A Study of insulin resistance by HOMA-IR and its cut-off value to identify metabolic syndrome in urban Indian adolescents

Objective: insulin resistance (ir) and associated metabolic abnormalities are increasingly being reported in the adolescent population. cut-off value of homeostasis model of assessment ir (homa-ir) as an indicator of metabolic syndrome (ms) in adolescents has not been established. this study aimed to investigate ir by homa-ir in urban indian adolescents and to establish cut-off values of homa-ir for defining ms. methods: a total of 691 apparently healthy adolescents (295 with normal body mass index (bmi),205 overweight,and 199 obese) were included in this cross-sectional study. ms in adolescents was defined by international diabetes federation (idf) and adult treatment panel iii (atp iii) criteria. ir was calculated using the homa model. results: mean height,waist circumference (wc),waist/hip ratio (whr),waist/height ratio (whtr),and blood pressure were significantly higher in boys as compared to girls. the homa-ir values increased progressively from normal weight to obese adolescents in both sexes. mean homa-ir values increased progressively according to sexual maturity rating in both sexes. homa-ir value of 2.5 had a sensitivity of >70% and specificity of >60% for ms. this cut-off identified larger number of adolescents with ms in different bmi categories (19.7% in normal weight,51.7% in overweight,and 77.0% in obese subjects) as compared to the use of idf or atp iii criteria for diagnosing ms. odds ratio for having ir (homa-ir of >2.5) was highest with whtr (4.9,p <0.0001) and wc (4.8,p <0.0001),compared to whr (3.3,p <0.0001). conclusions: in indian adolescents,homa-ir increased with sexual maturity and with progression from normal to obese. a homa-ir cut-off of 2.5 provided the maximum sensitivity and specificity in diagnosing ms in both genders as per atp iii and idf criteria. © journal of clinical research in pediatric endocrinology,published by galenos publishing.