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.
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.
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DOI：
10.4093/dmj.2016.40.4.318
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发表时间：
2016-08
影响因子：
5.9
通讯作者：
Park CY
中科院分区：
文献类型：
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作者：
Song YS;Hwang YC;Ahn HY;Park CY
最初的稳态模型评估（HOMA 1）和更新的HOMA模型（HOMA 2）已被用于评估胰岛素抵抗（IR）和β细胞功能，但对HOMA 2用于预测韩国人糖尿病的有用性知之甚少。本研究的目的是证明HOMA 2作为韩国无糖尿病人群2型糖尿病预测因子的有效性。研究人群包括104，694名参加健康检查计划的韩国人，并在2001年至2012年期间进行了随访。根据空腹血糖和糖化血红蛋白水平，参与者被分为正常葡萄糖耐量（NGT）组和糖尿病前期组。在基线检查时测量人体测量和实验室数据，并在基线和随访检查时计算HOMA值。使用多变量考克斯比例风险模型和Kaplan-Meier分析评价HOMA 1和HOMA 2值的风险比（HR）以及随访时糖尿病的患病率。在调整了几个糖尿病危险因素后，NGT组中除1/HOMA 1-β和1/HOMA 2-β外的所有HOMA值都是糖尿病进展的重要预测因子。在NGT组中，HOMA 1-IR（HR，1.09; 95%置信区间[CI]，1.04 - 1.14）和HOMA 2-IR（HR，1.11; 95% CI，1.04 - 1.19）无显著差异。然而，在糖尿病前期组中，1/HOMA 2-β是比HOMA 1-IR（HR，1.23; 95% CI，1.19 - 1.28）或1/HOMA 1-β（HR，1.14; 95% CI，1.12 - 1.16）更有效的标志物（HR，1.29; 95% CI，1.26 - 1.31）。在非糖尿病组（NGT+糖尿病前期）中，1/HOMA 2-β也是比HOMA 1-IR（HR，1.14; 95%CI，1.12 - 1.15）或1/HOMA 1-β（HR，1.13; 95%CI，1.11 - 1.14）更强的糖尿病预测因子（HR，1.27; 95%CI，1.25 - 1.29）。HOMA 2比HOMA 1更能预测糖尿病前期或非糖尿病韩国人的糖尿病进展。
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. 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. 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). HOMA2 is more predictive than HOMA1 for the progression to diabetes in pre-diabetes or non-diabetic Koreans.