HOMA-IR and QUICKI: decide on a general standard instead of making further comparisons

Department of Woman and Child Health, Division of Pediatrics, Karolinska Institute, Stockholm, Sweden.
Acta Paediatrica (Impact Factor: 1.84). 11/2010; 99(11):1735-40. DOI: 10.1111/j.1651-2227.2010.01911.x
Source: PubMed

ABSTRACT To limit further comparisons between the two fasting indices Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) and Quantitative Insulin Sensitivity Check Index (QUICKI), and to examine their robustness in assessing insulin sensitivity.
A total of 191 obese children and adolescents (age 13.9 ± 2.9 years, BMI SDS 6.1 ± 1.6), who had undergone a Frequently Sampled Intravenous Glucose Tolerance Test (FSIVGTT), were included. Receiver operating characteristic curve (ROC) analysis was used to compare indices in detecting insulin resistance and Bland-Altman plots to investigate agreement between three consecutive fasting samples when compared to using single samples.
ROC analysis showed that the diagnostic accuracy was identical for QUICKI and HOMA-IR [area under the curve (AUC) boys 0.80, 95%CI 0.70-0.89; girls 0.80, 0.71-0.88], while insulin had a nonsignificantly lower AUC (boys 0.76, 0.66-0.87; girls 0.75, 0.66-0.84). Glucose did not perform better than chance as a diagnostic test (boys 0.47, 0.34-0.60; girls 0.57, 0.46-0.68). Indices varied with consecutive sampling, mainly attributable to fasting insulin variations (mean maximum difference in HOMA-IR -0.8; -0.9 to -0.7).
Using both HOMA-IR and QUICKI in further studies is superfluous as these indices function equally well as predictors of the FSIVGTT sensitivity index. Focus should be on establishing a general standard for research and clinical purposes.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Atypical antipsychotics have become a common therapeutic option in both schizophrenia and bipolar disorder. However, these medications come with a high risk of metabolic side effects, particularly dyslipidemia and insulin resistance. Therefore, identification of patients who are at increased risk for metabolic side effects is of great importance. The genetics of fatty acid metabolism is one area of research that may help identify such patients. Therefore, in this present study, we aimed to determine the effect of one commonly studied genetic polymorphism from both fatty acid desaturase 1 (FADS1) and FADS2 gene on a surrogate measure of insulin resistance and lipid levels in a metabolically high-risk population of patients largely exposed to atypical antipsychotics. This study used a cross-sectional design, fasting blood draws, and genetic analysis to investigate associations between polymorphisms, haplotypes, and metabolic measures. A total of 320 subjects with schizophrenia (n = 226) or bipolar disorder (n = 94) were included in this study. The mean age of the population was 42.5 years and 45% were male. A significant association between FADS1 and FADS2 haplotypes was found with insulin resistance while controlling for confounders. Further investigation is required to replicate this finding.
    Cardiovascular Psychiatry and Neurology 12/2013; 2013:596945. DOI:10.1155/2013/596945
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Objective: The study aimed to determine the incidence of metabolic syndrome (MS) in a group of Czech obese children, to evaluate the incidence of insulin resistance according to HOMA-IR in this group, and to consider the diagnostic value of HOMA-IR in early MS detection in obese children using the logistic regression models for analyzing the relations between HOMA IR and MS. Subjects and Methods: Anthropometric and laboratory examinations were performed in a group of 274 obese children aged 10-17 years. Results: MS was established in 102 subjects (37%). The presence of insulin resistance according to HOMA-IR >3.16 was ascertained in 53% of the subjects. HOMA-IR limit was exceeded by 70% in the MS (+) group and by 43% in children in the MS (-) (p<0.0001) category. Conclusion: The relatively high incidence of insulin resistance in obese children without MS questions the prevailing diagnostic criteria of, perhaps, falsely excluding some cases of, MS.
    Journal of pediatric endocrinology & metabolism: JPEM 02/2014; DOI:10.1515/jpem-2013-0310 · 0.71 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Studies have indicated that ApoB/ApoA-I ratio is significantly associated with MetS and IR. This study was designedto assess the optimal cutoff values of ApolipoproteinB/ApolipoproteinA-I (ApoB/ApoA-I) ratio for the diagnosis of metabolic syndrome and insulin resistance (IR) in the population of Georgia. The subjects were 1522 Georgians of Caucasian origin aged 18-80 (653 women and 869 men) without diabetes mellitus. MetS was diagnosed using the updated ATP-III definition of the metabolic syndrome. Receiver operating characteristics (ROC) curve analysis was performed to calculate the cutoff values. ROC analysis showed that areas under the curve (AUCs) of ApoB/ApoA-I ratio for the detection of MetS were 0.786±0.025 (95%CI: 0.737-0.834) in women and 0.815±0.017 (95%CI: 0.782-0.847) in men. AUCs of ApoB/ApoA-I ratio for the diagnosis of IR were 0.887±0.019 (95%CI: 0.850-0.924) in women and 0.816±0.022 (95%CI: 0.773-0.860) in men. After adjustment for age, MetS components and low-density lipoprotein cholesterol, odds ratios according to the determined cutoff values of ApoB/ApoA-I ratio were: for MetS – 1.75 in women and 1.18 in men; for IR – 13.61 in women and 7.75 in men.
    International Journal of Sciences: Basic and Applied Research (IJSBAR) 08/2014; 17(2):224-235.