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Arch Pediatr Adolesc Med. 2012 Nov;166(11):1030-6. doi: 10.1001/archpediatrics.2012.1263.

Obesity, metabolic syndrome, and insulin resistance in urban high school students of minority race/ethnicity.

Author information

1
Departments of Psychiatry, New York University School of Medicine, New York, NY 10016, USA.

Abstract

OBJECTIVES:

To determine the point prevalences of metabolic syndrome (MetS) and its components among healthy weight, overweight, and obese inner-city public high school students, to compare the prevalences of MetS when using 2 different definitions (one with the impaired fasting glucose [IFG] level and the other with a homeostasis model assessment of insulin resistance [HOMA-IR] of 3.99 or higher to define the glucose regulation component), and to compare the degree to which HOMA-IR and fasting glucose level are associated with the other MetS components.

DESIGN:

Cross-sectional analysis.

SETTING:

Two New York City public high schools, from April 2008 through August 2011.

PARTICIPANTS:

Convenience sample of 1185 high school youth, comprising predominantly Hispanic and African American students from low-income households, participating in The Banishing Obesity and Diabetes in Youth Project, a medical screening and education program.

MAIN OUTCOME MEASURES:

Prevalences of the following individual MetS components: IFG threshold, HOMA-IR, hypertension, central adiposity, hypertriglyceridemia, and low high-density lipoprotein cholesterol. Rates of MetSIFG and MetSHOMA-IR were also assessed.

RESULTS:

MetSIFG and MetSHOMA-IR point prevalences were both 0.3% in the healthy weight group; they were 2.6% and 5.9%, respectively, in the overweight group and were 22.9% and 35.1%, respectively, in the obese group (P < .05 for both). An IFG threshold of 100 mg/dL or higher was found in 1.0% of participants, whereas a HOMA-IR of 3.99 or higher was found in 19.5% of participants.

CONCLUSIONS:

An elevated HOMA-IR is much more sensitive than an IFG threshold in identifying adolescents with metabolic dysregulation. Using a HOMA-IR threshold of 3.99 identifies more youth with MetS than using an IFG threshold of 100 mg/dL. In addition to increasing the sensitivity of MetS detection, HOMA-IR has a much higher association with the other MetS components than the IFG threshold and may better reflect a unified underlying pathologic process useful to identify youth at risk for disease.

PMID:
23007727
PMCID:
PMC3615436
DOI:
10.1001/archpediatrics.2012.1263
[Indexed for MEDLINE]
Free PMC Article

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