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

Katsuki, Akira MD
Sumida, Yasuhiro MD
Gabazza, Esteban C. MD
Murashima, Shuichi MD
Furuta, Masahiko MD
Araki-Sasaki, Rika MD
Hori, Yasuko MD
Yano, Yutaka MD
Adachi, Yukihiko 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: [email protected].

Received for publication 24 April 2000 and accepted in revised form 24 October 2000.

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.

Diabetes Care 24(2):p 362-365, February 2001.

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.