Prevalence and determinants of insulin resistance among U.S. adolescents. Diabetes Care 2006

OBJECTIVE — We sought to examine the distribution of insulin and homeostasis model assessment of insulin resistance (HOMA-IR) and associations of HOMA-IR with sex, race/ ethnicity, age, and weight status, as measured by BMI, among U.S. adolescents. RESEARCHDESIGNANDMETHODS — Of 4,902 adolescents aged 12–19 years who participated in the National Health and Nutrition Examination Survey 1999–2002, analysis was performed for a nationally representative subsample of 1,802 adolescents without diabetes who had fasting laboratory measurements. The main outcome measure was HOMA-IR, calculated from fasting insulin and glucose and log transformed for multiple linear regression analyses. RESULTS — In adjusted regression models that included age and weight status, girls had higher HOMA-IR than boys and Mexican-American children had higher HOMA-IR levels than white children. There were no significant differences in adjusted HOMA-IR between black and white children. Obese children (BMI 95th percentile) had significantly higher levels of HOMA-IR compared with children of normal weight (BMI85th percentile) in adjusted com-parisons (mean HOMA-IR 4.93 [95 % CI 4.56–5.35] vs. 2.30 [2.21–2.39], respectively). Weight status was by far the most important determinant of insulin resistance, accounting for 29.1 % o