Journal List > Korean J Pediatr Gastroenterol Nutr > v.14(4) > 1043524

Seo, Lee, Kim, and Park: HOMA-IR and Its Association with Metabolic Risk Factors among Korean Adolescents

Abstract

Purpose

This study was performed to evaluate the distribution of homeostasis model assessment of insulin resistance (HOMA-IR), a surrogate marker of insulin resistance, and its association with metabolic risk factors among Korean adolescents.

Methods

This study was based on data from Korean National Health and Nutrition Examination Survey (KNHANES) 2008~2009. Data from 2,035 adolescents (1,053 boys, 982 girls; aged 10~19 years) were analyzed. We classified all subjects into four groups, based on the quartiles of HOMA-IR, and the highest quartile group was defined as the group with insulin resistance. We performed multivariate logistic regression analysis to determine the independent risk factors for insulin resistance.

Results

The highest quartile values of HOMA-IR representing insulin resistance were 3.4 for boys and 3.6 for girls. Mean body mass index, waist circumference, systolic blood pressure, serum triglyceride, alanine aminotransferase (ALT), fasting glucose and insulin increased, whereas HDL cholesterol decreased with increased HOMA-IR. We found HOMA-IR has significant positive correlation with waist circumference, triglyceride, ALT level and systolic/diastolic blood pressure, while it has negative correlation with HDL-cholesterol level (p<0.005). Independent predictors (odds ratio) for insulin resistance were elevated ALT (3.53 for boys; 4.04 for girls), central obesity (3.01 for boys; 3.20 for girls), and hypertriglyceridemia (3.03 for boys; 1.94 for girls).

Conclusion

Metabolic risk factors were strongly associated with insulin resistance, defined as highest quartile values of HOMA-IR (≥3.4 for boys and ≥3.6 for girls). These values could be useful as a marker of insulin resistance and metabolic risk in Korean adolescents.

Figures and Tables

Table 1
General Characteristics of the Subjects
kjpgn-14-376-i001

Data are expressed as Mean±SE for continuous variables and percentage (%) for categorical variables. Obesity level was determined according to the gender and age-specific BMI percentile; normal (BMI<85 percentile), overweight (BMI≥85 percentile and <95 percentile) and obese (BMI≥95 percentile). *HDL: high density lipoprotein, AST: serum aspartate aminotransferase, ALT: serum alanine aminotransferase, §HOMA-IR: homeostasis model assessment of insulin resistance.

Table 2
Metabolic Risk Factors Stratified by HOMA-IR Quartiles
kjpgn-14-376-i002

Data are shown as means±SE. The subjects were stratified into four groups according to HOMA-IR quartiles. Obesity level was determined according to gender and age-specific BMI percentile; normal (BMI<85 percentile), overweight (BMI≥85 percentile and <95 percentile) and obese (BMI≥95 percentile). *HOMA-IR: homeostasis model assessment of insulin resistance, BP: blood pressure, HDL: high density lipoprotein, §AST: aspartate aminotransferase, ALT: alanine aminotransferase.

Table 3
Age-adjusted Correlations between Homeostasis Model Assessment of Insulin Resistance and Metabolic Risk Factors
kjpgn-14-376-i003

Correlation coefficients were calculated using partial correlation analysis. *ALT: alanine aminotransferase, HDL: high density lipoprotein.

Table 4
Age-adjusted Odds Ratios (95% Confidence Intervals) for Insulin Resistance by Multivariate Logistic Regression
kjpgn-14-376-i004

Subjects with a homeostasis model assessment of insulin resistance (HOMA-IR) level greater than the highest quartile (≥3.4 for boys and ≥3.6 for girls) were defined as insulin resistant. Elevated fasting glucose: Fasting glucose ≥100 mg/dL, Elevated ALT: ALT ≥32 IU/L for boys, ALT ≥24 IU/L for girls. Central obesity: Waist circumference ≥90 percentile of sex and age specific reference, Hypertriglyceridemia: TG ≥110 mg/dL. Low HDL: HDL <40 mg/dL, Hypertension: systolic BP or diastolic BP ≥90 percentile of sex, age and height specific reference. *OR: odds ratio, CI: confidence interval, ALT: alanine aminotransferase, §HDL: high density lipoprotein.

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