Assessment of Insulin Resistance using the Glucose Tolerance Insulin Response (GTIR) Test and Homeostasis Model Assessment-Estimated Insulin Resistance (HOMA-IR) Test
Background: The rising global number of Diabetes mellitus (DM) cases indicated the significance of early detection of insulin resistance trying to decrease the economic and healthcare burden caused by DM. Objectives: This study aimed to evaluate the efficacy of using Homeostasis Model Assessment-Est...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2024-10-01
|
| Series: | Dr. Sulaiman Al Habib Medical Journal |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/DSHMJ.DSHMJ_64_24 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Background:
The rising global number of Diabetes mellitus (DM) cases indicated the significance of early detection of insulin resistance trying to decrease the economic and healthcare burden caused by DM.
Objectives:
This study aimed to evaluate the efficacy of using Homeostasis Model Assessment-Estimated Insulin Resistance (HOMA-IR) and to define a suitable HOMA-IR cut-off value. The difficulty of performing a euglycaemic-hyperinsulinaemic clamp in extensive studies has stimulated the importance of using and developing surrogate insulin sensitivity indices.
Design:
Retrospective cohort study.
Setting:
Involved 397 participants referred from outpatient clinics at Dr. Sulaiman Alhabib Hospital between January 2011 and December 2021 for a Glucose Tolerance/Insulin Response test.
Methods:
Data was obtained from the electronic medical system in Dr. Sulaiman Alhabib hospital. Insulin response interpretation was based on the Kraft pattern, classifying insulin patterns into five types. HOMA-IR was calculated using the formula HOMA-IR = (FPI*FPG)/22.5. Statistical analyses were performed using MedCalc Statistical Software version 20. Receiver Operating Characteristic curves were plotted to assess the diagnostic performance of HOMA-IR in distinguishing between cases and non-cases of insulin resistance. The area under the curve and 95% confidence intervals were calculated. The Youden index was used to select the optimum cut-off points.
Results:
Youden index was used for selecting the optimum cut off points. For the combined dataset, a cut-off value of >1.93 showed a sensitivity of 66.91% and specificity of 71.31%. The logistic regression was used to assess various predictors of the development of diabetes mellitus. impaired glucose tolerance, impaired fasting glucose, or gestational diabetes. Insulin resistance based on HOMA-IR was a significant predictor.
Conclusion:
Insulin resistance is a hallmark of type 2 diabetes. Establishing and using a sensitive and specific population-based cut-off for HOMAIR is highly recommended for early detection of insulin resistance. The study faced some challenges such as limited participants and incomplete follow-up. |
|---|---|
| ISSN: | 2666-819X 2590-3349 |