Prevalence of insulin resistance and cardiometabolic risk in Korean children and adolescents: A population-based study

• Published in: Diabetes research and clinical practice 2014-01, Vol.103 (1), p.106-113
• Main Authors: Yi, Kyung Hee, Hwang, Jin Soon, Kim, Eun Young, Lee, Sun Hee, Kim, Dong Ho, Lim, Jung Sub
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Body Mass Index; Cardiovascular disease; Child; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - etiology; Endocrinology & Metabolism; Female; Humans; Hypertriglyceridemia - epidemiology; Hypertriglyceridemia - etiology; Insulin - blood; Insulin Resistance; Korean children and adolescents; Male; Metabolic syndrome; Metabolic Syndrome - epidemiology; Metabolic Syndrome - etiology; National Health and Nutrition Examination Survey; Nutrition Surveys; Obesity - complications; Overweight - complications; Prevalence; Republic of Korea - epidemiology; Risk Factors; Young Adult
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2013.10.021

Abstract Aims We aimed to establish normal reference values of serum insulin and the homeostasis model assessment of insulin resistance (HOMA-IR). We also aimed to verify HOMA-IR “cut-off values” in predicting cardiometabolic risk among Korean children and adolescents. Methods Data from 2716 Korean subjects (1421 male and 1295 female, aged 10–20 years) were evaluated. Insulin resistance was defined as HOMA-IR >95th percentile. The odds ratios of cardiometabolic risk were assessed based on the state of insulin resistance. Results Reference values of insulin and HOMA-IR were determined according to sex and age, based on data obtained from normal-weight subjects with normal fasting glucose levels. HOMA-IR values appeared to peak at the age of 14–15 years in male subjects and at the age of 12–13 years in female subjects. The prevalence of insulin resistance in the subjects was 9.8% (male = 10.9%, female = 8.6%). The prevalence of insulin resistance in normal-weight, overweight, and obese subjects were 4.7%, 25.6%, and 47.1% respectively. Subjects with insulin resistance had a higher prevalence of metabolic syndrome (odds ratios = 18.33; 95% confidence interval, 9.62–34.94) and its components, especially hyperglycemia and hypertriglyceridemia. Conclusion We established reference values of serum insulin and HOMA-IR according to age and sex. Obesity is the most important risk factor for insulin resistance and metabolic syndrome. However, insulin resistance independently increases cardiometabolic risk. This information may be useful for Korean as well as other Asian in planning programs for the prevention of type 2 diabetes.