Prevalence of insulin resistance and cardiometabolic risk in Korean children and adolescents: a population-based study.

Abstract

AIMS: 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. CONCLUSION: 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.