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Cut-off points of homeostasis model assessment of insulin resistance, beta-cell function, and fasting serum insulin to identify future type 2 diabetes: Tehran Lipid and Glucose Study

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Abstract

Aims

To determine cut-off points of homeostasis model assessment of insulin resistance (HOMA-IR), β-cell function (HOMA-B), insulin sensitivity (HOMA-S), and fasting insulin for identifying the subjects with type 2 diabetes mellitus (T2DM) in Iranian adults using data from a prospective population-based study.

Methods

From participants of Tehran Lipid and Glucose Study, 4942 Iranian subjects, aged 20–86 years, were followed for incident T2DM. Fasting serum insulin was determined by the electrochemiluminescence immunoasaay. The associations between HOMA-IR, HOMA-B, HOMA-S, and fasting insulin and incident T2DM were evaluated using Cox proportional hazards models. The receiver operator characteristic curve analysis was used to determine the cut-off points of HOMA-IR, HOMA-B, HOMA-S, and fasting insulin.

Results

After 9.2 year follow-up, 346 (7.0 %) incident cases of T2DM were identified; the risk-factor-adjusted hazard ratios for HOMA1-IR, HOMA2-IR, HOMA1-B, HOMA2-B, HOMA1-S, HOMA2-S, and insulin were 1.15, 1.70, 0.732, 0.997, 0.974, 0.986, and 1.01 in women and 1.37, 1.67, 0.588, 0.993, 0.986, 0.991, and 1.06 in men, respectively (all p < 0.05 except for HOMA2-B in women). Optimal cut-off points for HOMA1-IR, HOMA2-IR, HOMA1-B, HOMA2-B, HOMA1-S, HOMA2-S, and insulin were 1.85, 1.41, 86.2, 72.5, 54.1, 63.7, and 11.13 µU/ml in women and 2.17, 1.18, 67.1, 74.6, 46.1, 74.1, and 9.16 µU/ml in men, respectively.

Conclusions

HOMA-IR, HOMA-B (except for HOMA2-B in women), HOMA-S, and fasting insulin were independent predictors of T2DM. Optimal cut-off points of HOMA-IR, HOMA-B, HOMA-S, and fasting serum insulin were determined from a population-based study for identifying incident T2DM.

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Acknowledgments

This study was supported by Grant No. 121 from the National Research Council of the Islamic Republic of Iran. The authors wish to thank laboratory staff of Research Institute for Endocrine Sciences of Shahid Beheshti University of Medical Sciences.

Conflict of interest

This study was supported by Grant No.121 from the National Research Council of the Islamic Republic of Iran. We declare that we have no conflicts of interest.

Ethical standard

This study was approved by the institutional ethics committee of the Research Institute for the Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran [Dated 13th June 2014].

Human and animal rights disclosure

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. There are no animal rights issues as this is a clinical study.

Informed consent disclosure

Written informed consent was obtained from all participants before being included in the study.

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Authors and Affiliations

  1. Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Asghar Ghasemi

  2. Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Asghar Ghasemi & Fereidoun Azizi

  3. Prevention of Metabolic Disorder Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Parvaneh Street, Velenjak, P.O. Box 19395-4763, Tehran, Iran

    Maryam Tohidi, Arash Derakhshan, Mitra Hasheminia & Farzad Hadaegh

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  1. Asghar Ghasemi
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  2. Maryam Tohidi
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Correspondence to Maryam Tohidi.

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Ghasemi, A., Tohidi, M., Derakhshan, A. et al. Cut-off points of homeostasis model assessment of insulin resistance, beta-cell function, and fasting serum insulin to identify future type 2 diabetes: Tehran Lipid and Glucose Study. Acta Diabetol 52, 905–915 (2015). https://doi.org/10.1007/s00592-015-0730-3

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