Homeostasis Model Assessment Is a Reliable Indicator of Insulin Resistance During Follow-up of Patients With Type 2 Diabetes
- Akira Katsuki, MD,
- Yasuhiro Sumida, MD,
- Esteban C. Gabazza, MD,
- Shuichi Murashima, MD,
- Masahiko Furuta, MD,
- Rika Araki-Sasaki, MD,
- Yasuko Hori, MD,
- Yutaka Yano, MD and
- Yukihiko Adachi, MD
- 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.
- 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
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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.
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A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
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- Accepted October 24, 2000.
- Received April 24, 2000.
- by the American Diabetes Association, Inc.
