Homa-adiponectin index as useful surrogate marker in the screeening of insulin resistance

Background

The major adverse consequences of obesity are associated with the development of insulin resistance (IR) and adiposopathy. The Homeostasis Model Assessment-Adiponectin (HOMA-AD) was proposed as a modified version of the HOMA-IR, which incorporates adiponectin in the denominator of the index.

Objectives

Evaluate the performance of the HOMA-AD compared with the HOMA-IR as a surrogate marker of IR in women, and to establish the cutoff value of the HOMA-AD.

Materials and methods

The BRAMS is a cross-sectional multicenter survey. The data from 1.062 subjects met the desired criteria: 18-65 yrs. old, BMI: 18.5-49.9 Kg/m² and non-diabetic. The IR was assessed by the indexes HOMA-IR and HOMA-AD (total sample) and by the hyperglycemic clamp (n=49). Metabolic syndrome was defined using the IDF criteria.

Results

For the IR assessed by the clamp, the HOMA-AD demonstrated a stronger coefficient of correlation (r=-0.64) compared with the HOMA-IR (r=-0.56); p<0.0001. In the ROC analysis, compared with the HOMA-IR, the HOMA-AD showed higher values of the AUC for the identification of IR based on the clamp test (AUC: 0.844 vs. AUC: 0.804) and on the metabolic syndrome (AUC: 0.703 vs. AUC: 0.689), respectively; p<0.001 for all. However, the pairwise comparison did not suggest superiority for the HOMA-AD in the diagnostic of IR (p>0.05). The optimal cutoff identified for the HOMA-AD for the diagnosis of IR was 0.51.

Conclusions

HOMA-AD was demonstrated to be a useful surrogate marker for detecting IR among adult women and presented a similar performance as the HOMA-IR.