Diabetes Metab J.  2016 Aug;40(4):318-325. 10.4093/dmj.2016.40.4.318.

Comparison of the Usefulness of the Updated Homeostasis Model Assessment (HOMA2) with the Original HOMA1 in the Prediction of Type 2 Diabetes Mellitus in Koreans

• Song YS
• Hwang YC
• Ahn HY
• Park CY

• KMID: 2368519
• DOI: http://doi.org/10.4093/dmj.2016.40.4.318

Abstract

BACKGROUND
The original homeostasis model assessment (HOMA1) and the updated HOMA model (HOMA2) have been used to evaluate insulin resistance (IR) and β-cell function, but little is known about the usefulness of HOMA2 for the prediction of diabetes in Koreans. The aim of this study was to demonstrate the usefulness of HOMA2 as a predictor of type 2 diabetes mellitus in Koreans without diabetes.
METHODS
The study population consisted of 104,694 Koreans enrolled at a health checkup program and followed up from 2001 to 2012. Participants were divided into a normal glucose tolerance (NGT) group and a pre-diabetes group according to fasting glucose and glycosylated hemoglobin levels. Anthropometric and laboratory data were measured at the baseline checkup, and HOMA values were calculated at the baseline and follow-up checkups. The hazard ratios (HRs) of the HOMA1 and HOMA2 values and the prevalence of diabetes at follow-up were evaluated using a multivariable Cox proportional hazards model and Kaplan-Meier analysis.
RESULTS
After adjusting for several diabetes risk factors, all of the HOMA values except 1/HOMA1-β and 1/HOMA2-β in the NGT group were significant predictors of the progression to diabetes. In the NGT group, there was no significant difference in HOMA1-IR (HR, 1.09; 95% confidence interval [CI], 1.04 to 1.14) and HOMA2-IR (HR, 1.11; 95% CI, 1.04 to 1.19). However, in the pre-diabetes group, 1/HOMA2-β was a more powerful marker (HR, 1.29; 95% CI, 1.26 to 1.31) than HOMA1-IR (HR, 1.23; 95% CI, 1.19 to 1.28) or 1/HOMA1-β (HR, 1.14; 95% CI, 1.12 to 1.16). In the non-diabetic group (NGT+pre-diabetes), 1/HOMA2-β was also a stronger predictor of diabetes (HR, 1.27; 95% CI, 1.25 to 1.29) than HOMA1-IR (HR, 1.14; 95% CI, 1.12 to 1.15) or 1/HOMA1-β (HR, 1.13; 95% CI, 1.11 to 1.14).
CONCLUSION
HOMA2 is more predictive than HOMA1 for the progression to diabetes in pre-diabetes or non-diabetic Koreans.

Keyword

Homeostasis model assessment 1; Homeostasis model assessment 2; Insulin resistance; Insulin secretion

MeSH Terms

Diabetes Mellitus, Type 2*
Fasting
Follow-Up Studies
Glucose
Hemoglobin A, Glycosylated
Homeostasis*
Insulin Resistance
Kaplan-Meier Estimate
Prevalence
Proportional Hazards Models
Risk Factors
Glucose

Figure

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  Fig. 1 Kaplan-Meier curves for the cumulative prevalence of type 2 diabetes mellitus for the quartile of homeostasis model assessment (HOMA) values. (A) In the normal glucose tolerance group. (B) In the pre-diabetic group. (C) In the non-diabetic group. In each figure, the 1Q group is displayed in gray, the 2Q group is displayed in blue, the 3Q group in black, and the highest quartile in red. IR, insulin resistance.

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