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Prevalence and determinants of insulin resistance among U.S. adolescents: a population-based study.
Diabetes Care. 2006 Nov; 29(11):2427-32.DC

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.

Authors+Show Affiliations

300 NIB, Room 6E05, Campus Box 0456, Ann Arbor, MI 48109-0456, USA. joyclee@umich.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17065679

Citation

Lee, Joyce M., et al. "Prevalence and Determinants of Insulin Resistance Among U.S. Adolescents: a Population-based Study." Diabetes Care, vol. 29, no. 11, 2006, pp. 2427-32.
Lee JM, Okumura MJ, Davis MM, et al. Prevalence and determinants of insulin resistance among U.S. adolescents: a population-based study. Diabetes Care. 2006;29(11):2427-32.
Lee, J. M., Okumura, M. J., Davis, M. M., Herman, W. H., & Gurney, J. G. (2006). Prevalence and determinants of insulin resistance among U.S. adolescents: a population-based study. Diabetes Care, 29(11), 2427-32.
Lee JM, et al. Prevalence and Determinants of Insulin Resistance Among U.S. Adolescents: a Population-based Study. Diabetes Care. 2006;29(11):2427-32. PubMed PMID: 17065679.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and determinants of insulin resistance among U.S. adolescents: a population-based study. AU - Lee,Joyce M, AU - Okumura,Megumi J, AU - Davis,Matthew M, AU - Herman,William H, AU - Gurney,James G, PY - 2006/10/27/pubmed PY - 2006/12/16/medline PY - 2006/10/27/entrez SP - 2427 EP - 32 JF - Diabetes care JO - Diabetes Care VL - 29 IS - 11 N2 - 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. SN - 0149-5992 UR - https://www.unboundmedicine.com/medline/citation/17065679/Prevalence_and_determinants_of_insulin_resistance_among_U_S__adolescents:_a_population_based_study_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=17065679 DB - PRIME DP - Unbound Medicine ER -