Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.17/1905
Título: Optimal Cut-Off Value for Homeostasis Model Assessment (HOMA) Index of Insulin-Resistance in a Population of Patients Admitted Electively in a Portuguese Cardiology Ward
Outros títulos: Limiar do Índice Homeostasis Model Assessment (HOMA) para Resistência à Insulina numa População de Doentes Admitidos Electivamente numa Enfermaria Portuguesa de Cardiologia
Autor: Timóteo, AT
Miranda, F
Mota Carmo, M
Cruz Ferreira, R
Palavras-chave: HSM MED
HSM PAT CLIN
Glucose Tolerance Test
Homeostasis
Insulin Resistance Metabolic Syndrome
Data: 2014
Editora: Centro Editor e Livreiro da Ordem dos Médicos
Citação: Acta Med Port. 2014 Jul-Aug;27(4):473-9
Resumo: INTRODUCTION: Insulin resistance is the pathophysiological key to explain metabolic syndrome. Although clearly useful, the Homeostasis Model Assessment index (an insulin resistance measurement) hasn't been systematically applied in clinical practice. One of the main reasons is the discrepancy in cut-off values reported in different populations. We sought to evaluate in a Portuguese population the ideal cut-off for Homeostasis Model Assessment index and assess its relationship with metabolic syndrome. MATERIAL AND METHODS: We selected a cohort of individuals admitted electively in a Cardiology ward with a BMI < 25 Kg/m2 and no abnormalities in glucose metabolism (fasting plasma glucose < 100 mg/dL and no diabetes). The 90th percentile of the Homeostasis Model Assessment index distribution was used to obtain the ideal cut-off for insulin resistance. We also selected a validation cohort of 300 individuals (no exclusion criteria applied). RESULTS: From 7 000 individuals, and after the exclusion criteria, there were left 1 784 individuals. The 90th percentile for Homeostasis Model Assessment index was 2.33. In the validation cohort, applying that cut-off, we have 49.3% of individuals with insulin resistance. However, only 69.9% of the metabolic syndrome patients had insulin resistance according to that cut-off. By ROC curve analysis, the ideal cut-off for metabolic syndrome is 2.41. Homeostasis Model Assessment index correlated with BMI (r = 0.371, p < 0.001) and is an independent predictor of the presence of metabolic syndrome (OR 19.4, 95% CI 6.6 - 57.2, p < 0.001). DISCUSSION: Our study showed that in a Portuguese population of patients admitted electively in a Cardiology ward, 2.33 is the Homeostasis Model Assessment index cut-off for insulin resistance and 2.41 for metabolic syndrome. CONCLUSION: Homeostasis Model Assessment index is directly correlated with BMI and is an independent predictor of metabolic syndrome.
Peer review: yes
URI: http://hdl.handle.net/10400.17/1905
Aparece nas colecções:CAR - Artigos
PAT CLIN - Artigos

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