Abstrakt
Introduction: Insulin resistance (IR), a key pathogenesis mechanism of metabolic disorders, can be tested using homeostatic model as-sessment (HOMA). HOMA-IR quantifies peripheral tissue IR, whereas HOMA-i3 determines insulin secretion.
The cross-sectional study aimed to examine non-linear associations of HOMA indices with age when adjusting for body mass index (BMI), and thus to investigate the indices' ability to reflect the real development of glucose metabolism disorders over time.Material and methods: The sample comprised 3406 individuals without diabetes mellitus (DM) divided into those with normal glucose metabolism (NGT, n = 1947) and prediabetes (n = 1459) after undergoing biochemical analyses. Polynomial multiple multivariate regres- sion was applied to objectify associations of HOMA with both age and BMI.Results: Mean values of HOMA-IR and HOMA-i3 in individuals with NGT were 1.5 and 82.8, respectively, while in prediabetics they were 2.2 and 74.3, respectively.
The regression proved an inverse non-linear dependence of pancreatic i3 dysfunction, expressed by HOMA-i3, on age, but did not prove a dependence on age for HOMA-IR. Both indices were positively, statistically significantly related to BMI, with a unit increase in BMI representing an increase in HOMA-IR by 0.1 and in HOMA-i3 by 3.2.Conclusions: The mean values of HOMA indices showed that, compared with NGT, prediabetes is associated with more developed IR but lower insulin secretion.
Both HOMA-IR and HOMA-i3 are predicted by BMI, but only HOMA-i3 is predicted by age. HOMA indices can re-flect non-linear, closer-to-reality dependencies on age, which in many epidemiological studies are simplified to linear ones.
The assessment of glucose metabolism using HOMA indices is beneficial for the primary prevention of IR and thus DM.