High HOMA-IR, adjusted for puberty, relates to the metabolic syndrome in overweight and obese Chilean youths
- 22 March 2011
- journal article
- Published by Hindawi Limited in Pediatric Diabetes
- Vol. 12 (3pt2), 212-218
- https://doi.org/10.1111/j.1399-5448.2010.00685.x
Abstract
To determine how the homeostasis model assessment of insulin resistance (HOMA-IR) is related to metabolic risk in a sample of overweight and obese Chilean youths accounting for Tanner stage. A cross-sectional study assessing 486 overweight and obese youths (aged 5-15 years) recruited from the University of Chile, Pediatric Obesity Clinic. We measured anthropometry, Tanner stage, HOMA-IR, and laboratory tests related to metabolic risk. HOMA-IR was categorized by quartile for children (Tanner stages I and II) and adolescents (Tanner stage III and above) from a normative Chilean sample. Children and adolescents with HOMA-IR in the highest quartile were likely to have higher body mass index (BMI) Z-scores, elevated waist circumference, systolic and diastolic blood pressure, and triglycerides and low high-density lipoprotein. HOMA-IR had good negative predictive value for characteristics of the metabolic syndrome (MetS; 0.82). In a multivariate regression model, BMI Z-score [odds ratio (OR) 1.5] and HOMA-IR (OR 3.3) predicted 22% of the variance for the MetS, with 36% of the explained variance attributed to HOMA-IR. In a large clinical sample of overweight and obese Chilean youths, HOMA-IR ≥ 75th percentile was significantly associated with the cluster of factors referred to as the MetS. We emphasize the importance of establishing percentiles for HOMA-IR based on a normative sample and taking Tanner stage into account. Although BMI is easy to assess and interpret with minimal costs in a clinical setting, adding HOMA-IR explains more of the variance in the MetS than BMI Z-score alone.Keywords
This publication has 31 references indexed in Scilit:
- Metabolic syndrome in obese adolescentsPediatric Diabetes, 2010
- Insulin Resistance Markers in ChildrenHormone Research in Paediatrics, 2009
- Lipid Screening and Cardiovascular Health in ChildhoodPEDIATRICS, 2008
- Examining Metabolic Syndrome Definitions in Overweight Hispanic Youth: A Focus on Insulin ResistanceThe Journal of Pediatrics, 2008
- Metabolic Syndrome in Childhood Predicts Adult Metabolic Syndrome and Type 2 Diabetes Mellitus 25 to 30 Years LaterThe Journal of Pediatrics, 2008
- The dilemma of the metabolic syndrome in children and adolescents: disease or distraction?Pediatric Diabetes, 2006
- The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and AdolescentsPEDIATRICS, 2004
- Validation of surrogate estimates of insulin sensitivity and insulin secretion in children and adolescentsThe Journal of Pediatrics, 2004
- Trends in overweight and obesity prevalence in Chilean children: comparison of three definitionsEuropean Journal of Clinical Nutrition, 2002
- Insulin-Like Growth Factor Binding Protein-I Levels Are Strongly Associated with Insulin Sensitivity and Obesity in Early Pubertal ChildrenJournal of Clinical Endocrinology & Metabolism, 1998