The TyG index was evaluated as a surrogate method for estimation of insulin resistance (IR). TyG index correlated with adiposity, metabolic and atherosclerosis markers related to IR and presented a moderate degree of agreement with hyperglycemic clamp. TyG index represents an accessible tool for assessment of IR in clinical practice.
Neck circumference measurements are an alternative and innovative approach for determining body fat distribution. The NC is positively associated with MetS risk factors, IR and VF, with established cut-off values for the prediction of MetS and IR.
Objective: To investigate cut-off values for HOMA1-IR and HOMA2-IR to identify insulin resistance (IR) and metabolic syndrome (MS), and to assess the association of the indexes with components of the MS. Methods: Nondiabetic subjects from the Brazilian Metabolic Syndrome Study were studied (n = 1,203, 18 to 78 years). The cut-off values for IR were determined from the 90 th percentile in the healthy group (n = 297) and, for MS, a ROC curve was generated for the total sample. Results: In the healthy group, HOMA-IR indexes were associated with central obesity, triglycerides and total cholesterol (p < 0.001).
Objective: To verify the prevalence of metabolic syndrome and insulin resistance in obese
adolescents and its relationship with different body composition indicators. Methods: A cross-sectional study comprising 79 adolescents aged ten to 18 years old. The
assessed body composition indicators were: body mass index (BMI), body fat
percentage, abdominal circumference, and subcutaneous fat. The metabolic syndrome
was diagnosed according to the criteria proposed by Cook et al.
The insulin resistance was determined by the Homeostasis Model Assessment
for Insulin Resistance (HOMA-IR) index for values above 3.16. The
analysis of ROC curves was used to assess the BMI and the abdominal circumference,
aiming to identify the subjects with metabolic syndrome and insulin resistance.
The cutoff point corresponded to the percentage above the reference value used to
diagnose obesity. Results: The metabolic syndrome was diagnosed in 45.5% of the patients and insulin
resistance, in 29.1%. Insulin resistance showed association with HDL-cholesterol
(p=0.032) and with metabolic syndrome
(p=0.006). All body composition indicators were correlated with
insulin resistance (p<0.01). In relation to the cutoff point
evaluation, the values of 23.5 and 36.3% above the BMI reference point allowed the
identification of insulin resistance and metabolic syndrome. The best cutoff point
for abdominal circumference to identify insulin resistance was 40%. Conclusions: All body composition indicators, HDL-cholesterol and metabolic syndrome showed
correlation with insulin resistance. The BMI was the most effective anthropometric
indicator to identify insulin resistance.
RESUMOA disfunção das células-e a resistência insulínica são anormalidades metabólicas inter-relacionadas na etiologia do diabetes tipo 2. Em diversos países, tem sido observado o aumento da prevalência de obesidade e diabetes em associação com a presença da resistência insulínica. Nesse contexto, é útil a mensuração da resistência insulínica e da capacidade funcional das células-nos indivíduos. Os índices Homeostasis Model Assessment (HOMA) têm sido amplamente utilizados, representando uma das alternativas para avaliação desses parâmetros, principalmente por figurarem um método rápido, de fácil aplicação e de menor custo. Esta revisão discute sobre a origem e a evolução dos índices HOMA, bem como as particularidades do método, abordando aspectos relacionados à sua validação e aos pontos de corte existentes para sua interpretação. Beta-cell dysfunction and insulin resistance are interrelated metabolic abnormalities in the aetiology of Type 2 Diabetes. In several countries, increases in the prevalence of obesity and diabetes have been observed in association with the presence of insulin resistance. In this context, measurement of insulin resistance and beta-cell function is useful. The HOMA indexes (Homeostasis Model Assessment) have been widely used, representing an alternative for the evaluation of these parameters, particularly as a fast, easy and cheap method. This review discusses the origin and evolution of the HOMA index, as well as details of the method, analyzing features related to its validation and the cutoff limits for its interpretation.
INTRODUÇÃOA MANUTENÇÃO DA GLICEMIA NORMAL DEPENDE principalmente da capacidade funcional das células-pancreáticas (BcC) em secretar insulina e da sensibilidade tecidual à ação da insulina (SI) (1). A disfunção das células-e a resistência insulínica (RI) são anormalidades metabólicas inter-relacionadas na etiologia do diabetes melito do tipo 2 (DM2) (1,2). A RI caracteriza-se por falhas das células-alvo em responder aos níveis normais de insulina circulantes, revisão ANA CAROLINA J. VASQUES
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