A comparision of HOMA and QUICKI methods for the determination of insulin resistance in different patients groups (Type 2 Diabetes Mellitus, Obesity, Nonalcoholic Fatty Liver Disease, Chronic Hepatitis C) and healthy volunteers

Insulin is a key regulator in glucose homeostasis. Insulin resistance is defined as incomplete response to endogenous and exogenous insulin. Numerous studies have shown that insulin resistance is determined by both genetic and environmental factors. Also insulin resistance plays an important pathophysiological role in type 2 diabetes mellitus, dyslipidaemia, hypertension, coronary artery disease, obesity, nonalcoholic fatty liver disease and chronic hepatitis C.The hyperinsulinemic euglycemic clamp, the gold standart technique for estimation of insulin resistance, is accurate but complex and laborious enough that it is not practical for evaluation large number of populations at risk for insulin resistance. HOMA (Homeostasis model assessment) was developed in 1985 and widely used to predict insulin sensitivity. Katz et al. reported a new accurate index QUICKI (Quantitative insulin sensitvity check index) to assess insulin sensitivity, which better correlated to the gold standart clamp technique than other indexes. HOMA reflects insulin resistance, while QUICKI shows insulin sensitivity.The aim of our study was to show insulin resistance in patients with type 2 diabetes, obesity, nonalcoholic fatty liver disease (NAFLD), chronic hepatitis C compared to healthy individuals. Forty type 2 diabetic patients, 40 obese patients, 40 patients with NAFLD, 40 patients with chronic hepatitis C and 40 healthy subjects were admitted to Cukurova University School of Medicine Gastroenterology, Internal Medicine Department, Endocrinology and Metabolism Division between January 2009 to December 2010 included in the study. All patients were measured for height, weight and waist circumference and calculated for body mass index (BMI). Insulin sensitivity was calculated by using the HOMA index and QUICKI index. We used HOMA model for insulin resistance and QUICKI for insulin sensitivity. Cut off level for insulin resistance was accepted as ? 2,24 for HOMA, <0,3469 for QUICKI. Fasting glucose, insulin, HDL, LDL cholesterol and triglycerides were measured.In this study with smilarity as reported the literatures, we found that subjects with type 2 diabetes, obesity, nonalcoholic fatty liver disease, chronic hepatitis C were characterized by significantly higher insulin resistances (HOMA) and lower insulin sensitivites (QUICKI) indices compared to healthy subjects.Keywords: Insulin resistance, HOMA index, QUICKI index, type 2 diabetes mellitus, obesity, nonalcoholic fatty liver disease, chronic hepatitis C.