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
DOI:
https://doi.org/10.18203/2349-3291.ijcp20262794Keywords:
HOMA IR index, Insulin resistance, Acanthosis nigricans, Diabetes, Metabolic syndromeAbstract
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.
References
Hampl SE, Hassink SG, Skinner AC, Armstrong SC, Barlow SE, Bolling CF, et al. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity. Pediatrics. 2023;151(2):e2022060640.
Obesity. Available at: https://www.who.int/health-topics/obesity. Accessed on 01 August 2026.
Aravindakshan SS, David A, Saradakutty G, Agarwal P, Aravindakshan SS, David A, et al. Prevalence of Metabolic Syndrome and Its Associated Risk Factors Among Schoolchildren Aged 11-13 Years Living in Thiruvananthapuram District, Kerala, India: A Nested Case-Control Study. Cureus. 2024;16(11):e72994.
Khadilkar V, Shah N, Harish R, Ayyavoo A, Bang A, Basu S, et al. Indian Academy of Pediatrics Revised Guidelines on Evaluation, Prevention and Management of Childhood Obesity. Indian Pediatr. 2023;60(12):1013-31.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412-9.
Das RR, Mangaraj M, Nayak S, Satapathy AK, Mahapatro S, Goyal JP. Prevalence of Insulin Resistance in Urban Indian School Children Who Are Overweight/Obese: A Cross-Sectional Study. Front Med. 2021;12;8.
Singh Y, Garg M, Tandon N, Marwaha RK. A Study of Insulin Resistance by HOMA-IR and its Cut-off Value to Identify Metabolic Syndrome in Urban Indian Adolescents. J Clin Res Pediatr Endocrinol. 2013;5(4):245-51.
Tandon N, Garg MK, Singh Y, Marwaha RK. Prevalence of metabolic syndrome among urban Indian adolescents and its relation with insulin resistance (HOMA-IR). J Pediatr Endocrinol Metab JPEM. 2013;26(11-12):1123-30.
Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, et al. Obesity and the Metabolic Syndrome in Children and Adolescents. N Engl J Med. 2004;350(23):2362-74.
Keskin M, Kurtoglu S, Kendirci M, Atabek ME, Yazici C. Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics. 2005;115(4):e500-3.
Nogueira-de-Almeida CA, de Mello ED. Different Criteria for the Definition of Insulin Resistance and Its Relation with Dyslipidemia in Overweight and Obese Children and Adolescents. Pediatr Gastroenterol Hepatol Nutr. 2018;21(1):59-67.
Kostovski M, Simeonovski V, Mironska K, Tasic V, Gucev Z. Metabolic Profiles in Obese Children and Adolescents with Insulin Resistance. Open Access Maced J Med Sci. 2025;6(3):511-8.
Kluczynik CEN, Mariz LS, Souza LCF, Solano GB, Albuquerque FC de L, Medeiros CCM. Acanthosis nigricans and insulin resistance in overweight children and adolescents. An Bras Dermatol. 2012;87(4):531-7.
Stuart CA, Pate CJ, Peters EJ. Prevalence of acanthosis nigricans in an unselected population. Am J Med. 1989;87(3):269-72.
Sinaiko AR, Steinberger J, Moran A, Hong CP, Prineas RJ, Jacobs DR. Influence of Insulin Resistance and Body Mass Index at Age 13 on Systolic Blood Pressure, Triglycerides, and High-Density Lipoprotein Cholesterol at Age 19. Hypertension. 2006;48(4):730-6.
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