Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity - Studies in subjects with various degrees of glucose tolerance and insulin sensitivity

QBJECTIVE- To evaluate whether the homeostasis model assessment (HOMA) is a reliable surrogate measure of in vivo insulin sensitivity in humans. RESEARCH DESIGN AND METHODS- In the present stud): we compared insulin sensitivity as assessed by a 4-h euglycemic (similar to 5 mmol/l) hyperinsulinemic (similar to 300 pmol/l) clamp with HOMA in 115 subjects with various degrees of glucose tolerance and insulin sensitivity. RESULTS- We found a strong correlation between clamp-measured total glucose disposal and HOMA-estimated insulin sensitivity (r = -0.820, P < 0.0001), with no substantial differences between men (r = -0.800) and women (r = -0.796), younger (aged <50) years, r = -0.832) and older (r = -0.800) subjects, nonobese (BMT <27 kg/m(2), r = -0.800) and obese (r = -0.765) subjects, nondiabetic (r = -0.754) and diabetic (r = -0.695) subjects, and normotensive ( r = -0.786) and hypertensive (r = -0.762) subjects. Also, we found good agree ment between the two methods in the categorization of subjects according to insulin sensitivity (weighted k = 0.63). CONCLUSIONS- We conclude that the HOMA can be reliably used in large-scale or epidemiological studies in which only a fasting blood sample is available to assess insulin sensitivity.