The Homeostasis Model in the San Antonio Heart Study

作者：Steven M. Haffner, Heikki Miettinen, Michael P. Stern · 发表于：Diabetes Care · 年份：1997 · DOI：10.2337/diacare.20.7.1087 · 被引用次数：793 · 研究领域：Diabetes, Cardiovascular Risks, and Lipoproteins、Adipokines, Inflammation, and Metabolic Diseases、Regulation of Appetite and Obesity

OBJECTIVE: Both insulin resistance and decreased insulin secretion have been shown to predict the development of NIDDM. However, methods to assess insulin sensitivity and secretion are complicated and expensive to apply in epidemiological studies. The homeostasis model assessment (HOMA) has been suggested as a method to assess insulin resistance and secretion from the fasting glucose and insulin concentrations. However, this method has not been extensively evaluated, particularly in different ethnic groups. RESEARCH DESIGN AND METHODS: We applied the HOMA model to cross-sectional analyses of the San Antonio Heart Study (n = 2,465). RESULTS: HOMA insulin resistance (IR) was very strongly correlated with fasting insulin (r = 0.98) and HOMA beta-cell function (beta-cell) was moderately correlated with the 30-min increment in insulin concentration over the 30-min increment in glucose concentration (delta I30/delta G30) in an oral glucose tolerance test (OGTT) (r = 0.44). NIDDM was characterized by both high HOMA IR and low HOMA beta-cell function. In Mexican-Americans, HOMA IR in NIDDM subjects was 9.5 compared with 2.7 in normal glucose tolerance (NGT) subjects. In contrast, HOMA beta-cell function showed only small differences in Mexican-Americans (176 NIDDM; 257 NGT). However, the delta I30/delta G30 (pmol/mmol) showed much larger differences (75 NIDDM; 268 NGT). When modeled separately, impaired glucose tolerance (IGT) was characterized by high HOMA IR and high HOMA beta-cell...