Insulin resistance index (HOMA-IR) in the differentiation of patients with non-alcoholic fatty liver disease and healthy individuals
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CONTEXT: Due to its good correlation to glycemic clamp, HOMA-IR has been widely utilized as insulin resistance index in clinical and epidemiological studies involving non-alcoholic fatty liver disease carriers. However, values used for this parameter have shown large variability. OBJECTIVE: To identify the HOMA-IR cut value that best distinguishes non-diabetic non-alcoholic fatty liver disease patients from a control group. METHODS: One hundred sixteen non-alcoholic fatty liver disease patients were studied, diagnosed by clinical, biochemical, and liver image or biopsy criteria, and 88 healthy individuals, without any liver disease and testing for oral glucose tolerance within normality. These groups did not differ in age and gender. All were submitted to oral glucose tolerance test and blood samples were collected for glucose and insulin measurements by immunofluorometric method. HOMA-IR was calculated according to the formula: fasting insulin (µU/L) x fasting glucose (nmol/L)/22.5. RESULTS: NAFLD patients showed higher insulin, glycemia, and HOMA-IR values than control group, even when excluding glucose intolerant and diabetes mellitus patients by their glycemic curves. HOMA-IR 75th percentile for control group was 1.78 and the best area under the curve index was obtained for HOMA-IR values of 2.0 [AUC= 0.840 (0.781-0.899 CI 95%), sensitivity (Se): 85%, specificity (Sp): 83%] while value 2.5 showed best specificity without important loss in sensitivity [AUC=0,831 (0.773-0.888) Se = 72%, Sp = 94%]. CONCLUSION: HOMA-IR values above or equal to 2.0 or 2.5 show enhanced diagnostic value in distinguishing non-alcoholic fatty liver disease carriers from control group individuals.
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Previous proposed scoring systems have identified persons with overweight or obesity at risk of SO.
“Previous proposed scoring systems have identified persons with overweight or obesity at risk of SO [16, 33].”
From Sarcopenic Obesity Phenotype Index (SOP <i>i</i> ): A Population‐Based Study (2025) · cites this paper as [33]
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- Authors
- Salgado, A. L. F. D. A., Carvalho, L. D., Oliveira, A. C., Santos, V. N. D., Vieira, J. G., & Parise, E. R.
- Affiliations
- Universidade Federal de São Paulo, Brazil
- Universidade Federal de São Paulo (BR)
- Venue
- Arquivos de Gastroenterologia
- Publisher
- FapUNIFESP (SciELO)
- Published
- 2010-06
- Volume
- 47
- Issue
- 2
- Pages
- 165-169
- ISSN
- 0004-2803 (ISSN-L)
- OpenAlex
- W2156773567
- Cited by
- 315
- References
- 31
- Citations by year
- 2026: 13 · 2025: 24 · 2024: 38 · 2023: 40 · 2022: 34 · 2021: 40 · 2020: 27 · 2019: 26 · 2018: 17 · 2017: 16 · 2016: 15 · 2015: 11 · 2014: 3 · 2013: 7 · 2012: 2
- FWCI
- 2.56
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc
- Locations
- Arquivos de Gastroenterologia (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- Americanae (AECID Library) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Keywords
- HOMA-IR, insulin resistance, non-alcoholic fatty liver disease, diagnostic thresholds, fasting insulin, fasting blood glucose, oral glucose tolerance test, diagnostic accuracy, non-diabetic patients
- MeSH terms
- Adult, Blood Glucose, Diagnosis, Differential, Fasting, Fatty Liver, Female, Homeostasis, Humans, Insulin Resistance, Male, Reference Values, Fluoroimmunoassay, Case-Control Studies
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