum Zitat Kuwana B, Urayama O, Kawai K (2002) Reference value and cut-off value for diagnosis of insulin resistance in type 2 diabetes mellitus. Rinsho Byori 50(4):398–403PubMed Kuwana B, Urayama O, Kawai K (2002) Reference value and cut-off value for diagnosis of insulin resistance in type 2 diabetes mellitus. Rinsho Byori 50(4):398–403PubMed
39.
Zurück zum Zitat Mukai N, Doi Y, Ninomiya T, Hata J, Hirakawa Y, Fukuhara M, Iwase M, Kiyohara Y (2012) Cut-off values of fasting and post-load plasma glucose and HbA1c for predicting Type 2 diabetes in community-dwelling Japanese subjects: the Hisayama Study. Diabet Med 29(1):99–106. doi:10.1111/j.1464-5491.2011.03378.x Mukai N, Doi Y, Ninomiya T, Hata J, Hirakawa Y, Fukuhara M, Iwase M, Kiyohara Y (2012) Cut-off values of fasting and post-load plasma glucose and HbA1c for predicting Type 2 diabetes in community-dwelling Japanese subjects: the Hisayama Study. Diabet Med 29(1):99–106. doi:10.​1111/​j.​1464-5491.​2011.​03378.​x
42.
Zurück zum Zitat Usui C, Asaka M, Kawano H, Aoyama T, Ishijima T, Sakamoto S, Higuchi M (2010) Visceral fat is a strong predictor of insulin resistance regardless of cardiorespiratory fitness in non-diabetic people. J Nutr Sci Vitaminol (Tokyo) 56(2):109–116CrossRef Usui C, Asaka M, Kawano H, Aoyama T, Ishijima T, Sakamoto S, Higuchi M (2010) Visceral fat is a strong predictor of insulin resistance regardless of cardiorespiratory fitness in non-diabetic people. J Nutr Sci Vitaminol (Tokyo) 56(2):109–116CrossRef
43.
Zurück zum Zitat Hadaegh F, Bozorgmanesh M, Ghasemi A, Harati H, Saadat N, Azizi F (2008) High prevalence of undiagnosed diabetes and abnormal glucose tolerance in the Iranian urban population: Tehran Lipid and Glucose Study. BMC Public Health 8(1):176PubMedCentralCrossRefPubMed Hadaegh F, Bozorgmanesh M, Ghasemi A, Harati H, Saadat N, Azizi F (2008) High prevalence of undiagnosed diabetes and abnormal glucose tolerance in the Iranian urban population: Tehran Lipid and Glucose Study. BMC Public Health 8(1):176PubMedCentralCrossRefPubMed
44.
45.
Zurück zum Zitat Primeau V, Coderre L, Karelis AD, Brochu M, Lavoie ME, Messier V, Sladek R, Rabasa-Lhoret R (2011) Characterizing the profile of obese patients who are metabolically healthy. Int J Obes (Lond) 35(7):971–981. doi:10.1038/ijo.2010.216 CrossRef Primeau V, Coderre L, Karelis AD, Brochu M, Lavoie ME, Messier V, Sladek R, Rabasa-Lhoret R (2011) Characterizing the profile of obese patients who are metabolically healthy. Int J Obes (Lond) 35(7):971–981. doi:10.​1038/​ijo.​2010.​216 CrossRef
Metadaten
Titel
Cut-off points of homeostasis model assessment of insulin resistance, beta-cell function, and fasting serum insulin to identify future type 2 diabetes: Tehran Lipid and Glucose Study
verfasst von
Asghar Ghasemi
Maryam Tohidi
Arash Derakhshan
Mitra Hasheminia
Fereidoun Azizi
Farzad Hadaegh
Publikationsdatum
01.10.2015
Verlag
Springer Milan
Erschienen in
Acta Diabetologica / Ausgabe 5/2015
Print ISSN: 0940-5429
Elektronische ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-015-0730-3

Weitere Artikel der Ausgabe 5/2015

Acta Diabetologica 5/2015 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.