Optimal cut‐off point for homeostasis model assessment of insulin resistance to discriminate metabolic syndrome in non‐diabetic Japanese subjects

We have recently established a ‘health‐associated’ reference interval of homeostasis model assessment of insulin resistance (HOMA‐IR) between 0.4 and 2.4. In the present study, the aim was to establish a ‘decision‐based’ limit of HOMA‐IR for the discrimination of metabolic syndrome (MetS) in non‐diabetic Japanese subjects. The receiver–operating characteristic curve of HOMA‐IR for detecting MetS was developed using data from 6868 non‐diabetic subjects (3727 men, 3141 women). The optimal cut‐off point was determined based on the point that yielded the minimum value of the square root of [(1 – sensitivity)2 + (1 – specificity)2]. HOMA‐IR = 1.7 was determined as the optimal cut‐off value, with a sensitivity and specificity of 73.4% and 70.5% for men, and 81.5% and 77.0% for women, respectively. In conclusion, the optimal cut‐off value for HOMA‐IR to discriminate MetS in non‐diabetic Japanese subjects appears to be 1.7. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2012.00194.x, 2012)