# HOMA-IR

Source: https://synapse-lifestyle.com/en/reference-guide/biomarkers/homa-ir

## What is HOMA-IR?

HOMA-IR combines your fasting glucose and insulin into a single measure of insulin sensitivity. It shows how hard your body has to work to regulate your blood sugar. A lower value means your cells respond sensitively to insulin: favourable for your energy, weight and metabolism over the long term.

## Clinical frame

Calculation:

```
HOMA-IR = (fasting glucose [mmol/L] × fasting insulin [mIU/L]) / 22.5
HOMA-β  = (20 × insulin) / (glucose − 3.5), in %
HOMA-S  = 100 % / HOMA-IR
```

**HOMA-IR** estimates insulin resistance from fasting glucose and insulin; HOMA2-IR is the refined version of that same model (Oxford). The index mainly reflects **basal, hepatic insulin resistance** and can reveal metabolic dysregulation before fasting glucose rises [2].

There is **no universal cut-off value** for HOMA-IR. Values vary with, among other things, age, BMI, population and the insulin assay used [1]. Moreover, insulin assays are insufficiently standardised and insulin shows considerable intra-individual variation [3].

HOMA-IR is therefore best used for **risk grading and follow-up over time**, rather than as a hard diagnostic threshold. For longitudinal follow-up, measurements are preferably taken within the same laboratory and with the same assay [3].

## What moves this value?

Belly fat, little movement, sleep deprivation and lots of processed carbohydrates gradually reduce insulin sensitivity.

Building muscle, regular movement, fewer late snacks and better sleep make your cells more sensitive to insulin again over a few months.

## What this connects

- [Glucose](https://synapse-lifestyle.com/en/reference-guide/biomarkers/glucose)
- [HbA1c](https://synapse-lifestyle.com/en/reference-guide/biomarkers/hba1c)

Developed and reviewed with the Synapse [medical advisory board](https://synapse-lifestyle.com/en/advisory-board).

## References

1. Frigerio, F. et al. Capturing metabolic syndrome: new thresholds for insulin resistance and novel body composition indices. Int J Obes (Lond) 50, 654–661 (2026). https://doi.org/10.1038/s41366-025-01993-1
2. ter Horst, K. W. et al. Insulin resistance in obesity can be reliably identified from fasting plasma insulin. Int J Obes (Lond) 39, 1703–1709 (2015). https://doi.org/10.1038/ijo.2015.125
3. Isokuortti, E. et al. Use of HOMA-IR to diagnose non-alcoholic fatty liver disease: a population-based and inter-laboratory study. Diabetologia 60, 1873–1882 (2017). https://doi.org/10.1007/s00125-017-4340-1

- [Read more in the reference guide](https://synapse-lifestyle.com/en/reference-guide/metabolism#Consequence-CSInsulin-FHOMA2)
- [All biomarkers in the guide](https://synapse-lifestyle.com/en/reference-guide#biomarkers)

The colour zones are personal: they depend on age, sex, risk and history, and appear in the patient's own report.

Insights to discuss with the patient, not a diagnostic instrument.