Reference ranges of HOMA-IR in normal-weight and obese young Caucasians

Shashaj, Blegina; Luciano, Rosa; Contoli, Benedetta; Morino, Giuseppe; Spreghini, Maria Rita; Rustico, Carmela; Sforza, Rita Wietrzycowska; Dallapiccola, Bruno; Manco, Melania

doi:10.1007/s00592-015-0782-4

Cited by 201 publications

(175 citation statements)

References 32 publications

Supporting

Mentioning

152

Contrasting

Unclassified

Order By: Relevance

“…[8][9][10][11][12][13]26,32 In this study, indices showed differences in insulin sensitivity with puberty development similar to baseline insulin. Schwartz et al found a modest correlation between insulin sensitivity surrogates 33 Only insulin level and the HOMA-IR index showed changes in insulin sensitivity during prepuberty.…”

Section: Discussionsupporting

confidence: 50%

Insulin level and insulin sensitivity indices among healthy children and adolescents

et al. 2016

View full text Add to dashboard Cite

Introduction. Information on insulin reference values and insulin sensitivity indices in the field of pediatrics is scarce. Objective. To describe insulin range and insulin sensitivity surrogate indices during childhood. Population and methods. Fasting insulin level range and surrogate indices, such as the homeostasis model assessment of insulin resistance (HOMA-IR), among healthy children and adolescents by age, body mass index, pubertal stage (PS), insulin-like growth factor-1 (IGF-1), total cholesterol, and triglycerides. Results. Two hundred and twenty-six healthy children and adolescents (1-18 years old) were included. Insulin increased with age, body mass index, pubertal stage, IGF-1 and triglyceride levels (r 2 = 0.38, p < 0.0001). Prepubertal children > 7.5 years old had higher insulin levels [median (P3 and P97) µIU/mL: 5.0 (1.7-9.6)] than prepubertal children ≤ 7.5 years old [2.9 µIU/ mL (1.3-10.9), p < 0.01]. During puberty (from PS II to PS V), insulin was higher in girls than in boys [7.4 (1.8-16.9) versus 5.8 (1.8-12.9), p < 0.01]. The HOMA-IR index increased in the group of prepubertal children > 7.5 years old: 1.1 (0.3-2.0) versus children ≤ 7.5 years old: 0.6 (0.3-1.4, p < 0.01). The insulin level and HOMA-IR results were higher in pubertal children compared to the prepubertal group (p < 0.001). Conclusions. Known physiological changes were observed in both insulin levels and the HOMA-IR index among children and adolescents. A fasting blood insulin level of 10 µIU/mL in prepubertal children and of 17 µIU/mL and 13 µIU/mL in pubertal girls and boys, respectively, may be considered as an acceptable cut-off value in healthy children. A HOMA-IR value > 2.0 and > 2.6 in prepubertal and pubertal children, respectively, may be considered a warning sign for pediatricians to further investigate insulin resistance.

show abstract

Section: Discussionsupporting

confidence: 50%

Insulin level and insulin sensitivity indices among healthy children and adolescents

et al. 2016

View full text Add to dashboard Cite

show abstract

“…21,22 HOMA-IR was calculated by multiplying glucose (mg/dL) by insulin (µU/mL) and dividing by 405. 23 The cutoff value of 2.56 was used to diagnose for IR, as previously reported in Korean adults.…”

Section: Definition Of Irmentioning

confidence: 99%

Insulin Resistance Is a Risk Factor for Silent Lacunar Infarction

Lee

Shin

Yun

et al. 2016

Stroke

View full text Add to dashboard Cite

Background and Purpose— This study aims to investigate the association between insulin resistance (IR) and silent lacunar infarction (SLI) in healthy adults. Methods— We recruited 2326 healthy Korean adults who took health checkups, including a brain magnetic resonance imaging. SLI was defined as an infarction measuring 0.3 to 1.5 cm in diameter that was localized in the territory of perforating branches of cerebral arteries, as seen in the brain magnetic resonance imaging. The homeostasis model assessment–estimated insulin resistance index was used for IR estimation, and the cutoff value for its diagnosis for Koreans was 2.56. Results— The mean age of the study population was 56.2 years (range, 40–79 years), and 1279 subjects (55.0%) were male. The prevalence of SLI and IR was 8.1% and 18.1%, respectively. In multivariate logistic analysis, after adjusting for traditional SLI-associated risk factors, IR was positively associated with the prevalence of SLI (adjusted odds ratio, 1.69; 95% confidence interval, 1.16–2.46). The proportion of subjects with multiple SLI lesions (≥2) was also higher in the IR (+) group than that in the IR (−) group (4.3% versus 1.7%; P <0.001). In ordered logistic regression, IR was positively associated with an increase in SLI severity (adjusted odds ratio, 1.76; 95% confidence interval, 1.21–2.56). Conclusions— IR is an independent risk factor of SLI presence and its severity in Koreans. Whether improvement of IR might prevent SLI occurrence needs to be addressed by clinical trials.

show abstract

“…In order to account for changes in HOMA-IR values that occur with age and sex, HOMA-IR values were converted to Z-scores, derived from HOMA-IR percentiles from an overweight/obese population sample. 29 Because reference values were only available up to the 97th percentile, in cases where the HOMA-IR exceeded the 97th percentile, we simply assigned the Z-score corresponding to the 97th percentile (ie, 1.88).…”

Section: Measurementsmentioning

confidence: 99%

“…A strength of our study is evaluation from the time of SDB diagnosis and intervention with PAP therapy. Further, we have used HOMA-IR percentiles, which are standardized by age and sex, 29 which partially account for pubertal status in the evaluation of metabolic status.…”

Section: Metabolic Markersmentioning

confidence: 99%

Insulin Resistance and Hypertension in Obese Youth With Sleep-Disordered Breathing Treated With Positive Airway Pressure: A Prospective Multicenter Study

Katz

MacLean

Hoey

et al. 2017

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

Study Objectives: There is evidence that cardiometabolic disease associated with obesity and sleep-disordered breathing (SDB) in adults is present in youth. SDB is often treated with positive airway pressure (PAP) in youth with obesity. Our aims were to determine: (1) the prevalence of cardiometabolic disease and (2) whether PAP improves markers of cardiometabolic disease, in youth with obesity and newly diagnosed moderate-severe SDB. Methods: A prospective multicenter cohort study was conducted in youth (8 to 16 years old) with obesity, prescribed PAP therapy for newly diagnosed moderate-severe SDB. Assessments occurred at baseline and at 6 and 12 months. Outcomes included markers of insulin resistance (change in homeostasis model assessment of insulin resistance (HOMA-IR) at 6 months = primary outcome), hypertension (24-hour ambulatory/blood pressure) and inflammation (high-sensitivity C-reactive protein: hs-CRP). Results: Twenty-seven participants were enrolled. Of those with baseline testing available, 10/25 (40%) had HOMA-IR above the 97th percentile, 10/23 (44%) were hypertensive, 16/23 (70%) had loss of nocturnal blood pressure dip and hs-CRP was elevated in 16/27 (64%). There were no significant changes over time in markers of metabolic dysfunction or blood pressure, nor between PAP-adherent and non-adherent subgroups. Conclusions:In youth with obesity and SDB, metabolic dysfunction and hypertension were highly prevalent. There were no statistically significant improvements in cardiometabolic markers 1 year after the prescription of PAP therapy, although clinically relevant improvements were seen in insulin resistance and systolic blood pressure load, important predictors of future risk of cardiovascular disease. Larger, longer-term studies are needed to determine whether PAP improves cardiometabolic outcomes in obese youth. I NTRO DUCTI O NThe fivefold increase in prevalence of childhood obesity in North America over the past 20 years has led to an increasing number of pediatric cases of obesity-related sleep-disordered breathing (SDB), which includes both obstructive sleep apnea (OSA) and nocturnal hypoventilation.1 The prevalence of SDB, particularly OSA, is significantly higher among obese children (13% to 66%) compared with the general population (1% to 3%).2 Routine treatment for SDB with adenotonsillectomy is not curative in 70% to 80% of children with obesity.3 Thus, positive airway pressure (PAP) treatment is usually prescribed. 2Additional obesity-related complications are also increasingly recognized in children, including metabolic disturbances with insulin resistance (IR) and hypertension. 4,5 This is concerning, as IR is an identified surrogate measure of future obesity-related sequelae, including diabetes, , hypertension, and systemic inflammation) is highly prevalent at the time of SDB diagnosis in youth with obesity. We were unable to detect statistically significant improvements in cardiometabolic markers 1 year after prescription of PAP therapy. There were, however, clinically relevan...

show abstract

Reference ranges of HOMA-IR in normal-weight and obese young Caucasians

Cited by 201 publications

References 32 publications

Insulin level and insulin sensitivity indices among healthy children and adolescents

Insulin level and insulin sensitivity indices among healthy children and adolescents

Insulin Resistance Is a Risk Factor for Silent Lacunar Infarction

Insulin Resistance and Hypertension in Obese Youth With Sleep-Disordered Breathing Treated With Positive Airway Pressure: A Prospective Multicenter Study

Contact Info

Product

Resources

About