Validation of HOMA-AD index as a surrogate marker of insulin resistance - Brazilian Metabolic Syndrome Study (BRAMS)

Abstract

Rationale: The prevalence of obesity and type 2 diabetes (T2DM) has reached epidemic proportions. Obese individuals are more susceptible to developing insulin resistance (IR), metabolic disorder also characteristic of T2DM. The clamp technique is the reference for evaluation of IR. The index HOMA1-IR (Homeostasis Model Assessment-Insulin Resistance) is a method accessible and easy to apply. HOMA-AD (Homeostasis Model Assessment-Adiponectin) is a new proposal to evaluate RI, aggregating information from the peripheral IR index HOMA1-IR by using the dosage of serum adiponectin to its denominator. The RI presents distinct distribution among ethnic groups and the availability of methods accessible, accurate and validated it is necessary for application in clinical practice and in epidemiological studies.Objectives: To validate the HOMA-AD ahead to clamp technique to identify IR and compare it to substitute methods of RI in a representative sample of the Brazilian populationMaterials and methods: A cross-sectional study, which will be evaluated in 1000 adults of both genders, with different levels of adiposity and glucose tolerance. The RI was assessed by hyperinsulinemic euglycemic clamp technique and hyperglycemic clamp in 10% of the total sample. The methods was assessed replacement IR: HOMA1-IR, HOMA2-IR, HOMA-AD and TYG. We assessed anthropometry, body composition and metabolic syndrome. Will be performed multivariate linear regression analysis, kappa test and ROC analysis.Perspective: validating surrogate index of IR, HOMA-AD, for the Brazilian population will assist in the tracking of IR in epidemiological studies and in clinical practice, monitoring of individuals resistant to insulin and understanding of the etiopathogenic T2DM.