Abstract
ObjectiveTo investigate whether indices of obesity are associated with insulin resistance in Korean adolescents.MethodsThis study was conducted as a cross-sectional analysis of 817 healthy adolescents aged 15–16 years without diabetes. Percentiles group of weight-for-height, body mass index (BMI)-for-age, waist circumference (WC)-for-age, and skin fold thickness (SFT)-for-age were based on the 2007 Korean National Growth Charts. Percentiles of waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and percent body fat were calculated for the study population. Insulin resistance was estimated by homeostatic model assessment (HOMA-IR). Logistic regression models were used to estimate odds ratio for insulin resistance according to seven obesity indices. Generalized linear models were used to assess the associations between obesity indices and continuous HOMA-IR levels.ResultsSex and age-adjusted odds ratios (95% confidence interval) for insulin resistance, defined as HOMA-IR>2.50, of the 75–94th and ≥95th percentiles of weight-for-height were 3.87 (2.38–6.30) and 11.37 (5.87–22.02), compared to the <50th percentile. Corresponding odds ratios were 3.27 (2.02–5.28) and 11.72 (6.05–22.73) for BMI-for-age, 4.72 (2.82–7.88) and 13.22 (6.42–27.23) for WC-for-age, 3.67 (2.27–5.94) and 13.58 (6.71–27.48) for WHR, 4.78 (2.99–7.67) and 12.84 (6.23–26.46) for WHtR, 2.62 (1.61–4.26) and 6.68 (3.46–12.90) for SFT-for-age, and 2.29 (1.33–4.26) and 10.06 (4.39–23.06) for body fat. These associations were more prominent when insulin resistance was defined as HOMA-IR>3.16 and were stronger in males than in females. Continuous measure of HOMA-IR was significantly associated with body weight, BMI, WC, WHR, WHtR, and SFT in both sexes (p<0.001), and with percent body fat in males only (p<0.001).ConclusionOur findings suggest that obesity indices are positively associated with insulin resistance in apparently healthy adolescents.
Highlights
Corresponding odds ratios were 3.27 (2.02–5.28) and 11.72 (6.05–22.73) for body mass index (BMI)-for-age, 4.72 (2.82–7.88) and 13.22 (6.42–27.23) for waist circumference (WC)-for-age, 3.67 (2.27–5.94) and 13.58 (6.71–27.48) for waist-to-hip ratio (WHR), 4.78 (2.99–7.67) and 12.84 (6.23–26.46) for waist-to-height ratio (WHtR), 2.62 (1.61–4.26) and 6.68 (3.46–12.90) for skin fold thickness (SFT)-for-age, and 2.29 (1.33–4.26) and 10.06 (4.39–23.06) for body fat. These associations were more prominent when insulin resistance was defined as HOMA-IR>3.16 and were stronger in males than in females
Our findings suggest that obesity indices are positively associated with insulin resistance in apparently healthy adolescents
We observed that insulin resistance, which is known to increase the risk of developing diabetes, is closely associated with obesity indices in apparently healthy adolescents
Summary
The epidemic status of obesity is associated with an increasing number of children and adolescents with type 2 diabetes [2]. Overweight and obesity are important risk factors of type 2 diabetes; they have been shown to be associated with insulin resistance in persons with normal glucose level [3]. In previous studies increased risk for insulin resistance was noted for adolescents with prominent obesity [5, 6]. The association between obesity and insulin resistance was reported in Korean patients with hyperlipidemia and middle-aged Korean offspring of hypertensive parents [7, 8]. We investigated the association between various indices of obesity and insulin resistance as measured by HOMA-IR in a healthy Korean adolescent population
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