Bhattacharya S, Smith GD, Shah SH, Ben-Shlomo Y and Kinra S
Aims: To evaluate the relationship of anthropometric measures with insulin resistance (IR) in 1162 Indian adolescents from the follow-up survey of the Hyderabad Nutrition trial.
Methods: Analysis was done on data collected from 1162 adolescent participants of the Hyderabad Nutrition trial follow up survey. Participation included an interview, physical examinations and blood draws. Associations of body mass index (BMI), fat mass index (FMI), fat free mass index (FFMI), central to peripheral skinfold ratio (CPR), percent of body fat, waist circumference (WC) and waist-hip ratio (WHR) with IR were studied using linear regression models accounting for village clustering and adjusting for age and pubertal stage. Anthropometric indices were calculated from height, weight, skinfold thickness, waist and hip circumferences and IR was calculated by the homoeostasis model assessment (HOMA).
Results: We observed strong associations of BMI, FMI and FFMI with HOMA. Interestingly, FFMI (β (95% confidence interval) -0.03 (0.01, 0.06); P=0.007 (girls) and 0.06 (0.03, 0.09); P<0.0001 (boys)) was as strongly associated with IR as BMI (0.03 (0.01, 0.06); P=0.006 (girls) and 0.06 (0.03, 0.09); P<0.0001(boys)) and FMI (0.03 (0.01, 0.05); P=0.02 (girls) and 0.05 (0.02, 0.07); P=0.001 (boys)) We explored the relationship of lean mass with IR relative to fat mass and the associations remained strong.
Conclusions: We conclude that lean mass is as strongly associated with IR as fat mass in rural Indian adolescents. These findings appear contrary to the belief that higher rates of IR in South Asians reflect greater central adiposity. Future research needs to increase our understanding of the underlying mechanisms that lead to these associations in both obese and lean populations.
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