Homeostatic model assessment of insulin resistance as a predictor of metabolic syndrome: Consequences of obesity in children and adolescents

Abstract

Background: Obesity and/or insulin resistance have gained increasing attention as the core manifestations of metabolic syndrome. Objective: To evaluate insulin resistance according to homeostasis model assessment of insulin resistance index HOMA-IR in obese children and adolescents with or without metabolic syndrome at risk of type 2 diabetes mellitus. Design and subjects: 60 obese children and adolescents were recruited, metabolic syndrome was diagnosed according to the modified WHO criteria adapted for children and adolescents. Insulin resistance was calculated using the HOMA-IR. Results: Metabolic syndrome (MS) was found in 42 subjects (70%), using modified WHO guidelines for diagnosing MS. On comparing MS-related parameters between the groups with (MS+) and without metabolic syndrome (MS−), median body mass index, waist circumference, waist/height ratio, and blood pressure, total cholesterol and triglyceride were significantly higher in the MS + group. Basal insulin level as well as HOMA-IR was also significantly different between MS+ and MS-groups. The presence of insulin resistance according to HOMA-IR was identified in 53% of obese children and adolescents. This HOMA-IR age and sex limit was exceeded by 70% children in the MS + group, but only by 43% children in the MS-group (p < 0.001). HOMA-IR was positively correlated with the majority of anthropometric and biochemical parameters. The correlation was strongest with body mass index, waist circumference and diastolic blood pressure. Conclusions: HOMA-IR might be a reliable surrogate measure of insulin resistance and a strong predictor of type 2 diabetes in obese adolescents allowing the development of preventive measures and treatment when needed.

Keywords

• Insulin resistance
• Metabolic syndrome
• HOMA-IR
• Adolescents