title: Weight, physical activity, and smoking as determinants of insulinemia in adolescents.
abstract: BACKGROUND
  It is known that insulinemia is the result of the interaction among several factors, such as weight, body fat pattern distribution, and physical activity as well as ethnicity. There is little information regarding this question among Mexican adolescents. The association among fasting insulin levels, weight, fat distribution, physical activity, and cigarette smoking was studied in Mexican adolescents.
  
  
  METHODS
  Cross-sectional data were collected from 352 Mexican adolescents aged 14-19 years (response rate 41.5%). Fasting insulin levels were measured by microparticle enzyme immunoassay; body mass index (BMI), waist-to-hip ratio (WHR), and waist circumference (WC) were determined using standardized techniques, while physical activity was determined by 7-day Stanford physical activity inventory. Cigarette smoking was defined as number of cigarettes/year.
  
  
  RESULTS
  Increased BMI and waist circumference, low physical activity, younger age, and non-smoking were associated with high insulin levels. Non-smokers had higher fasting insulin levels compared to smokers (57.8 pmol +/- 1.84 vs. 49.7 pmol/L +/- 2.8; p = 0.034). However, adjusted odds ratio (OR) between insulin and smoking status was not significant. Multivariate analysis showed the following: insulin increased 1.06 pmol/L for each unit of change in BMI; increased 1.02 pmol/L for each unit of change in waist circumference; increased 1.16 pmol/L for non-smoking, and decreased 1.07 pmol/L for each 250 kcal/day of energy expenditure.
  
  
  CONCLUSIONS
  Our results support the concept that Mexican adolescents who are overweight have abdominal fat distribution and physical inactivity, and significant hyperinsulinemia. The relationship between smoking and lower insulinemia found in this research warrants further study.
authors.affiliation: Unidad de Investigación Epidemiológica y en Servicios de Salud del Adolescente, Instituto Mexicano del Seguro Social (IMSS), Tonalá, Jalisco, Mexico. ramilope@hotmail.com
authors.forename: G
authors.initials: G
authors.lastname: Ramírez-López
authors.forename: C
authors.initials: C
authors.lastname: González-Villalpando
authors.forename: J
authors.initials: J
authors.lastname: Sánchez-Corona
authors.forename: J
authors.initials: J
authors.lastname: Salmerón-Castro
authors.forename: M
authors.initials: M
authors.lastname: González-Ortíz
authors.forename: A
authors.initials: A
authors.lastname: Celis-de la Rosa
authors.forename: V
authors.initials: V
authors.lastname: Valles-Sánchez
mesh_terms: D000293:Adolescent; D000328:Adult; D001835:Body Weight; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood*; D008297:Male; D008800:Mexico; D012907:Smoking / Q000097:blood*
chemical_list: D007328:Insulin