Use of HOMA-IR to diagnose non-alcoholic fatty liver disease : a population-based and inter-laboratory study

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Isokuortti , E , Zhou , Y , Peltonen , M , Bugianesi , E , Clement , K , Bonnefont-Rousselot , D , Lacorte , J-M , Gastaldelli , A , Schuppan , D , Schattenberg , J M , Hakkarainen , A , Lundbom , N , Jousilahti , P , Mannisto , S , Keinanen-Kiukaanniemi , S , Saltevo , J , Anstee , Q M & Yki-Jarvinen , H 2017 , ' Use of HOMA-IR to diagnose non-alcoholic fatty liver disease : a population-based and inter-laboratory study ' , Diabetologia , vol. 60 , no. 10 , pp. 1873-1882 .

Title: Use of HOMA-IR to diagnose non-alcoholic fatty liver disease : a population-based and inter-laboratory study
Author: Isokuortti, Elina; Zhou, You; Peltonen, Markku; Bugianesi, Elisabetta; Clement, Karine; Bonnefont-Rousselot, Dominique; Lacorte, Jean-Marc; Gastaldelli, Amalia; Schuppan, Detlef; Schattenberg, Joern M.; Hakkarainen, Antti; Lundbom, Nina; Jousilahti, Pekka; Mannisto, Satu; Keinanen-Kiukaanniemi, Sirkka; Saltevo, Juha; Anstee, Quentin M.; Yki-Jarvinen, Hannele
Contributor organization: Clinicum
University of Helsinki
Department of Medicine
Department of Diagnostics and Therapeutics
Palmenia, Helsinki
HUS Medical Imaging Center
HUS Internal Medicine and Rehabilitation
Date: 2017-10
Language: eng
Number of pages: 10
Belongs to series: Diabetologia
ISSN: 0012-186X
Abstract: Aims/hypothesis Recent European guidelines for nonalcoholic fatty liver disease (NAFLD) call for reference values for HOMA-IR. In this study, we aimed to determine: (1) the upper limit of normal HOMA-IR in two population-based cohorts; (2) the HOMA-IR corresponding to NAFLD; (3) the effect of sex and PNPLA3 genotype at rs738409 on HOMA-IR; and (4) inter-laboratory variations in HOMA-IR. Methods We identified healthy individuals in two population-based cohorts (FINRISK 2007 [n = 5024] and the Programme for Prevention of Type 2 Diabetes in Finland [FIN-D2D; n = 2849]) to define the upper 95th percentile of HOMA-IR. Non-obese individuals with normal fasting glucose levels, no excessive alcohol use, no known diseases and no use of any drugs were considered healthy. The optimal HOMA-IR cut-off for NAFLD (liver fat >= 5.56%, based on the Dallas Heart Study) was determined in 368 non-diabetic individuals (35% with NAFLD), whose liver fat was measured using proton magnetic resonance spectroscopy (1H-MRS). Samples from ten individuals were simultaneously analysed for HOMA-IR in seven European laboratories. Results The upper 95th percentiles of HOMA-IR were 1.9 and 2.0 in healthy individuals in the FINRISK (n = 1167) and FIN-D2D (n = 459) cohorts. Sex or PNPLA3 genotype did not influence these values. The optimal HOMA-IR cutoff for NAFLD was 1.9 (sensitivity 87%, specificity 79%). A HOMA-IR of 2.0 corresponded to normal liver fat ( Conclusions/interpretation The upper limit of HOMA-IR in population-based cohorts closely corresponds to that of normal liver fat. Standardisation of insulin assays would be the first step towards definition of normal values for HOMA-IR.
Subject: Insulin
Liver fat
Reference values
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: publishedVersion

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