title: High HOMA-IR, adjusted for puberty, relates to the metabolic syndrome in overweight and obese Chilean youths.
abstract: 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.
authors.affiliation: Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile.
authors.forename: Raquel A
authors.initials: RA
authors.lastname: Burrows
authors.forename: Laura B
authors.initials: LB
authors.lastname: Leiva
authors.forename: Gerardo
authors.initials: G
authors.lastname: Weisstaub
authors.forename: Lydia M
authors.initials: LM
authors.lastname: Lera
authors.forename: Cecilia B
authors.initials: CB
authors.lastname: Albala
authors.forename: Estela
authors.initials: E
authors.lastname: Blanco
authors.forename: Sheila
authors.initials: S
authors.lastname: Gahagan
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D002677:Chile / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006706:Homeostasis; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology*; D015999:Multivariate Analysis; D050177:Overweight / Q000097:blood / Q000453:epidemiology*; D012044:Regression Analysis; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D008075:Lipoproteins, HDL; D014280:Triglycerides