title: Prevalence of insulin resistance and cardiometabolic risk in Korean children and adolescents: a population-based study.
abstract: OBJECTIVE
  We aimed to establish normal reference values of serum insulin and the homeostasis model assessment of insulin resistance (HOMA-IR). We also aimed to verify HOMA-IR "cut-off values" in predicting cardiometabolic risk among Korean children and adolescents.
  
  
  METHODS
  Data from 2716 Korean subjects (1421 male and 1295 female, aged 10-20 years) were evaluated. Insulin resistance was defined as HOMA-IR >95th percentile. The odds ratios of cardiometabolic risk were assessed based on the state of insulin resistance.
  
  
  RESULTS
  Reference values of insulin and HOMA-IR were determined according to sex and age, based on data obtained from normal-weight subjects with normal fasting glucose levels. HOMA-IR values appeared to peak at the age of 14-15 years in male subjects and at the age of 12-13 years in female subjects. The prevalence of insulin resistance in the subjects was 9.8% (male=10.9%, female=8.6%). The prevalence of insulin resistance in normal-weight, overweight, and obese subjects were 4.7%, 25.6%, and 47.1% respectively. Subjects with insulin resistance had a higher prevalence of metabolic syndrome (odds ratios=18.33; 95% confidence interval, 9.62-34.94) and its components, especially hyperglycemia and hypertriglyceridemia.
  
  
  CONCLUSIONS
  We established reference values of serum insulin and HOMA-IR according to age and sex. Obesity is the most important risk factor for insulin resistance and metabolic syndrome. However, insulin resistance independently increases cardiometabolic risk. This information may be useful for Korean as well as other Asian in planning programs for the prevention of type 2 diabetes.
authors.affiliation: Department of Pediatrics, Wonkwang University Sanbon Medical Center, Sanbon, Republic of Korea.
authors.forename: Kyung Hee
authors.initials: KH
authors.lastname: Yi
authors.affiliation: Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, Suwon, Republic of Korea.
authors.forename: Jin Soon
authors.initials: JS
authors.lastname: Hwang
authors.affiliation: Department of Pediatrics, College of Medicine Chosun University, Gwangju, Republic of Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Busan Paik Hospital College of Medicine, Inje University, Busan, Republic of Korea.
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Republic of Korea.
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Republic of Korea. Electronic address: limjs@kcch.re.kr.
authors.forename: Jung Sub
authors.initials: JS
authors.lastname: Lim
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000453:epidemiology* / Q000209:etiology; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000209:etiology; D009749:Nutrition Surveys; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000150:complications; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D055815:Young Adult
chemical_list: D007328:Insulin
keywords: Cardiovascular disease; Insulin resistance; Korean children and adolescents; Metabolic syndrome; National Health and Nutrition Examination Survey