Scientific Overview of Dr. Antonino Buttà's Clinical Calculators
Modern clinical nutrition and preventive longevity extend far beyond basic caloric bookkeeping or bathroom scales. To accurately assess cardiometabolic risk, clinicians must evaluate blood biochemistry in conjunction with genuine visceral adipose geometry.
Why evaluate HOMA-IR instead of fasting glucose alone?
Type 2 diabetes and vascular deterioration do not emerge overnight when fasting blood glucose passes 100 mg/dL. They develop 10 to 15 years prior, as pancreatic beta-cells overproduce insulin (compensatory hyperinsulinemia) to suppress rising blood sugar. The HOMA-IR index by Matthews et al. quantifies this compensatory strain: scores above 2.0 indicate early resistance, while scores over 2.5 represent marked peripheral resistance requiring targeted nutritional intervention.
The ADAG Consensus for Glycated Hemoglobin (HbA1c)
Glycated hemoglobin reflects non-enzymatic glycosylation over the erythrocyte lifespan (approximately 90-120 days). Validated by the international ADAG trial, the mathematical linear model eAG = (28.7 × HbA1c) - 46.7 bridges the gap between percentage readings and tangible daily blood sugar levels (mg/dL), providing an intuitive metric for both physician and patient.
Moving Beyond Outdated BMI: The Body Roundness Index (BRI JAMA)
Published in JAMA Network Open, the Body Roundness Index resolves the major flaws of the traditional Body Mass Index. While BMI misclassifies muscular individuals and overlooks sarcopenic visceral obesity (TOFI: Thin Outside, Fat Inside), BRI applies an ellipsoidal eccentricity model that captures deep organ compression and low-grade systemic inflammation.