Modelo Homeostático para Evaluar la Resistencia de Insulina y Prevención del Síndrome Metabólico en Adultos
Palabras clave:
síndrome metabólico, resistencia a la insulina, obesidad
Resumen
El síndrome metabólico, un problema de salud pública que afecta a entre el 20% y el 25% de los adultos de todo el mundo, se asocia a complicaciones graves como las enfermedades cardiovasculares y la diabetes de tipo 2. La presente investigación tiene como propósito identificar la importancia del HOMA-IR para el diagnóstico del síndrome metabólico, mediante una revisión bibliográfica, para dar a conocer su utilidad en la práctica clínica en adultos. Basándose en una revisión de estudios recientes, destaca las variaciones en los puntos de corte del HOMA-IR entre distintos países, influidos por factores demográficos y culturales. En Brasil, por ejemplo, se identificó un valor de corte de 2,35, mientras que se observaron diferencias significativas en India, Irán y China, lo que refleja la necesidad de adaptar estos valores al contexto local. En Ecuador, aún no se han establecido valores de referencia específicos, lo que representa un reto para su aplicación clínica. La integración del HOMA-IR en las consultas médicas y programas de salud pública permitiría la detección temprana del síndrome metabólico, facilitando intervenciones personalizadas y efectivas que reduzcan el riesgo de complicaciones graves y optimicen la gestión de los recursos sanitarios.
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Arjmand, B., Ebrahimi Fana, S., Ghasemi, E., Kazemi, A., Ghodssi-Ghassemabadi, R., Dehghanbanadaki, H., Najjar, N., Kakaii, A., Forouzanfar, K., Nasli-Esfahani, E., Farzadfar, F., Larijani, B., & Razi, F. (2022). Metabolic signatures of insulin resistance in non-diabetic individuals. BMC Endocrine Disorders, 22(1). https://doi.org/10.1186/S12902-022-01130-3
Barreto, B. F. de M., Punaro, G. R., Elias, M. C., & Parise, E. R. (2022). IS HOMEOSTASIS MODEL ASSESSMENT FOR INSULIN RESISTANCE >2.5 A DISTINGUISHED CRITERIA FOR METABOLIC DYSFUNCTION-ASSOCIATED FATTY LIVER DISEASE IDENTIFICATION? Arquivos de gastroenterologia, 59(3), 402–407. https://doi.org/10.1590/S0004-2803.202203000-72
da Silva, C. de C., Zambon, M. P., Vasques, A. C. J., Camilo, D. F., de Góes Monteiro Antonio, M. Â. R., & Geloneze, B. (2023). The threshold value for identifying insulin resistance (HOMA-IR) in an admixed adolescent population: A hyperglycemic clamp validated study. Archives of Endocrinology and Metabolism, 67(1), 119. https://doi.org/10.20945/2359-3997000000533
de Fátima Haueisen Sander Diniz, M., Beleigoli, A. M. R., Schmidt, M. I., Duncan, B. B., Ribeiro, A. L. P., Vidigal, P. G., Benseñor, I. M., Lotufo, P. A., Santos, I. S., Griep, R. H., & Barreto, S. M. (2020). Homeostasis model assessment of insulin resistance (HOMA-IR) and metabolic syndrome at baseline of a multicentric Brazilian cohort: ELSA-Brasil study. Cadernos de saude publica, 36(8). https://doi.org/10.1590/0102-311X00072120
D’ELIA, L., MASULLI, M., BARBATO, A., RENDINA, D., IACONE, R., RUSSO, O., STRAZZULLO, P., & GALLETTI, F. (2024). Triglyceride-Glucose Index, HOMA Index and metabolic syndrome in a sample of adult men. Minerva Medica, 115(3), 301–307. https://doi.org/10.23736/S0026-4806.24.09155-9
Endukuru, C. K., Gaur, G. S., Yerrabelli, D., Sahoo, J., & Vairappan, B. (2020). Cut-off Values and Clinical Utility of Surrogate Markers for Insulin Resistance and Beta-Cell Function to Identify Metabolic Syndrome and Its Components among Southern Indian Adults. Journal of Obesity & Metabolic Syndrome, 29(4), 281. https://doi.org/10.7570/JOMES20071
Fahed, G., Aoun, L., Zerdan, M. B., Allam, S., Zerdan, M. B., Bouferraa, Y., & Assi, H. I. (2022). Metabolic Syndrome: Updates on Pathophysiology and Management in 2021. International journal of molecular sciences, 23(2). https://doi.org/10.3390/IJMS23020786
García, S., Pastor, R., Monserrat-Mesquida, M., Álvarez-Álvarez, L., Rubín-García, M., Martínez-González, M. Á., Salas-Salvadó, J., Corella, D., Goday, A., Martínez, J. A., Alonso-Gómez, Á. M., Wärnberg, J., Vioque, J., Romaguera, D., Lopez-Miranda, J., Estruch, R., Tinahones, F. J., Lapetra, J., Serra-Majem, L., … Bouzas, C. (2023). Metabolic syndrome criteria and severity and carbon dioxide (CO2) emissions in an adult population. Globalization and Health, 19(1). https://doi.org/10.1186/S12992-023-00948-3
Lee, S. H., Park, S. Y., & Choi, C. S. (2022). Insulin Resistance: From Mechanisms to Therapeutic Strategies. Diabetes & metabolism journal, 46(1), 15–37. https://doi.org/10.4093/DMJ.2021.0280
Lin, S. Y., Li, W. C., Yang, T. A., Chen, Y. C., Yu, W., Huang, H. Y., Xiong, X. J., & Chen, J. Y. (2022). Optimal Threshold of Homeostasis Model Assessment of Insulin Resistance to Identify Metabolic Syndrome in a Chinese Population Aged 45 Years or Younger. Frontiers in endocrinology, 12. https://doi.org/10.3389/FENDO.2021.746747
Park, S. Y., Gautier, J. F., & Chon, S. (2021). Assessment of Insulin Secretion and Insulin Resistance in Human. Diabetes & Metabolism Journal, 45(5), 641. https://doi.org/10.4093/DMJ.2021.0220
Pérez-Galarza, J., Baldeón, L., Franco, O. H., Muka, T., Drexhage, H. A., Voortman, T., & Freire, W. B. (2021). Prevalence of overweight and metabolic syndrome, and associated sociodemographic factors among adult Ecuadorian populations: the ENSANUT-ECU study. Journal of Endocrinological Investigation, 44(1), 63. https://doi.org/10.1007/S40618-020-01267-9
Petermann-Rocha, F., Martínez-Sanguinetti, M. A., Ho, F. K., Celis-Morales, C., & Pizarro, A. (2020). Optimal cut-off points for waist circumference in the definition of metabolic syndrome in Chile. Public Health Nutrition, 23(16), 2898. https://doi.org/10.1017/S1368980020001469
Prasun, P. (2020). Mitochondrial dysfunction in metabolic syndrome. Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease, 1866(10), 165838. https://doi.org/10.1016/J.BBADIS.2020.165838
Ramírez-López, L. X., Aguilera, A. M., Rubio, C. M., Aguilar-Mateus, Á. M., Ramírez-López, L. X., Aguilera, A. M., Rubio, C. M., & Aguilar-Mateus, Á. M. (2021). Síndrome metabólico: una revisión de criterios internacionales. Revista Colombiana de Cardiología, 28(1), 60–66. https://doi.org/10.24875/RCCAR.M21000010
Rus, M., Crisan, S., Andronie-Cioara, F. L., Indries, M., Marian, P., Pobirci, O. L., & Ardelean, A. I. (2023). Prevalence and Risk Factors of Metabolic Syndrome: A Prospective Study on Cardiovascular Health. Medicina, 59(10). https://doi.org/10.3390/MEDICINA59101711
Tamura, Y., Omura, T., Toyoshima, K., & Araki, A. (2020). Nutrition Management in Older Adults with Diabetes: A Review on the Importance of Shifting Prevention Strategies from Metabolic Syndrome to Frailty. Nutrients, 12(11), 1–29. https://doi.org/10.3390/NU12113367
Toin, T., Reynaud, Q., Denis, A., Durieu, I., Mainguy, C., Llerena, C., Pin, I., Touzet, S., & Reix, P. (2022). HOMA indices as screening tests for cystic fibrosis-related diabetes. Journal of Cystic Fibrosis, 21(1), 123–128. https://doi.org/10.1016/J.JCF.2021.05.010
Urashima, K., Miramontes, A., Garcia, L. A., & Coletta, D. K. (2021). Potential evidence for epigenetic biomarkers of metabolic syndrome in human whole blood in Latinos. PLOS ONE, 16(10), e0259449. https://doi.org/10.1371/JOURNAL.PONE.0259449
Valverde Pulla, J., Prieto Fuentemayor, C., Valverde Pulla, J., & Prieto Fuentemayor, C. (2021). Índice HOMA-IR como indicador de riesgo de enfermedades endocrino-metabólicas en niños y adolescentes con obesidad. Vive Revista de Salud, 4(11), 60–79. https://doi.org/10.33996/REVISTAVIVE.V4I11.86
Barreto, B. F. de M., Punaro, G. R., Elias, M. C., & Parise, E. R. (2022). IS HOMEOSTASIS MODEL ASSESSMENT FOR INSULIN RESISTANCE >2.5 A DISTINGUISHED CRITERIA FOR METABOLIC DYSFUNCTION-ASSOCIATED FATTY LIVER DISEASE IDENTIFICATION? Arquivos de gastroenterologia, 59(3), 402–407. https://doi.org/10.1590/S0004-2803.202203000-72
da Silva, C. de C., Zambon, M. P., Vasques, A. C. J., Camilo, D. F., de Góes Monteiro Antonio, M. Â. R., & Geloneze, B. (2023). The threshold value for identifying insulin resistance (HOMA-IR) in an admixed adolescent population: A hyperglycemic clamp validated study. Archives of Endocrinology and Metabolism, 67(1), 119. https://doi.org/10.20945/2359-3997000000533
de Fátima Haueisen Sander Diniz, M., Beleigoli, A. M. R., Schmidt, M. I., Duncan, B. B., Ribeiro, A. L. P., Vidigal, P. G., Benseñor, I. M., Lotufo, P. A., Santos, I. S., Griep, R. H., & Barreto, S. M. (2020). Homeostasis model assessment of insulin resistance (HOMA-IR) and metabolic syndrome at baseline of a multicentric Brazilian cohort: ELSA-Brasil study. Cadernos de saude publica, 36(8). https://doi.org/10.1590/0102-311X00072120
D’ELIA, L., MASULLI, M., BARBATO, A., RENDINA, D., IACONE, R., RUSSO, O., STRAZZULLO, P., & GALLETTI, F. (2024). Triglyceride-Glucose Index, HOMA Index and metabolic syndrome in a sample of adult men. Minerva Medica, 115(3), 301–307. https://doi.org/10.23736/S0026-4806.24.09155-9
Endukuru, C. K., Gaur, G. S., Yerrabelli, D., Sahoo, J., & Vairappan, B. (2020). Cut-off Values and Clinical Utility of Surrogate Markers for Insulin Resistance and Beta-Cell Function to Identify Metabolic Syndrome and Its Components among Southern Indian Adults. Journal of Obesity & Metabolic Syndrome, 29(4), 281. https://doi.org/10.7570/JOMES20071
Fahed, G., Aoun, L., Zerdan, M. B., Allam, S., Zerdan, M. B., Bouferraa, Y., & Assi, H. I. (2022). Metabolic Syndrome: Updates on Pathophysiology and Management in 2021. International journal of molecular sciences, 23(2). https://doi.org/10.3390/IJMS23020786
García, S., Pastor, R., Monserrat-Mesquida, M., Álvarez-Álvarez, L., Rubín-García, M., Martínez-González, M. Á., Salas-Salvadó, J., Corella, D., Goday, A., Martínez, J. A., Alonso-Gómez, Á. M., Wärnberg, J., Vioque, J., Romaguera, D., Lopez-Miranda, J., Estruch, R., Tinahones, F. J., Lapetra, J., Serra-Majem, L., … Bouzas, C. (2023). Metabolic syndrome criteria and severity and carbon dioxide (CO2) emissions in an adult population. Globalization and Health, 19(1). https://doi.org/10.1186/S12992-023-00948-3
Lee, S. H., Park, S. Y., & Choi, C. S. (2022). Insulin Resistance: From Mechanisms to Therapeutic Strategies. Diabetes & metabolism journal, 46(1), 15–37. https://doi.org/10.4093/DMJ.2021.0280
Lin, S. Y., Li, W. C., Yang, T. A., Chen, Y. C., Yu, W., Huang, H. Y., Xiong, X. J., & Chen, J. Y. (2022). Optimal Threshold of Homeostasis Model Assessment of Insulin Resistance to Identify Metabolic Syndrome in a Chinese Population Aged 45 Years or Younger. Frontiers in endocrinology, 12. https://doi.org/10.3389/FENDO.2021.746747
Park, S. Y., Gautier, J. F., & Chon, S. (2021). Assessment of Insulin Secretion and Insulin Resistance in Human. Diabetes & Metabolism Journal, 45(5), 641. https://doi.org/10.4093/DMJ.2021.0220
Pérez-Galarza, J., Baldeón, L., Franco, O. H., Muka, T., Drexhage, H. A., Voortman, T., & Freire, W. B. (2021). Prevalence of overweight and metabolic syndrome, and associated sociodemographic factors among adult Ecuadorian populations: the ENSANUT-ECU study. Journal of Endocrinological Investigation, 44(1), 63. https://doi.org/10.1007/S40618-020-01267-9
Petermann-Rocha, F., Martínez-Sanguinetti, M. A., Ho, F. K., Celis-Morales, C., & Pizarro, A. (2020). Optimal cut-off points for waist circumference in the definition of metabolic syndrome in Chile. Public Health Nutrition, 23(16), 2898. https://doi.org/10.1017/S1368980020001469
Prasun, P. (2020). Mitochondrial dysfunction in metabolic syndrome. Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease, 1866(10), 165838. https://doi.org/10.1016/J.BBADIS.2020.165838
Ramírez-López, L. X., Aguilera, A. M., Rubio, C. M., Aguilar-Mateus, Á. M., Ramírez-López, L. X., Aguilera, A. M., Rubio, C. M., & Aguilar-Mateus, Á. M. (2021). Síndrome metabólico: una revisión de criterios internacionales. Revista Colombiana de Cardiología, 28(1), 60–66. https://doi.org/10.24875/RCCAR.M21000010
Rus, M., Crisan, S., Andronie-Cioara, F. L., Indries, M., Marian, P., Pobirci, O. L., & Ardelean, A. I. (2023). Prevalence and Risk Factors of Metabolic Syndrome: A Prospective Study on Cardiovascular Health. Medicina, 59(10). https://doi.org/10.3390/MEDICINA59101711
Tamura, Y., Omura, T., Toyoshima, K., & Araki, A. (2020). Nutrition Management in Older Adults with Diabetes: A Review on the Importance of Shifting Prevention Strategies from Metabolic Syndrome to Frailty. Nutrients, 12(11), 1–29. https://doi.org/10.3390/NU12113367
Toin, T., Reynaud, Q., Denis, A., Durieu, I., Mainguy, C., Llerena, C., Pin, I., Touzet, S., & Reix, P. (2022). HOMA indices as screening tests for cystic fibrosis-related diabetes. Journal of Cystic Fibrosis, 21(1), 123–128. https://doi.org/10.1016/J.JCF.2021.05.010
Urashima, K., Miramontes, A., Garcia, L. A., & Coletta, D. K. (2021). Potential evidence for epigenetic biomarkers of metabolic syndrome in human whole blood in Latinos. PLOS ONE, 16(10), e0259449. https://doi.org/10.1371/JOURNAL.PONE.0259449
Valverde Pulla, J., Prieto Fuentemayor, C., Valverde Pulla, J., & Prieto Fuentemayor, C. (2021). Índice HOMA-IR como indicador de riesgo de enfermedades endocrino-metabólicas en niños y adolescentes con obesidad. Vive Revista de Salud, 4(11), 60–79. https://doi.org/10.33996/REVISTAVIVE.V4I11.86
Publicado
2025-02-06
Cómo citar
Pesantes Honores, L. A., Salguero Jaramillo, J. E., & Paladines Figueroa, F. B. (2025). Modelo Homeostático para Evaluar la Resistencia de Insulina y Prevención del Síndrome Metabólico en Adultos. Ciencia Latina Revista Científica Multidisciplinar, 9(1), 1266-1280. https://doi.org/10.37811/cl_rcm.v9i1.15887
Número
Sección
Ciencias de la Salud
Derechos de autor 2025 Luis Alberto Pesantes Honores, Jeremy Estanislao Salguero Jaramillo, Franklin Benjamín Paladines Figueroa
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
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