Markers of insulin resistance are associated with fatness and fitness in school-aged children: the European Youth Heart Study

• Published in: Diabetologia Vol. 50; no. 7; pp. 1401 - 1408
• Main Authors: Ruiz, J. R, Rizzo, N. S, Ortega, F. B, Loit, H. M, Veidebaum, T, Sjöström, M
• Format: Journal Article
• Language: English
• Published: Berlin Berlin/Heidelberg : Springer-Verlag 01.07.2007; Springer; Springer Nature B.V
• Subjects: Adipose Tissue - metabolism; Biological and medical sciences; Blood Glucose - metabolism; Body Composition; Body fat; Body Weight; Cardiorespiratory fitness; Child; children; Children & youth; Cross-sectional studies; Data collection; Diabetes; Diabetes Mellitus - diagnosis; Diabetes Mellitus - etiology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Europe; Fasting; Female; Glucose; Heart; HOMA; Homeostasis; Humans; Insulin - metabolism; Insulin Resistance; Male; Medical sciences; Medicin och hälsovetenskap; Metabolic diseases; Nutrition; Obesity; Overweight; physical activity; Physical fitness; Schools; Europe; Sweden; Estonia; Endocrinopathy; Human; Heart; Physical exercise; Obesity; Body fat; Physical activity; Diabetes mellitus; Nutrition disorder; Glucose; Physical fitness; Insulin resistance; Cardiorespiratory fitness; HOMA; Circulatory system; Children; Diabetes; Child; Nutritional status
• ISSN: 0012-186X; 1432-0428
• DOI: 10.1007/s00125-007-0678-0

Aims/hypothesis Our aim was to examine the association between markers of insulin resistance and: (1) body fat and waist circumference, taking into account cardiorespiratory fitness in school-aged children; and (2) cardiorespiratory fitness at differing levels of body fat and waist circumference. Subjects and methods This was a cross-sectional study of 873 children aged 9.6 ± 0.4 years from Estonia and Sweden. Weight, height and waist circumference were measured. Body fat was expressed as the sum of five skinfold thicknesses. Cardiorespiratory fitness was estimated by a maximal cycle-ergometer test. The studied markers of insulin resistance were fasting insulin and glucose, and homeostasis model assessment (HOMA). Results HOMA and fasting insulin were positively associated with body fat and waist circumference after adjusting for cardiorespiratory fitness, age, pubertal status and study location. HOMA and fasting insulin were negatively associated with cardiorespiratory fitness in children in the third (highest) tertile of body fat and waist circumference after controlling for sex, age, pubertal status and study location. Fasting glucose was negatively associated with cardiorespiratory fitness in children in the third (highest) tertile of waist circumference, but it was not associated when body fat was taken into account. Conclusions/interpretation In school-aged children, HOMA and fasting insulin are significantly associated with body fat and waist circumference. In addition, cardiorespiratory fitness explains a significant proportion of the HOMA and fasting insulin variance in those children with high levels of body fat and waist circumference. The findings suggest that the deleterious consequences ascribed to high fatness could be counteracted by having high levels of cardiorespiratory fitness.