Prevalence of Insulin Resistance and Association With Metabolic Risk Factors and Food Consumption in Adolescents - Recife/Brazil

Abstract

Objective: To identify the prevalence of insulin resistance in adolescents and its associations with metabolic factors and food intake. Methods: Cross-sectional study conducted with a stratified, complex, school-based sample. The subjects were adolescents (n=1,081) who participated in the Study of Cardiovascular Risk in Adolescents in the city of Recife (Pernambuco, Brazil). We analyzed demographic, socioeconomic, behavioral, anthropometric, biochemical, and dietary variables. Insulin resistance was defined as HOMA-IR>75th percentile. A Poisson multivariate regression model with robust variance adjustment was used, and variables with p≤0.05 in the final model were considered statistically associated with insulin resistance. Results: Median age was 14 years (interquartile range: 13-16 years), and 25.3% of the sample showed insulin resistance. The variables associated with insulin resistance in the final model were age, body mass index-for-age (BMI/A), biochemical markers (triglycerides and high-density lipoprotein cholesterol) and saturated fat intake, with insulin resistance being more prevalent in individuals whose consumption of this type of fat was below the median of the sample distribution. Conclusions: Insulin resistance was prevalent in the adolescents analyzed and was significantly associated with metabolic variables and saturated fat intake.

Insulin resistance and associated factors in female adolescents from two capital cities in the north and south of Brazil

“…Indeed, specific characteristics in each study, such as the age of the adolescent population and criteria used to define IR at each age may have influenced on this variation [ 31 ]. Similar to our findings, one study with Brazilian female adolescents using the 75th percentile of the HOMA-IR found a 27.8% prevalence of IR [ 9 ].…”

“…While the relationship between puberty and IR has been reported in different studies, IR and time of menarche have been addressed less frequently [ 9 ], although emerging evidence suggests an association between excess weight and age at menarche [ 10 , 11 ]. According to studies conducted in Brazil, it differs from other countries in being such a large country, with significant demographic, cultural and ethnic diversity among its regions, such as in the north and south of the country [ 12 , 13 ].…”

Is Macronutrients Intake a Challenge for Cardiometabolic Risk in Obese Adolescents?

“…In a large cohort of adolescents (with subjects included independently of their BMI), an energy-dense, high-fat, and low-fiber dietary pattern was positively associated with higher levels of insulin and HOMA-IR [ 51 ]. Moreover, a recent Brazilian cross-sectional study found that in a cohort of adolescents (again, including subjects independently of their BMI), an elevated saturated fat intake was associated with insulin resistance [ 52 ]. In adults, different studies on large cohorts and with long follow-up have demonstrated that a low-fat (but high-carbohydrate) diet is effective in the prevention of type 2 diabetes mellitus, reporting reductions in its incidence of up to 58% [ 53 , 54 , 55 , 56 ].…”

Hipertensão Arterial e Parâmetros Lipídicos, Glicídicos e de Adiposidade Associados em Adolescentes Escolares do Distrito Federal

“…Além disso, verificou-se elevação nos níveis de insulina e HOMA-IR. Andrade et al 26 sugerem, no entanto, que a RI pode estar relacionada ao desenvolvimento na adolescência, envolvendo alterações hormonais e de composição corporal em indivíduos de estágios iniciais da puberdade, podendo ser revertida após o estirão de crescimento. No entanto, isso não explica os resultados encontrados, pois a maior parte da população estudada encontrava-se na fase final da puberdade.…”