Insulin Resistance in Obese Adolescents at a Tertiary care hospital in Bangladesh

Abstract

Background: Insulin resistance has evolved as an important metabolic alteration in obese children especially during adolescence. Emerging data suggest that insulin resistance in obesity play the key role in the pathogenesis of hypertension, dyslipidemia, impaired glucose tolerance, type 2 diabetes mellitus, non-alcoholic fatty liver disease and metabolic syndrome. Objective: The aim of this study was to assess the insulin resistance status of Bangladeshi obese adolescents in hospital settings. Methods: It was a cross sectional study done in children, aged 10 to 16 years, attending the paediatric endocrine clinic, paediatric outpatient and paediatric inpatient department, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka over a period of 15 months. Homeostasis Model Assessment of Insulin Resistance (HOMA- IR) value was obtained from fasting insulin & fasting blood glucose level to assess insulin resistance in obese and normal weight children. Results: Among obese adolescents, 78.8% were insulin resistant in comparison to16% in non-obese adolescent. Mean HOMA-IR level of obese group were significantly higher than non-obese group (4.46±1.82 Vs 1.98±1.26, p<0.001). Insulin resistance was observed in 73.8% and 84.2% among grade 1 obese and grade 2 obese adolescents respectively. HOMA-IR showed positive correlation with BMI and waist circumference. Insulin resistance showed significant association with central obesity, puberty and acanthosis nigricans (AN). Conclusion: In this study, insulin resistance was observed in higher frequency among obese adolescents than normal weight adolescents. Obese adolescents with central obesity, acanthosis nigricans and puberty are at increased risk of insulin resistance. Bangladesh Med Res Counc Bull 2021; 47(2): 212-218