The HOMA-IR Performance to Identify New Diabetes Cases by Degree of Urbanization and Altitude in Peru: The CRONICAS Cohort Study
Aims. Prognostic thresholds to identify new type 2 diabetes mellitus (T2DM) cases using the HOMA-IR have not been defined. We studied the HOMA-IR performance to identify incident T2DM cases and to assess if the thresholds varied according to urbanization and altitude in Peru. Methods. Longitudinal a...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2018/7434918 |
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| author | Rodrigo M. Carrillo-Larco J. Jaime Miranda Robert H. Gilman William Checkley Liam Smeeth Antonio Bernabe-Ortiz CRONICAS Cohort Study Group |
| author_facet | Rodrigo M. Carrillo-Larco J. Jaime Miranda Robert H. Gilman William Checkley Liam Smeeth Antonio Bernabe-Ortiz CRONICAS Cohort Study Group |
| author_sort | Rodrigo M. Carrillo-Larco |
| collection | DOAJ |
| description | Aims. Prognostic thresholds to identify new type 2 diabetes mellitus (T2DM) cases using the HOMA-IR have not been defined. We studied the HOMA-IR performance to identify incident T2DM cases and to assess if the thresholds varied according to urbanization and altitude in Peru. Methods. Longitudinal analysis. The outcome was incident T2DM cases: self-report diagnosis and fasting glucose. The exposure was the HOMA-IR. Receiver operating characteristic (ROC) curves were plotted, and the area under the ROC curve (AUC) was estimated with 95% confidence intervals (95% CIs). Results are presented overall and stratified by study site (Lima, Tumbes, urban Puno, and rural Puno), rurality (urban, semiurban, and rural), and altitude (low and high). Results. A total of 3120 participants (mean age: 55.6 years, 51.2% females) contributed data to this analysis. The median baseline HOMA-IR was 1.7 (IQR 1.0–2.9), with median values ranging from 1.1 in rural Puno to 2.0 in Lima and Tumbes (p<0.001). Overall for incident T2DM, the AUC was 0.69 (95% CI: 0.64–0.74) with an empirical threshold of 2.8 yielding a positive likelihood ratio of 2.30 and a negative one of 0.61; the positive and negative predictive values were 14.6% and 95.7%, respectively. The empirical thresholds varied within the variables of interest, for example, from 0.9 in urban Puno to 2.9 in Lima. Conclusions. Using the HOMA-IR to identify incident T2DM cases seems to yield moderate accuracy. The HOMA-IR could help improve identifying people at high risk of T2DM. |
| format | Article |
| id | doaj-art-32181e4ba1cd4eeba47eaa0ac0bfc213 |
| institution | OA Journals |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-32181e4ba1cd4eeba47eaa0ac0bfc2132025-08-20T02:07:39ZengWileyJournal of Diabetes Research2314-67452314-67532018-01-01201810.1155/2018/74349187434918The HOMA-IR Performance to Identify New Diabetes Cases by Degree of Urbanization and Altitude in Peru: The CRONICAS Cohort StudyRodrigo M. Carrillo-Larco0J. Jaime Miranda1Robert H. Gilman2William Checkley3Liam Smeeth4Antonio Bernabe-Ortiz5CRONICAS Cohort Study Group6CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, PeruCRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, PeruCRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, PeruCRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, PeruCRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, PeruCRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, PeruCRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, PeruAims. Prognostic thresholds to identify new type 2 diabetes mellitus (T2DM) cases using the HOMA-IR have not been defined. We studied the HOMA-IR performance to identify incident T2DM cases and to assess if the thresholds varied according to urbanization and altitude in Peru. Methods. Longitudinal analysis. The outcome was incident T2DM cases: self-report diagnosis and fasting glucose. The exposure was the HOMA-IR. Receiver operating characteristic (ROC) curves were plotted, and the area under the ROC curve (AUC) was estimated with 95% confidence intervals (95% CIs). Results are presented overall and stratified by study site (Lima, Tumbes, urban Puno, and rural Puno), rurality (urban, semiurban, and rural), and altitude (low and high). Results. A total of 3120 participants (mean age: 55.6 years, 51.2% females) contributed data to this analysis. The median baseline HOMA-IR was 1.7 (IQR 1.0–2.9), with median values ranging from 1.1 in rural Puno to 2.0 in Lima and Tumbes (p<0.001). Overall for incident T2DM, the AUC was 0.69 (95% CI: 0.64–0.74) with an empirical threshold of 2.8 yielding a positive likelihood ratio of 2.30 and a negative one of 0.61; the positive and negative predictive values were 14.6% and 95.7%, respectively. The empirical thresholds varied within the variables of interest, for example, from 0.9 in urban Puno to 2.9 in Lima. Conclusions. Using the HOMA-IR to identify incident T2DM cases seems to yield moderate accuracy. The HOMA-IR could help improve identifying people at high risk of T2DM.http://dx.doi.org/10.1155/2018/7434918 |
| spellingShingle | Rodrigo M. Carrillo-Larco J. Jaime Miranda Robert H. Gilman William Checkley Liam Smeeth Antonio Bernabe-Ortiz CRONICAS Cohort Study Group The HOMA-IR Performance to Identify New Diabetes Cases by Degree of Urbanization and Altitude in Peru: The CRONICAS Cohort Study Journal of Diabetes Research |
| title | The HOMA-IR Performance to Identify New Diabetes Cases by Degree of Urbanization and Altitude in Peru: The CRONICAS Cohort Study |
| title_full | The HOMA-IR Performance to Identify New Diabetes Cases by Degree of Urbanization and Altitude in Peru: The CRONICAS Cohort Study |
| title_fullStr | The HOMA-IR Performance to Identify New Diabetes Cases by Degree of Urbanization and Altitude in Peru: The CRONICAS Cohort Study |
| title_full_unstemmed | The HOMA-IR Performance to Identify New Diabetes Cases by Degree of Urbanization and Altitude in Peru: The CRONICAS Cohort Study |
| title_short | The HOMA-IR Performance to Identify New Diabetes Cases by Degree of Urbanization and Altitude in Peru: The CRONICAS Cohort Study |
| title_sort | homa ir performance to identify new diabetes cases by degree of urbanization and altitude in peru the cronicas cohort study |
| url | http://dx.doi.org/10.1155/2018/7434918 |
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