Critical Evaluation of Models to Identify Individuals With Insulin Resistance
- Wolfgang Rathmann, MD, MSPH1,
- Burkhard Haastert, PHD1,
- Guido Giani, PHD1,
- Rolf Holle, PHD2,
- Wolfgang Koenig, MD3,
- Christian Herder, PHD4 and
- Hannelore Löwel, MD5
- 1Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute at the Heinrich-Heine-University, Düsseldorf, Germany
- 2GSF National Research Center for Environment and Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany
- 3University of Ulm Medical Center, Ulm, Germany
- 4German Diabetes Clinic, German Diabetes Center, Leibniz Institute at the Heinrich-Heine-University, Düsseldorf, Germany
- 5GSF National Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Germany
- Address correspondence to Dr. Wolfgang Rathmann, MSPH (USA), Institute of Biometrics and Epidemiology, German Diabetes Center, Auf‘m Hennekamp 65 D-40225 Düsseldorf, Germany. E-mail: rathmann{at}ddz.uni-duesseldorf.de
Clinical indexes of insulin resistance (IR) have acquired increasing importance with the development of various drugs that improve endogenous insulin action (1). Recently, the largest database on insulin clamp studies has been established. This database includes 2,321 subjects, of whom 2,138 are nondiabetic (92%), from 19 sites worldwide (2). Using classification trees, three models have been derived. Model 1 is based on homeostasis model assessment of insulin resistance (HOMA-IR) >4.65, BMI >28.9 kg/m2, or HOMA-IR >3.60 and BMI >27.5 kg/m2. Model 2 is based on BMI >28.7 kg/m2, …
