Burrows R, Correa-Burrows P, Reyes M, Blanco E, Albala C, Gahagan S
Institute of Nutrition and Food Technology, University of Chile, Avenida El Líbano 5524, Macul, 7840390 Santiago, Chile.
Division of Child Development and Community Health, University of California, San Diego, 9500 Gilman Drive, MC 0927, La Jolla, San Diego, CA 92093-0927, USA.
J Diabetes Res. 2015;2015:783296. doi: 10.1155/2015/783296. Epub 2015 Jul 27.
To determine the optimal cutoff of the homeostasis model assessment-insulin resistance (HOMA-IR) for diagnosis of the metabolic syndrome (MetS) in adolescents and examine whether insulin resistance (IR), determined by this method, was related to genetic, biological, and environmental factors.
In 667 adolescents (16.8 ± 0.3 y), BMI, waist circumference, glucose, insulin, adiponectin, diet, and physical activity were measured. Fat and fat-free mass were assessed by dual-energy X-ray absorptiometry. Family history of type 2 diabetes (FHDM) was reported. We determined the optimal cutoff of HOMA-IR to diagnose MetS (IDF criteria) using ROC analysis. IR was defined as HOMA-IR values above the cutoff. We tested the influence of genetic, biological, and environmental factors on IR using logistic regression analyses.
Of the participants, 16% were obese and 9.4 % met criteria for MetS. The optimal cutoff for MetS diagnosis was a HOMA-IR value of 2.6. Based on this value, 16.3% of participants had IR. Adolescents with IR had a significantly higher prevalence of obesity, abdominal obesity, fasting hyperglycemia, and MetS compared to those who were not IR. FHDM, sarcopenia, obesity, and low adiponectin significantly increased the risk of IR.
In adolescents, HOMA-IR ≥ 2.6 was associated with greater cardiometabolic risk.
确定青少年代谢综合征（MetS）诊断中稳态模型评估胰岛素抵抗（HOMA-IR）的最佳截断值，并研究通过该方法确定的胰岛素抵抗（IR）是否与遗传、生物学和环境因素相关。
对667名青少年（16.8±0.3岁）测量体重指数（BMI）、腰围、血糖、胰岛素、脂联素、饮食和身体活动情况。采用双能X线吸收法评估脂肪和去脂体重。记录2型糖尿病家族史（FHDM）。我们使用ROC分析确定诊断MetS（国际糖尿病联盟标准）的HOMA-IR最佳截断值。IR定义为HOMA-IR值高于截断值。我们使用逻辑回归分析测试遗传、生物学和环境因素对IR的影响。
参与者中，16%为肥胖，9.4%符合MetS标准。MetS诊断的最佳截断值是HOMA-IR值为2.6。基于该值，16.3%的参与者存在IR。与无IR的青少年相比，有IR的青少年肥胖、腹型肥胖、空腹血糖升高和MetS的患病率显著更高。FHDM、肌肉减少症、肥胖和低脂联素显著增加IR风险。
在青少年中，HOMA-IR≥2.6与更高的心脏代谢风险相关。
