Utility of Homeostasis Model Assessment of β-Cell Function in Predicting Diabetes in 12,924 Healthy Koreans

  1. Ki-Chul Sung, MD, PHD1,
  2. Gerald M. Reaven, MD2 and
  3. Sun H. Kim, MD2
  1. 1Department of Medicine, Division of Cardiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea;
  2. 2Department of Medicine, Division of Endocrinology, Stanford University School of Medicine, Stanford, California.
  1. Corresponding author: Ki-Chul Sung, kcmd.sung{at}samsung.com.


OBJECTIVE It is unclear how well homeostasis model assessment of β-cell function (HOMA-β) predicts diabetes development beyond its components, especially glucose.

RESEARCH DESIGN AND METHODS We identified 12,924 nondiabetic Koreans who had fasting plasma glucose and insulin concentrations measured in 2003 and again in 2008. To minimize the impact of differences in baseline glucose concentration, individuals were divided into three glucose categories: normal fasting glucose (NFG, glucose <5.6 mmol/l), impaired fasting glucose (IFG-100) (5.6–6.0 mmol/l), and IFG-110 (6.1–6.9 mmol/l).

RESULTS Diabetes developed in 29% of individuals in the IFG-110 group, compared with 5% in IFG-100 and 0.3% in NFG groups. Within each glucose category, those who progressed to diabetes had higher baseline glucose concentrations (P ≤ 0.04). Baseline HOMA-β, however, was not lower but higher in individuals who developed diabetes in the NFG group (P = 0.009) and similar in the IFG-100 and IFG-110 groups.

CONCLUSIONS These data question the utility of using HOMA-β to predict the development of diabetes.


  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Received June 11, 2009.
    • Accepted September 10, 2009.
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  1. Diabetes Care vol. 33 no. 1 200-202
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