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

BackgroundObesity and/or insulin resistance have gained increasing attention as the core manifestations of metabolic syndrome.ObjectiveTo 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 subjects60 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.ResultsMetabolic 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.ConclusionsHOMA-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.