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The threshold value for identifying insulin resistance (HOMA-IR) in an admixed adolescent population: A hyperglycemic clamp validated study
Silva, Cleliani de Cassia da; Zambon, Mariana Porto; Vasques, Ana Carolina Junqueira; Camilo, Daniella Fernandes; Antonio, Maria Ângela Reis de Góes Monteiro; Geloneze, Bruno.
  • Silva, Cleliani de Cassia da; Universidade Estadual de Campinas. Laboratório de Investigação em Metabolismo e Diabetes. Centro de Diagnóstico e Pesquisa Gastroenterológica. Campinas. BR
  • Zambon, Mariana Porto; Universidade Estadual de Campinas. Programa de Pós-graduação em Saúde da Criança e do Adolescente. Faculdade de Ciências Médicas. Campinas. BR
  • Vasques, Ana Carolina Junqueira; Universidade Estadual de Campinas. Laboratório de Investigação em Metabolismo e Diabetes. Centro de Diagnóstico e Pesquisa Gastroenterológica. Campinas. BR
  • Camilo, Daniella Fernandes; Universidade Estadual de Campinas. Laboratório de Investigação em Metabolismo e Diabetes. Centro de Diagnóstico e Pesquisa Gastroenterológica. Campinas. BR
  • Antonio, Maria Ângela Reis de Góes Monteiro; Universidade Estadual de Campinas. Programa de Pós-graduação em Saúde da Criança e do Adolescente. Faculdade de Ciências Médicas. Campinas. BR
  • Geloneze, Bruno; Universidade Estadual de Campinas. Laboratório de Investigação em Metabolismo e Diabetes. Centro de Diagnóstico e Pesquisa Gastroenterológica. Campinas. BR
Arch. endocrinol. metab. (Online) ; 67(1): 119-125, Jan.-Feb. 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1420094
ABSTRACT
ABSTRACT

Objectives:

To validate the homeostasis model assessment (HOMA) of insulin resistance (IR) as a surrogate to the hyperglycemic clamp to measure IR in both pubertal and postpubertal adolescents, and determine the HOMA-IR cutoff values for detecting IR in both pubertal stages. Subjects and

methods:

The study sample comprised 80 adolescents of both sexes (aged 10-18 years; 37 pubertal), in which IR was assessed with the HOMA-IR and the hyperglycemic clamp.

Results:

In the multivariable linear regression analysis, adjusted for sex, age, and waist circumference, the HOMA-IR was independently and negatively associated with the clamp-derived insulin sensitivity index in both pubertal (unstandardized coefficient - B = −0.087, 95% confidence interval [CI] = −0.135 to −0.040) and postpubertal (B = −0.101, 95% CI, −0.145 to −0.058) adolescents. Bland-Altman plots showed agreement between the predicted insulin sensitivity index and measured clamp-derived insulin sensitivity index in both pubertal stages (mean = −0.00 for pubertal and postpubertal); all P > 0.05. The HOMA-IR showed a good discriminatory power for detecting IR with an area under the receiver operator characteristic curve of 0.870 (95% CI, 0.718-0.957) in pubertal and 0.861 (95% CI, 0.721-0.947) in postpubertal adolescents; all P < 0.001. The optimal cutoff values of the HOMA-IR for detecting IR were > 3.22 (sensitivity, 85.7; 95% CI, 57.2-98.2; specificity, 82.6; 95% CI, 61.2-95.0) for pubertal and > 2.91 (sensitivity, 63.6; 95% CI, 30.8-89.1, specificity, 93.7; 95%CI, 79.2-99.2) for postpubertal adolescents.

Conclusion:

The threshold value of the HOMA-IR for identifying insulin resistance was > 3.22 for pubertal and > 2.91 for postpubertal adolescents.


Full text: Available Index: LILACS (Americas) Type of study: Prognostic study Language: English Journal: Arch. endocrinol. metab. (Online) Journal subject: Endocrinology / Metabolism Year: 2023 Type: Article / Project document Affiliation country: Brazil Institution/Affiliation country: Universidade Estadual de Campinas/BR

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Full text: Available Index: LILACS (Americas) Type of study: Prognostic study Language: English Journal: Arch. endocrinol. metab. (Online) Journal subject: Endocrinology / Metabolism Year: 2023 Type: Article / Project document Affiliation country: Brazil Institution/Affiliation country: Universidade Estadual de Campinas/BR