Homeostatic model assessment

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The homeostatic model assessment (HOMA) is a method used to quantify insulin resistance and beta-cell function. It was first described under the name HOMA by Matthews et al in 1985.

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[edit] Derivation

The HOMA authors used data from physiological studies to develop mathematical equations describing glucose regulation as a feedback loop.[1] They published computer software that solves the equations, so that insulin resistance and beta-cell function can be estimated from fasting glucose and insulin levels. They also published an equation (see below) that gave approximately the same answers as an early version of the computer software.[2] The computer model has since been improved to better reflect human physiology and recalibrated to modern insulin assays, and the developers have written that they recommend the computer software be used wherever possible.[3][4]

[edit] Notes

The HOMA model was originally designed as a special case of a more general model called HOMA-CIGMA.[5]

The approximating equation for insulin resistance, in the early model, used a fasting blood sample, and was derived by use of the insulin-glucose product, divided by a constant:

\frac{\mbox{Glucose} \times \mbox{Insulin}}{405}
where Glucose is given in mg/dL and Insulin is given in μU/mL.

In this equation, one should use the constant 22.5 instead of 405 if the glucose is reported in mmol/L. This model correlated well with estimates using the euglycemic clamp method (r = 0.88).

The authors have tested HOMA extensively against other measures of insulin resistance (or its reciprocal, insulin sensitivity) and beta-cell function.[6][7][8]


[edit] References

  1. ^ Turner et al. (1979) Insulin deficiency and insulin resistance interaction in diabetes: estimation of their relative contribution by feedback analysis from basal plasma insulin and glucose concentrations. Metabolism 28: 1086–96.
  2. ^ Matthews et al. (1985) Homeostasis model assessment: insulin resistance and B-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28: 412–9.
  3. ^ Wallace et al. (2004) Use and Abuse of HOMA modeling. Diabetes Care 27:1487–95.
  4. ^ Levy et al. (1998) Correct Homeostasis Model Assessment (HOMA) Evaluation uses the computer program. Diabetes Care 21: 2191–2.
  5. ^ Turner et al. (1993) Measurement of insulin resistance and beta-cell function: the HOMA and CIGMA approach. Current topics in diabetes research (eds) F. Belfiore, R. Bergman and G. Molinatti Front Diabetes. Basel, Karger 12: 66–75
  6. ^ Hermans et al. (1999) Comparison of tests of β-cell function across a range of glucose tolerance from normal to diabetes. Diabetes 48: 1770–86
  7. ^ Hermans et al. (1999b) Comparison of insulin sensitivity tests across a range of glucose tolerance from normal to diabetes Diabetologia 42: 678–87
  8. ^ Wallace et al. (2004) Use and Abuse of HOMA modeling. Diabetes Care 27:1487–95.

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