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High prevalence of insulin resistance in postpubertal Asian Indian children is associated with adverse truncal body fat patterning, abdominal adiposity and excess body fat

International Journal of Obesity volume 28, pages 1217–1226 (2004)Cite this article

Abstract

OBJECTIVE: The objectives were to study the relationships of insulin resistance with generalized and abdominal obesity, and body fat patterning in urban postpubertal Asian Indian children.

DESIGN: Cross-sectional, population-based epidemiological study.

SUBJECTS: In all, 250 (155 males and 95 females) healthy urban postpubertal children.

MEASUREMENTS: Anthropometric profile, percentage of body fat (%BF), fasting serum insulin, and lipoprotein profile.

RESULTS: Fasting insulin correlated significantly with body mass index (BMI), %BF, waist circumference (WC), central and peripheral skinfold thicknesses and sum of four skinfold thicknesses (∑4SF) in both sexes, and with systolic blood pressure and waist–to hip circumference ratio (W–HR) in males only. Consistent increase in fasting insulin was noted with increasing values of central skinfold thickness at each tertile of peripheral skinfold thickness, WC, and %BF. Central skinfold thickness correlated with fasting insulin even after adjusting for WC, W–HR, and %BF. The odds ratios (OR) (95% CI) of hyperinsulinemia (fasting insulin concentrations in the highest quartile) were 4.7 (2.4–9.4) in overweight subjects, 8 (4.1–15.5) with high %BF, 6.4 (3.2–12.9) with high WC, 3.7 (1.9–7.3) with high W–HR, 6.8 (3.3–13.9) with high triceps skinfold thickness, 8 (4.1–15.7) with high subscapular skinfold thickness, and 10.1 (5–20.5) with high ∑4SF. In step-wise multiple logistic regression analysis, %BF [OR (95% CI): 3.2 (1.4–7.8)] and ?4SF [OR (95% CI): 4.5 (1.8–11.3)] were independent predictors of hyperinsulinemia, similar to insulin resistance assessed by HOMA (homeostatic model of assessment) in the study.

CONCLUSION: A high prevalence of insulin resistance in postpubertal urban Asian Indian children was associated with excess body fat, abdominal adiposity, and excess truncal subcutaneous fat. Primary prevention strategies for coronary heart disease and diabetes mellitus in Asian Indians should focus on the abnormal body composition profile in childhood.

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Acknowledgements

The study was funded by a grant from the Department of Science and Technology, Ministry of Science and Technology, Government of India, New Delhi. The authors are thankful to Ministry of Education, Government of New Delhi for their assistance in conducting the study. Mr Ramesh Giri assisted in anthropometry and body fat measurement, Mr Inder Taneja, Mr Gian Chand, and Mrs Alice Jacob performed biochemical investigations and insulin assay, and Mr RL Taneja supervised the quality control of biochemical tests. The cooperation of the children who took part in the study, and the help extended by the principals, teachers, and staff of the various schools and colleges where the study was conducted is greatly appreciated.

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Authors and Affiliations

  1. Department of Medicine, All India Institute of Medical Sciences, New Delhi, India

    A Misra, N K Vikram, S Arya, V Dhingra & R Guleria

  2. Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India

    R M Pandey

  3. Department of Dietetics, All India Institute of Medical Sciences, New Delhi, India

    A Chatterjee & R Sharma

  4. Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India

    M Dwivedi & K Luthra

  5. Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India

    K K Talwar

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  1. A Misra
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Misra, A., Vikram, N., Arya, S. et al. High prevalence of insulin resistance in postpubertal Asian Indian children is associated with adverse truncal body fat patterning, abdominal adiposity and excess body fat. Int J Obes 28, 1217–1226 (2004). https://doi.org/10.1038/sj.ijo.0802704

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