We have recently established a 'health-associated' reference interval of homeostasis model assessment of insulin resistance (HOMA-IR) between 0.4 and 2.4. In the present study, the aim was to establish a 'decision-based' limit of HOMA-IR for the discrimination of metabolic syndrome (MetS) in non-diabetic Japanese subjects. The receiver-operating characteristic curve of HOMA-IR for detecting MetS was developed using data from 6868 non-diabetic subjects (3727 men, 3141 women). The optimal cut-off point was determined based on the point that yielded the minimum value of the square root of [(1 - sensitivity)(2) + (1 - specificity)(2)]. HOMA-IR = 1.7 was determined as the optimal cut-off value, with a sensitivity and specificity of 73.4% and 70.5% for men, and 81.5% and 77.0% for women, respectively. In conclusion, the optimal cut-off value for HOMA-IR to discriminate MetS in non-diabetic Japanese subjects appears to be 1.7. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2012.00194.x, 2012).
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