Cut-off Values for the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) in Identifying Insulin Resistance and Metabolic Syndrome among the Non-Diabetic Office Staff in Government Departments, Yangon Region

Khin Mi Mi Lay 1*, Han Win 1, Sandar Win 1, Thae Maung Maung 1, May Thazin Hlaing 1, Khaing Lay Mon 2, Mo Mo Win 1, Hlaing Myat Thu 1 & Zaw Than Htun 1

Myanmar Health Sciences Research Journal, Vol. 37, No. 1-3, 2025

Although insulin resistance (IR) is an important risk factor for cardiovascular disease (CVD) and type-2 diabetes mellitus (T2DM), its cut-off values (CVs) are different according to ethnicity, clinical methods of estimation, and metabolic condition of the studied population. The homeostasis model assessment of IR (HOMA-IR) is a validated method to measure IR from fasting glucose and insulin. Specific CVs for HOMA-IR had not yet been studied in Myanmar. This study aimed to investigate the optimal CVs for HOMA-IR to identify IR and metabolic syndrome (MetS) among the non-diabetic office staff. A cross-sectional study was conducted at the five Government Departments in Yangon Region during March-July, 2023. Among (400) volunteers who gave written consents, non-diabetic men and women, aged between ≥35 and <62 years old with HbA1c <6.5%, and those who are not taking anti-diabetic medications were selected. Anthropometric and blood pressure measurements were done by using standard procedures. 

Insulin resistance (IR) is a condition in which peripheral tissue become non-responsive to the effect of insulin.¹ MetS, a cluster of clinical signs, plays as a major pathophysiological factor in the development of many common non-communicable diseases (NCDs) such as atherosclerotic CVD and T2DM.^2,3 The prevalence of MetS has been investigated in 2020 by a community based cross-sectional study and it was about (29.1%) in Yangon Region.⁴ Most individuals with MetS exhibit IR. Insulin facilitates the transport of glucose into cells for energy production. 

A cross-sectional study was conducted during March-July, 2023 at the five Government Departments in Yangon Region: Department of Medical Research (DMR), Yangon City Development Committee, University of Medicine (2), Yangon, University of Medicine (1), Yangon, Institute of Sports and Physical Education, Yangon.

In the present study, strong association was found between IR and cardio-metabolic risk markers as shown in Table 3. These findings support the evidence that individual with IR has increased cardio-metabolic risk than those without IR in the non-diabetes adults. The optimal CVs for HOMA-IR (HOMA-IR ≥2.47) investigated to differentiate normal from impaired insulin sensitivity was consis- tent with those of Chinese, Portuguese, and Brazilian adults, however, it was slightly higher than that of Siamese and slightly lower than those of Korean and Spanish Table 4. 

The authors would like to acknowledge the followings: Rector, University of Medicine (1), Rector, University of Medicine (2), Headmaster, Institute of Sports and Physical Education, Yangon, Head of Department, Yangon City Development Committee, Academic Committee, DMR and All participants in the present study.

There were no competing interests.

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2.       Abdelhamid A, Zidoum H, Zadjali F, Hedjam R, Al-Ansari A, Bayoumi R, et al. Estimate of the HOMA-IR cut-off value for identifying subjects at risk of insulin resistance using a machine learning approach. Sultan Qaboos University Medical Journal 2021; 21(4):
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