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| The '''homeostatic model assessment''' (HOMA) is a method used to quantify [[insulin resistance]] and [[beta-cell]] function. It was first described under the name HOMA by Matthews ''et al.'' in 1985.
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| ==Derivation==
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| The HOMA authors used data from physiological studies to develop mathematical equations describing glucose regulation as a feedback loop. | |
| <ref name="pmid386029">{{cite journal| author=Turner RC, Holman RR, Matthews D, Hockaday TD, Peto J| title=Insulin deficiency and insulin resistance interaction in diabetes: estimation of their relative contribution by feedback analysis from basal plasma insulin and glucose concentrations. | journal=Metabolism | year= 1979 | volume= 28 | issue= 11 | pages= 1086–96 | pmid=386029 | doi=10.1016/0026-0495(79)90146-X | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=386029 }} </ref>
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| They published computer software that solves the equations, so that insulin resistance and β-cell function can be estimated from fasting glucose and insulin levels. They also published an equation (see below) that gave approximately the same answers as an early version of the computer software.
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| <ref name="Mathews1985">{{cite journal| author=Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC| title=Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. | journal=Diabetologia | year= 1985 | volume= 28 | issue= 7 | pages= 412–9 | pmid=3899825 | doi=10.1007/BF00280883 | pmc= | url= }} </ref>
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| The computer model has since been improved to a HOMA2 model<ref name="Rudenski">
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| {{Cite journal
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| | title = Understanding insulin resistance: Both glucose resistance and insulin resistance are required to model human diabetes
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| | journal = Metabolism
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| | volume = 40
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| | issue = 9
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| | pages = 908–917
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| | date = September 1991
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| | issn = 0026-0495
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| | pmid = 1895955
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| | doi = 10.1016/0026-0495(91)90065-5
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| | author = A. S. Rudenski and D. R. Matthews and J. C. Levy and R. C. Turner
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| }}</ref> to better reflect human physiology and recalibrated to modern insulin assays. In this updated version it is possible to determine insulin sensitivity and β-cell function from paired fasting plasma glucose and [[radioimmunoassay]] insulin, specific insulin, or C-peptide concentrations. The authors recommend the computer software be used wherever possible.
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| <ref name="Wallace2004">{{cite journal| author=Wallace TM, Levy JC, Matthews DR| title=Use and abuse of HOMA modeling. | journal=Diabetes Care | year= 2004 | volume= 27 | issue= 6 | pages= 1487–95 | pmid=15161807 | doi=10.2337/diacare.27.6.1487 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15161807 }} </ref>
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| <ref name="pmid9839117">{{cite journal| author=Levy JC, Matthews DR, Hermans MP| title=Correct homeostasis model assessment (HOMA) evaluation uses the computer program. | journal=Diabetes Care | year= 1998 | volume= 21 | issue= 12 | pages= 2191–2 | pmid=9839117 | doi= 10.2337/diacare.21.12.2191| pmc= | url= }} </ref>
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| ==Notes==
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| The HOMA model was originally designed as a special case of a more general model called [[HOMA-CIGMA]].<ref>Turner et al. (1993) ''Measurement of insulin resistance and β-cell function: the HOMA and CIGMA approach.'' Current topics in diabetes research (eds) F. Belfiore, R. Bergman and G. Molinatti Front Diabetes. Basel, Karger 12: 66-75</ref>
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| The approximating equation for insulin resistance, in the early model, used a fasting plasma sample, and was derived by use of the [[insulin]]-[[glucose]] product, divided by a constant: (assuming normal-weight, normal subjects < 35 years, having 100% β-cell function an insulin resistance of 1)
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| {| class="wikitable"
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| | <math>\text{HOMA-IR} = \frac{\text{Glucose} \times \text{Insulin}}{22.5}</math> || <math>\text{HOMA-IR} = \frac{\text{Glucose} \times \text{Insulin}}{405}</math>
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| | <math> \text{HOMA-}\beta = \frac{20 \times \text{Insulin}}{\text{Glucose}-3.5} %</math> || <math> \text{HOMA-}\beta = \frac{360 \times \text{Insulin}}{\text{Glucose}-63} %</math>
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| ! Glucose in [[Blood_glucose#Blood_glucose_measurement_units|Molar Units]] mmol/L !! Glucose in [[Blood_glucose#Blood_glucose_measurement_units|mass units]] mg/dL
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| |}
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| '''IR''' is insulin resistance and ''' %β ''' is the β-cell function.
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| Insulin is given in [[Insulin_therapy#The_dosage_units|mU/L]]. Glucose and insulin are both during fasting.<ref name="Mathews1985"/>
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| This model correlated well with estimates using the [[Insulin_resistance#Measuring_insulin_resistance|euglycemic clamp method]] (r = 0.88).<ref name="Mathews1985"/>
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| The authors have tested HOMA extensively against other measures of insulin resistance (or its reciprocal, insulin sensitivity) and β-cell function.<ref name="Wallace2004"/>
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| <ref name="pmid10480608">{{cite journal| author=Hermans MP, Levy JC, Morris RJ, Turner RC| title=Comparison of tests of beta-cell function across a range of glucose tolerance from normal to diabetes. | journal=Diabetes | year= 1999 | volume= 48 | issue= 9 | pages= 1779–86 | pmid=10480608 | doi= 10.2337/diabetes.48.9.1779| pmc= | url= }} </ref>
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| <ref name="pmid10382587">{{cite journal| author=Hermans MP, Levy JC, Morris RJ, Turner RC| title=Comparison of insulin sensitivity tests across a range of glucose tolerance from normal to diabetes. | journal=Diabetologia | year= 1999 | volume= 42 | issue= 6 | pages= 678–87 | pmid=10382587 | doi=10.1007/s001250051215 | pmc= | url= }} </ref>
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| ==References==
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| {{Reflist}}
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| ==External links==
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| *http://www.ihoma.co.uk
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| {{DEFAULTSORT:Homeostatic Model Assessment}}
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| [[Category:Diabetes]]
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| [[Category:Endocrinology]]
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| [[Category:Human homeostasis]]
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