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HOMA2-B enhances assessment of type 1 diabetes risk among TrialNet Pathway to Prevention participants.
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- Author(s): Felton JL;Felton JL;Felton JL; Cuthbertson D; Cuthbertson D; Warnock M; Warnock M; Lohano K; Lohano K; Meah F; Meah F; Wentworth JM; Wentworth JM; Wentworth JM; Sosenko J; Sosenko J; Evans-Molina C; Evans-Molina C; Evans-Molina C; Evans-Molina C; Evans-Molina C; Evans-Molina C
- Source:
Diabetologia [Diabetologia] 2022 Jan; Vol. 65 (1), pp. 88-100. Date of Electronic Publication: 2021 Oct 12.- Publication Type:
Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't- Language:
English - Source:
- Additional Information
- Corporate Authors:
- Source: Publisher: Springer Verlag Country of Publication: Germany NLM ID: 0006777 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-0428 (Electronic) Linking ISSN: 0012186X NLM ISO Abbreviation: Diabetologia Subsets: MEDLINE
- Publication Information: Original Publication: Berlin Springer Verlag
- Subject Terms:
- Abstract: Aims/hypothesis: Methods to identify individuals at highest risk for type 1 diabetes are essential for the successful implementation of disease-modifying interventions. Simple metabolic measures are needed to help stratify autoantibody-positive (Aab+) individuals who are at risk of developing type 1 diabetes. HOMA2-B is a validated mathematical tool commonly used to estimate beta cell function in type 2 diabetes using fasting glucose and insulin. The utility of HOMA2-B in association with type 1 diabetes progression has not been tested.
Methods: 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) individuals enrolled in the TrialNet Pathway to Prevention study were compared. Cox proportional hazard models were used to determine associations between HOMA2-B tertiles and time to progression to type 1 diabetes, with adjustments 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.
Results: 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; p < 0.001). 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 [95% CI 0.652, 0.794]).
Conclusions/interpretation: These data suggest that HOMA2-B may have utility as a single-time-point measurement to stratify risk of type 1 diabetes development in Aab+ individuals.
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J Autoimmun. 2016 Jul;71:88-96. (PMID: 27068279) - Grant Information: U01 DK085476 United States DK NIDDK NIH HHS; U01 DK085453 United States DK NIDDK NIH HHS; I01 BX001733 United States BX BLRD VA; U01 DK106993 United States DK NIDDK NIH HHS; U01 DK103282 United States DK NIDDK NIH HHS; UC4 DK106993 United States DK NIDDK NIH HHS; U01 DK061042 United States DK NIDDK NIH HHS; U01 DK085509 United States DK NIDDK NIH HHS; UC4 DK117009 United States DK NIDDK NIH HHS; R01 DK093954 United States DK NIDDK NIH HHS; R01 DK127308 United States DK NIDDK NIH HHS; UC4 DK104166 United States DK NIDDK NIH HHS; R21 DK119800 United States DK NIDDK NIH HHS; U01 DK061010 United States DK NIDDK NIH HHS; U01 DK127786 United States DK NIDDK NIH HHS; U01 DK085466 United States DK NIDDK NIH HHS; U01 DK103153 United States DK NIDDK NIH HHS; U01 DK061058 United States DK NIDDK NIH HHS; U01 DK106984 United States DK NIDDK NIH HHS; U01 DK085499 United States DK NIDDK NIH HHS; U01 DK107013 United States DK NIDDK NIH HHS; U01 DK103266 United States DK NIDDK NIH HHS; R01 DK127236 United States DK NIDDK NIH HHS; U01 DK127382 United States DK NIDDK NIH HHS; P30 DK097512 United States DK NIDDK NIH HHS; U01 DK107014 United States DK NIDDK NIH HHS; U01 DK106994 United States DK NIDDK NIH HHS; U01 DK061034 United States DK NIDDK NIH HHS; U01 DK085461 United States DK NIDDK NIH HHS; U01 DK103180 United States DK NIDDK NIH HHS; U01 DK085465 United States DK NIDDK NIH HHS; U01 DK085504 United States DK NIDDK NIH HHS
- Contributed Indexing: Keywords: Autoantibody; Biomarker; HOMA2-B; Risk prediction; TrialNet Pathway to Prevention; Type 1 diabetes
- Accession Number: 0 (Autoantibodies)
0 (Blood Glucose)
0 (Insulin) - Publication Date: Date Created: 20211013 Date Completed: 20220331 Latest Revision: 20230102
- Publication Date: 20231215
- Accession Number: PMC8752172
- Accession Number: 10.1007/s00125-021-05573-6
- Accession Number: 34642772
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