Proportion of insulin resistance in overweight and obese children of the age group 5-15 years using the homeostasis model assessment of insulin resistance index

Abstract

Background: Childhood obesity is increasingly recognized as a major public health concern and is associated with insulin resistance, the underlying mechanism behind many components of metabolic syndrome. Early detection of insulin resistance may provide an opportunity for timely intervention. The homeostasis model assessment of insulin resistance (HOMA-IR) is a simple and validated index used to quantify insulin resistance. Methods: We conducted a hospital-based cross-sectional study among 165 children attending the outpatient department or admitted under the Department of Paediatrics at a tertiary care centre in southern India. Detailed history, clinical examination, anthropometric measurements, and laboratory investigations were performed. Insulin resistance was assessed using HOMA-IR, with a value ≥2.5 considered indicative of insulin resistance. Results: Insulin resistance (HOMA-IR≥2.5) was present in 124 (75.2%) children. Significant associations were observed between insulin resistance and acanthosis nigricans, and a positive family history of type 2 diabetes mellitus. Although 78.2% of children had normal fasting blood glucose levels, a substantial proportion exhibited insulin resistance. Mean total cholesterol and triglyceride levels were 180.2±25.9 mg/dl and 105±34.5 mg/dl, respectively, and both showed significant positive correlations with HOMA-IR (r=0.417 and r=0.511, respectively; p<0.01). Conclusions: Insulin resistance is highly prevalent among overweight and obese children and may precede overt abnormalities in blood glucose. Reliance on fasting blood glucose alone may underestimate the burden of metabolic dysfunction. Early identification using HOMA-IR may facilitate timely lifestyle interventions during a potentially reversible stage and help prevent future metabolic complications.