Utility of Homeostasis Model Assessment of β-Cell Function in Predicting Diabetes in 12,924 Healthy Koreans

OBJECTIVE: It is unclear how well homeostasis model assessment of β-cell function (HOMA-β) predicts diabetes development beyond its components, especially glucose. RESEARCH DESIGN AND METHODS: We identified 12,924 nondiabetic Koreans who had fasting plasma glucose and insulin concentrations measured in 2003 and again in 2008. To minimize the impact of differences in baseline glucose concentration, individuals were divided into three glucose categories: normal fasting glucose (NFG, glucose <5.6 mmol/l), impaired fasting glucose (IFG-100) (5.6–6.0 mmol/l), and IFG-110 (6.1–6.9 mmol/l). RESULTS: Diabetes developed in 29% of individuals in the IFG-110 group, compared with 5% in IFG-100 and 0.3% in NFG groups. Within each glucose category, those who progressed to diabetes had higher baseline glucose concentrations (P ≤ 0.04). Baseline HOMA-β, however, was not lower but higher in individuals who developed diabetes in the NFG group (P = 0.009) and similar in the IFG-100 and IFG-110 groups. CONCLUSIONS: These data question the utility of using HOMA-β to predict the development of diabetes.