HOMA-IR and Its Association with Metabolic Risk Factors among Korean Adolescents

Abstract

Purpose: This study was performed to evaluate the distribution of homeostasis model assessment of insulin resistance (HOMA-IR), a surrogate marker of insulin resistance, and its association with metabolic risk factors among Korean adolescents. Methods: This study was based on data from Korean National Health and Nutrition Examination Survey (KNHANES) 2008∼2009. Data from 2,035 adolescents (1,053 boys, 982 girls; aged 10∼19 years) were analyzed. We classified all subjects into four groups, based on the quartiles of HOMA-IR, and the highest quartile group was defined as the group with insulin resistance. We performed multivariate logistic regression analysis to determine the independent risk factors for insulin resistance. Results: The highest quartile values of HOMA-IR representing insulin res istance were 3.4 for boys and 3.6 for girls. Mean body mass index, waist circumference, systolic blood pressure, serum triglyceride, alanine aminotransferase (ALT), fasting glucose and insulin increased, whereas HDL cholesterol decreased with increased HOMA-IR. We found HOMA-IR has significant positive correlation with waist circumference, triglyceride, ALT level and systolic/diastolic blood pressure, while it has negative correlation with HDL-cholesterol level (p＜0.005). Independent predictors (odds ratio) for insulin resistance were elevated ALT (3.53 for boys; 4.04 for girls), central obesity (3.01 for boys; 3.20 for girls), and hypertriglyceridemia (3.03 for boys; 1.94 for girls). Conclusion: Metabolic risk factors were strongly associated with insulin resistance, defined as highest quartile values of HOMA-IR (≥3.4 for boys and ≥3.6 for girls). These values could be useful as a marker of insulin resistance and metabolic risk in Korean adolescents. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 376∼384)