Insulin Sensitivity and Insulin Secretion Determined by Homeostasis Model Assessment and Future Risk of Diabetes Mellitus in Korean Men

Eun-Suk Choi; Eun-Jung Rhee; Ji-Hoon Kim; Jong-Chul Won; Cheol-Young Park; Won-Young Lee; Ki-Won Oh; Sung-Woo Park; Sun-Woo Kim

doi:10.4093/kdj.2008.32.6.498

Journal List > Korean Diabetes J > v.32(6) > 1002258

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Choi, Rhee, Kim, Won, Park, Lee, Oh, Park, and Kim: Insulin Sensitivity and Insulin Secretion Determined by Homeostasis Model Assessment and Future Risk of Diabetes Mellitus in Korean Men

Original Article

Korean Diabetes Journal

Korean Diabetes Journal 2008; 32(6): 498-505.

Published online: 31 December 2008

DOI: https://doi.org/10.4093/kdj.2008.32.6.498

Insulin Sensitivity and Insulin Secretion Determined by Homeostasis Model Assessment and Future Risk of Diabetes Mellitus in Korean Men

Eun-Suk Choi, Eun-Jung Rhee, Ji-Hoon Kim, Jong-Chul Won, Cheol-Young Park, Won-Young Lee, Ki-Won Oh, Sung-Woo Park, Sun-Woo Kim

Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Korea.

Corresponding author: hongsiri@hanmail.net

Received 21 August 2008 Accepted 11 November 2008

Abstract

Background

Insulin resistance and progressive pancreatic beta cell dysfunction have been identified as the two fundamental features in the type 2 diabetes. Homeostasis model assessment (HOMA), based on plasma levels of fasting glucose and insulin, has been widely validated and applied for quantifying insulin resistance and secretion. This study was performed to assess the predictive value of HOMA indices for future diabetes risk.

Methods

In 14,976 Korean men, in which medical check-up was performed both in 2002 and 2006 in a university hospital health promotion center in Seoul, Korea, prospective assessment for diabetes risk was assessed. At baseline, anthropometric measurements were done and fasting glucose, insulin, lipid profiles were measured. HOMA-insulin resistance (HOMA-IR) and beta cell function (HOMA β-cell) were calculated from fasting glucose and insulin levels.

Results

After 4 years, 286 subjects (1.9%) were newly diagnosed as diabetes mellitus. These patients (mean age 40.3 years) were age-matched with 632 control subjects (mean age 39.8 years) and diabetes risk was assessed with HOMA indices. Among the parameters, body mass index, fasting glucose and HOMA β-cell were the significant determinants for future diabetes risk. When the subjects were divided into two groups according to the baseline median values of HOMA-IR and HOMA β-cell, and assessed jointly, those with the low HOMA β-cell and high HOMA-IR showed the highest risk for future diabetes (RR 39.065, 95% CI 11.736~130.035, P < 0.01). The subjects with low baseline HOMA β-cell showed higher RR for diabetes than those with high baseline HOMA-IR (4.413 vs. 3.379, P = 0.018, P = 0.051).

Conclusion

High HOMA-IR and low HOMA β-cell were associated with the highest risk for future diabetes in this prospective study of Korean male subjects. These data suggest the value of HOMA indices for diabetes risk in epidemiologic studies in Asian subjects.

Keywords: Diabetes mellitus, HOMA-IR, HOMA β-cell

Figures and Tables

Fig. 1

Selection and entry of study subjects in this study.

Table 1

Baseline characteristics of diabetic case and control subjects

BMI, body mass index; DBP, diastolic blood pressure; HOMA-IR, homeostasis model assessment of insulin resistance; SBP, systolic blood pressure.

Table 2

Multiple logistic regression analysis with newly diagnosed diabetes mellitus as the dependent variable

BMI, body mass index; HOMA-IR, homeostasis model assessment of insulin resistance.

Table 3

Relative risk for future diabetes according to different levels of HOMA-IR and HOMA β-cell

Logistic regression analyses were performed with age, body mass index and smoking included in the model. HOMA-IR, homeostasis model assessmentof insulin resistance.

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