Use and Abuse of HOMA Modeling
TLDR
The HOMA model has become a widely used clinical and epidemiological tool and, when used appropriately, it can yield valuable data, however, as with all models, the primary input data needs to be robust, and the data need to be interpreted carefully.Abstract:
Homeostatic model assessment (HOMA) is a method for assessing beta-cell function and insulin resistance (IR) from basal (fasting) glucose and insulin or C-peptide concentrations. It has been reported in >500 publications, 20 times more frequently for the estimation of IR than beta-cell function. This article summarizes the physiological basis of HOMA, a structural model of steady-state insulin and glucose domains, constructed from physiological dose responses of glucose uptake and insulin production. Hepatic and peripheral glucose efflux and uptake were modeled to be dependent on plasma glucose and insulin concentrations. Decreases in beta-cell function were modeled by changing the beta-cell response to plasma glucose concentrations. The original HOMA model was described in 1985 with a formula for approximate estimation. The computer model is available but has not been as widely used as the approximation formulae. HOMA has been validated against a variety of physiological methods. We review the use and reporting of HOMA in the literature and give guidance on its appropriate use (e.g., cohort and epidemiological studies) and inappropriate use (e.g., measuring beta-cell function in isolation). The HOMA model compares favorably with other models and has the advantage of requiring only a single plasma sample assayed for insulin and glucose. In conclusion, the HOMA model has become a widely used clinical and epidemiological tool and, when used appropriately, it can yield valuable data. However, as with all models, the primary input data need to be robust, and the data need to be interpreted carefully.read more
Citations
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Prevalence of hepatic steatosis in an urban population in the United States: Impact of ethnicity
Jeffrey D. Browning,Lidia S. Szczepaniak,Robert L. Dobbins,Pamela Nuremberg,Jay D. Horton,Jonathan Cohen,Scott M. Grundy,Helen H. Hobbs +7 more
TL;DR: The prevalence of hepatic steatosis was greater in men than women among whites, but not in blacks or Hispanics, and significant ethnic and sex differences in the prevalence may have a profound impact on susceptibility to Steatosis‐related liver disease.
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Glycemic durability of rosiglitazone, metformin, or glyburide monotherapy.
Steven E. Kahn,Steven M. Haffner,Heise Ma,William H. Herman,Rury R. Holman,Nigel P. Jones,Barbara G. Kravitz,John M. Lachin,O'Neill Mc,Bernard Zinman,Giancarlo Viberti +10 more
TL;DR: The potential risks and benefits, the profile of adverse events, and the costs of these three drugs should all be considered to help inform the choice of pharmacotherapy for patients with type 2 diabetes.
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The Metabolic Syndrome: Time for a Critical Appraisal Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes
TL;DR: Until much needed research is completed, clinicians should evaluate and treat all CVD risk factors without regard to whether a patient meets the criteria for diagnosis of the "metabolic syndrome."
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The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1)
Anup Ramachandran,Chamukuttan Snehalatha,Simon Mary,B. Mukesh,A. D. Bhaskar,V. Vijay,Indian Diabetes Prevention Programme +6 more
TL;DR: Both LSM and MET significantly reduced the incidence of diabetes in Asian Indians with IGT; there was no added benefit from combining them.
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The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report
Ricardo Azziz,Enrico Carmina,Didier Dewailly,Evanthia Diamanti-Kandarakis,Héctor F. Escobar-Morreale,Walter Futterweit,Onno E. Janssen,Richard S. Legro,Robert J. Norman,Ann Taylor,Selma F. Witchel +10 more
TL;DR: It is the view of the AE-PCOS Society Task Force that PCOS should be defined by the presence of hyperandrogenism, ovarian dysfunction, and/or polycystic ovaries, and the exclusion of related disorders.
References
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Journal ArticleDOI
Homeostasis model assessment : insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man
TL;DR: The correlation of the model's estimates with patient data accords with the hypothesis that basal glucose and insulin interactions are largely determined by a simple feed back loop.
Journal ArticleDOI
Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans.
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TL;DR: It is concluded that QUICKI is an index of insulin sensitivity obtained from a fasting blood sample that may be useful for clinical research.
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Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity.
Enzo Bonora,Giovanni Targher,Maria Alberiche,Riccardo C. Bonadonna,F. Saggiani,M. Zenere,T Monauni,Michele Muggeo +7 more
TL;DR: The HOMA can be reliably used in large-scale or epidemiological studies in which only a fasting blood sample is available to assess insulin sensitivity and there is good agreement between the two methods in the categorization of subjects according to insulin sensitivity.
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TL;DR: From a single glucose injection it is possible to obtain a quantitative index of insulin sensitivity that may have clinical applicability, and this index was defined as the ratio of two parameters of the chosen model and could be estimated with good reproducibility from the 300 mg/kg injection experiments.
Journal Article
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