HOMA-IR and HOMA-Beta as predictors of metabolic syndrome: associations with cardio-metabolic risk factors across distinct obesity phenotypes in young adults from central India.

Abstract Introduction: Metabolic syndrome (MetS) is a growing health hazard, characterized by central adiposity, hypertension, dyslipidaemia, and hyperglycaemia. This study assesses the predictive utility of HOMA-IR and HOMA-Beta (β) for MetS among young adults. Methods:A cross-sectional study was conducted with 403 college going young adults, categorized into four obesity phenotypes: Metabolically Healthy Normal Weight (MHNW), Metabolically Healthy Obese (MHO), Metabolically Unhealthy Normal Weight (MUNW), and Metabolically Unhealthy Obese (MUO). Correlations of HOMA-IR and HOMA- β with cardiometabolic parameters were assessed by using Pearson’s correlation. Logistic regression, and ROC analysis were done to determine predictive accuracy of HOMA-IR and HOMA- β for MetS. Results: HOMA-β exhibited better predictive accuracy for MetS than HOMA-IR. MUO had significantly lower HOMA-Beta (75.28 ± 13.35) than MHNW (123.03 ± 72.21). MHO showed well-maintained β-cell function (HOMA-β: 103.73 ± 38.60) despite higher HOMA-IR (2.03 ± 0.61). HOMA-β correlated negatively with fasting blood glucose (r = -0.89, MHO; r = -0.59, MUO), while HOMA-IR correlations were weaker (r = 0.17 to 0.35). ROC analysis showed HOMA-β (AUC = 0.77) outperformed HOMA-IR (AUC = 0.38), insulin levels (AUC = 0.49), and HbA1c (AUC = 0.25). Conclusion: HOMA- β is a superior predictor of MetS, highlighting β-cell function over insulin resistance in young adults. Early detection and phenotype-based interventions are crucial for prevention.