Optimal Cut-Offs of Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) to Identify Dysglycemia and Type 2 Diabetes Mellitus: A 15-Year Prospective Study in Chinese
Open accessAbstract
BACKGROUND: The optimal reference range of homeostasis model assessment of insulin resistance (HOMA-IR) in normal Chinese population has not been clearly defined. Here we address this issue using the Hong Kong Cardiovascular Risk Factor Prevalence Study (CRISPS), a prospective population-based cohort study with long-term follow-up. MATERIAL & METHODS: In this study, normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) were defined according to the 1998 World Health Organization criteria. Dysglycemia referred to IFG, IGT or T2DM. This study comprised two parts. Part one was a cross-sectional study involving 2,649 Hong Kong Chinese subjects, aged 25-74 years, at baseline CRISPS-1 (1995-1996). The optimal HOMA-IR cut-offs for dysglycemia and T2DM were determined by the receiver-operating characteristic (ROC) curve. Part two was a prospective study involving 872 subjects who had persistent NGT at CRISPS-4 (2010-2012) after 15 years of follow-up. RESULTS: At baseline, the optimal HOMA-IR cut-offs to identify dysglyceia and T2DM were 1.37 (AUC = 0.735; 95% confidence interval [CI] = 0.713-0.758; Sensitivity [Se] = 65.6%, Specificity [Sp] = 71.3%] and 1.97 (AUC = 0.807; 95% CI = 0.777-0.886; Se = 65.5%, Sp = 82.9%) respectively. These cut-offs, derived from the cross-sectional study at baseline, corresponded closely to the 75th (1.44) and 90th (2.03) percentiles, respectively, of the HOMA-IR reference range derived from the prospective study of subjects with persistent NGT. CONCLUSIONS: HOMA-IR cut-offs, of 1.4 and 2.0, which discriminated dysglycemia and T2DM respectively from NGT in Southern Chinese, can be usefully employed as references in clinical research involving the assessment of insulin resistance.
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In a cross-sectional study of middle-aged Chinese people, Lee et al. found that a HOMA-IR cut-off of 1.97 was able to discriminate nondiabetics from diabetics.
“In a cross-sectional study of middle-aged Chinese people, Lee et al. found that a HOMA-IR cut-off of 1.97 was able to discriminate nondiabetics from diabetics [5].”
From Optimal Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) Cut-Offs: A Cross-Sectional Study in the Czech Population (2019) · cites this paper as [5]
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References 27 · Cited by 114
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- Authors
- Lee, C. H., Shih, A. Z. L., Woo, Y. C., Fong, C. H. Y., Leung, O. Y., Janus, E., Cheung, B. M. Y., & Lam, K. S. L.
- Affiliations
- University of Hong Kong (HK)
- The University of Melbourne (AU)
- Corresponding author
- Lam, K. S. L.
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2016-09-22
- Volume
- 11
- Issue
- 9
- Pages
- e0163424
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC5033570
- OpenAlex
- W2521293947
- Cited by
- 114
- References
- 27
- Citations by year
- 2026: 13 · 2025: 12 · 2024: 9 · 2023: 12 · 2022: 19 · 2021: 20 · 2020: 9 · 2019: 9 · 2018: 10 · 2017: 1
- FWCI
- 6.70
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion, cc-by-nc-nd)
- Funders
- Hong Kong Research Grant Council (GRF780210M)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- HOMA-IR, insulin resistance, cut-off values, type 2 diabetes, dysglycemia, impaired fasting glucose, impaired glucose tolerance, reference values, Hong Kong Chinese, cardiovascular risk factors, diagnostic accuracy
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