Predictors of Insulin Resistance in Indonesian Adolescents with Obesity
Keywords:
Adolescents, Diabetes, Homeostasis model, Indonesia, Insulin resistance, Obesity, Predictive factorsAbstract
Insulin resistance commonly results from obesity with excessive adipose tissue, increasing body mass index and waist circumference. This cross-sectional correlational study aimed to examine factors influencing insulin resistance in Indonesian adolescents with obesity. A total of 134 adolescents with obesity aged 13-15 years were recruited from five randomly selected junior high schools in a southern city in Indonesia. Participants were classified into insulin resistance (n =67) and non-insulin resistance (n =67) based on the homeostasis model assessment of insulin resistance. Data were collected using a demographic questionnaire, the Adolescent Sedentary Activity Questionnaire, and had a nutritional assessment comprised of waist circumference, body mass index, snacking calories, fasting blood glucose and plasma insulin. Data were analyzed using descriptive statistics, and univariate and multivariate logistic regression.
The univariate logistic regression indicated that waist circumference, body mass index, family history of obesity or diabetes, frequency of breakfast, snacking calories, sedentary behavior, and father’s income and mother’s education were significantly associated with insulin resistance. The multivariate logistic regression model predicting insulin resistance included waist circumference, family history of obesity or diabetes, and sedentary behavior >5 hours/day. These three variables together explained 76.7% variance of the insulin resistance. Nurses’ roles should include monitoring health education and assessment of adolescents and their families, and promoting physical activity in schools, and particularly for those adolescents with obesity and family history of obesity or diabetes.
References
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35. Perdana F, Hardinsyah. Analysis of type, amount, and nutritional Quality of breakfast among Indonesian children. Journal Gizidan Pangan 2013; 8(1): 39-46.
36. Takumansang R, Warouw SM, Lestari H. Interleukin-6 and insulin resistance in obese adolescents. Paediatrica Indonesiana. 2013; 53(5): 268-72.
37. León-Latre M, Moreno-Franco B, Andrés-Esteban EM, Ledesma M, Laclaustra M, Alcalde V, Casasnovas JA et al. Sedentary lifestyle and its relation to cardiovascular risk factors, insulin resistance and inflammatory profile. Revista Española de Cardiología (English Edition). 2014; 67(6): 449-55; doi:https://dx.doi.org/10.1016/j.rec.2013. 10.015.
38. Velásquez-Rodríguez CM, Velásquez-Villa M, GómezOcampo L, Bermúdez-Cardona J. Abdominal obesity and low physical activity are associated with insulin resistance in overweight adolescents: a cross-sectional study. BMC Pediatrics. 2014; 14(1): 258; doi:10.1186/14712431-14-258.
39. Mingrone G, Manco M, Mora ME, Guidone C, Iaconelli A, Gniuli D, Ghirlanda G et al. Influence of maternal obesity on insulin sensitivity and secretion in offspring. Diabetes care. 2008; 31(9): 1872-6.
2. Nasreddine L, Mehio-Sibai A, Mrayati M, Adra N, Hwalla N. Adolescent obesity in Syria: prevalence and associated factors. Child: Care, Health and Development. 2010; 36(3): 404-13; doi:10.1111/j.1365-2214.2009. 01042.x.
3. De Moraes AC, Fadoni RP, Ricardi LM, Souza TC, Rosaneli CF, Nakashima AT, Falcão MC. Prevalence of abdominal obesity in adolescents: a systematic review. Obesity reviews. 2011; 12(2): 69-77; doi:10.1111/ j.1467-789X.2010.00753.x.
4. Romualdo MC, Nóbrega FJ, Escrivão MA. Insulin resistance in obese children and adolescents. J Pediatr. 2014; 90(6): 600-7; doi:https://dx.doi.org/10.1016/j. jped.2014.03.005.
5. Johnson AM, Olefsky JM. The origins and drivers of insulin resistance. Cell. 2013; 152(4): 673-84.
6. 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.
7. Van der Aa MP, Fazeli Farsani S, Knibbe CA, De Boer A, van der Vorst MM. Population-based studies on the epidemiology of insulin resistance in children. Journal of diabetes research. 2015; 1-9.
8. Pulungan AB, Puspitadewi A, Sekartini R. Prevalence of insulin resistance in obese adolescents. Paediatrica Indonesiana. 2013; 53: 167-72.
9. Allcock DM, Gardner MJ, Sowers JR. Relation between childhood obesity and adult cardiovascular risk. International Journal of Pediatric Endocrinology. 2009; 108187.Doi: 10.1155/2009/108187.
10. Centers for Disease Control and Prevention. 2000 CDC growth charts for the United States: Methods and development 2002. Maryland: Hyattsville.
11. Stokols D, Misra S, Runnerstrom MG, Hipp JA. Psychology in an age of ecological crisis: From personal angst to collective action. American Psychologist. 2009; 64(3): 181-93.
12. Williams JE. Child obesity in context: ecology of family and community. International Journal of Exercise Science. 2011; 4(2): 86-92.
13. Antuna-Puente B, Disse E, Rabasa-Lhoret R, Laville M, Capeau J, Bastard JP. How can we measure insulin sensitivity/resistance?. Diabetes & Metabolism. 2011; 37(3): 179-88; doi:10.1016/j.diabet.2011.01.002.
14. Ling JC, Mohamed MN, Jalaludin MY, Rampal S, Zaharan NL, Mohamed Z. Determinants of High Fasting Insulin and Insulin Resistance Among Overweight/Obese Adolescents. Scientific Reports. 2016; 6; doi: 10.1038/ srep36270.
15. Burrows R, Correa-Burrows P, Reyes M, Blanco E, Albala C, Gahagan S. Healthy Chilean adolescents with HOMA-IR ≥ 2.6 have increased cardiometabolic risk: association with genetic, biological, and environmental factors. Journal of diabetes research. 2015; 1-8. [cited 2017 11 May]. Available from https://dx.doi.org/10.1155/2015/ 783296.
16. Lee S, Kim Y. Effects of exercise alone on insulin sensitivity and glucose tolerance in obese youth. Diabetes & Metabolism Journal. 2013; 37(4): 225-32.
18. Shafiee G, Kelishadi R, Qorbani M, Motlagh ME, Taheri M, Ardalan G, Taslimi M, Poursafa P, Heshmat R, Larijani B. Association of breakfast intake with cardiometabolic risk factors. J Pediatr. 2013; 89(6): 575-82.
19. Booth FW, Roberts CK, Laye MJ. Lack of exercise is a major cause of chronic diseases. Comprehensive Physiology. 2012; 2(2): 1143-1211; doi:10.1002/cphy.c110025.
20. González-Jiménez E, Schmidt-RioValle J, Montero-Alonso MA, Padez C, García-García CJ, Perona JS. Influence of Biochemical and Anthropometric Factors on the Presence of Insulin Resistance in Adolescents. Biological research for nursing. 2016; 18(5): 541-8.
21. Astbury NM, Taylor MA, Macdonald IA. Breakfast consumption affects appetite, energy intake, and the metabolic and endocrine responses to foods consumed later in the day in male habitual breakfast eaters. The Journal of Nutrition. 2011; 141(7): 1381-9; doi:10.3945/jn. 110.128645.
22. Syafitri Y, Syarief H, Baliwati YF. Snacking habits among elementary school students, case study in elementary school of Lawanggintung Bogor city. Journal GizidanPangan 2009; 4(3): 167 – 175.
23. Ambrosini GL, Oddy WH, Huang RC, Mori TA, Beilin LJ, Jebb SA. Prospective associations between sugar-sweetened beverage intakes and cardiometabolic risk factors in adolescents. The American Journal of Clinical Nutrition. 2013; 98(2): 327-34; doi:10.3945/ajcn.112.051383.
24. Cañete R, Gil-Campos M, Aguilera CM, Gil A. Development of insulin resistance and its relation to diet in the obese child. European Journal of Nutrition. 2007; 46(4): 181-7; doi:10.1007/s00394-007-0648-9.
25. Demment MM, Haas JD, Olson CM. Changes in family income status and the development of overweight and obesity from 2 to 15 years: a longitudinal study. BMC Public Health. 2014; 14(1): 417.
26. Han YS, Jun WP. Parental involvement in child’s development: Father vs. mother. Open Journal of Medical Psychology. 2013; 2(04): 1-6.
27. Noh JW, Kim YE, Oh IH, Kwon YD. Influences of socioeconomic factors on childhood and adolescent overweight by gender in Korea: cross-sectional analysis of nationally representative sample. BMC public health. 2014; 14(324): 1-8.
28. Noh JW, Kim YE, Park J, Oh IH, Kwon YD. Impact of parental socioeconomic status on childhood and adolescent overweight and underweight in Korea. Journal of Epidemiology. 2014; 24(3): 221-9; doi:10.2188/jea. JE20130056.
29. Kelsey JL, Whittemore AS, Evans AS, Thompson WD. Methods in observational epidemiology. 1996. New York: Oxford Univ Pr. 366p. 1996.
30. Hardy LL, Booth ML, Okely AD. The reliability of the adolescent sedentary activity questionnaire (ASAQ). Preventive medicine. 2007; 45(1): 71-4.
31. Tremblay MS, LeBlanc AG, Kho ME, Saunders TJ, Larouche R, Colley RC et al. Systematic review of sedentary behaviour and health indicators in school-aged children and youth. International Journal of Behavioral Nutrition and Physical Activity. 2011; 8(98): 1-22.
32. Thompson-McCormick JJ, Thomas JJ, Bainivualiku A, Khan AN, Becker AE. Breakfast skipping as a risk correlate of overweight and obesity in school-going ethnic Fijian adolescent girls. Asia Pacific Journal of Clinical Nutrition. 2010; 19(3): 372-82.
33. Poh BK, Jannah AN, Chong LK, Ruzita AT, Ismail MN, McCarthy D. Waist circumference percentile curves for Malaysian children and adolescents aged 6.0–16.9 years. International Journal of Pediatric Obesity. 2011; 6(3-4): 229-35; doi:10.3109/17477166.2011.583658.
34. Erhardt J, Gross R. Nutrition surveys and calculations: guidelines, software and additional information [internet]. 2010. [cited 2016 13 March]. Available from: https:// www.nutrisurvey.de/
35. Perdana F, Hardinsyah. Analysis of type, amount, and nutritional Quality of breakfast among Indonesian children. Journal Gizidan Pangan 2013; 8(1): 39-46.
36. Takumansang R, Warouw SM, Lestari H. Interleukin-6 and insulin resistance in obese adolescents. Paediatrica Indonesiana. 2013; 53(5): 268-72.
37. León-Latre M, Moreno-Franco B, Andrés-Esteban EM, Ledesma M, Laclaustra M, Alcalde V, Casasnovas JA et al. Sedentary lifestyle and its relation to cardiovascular risk factors, insulin resistance and inflammatory profile. Revista Española de Cardiología (English Edition). 2014; 67(6): 449-55; doi:https://dx.doi.org/10.1016/j.rec.2013. 10.015.
38. Velásquez-Rodríguez CM, Velásquez-Villa M, GómezOcampo L, Bermúdez-Cardona J. Abdominal obesity and low physical activity are associated with insulin resistance in overweight adolescents: a cross-sectional study. BMC Pediatrics. 2014; 14(1): 258; doi:10.1186/14712431-14-258.
39. Mingrone G, Manco M, Mora ME, Guidone C, Iaconelli A, Gniuli D, Ghirlanda G et al. Influence of maternal obesity on insulin sensitivity and secretion in offspring. Diabetes care. 2008; 31(9): 1872-6.
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2017-08-07
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Nuru H, Piaseu N, Phuphaibul R, Suthutvoravut U. Predictors of Insulin Resistance in Indonesian Adolescents with Obesity. PRIJNR [Internet]. 2017 Aug. 7 [cited 2024 Nov. 18];21(4):280-9. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/85828
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