Médecine interne: libre accès
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Insulin and HOMA-IR in Healthy Young Mexicans: A Cut-off Points Proposal

Miguel Murguía-Romero, J Rafael Jiménez-Flores, A René Méndez-Cruz, Santiago C Sigrist-Flores and Rafael Villalobos-Molina

Background: Insulin resistance is recognized as impairment subjacent in many metabolic disorders, most of them conditioning the development of diabetes mellitus type II. Cut-off points for clinical parameters such as glucose or HDL cholesterol have been established; however there is no consensus for cut-off points for two of the most used parameters to detect insulin resistance: insulin and homeostasis model assessment of insulin resistance (HOMA-IR). The aim of this study is to propose cut-off points for normal blood levels of insulin and HOMA-IR for young Mexicans.  
Methods: A sample of 1,359 young Mexicans (17-24 years old) was studied. The set of metabolic alterations related to metabolic syndrome (MetS) was identified, forming two groups of young: ‘Healthy’ and ‘Non-Healthy’, whether or not they presented one or more of the five alterations according to an international definition of MetS. The cut-off points were calculated using two statistical methods, applying sensitivity analysis, and calculating the percentile 95 of ‘Healthy’ young to obtain normal ranges, and the ‘probability of a correct diagnosis’ was used to assess its efficacy.
  Results: The cut-off point values proposed for young Mexicans are, for insulin 14.0 μU/ml for women and 11.0 μU/ml for men and for HOMA-IR 2.9 for women and 2.3 for men. Conclusions: These upper limits could be useful to detect high risk or presence of metabolic alterations related to the MetS in young Mexicans.
    Conclusions: These upper limits could be useful to detect high risk or presence of metabolic alterations related to the MetS in young Mexicans.