title: Obesity, metabolic syndrome, and insulin resistance in urban high school students of minority race/ethnicity.
abstract: OBJECTIVE
  To determine the point prevalences of metabolic syndrome (MetS) and its components among healthy weight, overweight, and obese inner-city public high school students, to compare the prevalences of MetS when using 2 different definitions (one with the impaired fasting glucose [IFG] level and the other with a homeostasis model assessment of insulin resistance [HOMA-IR] of 3.99 or higher to define the glucose regulation component), and to compare the degree to which HOMA-IR and fasting glucose level are associated with the other MetS components.
  
  
  METHODS
  Cross-sectional analysis.
  
  
  METHODS
  Two New York City public high schools, from April 2008 through August 2011.
  
  
  METHODS
  Convenience sample of 1185 high school youth, comprising predominantly Hispanic and African American students from low-income households, participating in The Banishing Obesity and Diabetes in Youth Project, a medical screening and education program.
  
  
  METHODS
  Prevalences of the following individual MetS components: IFG threshold, HOMA-IR, hypertension, central adiposity, hypertriglyceridemia, and low high-density lipoprotein cholesterol. Rates of MetSIFG and MetSHOMA-IR were also assessed.
  
  
  RESULTS
  MetSIFG and MetSHOMA-IR point prevalences were both 0.3% in the healthy weight group; they were 2.6% and 5.9%, respectively, in the overweight group and were 22.9% and 35.1%, respectively, in the obese group (P < .05 for both). An IFG threshold of 100 mg/dL or higher was found in 1.0% of participants, whereas a HOMA-IR of 3.99 or higher was found in 19.5% of participants.
  
  
  CONCLUSIONS
  An elevated HOMA-IR is much more sensitive than an IFG threshold in identifying adolescents with metabolic dysregulation. Using a HOMA-IR threshold of 3.99 identifies more youth with MetS than using an IFG threshold of 100 mg/dL. In addition to increasing the sensitivity of MetS detection, HOMA-IR has a much higher association with the other MetS components than the IFG threshold and may better reflect a unified underlying pathologic process useful to identify youth at risk for disease.
authors.affiliation: Departments of Psychiatry, New York University School of Medicine, New York, NY 10016, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Turchiano
authors.forename: Victoria
authors.initials: V
authors.lastname: Sweat
authors.forename: Arthur
authors.initials: A
authors.lastname: Fierman
authors.forename: Antonio
authors.initials: A
authors.lastname: Convit
mesh_terms: D000293:Adolescent; D001741:Black or African American; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D016014:Linear Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000208:ethnology / Q000209:etiology*; D054525:Minority Health / Q000706:statistics & numerical data*; D009519:New York City; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000208:ethnology; D050177:Overweight / Q000097:blood / Q000150:complications / Q000208:ethnology; D015995:Prevalence; D012680:Sensitivity and Specificity; D014504:Urban Health / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose