Appropriate use of the homeostasis model assessment of insulin resistance indices

Abstract

Introduction. Timely detection of insulin resistance is of great importance and a number of indices have been developed for its evaluation, among which the homeostasis model assessment of insulin resistance index is the most commonly used in clinical practice. However, it can be calculated via two different models - homeostasis model assessment 1 and homeostasis model assessment 2. Most studies determine the cut-off values of the study population using the homeostasis model assessment 1, while recently most physicians use homeostasis model assessment 2 in everyday clinical practice. The aim of our study was to examine whether there was a difference in the values of homeostasis model assessment of insulin resistance and homeostasis model assessment of panceratic beta cells function calculated using these two models. Material and Methods. Laboratory findings of 42 patients who were diagnosed with glycemia and insulinemia were used in this study. Fasting and postprandial glycemia and insulinemia were used to calculate homeostasis model assessment indices using homeostasis model assessment 1 and homeostasis model assessment 2. Results. When comparing the values of the homeostasis model assessment of insulin resistance and homeostasis model assessment B indices, calculated via homeostasis model assessment 1 and homeostasis model assessment 2, we found a statistically significant difference (p < 0.001) which was also obtained when comparing the values of the homeostasis model assessment B index. Linear correlation analysis showed a significant positive correlation between the measured values of the homeostasis model assessment of insulin resistance (calculated via both models) and postprandial insulinemia at 120 minutes (p < 0.005). Conclusion. The results indicate that homeostasis model assessment 2 yields significantly lower homeostasis model assessment of insulin resistance and homeostasis model assessment B index values than when calculated by the homeostasis model assessment, which may be a stumbling block in the use of homeostasis model assessment index. It is necessary to pay attention which homeostasis model assessment model was used to define the cut-off values of these indices, and to use the same model in the diagnosis of insulin resistance in each patient in everyday clinical practice.