HOMA index (insulin/glucose ratio)
Why this test?
To assess the development of insulin resistance. To assess the risk of developing diabetes, atherosclerosis, and cardiovascular diseases. For a comprehensive assessment of the possible development of insulin resistance in metabolic syndrome, polycystic ovaries, chronic renal failure, chronic hepatitis B and C, liver steatosis.
In what cases is it prescribed?
When assessing the risk of development and clinical manifestations of arterial hypertension, coronary heart disease, ischemic stroke, type 2 diabetes, atherosclerosis. In complex diagnostics, when insulin resistance is suspected in metabolic syndrome, polycystic ovaries, chronic renal failure, chronic hepatitis B and C, nonalcoholic steatosis of the liver, gestational diabetes, infectious diseases, and the use of certain medications.
Insulin resistance is a decrease in the sensitivity of insulin-dependent cells to the action of insulin with subsequent disruption of glucose metabolism and its entry into cells.
The development of insulin resistance is due to a combination of metabolic and hemodynamic disorders against the background of inflammatory processes and genetic predisposition to diseases. At the same time, the risk of diabetes, cardiovascular diseases, metabolic disorders, and metabolic syndrome increases. Insulin is a peptide hormone that is synthesized from proinsulin by the beta cells of the islets of Langerhans of the pancreas. Insulin is involved in the transport of glucose from the blood into tissue cells, in particular muscle and fat cells.
The hormone also activates glycolysis and the synthesis of glycogen and fatty acids in liver cells, reduces lipolysis and ketogenesis, participates in the accumulation of energy compounds in cells and their use in metabolic processes.
With the development of resistance of cells and tissues to insulin, its concentration in the blood increases, which leads to an increase in the concentration of glucose. As a result, the development of type 2 diabetes, atherosclerosis, including coronary vessels, arterial hypertension, coronary heart disease, and ischemic stroke is possible.
The HOMA-IR index (Homeostasis Model Assessment of Insulin Resistance) can be used to assess insulin resistance. It is calculated according to the formula: HOMA-IR = fasting insulin (μU / ml) x fasting glucose (mmol / l) / 22.5. An increase in HOMA-IR values is noted when fasting glucose or insulin levels increase. This corresponds to an increase in the resistance of cells and tissues to insulin and an increased risk of developing type 2 diabetes and cardiovascular diseases.
The index of insulin resistance can be used as an additional diagnostic indicator of metabolic syndrome. Metabolic syndrome is a complex of risk factors for cardiovascular diseases, type 2 diabetes, atherosclerosis, steatosis of the liver and some types of cancer.
As a result, a complex of metabolic, hormonal and clinical disorders develops against the background of obesity as a result of the development of insulin resistance. The HOMA-IR index is an informative indicator of the development of impaired glucose tolerance and diabetes in patients with a glucose level below 7 mmol/l.
Also, the calculation of this indicator can be used when the development of insulin resistance is suspected in women with polycystic ovary syndrome, gestational diabetes, chronic renal failure, chronic hepatitis B and C, steatosis of the liver of non-alcoholic etiology, a number of infectious, oncological, autoimmune diseases and therapy with some medicines (glucocorticoids, oral contraceptives and others).