Use of HOMA-IR to diagnose non-alcoholic fatty liver disease: a population-based and inter-laboratory study

被引：102

作者：

Isokuortti, Elina ^{[1
,2
,3
]}

Zhou, You ^{[4
,5
]}

Peltonen, Markku ^{[6
]}

Bugianesi, Elisabetta ^{[7
]}

Clement, Karine ^{[8
,9
]}

Bonnefont-Rousselot, Dominique ^{[10
,11
,12
]}

Lacorte, Jean-Marc ^{[8
,9
,13
]}

Gastaldelli, Amalia ^{[14
]}

Schuppan, Detlef ^{[15
]}

Schattenberg, Joern M. ^{[16
]}

Hakkarainen, Antti ^{[3
,17
]}

Lundbom, Nina ^{[3
,17
]}

Jousilahti, Pekka ^{[6
]}

Mannisto, Satu ^{[6
]}

Keinanen-Kiukaanniemi, Sirkka ^{[18
]}

Saltevo, Juha ^{[19
]}

Anstee, Quentin M. ^{[20
,21
]}

Yki-Jarvinen, Hannele ^{[1
,2
,3
]}

机构：

[1] Helsinki 2 U, Minerva Fdn, Inst Med Res, Biomedicum, Tukholmankatu 8, FIN-00290 Helsinki, Finland

[2] Univ Helsinki, Dept Med, Helsinki, Finland

[3] Helsinki Univ Hosp, Helsinki, Finland

[4] Cardiff Univ, Syst Immun Univ Res Inst, Cardiff, S Glam, Wales

[5] Cardiff Univ, Sch Med, Div Infect & Immun, Cardiff, S Glam, Wales

[6] Natl Inst Hlth & Welf, Helsinki, Finland

[7] Univ Turin, Div Gastroenterol, Dept Med Sci, Turin, Italy

[8] Hop La Pitie Salpetriere, Inst Cardiometab & Nutr ICAN, Paris, France

[9] UPMC Univ Paris 06, Sorbonne Univ, INSERM, UMR S 1166, Paris, France

[10] La Pitie Salpetriere Charles Foix Univ Hosp, AP HP, Dept Metab Biochem, Paris, France

[11] Paris Descartes Univ, Dept Biochem, Fac Pharm, Paris, France

[12] Paris Descartes Univ, CNRS, INSERM, Fac Pharm,UMR8258,U1022, Paris, France

[13] La Pitie Salpetriere Charles Foix Univ Hosp, AP HP, Dept Endocrine & Oncol Biochem, Paris, France

[14] CNR, Inst Clin Physiol, Cardiometab Risk Lab, Pisa, Italy

[15] Johannes Gutenberg Univ Mainz, Univ Med Ctr, Inst Translat Immunol, Res Ctr Immune Therapy, Mainz, Germany

[16] Johannes Gutenberg Univ Mainz, Univ Med Ctr, Dept Med 1, Mainz, Germany

[17] Univ Helsinki, Helsinki Med Imaging Ctr, Helsinki, Finland

[18] Univ Oulu, Inst Hlth Sci, Oulu, Finland

[19] Cent Finland Cent Hosp, Dept Med, Jyvaskyla, Finland

[20] Newcastle Univ, Inst Cellular Med, Med Sch, Newcastle Upon Tyne, Tyne & Wear, England

[21] Freeman Rd Hosp, Newcastle Tyne Hosp NHS Trust, Liver Unit, Newcastle Upon Tyne, Tyne & Wear, England

来源：

DIABETOLOGIA | 2017年 / 60卷 / 10期

基金：

芬兰科学院;

关键词：

Insulin; Liver fat; NAFLD; PNPLA3; Reference values; HOMEOSTASIS MODEL ASSESSMENT; INSULIN-RESISTANCE; METABOLIC SYNDROME; GLUCOSE-TOLERANCE; HEPATIC STEATOSIS; THRESHOLD VALUE; GENE VARIANT; PNPLA3; PREVALENCE; PATHOGENESIS;

D O I：

10.1007/s00125-017-4340-1

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Aims/hypothesis Recent European guidelines for nonalcoholic fatty liver disease (NAFLD) call for reference values for HOMA-IR. In this study, we aimed to determine: (1) the upper limit of normal HOMA-IR in two population-based cohorts; (2) the HOMA-IR corresponding to NAFLD; (3) the effect of sex and PNPLA3 genotype at rs738409 on HOMA-IR; and (4) inter-laboratory variations in HOMA-IR. Methods We identified healthy individuals in two population-based cohorts (FINRISK 2007 [n = 5024] and the Programme for Prevention of Type 2 Diabetes in Finland [FIN-D2D; n = 2849]) to define the upper 95th percentile of HOMA-IR. Non-obese individuals with normal fasting glucose levels, no excessive alcohol use, no known diseases and no use of any drugs were considered healthy. The optimal HOMA-IR cut-off for NAFLD (liver fat >= 5.56%, based on the Dallas Heart Study) was determined in 368 non-diabetic individuals (35% with NAFLD), whose liver fat was measured using proton magnetic resonance spectroscopy (1H-MRS). Samples from ten individuals were simultaneously analysed for HOMA-IR in seven European laboratories. Results The upper 95th percentiles of HOMA-IR were 1.9 and 2.0 in healthy individuals in the FINRISK (n = 1167) and FIN-D2D (n = 459) cohorts. Sex or PNPLA3 genotype did not influence these values. The optimal HOMA-IR cutoff for NAFLD was 1.9 (sensitivity 87%, specificity 79%). A HOMA-IR of 2.0 corresponded to normal liver fat (<5.56% on H-1-MRS) in linear regression analysis. The 2.0 HOMA-IR measured in Helsinki corresponded to 1.3, 1.6, 1.8, 1.8, 2.0 and 2.1 in six other laboratories. The inter-laboratory CV% of HOMA-IR was 25% due to inter-assay variation in insulin (25%) rather than glucose (5%) measurements. Conclusions/interpretation The upper limit of HOMA-IR in population-based cohorts closely corresponds to that of normal liver fat. Standardisation of insulin assays would be the first step towards definition of normal values for HOMA-IR.

引用

页码：1873 / 1882

页数：10

共 44 条

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