A Prospective Analysis of the HOMA Model: The Mexico City Diabetes Study

Steven M Haffner; Clicerio Gonzalez; Heikki Miettinen; Esmarie Kennedy; Michael P Stern

doi:10.2337/diacare.19.10.1138

Short Reports

A Prospective Analysis of the HOMA Model: The Mexico City Diabetes Study

Steven M Haffner, MD,
Clicerio Gonzalez, MD,
Heikki Miettinen, MD,
Esmarie Kennedy, MS and
Michael P Stern, MD

Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio San Antonio, Texas
Centra de Estudios en Diabetes, American British Cowdray Hospital Mexico City, Mexico

Address correspondence and reprint requests to Steven M. Haffner, MD, Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78284-7873.

Diabetes Care 1996 Oct; 19(10): 1138-1141. https://doi.org/10.2337/diacare.19.10.1138

Abstract

OBJECTIVE Both insulin resistance (IR) and decreased insulin secretion have been shown to predict the development of NIDDM. However, methods to assess insulin sensitivity and secretion are complicated and expensive to apply in epidemiological studies. The homeostasis model assessment (HOMA) has been suggested as a method to assess IR and secretion from the fasting glucose and insulin concentrations.

RESEARCH DESIGN AND METHODS We applied the HOMA model in the 3.5-year follow-up of the Mexico City Diabetes Study.

RESULTS Out of 1,449 subjects, 97 developed diabetes. When modeled separately insulin resistance but not insulin secretion predicted NIDDM. However, when both variables were entered into the same regression model, both increased IR and decreased β-cell function significantly predicted NIDDM.

CONCLUSIONS We conclude that the HOMA provides a useful model to assess ²-cell function in epidemiological studies and that it is important to take into account the degree of IR in assessing insulin secretion.