Homeostasis Model Assessment Is a Reliable Indicator of Insulin Resistance During Follow-up of Patients With Type 2 Diabetes

  1. Akira Katsuki, MD,
  2. Yasuhiro Sumida, MD,
  3. Esteban C. Gabazza, MD,
  4. Shuichi Murashima, MD,
  5. Masahiko Furuta, MD,
  6. Rika Araki-Sasaki, MD,
  7. Yasuko Hori, MD,
  8. Yutaka Yano, MD and
  9. Yukihiko Adachi, MD
  1. From the Third Department of Internal Medicine (A.K., Y.S., E.C.G., M.F., R.A.-S., Y.H., Y.Y., Y.A.), the Department of Radiology (S.M.), Mie University School of Medicine, Mie, Japan.
  1. Address correspondence and reprint requests to Akira Katsuki, MD, Third Department of Internal Medicine, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan. E-mail: katukia{at}clin.medic.mie-u.ac.jp .

Abstract

OBJECTIVE— To investigate the usefulness of the homeostasis model assessment as an index of insulin resistance (HOMA-IR) for evaluating the clinical course of patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS— The usefulness of HOMA-IR and its relationship with insulin resistance assessed by the hyperinsulinemic-euglycemic clamp study (clamp IR) were evaluated in 55 Japanese patients with type 2 diabetes before and after treatment. The patients were subjected to diet (∼1,440-1,720 kcal/day) and exercise therapy (walking 10,000 steps daily) for 6 weeks during their hospitalization.

RESULTS— Univariate regression analysis disclosed a significant correlation between log-transformed HOMA-IR and log-transformed clamp IR before (r = -0.613, P < 0.0001) and after (r = -0.734, P < 0.0001) treatment. Neither the slopes (-0.71 ± 0.12 vs. -0.79 ± 0.09, F = 0.25, P = 0.61) nor the intercepts (y-intercept = 1.67 vs. 1.70, x-intercept = 2.36 vs. 2.15, F = 0.02, P = 0.88) of the regression lines between HOMA-IR and clamp IR were significantly different before and after treatment. There was a significant correlation between the decrease in log-transformed HOMA-IR and the increase in clamp IR during treatment (r = -0.617, P < 0.0001).

CONCLUSIONS— HOMA-IR may constitute a useful method not only for diagnosing insulin resistance, but also for follow-up during the treatment of patients with type 2 diabetes.

Footnotes

  • Abbreviations: clamp IR, insulin resistance assessed by the hyperinsulinemic-euglycemic clamp; HOMA-IR, homeostasis model assessment of insulin resistance; OGTT, oral glucose tolerance test; SHBG, sex hormone-binding globulin.

  • A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    • Accepted October 24, 2000.
    • Received April 24, 2000.
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