Obesity and Insulin Resistance Screening Tools in American Adolescents: National Health and Nutrition Examination Survey (NHANES) 1999 to 2010.
OBJECTIVE
To identify which feasible obesity and insulin resistance (IR) screening tools are most strongly associated in adolescents by using a nationally representative sample.


METHODS
Adolescents aged 12.0 to 18.9 years who were participating in the National Health and Nutrition Examination Survey (NHANES) (n=3584) and who were measured for height, weight, waist circumference (WC), triceps and subscapular skinfold thickness, glycated hemoglobin, fasting glucose (FG) and fasting insulin (FI) level were included. Adolescents were split by gender and grouped by body mass index (BMI) percentile. Age- and gender-specific classifications were constructed for each obesity screening tool measure to account for growth and maturation. General linear models were used to establish groups objectively for analysis based on when IR began to increase. Additional general linear models were used to identify when IR significantly increased for each IR measure as obesity group increased and to identify the variance accounted for among each obesity-IR screening tool relationship.


RESULTS
As the obesity group increased, homeostasis model assessment-insulin resistance (HOMA-IR) and FI significantly increased, while FG increased only (above the referent) in groups with BMI percentiles ≥95.0, and glycated hemoglobin level did not vary across obesity groups. The most strongly associated screening tools were WC and FI in boys (R(2)=0.253) and girls (R(2)=0.257). FI had the strongest association with all of the obesity measures. BMI associations were slightly weaker than WC in each in relation to IR.


CONCLUSIONS
Our findings show that WC and FI are the most strongly associated obesity and IR screening tool measures in adolescents. These feasible screening tools should be utilized in screening practices for at-risk adolescents.
Department of Kinesiology, Iowa State University, Forker Building, Ames, Iowa, USA. Electronic address: jalee3@iastate.edu.
Joey A
JA
Lee
School of Kinesiology and Recreation, Illinois State University, McCormick Hall, Normal, Illinois, USA.
Kelly R
KR
Laurson
D000293:Adolescent; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D016014:Linear Models; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009749:Nutrition Surveys; D009765:Obesity / Q000150:complications*; D055105:Waist Circumference
D007328:Insulin
body mass index; indice de masse corporelle; insulin sensitivity; insulinosensibilité; jeunesse; overweight; surcharge pondérale; tour de taille; waist circumference; youth