Homeostatic model assessment of insulin resistance as a predictor of metabolic syndrome : consequences of obesity in children and adolescents

Abstract EN

Background : Obesity and / or insulin resistance have gained increasing attention as the core manifestations of metabolic syndrome.

Objective : To evaluate insulin resistance according to homeostasis model assessment of insulin resistance index HOMA-IR in obese children and adolescents with or without metabolic syndrome at risk of type 2 diabetes mellitus.

Design and subjects : 60 obese children and adolescents were recruited, metabolic syndrome was diagnosed according to the modified WHO criteria adapted for children and adolescents.

Insulin resistance was calculated using the HOMA-IR.

Results : Metabolic syndrome (MS) was found in 42 subjects (70 %), using modified WHO guidelines for diagnosing MS.

On comparing MS-related parameters between the groups with (MS+) and without metabolic syndrome (MS_), median body mass index, waist circumference, waist / height ratio, and blood pressure, total cholesterol and triglyceride were significantly higher in the MS+ group.

Basal insulin level as well as HOMA-IR was also significantly different between MS+ and MS-groups.

The presence of insulin resistance according to HOMA-IR was identified in 53 % of obese children and adolescents.

This HOMA-IR age and sex limit was exceeded by 70 % children in the MS + group, but only by 43 % children in the MS-group (p < 0.001).

HOMA-IR was positively correlated with the majority of anthropometric and biochemical parameters.

The correlation was strongest with body mass index, waist circumference and diastolic blood pressure.

Conclusions : HOMA-IR might be a reliable surrogate measure of insulin resistance and a strong predictor of type 2 diabetes in obese adolescents allowing the development of preventive measures and treatment when needed.