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...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-10-01
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| Series: | Dr. Sulaiman Al Habib Medical Journal |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/DSHMJ.DSHMJ_64_24 |
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| author | Mona F. Kardus Rana A. Hallak Ahmed Alakedi Alaa S Abdulkarim Shaykhah Alsheddi Fouzah S. Farhan Othman Y. Alyousef Ruwayda A. Alturki Youssef Kurdi Salma A. Mewally |
| author_facet | Mona F. Kardus Rana A. Hallak Ahmed Alakedi Alaa S Abdulkarim Shaykhah Alsheddi Fouzah S. Farhan Othman Y. Alyousef Ruwayda A. Alturki Youssef Kurdi Salma A. Mewally |
| author_sort | Mona F. Kardus |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-99f50ee9efee40f29ecceedcc7483198 |
| institution | Kabale University |
| issn | 2666-819X 2590-3349 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Dr. Sulaiman Al Habib Medical Journal |
| spelling | doaj-art-99f50ee9efee40f29ecceedcc74831982025-08-21T05:04:41ZengWolters Kluwer Medknow PublicationsDr. Sulaiman Al Habib Medical Journal2666-819X2590-33492024-10-016421522110.4103/DSHMJ.DSHMJ_64_24Assessment of Insulin Resistance using the Glucose Tolerance Insulin Response (GTIR) Test and Homeostasis Model Assessment-Estimated Insulin Resistance (HOMA-IR) TestMona F. KardusRana A. HallakAhmed AlakediAlaa S AbdulkarimShaykhah AlsheddiFouzah S. FarhanOthman Y. AlyousefRuwayda A. AlturkiYoussef KurdiSalma A. MewallyBackground: 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.https://journals.lww.com/10.4103/DSHMJ.DSHMJ_64_24gtthoma-irhyperinsulinemiainsulin resistance |
| spellingShingle | Mona F. Kardus Rana A. Hallak Ahmed Alakedi Alaa S Abdulkarim Shaykhah Alsheddi Fouzah S. Farhan Othman Y. Alyousef Ruwayda A. Alturki Youssef Kurdi Salma A. Mewally Assessment of Insulin Resistance using the Glucose Tolerance Insulin Response (GTIR) Test and Homeostasis Model Assessment-Estimated Insulin Resistance (HOMA-IR) Test Dr. Sulaiman Al Habib Medical Journal gtt homa-ir hyperinsulinemia insulin resistance |
| title | Assessment of Insulin Resistance using the Glucose Tolerance Insulin Response (GTIR) Test and Homeostasis Model Assessment-Estimated Insulin Resistance (HOMA-IR) Test |
| title_full | Assessment of Insulin Resistance using the Glucose Tolerance Insulin Response (GTIR) Test and Homeostasis Model Assessment-Estimated Insulin Resistance (HOMA-IR) Test |
| title_fullStr | Assessment of Insulin Resistance using the Glucose Tolerance Insulin Response (GTIR) Test and Homeostasis Model Assessment-Estimated Insulin Resistance (HOMA-IR) Test |
| title_full_unstemmed | Assessment of Insulin Resistance using the Glucose Tolerance Insulin Response (GTIR) Test and Homeostasis Model Assessment-Estimated Insulin Resistance (HOMA-IR) Test |
| title_short | Assessment of Insulin Resistance using the Glucose Tolerance Insulin Response (GTIR) Test and Homeostasis Model Assessment-Estimated Insulin Resistance (HOMA-IR) Test |
| title_sort | assessment of insulin resistance using the glucose tolerance insulin response gtir test and homeostasis model assessment estimated insulin resistance homa ir test |
| topic | gtt homa-ir hyperinsulinemia insulin resistance |
| url | https://journals.lww.com/10.4103/DSHMJ.DSHMJ_64_24 |
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