Homeostatic model assessment of adiponectin (HOMA-Adiponectin) as a surrogate measure of insulin resistance in adolescents: Comparison with the hyperglycaemic clamp and homeostatic model assessment of insulin resistance

Abstract

BackgroundStudies on adults have reported inverse association between the homeostatic model assessment (HOMA) of adiponectin (HOMA-Adiponectin) and the insulin resistance assessed by the glucose clamp technique. To our knowledge, in the pediatric population this association has not been previously investigated.ObjectivesTo evaluate the association between the HOMA-Adiponectin and the insulin resistance assessed by the glucose clamp technique in adolescents, and to compare the accuracy of HOMA-Adiponectin and HOMA-insulin resistance (HOMA-IR) for identifying insulin resistance.MethodsThis was a cross-sectional study of 56 adolescents (aged 10–18 years). Insulin resistance was assessed using the HOMA-IR, HOMA-Adiponectin and the hyperglycaemic clamp technique. The clamp-derived insulin sensitivity index, HOMA-Adiponectin, and HOMA-IR were log-transformed to get closer to a normal distribution before analysis.ResultsIn the multivariable linear regression analysis controlling for sex and Tanner stage, HOMA-Adiponectin was inversely associated with the clamp-derived insulin sensitivity index (unstandardized coefficient [B] = -0.441; P < 0.001). After additional adjustment for waist circumference-to-height ratio, this association remained significant (B = -0.349; P = < 0.001). Similar results were observed when HOMA-IR replaced HOMA-Adiponectin in the model (B = -1.049 and B = -0.968 after additional adjustment for waist circumference-to-height ratio); all P < 0.001. The area under the receiver operating characteristic curve for predicting insulin resistance was 0.712 (P = 0.02) for HOMA-Adiponectin and 0.859 (P < 0.0001) HOMA-IR.ConclusionsThe HOMA-Adiponectin was independently associated with insulin resistance and exhibited a good discriminatory power for predicting it. However, it did not show superiority over HOMA-IR in the diagnostic accuracy.

Cut-off Values and Clinical Utility of Surrogate Markers for Insulin Resistance and Beta-Cell Function to Identify Metabolic Syndrome and Its Components among Southern Indian Adults

“…The ideal cut-off value for identifying MetS with the HOMA-AD index was ≥ 6.26. Contrary to our findings, Da Silva et al 32 found that the HOMA-AD (AUC, 0.712) had less detectable accuracy than HOMA-IR (AUC, 0.859). However, they also found that HOMA-AD could discriminate patients with and without IR as well as HOMA-IR.…”

Prevalence of Insulin Resistance and Association With Metabolic Risk Factors and Food Consumption in Adolescents - Recife/Brazil

“…1,22 Researchers recommend the use of the HOMA-IR index to assess IR in epidemiological investigations. 5,23 However, there is no consensus in the literature regarding the cut-off point to use for adolescents, which leads to variations in the prevalence of IR reported. 1,5,24 In the present study, we adopted the 75 th percentile of the HOMA-IR index, which corresponded to 2.27.…”

“…In contrast, this disorder affected more female adolescents in the present study, which is in agreement with the findings of other studies, despite the different cutoff points used for the HOMA-IR index. 1,22,23 The distinction in distribution between genders is due to differences in the changes in body composition between boys and girls and the action of hormones characteristic of the sexual maturation phase. 22 However, we found no significant association between the stages of sexual maturation and the HOMA-IR in the present study.…”

Insulin resistance and type 2 diabetes in children

“…In particular, changes in circulating concentrations of TNF-α, MCP1, and PDGF-BB were consistently correlated with IR in obese children. 67) Da Silva et al 70) examined the accuracy of HOMA-Adiponectin in detecting IR based on the hyperglycemic clamp technique in adolescents. Adiponectin increases fatty-acid oxidation in muscle and liver via activation of AMP-activated protein kinase and peroxisome proliferator-activated receptor alpha mediated by a specific receptor.…”