Optimal cut-off point for homeostasis model assessment of insulin resistance to discriminate metabolic syndrome in non-diabetic Japanese subjects

Abstract

We have recently established a 'health-associated' reference interval of homeostasis model assessment of insulin resistance (HOMA-IR) between 0.4 and 2.4. In the present study, the aim was to establish a 'decision-based' limit of HOMA-IR for the discrimination of metabolic syndrome (MetS) in non-diabetic Japanese subjects. The receiver-operating characteristic curve of HOMA-IR for detecting MetS was developed using data from 6868 non-diabetic subjects (3727 men, 3141 women). The optimal cut-off point was determined based on the point that yielded the minimum value of the square root of [(1-sensitivity) 2+(1-specificity) 2]. HOMA-IR=1.7 was determined as the optimal cut-off value, with a sensitivity and specificity of 73.4% and 70.5% for men, and 81.5% and 77.0% for women, respectively. In conclusion, the optimal cut-off value for HOMA-IR to discriminate MetS in non-diabetic Japanese subjects appears to be 1.7. © 2012 Asian Association for the Study of Diabetes and Blackwell Publishing Asia Pty Ltd.