Healthy Chilean Adolescents with HOMA-IR ≥ 2.6 Have Increased Cardiometabolic Risk: Association with Genetic, Biological, and Environmental Factors.
OBJECTIVE
To determine the optimal cutoff of the homeostasis model assessment-insulin resistance (HOMA-IR) for diagnosis of the metabolic syndrome (MetS) in adolescents and examine whether insulin resistance (IR), determined by this method, was related to genetic, biological, and environmental factors.


METHODS
In 667 adolescents (16.8 ± 0.3 y), BMI, waist circumference, glucose, insulin, adiponectin, diet, and physical activity were measured. Fat and fat-free mass were assessed by dual-energy X-ray absorptiometry. Family history of type 2 diabetes (FHDM) was reported. We determined the optimal cutoff of HOMA-IR to diagnose MetS (IDF criteria) using ROC analysis. IR was defined as HOMA-IR values above the cutoff. We tested the influence of genetic, biological, and environmental factors on IR using logistic regression analyses.


RESULTS
Of the participants, 16% were obese and 9.4 % met criteria for MetS. The optimal cutoff for MetS diagnosis was a HOMA-IR value of 2.6. Based on this value, 16.3% of participants had IR. Adolescents with IR had a significantly higher prevalence of obesity, abdominal obesity, fasting hyperglycemia, and MetS compared to those who were not IR. FHDM, sarcopenia, obesity, and low adiponectin significantly increased the risk of IR.


CONCLUSIONS
In adolescents, HOMA-IR ≥ 2.6 was associated with greater cardiometabolic risk.
Institute of Nutrition and Food Technology, University of Chile, Avenida El Líbano 5524, Macul, 7840390 Santiago, Chile.
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R
Burrows
Institute of Nutrition and Food Technology, University of Chile, Avenida El Líbano 5524, Macul, 7840390 Santiago, Chile.
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P
Correa-Burrows
Institute of Nutrition and Food Technology, University of Chile, Avenida El Líbano 5524, Macul, 7840390 Santiago, Chile.
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M
Reyes
Division of Child Development and Community Health, University of California, San Diego, 9500 Gilman Drive, MC 0927, La Jolla, San Diego, CA 92093-0927, USA.
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E
Blanco
Institute of Nutrition and Food Technology, University of Chile, Avenida El Líbano 5524, Macul, 7840390 Santiago, Chile.
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C
Albala
Division of Child Development and Community Health, University of California, San Diego, 9500 Gilman Drive, MC 0927, La Jolla, San Diego, CA 92093-0927, USA.
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S
Gahagan
D015502:Absorptiometry, Photon; D000293:Adolescent; D000886:Anthropometry; D001823:Body Composition; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics*; D002677:Chile; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D004777:Environment; D004781:Environmental Exposure; D005260:Female; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology; D009765:Obesity / Q000097:blood / Q000150:complications / Q000175:diagnosis; D012372:ROC Curve; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014505:Urban Population; D055105:Waist Circumference