Identification of a HOMA-IR cut-off point for cardiometabolic risk and modifiable risk factors in peruvian adolescents.

Abstract

Although HOMA-IR is widely used to assess insulin resistance, reported cut-off values vary substantially across population, particularly during adolescence. The aim of this study was to determine the distribution of HOMA-IR values. identify a HOMA-IR cut-off associated with metabolic syndrome (MS), and assess modifiable risk factors of IR in a longitudinal cohort of Peruvian adolescents. We performed a secondary data analysis from a longitudinal adolescent's study. A sample of 371 adolescents (14.5 ± 0.1 years old) from low- medium socioeconomic status. ROC curve analysis was used to identify the specific cut-off point to classify IR using the sensitivity and specificity values in comparison with the MS. Multiple logistic regression analysis including diet, physical activity and body composition from adolescence, excess weight during infancy and family history of non-chronic disease was included to identify risk factors (FHCD) associated with IR. The HOMA-IR was 3.29 (SD 1.71) with no differences by sex. We identified 3.9 for HOMA-IR as the cut-off point with sensitivity (72.4%) and specificity (75.4%) for predicting MS. IR was present in 28.6% (95% CI 24.2;33.4%); 84% had at least one cardiometabolic risk factor and low HDL and abdominal obesity were the most prevalent (62 and 35%, respectively). Adolescents with higher fat mass index (OR 16.03, 95% CI 6.79 to 37.86), and those physically inactive (OR 2.08 95% CI 1.06 to 4.07) were more likely to have IR. No association was found with diet, excess weight at infancy and FHCD. A cut-offs point of 3.9 for HOMA-IR allows to identify adolescents with high metabolic risk. Strategies to promote lower FMI and improve the physical activity levels could reduce the risk of IR in adolescents.