Agustin Iskandar
Departemen Patologi Klinik Dan Kedokteran Laboratorium, Fakultas Kedokteran, Universitas Brawijaya / RSUD Dr Saiful Anwar, Malang

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Journal : Narra J

HOMA-IR value in predicting retinal microvascular dysfunction Prayitnaningsih, Seskoati; Yuniasih, Kristina; Kautsarani, Intan; Hamid, Aulia A.; Iskandar, Agustin
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1732

Abstract

Obesity and retinal microvasculature dysfunction are linked and impact visual acuity. The aim of this study was to determine the relationship between the HOMA-IR score and the presence of vascular dysfunction (perfusion index and flux index) of the optic nerve head (ONH) of the retina in obese patients and to determine its diagnostic performance to predict vascular dysfunction. A case-control study was conducted in 2022 involving individuals from obese and non-obese groups. Insulin resistance was measured using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) score using the levels of insulin and fasting glucose. Optical coherence tomography angiography (OCT-A) was performed to evaluate the flux index and capillary perfusion of ONH. The correlation between HOMA-IR, flux index, and capillary perfusion was assessed using Pearson’s correlation, and the diagnostic performance of HOMA-IR, including sensitivity, specificity, and the area under the curve (AUC), was measured. Logistic regression was used to identify the association between the HOMA-IR cutoff score with the presence of retinal microvascular dysfunction. A total of 80 individuals were included from each obese and non-obese group. The HOMA-IR score showed significant negative correlations with the perfusion of the superior (p<0.001), inferior (p<0.001), and outer (p=0.008) regions of the retinal of ONH. For the flux index, the HOMA-IR score had significant negative correlations with the superior (p=0.001), inferior (p<0.001), nasal (p=0.003), and outer (p=0.035) regions of ONH of the retina. The receiver operating characteristic (ROC) curve analysis for the HOMA-IR score at a cutoff value of 5.51 demonstrated an area under the curve (AUC) of 0.819, with a 95% confidence interval (CI) ranging from 0.727 to 0.912, suggesting its effectiveness in detecting vascular dysfunction. Multivariate logistic regression revealed a significant association between the HOMA-IR cutoff score of 5.51 with capillary perfusion of the superior (p=0.005) and nasal region (p=0.043), as well as the flux index of the inferior (p=0.013) and outer (p=0.022) regions of the ONH. These findings suggest that HOMA-IR is a promising biomarker for predicting retinal microvascular dysfunction in obese patients.
Co-Authors Aditya Sri Listyoko Agustina Tri Endharti Aina Angelina Akmaly, Triyana Dian Dhuha Alim, Fathi Nabila Amalia, Najwa Anik Widijanti Aprilia, Andrea Aris Widayati Aryati Aryati Aryati Aryati Aryati Aryati Beti Ernawati Dewi Carla Pramudita Susanto Catur Suci Sutrisnani Corebima, Brigitta IRV Deasy Ayuningtyas Tandio Dewi, Rose Khasana Dian Nugrahenny Dina Fauziah Edi Widjajanto Eko Sulistijono Eko Sulistijono Ery Olivianto Fran Siska Hambiah Hari Oki Hambiah Hari Oki Hamid, Aulia A. Hardi Darmawan Hartanti, Khoirunisah Dwi Herdiman T. Pohan Ihda Dian Kusuma Indriana, Kristin Jahono, Maxie Felix Joko Agus Gunawan Karima, Karima Kautsarani, Intan Khadafi Indrawan Kristin Indriana Leonard Nainggolan Lindayanti Sumali Loeki Enggar Fitri Ludytajati, Ferine Maisaroh, Luluk Mayashita, Dearikha Karina Mirza, Sarah Zoraya Mufidatun Hasanah Muhammad Anshory Muhammad Anshory, Muhammad Mulyohadi Ali Mustika Dewi Nada Putri Pranidya Norwahyuni, Yuyun Novi Khila Firani Novi Kurnianingsih Nur Permatasari Nur Samsu Prameswari, Asri Pranidya, Nada Putri Pratama, Gusti Rajendra Yoga Putri Wulan Akbar Rahajuningsih Dharma Rambe, Annisa Fadhila Aurelia Rianto Setiabudy Riskawati, Yhusi Karina Rosari, M Angelina de Sanjaya, Hayyu Rafina Saptadi Yuliarto Seskoati Prayitnaningsih Settrin Chenderawasi Siska, Fran Sudjari Sudjari Suhendro Suhendro Syahfitri, Rininta Syahrul Chilmi Tri Wahju Astuti, Tri Wahju Triwahju Astuti Wafi, Muhammad Wihastuti TA Yeni Ayu Prihastuti Yeni Ayu Prihastuti Yuanita Mulyastuti Yuniasih, Kristina