Homeostatic model assessment of adiponectin (HOMA-Adiponectin) as a surrogate measure of insulin resistance in adolescents: Comparison with the hyperglycaemic clamp and homeostatic model assessment of insulin resistance.

Cleliani de Cassia da Silva, Mariana Porto Zambon, Ana Carolina Junqueira Vasques, Daniella Fernandes Camilo, Ana Maria De Bernardi Rodrigues, Maria Ângela Reis de Góes Monteiro Antonio, Ana Raimunda Dâmaso, Sergio Tufik, Marco Tulio de Mello, Raquel Munhoz da Silveira Campos, Bruno Geloneze

Journal: PloS one 2019;14(3):e0214081

PMID: 30908521

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Abstract

BACKGROUND

Studies on adults have reported inverse association between the homeostatic model assessment (HOMA) of adiponectin (HOMA-Adiponectin) and the insulin resistance assessed by the glucose clamp technique. To our knowledge, in the pediatric population this association has not been previously investigated.

OBJECTIVES

To evaluate the association between the HOMA-Adiponectin and the insulin resistance assessed by the glucose clamp technique in adolescents, and to compare the accuracy of HOMA-Adiponectin and HOMA-insulin resistance (HOMA-IR) for identifying insulin resistance.

METHODS

This was a cross-sectional study of 56 adolescents (aged 10-18 years). Insulin resistance was assessed using the HOMA-IR, HOMA-Adiponectin and the hyperglycaemic clamp technique. The clamp-derived insulin sensitivity index, HOMA-Adiponectin, and HOMA-IR were log-transformed to get closer to a normal distribution before analysis.

RESULTS

In the multivariable linear regression analysis controlling for sex and Tanner stage, HOMA-Adiponectin was inversely associated with the clamp-derived insulin sensitivity index (unstandardized coefficient [B] = -0.441; P < 0.001). After additional adjustment for waist circumference-to-height ratio, this association remained significant (B = -0.349; P = < 0.001). Similar results were observed when HOMA-IR replaced HOMA-Adiponectin in the model (B = -1.049 and B = -0.968 after additional adjustment for waist circumference-to-height ratio); all P < 0.001. The area under the receiver operating characteristic curve for predicting insulin resistance was 0.712 (P = 0.02) for HOMA-Adiponectin and 0.859 (P < 0.0001) HOMA-IR.

CONCLUSIONS

The HOMA-Adiponectin was independently associated with insulin resistance and exhibited a good discriminatory power for predicting it. However, it did not show superiority over HOMA-IR in the diagnostic accuracy.

Address: Laboratory of Investigation on Metabolism and Diabetes (Limed), Gastroenterological Diagnosis and Research Center (Gastrocentro), University of Campinas - Unicamp, Campinas, São Paulo, Brazil.; Postgraduate Program in Child and Adolescent Health, Faculty of Medical Sciences, University of Campinas - Unicamp, Campinas, São Paulo, Brazil.; Postgraduate Program in Child and Adolescent Health, Faculty of Medical Sciences, University of Campinas - Unicamp, Campinas, São Paulo, Brazil.; Department of Pediatrics, University of Campinas - Unicamp, Campinas, São Paulo, Brazil.; Laboratory of Investigation on Metabolism and Diabetes (Limed), Gastroenterological Diagnosis and Research Center (Gastrocentro), University of Campinas - Unicamp, Campinas, São Paulo, Brazil.; Postgraduate Program in Child and Adolescent Health, Faculty of Medical Sciences, University of Campinas - Unicamp, Campinas, São Paulo, Brazil.; School of Applied Sciences, University of Campinas - Unicamp, Limeira, São Paulo, Brazil.; Laboratory of Investigation on Metabolism and Diabetes (Limed), Gastroenterological Diagnosis and Research Center (Gastrocentro), University of Campinas - Unicamp, Campinas, São Paulo, Brazil.; School of Health and Life Sciences, University Center Our Lady of Patronage, Itu, São Paulo, Brazil.; Postgraduate Program of Nutrition, Federal University of São Paulo - Unifesp, São Paulo, São Paulo, Brazil.; Department of Psychobiology, Federal University of São Paulo - Unifesp, São Paulo, São Paulo, Brazil.; Department of Psychobiology, Federal University of São Paulo - Unifesp, São Paulo, São Paulo, Brazil.; School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.; Department of Physiotherapy, Therapeutic Resources Laboratory, Federal University of São Carlos - UFSCar, São Carlos, São Paulo, Brazil.

DOI: 10.1371/journal.pone.0214081

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MeSH Terms: Adiponectin, Adolescent, Child, Cross-Sectional Studies, Female, Glucose Clamp Technique, Homeostasis, Humans, Insulin Resistance, Male, Models, Biological