A Practical Clinical Index of Insulin Resistance in Obese Patients with Impaired Glucose Tolerance. An Application of HOMA's Index.:An Application of HOMA's Index
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Although several methods of evaluation have been developed to quantify insulin sensitivity and resistance in patients with impaired glucose tolerance (IGT) or diabetes, they are complicated expensive, and patient poorly tolerated by patients, and as a result not used in outpatient clinics. In order to find a simple index for evaluating insulin resistance in IGT and diabetes, we investigated the usefulness of an index of insulin resistance obtained by applying a Basal Homeostasis Model Assessment (HOMA) equation in 40 obese subjects with IGT (OIGT), 46 non-obese subjects with IGT (NIGT), and 18 control subjects with normal glucose tolerance (C). Obesity was defined as a BMI of 26.4kg/m<SUP>2</SUP>in men and 25.8kg/m<SUP>2</SUP>in women. HOMA insulin resistance index (HOMA-R) was obtained by solving the equation: FIRI/22.5 e<SUP>-InFpG</SUP>.<BR>The BMI and glycohemoglobin (HbAic) was 28.4±0.4 kg/m2 and 5.5±0.1%, respectively, in OIGT, 22.4±0.3kg/m2 and 5.6±0.1% in NIGT, and 21.9±0.2kg/m2 and 5.3±0.1% in C. Hyperinsulinemia, hyperlipidemia, and high blood pressure were present in OIGT, but no differences in HbAic or fasting blood glucose were found between the groups. On the other hand, HOMA-R was 3.1±0.2 (mU·mmol/12) in OIGT, 2.0±0.1 in NIGT, and 1.4±0.1 in the control, and significantly higher in OIGT than in the other groups. HOMA-R in NIGT was also significantly higher than in the control. HOMA-R was positively correlated with BMI, FIRI, FPG, I PG, I IRI, I IRI/I PG, MaxPG, Ma×IRI, and Ma×IRI/Ma×PG, and the correlation coefficient between HOMA-R and FIRI was strongly positive (γ=0.913)<BR>Thus, HOMA-R appears to be a useful and simple index of insulin resistance in obese and nonobese IGT and NIDDM subjects. It is a near approximation of the glucose infusion rate in the euglycemic glucose clamp method. HOMA-R clearly has some limitations and disadvantages when used; 1) in IDDM subjects, 2) in NIDDM subjects with suppressed insulin secretion, or 3) in diabetic subjects with insulin abnormality or insulin receptor abnormality.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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