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Altogether 2, Germans 31—72 years, The Youden Index YI was used to determine optimal cut-off values, and a non-parametric ROC regression was used to examine whether the discriminatory accuracy varied by sex and age. The incidence and prevalence of type 2 diabetes hereafter, diabetes are increasing rapidly worldwide due to aging of the population and the Western lifestyle 1 , 2.
According to diabetes burden research by the International Diabetes Federation IDF , it was estimated that there were million adults with diabetes worldwide in , and it is predicted that million adults will have diabetes by 3. A large proportion of all people living with diabetes IDF estimates Although timely treatment of diabetes reduces the risk of diabetes-related outcomes 4 , this requires efficient screening strategies and early detection of prediabetes and diabetes.
Therefore, the development of accurate and cost-efficient screening tools as an alternative is warranted. Insulin resistance IR is a metabolic state where insulin-dependent tissues become less sensitive to the actions of insulin, leading to an imbalance in metabolism. Homeostatic model assessment of insulin resistance HOMA-IR has been used as a robust surrogate marker for defining IR because of the practical, ethical and economic issues of the hyperinsulinemic euglycemic clamp, which is the gold standard test for measurement of IR 7.