Elsevier

The Journal of Pediatrics

Volume 151, Issue 3, September 2007, Pages 275-279
The Journal of Pediatrics

Original article
Insulin Resistance in Adolescents

https://doi.org/10.1016/j.jpeds.2007.03.023Get rights and content

Objectives

To investigate the relationship of other body mass index (BMI) ranges with Homeostasis Model Assessment–Insulin Resistance (HOMA-IR), a surrogate marker for insulin resistance in adolescents.

Study design

Cross-sectional analysis of a nationally representative sample of 1837 nondiabetic, nonpregnant 12 to 19 year old persons from the National Health and Nutrition Examination Survey, 1999-2002. The main outcome measurement of insulin resistance was calculated as HOMA-IR >3.16.

Results

Having a BMI ≥75th percentile is associated with a high HOMA-IR levels. As the BMI percentile increases, the odds of high HOMA-IR levels increase (BMI percentile 75-84.9, OR 4.277, 95% CI 2.090-8.752; BMI percentile 85-94.9, OR 4.299, 95% CI 2.158-8.563; BMI ≥95th percentile, OR 17.907, 95% CI 11.360-28.228).

Conclusion

Adolescents with BMI percentile of 75 to 84.9, which represents approximately 1.2 million US adolescents, have not previously been identified as having higher HOMA-IR levels.

Section snippets

Study Population

Data from the 1999-2002 National Health and Nutrition Examination Survey (NHANES) were analyzed. NHANES included participants from a nationally representative sample of non-institutionalized residents of the United States. The survey was conducted by the National Center for Health Statistics (NCHS) and included laboratory and interview information.

Samples were weighted to be representative of the US population so population estimates could be made. The NHANES sampling weights account for

Results

Table I shows the characteristics of the unweighted study population of 1837 persons representing a weighted population of 31,285,208 adolescents between 12 and 19 years of age. The average age was 15.4 years, which was similar across all BMI categories. Overweight and risk for overweight adolescents reported less physical activity than normal weight adolescents. Overall, the majority of normal-weight adolescents were classified as being of moderate fitness on the CV fitness test. More than

Discussion

Adolescents with BMI percentile of 75 to 84.9, which represents approximately 1.2 million US adolescents, have high HOMA-IR levels. Although several previous studies have identified an increase in insulin resistance in the overweight and risk for overweight adolescent populations,9, 13, 14 this is the first study to show high HOMA-IR levels in the BMI percentile of 75 to 84.9, a group considered to be “normal” weight.

Adolescents with insulin resistance tend to have higher total cholesterol with

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