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High HOMA‐IR, adjusted for puberty, relates to the metabolic syndrome in overweight and obese Chilean youths
Author(s) -
Burrows Raquel A,
Leiva Laura B,
Weisstaub Gerardo,
Lera Lydia M,
Albala Cecilia B,
Blanco Estela,
Gahagan Sheila
Publication year - 2011
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/j.1399-5448.2010.00685.x
Subject(s) - medicine , overweight , metabolic syndrome , body mass index , waist , quartile , insulin resistance , obesity , anthropometry , endocrinology , confidence interval
Burrows RA, Leiva LB, Weisstaub G, Lera LM, Albala CB, Blanco E, Gahagan S. High HOMA‐IR, adjusted for puberty, relates to the metabolic syndrome in overweight and obese Chilean youths. Objective: 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. Methods: 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. Results: 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. Conclusions: 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.