Determining Insulin Resistance Cutoffs in Mexican Adults: Percentile Distribution vs. Receiver Operating...

Area of Science:

• Endocrinology
• Metabolic Health
• Clinical Diagnostics

Background:

• Insulin resistance (IR) is a critical factor in metabolic syndrome (MetS), type 2 diabetes, and cardiovascular disease.
• The Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) is a common tool for estimating IR.
• Optimal HOMA-IR cutoff values for risk identification lack consensus.

Purpose of the Study:

• To compare percentile distributions and receiver operating characteristic (ROC) curve analysis for determining HOMA-IR cutoffs.
• To establish optimal HOMA-IR cutoff values in a Mexico City population.
• To assess the efficacy of different methodologies for early IR detection.

Main Methods:

• Cross-sectional study of 765 adults in Mexico City.
• Comparison of HOMA-IR values using the 75th percentile in a healthy reference group and ROC curve analysis in a MetS group.
• Determination of optimal cutoffs using the Youden index.

Main Results:

• The 75th and 90th HOMA-IR percentiles were 2.72 and 3.71, respectively.
• ROC curve analysis produced higher cutoff values for MetS diagnosis than the percentile method.
• The percentile-based approach facilitated earlier identification of at-risk individuals, including those without overt MetS.

Conclusions:

• Methodologies for HOMA-IR cutoff determination yield variable results, underscoring the need for population-specific values.
• A percentile-based approach is effective for early IR detection and preclinical intervention.
• Percentile-based cutoffs offer a practical tool for enhanced risk assessment and clinical decision-making.