Assessment of Insulin Resistance using the Glucose Tolerance Insulin Response (GTIR) Test and Homeostasis Model Assessment-Estimated Insulin Resistance (HOMA-IR) Test.

Autor: Kardus, Mona F., Hallak, Rana A., Alakedi, Ahmed, Abdulkarim, Alaa S, Alsheddi, Shaykhah, Farhan, Fouzah S., Alyousef, Othman Y., Alturki, Ruwayda A., Kurdi, Youssef, Mewally, Salma A.
Zdroj: Dr. Sulaiman Al Habib Medical Journal; Oct2024, Vol. 6 Issue 4, p215-221, 7p
Abstrakt: Background: The rising global number of Diabetes mellitus (DM) cases indicated the significance of early detection of insulin resistance trying to decrease the economic and healthcare burden caused by DM. Objectives: This study aimed to evaluate the efficacy of using Homeostasis Model Assessment-Estimated Insulin Resistance (HOMA-IR) and to define a suitable HOMA-IR cut-off value. The difficulty of performing a euglycaemic-hyperinsulinaemic clamp in extensive studies has stimulated the importance of using and developing surrogate insulin sensitivity indices. Design: Retrospective cohort study. Setting: Involved 397 participants referred from outpatient clinics at Dr. Sulaiman Alhabib Hospital between January 2011 and December 2021 for a Glucose Tolerance/Insulin Response test. Methods: Data was obtained from the electronic medical system in Dr. Sulaiman Alhabib hospital. Insulin response interpretation was based on the Kraft pattern, classifying insulin patterns into five types. HOMA-IR was calculated using the formula HOMA-IR = (FPI*FPG)/22.5. Statistical analyses were performed using MedCalc Statistical Software version 20. Receiver Operating Characteristic curves were plotted to assess the diagnostic performance of HOMA-IR in distinguishing between cases and non-cases of insulin resistance. The area under the curve and 95% confidence intervals were calculated. The Youden index was used to select the optimum cut-off points. Results: Youden index was used for selecting the optimum cut off points. For the combined dataset, a cut-off value of >1.93 showed a sensitivity of 66.91% and specificity of 71.31%. The logistic regression was used to assess various predictors of the development of diabetes mellitus. impaired glucose tolerance, impaired fasting glucose, or gestational diabetes. Insulin resistance based on HOMA-IR was a significant predictor. Conclusion: Insulin resistance is a hallmark of type 2 diabetes. Establishing and using a sensitive and specific population-based cut-off for HOMAIR is highly recommended for early detection of insulin resistance. The study faced some challenges such as limited participants and incomplete follow-up. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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