PMID- 31108989 OWN - NLM STAT- MEDLINE DCOM- 20191206 LR - 20200225 IS - 1648-9144 (Electronic) IS - 1010-660X (Print) IS - 1010-660X (Linking) VI - 55 IP - 5 DP - 2019 May 17 TI - Optimal Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) Cut-Offs: A Cross-Sectional Study in the Czech Population. LID - 10.3390/medicina55050158 [doi] LID - 158 AB - Background and Objectives: The key pathogenetic mechanism of glucose metabolism disorders, insulin resistance (IR), can be assessed using the Homeostasis Model Assessment of IR (HOMA-IR). However, its application in clinical practice is limited due to the absence of cut-offs. In this study, we aimed to define the cut-offs for the Czech population. Methods: After undergoing anthropometric and biochemical studies, the sample of 3539 individuals was divided into either nondiabetics, including both subjects with normal glucose tolerance (NGT, n = 1947) and prediabetics (n = 1459), or diabetics (n = 133). The optimal HOMA-IR cut-offs between subgroups were determined to maximize the sum of the sensitivity and specificity for diagnosing type 2 diabetes mellitus (T2DM) or prediabetes. The predictive accuracy was illustrated using receiver operating characteristic (ROC) curves. Logistic regression was performed to assess the association between a target variable (presence/absence of T2DM) depending on the HOMA-IR score as well as on the age and sex. Results: The HOMA-IR cut-off between nondiabetics and diabetics for both sexes together was 3.63, with a sensitivity of 0.56 and a specificity of 0.86. The area under the ROC curve was 0.73 for T2DM diagnosing in both sexes. The HOMA-IR cut-off between the NGT subjects and prediabetics was 1.82, with a sensitivity of 0.60 and a specificity of 0.66. Logistic regression showed that increased HOMA-IR is a risk factor for the presence of T2DM (odds ratio (OR) 1.2, 95% confidence interval (CI) 1.14-1.28, p < 0.0001). The predictive ability of HOMA-IR in diagnosing T2DM is statistically significantly lower in females (OR 0.66, 95% CI 0.44-0.98). The results are valid for middle-aged European adults. Conclusions: The results suggest the existence of HOMA-IR cut-offs signaling established IR. Introduction of the instrument into common clinical practice, together with the known cut-offs, may contribute to preventing T2DM. FAU - Horakova, Dagmar AU - Horakova D AD - Department of Public Health, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 77515 Olomouc, Czech Republic. dagmar.horakova@upol.cz. FAU - Stepanek, Ladislav AU - Stepanek L AD - Department of Public Health, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 77515 Olomouc, Czech Republic. stepanek.ladislav@gmail.com. FAU - Janout, Vladimir AU - Janout V AD - Department of Public Health, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 77515 Olomouc, Czech Republic. janout@lf.upol.cz. FAU - Janoutova, Jana AU - Janoutova J AD - Department of Healthcare Management, Faculty of Health Sciences, Palacky University Olomouc, Hnevotinska 3, 77515 Olomouc, Czech Republic. jana.janoutova01@upol.cz. FAU - Pastucha, Dalibor AU - Pastucha D AD - ReFit Clinic s.r.o., U Realky 4, 77900 Olomouc, Czech Republic. dalibor.pastucha@refitclinic.cz. FAU - Kollarova, Helena AU - Kollarova H AD - Department of Public Health, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 77515 Olomouc, Czech Republic. helena.kollarova@upol.cz. FAU - Petrakova, Alena AU - Petrakova A AD - Department of Public Health, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 77515 Olomouc, Czech Republic. alena.petrakova@upol.cz. FAU - Stepanek, Lubomir AU - Stepanek L AD - Institute of Biophysics and Informatics, First Faculty of Medicine, Charles University, Salmovska 1, 12000 Prague, Czech Republic. Stepanek@lf1.cuni.cz. FAU - Husar, Roman AU - Husar R AD - Department of Public Health, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 77515 Olomouc, Czech Republic. roman.husar@upol.cz. FAU - Martinik, Karel AU - Martinik K AD - Ambulance Prof. MUDr. Karla Martinika DrSc. s.r.o, Bratri Stefanu 895, 50003 Hradec Kralove, Czech Republic. ambulance@profmartinik.cz. LA - eng GR - IGA UPOL LF 2019/Univerzita Palackeho v Olomouci/ PT - Journal Article DEP - 20190517 PL - Switzerland TA - Medicina (Kaunas) JT - Medicina (Kaunas, Lithuania) JID - 9425208 RN - 0 (Insulin) RN - 97C5T2UQ7J (Cholesterol) RN - IY9XDZ35W2 (Glucose) SB - IM MH - Adult MH - Aged MH - Cholesterol/analysis/blood MH - Cross-Sectional Studies MH - Czech Republic MH - Female MH - Glucose/analysis MH - Glucose Tolerance Test/methods MH - Homeostasis/drug effects/*physiology MH - Humans MH - Insulin/analysis/blood MH - Insulin Resistance/*physiology MH - Logistic Models MH - Male MH - Middle Aged MH - Needs Assessment MH - Odds Ratio PMC - PMC6571793 OTO - NOTNLM OT - HOMA-IR OT - cut-off point OT - insulin resistance OT - prediabetes OT - type 2 diabetes mellitus COIS- None of the authors had any personal or financial conflict of interest. EDAT- 2019/05/22 06:00 MHDA- 2019/12/18 06:00 PMCR- 2019/05/17 CRDT- 2019/05/22 06:00 PHST- 2018/12/31 00:00 [received] PHST- 2019/02/13 00:00 [revised] PHST- 2019/05/14 00:00 [accepted] PHST- 2019/05/22 06:00 [entrez] PHST- 2019/05/22 06:00 [pubmed] PHST- 2019/12/18 06:00 [medline] PHST- 2019/05/17 00:00 [pmc-release] AID - medicina55050158 [pii] AID - medicina-55-00158 [pii] AID - 10.3390/medicina55050158 [doi] PST - epublish SO - Medicina (Kaunas). 2019 May 17;55(5):158. doi: 10.3390/medicina55050158.