- Homeostatic model assessment
The homeostatic model assessment (HOMA) is a method used to quantify
insulin resistanceand beta-cellfunction. It was first described under the name HOMA by Matthews "et al" in 1985.
The HOMA authors used data from physiological studies to develop mathematical equations describing glucose regulation as a feedback loop. [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.] 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. [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.] 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. [Wallace et al. (2004) "Use and Abuse of HOMA modeling." Diabetes Care 27:1487–95.] [Levy et al. (1998) "Correct Homeostasis Model Assessment (HOMA) Evaluation uses the computer program." Diabetes Care 21: 2191–2.]
The HOMA model was originally designed as a special case of a more general model called HOMA-CIGMA. [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]
The approximating equation for insulin resistance, in the early model, used a fasting blood sample, and was derived by use of the
insulin- glucoseproduct, divided by a constant:
::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. [ 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] [ Hermans et al. (1999b) "Comparison of insulin sensitivity tests across a range of glucose tolerance from normal to diabetes" Diabetologia 42: 678–87] [Wallace et al. (2004) "Use and Abuse of HOMA modeling." Diabetes Care 27:1487–95.]
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