Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: Studies in subjects with various degrees of glucose tolerance and insulin sensitivity

Abstract

OBJECTIVE — To evaluate whether the homeostasis model assessment (HOMA) is a reli- able surrogate measure of in vivo insulin sensitivity in humans. RESEARCH DESIGN AND METHODS — In the present study, we compared insulin sensitivity as assessed by a 4-h euglycemic ( 5 mmol/l) hyperinsulinemic ( 300 pmol/l) clamp with HOMA in 115 subjects with various degrees of glucose tolerance and insulin sensitivity. RESULTS — We found a strong correlation between clamp-measured total glucose disposal and HOMA-estimated insulin sensitivity (r = 0.820, P 0.0001), with no substantial dif- ferences between men (r = 0.800) and women (r = 0.796), younger (aged 50 years, r = 0.832) and older (r = 0.800) subjects, nonobese (BMI 27 kg/m2, r = 0.800) and obese (r = 0.765) subjects, nondiabetic (r = 0.754) and diabetic (r = 0.695) subjects, and nor- motensive ( r = 0.786) and hypertensive (r = 0.762) subjects. Also, we found good agree- ment between the two methods in the categorization of subjects according to insulin sensitiv- ity (weighted k = 0.63). CONCLUSIONS — We conclude that the HOMA can be reliably used in large-scale or epidemiological studies in which only a fasting blood sample is available to assess in- sulin sensitivity.