The association of circulating irisin with metabolic risk factors in Chinese adults: a cross-sectional community-based study

Abstract Background Irisin is a myokine that leads to increased energy expenditure by stimulating the browning of white adipose tissue. We aimed to investigate the association of serum irisin levels with metabolic parameters in middle aged Chinese population. Methods The study was based on a cross-sectional analysis of data from 524 nondiabetic subjects aged 40~65. All participants were recruited from a screening survey for Metabolic Syndrome in a community in Southwest China, including 294 subjects categorized as overweight (defined as BMI≧25 kg/m2) and 230 subjects as normal control (defined as 18.5≦BMI < 25 kg/m2). Serum irisin concentration was quantified by enzyme linked immunosorbent assay (ELISA). The relationship of irisin with metabolic factors was determined by Pearson correlation. Multivariate linear regression was used to analyze the association of irisin with insulin resistance. Logistic regression was performed to assess the association of irisin with odds of overweight. Results Serum irisin levels were significantly lower in nondiabetic overweight subjects compared with control (11.46 ± 4.11vs14.78 ± 7.03 μg/mL, p = 0.02). Circulating irisin was positively correlated with quantitative insulin sensitivity check index (QUICKI, r = 0.178, p = 0.045) and triglycerides (r = 0.149, p = 0.022); while irisin was negatively correlated with waist circumference (WC, r = − 0.185, p = 0.037), waist-to-hip ratio (WHR, r = − 0.176, p = 0.047), fasting insulin (r = − 0.2, p = 0.024), serum creatinine (r = − 0.243, p = 0.006), homeostasis model assessment for insulin resistance (HOMA-IR, r = − 0.189, p = 0.033). Multiple linear regression showed that irisin was inversely associated with HOMA-IR (β = − 0.342 ± 0.154, p = 0.029). Higher irisin was associated with decreased odds of being overweight (OR = 0.281, β = − 1.271, p = 0.024). Conclusions We found that serum irisin levels were lower in overweight subjects. Moreover, serum irisin levels were inversely correlated with adverse metabolic parameters including WC, WHR, creatinine, HOMA-IR and fasting insulin, suggesting that irisin may play a role in obesity related insulin resistance.

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The association of circulating irisin with metabolic risk factors in Chinese adults: a cross-sectional community-based study

10.21203/rs.2.13765/v2 ◽

2019 ◽

Author(s):

Lizhi Tang ◽

Yuzhen Tong ◽

Fang Zhang ◽

Guilin Chen ◽

Yun Cong Zhang ◽

...

Keyword(s):

Insulin Resistance ◽

Linear Regression ◽

Pearson Correlation ◽

Metabolic Parameters ◽

Enzyme Linked Immunosorbent Assay ◽

Model Assessment ◽

Fasting Insulin ◽

Cross Sectional ◽

Sectional Analysis ◽

Overweight Subjects

Abstract Background Irisin is a myokine that leads to increased energy expenditure by stimulating the browning of white adipose tissue. We aimed to investigate the association of serum irisin levels with metabolic parameters in middle aged Chinese population. Methods The study was based on a cross-sectional analysis of data from 524 nondiabetic subjects aged 40~65. All participants were recruited from a screening survey for Metabolic Syndrome in a community in Southwest China, including 294 subjects categorized as overweight (defined as BMI≧25 kg/m2 ) and 230 subjects as normal control (defined as 18.5≦BMI<25 kg/m2). Serum irisin concentration was quantified by enzyme linked immunosorbent assay (ELISA). The relationship of irisin with metabolic factors was determined by Pearson correlation. Multivariate linear regression was used to analyze the association of irisin with insulin resistance. Logistic regression was performed to assess the association of irisin with odds of overweight. Results Serum irisin levels were significantly lower in nondiabetic overweight subjects compared with control (11.46 ± 4.11vs14.78 ± 7.03µg/mL, p = 0.02). Circulating irisin was positively correlated with quantitative insulin sensitivity check index (QUICKI, r = 0.178, p = 0.045) and triglycerides (r = 0.149, p = 0.022); while irisin was negatively correlated with waist circumference (WC, r = -0.185, p = 0.037), waist-to-hip ratio (WHR, r = -0.176, p = 0.047), fasting insulin (r = -0.2, p = 0.024), serum creatinine (r = -0.243, p = 0.006), homeostasis model assessment for insulin resistance (HOMA-IR, r = -0.189, p = 0.033). Multiple linear regression showed that irisin was inversely associated with HOMA-IR (β = -0.342 ± 0.154, p = 0.029). Higher irisin was associated with decreased odds of being overweight (OR = 0.281, β = -1.271, p = 0.024). Conclusions We found that serum irisin levels were lower in overweight subjects. Moreover, serum irisin levels were inversely correlated with adverse metabolic parameters including WC, WHR, creatinine, HOMA-IR and fasting insulin, suggesting that irisin may play a role in obesity related insulin resistance.

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The association of circulating irisin with metabolic risk factors in Chinese adults: a cross-sectional community-based study

10.21203/rs.2.13765/v1 ◽

2019 ◽

Author(s):

Lizhi Tang ◽

Yuzhen Tong ◽

Fang Zhang ◽

Guilin Chen ◽

Yun Cong Zhang ◽

...

Keyword(s):

Insulin Resistance ◽

Linear Regression ◽

Pearson Correlation ◽

Metabolic Parameters ◽

Enzyme Linked Immunosorbent Assay ◽

Model Assessment ◽

Fasting Insulin ◽

Cross Sectional ◽

Sectional Analysis ◽

Overweight Subjects

Abstract Background Irisin is a myokine that leads to increased energy expenditure by stimulating the browning of white adipose tissue. We aimed to investigate the association of serum irisin levels with metabolic parameters in middle aged Chinese population.Methods The study was based on cross-sectional analysis of data from 524 nondiabetic subjects aged 40~65. All participants were recruited from a screening survey for Metabolic Syndrome in a community in Southwest China, including 294 subjects categorized as overweight (defined as BMI≧25 kg/m 2 ) and 230 subjects as normal control (defined as 18.5≦BMI<25 kg/m 2 ). Serum irisin concentration was quantified by enzyme linked immunosorbent assay (ELISA). The relationship of irisin with metabolic factors was determined by Pearson correlation. Multivariate linear regression was used to analyze the association of irisin with insulin resistance. Logistic regression was performed to assess the association of irisin with odds of overweight.Results Serum irisin levels were significantly lower in nondiabetic overweight subjects compared with control (11.46±4.11vs14.78±7.03µg/mL, p=0.02). Circulating irisin was positively correlated with quantitative insulin sensitivity check index (QUICKI, r=0.178, p=0.045) and triglycerides (r=0.149, p=0.022); while irisin was negatively correlated with waist circumference (WC, r=-0.185, p=0.037), waist-to-hip ratio (WHR, r=-0.176, p=0.047), fasting insulin (r=-0.2, p=0.024), serum creatinine (r=-0.243, p=0.006), homeostasis model assessment for insulin resistance (HOMA-IR, r=-0.189, p=0.033). Multiple linear regression showed that irisin was inversely associated with HOMA-IR (β=-0.342±0.154, p=0.029). Higher irisin was associated with decreased odds of being overweight (OR=0.281, β=-1.271, p=0.024).Conclusions We found that serum irisin levels were lower in overweight subjects. Moreover, serum irisin levels were inversely correlated with adverse metabolic parameters including WC, WHR, creatinine, HOMA-IR and fasting insulin, suggesting that irisin may play a role in obesity related insulin resistance.

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Investigating the relationship between insulin resistance and adipose tissue in a randomized Tehrani population

Hormone Molecular Biology and Clinical Investigation ◽

10.1515/hmbci-2020-0084 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Jalaledin Mirzay Razzaz ◽

Hossein Moameri ◽

Zahra Akbarzadeh ◽

Mohammad Ariya ◽

Seyed ali Hosseini ◽

...

Keyword(s):

Insulin Resistance ◽

Adipose Tissue ◽

Body Fat ◽

Odds Ratio ◽

Cross Sectional Study ◽

Model Assessment ◽

Fasting Insulin ◽

Cross Sectional ◽

Body Fat Percent ◽

The Relationship

Abstract Objectives Insulin resistance is the most common metabolic change associated with obesity. The present study aimed to investigate the relationship between insulin resistance and body composition especially adipose tissue in a randomized Tehrani population. Methods This study used data of 2,160 individuals registered in a cross-sectional study on were randomly selected from among subjects who were referred to nutrition counseling clinic in Tehran, from April 2016 to September 2017. Insulin resistance was calculated by homeostasis model assessment formula. The odds ratio (95% CI) was calculated using logistic regression models. Results The mean age of the men was 39 (±10) and women were 41 (±11) (the age ranged from 20 to 50 years). The risk of increased HOMA-IR was 1.03 (95% CI: 1.01–1.04) for an increase in one percent of Body fat, and 1.03 (95% CI: 1.00–1.05) for an increase in one percent of Trunk fat. Moreover, the odds ratio of FBS for an increase in one unit of Body fat percent and Trunk fat percent increased by 1.05 (adjusted odds ratio [95% CI: 1.03, 1.06]) and 1.05 (95% CI: 1.02, 1.08). Also, the risk of increased Fasting Insulin was 1.05 (95% CI: 1.03–1.07) for an increase in one unit of Body fat percent, and 1.05 (95% CI: 1.02–1.08) for an increase in one unit of Trunk fat percent. Conclusions The findings of the present study showed that there was a significant relationship between HOMA-IR, Fasting blood sugar, Fasting Insulin, and 2 h Insulin with percent of Body fat, percent of Trunk fat.

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Thyroid-stimulating Hormone and Insulin Resistance: Their Association with Polycystic Ovary Syndrome without Overt Hypothyroidism

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0037-1601436 ◽

2017 ◽

Vol 39 (05) ◽

pp. 224-228 ◽

Cited By ~ 1

Author(s):

Cristina Benetti-Pinto ◽

Vanessa Piccolo ◽

Daniela Yela ◽

Heraldo Garmes

Keyword(s):

Insulin Resistance ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Thyroid Stimulating Hormone ◽

Metabolic Parameters ◽

Overt Hypothyroidism ◽

Model Assessment ◽

Ovary Syndrome ◽

Cross Sectional ◽

Stimulating Hormone

Objective This study analyzed the effectiveness of the thyroid-stimulating hormone (TSH) as a predictor of insulin resistance (IR) and its association with the clinical and metabolic parameters of women with polycystic ovary syndrome (PCOS) without overt hypothyroidism. Study Design A cross-sectional study was performed. Women with PCOS and without overt hypothyroidism (n = 168) were included. Methods Receiver operating characteristic (ROC) curve was used to determine the cut-off point for TSH that would maximize sensitivity and specificity for a diagnosis of IR using homeostatic model assessment of insulin resistance (HOMA-IR) ≥ 2.71. Clinical and metabolic parameters were compared as a function of the TSH cut-off limit and the presence of IR. Results Thyroid-stimulating hormone ≥ 2.77 mIU/L was associated with a diagnosis of IR, with sensitivity of 47.9% and specificity of 65.3%. There were no differences in clinical, hormonal or metabolic parameters between TSH < 2.77 and TSH of 2.77 – 10 mIU/L. Conclusion In women with PCOS without overt hypothyroidism, TSH ≥ 2.77 mIU/L is associated with IR; however, with poor sensibility, showing TSH to be a poor predictor of IR in this population. No clinical or metabolic alterations were found that would justify a change in clinical management. Thus, the IR should be investigated in all women with PCOS irrespective of TSH level.

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The Relationship between HIV Duration, Insulin Resistance and Diabetes Risk

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18083926 ◽

2021 ◽

Vol 18 (8) ◽

pp. 3926

Author(s):

Eduard Tiozzo ◽

Allan Rodriguez ◽

Janet Konefal ◽

Gary J. Farkas ◽

Jennifer L. Maher ◽

...

Keyword(s):

Insulin Resistance ◽

Hiv Infection ◽

Cross Sectional Study ◽

People Living With Hiv ◽

Model Assessment ◽

Fasting Insulin ◽

Long Term Effects ◽

Cross Sectional ◽

Living With Hiv ◽

The Relationship

The risk of developing Type 2 Diabetes Mellitus in people living with HIV (PLWH) can be four times greater and can occur at an earlier age and even without the presence of obesity compared to those without HIV. Therefore, the purpose of this analytical cross-sectional study was to determine the relationship between HIV duration and glucose metabolism among PLWH. Eighty-two PLWH were categorized into shorter (≤15 years) or longer HIV duration (≥16 years) and then compared for differences in demographics, physical and clinical characteristics, biomarkers, and dietary intake. Compared to those with shorter HIV duration (n = 34), those with longer HIV duration (n = 48) were on average older (p = 0.02), reported lower consumption of alcohol (p = 0.05), had higher levels of homeostasis model assessment of insulin resistance (HOMA-IR, p = 0.02), were also more likely to be a woman (p = 0.06), and have higher levels of fasting insulin (p = 0.06). When adjusted for age and body weight, the levels of HOMA-IR and fasting insulin were higher (p = 0.02 and p = 0.04) with longer compared to shorter HIV duration, respectively. Longer exposure to HIV infection is associated with impaired insulin sensitivity. Continuing research aimed at the long-term effects of HIV infection and (antiretroviral therapy) is required.

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Hubungan Lingkar Pinggang, Homeostasis Model Assessment of Insulin Resistance, dan Prostaglandin-I2 dengan Test Agregasi Trombosit pada Subyek Obesitas Sentral

Medical Scope Journal ◽

10.35790/msj.2.2.2021.32597 ◽

2021 ◽

Vol 2 (2) ◽

Author(s):

Lucrezia Renata ◽

Karel Pandelaki ◽

Linda W. A. Rotty

Keyword(s):

Insulin Resistance ◽

Platelet Aggregation ◽

Central Obesity ◽

Thrombus Formation ◽

Pearson Correlation ◽

Model Assessment ◽

Prostaglandin I2 ◽

Obese People ◽

Cross Sectional ◽

Obese Subjects

Abstract: Overweight and obese are global health problems and tend to increase in Indonesia. Central obesity is associated with inflammation, insulin resistance, and increased reactive oxidative stress. Insulin resistance can cause a decrease in prostaglandin I2 (PGI2) and nitric oxide (NO) levels, and an increase in platelet aggregation. Its effect in platelet aggregation may increase thrombus formation in blood vessels. This study was aimed to determine the relationship between waist circumference (WC) with HOMA-IR, PGI2 and platelet aggregation test (PAT) in central obese subjects. This was an observational and analytical correlational study with a cross-sectional design conducted at Prof. dr. R. D. Kandou Hospital, Manado. Samples were 33 central obese subjects, 19 were male and 14 were female. Insulin resistance was measured by using HOMA- IR, urine PGI2, and PAT. The Spearmann and Pearson correlation test showed a positive correlation between WC and HOMA-IR (r=0.366, p=0.036). There was a negative correlation but not significant between WC and PGI2 (r=-0.169, p=0.347); between WC and PAT (r=0.094, p=0.603); between HOMA-IR and PGI2 (r=-0.218, p=0.223); and between HOMA-IR and PAT (r=0.080, p=0.658). In conclusion, in central obese people, there is a relationship between WC and HOMA-IR, but there is no relationship between WC, PGI2, and PAT.Keywords: central obesity, HOMA-IR, prostaglandin-I2, platelet aggregation test Abstrak: Berat badan berlebih atau obesitas merupakan masalah kesehatan global dan terus meningkat di Indonesia. Pada obesitas sentral terjadi inflamasi, resistensi insulin, dan mening-katnya reaktif oksidatif stress. Resistensi insulin mampu menyebabkan penurunan kadar prostaglandin I2 (PGI2) dan nitrik oksida (NO). Penurunan kadar PGI2 dapat menyebabkan peningkatan agregasi trombosit yang selanjutnya meningkatkan kemungkinan terjadinya trombus dalam pembuluh darah. Penelitian ini bertujuan untuk mengetahui hubungan antara lingkar pinggang dengan HOMA-IR, PGI2, dan test agregasi trombosit (TAT) pada subyek obes sentral. Jenis penelitian ialah observasional analitik bentuk korelasional dengan desain potong lintang. Penelitian dilakukan di RSUP Prof. dr. R. D. Kandou Manado. Total sampel 33 subyek dengan obesitas sentral, 19 laki-laki dan 14 perempuan. Pengukuran resistensi insulin menggunakan HOMA-IR, PGI2 urin, dan TAT. Uji korelasi Spearmann dan Pearson. mendapatkan korelasi positif antara LP dengan HOMA-IR (r=0,366; p=0,036). Terdapat korelasi negatif tidak bermakna pada hubungan antara LP dengan PGI2 (r=-0,169; p=0,347); hubungan antara LP dengan TAT (r=0,094; p=0,603); hubungan antara HOMA-IR dengan PGI2 (r=-0,218;p=0,223); dan hubungan antara HOMA-IR dengan TAT (r=0,080; p=0,658). Simpulan penelitian ini ialah pada subyek obes sentral terdapat hubungan antara lingkar pinggang dengan HOMA-IR, tetapi tidak terdapat hubungan antara lingkar pinggang dengan PGI2 dan TAT. Kata kunci: obesitas sentral, HOMA-IR, prostaglandin-I2, tes agregasi trombosit

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Insulin Resistance Diagnosed by HOMA-IR may be Overestimated in Adults with Greater Fat-Free Mass: The ELSA-Brasil Study

10.21203/rs.3.rs-16471/v1 ◽

2020 ◽

Author(s):

Divanei Zaniqueli ◽

Rafael de Oliveira Alvim ◽

Rosane Harter Griep ◽

Isabela Martins Benseñor ◽

Sandhi Maria Barreto ◽

...

Keyword(s):

Insulin Resistance ◽

Body Fat ◽

Bioelectrical Impedance ◽

Tolerance Test ◽

Fat Free Mass ◽

Percent Body Fat ◽

Oral Glucose ◽

Model Assessment ◽

Fasting Insulin ◽

Cross Sectional

Abstract Background Conflicting results have been reported on the association of fat-free mass (FFM) and insulin resistance (IR). The way of indexing FFM may be a bias. This study sought to test the association of FFM and IR after indexing FFM to avoid collinearity. Methods This cross-sectional study comprised 11,284 volunteers, ages 38-79 years. Body composition was assessed by multi-frequency bioelectrical impedance. FFM indexed to body surface area (FFMbsa) was calculated. Excess body fat was assigned to individuals with percent body fat ≥ 85th percentile for age and sex. Fasting insulin and glucose, and 2h glucose in the oral glucose tolerance test were obtained. Homeostasis model assessment-insulin resistance (HOMA-IR) > 3.0 was set as the cut-off for IR.Results Percent body fat decreased from the 1st to the 5th quintile of FFMbsa in both women (Eta 2 = 0.166) and men (Eta 2 = 0.133). In women, fasting insulin (Eta 2 = 0.002), glucose (Eta 2 = 0.006), and HOMA-IR (Eta 2 = 0.007) increased slightly, whereas 2h glucose did not change towards the highest quintile of FFMbsa. In men, fasting insulin and HOMA-IR were similar across the quintiles of FFMbsa, whereas fasting glucose increased slightly (Eta 2 = 0.002) and 2h glucose decreased (Eta 2 = 0.005) towards the highest quintile of FFMbsa. Greater FFMbsa explained 1.8% of the odds of IR among women and 0.9% among men.Conclusion The lack of association of FFM and 2h glucose contrasted with greater odds of IR (by HOMA-IR) associated with greater FFM. The association of greater FFM and IR may be overestimated when the diagnosis is provided by HOMA-IR.

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Identification of neck circumference cut-off points for insulin resistance as a marker in adolescents

Revista de Nutrição ◽

10.1590/1678-9865202134e200190 ◽

2021 ◽

Vol 34 ◽

Author(s):

Ingrid Ribeiro da Cruz MELO ◽

Márcia Ferreira Cândido de SOUZA ◽

Íkaro Daniel de Carvalho BARRETO ◽

Danielle Góes da SILVA ◽

Ricardo Queiroz GURGEL

Keyword(s):

Insulin Resistance ◽

Linear Regression ◽

Multiple Linear Regression ◽

Characteristic Curve ◽

Linear Regression Analysis ◽

Neck Circumference ◽

Model Assessment ◽

Cardiovascular Risks ◽

Homeostasis Model Assessment ◽

Cross Sectional

ABSTRACT Objective To identify cut-off points of neck circumference measurement to predict insulin resistance in adolescents. Methods Cross-sectional analysis with data derived from the Study of Cardiovascular Risks in Adolescents, nationwide, multicenter, school-based survey. We evaluated 901 adolescents, aged 12 to 17, from public and private schools in two cities of Sergipe state in Brazil. We measured demographic, anthropometric, and biochemical data, and insulin resistance using Homeostasis Model Assessment-Insulin Resistance. We used multiple linear regression and logistic analysis to evaluate the association between dependent variables (biochemical) and independent variables (anthropometric) controlled by body mass index, age, gender, and Tanner’s stage. We used the Receiver operating characteristic curve to determine cut-off points of neck circumference that can identify insulin resistance. Results The multiple linear regression analysis showed a positive association between neck circumference measurement with fasting glycemia and glycated hemoglobin (p<0.001) and a negative association with insulin (p<0.024). Furthermore, in logistic regression, the measurement of neck circumference was the only anthropometric indicator positively correlated with homeostasis model assessment-insulin resistance. The cut-off points of neck circumference for predicting insulin resistance were: 30.55cm for female pubertal and 32.10cm for post-pubertal adolescents; 35.90cm for male pubertal adolescents and 36.65cm for post-pubertal adolescents. Conclusions The measurement of neck circumference is a simple, practical anthropometric indicator and can be used as a screening tool to identify insulin resistance in adolescents.

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Resistin Levels In Healthy Non-Diabetes Nigerian-Africans: Effect Of Obesity The ABU Adiporesistin Survey

10.21203/rs.3.rs-21732/v1 ◽

2020 ◽

Author(s):

Obiageli UZOAMAKA Onyemelukwe ◽

Dimie Ogoina ◽

Geoffery Chukwubuike Onyemelukwe (MON)

Keyword(s):

Insulin Resistance ◽

Study Groups ◽

Cross Sectional Study ◽

Normal Weight ◽

Enzyme Linked Immunosorbent Assay ◽

Model Assessment ◽

Geographical Differences ◽

Cross Sectional ◽

Black Africans ◽

Obesity Indices

Abstract Background Conflicting findings exist on the mechanisms of resistin in obesity and insulin resistance among white populations, as data on these in black Africans are scarce, on account of genetic/geographical differences. Hence, the study aimed to determine plasma resistin levels in Nigerian-Africans and explore its relationship with obesity and selected cardiometabolic risks. Materials and Methods A cross-sectional study on 87 randomly-selected non-diabetes Nigerians of both genders allocated into three study groups: 24 normal weight; 23 overweight and 40 obese groups by the WHO criteria. Fasting Insulin (FI), Homeostasis Model Assessment-Insulin resistance (HOMA-IR) and obesity indices were determined. Plasma resistin was measured via enzyme linked immunosorbent assay. One-way Kruskal-Wallis test determined cardiometabolic parameters across the groups with Spearman’s correlation assessing relationships. Results Resistin levels were higher in overweight and obese than normal weight subjects {6.6±3.8, 6.7±4.2 versus 5.6±2.9 µIU/mL, ( p<0.001 )}, with highest concentrations in severely obese than mildly and non-obese subjects {(7.4±5.6 versus 6.7±4.2 versus 6.05±3.0 µIU/mL ( p<0.001 , One-way Kruskal-Wallis). However, resistin showed no significant ( p>0.05 ) correlations to HOMA-IR, FI and obesity indices. The higher HOMA-IR found in overweight and obese than normal weight subjects (3.7±3.5, 2.9±2.4 vs. 2.1±0.4, p<0.001 ), was positively correlated to obesity and FI, which also increased from mild to severe BMI categories. Conclusion Higher resistin concentrations are found in severe obesity among non-diabetes black Africans, but its lack of correlation with insulin resistance and obesity indices may suggests possible interplay of other pro-inflammatory cytokines or hormones which may be evaluated in further studies.

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Association of Exposure to Di-2-Ethylhexylphthalate Replacements With Increased Insulin Resistance in Adolescents From NHANES 2009–2012

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2015-1686 ◽

2015 ◽

Vol 100 (7) ◽

pp. 2640-2650 ◽

Cited By ~ 35

Author(s):

Teresa M. Attina ◽

Leonardo Trasande

Keyword(s):

Insulin Resistance ◽

Cross Sectional Study ◽

Environmental Chemicals ◽

Model Assessment ◽

Cross Sectional ◽

The Third ◽

Health And Nutrition ◽

Homeostatic Model Assessment ◽

Secondary Analyses ◽

Sectional Analysis

Context: Di-isononyl phthalate (DINP) and di-isodecyl phthalate (DIDP) are environmental chemicals increasingly used to replace di-2-ethylhexylphthalate (DEHP) and commonly found in processed foods. Phthalate exposures, in particular DEHP, have been associated with insulin resistance in adolescents, but there are no data regarding the two substitutes, DINP and DIDP. Objective: This study aimed to examine associations of DINP, DIDP, and DEHP with insulin resistance outcomes. Design, Setting, and Participants: This was a cross-sectional analysis of 2009–2012 National Health and Nutrition Examination Surveys (NHANES) composed of 356 fasting 12–19-year-olds. Main Outcome Measures: Insulin resistance as a categorical outcome expressed as homeostatic model assessment of insulin resistance (HOMA-IR), using a cut point of 4.39 to define insulin resistance. We also examined continuous HOMA-IR as an outcome in secondary analyses. Results: Controlling for demographic and behavioral factors, diet, age, body mass index, and urinary creatinine, for each log increase in DINP metabolite, a 0.08 (P = .001) increase in HOMA-IR was identified. Compared with the first tertile of DINP (23.4% adjusted prevalence), the third tertile was associated with a 34.4% prevalence (95% confidence interval [CI], 27.3–41.6%; P = .033) of insulin resistance. Similarly, compared with the first tertile of DEHP (20.5% adjusted prevalence), the third tertile had 37.7% prevalence (95% CI 29.8–45.6%; P = .003). Conclusions: Urinary DINP concentrations were associated with increased insulin resistance in this cross-sectional study of adolescents. The previously identified association of DEHP with insulin resistance was also confirmed. Further, longitudinal studies are needed to confirm these associations, with the possibility to assess opportunities for intervention.

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