The threshold value for identifying insulin resistance (HOMA-IR) in an admixed adolescent population: A hyperglycemic clamp validated study
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...
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| Format: | Article |
| Language: | English |
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Brazilian Society of Endocrinology and Metabolism
2023-01-01
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| Series: | Archives of Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972023000100119&tlng=en |
| _version_ | 1797938704351756288 |
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| author | Cleliani de Cassia da Silva Mariana Porto Zambon Ana Carolina Junqueira Vasques Daniella Fernandes Camilo Maria Ângela Reis de Góes Monteiro Antonio Bruno Geloneze |
| author_facet | Cleliani de Cassia da Silva Mariana Porto Zambon Ana Carolina Junqueira Vasques Daniella Fernandes Camilo Maria Ângela Reis de Góes Monteiro Antonio Bruno Geloneze |
| author_sort | Cleliani de Cassia da Silva |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-10T19:03:49Z |
| format | Article |
| id | doaj.art-ccc0aa47d17841c08ac82ea98f05864e |
| institution | Directory Open Access Journal |
| issn | 2359-4292 |
| language | English |
| last_indexed | 2024-04-10T19:03:49Z |
| publishDate | 2023-01-01 |
| publisher | Brazilian Society of Endocrinology and Metabolism |
| record_format | Article |
| series | Archives of Endocrinology and Metabolism |
| spelling | doaj.art-ccc0aa47d17841c08ac82ea98f05864e2023-01-31T07:32:39ZengBrazilian Society of Endocrinology and MetabolismArchives of Endocrinology and Metabolism2359-42922023-01-0167111912510.20945/2359-3997000000533The threshold value for identifying insulin resistance (HOMA-IR) in an admixed adolescent population: A hyperglycemic clamp validated studyCleliani de Cassia da Silvahttps://orcid.org/0000-0001-5503-9533Mariana Porto Zambonhttps://orcid.org/0000-0002-7113-3068Ana Carolina Junqueira Vasqueshttps://orcid.org/0000-0001-9222-1107Daniella Fernandes Camilohttps://orcid.org/0000-0002-4482-1885Maria Ângela Reis de Góes Monteiro Antoniohttps://orcid.org/0000-0002-7290-7950Bruno Gelonezehttps://orcid.org/0000-0002-0557-4578ABSTRACT 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972023000100119&tlng=enHomeostasis model assessmentinsulin resistanceglucose clamp techniqueadolescents |
| spellingShingle | Cleliani de Cassia da Silva Mariana Porto Zambon Ana Carolina Junqueira Vasques Daniella Fernandes Camilo Maria Ângela Reis de Góes Monteiro Antonio Bruno Geloneze The threshold value for identifying insulin resistance (HOMA-IR) in an admixed adolescent population: A hyperglycemic clamp validated study Archives of Endocrinology and Metabolism Homeostasis model assessment insulin resistance glucose clamp technique adolescents |
| title | The threshold value for identifying insulin resistance (HOMA-IR) in an admixed adolescent population: A hyperglycemic clamp validated study |
| title_full | The threshold value for identifying insulin resistance (HOMA-IR) in an admixed adolescent population: A hyperglycemic clamp validated study |
| title_fullStr | The threshold value for identifying insulin resistance (HOMA-IR) in an admixed adolescent population: A hyperglycemic clamp validated study |
| title_full_unstemmed | The threshold value for identifying insulin resistance (HOMA-IR) in an admixed adolescent population: A hyperglycemic clamp validated study |
| title_short | The threshold value for identifying insulin resistance (HOMA-IR) in an admixed adolescent population: A hyperglycemic clamp validated study |
| title_sort | threshold value for identifying insulin resistance homa ir in an admixed adolescent population a hyperglycemic clamp validated study |
| topic | Homeostasis model assessment insulin resistance glucose clamp technique adolescents |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972023000100119&tlng=en |
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