Insulin Resistance Syndrome in Children

Leslie K. Scott

Disclosures

Pediatr Nurs. 2006;32(2):119-124, 143. 

In This Article

Prevalence of Insulin Resistance Syndrome

One in three adult Americans has insulin resistance. It is estimated that insulin resistance affects 70 to 80 million Americans (AACE, 2002). Up to 50% of all individuals with essential hypertension have insulin resistance and over 80% of the more than 17 million Americans with diabetes are insulin resistant (Olatunbosun & Schade, 2002). The adult prevalence rate for IRS in the U.S. is estimated at 24% of the adult population (McKeowan et al., 2004). However, there is little prevalence data on IRS in children. The current epidemic of overweight in children and adolescents puts them at risk for insulin resistance and its complications (ACE, 2003). As many as 15% of children 6-19 years of age are overweight (BMI > 95th percentile for age and gender) (Ogden, Flegal, Carroll, & Johnson, 2002). This figure is up from 11% in 1998 (Rocchini, 2002). Current age-adjusted prevalence reports "risk of overweight" (BMI 85%-95% for age and gender) or overweight (BMI >95% for age and gender) rates in children may be as high as 20%-30% (Keiss et al., 2001).

Prior to 2002, no widely accepted definition for IRS in children existed (Invetti et al., 2002). As a result, Invetti and colleagues (2002) created child-specific criteria for determining IRS (see Table 1 ).

Limited studies on the epidemiology of IRS have been conducted in children. Bavdekar et al. (1999) studied IRS in 477, 8-year old Indian children. Birth weight, height/weight at 8 years of age, and other risk factors of IRS were examined to determine if a relationship existed between birth weight and cardiovascular risk. Highest levels of insulin resistance were reported in children of low birth weight but high fat mass by 8 years of age (Bavdekar et al., 1999). Chaoyang, Johnson, and Goran (2001) studied low birth weight and its influence on IRS in 139 Caucasian and African-American children 4-14 years of age. Children of low birth weight had significantly higher fasting insulin concentrations, higher visceral fat mass, and higher cholesterol levels, particularly in African-American children (Chaoyang et al., 2001).

Another study specifically looked at IRS among 137, 5-10 year-old obese, African-American children (Young-Hyman, Schlundt, Herman, DeLuca, & Counts, 2001). Many of the cluster factors that make up IRS already existed in the youth. Young African-American girls already showed evidence of hyperinsulinemia suggesting early metabolic decompensation leading toward type 2 diabetes (Young-Hyman et al., 2001). The Bogalusa Heart Study looked at the predictability of childhood adiposity with development of IRS in young adulthood (Strinivasan et al., 2002). Body Mass Index was the most significant predictor of IRS in young adulthood (by 21 years of age) (Steinberger, 2001). All of these findings reinforce the need for further studies, as well as the importance of early recognition and screening of youth at-risk for IRS.

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