Association between Obesity Indices and Insulin Resistance among Healthy Korean Adolescents: The JS High School Study

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.

Prevalence of Insulin Resistance and its Association with Obesity and Alcoholism in Male Medical Students of Bhopal

“…Likewise, Lim et al reported positive association of HOMA-IR with both the obesity indices-BMI and WC. [26] In our study, there was no statistically significant association of alcoholism with HOMA-IR. Since our study was on first year students, the duration of alcoholism was short and may not have had a significant effect.…”

METS‐IR, a novel simple insulin resistance indexes, is associated with hypertension in normal‐weight Chinese adults

“…IR can also promote BP elevation by activating the renin‐angiotensin‐aldosterone system and increasing the synthesis and release of endothelin . Obesity is a significant risk factor for IR, so many individuals with normal BMI are often assumed not to have IR and to be metabolically healthy . However, a large number of people with normal BMI have IR and are metabolically unhealthy .…”

“…16,17 Obesity is a significant risk factor for IR, so many individuals with normal BMI are often assumed not to have IR and to be metabolically healthy. 18 However, a large number of people with normal BMI have IR and are metabolically unhealthy. 19 Therefore, the recognition of IR, especially in normal-weight individuals, is of great significance for the prevention and treatment of hypertension.…”

Body composition of obese adolescents: association between adiposity indicators and cardiometabolic risk factors

“…In studies with Greek children, BMI was correlated with fasting insulin and HOMA-IR, and was considered useful for identifying children at risk of developing insulin resistance (47) . The amount and difference in the distribution of body fat between the sexes and the increased oestrogen levels in women, resulting in an improvement in insulin sensitivity, are factors that explain, at least in part, the difference between the sexes observed for associations between indicators of adiposity and insulin resistance (48) .…”