How the parameter is calculated and evaluated
A special mathematical model is used to calculate the index. The formula incorporates fasting blood plasma values: the insulin concentration in µIU/mL is multiplied by the glucose level in mmol/L, after which the resulting product is divided by the constant 22.5.
The critical threshold level is a value equal to or exceeding 2.5. Such a result indicates the development of insulin resistance in body tissues. It is important to consider that in patients with already diagnosed overt diabetes mellitus, the informative and diagnostic value of this calculation is noticeably reduced.
Clinical application in NAFLD
In medical practice, the determination of this parameter has strictly regulated indications. Testing fasting plasma insulin levels followed by index calculation is recommended as a supplementary diagnostic method.
This approach is used in patients with suspected non-alcoholic fatty liver disease if they lack standard cardiometabolic risk factors. This allows for the timely detection of carbohydrate metabolism disorders at a preclinical stage.
Role in the diagnosis of carbohydrate metabolism disorders
The assessment of tissue sensitivity to the hormone is closely related to the differential diagnosis of various types of carbohydrate metabolism disorders. Specifically, in type 2 diabetes mellitus, the pathogenetic basis is precisely the combination of tissue insulin resistance and progressive beta-cell function impairment.
In contrast, type 1 the disease exhibits absolute insulin deficiency, while signs of metabolic syndrome and elevated baseline insulin or C-peptide levels are not typical. Calculated indices help the physician build a complete picture of the patient's metabolic status.
HOMA-IR: multiply fasting insulin and glucose, divide by the fixed standard of 22.5. A figure of 2.5 or higher is a sign of resistance.
Class and exam questions
What HOMA-IR index value is considered normal?
A HOMA-IR value greater than or equal to 2.5 is considered indicative of insulin resistance.
In which clinical cases is the calculation of this index ordered?
The test is recommended as a supplementary method for patients with suspected non-alcoholic fatty liver disease in the absence of major cardiometabolic risk factors.
What are the limitations of the HOMA-IR method?
The diagnostic value of this calculated index is significantly reduced in patients with already established overt diabetes mellitus.
What else to study on this topic
- Biochemical differential diagnosis of type 1 and type 2 diabetes mellitus
- The role of fasting and stimulated C-peptide in assessing insulin secretion
- Features of autoimmune pancreatic beta-cell destruction
- Criteria for metabolic syndrome and their association with insulin resistance
- Other calculated methods for assessing insulin sensitivity, such as QUICKI and the Matsuda index
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