Abstract
Considering the current changes in dietary patterns and the increasing prevalence of excess weight throughout the world, several studies have reported insulin resistance, which is a key driver of many chronic diseases, to be an important public health problem in all age groups. Therefore, the aim of the present study was to identify the prevalence and independent predictors of insulin resistance in Brazilian adolescents. A cross-sectional study was conducted with a probabilistic, representative sample of Brazilian adolescents (n = 37,023) who participated in the Study of Cardiovascular Risk in Adolescents. Data were collected on demographic, socioeconomic, lifestyle, anthropometric, and biochemical characteristics as well as antioxidant micronutrient intake (vitamins A, C, E, zinc, and selenium). Insulin resistance was determined using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and classified based on the 75th percentile of the sample distribution. Insulin resistance was detected in 27% of the adolescents and was more prevalent among those aged 12 to 14 years (PR: 1.26 [95%CI: 1.13;1.41]), those residing in the southern and south-eastern regions of the country (PR: 1.47 [95%CI: 1.27;1.70]), those who were physically inactive (PR: 1.12 [95%CI: 1.02;1.23]), and those did not consume alcohol (PR: 1.50 [95%CI: 1.13;1.99]). The prevalence of insulin resistance was 2.5-fold higher among individuals with severe obesity (PR: 2.49 [95%CI: 2.07;3.00]). Waist circumference indicative of cardiovascular risk and high serum triglyceride levels increased the likelihood of insulin resistance (PR: 1.37 [95%CI: 1.19;1.59] and 1.60 [95%CI: 1.45;1.78], respectively). The prevalence of the outcome was higher among adolescents in the lower quartiles of vitamin E intake (p<0.05). In the present study, the prevalence of insulin resistance was high among Brazilian adolescents and we identified sociodemographic, lifestyle, anthropometric, biochemical, and dietary predictors of this outcome.
Highlights
Hyperinsulinemia and a reduction insulin sensitivity are physiological phenomena inherent to adolescence [1]
Previous studies [4,5] recommend the use of the Homeostatic Model Assessment for Insulin Resistance (HOMA-insulin resistance (IR)) for the identification of IR using cut-off points validated for the population studied
Using the P75 of the distribution of the HOMA-IR index in the present study, 27% of the sample of Brazilian adolescents exhibited IR and the prevalence was higher among individuals living in the southern region of the country (35.9%)
Summary
Hyperinsulinemia and a reduction insulin sensitivity are physiological phenomena inherent to adolescence [1]. With the occurrence of the so-called nutritional transition (shift in eating patterns and energy expenditure) and the consequent increase in the prevalence of overweight and obesity in all population groups, insulin resistance (IR) has become a chronic disorder and is considered an important public health problem [2,3]. Previous studies [4,5] recommend the use of the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) for the identification of IR using cut-off points validated for the population studied. Despite the absence of standardised cut-off points for youths in Brazil [4], studies report that the prevalence of IR ranges from 2.1% to 90.8% among adolescents in different stages of sexual maturity and with different nutritional states [6,7,8,9]. The aim of the present study was to identify the prevalence and independent predictors of IR in Brazilian adolescents
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
