Endpoint
HOMA-IR
CAT:outcome/homa-irreported in index
Method
Homeostatic model assessment of insulin resistance, computed as fasting insulin multiplied by fasting glucose divided by the model constant — 22.5 for mU/L with mmol/L, 405 for microIU/mL with mg/dL. The constant and the input units are recorded on the edge.
The method is part of the endpoint identity. Studies measuring the same quantity by a different method are held as separate endpoints.
Notes
Fasting insulin and fasting blood glucose are its two INPUTS, not its neighbours. A graph carrying all three from one blood draw triple-counts a single measurement and inflates the apparent weight of evidence; the three must be weighted as one observation from any given trial. It is nevertheless not interchangeable with fasting insulin alone, because the glucose term can move independently. Distinct from HOMA-B (beta-cell function), computed from the same two inputs by a different formula with a different direction of benefit — the shared 'HOMA' prefix is the whole of the confusion. Also distinct from the clamp-derived insulin sensitivity index, which measures the construct directly rather than modelling it.
Findings
4 findings from 4 compounds, strongest first.
all-cis-5,8,11,14,17-icosapentaenoic acid — decreases
Well establishedGrade A, Well established. Replicated human trial evidence, consistent direction.Finding“Insulin resistance (HOMA-IR) significantly decreased in the EPA-rich fish oil than the controls (p = 0.001).”
Quoted verbatim from Eicosapentaenoic acid decreases inflammation and improves glucose homeostasis in patients with burns: a randomized clinical trial.. - Study
- RCT
- Participants
- 24
- Duration
- 3 weeks
- Dose
- 1.5 g/day EPA as EPA-rich fish oil capsules (500 mg EPA per capsule, three times daily with meals)
- Population
- Hospitalised adults aged 18-65 with non-severe burns covering less than 20% of total body surface area, able to take more than 90% of their daily calorie requirement by mouth, without diabetes, organ failure, cancer or immune disorder; both the EPA arm and the control arm also received 600 mg/day DHA.
Eicosapentaenoic acid decreases inflammation and improves glucose homeostasis in patients with burns: a randomized clinical trial.2025PMID:41254027
curcumin — decreases
LikelyGrade B, Likely. Human evidence, limited replication or design limits.Finding“The results showed that curcumin reduced HOMA-IR compared with placebo [WMD = -0.28, 95% CI (-0.36, -0.20), P < 0.00001].”
Quoted verbatim from Efficacy and safety of dietary polyphenol supplementation in the treatment of non-alcoholic fatty liver disease: A systematic review and meta-analysis.. - Study
- meta-analysis
- Participants
- 343
- Population
- adults with non-alcoholic fatty liver disease
Effect -0.28 mean difference, 95% CI -0.36 to -0.2
Efficacy and safety of dietary polyphenol supplementation in the treatment of non-alcoholic fatty liver disease: A systematic review and meta-analysis.2022PMID:36159792
berberine — decreases
LikelyGrade B, Likely. Human evidence, limited replication or design limits.Finding“Improved insulin resistance was assessed by lowering FINS (MD = -2.05, 95% CI (-2.62, -1.48)), HOMA-IR (MD = -0.71, 95% CI (-1.03, -0.39)), and BMI (MD = -1.07, 95% CI (-1.76, -0.37)).”
Quoted verbatim from The Effect of Berberine on Metabolic Profiles in Type 2 Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.. - Study
- meta-analysis
- Population
- patients with type 2 diabetes mellitus
The Effect of Berberine on Metabolic Profiles in Type 2 Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.2021PMID:34956436
L-citrulline — no detected effect on
SuggestiveGrade C, Suggestive. Weak human evidence, or strong evidence in a mismatched population.FindingNull result“Importantly, although we did not observe statistical significance in HOMA-IR, there was a decreasing trend in CIT and an increasing trend in placebo after 4 weeks.”
Quoted verbatim from Effects of L-Citrulline Supplementation on Endothelial Function, Arterial Stiffness, and Blood Glucose Level in the Fasted and Acute Hyperglycemic States in Middle-Aged and Older Adults with Type 2 Diabetes.. - Study
- crossover
- Participants
- 16
- Duration
- 4 weeks
- Dose
- 6 g/day L-citrulline as 750 mg capsules, four in the morning and four in the evening, for 4 weeks
- Population
- Middle-aged and older adults with type 2 diabetes, mean age 62 years, treated with oral hypoglycaemic drugs and/or insulin, none doing structured exercise.