HOMA indices as screening tests for cystic fibrosis-related diabetes

Autor: Catherine Mainguy, Isabelle Durieu, S. Touzet, Quitterie Reynaud, Angélique Denis, Philippe Reix, Catherine Llerena, Tom Toin, Isabelle Pin
Rok vydání: 2021
Předmět:
0301 basic medicine
Pulmonary and Respiratory Medicine
Adult
Blood Glucose
Male
medicine.medical_specialty
endocrine system diseases
Screening test
Adolescent
Cystic Fibrosis
Cystic fibrosis-related diabetes
Cystic fibrosis
Gastroenterology
Cohort Studies
03 medical and health sciences
Young Adult
0302 clinical medicine
Insulin resistance
Age groups
Predictive Value of Tests
Positive predicative value
Diabetes mellitus
Internal medicine
Insulin-Secreting Cells
medicine
Diabetes Mellitus
Humans
Insulin
Prospective Studies
Prospective cohort study
Child
business.industry
nutritional and metabolic diseases
Glucose Tolerance Test
medicine.disease
030104 developmental biology
030228 respiratory system
Pediatrics
Perinatology and Child Health
Female
Insulin Resistance
business
hormones
hormone substitutes
and hormone antagonists
Biomarkers
Zdroj: Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society. 21(1)
ISSN: 1873-5010
Popis: We assessed the diagnostic performances of homeostasis model assessment indices (HOMA) of β-cell function (HOMA-%β) and of insulin resistance (HOMA-IR) for cystic fibrosis related diabetes (CFRD) screening.Data were collected from a prospective cohort of 228 patients with CF (117 adults and 111 children). Fasting insulin and glucose levels were measured to calculate HOMA-%β and HOMA-IR. HOMA-%β100 indicated insulin secretion deficiency and HOMA-IR1 insulin resistance. Both were used to calculate sensitivity, specificity, and positive and negative predictive values (PPV and NPV). Two-hour oral glucose tolerance tests (2h-OGTT) defined CFRD. Analyses were conducted separately for children and adults. Performances of HOMA-%β and HOMA-IR were calculated at inclusion, for each year of follow-up and for pooled data over the follow-up period.Sensitivity, specificity, NPV and PPV were respectively: 88%, 45%, 98% and 11% for HOMA-%β and 42%, 48%, 91% and 6% for HOMA-IR in the pooled data of children; and 83%, 18%, 90% and 10% for HOMA-%β, and 39%, 80%, 92% and 18% for HOMA-IR in the pooled data of adults. Combining HOMA-%β and HOMA-IR did not improve performances.Within both age groups, HOMA-%β100 provided good sensitivity and NPV. HOMA-IR1 had low sensitivity. Calculation of the HOMA-%β could be an interesting first-line screening approach to exclude CFRD and thus avoid unnecessary OGTT in patients for whom value is ≥100. However, HOMA-%β100 does not support the diagnosis of CFRD and should be complemented by OGTT.
Databáze: OpenAIRE
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