title: Obesity-related insulin resistance in adolescents: a systematic review and meta-analysis of observational studies.
abstract: Insulin resistance is common among obese adolescents; however, the extent of this problem is not clear. We conducted a systematic review of PubMed-Medline, CINAHL, The Web of Science, EMBASE and Scopus for observational studies evaluating components defining insulin resistance (insulin, C-peptide and homeostatic model assessment-insulin resistance [HOMA-IR]) in obese adolescents (12-18 years) versus non-obese adolescents. Our systematic review and meta-analysis followed the PRISMA guidelines. Data were combined using a random-effects model and summary statistics were calculated using the mean differences (MDs). 31 studies were included (n = 8655). In 26 studies, fasting insulin levels were higher in obese adolescents when compared to non-obese adolescents (MD = 64.11 pmol/L, 95%CI 49.48-78.75, p < 0.00001). In three studies, fasting C-peptide levels were higher in obese adolescents when compared to non-obese adolescents (MD = 0.29 nmol/L, 95%CI 0.22-0.36, p < 0.00001). In 24 studies, HOMA-IR values were higher in obese adolescents when compared to non-obese adolescents (MD = 2.22, 95%CI 1.78-2.67, p < 0.00001). Heterogeneity of effects among studies was moderate to high. Subgroup analyses showed similar results to the main analyses. Circulating insulin and C-peptide levels and HOMA-IR values were significantly higher in obese adolescents compared to those non-obese.
authors.affiliation: a School of Medicine , Case Western Reserve University , Cleveland , OH , USA.
authors.forename: P
authors.initials: P
authors.lastname: Thota
authors.affiliation: b Department of Obstetrics and Gynecology , University of Zaragoza Faculty of Medicine and Lozano Blesa University Hospital , Domingo Miral s/n, Zaragoza , Spain.
authors.forename: F R
authors.initials: FR
authors.lastname: Perez-Lopez
authors.affiliation: c Center for Public Health Research, Research Institute, Faculty of Medicine, University of San Martin de Porres , Lima , Peru.
authors.forename: V A
authors.initials: VA
authors.lastname: Benites-Zapata
authors.affiliation: a School of Medicine , Case Western Reserve University , Cleveland , OH , USA.
authors.forename: V
authors.initials: V
authors.lastname: Pasupuleti
authors.affiliation: d School of Medicine , Universidad Peruana de Ciencias Aplicadas (UPC) , Lima , Peru , and.|e Department of Quantitative Health Sciences , Health Outcomes and Clinical Epidemiology Section, Cleveland Clinic, Cleveland, OH , USA.
authors.forename: A V
authors.initials: AV
authors.lastname: Hernandez
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D015415:Biomarkers / Q000097:blood; D002096:C-Peptide / Q000097:blood; D006801:Humans; D006946:Hyperinsulinism / Q000209:etiology / Q000517:prevention & control; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000209:etiology / Q000517:prevention & control; D064887:Observational Studies as Topic; D063766:Pediatric Obesity / Q000097:blood / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy; D015203:Reproducibility of Results
chemical_list: D015415:Biomarkers; D002096:C-Peptide; D007328:Insulin
keywords: Adolescence; C-peptide; HOMA-IR; homeostatic model assessment-insulin resistance; insulin; insulin resistance; obesity