IS IT RELIABLE TO ESTIMATE INSULIN RESISTANCE BY THE METHODS OF HOMA-IR OR QUICKI IN DIFFERENT DISORDERS INCLUDING TYPE 2 DIABETES MELLITUS, OBESITY, NONALCOHOLIC FATTY LIVER DISEASE AND CHRONIC HEPATITIS C?

Aims: Insulin resistance is a very prevalent disturbance in clinical practice and associated with morbidity and mortality. Homeostasis Model Assessment (HOMA) and Quantitative insulin sensitivity check index (QUICKI) are two practical insulin resistance estimating methods. We compared these two methods in different disorders including type 2 diabetes mellitus, obesity, nonalcoholic fatty liver disease and chronic hepatitis C. Materials and methods: Considering the inclusion criterions, total 200 subjects (type 2 diabetics 40, obese 40, nonalcoholic fatty liver disease 40, chronic hepatitis C 40 and control 40) were included the study. All subjects were measured for waist circumference, and body mass index (BMI) calculated. HOMA model for insulin resistance and QUICKI for insulin sensitivity were used. Cut off level for insulin resistance was accepted as >= 2.24; and <0.3469 for HOMA and QUICKI, respectively. Following 12-h fasting, serum glucose (oral glucose tolerance test for non diabetics), insulin, high density lipoprotein (HDL), low density lipoprotein (LDL) and triglycerides were measured. Results: The results of 200 subjects were evaluated. The ages of patients ranged 18 to 73 years. All disease groups showed significantly higher HOMA and lower QUICKI than the control group (p<0.001). The highest HOMA value (4.73 +/- 3.05) was found in type 2 diabetic subjects. QUICKI values of type 2 diabetic group were also significantly lower than the control subjects (p<0.001). Insulin resistance by HOMA were found as 87.5%, 75%, 65%, 55% and 12.5% in type 2 diabetes mellitus, obesity, nonalcoholic fatty liver disease, chronic hepatitis C and control group, respectively. Insulin resistance by QUICKI were found 90%, 82.5%, 72.5%, 60% and 22.5% in type 2 diabetes mellitus, obesity, nonalcoholic fatty liver disease, chronic hepatitis C and control group, respectively. Conclusion: In clinical practice both HOMA and QUICKI are easy and efficient methods to assess the insulin resistance, in type 2 diabetes mellitus, obesity, nonalcoholic fatty liver disease and chronic hepatitis C.