HOMA2-B helpful for assessment of type 1 diabetes risk, finds study
USA: Recent data suggest that HOMA2-B may be useful as a single-time-point measurement for stratifying the risk of developing type 1 diabetes (T1D) in autoantibody-positive (Aab+) individuals. The study appears in the journal Diabetologia.
Methods for identifying people at highest risk of type 1 diabetes are important for the successful implementation of disease-modifying interventions. There is a need for simple metabolic measures to help stratify Aab+ people at risk of developing type 1 diabetes. HOMA2-B is a validated mathematical tool used commonly to estimate beta cell function in type 2 diabetes using fasting glucose and insulin. However, the use of HOMA2-B with regard to type 1 diabetes progression has not been tested.
Against the above background, Carmella Evans-Molina, Roudebush VA Medical Center, Indianapolis, IN, USA, and colleagues aimed to assess whether HOMA2-B is associated with risk of type 1 diabetes progression.
The study included individuals enrolled in the TrialNet Pathway to Prevention study. Baseline HOMA2-B values from single-Aab+ (n = 2652; mean age, 21.1 ± 14.0 years) and multiple-Aab+ (n = 3794; mean age, 14.5 ± 11.2 years) were compared. The associations between HOMA2-B tertiles and time to progression to type 1 diabetes were determined after adjusting for age, sex, HLA status and BMI z score. Receiver operating characteristic (ROC) analysis was used to test the association of HOMA2-B with type 1 diabetes development in 1, 2, 5 and 10 years.
Following were the study's key findings:
- At study entry, HOMA2-B values were higher in single- compared with multiple-Aab+ Pathway to Prevention participants (91.1 ± 44.5 vs 83.9 ± 38.9).
- Single- and multiple-Aab+ individuals in the lowest HOMA2-B tertile had a higher risk and faster rate of progression to type 1 diabetes.
- For progression to type 1 diabetes within 1 year, area under the ROC curve (AUC-ROC) was 0.685, 0.666 and 0.680 for all Aab+, single-Aab+ and multiple-Aab+ individuals, respectively.
- When correlation between HOMA2-B and type 1 diabetes risk was assessed in combination with additional factors known to influence type 1 diabetes progression (insulin sensitivity, age and HLA status), AUC-ROC was highest for the single-Aab+ group's risk of progression at 2 years (AUC-ROC 0.723).
"These findings suggest that HOMA2-B may have utility as a single-time-point measurement to stratify risk of type 1 diabetes development in Aab+ individuals," the authors concluded.
Reference:
Felton, J.L., Cuthbertson, D., Warnock, M. et al. HOMA2-B enhances assessment of type 1 diabetes risk among TrialNet Pathway to Prevention participants. Diabetologia 65, 88–100 (2022). https://doi.org/10.1007/s00125-021-05573-6
Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.
NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.