Identificação dos pontos de corte do índice Homeostatic Model Assessment for Insulin Resistance em adolescentes: revisão sistemática

Andrade, Maria Izabel Siqueira de; Oliveira, Juliana Souza; Leal, Vanessa Sá; Lima, Niedja Maria da Silva; Costa, Emília Chagas; Aquino, Nathalia Barbosa de; Lira, Pedro Israel Cabral de

doi:10.1016/j.rpped.2015.08.006

Cited by 46 publications

(24 citation statements)

References 37 publications

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“…Of these, a limited number are population-based studies, and the remaining have been conducted on small samples. [33] A systematic review has recommended a value of >2.5 HOMA1-IR as a cut-off in healthy adolescents of both genders to identify IR. [33] A similar observation was made in an Indian study.…”

Section: Discussionmentioning

confidence: 99%

Association of acanthosis Nigricans and insulin resistance in indian children and youth – A HOMA2-IR based cross-sectional study

Nithun

Ranugha

Betkerur

et al. 2019

Indian Dermatol Online J

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Introduction: The American Diabetes Association includes acanthosis nigricans (AN) as an indicator of diabetes mellitus risk in overweight youth entering puberty. Some argue that AN is not an independent predictor of insulin resistance (IR), when body mass index (BMI) is controlled for. There is a paucity of studies on the association of AN and IR among children and young adults from India. Homeostatic model assessment-IR (HOMA2-IR), a computerized updated model, which is supposed to be superior to HOMA1-IR, has rarely been used for quantification of IR. Methods: Sixty cases (irrespective of BMI), aged 2–24 years with AN, and 30 age- and sex-matched normal weight controls were included. A thorough clinical examination and grading of AN was done. BMI, fasting glucose levels, and fasting insulin levels were measured for all. HOMA-IR calculator V.2.2.3 was used to calculate IR. Those with HOMA 2-IR >1.8 were considered insulin-resistant. Lifestyle modifications were advised for patients with IR. Results: The mean HOMA2-IR value in cases and controls was 2.422 and 1.322, respectively, which was statistically significant. Overweight and obese cases had 2.5 and 11.25 times higher risk of having IR, respectively, by logistic regression. The association of AN with IR was found to be statistically significant in normal weight cases when compared with controls ( P = 0.045). Grade 4 of neck severity ( P = 0.007), Grade 3 of neck texture ( P = 0.001), and Grade 4 of axillary severity ( P = 0.001) of AN were found to be significantly associated with IR. Limitations: The relatively small sample size may not reflect the accuracy of AN as a marker of IR. Conclusion: Acanthosis nigricans is associated with IR in both normal and obese. We propose that all children, adolescents, and youth with AN be screened for IR irrespective of BMI. Early identification and prompt lifestyle interventions may prevent or delay the onset of diabetes later.

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Section: Discussionmentioning

confidence: 99%

Association of acanthosis Nigricans and insulin resistance in indian children and youth – A HOMA2-IR based cross-sectional study

Nithun

Ranugha

Betkerur

et al. 2019

Indian Dermatol Online J

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“…HOMA‐IR = plasma glucose (mmol L −1 ) × plasma insulin (μU ml −1 ) / 22.5 . Because there is no recommended threshold for insulin resistance in children, adolescents and adults, a cut‐off of 2.5 was used to separate participants into having normal or elevated HOMA‐IR .…”

Section: Methodsmentioning

confidence: 99%

Definition of new cut-offs of BMI and waist circumference based on body composition and insulin resistance: differences between children, adolescents and adults

Hübers

Pourhassan

Braun

et al. 2017

Obesity Science & Practice

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SummaryObjectiveThis study aims to determine associations between anthropometric traits, regional fat depots and insulin resistance in children, adolescents and adults to define new cut‐offs of body mass index (BMI) or waist circumference (WC).DesignCross‐sectional data were assessed in 433 children, adolescents and adults (aged: 6–60 years, BMI: 23.6 [21.0–27.7] kg m−2). Total adipose tissue (TAT), regional subcutaneous adipose tissue (SATtotal, SATtrunk) and visceral adipose tissue (VAT) were determined by whole‐body magnetic resonance imaging, fat mass by air‐displacement plethysmography. Insulin resistance was evaluated by homeostasis model assessment of insulin resistance (HOMA‐IR). Bivariate as well as partial correlations and regression analyses were used. Cut‐off values of BMI and WC related to regional fat depots and HOMA‐IR were analysed by receiver operating characteristics curve.ResultsIn adults, TAT, SATtotal and SATtrunk increased linearly with increasing BMI and WC, whereas they followed a cubic function in children and adolescents with a steep increase at BMI and WC ≥1 standard deviation score and VAT at WC ≥2 standard deviation score. Sex differences were apparent in adults with women having higher masses of TAT and SAT and men having higher VAT. Using established BMI or WC cut‐offs, correspondent masses of TAT, SATtotal, SATtrunk and VAT increased from childhood to adulthood. In all age groups, there were positive associations between BMI, WC, SATtrunk, VAT and HOMA‐IR. When compared with normative cut‐offs of BMI or WC, HOMA‐IR‐derived cut‐offs of regional fat depots were lower in all age groups.ConclusionsAssociations between BMI, WC and regional fat depots varied between children, adolescents, young and older adults. When compared with BMI‐derived and WC‐derived values, an insulin resistance‐derived cut‐off corresponded to lower masses of regional fat depots. Thus, established BMI and WC cut‐offs are not appropriate to assess metabolic disturbances associated with obesity; therefore, new cut‐offs of BMI and WC are needed for clinical practice.

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“…However, it has been reported that the HOMA-IR value increases with the age and pubertal stage of children and adolescents; for that reason, some authors prefer to use higher values [ 9 ]. Factors such as the development of puberty and ethnic differences are associated with variations in HOMA-IR from 1.8, 2.5, 3.16, and 3.2 to greater than 4 according to the population [ 2 , 38 ]. In our study, the group with obesity showed higher values with statistical significance in fasting glucose, fasting insulin, HOMA-IR, and HOMA-IR > 3.16, with respect to their controls at any stage of pubertal development.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Obesity on Puberty and Insulin Resistance in Mexican Children

Cardenas-Vargas

Nava

Garza‐Veloz

et al. 2018

International Journal of Endocrinology

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Obesity is considered the main risk factor associated with the development of insulin resistance (IR). The aim of this study was to evaluate the influence of obesity on puberty onset and IR in Mexican children. A total of 378 children (189 boys and 189 girls) aged 8–14 years participated in the study. IR was estimated using the homeostasis model assessment for IR (HOMA-IR). The mean fasting glucose (FG) and basal insulin levels were 82 mg/dl and 11.0 μIU/ml in boys and 77.3 mg/dl and 12.3 μIU/ml in girls (P < 0.05). Subjects with obesity at Tanner stages II–V showed increased FG levels (P < 0.05). In boys with obesity, there was a decrease in HOMA-IR in Tanner stage IV and differences in age between boys with normal weight and those with obesity in Tanner V, being older the boys with obesity. Obesity in children and adolescents was associated with higher HOMA-IR values. In boys with obesity, IR increased at the end of pubertal maturation, with a delay in puberty. These findings should be considered on the establishment of IR cutoff values for pubertal population in Mexico and in the establishment of strategies to prevent the health problems related to obesity.

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Identificação dos pontos de corte do índice Homeostatic Model Assessment for Insulin Resistance em adolescentes: revisão sistemática

Cited by 46 publications

References 37 publications

Association of acanthosis Nigricans and insulin resistance in indian children and youth – A HOMA2-IR based cross-sectional study

Association of acanthosis Nigricans and insulin resistance in indian children and youth – A HOMA2-IR based cross-sectional study

Definition of new cut-offs of BMI and waist circumference based on body composition and insulin resistance: differences between children, adolescents and adults

The Influence of Obesity on Puberty and Insulin Resistance in Mexican Children

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