Homeostasis model assessment of insulin resistance and the risk of cardiovascular events in middle-aged non-diabetic Japanese men

Nakamura, Koshi; Sakurai, Masaru; Miura, Katsuyuki; Morikawa, Yuko; Ishizaki, Masao; Yoshita, Katsushi; Kido, Teruhiko; Naruse, Yuchi; Nakagawa, Hideaki

doi:10.1007/s00125-010-1803-z

Cited by 42 publications

(41 citation statements)

References 49 publications

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“…The present study demonstrated positive relationship between HOMA-IR and ischemic stroke in non-diabetic patients adjusting for traditional risk factors for stroke, which is similar to the studies done by Rundek [6] in western population and Nakamura et al [13] in Asians and in Bruneck study [14]. This finding suggests that IR has alternative pathways directly related to inflammation, atherosclerosis and stroke and IR is considered an important independent marker of stroke risk.…”

Section: Discussionsupporting

confidence: 79%

Insulin Resistance as an Inflammatory Marker for Ischemic Stroke Severity Among Non-Diabetics: A Prospective Study

et al. 2016

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Section: Discussionsupporting

confidence: 79%

Insulin Resistance as an Inflammatory Marker for Ischemic Stroke Severity Among Non-Diabetics: A Prospective Study

et al. 2016

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“…Mounting evidence from the last years supports the importance of the HOMA-IR index as a prognosticator even at values very close to the normal range, i.e., in patients not fitting a diagnosis of T2D. Recent studies demonstrated its independent value in the prediction of CV events in the general adult non-diabetic population [12,13] . In light of these epidemiological findings, our results appear strengthened in their clinical significance, strongly advocating further research in the field.…”

Section: Discussionmentioning

confidence: 98%

A nutraceutical combination improves insulin sensitivity in patients with metabolic syndrome

Affuso¹

2012

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AIM:To test the efficacy of a proprietary nutraceutical combination in reducing insulin resistance associated with the metabolic syndrome (MetS). METHODS:Sixty-four patients with MetS followed at a tertiary outpatient clinic were randomly assigned to receive either placebo or a proprietary nutraceutical combination (AP) consisting of berberine, policosanol and red yeast rice, in a prospective, double-blind, placebo-controlled study. Evaluations were performed at baseline and after 18 wk of treatment. The homeostasis model assessment of insulin resistance (HOMA-IR) index was the primary outcome measure. Secondary endpoints included lipid panel, blood glucose and insulin fasting, after a standard mixed meal and after an oral glucose tolerance test (OGTT), flow-mediated dilation (FM�), and waist circumference. RESULTS:Fifty nine patients completed the study, 2 withdrew because of adverse effects. After 18 wk there was a significant reduction in the HOMA-IR index in the AP group compared with placebo (ΔHOMA respectively -0.6 ± 1.2 vs 0.4 ± 1.9; P < 0.05). Total and low density lipoprotein cholesterol also significantly decreased in the treatment arm compared with placebo (Δlow density lipoprotein cholesterol -0.82 ± 0.68 vs -0.13 ± 0.55 mmol/L; P < 0.001), while triglycerides, high density lipoprotein cholesterol, and the OGTT were not affected. In addition, there were significant reductions in blood glucose and insulin after the standard mixed meal, as well as an increase in FMD (ΔFMD 1.9 ± 4.2 vs 0 ± 1.9 %; P < 0.05) and a significant reduction in arterial systolic blood pressure in the AP arm. CONCLUSION:This short-term study shows that AP has relevant beneficial effects on insulin resistance and many other components of MetS.

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“…There is still no clear cutoff for the definition of insulin resistance based on HOMA-IR, and Japanese subjects have lower levels of HOMA-IR and lower insulin secretion than Western subjects (26,27). A recent prospective study showed that even minimal increases in HOMA-IR levels predicted subsequent cardiovascular events in non-diabetic Japanese men (28). These findings suggest that the HOMA-IR cutoff value proposed by this study may have clinical implications for type 2 diabetes and cardiovascular disease.…”

Section: Discussionmentioning

confidence: 60%

Proposed Cutoff Level of Waist Circumference in Japanese Men: Evaluation by Homeostasis Model Assessment of Insulin Resistance Levels

et al. 2012

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Objective The aim of this study is to propose the cutoff level of waist circumference (WC) on the basis of homeostasis model assessment of insulin resistance (HOMA-IR) levels in order to diagnose metabolic syndrome (MetS). Methods We examined a total of 798 non-diabetic men (40-65 years of age) by using a receiver operating characteristic (ROC) curve to determine the cutoff level that yielded the maximum sensitivity plus specificity. According to the criteria proposed by the International Diabetes Federation (IDF), and the Japanese Society of Internal Medicine (JSIM), subjects with ! 2 metabolic components other than abdominal obesity, were considered to have MetS.Results The overall prevalence rates of IDF-and JSIM-MetS were 17.4% (n=139) and 15.5% (n=124), respectively. The median levels of WC and HOMA-IR were 83.1 [interquartile range (IQR): 78.5-88.4] cm and 0.84 (IQR: 0.61-1.19), respectively. HOMA-IR was highly correlated with each metabolic parameter (each p< 0.05), and in addition, multiple linear regression analysis of HOMA-IR (adjusted R 2 =0.459) showed that WC level was the strongest independent predictors of HOMA-IR level (F=141.1, p<0.05). According to ROC curve analysis, the cutoff level of HOMA-IR for predicting IDF-and JSIM-MetS was 0.92 for both (sensitivity: 79.9% and 78.2%, specificity: 64.9% and 63.6%). Based on the HOMA-IR level, the proposed WC cutoff level was 82.7 cm (sensitivity: 75.4%, specificity: 63.8%). Conclusion This study suggests that WC level should be more strictly managed than current criteria, for preventing the development of MetS in non-diabetic middle-aged Japanese men.

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Homeostasis model assessment of insulin resistance and the risk of cardiovascular events in middle-aged non-diabetic Japanese men

Abstract: Increased HOMA-IR predicted subsequent cardiovascular events in non-diabetic Japanese men. The association was independent of traditional cardiovascular risk factors and other relevant metabolic disorders.

Cited by 42 publications

References 49 publications

Insulin Resistance as an Inflammatory Marker for Ischemic Stroke Severity Among Non-Diabetics: A Prospective Study

Insulin Resistance as an Inflammatory Marker for Ischemic Stroke Severity Among Non-Diabetics: A Prospective Study

A nutraceutical combination improves insulin sensitivity in patients with metabolic syndrome

Proposed Cutoff Level of Waist Circumference in Japanese Men: Evaluation by Homeostasis Model Assessment of Insulin Resistance Levels

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