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. 2022 Jan 1;107(1):e25-e37.
doi: 10.1210/clinem/dgab645.

Insulin Resistance and Cardiometabolic Risk Profile Among Nondiabetic American Young Adults: Insights From NHANES

Vibhu Parcha  1 , Brittain Heindl  1 , Rajat Kalra  2 , Peng Li  3 , Barbara Gower  4 , Garima Arora  1 , Pankaj Arora  1   5
Affiliations

Insulin Resistance and Cardiometabolic Risk Profile Among Nondiabetic American Young Adults: Insights From NHANES

Vibhu Parcha et al. J Clin Endocrinol Metab. .

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

Keywords: cardiovascular disease; cardiovascular risk; diabetes; hypercholesterolemia; hypertension; insulin resistance; young adults.

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Figures

Figure 1.
Figure 1.
Association of measures of adiposity with homeostatic model for insulin resistance (HOMA-IR) among National Health and Nutrition Examination Survey participants 18-44 years of age. The figure depicts the linear association of HOMA-IR values and the measures of adiposity, which includes body mass index (A), waist circumference (B), total fat mass (C), total lean mass (D), leg fat mass (E), arm fat mass (F) and trunk fat mass (G).
Figure 2.
Figure 2.
Predictors of insulin resistance among young American adults 8 to 44 years: National Health and Nutrition Examination Survey 2007-2018. The figure depicts the odds ratio and CIs for the various predictors of insulin resistance derived from a multivariable logistic regression model.
See this image and copyright information in PMC

References

    1. Kekäläinen P, Sarlund H, Laakso M. Long-term association of cardiovascular risk factors with impaired insulin secretion and insulin resistance. Metabolism. 2000;49(10):1247-1254. - PubMed
    1. Ormazabal V, Nair S, Elfeky O, Aguayo C, Salomon C, Zuñiga FA. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol. 2018;17(1):122. - PMC - PubMed
    1. Laakso M, Kuusisto J. Insulin resistance and hyperglycaemia in cardiovascular disease development. Nat Rev Endocrinol. 2014;10(5):293-302. - PubMed
    1. Hedblad B, Nilsson P, Engström G, Berglund G, Janzon L. Insulin resistance in non-diabetic subjects is associated with increased incidence of myocardial infarction and death. Diabetic Med. 2002;19(6):470-475. - PubMed
    1. Jeppesen J, Hansen TW, Rasmussen S, Ibsen H, Torp-Pedersen C, Madsbad S. Insulin resistance, the metabolic syndrome, and risk of incident cardiovascular disease: a population-based study. J Am Coll Cardiol. 2007;49(21):2112-2119. - PubMed

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