HOMA-IR (Homeostatic Model Assessment for Insulin Resistance)
Approximates insulin resistance
作成者
Dr. David R. Matthews, MDMin 0 – Max 500
Introduction
The homeostatic model assessment for insulin resistance (HOMA-IR) score is a shortcut for estimating severity of insulin resistance (IR) in patients evaluated for potentially impaired glucose tolerance and diabetes. It is not intended for patients on insulin, and studies have questioned its accuracy in several populations, such as the elderly. The score may be most beneficial for population-based assessments. Additionally, optimal diagnostic cutoffs for normal insulin resistance and insulin resistance related conditions can vary considerably across populations.
"Clamp' measurement is the gold standard for measuring IR but remains resource intensive, invasive, and time consuming. The HOMAR-IR score is often considered as a surrogate metric. Studies suggest a reasonable correlation between HOMAR-IR and 'clamp' measurement. However, agreement levels between the two are weak which suggests more research is needed to gauge individual accuracy and clinical use.
Scoring
The homeostatic model assessment for insulin resistance (HOMAR-IR) score is used as a surrogate metric for insulin resistance (IR) severity. The 'clamp' measurement remains the gold standard. Additionally, optimal diagnostic cutoffs for normal insulin resistance and insulin resistance related conditions can vary considerably across populations.
Formula
HOMAR-IR Score = (Fasting Insulin, µIU/mL) * (Fasting Glucose, mg/dL) / 405
Results
Common reference levels for HOMAR-IR insulin resistance range from 0.7 - 2.
Studies suggests a score > 2 may indicate insulin resistance. However, "normal" values appear to vary greatly by population.
すべての質問と考えられる結果
Questionsタイトルは非表示です
Fasting Insulin
A number between 0 and 500, in µIU/mL or pmol/L.
Fasting Glucose
A number between 0 and 1000, in mg/dL or mmol/L.
考えられる結果
HOMA-IR Score
Studies suggests a score > 2 may indicate insulin resistance. However, "normal" values appear to vary greatly by population.
- Should not be used in patients on insulin.
引用
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985 Jul;28(7):412-9.
文献
Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985 Jul;28(7):412-9.
https://pubmed.ncbi.nlm.nih.gov/3899825/Validation of simple indexes to assess insulin sensitivity during pregnancy in Wistar and Sprague-Dawley rats. Am J Physiol Endocrinol Metab. 2008 Nov;295(5):E1269-76.
https://pubmed.ncbi.nlm.nih.gov/18796548/Age- and sex-specific reference values for fasting serum insulin levels and insulin resistance/sensitivity indices in healthy Iranian adults: Tehran Lipid and Glucose Study. Clin Biochem. 2014 Apr;47(6):432-8.
https://pubmed.ncbi.nlm.nih.gov/24530467/Insulin resistance index (HOMA-IR) in the differentiation of patients with non-alcoholic fatty liver disease and healthy individuals. Arq Gastroenterol [Internet]. 2010Apr;47(2):165–9.
https://www.scielo.br/j/ag/a/3zP6Zw4zPXY9Rv3Tzk4TZ6N/?lang=en#
- 作成者
- 提供元
EVAL Foundation
- 寄稿者 · 査読者
Jennifer Glen, DNP, FNP-BCEVAL Health, Chief Medical Officer EVAL Foundation
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