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Insulin resistance syndrome in a representative sample of children and adolescents from Quebec, Canada

International Journal of Obesity volume 28, pages 833–841 (2004)Cite this article

Abstract

OBJECTIVES: To estimate the prevalence of insulin resistance syndrome (IRS) in a representative sample of youth. To test for the independent contribution of insulin resistance (IR) and adiposity to clustering of metabolic risk factors. To identify the underlying components of IRS. To examine the relationship between adiposity and fasting plasma levels of free fatty acids (FFA).

METHODS: In 1999, we conducted a school-based survey of a representative sample of youth aged 9, 13 and 16 y in Quebec, Canada. Age-specific questionnaire data, standardized clinical measurements and a fasting blood sample were available for 2244 subjects. Fasting insulin and HOMA were used as surrogate measures of IR.

RESULTS: In all age–sex groups, adiposity indices, blood pressure (BP), plasma glucose and triglycerides (TG) increased significantly with increasing insulin quartiles while HDL cholesterol (HDL-C) decreased. The overall prevalence of IRS defined as hyperinsulinaemia combined with two or more risk factors including overweight, high systolic BP, impaired fasting glucose, high TG and low HDL-C, was 11.5% (95% CI: 10.2–12.9). There were no significant differences in the prevalence of IRS across ages or between sexes. The independent contribution of adiposity to clustering of risk factors was stronger than that of fasting insulin (or HOMA-IR). Factor analysis revealed three factors (BMI/insulin/lipids, BMI/insulin/glucose and diastolic/systolic BP) consistent across ages suggesting that more than one pathophysiologic process underlies IRS. Although elevation of FFA might be in the causal pathway linking obesity to IR, we did not detect any consistent association between measures of fatness and fasting plasma FFA.

CONCLUSION: IRS is highly prevalent in youth, even among children as young as age 9 y. Factor analysis identifies three physiologic domains within IRS with a unifying role for markers of IR and adiposity.

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Acknowledgements

The survey was funded by the Quebec Ministry of Health and Social Services and by Health Canada. The study on insulin and cardiovascular risk factors in youth is funded by the Canadian Institutes of Health Research (MOP-44027). JOL is an Investigator of the Canadian Institutes of Health Research. We thank Ginette Lagacé for technical assistance, Igor Karp for programming of statistical analyses, Jacinthe Aubin, Claudette Lavallée and Daniel Tremblay for coordination of the survey data collection. This work was presented in part at the American Heart Association's 41st Annual Conference on Cardiovascular Disease Epidemiology and Prevention.

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Authors and Affiliations

  1. Department of Pediatrics, Ste-Justine Hospital and University of Montreal, Montreal, Quebec, Canada

    M Lambert

  2. Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada

    G Paradis, J O'Loughlin & J A Hanley

  3. Department of Clinical Biochemistry, Ste-Justine Hospital and University of Montreal, Montreal, Quebec, Canada

    E E Delvin

  4. Department of Nutrition, Ste-Justine Hospital and University of Montreal, Montreal, Quebec, Canada

    E Levy

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  1. M Lambert
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Correspondence to M Lambert.

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Lambert, M., Paradis, G., O'Loughlin, J. et al. Insulin resistance syndrome in a representative sample of children and adolescents from Quebec, Canada. Int J Obes 28, 833–841 (2004). https://doi.org/10.1038/sj.ijo.0802694

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