Prevalence and determinants of insulin resistance among US adolescents - A population-based study

被引:339
作者
Lee, Joyce M.
Okumura, Megumi J.
Davis, Matthew M.
Herman, William H.
Gurney, James G.
机构
[1] Univ Michigan, Pediat Endocrinol Unit, Ann Arbor, MI 48109 USA
[2] Univ Michigan, CHEAR Unit, Ann Arbor, MI 48109 USA
[3] Univ Calif San Francisco, Div Gen Pediat, San Francisco, CA 94143 USA
[4] Univ Michigan, Gerald R Ford Sch Publ Policy, Ann Arbor, MI 48109 USA
[5] Univ Michigan, Dept Internal Med, Ann Arbor, MI 48109 USA
[6] Univ Michigan, Dept Epidemiol, Ann Arbor, MI 48109 USA
关键词
D O I
10.2337/dc06-0709
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:2427 / 2432
页数:6
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