Homeostasis Model Assessment of β-Cell Function for Diagnosis of Insulinoma
Authors' conclusion
HOMA-B, as calculated at the end of the fasting test employing defined cutoffs for insulin and C-peptide, provides excellent diagnostic efficacy, suggesting that it might represent an alternative and precise tool to diagnose insulinoma.
Study context
- Population
- Patients with suspected insulinoma undergoing 72-hour fasting tests; 23 with and 81 without insulinomasuspected insulinoma
- Participants
- 104 patients
- Comparison
- HOMA-B at end of 72-hour fasting test vs ES and ENETS/NANETS criteria for insulinoma diagnosis
- Outcome
- Diagnostic efficacy (sensitivity, specificity) for insulinoma
- Follow-up
- End of fasting test (lowest glucose)
Performance
As reported in the abstract
Diagnostic performance for insulinoma · end of fasting test
| Test or model | Sensitivity | Sensitivity (insulin) | Sensitivity (C-peptide) | Specificity | Specificity (insulin) | Specificity (C-peptide) |
|---|---|---|---|---|---|---|
| HOMA-B | 0.96, 0.78 to 1.00 | — not stated in the abstract | — not stated in the abstract | 0.96 or greater (≥0.89-0.99) | — not stated in the abstract | — not stated in the abstract |
| ES criteria | — not stated in the abstract | less than or equal to 0.96 (≤0.78-1.00) | — not stated in the abstract | — not stated in the abstract | ≤0.85 (≤0.76-0.92) | — not stated in the abstract |
| ENETS/NANETS criteria | — not stated in the abstract | — not stated in the abstract | ≤0.83 (≤0.61-0.95) | — not stated in the abstract | — not stated in the abstract | less than or equal to 1.00 (≤0.96-1.00) |
Sensitivity
HOMA-B0.96, 0.78 to 1.00
ES criteria— not stated in the abstract
ENETS/NANETS criteria— not stated in the abstract
Sensitivity (insulin)
HOMA-B— not stated in the abstract
ES criterialess than or equal to 0.96 (≤0.78-1.00)
ENETS/NANETS criteria— not stated in the abstract
Sensitivity (C-peptide)
HOMA-B— not stated in the abstract
ES criteria— not stated in the abstract
ENETS/NANETS criteria≤0.83 (≤0.61-0.95)
Specificity
HOMA-B0.96 or greater (≥0.89-0.99)
ES criteria— not stated in the abstract
ENETS/NANETS criteria— not stated in the abstract
Specificity (insulin)
HOMA-B— not stated in the abstract
ES criteria≤0.85 (≤0.76-0.92)
ENETS/NANETS criteria— not stated in the abstract
Specificity (C-peptide)
HOMA-B— not stated in the abstract
ES criteria— not stated in the abstract
ENETS/NANETS criterialess than or equal to 1.00 (≤0.96-1.00)
— not stated in the abstract
- HOMA-B vs ENETS/NANETS criteria: P = 0.063 — tended to be higher with HOMA-B
- HOMA-B vs ES criteria: both P < .005 — higher with HOMA-B vs ES criteria using insulin and C-peptide
Further findings
HOMA-B in patients with vs without insulinoma · end of fasting test
- HOMA-B >6.5-fold higher with (n = 23) than without (n = 81) insulinoma (insulin and C-peptide)
- both P < .001
Original publication
Homeostasis Model Assessment of β-Cell Function for Diagnosis of Insulinoma. J Clin Endocrinol Metab. Published 27 October 2023. doi:10.
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