Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA.
Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA.
J Clin Endocrinol Metab. 2022 Jan 1;107(1):e25-e37. doi: 10.1210/clinem/dgab645.
The burden of insulin resistance (IR) among young American adults has not been previously assessed. We evaluated (1) the prevalence and trends of IR and cardiometabolic risk factors and (2) the association between measures of adiposity and IR among adults 18 to 44 years of age without diabetes and preexisting cardiovascular disease.
Cross-sectional survey data from six consecutive National Health and Nutrition Examination Survey (2007-2008 to 2017-2018) cycles were analyzed. IR was defined by the homeostatic model assessment for IR (HOMA-IR) of ≥2.5. The temporal trends of IR, cardiometabolic risk factors, and the relationship between IR and measures of adiposity were assessed using multivariable-adjusted regression models.
Among 6247 young adults 18 to 44 years of age, the prevalence of IR was 44.8% (95% CI: 42.0%-47.6%) in 2007-2010 and 40.3% (95% CI: 36.4%-44.2%) in 2015-2018 (P for trend = 0.07). There was a modest association of HOMA-IR with higher body mass index (BMI), waist circumference, total lean fat mass, and total and localized fat mass (all Ps < 0.001). Participants with IR had a higher prevalence of hypertension [31.3% (95% CI: 29.2%-33.5%) vs 14.7% (95% CI: 13.2%-16.2%)], hypercholesterolemia [16.0% (95% CI: 12.4%-19.5%) vs 7.0% (95% CI: 5.8%-8.5%)], obesity [56.6% (95% CI: 53.9%-59.3%) vs 14.7% (95% CI: 13.0%-16.5%)], and poor physical activity levels [18.3% (95% CI: 16.4%-20.2%) vs 11.7% (95%CI: 10.3-13.1%)] compared to participants without IR (all Ps < 0.05).
Four-in-10 young American adults have IR, which occurs in a cluster with cardiometabolic risk factors. Nearly half of young adults with IR are nonobese. Screening efforts for IR irrespective of BMI may be required.
胰岛素抵抗（IR）在年轻美国成年人中的负担尚未得到评估。我们评估了（1）IR 和心血管代谢风险因素的流行率和趋势，以及（2）18 至 44 岁无糖尿病和既往心血管疾病的成年人中肥胖指标与 IR 之间的关联。
对六个连续国家健康和营养检查调查（2007-2008 年至 2017-2018 年）周期的横断面调查数据进行了分析。IR 由稳态模型评估的胰岛素抵抗（HOMA-IR）定义为≥2.5。使用多变量调整回归模型评估 IR、心血管代谢风险因素的时间趋势以及 IR 与肥胖指标之间的关系。
在 6247 名 18 至 44 岁的年轻人中，IR 的患病率在 2007-2010 年为 44.8%（95%CI：42.0%-47.6%），在 2015-2018 年为 40.3%（95%CI：36.4%-44.2%）（趋势 P=0.07）。HOMA-IR 与较高的体重指数（BMI）、腰围、总瘦体脂肪、总脂肪量和局部脂肪量呈适度相关（均 P<0.001）。IR 患者高血压的患病率较高[31.3%（95%CI：29.2%-33.5%）vs 14.7%（95%CI：13.2%-16.2%）]、高胆固醇血症[16.0%（95%CI：12.4%-19.5%）vs 7.0%（95%CI：5.8%-8.5%）]、肥胖[56.6%（95%CI：53.9%-59.3%）vs 14.7%（95%CI：13.0%-16.5%）]和体力活动水平较差[18.3%（95%CI：16.4%-20.2%）vs 11.7%（95%CI：10.3-13.1%）]与无 IR 患者相比（均 P<0.05）。
每四个年轻的美国成年人中就有一个患有 IR，这种情况与心血管代谢危险因素同时发生。近一半的 IR 年轻成年人并非肥胖。可能需要进行无论 BMI 如何的 IR 筛查工作。
