While not validated, the R Factor is widely used and has been incorporated into guideline recommendations for assessing liver injury.For example: If you have a fasting insulin that is on the high side, like 10. Above 2.9 indicates significant insulin resistance. Above 1.9 indicates early insulin resistance. Optimal Range: 1.0 (0.51.4) Less than 1.0 means you are insulin-sensitive which is optimal. This calculator uses 40 as the ULN of ALT and 120 as the ULN of ALP. A HOMA-IR calculator is here you can also Convert to S.I. The ULN varies among different laboratories. The use of upper limit of normal (ULN) in the equation creates some room for variability.It is recommended that the initial liver chemistries suggesting liver injury be used, but ultimately left to the clinician to decide what set of liver chemistries to use when making an assessment. Because the pattern of liver injury can evolve over time, the time point at which liver chemistries are used to calculate the R Factor can alter the final result.Calculating the R Factor is the first step in calculating the Roussel Uclaf Causality Assessment Method (RUCAM) when determining if liver injury is related to a specific drug.Identifying the pattern of liver injury can guide diagnostic approach to DILI, including appropriate further diagnostic testing necessary to rule out other causes of liver injury.The pattern of acute liver injury (and therefore the R Factor) can vary throughout the clinical course of the illness.
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