HOMA-IR (Homeostatic Model Assessment for Insulin Resistance)

Normal values appear to vary greatly by population

HOMA‑IR estimates insulin resistance from fasting glucose and insulin levels.

Fasting glucose

mg/dL

Fasting insulin

mIU/L

Indicazioni d'uso

Identifies insulin resistance in obesity, prediabetes, type 2 diabetes, and MASLD, where it correlates with disease severity and cardiometabolic risk (EASL‑EASD‑EASO MASLD guideline 1 [Level I evidence]).

Useful for baseline metabolic risk stratification, tracking response to lifestyle/pharmacologic therapy, and research settings; not reliable as a screening test for dysglycemia, given low sensitivity/specificity versus OGTT in CAD cohorts (EUROASPIRE V, n=3534 2 [Level II evidence]).

Approfondimenti e precauzioni

Interpreting results requires fasting, but values vary by assay and lack universal cutoffs. Higher values correlate with obesity and MASLD severity and worsen cardiometabolic risk 1 [Level I evidence]. Diagnostic accuracy for dysglycemia is poor and should not replace OGTT in CAD patients 2 [Level II evidence]. Cardiovascular risk rises mainly in prediabetes and diabetes, not normal glucose tolerance 3 [Level I evidence].