Jornal Brasileiro de Patologia e Medicina Laboratorial
Print version ISSN 1676-2444
OLIVEIRA, Ernesto Pereira de; SOUZA, Mirabeau Levi Alves de and LIMA, Maria das Dores Acioli de. HOMA (homeostasis model assessment) index in clinical practice: a review. J. Bras. Patol. Med. Lab. [online]. 2005, vol.41, n.4, pp. 237-243. ISSN 1676-2444. http://dx.doi.org/10.1590/S1676-24442005000400004.
INTRODUCTION: Since the 1980s, insulin resistance (IR) has been associated to the risk of cardiovascular disease and type 2 diabetes mellitus. HOMA index is one of the methods used for IR measurement, mainly in epidemiological studies. However, the current state of application of this index in clinical practice, where it should be helpful in the anticipation of preventive intervention, still needs to achieve consensual results. METHOD: A systematic review of the literature, from 2000 to 2004, relating to HOMA index in clinical practice. RESULTS: Among 670 articles where the term HOMA was found, 49 met eligibility criteria. Most of them refer to the index as an outcome measure in therapeutic trials and only a few are designed to evaluate diagnosis tests. DISCUSSION: HOMA index variability reduces the sensitivity and the specificity of the method as much as the discriminant power of the results, which turn to be a limitation for clinical trials. However, it does not prevent the index to be reliably used in population-based epidemiological investigation. CONCLUSION: The results point out the need of establishment of standard conditions to improve the test, better definition of cut-off limits as much as confident criteria for the HOMA index interpretation.
Keywords : Insulin resistance; Metabolic syndrome X; Diagnosis; HOMA.