Anthropometric Measures and Insulin Resistance in Rural Indian Adolescents

Bhattacharya S

doi:10.4172/2332-0893.1000116

Abstract

Aims: To evaluate the relationship of anthropometric measures with insulin resistance (IR) in 1162 Indian adolescents from the follow-up survey of the Hyderabad Nutrition trial. Methods: Analysis was done on data collected from 1162 adolescent participants of the Hyderabad Nutrition trial follow up survey. Participation included an interview, physical examinations and blood draws. Associations of body mass index (BMI), fat mass index (FMI), fat free mass index (FFMI), central to peripheral skinfold ratio (CPR), percent of body fat, waist circumference (WC) and waist-hip ratio (WHR) with IR were studied using linear regression models accounting for village clustering and adjusting for age and pubertal stage. Anthropometric indices were calculated from height, weight, skinfold thickness, waist and hip circumferences and IR was calculated by the homoeostasis model assessment (HOMA). Results: We observed strong associations of BMI, FMI and FFMI with HOMA. Interestingly, FFMI (β (95% confidence interval) -0.03 (0.01, 0.06); P=0.007 (girls) and 0.06 (0.03, 0.09); P<0.0001 (boys)) was as strongly associated with IR as BMI (0.03 (0.01, 0.06); P=0.006 (girls) and 0.06 (0.03, 0.09); P<0.0001(boys)) and FMI (0.03 (0.01, 0.05); P=0.02 (girls) and 0.05 (0.02, 0.07); P=0.001 (boys)) We explored the relationship of lean mass with IR relative to fat mass and the associations remained strong. Conclusions: We conclude that lean mass is as strongly associated with IR as fat mass in rural Indian adolescents. These findings appear contrary to the belief that higher rates of IR in South Asians reflect greater central adiposity. Future research needs to increase our understanding of the underlying mechanisms that lead to these associations in both obese and lean populations.

Highlights

The rates of diabetes in India are rising dramatically, with the number of people with diabetes projected to rise to 57.2 million by 2025 [1]
Glucose and insulin data were available on 1008 adolescents, mainly as insulin assay reagents could not be obtained for the last batch of samples (n=48) [17]
To further evaluate the relationship of fat free mass index (FFMI) with insulin resistance (IR) relative to fat mass index (FMI), we explored the associations of the ratio of FMI to FFMI with homoeostasis model assessment (HOMA) (Appendix 3)

Summary

Introduction

The rates of diabetes in India are rising dramatically, with the number of people with diabetes projected to rise to 57.2 million by 2025 [1]. South Asian children and adolescents have high rates of IR compared to children and adolescents of other ethnicities [2]. Indian adolescents have an increased sensitivity to adiposity, high percent of body fat, abdominal obesity and high subcutaneous fat levels [4,5]. Studies in adolescents have shown that obesity, visceral obesity, is associated with the development of IR in this age group, with evidence of a 50% increase in IR in overweight adolescents with every half unit increase in body mass index (BMI) [6,7,8]

Methods

Results

Conclusion