Индекс HOMA (Инсулин, Глюкоза)

HOMA-IR (Homeostasis Model Assessment of Insulin Resistance) estimates insulin resistance from fasting insulin and fasting glucose. The insulin resistance index supports early assessment of impaired insulin action and helps stratify cardiometabolic risk, including the likelihood of type 2 diabetes, atherosclerosis, and cardiovascular disease. The test is also applied in comprehensive evaluation of metabolic syndrome, polycystic ovary syndrome, chronic kidney disease, chronic hepatitis B or C, and nonalcoholic fatty liver disease.

Insulin resistance reflects reduced responsiveness of insulin‑dependent tissues to insulin, leading to impaired glucose uptake and altered glucose metabolism. It arises from interacting metabolic and hemodynamic disturbances against a background of inflammation and genetic predisposition, and it is associated with higher risk of type 2 diabetes, cardiovascular disease, dysmetabolism, and metabolic syndrome. Insulin is a peptide hormone produced from proinsulin by pancreatic beta cells. It facilitates glucose transport into skeletal muscle and adipose tissue, promotes glycolysis and the synthesis of glycogen and fatty acids in the liver, suppresses lipolysis and ketogenesis, and supports energy storage and use in cellular pathways. When tissues become insulin‑resistant, circulating insulin concentrations increase and fasting glucose tends to rise. This state is linked to type 2 diabetes, atherosclerosis (including coronary disease), arterial hypertension, ischemic heart disease, and ischemic stroke. HOMA-IR is calculated as fasting insulin (µU/mL) × fasting glucose (mmol/L) ÷ 22.5. The index increases when either fasting glucose or fasting insulin is elevated and indicates greater insulin resistance with correspondingly higher risk for type 2 diabetes and cardiovascular disease. Population thresholds for insulin resistance by HOMA-IR are commonly defined at the 70th–75th percentile of its cumulative distribution. The index serves as an adjunctive marker of metabolic syndrome and is informative even when fasting glucose is below 7 mmol/L. It may be used when insulin resistance is suspected in polycystic ovary syndrome, gestational diabetes, chronic kidney disease, chronic hepatitis B or C, and nonalcoholic fatty liver disease, as well as in a range of infectious, oncologic, and autoimmune conditions and during therapy with certain drugs (glucocorticoids, oral contraceptives, and others).