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
相关论文
共 35 条
[11]   The utility of body mass index as a measure of body fatness in children and adolescents: Differences by race and gender [J].
Daniels, SR ;
Khoury, PR ;
Morrison, JA .
PEDIATRICS, 1997, 99 (06) :804-807
[12]  
DEFRONZO RA, 1979, AM J PHYSIOL, V237, pE214
[14]   Comparison of metabolic syndrome prevalence using six different definitions in overweight pre-pubertal children enrolled in a weight management study [J].
Golley, RK ;
Magarey, AM ;
Steinbeck, KS ;
Baur, LA ;
Daniels, LA .
INTERNATIONAL JOURNAL OF OBESITY, 2006, 30 (05) :853-860
[15]   Influence of total vs. visceral fat on insulin action and secretion in African American and white children [J].
Goran, MI ;
Bergman, RN ;
Gower, BA .
OBESITY RESEARCH, 2001, 9 (08) :423-431
[16]   Insulin resistance and associated compensatory responses in African-American and Hispanic children [J].
Goran, MI ;
Bergman, RN ;
Cruz, ML ;
Watanabe, R .
DIABETES CARE, 2002, 25 (12) :2184-2190
[17]   Longitudinal study on pubertal insulin resistance [J].
Goran, MI ;
Gower, BA .
DIABETES, 2001, 50 (11) :2444-2450
[18]   Validation of surrogate estimates of insulin sensitivity and insulin secretion in children and adolescents [J].
Gungor, N ;
Saad, R ;
Janosky, J ;
Arslanian, S .
JOURNAL OF PEDIATRICS, 2004, 144 (01) :47-55
[19]   Type 2 diabetes mellitus in youth: The complete picture to date [J].
Gungor, N ;
Hannon, T ;
Libman, I ;
Bacha, F ;
Arslanian, S .
PEDIATRIC CLINICS OF NORTH AMERICA, 2005, 52 (06) :1579-+
[20]  
Haymond Morey W, 2003, Pediatr Diabetes, V4, P115, DOI 10.1034/j.1399-5448.2003.00024.x