Abstract

Background

The burden of insulin resistance (IR) among young American adults has not been previously assessed. We evaluated (1) the prevalence and trends of IR and cardiometabolic risk factors and (2) the association between measures of adiposity and IR among adults 18 to 44 years of age without diabetes and preexisting cardiovascular disease.

Methods

Cross-sectional survey data from six consecutive National Health and Nutrition Examination Survey (2007-2008 to 2017-2018) cycles were analyzed. IR was defined by the homeostatic model assessment for IR (HOMA-IR) of ≥2.5. The temporal trends of IR, cardiometabolic risk factors, and the relationship between IR and measures of adiposity were assessed using multivariable-adjusted regression models.

Results

Among 6247 young adults 18 to 44 years of age, the prevalence of IR was 44.8% (95% CI: 42.0%-47.6%) in 2007-2010 and 40.3% (95% CI: 36.4%-44.2%) in 2015-2018 (P for trend = 0.07). There was a modest association of HOMA-IR with higher body mass index (BMI), waist circumference, total lean fat mass, and total and localized fat mass (all Ps < 0.001). Participants with IR had a higher prevalence of hypertension [31.3% (95% CI: 29.2%-33.5%) vs 14.7% (95% CI: 13.2%-16.2%)], hypercholesterolemia [16.0% (95% CI: 12.4%-19.5%) vs 7.0% (95% CI: 5.8%-8.5%)], obesity [56.6% (95% CI: 53.9%-59.3%) vs 14.7% (95% CI: 13.0%-16.5%)], and poor physical activity levels [18.3% (95% CI: 16.4%-20.2%) vs 11.7% (95%CI: 10.3–13.1%)] compared to participants without IR (all Ps < 0.05).

Conclusions

Four-in-10 young American adults have IR, which occurs in a cluster with cardiometabolic risk factors. Nearly half of young adults with IR are nonobese. Screening efforts for IR irrespective of BMI may be required.

中文翻译：

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非糖尿病美国年轻人的胰岛素抵抗和心脏代谢风险概况：来自 NHANES 的见解

摘要

背景

以前没有评估过美国年轻成年人的胰岛素抵抗 (IR) 负担。我们评估了 (1) IR 和心脏代谢危险因素的患病率和趋势，以及 (2) 在 18 至 44 岁没有糖尿病和既往心血管疾病的成年人中，肥胖和 IR 测量值之间的关联。

方法

分析了连续六次全国健康与营养检查调查（2007-2008 年至 2017-2018 年）周期的横断面调查数据。IR 由 IR (HOMA-IR) ≥2.5 的稳态模型评估定义。使用多变量调整回归模型评估 IR、心脏代谢危险因素的时间趋势以及 IR 与肥胖测量之间的关系。

结果

在 6247 名 18 至 44 岁的年轻人中，2007-2010 年 IR 的患病率为 44.8%（95% CI：42.0%-47.6%），2015-2015 年为 40.3%（95% CI：36.4%-44.2%） 2018 年（趋势P = 0.07）。HOMA-IR 与较高的体重指数 (BMI)、腰围、总瘦脂肪量以及总和局部脂肪量之间存在适度关联（所有Ps < 0.001）。IR 参与者的高血压患病率较高 [31.3% (95% CI: 29.2%-33.5%) vs 14.7% (95% CI: 13.2%-16.2%)]、高胆固醇血症 [16.0% (95% CI: 12.4%) -19.5%) vs 7.0% (95% CI: 5.8%-8.5%)]，肥胖 [56.6% (95% CI: 53.9%-59.3%) vs 14.7% (95% CI: 13.0%-16.5%)] , 和较差的体力活动水平 [18.3% (95% CI: 16.4%-20.2%) vs11.7% (95%CI: 10.3–13.1%)] 与没有 IR 的参与者相比（所有P s < 0.05）。

结论

十分之四的年轻美国成年人患有 IR，它与心脏代谢危险因素聚集在一起。近一半患有 IR 的年轻人没有肥胖。可能需要进行 IR 筛查，而不考虑 BMI。