Are HOMA-IR and HOMA-B good predictors for diabetes and pre-diabetes subtypes?

BACKGROUND: To investigate the association between the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and Homeostasis Model Assessment of Beta-cell function (HOMA-B) with the incidence of diabetes and pre-diabetes subtypes. METHODS: A total of 3101 normoglycemic people aged 20-70 years were included in the 6-year follow-up study. Multinomial logistic regression was used to calculate the incidence possibility of isolated Impaired Fasting Glucose (iIFG), isolated Impaired Glucose Tolerance (iIGT), Combined impaired fasting glucose & impaired glucose tolerance (CGI), and Diabetes Mellitus (DM) per standard deviation (SD) increment in HOMA-IR and HOMA-B in the crude and multivariable model. RESULTS: In the multivariate model, an increase in one SD change in HOMA-IR was associated with a 43, 42, 75, and 92% increased risk of iIFG, iIGT, CGI, and DM, respectively. There was a positive correlation between the increase in HOMA-B and the incidence of iIGT; however, after adjusting the results for metabolic syndrome components, it was inversely correlated with the incidence of iIFG [Odds Ratio = 0.86(0.75-0.99)]. CONCLUSIONS: HOMA-IR is positively correlated with diabetes and pre-diabetes subtypes' incidence, and HOMA-B is inversely correlated with the incidence of iIFG but positively correlated with iIGT incidence. However, none of these alone is a good criterion for predicting diabetes and pre-diabetes.

Survival of thyroid cancer and social determinants in Iran, 2001-2005.

BACKGROUND: Thyroid cancer is the most common endocrine system malignancy in the world, being the 7th most common cancer in females, 14th in males and 11th in both sexes in the Iranian population. The present study aimed to determine survival of thyroid cancers in Iran based on sex, age group, pathology and geographical location. METHODS: The patients selected for this study were 602 out of 5,759 cases listed in the cancer registry system between 2001 and 2005. The Kaplan-Meier method was used for survival estimation and Cox's proportional hazard model for calculating hazard ratios according to demographic and risk variables. RESULTS: The overall 5-year survival rate was 88.0%. There was a significant difference between survivals of the two sexes. The best and worst survival were in the age groups under 40 and over 60 years old, respectively. The best survival was for papillary type, with the anaplastic type demonstrating the worst survival. The best survival was in the southwest (Khuzestan) and the worst in the northwest (Azarbaijan). CONCLUSION: Size of young population and social determinants may be important effective elements for differences in survival, which should be taken more into consideration in managing chronic disease such as thyroid cancer.