Distribution of homeostasis model assessment of insulin resistance and its correlation with leptin/adiponectin ratio among children and adolescents in Beijing

Abstract

Objective To analysis the distribution of HOMA-IR, and explore the diagnostic value of leptin/adiponectin ratio (LEP/APN) on insulin sensitivity in Beijing children and adolescents. Methods A total of 3506 schoolchildren, selected from the Beijing Child and Adolescent Metabolic Syndrome Study(BCAM study), were included in the current study, among them 659 were overweight and 1219 were obese. Age- and sex-specific body mass index (BMI) percentiles, developed by the Working Group for Obesity in China, were used to classify participants as normal weight (BMI <85%), overweight (BMI ≥85% but <95%), or obese (BMI ≥ 95%). Examination included anthropometry, pubertal development, and levels of fasting lipid profile, insulin, LEP and APN. Insulin resistance (IR) was evaluated by HOMA-IR. Correlation analysis and receiver operating characteristic curve (ROC) were used in the statistical analysis. Results According to the distribution of HOMA-IR in healthy children and adolescents, the cutoff value for IR was ≥2 .6 in pre-pubertal stage and ≥3.4 in pubertal phase, respectively. The prevalence of IR was 22.2% and 42.9% respectively in overweight and obese children and adolescences. The LEP/APN ratio was progressively increased from normal group to overweight group and to obesity group, and correlated with HOMA-IR significantly (Pearson correlation coefficient was 0.51 and partial correlation coefficient was 0.40). After adjusting for age, sex, puberty and other confounding factors, the LEP/APN ratio is an independent predicator for HOMA-IR by multivariate linear regression analysis (unstandardized coefficient was 0.273 and standardized coefficient was 0.467, P<0.01). Area under the ROC curve of LEP/APN ratio for diagnosing of IR was larger than those of LEP, APN, BMI, waist circumference and FAT%. Conclusions Evaluation of IR needs to consider puberty status and prevalence of IR is obvious in overweight and obese children and adolescents. The LEP/APN ratio is expected to be early biomarker of IR state, and an early potent predicator of metabolic disorders. Key words: Children and adolescents; Obesity; Insulin resistance; Leptin/adiponectin ratio