Prevalence and determinants of insulin resistance among U.S. adolescents: a population-based study

Diabetes Care. 2006 Nov;29(11):2427-32. doi: 10.2337/dc06-0709.

Abstract

Objective: We sought to examine the distribution of insulin and homeostasis model assessment of insulin resistance (HOMA-IR) and associations of HOMA-IR with sex, race/ethnicity, age, and weight status, as measured by BMI, among U.S. adolescents.

Research design and methods: Of 4,902 adolescents aged 12-19 years who participated in the National Health and Nutrition Examination Survey 1999-2002, analysis was performed for a nationally representative subsample of 1,802 adolescents without diabetes who had fasting laboratory measurements. The main outcome measure was HOMA-IR, calculated from fasting insulin and glucose and log transformed for multiple linear regression analyses.

Results: In adjusted regression models that included age and weight status, girls had higher HOMA-IR than boys and Mexican-American children had higher HOMA-IR levels than white children. There were no significant differences in adjusted HOMA-IR between black and white children. Obese children (BMI >/=95th percentile) had significantly higher levels of HOMA-IR compared with children of normal weight (BMI <85th percentile) in adjusted comparisons (mean HOMA-IR 4.93 [95% CI 4.56-5.35] vs. 2.30 [2.21-2.39], respectively). Weight status was by far the most important determinant of insulin resistance, accounting for 29.1% of the variance in HOMA-IR. The prevalence of insulin resistance in obese adolescents was 52.1% (95% CI 44.5-59.8).

Conclusions: Obesity in U.S. adolescents represents the most important risk factor for insulin resistance, independent of sex, age, or race/ethnicity. The prevalence of insulin resistance in obese children foreshadows a worrisome trend for the burden of type 2 diabetes in the U.S.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • African Continental Ancestry Group / statistics & numerical data
  • Age Distribution
  • Body Mass Index
  • Child
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / epidemiology*
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Humans
  • Insulin Resistance*
  • Male
  • Mexican Americans / statistics & numerical data
  • Obesity / epidemiology*
  • Prevalence
  • Sex Distribution
  • United States / epidemiology