Two measures of insulin sensitivity provided similar information in a U.S. population

Two methods for measuring insulin sensitivity, fasting plasma insulin (FPI) and homeostasis model assessment (HOMA) have been proposed for use in large epidemiological research and clinical practice. This project describes the range of observed values of the HOMA and FPI in a large sample of the U.S. population. We used fasting plasma glucose and insulin values from the Third National Health and Nutrition Survey (NHANES III) to identify the FPI and HOMA values. For both FPI and HOMA, higher values indicate lower insulin sensitivity. Among 6,511 participants without treated diabetes mellitus, FPI ranged from 1.8 to 175.8 μU/mL, with 25th percentile = 6.7, median = 9.3, 75th percentile = 13.3, and mean±1 SD = 11.2±7.5; HOMA ranged from 0.3 to 52.6 (mmol)(μU)/L 2, with 25th percentile = 1.5, median = 2.2, 75th percentile = 3.3, and mean±SD = 2.8±2.4. These findings describe the spectrum of insulin sensitivity and may be useful in helping physicians develop a clinical understanding of the dynamic range of both FPI and HOMA measures.