Neighborhood characteristics and components of the insulin resistance syndrome in young adults: the coronary artery risk development in young adults (CARDIA) study.
OBJECTIVE
To examine associations of neighborhood characteristics with six components of the insulin resistance syndrome (IRS) in young adults.


METHODS
Cross-sectional data from the Coronary Artery Risk Development in Young Adults (CARDIA) Study were used to examine associations of neighborhood characteristics with the IRS in 3,093 nondiabetic adults aged 28-40 years. Measures of BMI, fasting HDL cholesterol, triglycerides, insulin, glucose, and systolic blood pressure were combined into an IRS score. U.S. Census-derived neighborhood characteristics were summarized into a neighborhood socioeconomic score, with an increasing score signifying increasing socioeconomic advantage.


RESULTS
Among white men and women, the IRS score was inversely related to neighborhood socioeconomic score. Neighborhood characteristics remained associated with the IRS score after controlling for personal income and education (adjusted mean differences for 95th vs. 5th percentile of neighborhood score: -0.24 standard deviation units [SE = 0.12] in men and -0.56 standard deviation units [SE = 0.10] in women). Among black participants, neighborhood score was inversely associated with IRS score in persons of high income and education (mean differences 95th vs. 5th percentile -0.54 [SE 0.26] in men and -0.52 [SE 0.26] in women) but positively associated or not associated with IRS score in persons of low income and education (mean differences 0.60 [SE 0.21] in men and 0.00 [SE 0.16] in women).


CONCLUSIONS
The IRS score is associated with neighborhood characteristics as early as young adulthood. Features of residential environments may be related to the development of insulin resistance.
Diez Roux
Ana V
AV
Division of General Medicine, Columbia College of Physicians and Surgeons and Division of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10032, USA. ad290@columbia.edu
Jacobs
David R
DR
Kiefe
Catarina I
CI
D000293:Adolescent; D000328:Adult; D044383:Black People; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000503:physiopathology*; D012307:Risk Factors; D012727:Sex Characteristics; D014481:United States / Q000453:epidemiology; D044465:White People; D001741:Black or African American