Insulin Resistance and Cardiometabolic Risk Profile Among Nondiabetic American Young Adults: Insights From NHANES

Abstract

Background The burden of insulin resistance (IR) among young American adults has not been previously assessed. We evaluated the 1) prevalence and trends of IR and cardiometabolic risk factors and, 2) assessed the association between measures of adiposity and IR among adults aged 18-44 years without diabetes and preexisting cardiovascular disease. Methods Cross-sectional survey data from six consecutive National Health and Nutrition Examination Survey (2007-2008 to 2017-2018) cycles were analyzed. IR was defined by the homeostatic model assessment for IR (HOMA-IR) of ≥2.5. The temporal trends of IR, cardiometabolic risk factors, and the relationship between IR and measures of adiposity were assessed using multivariable-adjusted regression models. Results Among 6,247 young adults aged 18-44 years, the prevalence of IR was 44.8% (95% CI: 42.0-47.6%) in 2007-2010 and 40.3% (95% CI: 36.4-44.2%) in 2015-2018 (Ptrend=0.07). There was a modest association of HOMA-IR with higher body mass index (BMI), waist circumference, total lean fat mass, and total and localized fat mass (all p<0.001). Participants with IR had a higher prevalence of hypertension (31.3% [95% CI: 29.2-33.5%] vs. 14.7% [95% CI: 13.2-16.2%]), hypercholesterolemia (16.0% [95% CI: 12.4-19.5%] vs. 7.0% [95% CI: 5.8-8.5%]), obesity (56.6% [95% CI: 53.9-59.3%] vs. 14.7% [95%CI: 13.0-16.5%]) and poor physical activity levels (18.3% [95% CI: 16.4-20.2%] vs. 11.7% [95%CI: 10.3-13.1%]) compared to participants without IR (all p<0.05). Conclusions Four-in-ten young American adults have IR, which occurs in a cluster with cardiometabolic risk factors. Nearly half of young adults with IR are non-obese. Screening efforts for IR irrespective of BMI may be required.

A combined index of waist circumference and muscle quality is associated with cardiovascular disease risk factor accumulation in Japanese obese patients: a cross-sectional study

“…Our study demonstrated that MQ was most associated with CVD risk factor accumulation compared with SMI and HGS, regardless of sex and age (Table 2B ). MQ was reported to be negatively associated with insulin resistance after adjusting for age, body fat, highly sensitive C-reactive protein levels, and physical activity level in adult obese women [ 47 ] and further that insulin resistance contributes to the development of atherosclerosis [ 48 , 49 ], findings that are consistent with our results.…”

A Combined Index of Waist Circumference and Muscle Quality is Associated with Accumulation of Cardiovascular Disease Risk Factors in Obese Patients: A Cross-sectional Study

“…In addition, low HGS has been reported to be associated with coronary artery calci cation, CVD, and all-cause mortality [45][46][47] Our study demonstrated that MQ was most associated with the accumulation of CVD risk factors compared with SMI and HGS, regardless of sex and age (Table 2B). MQ was reported to be negatively associated with insulin resistance after adjusting for age, body fat, highly sensitive C-reactive protein levels, and physical activity level in adult obese women [48] and further that insulin resistance contributes to the development of atherosclerosis [49,50], ndings that are consistent with our results.…”

AHA Life's essential 8 and ideal cardiovascular health among young adults

“…The average self-reported duration of sleep per day was obtained from the sleep disorders questionnaire. Additionally, data on insurance status (yes/no), number of healthcare visits in the past year (none, 1 to 3, 4 or more), poverty income ratio (≥3.50, 1.30-3.49, <1.30), and educational status (≤12 years of education, some college education, and a college degree or higher) were used in this study [ 15 , 22 ].…”