EVALUATION OF HOMA-IR(HOMEOSTATIC MODEL ASSESSMENT INSULIN RESISTENCE) AND ITS CORRELATION WITH ANTHROPOMETRY IN THE OBESE OR OVERWEIGHT CHILDREN AND ADOLESCENT

Ajmariya M.*, Ghanghoriya P., Agrawal G. and Mittal P.,

ABSTRACT

Objective-evaluation of HOMA-IR(homeostatic model assessment insulin resistence) and its correlation with anthropometry in the obese or overweight children and adolescent. Methodology: Study was approved by the ethical committee and subjects were enrolled after written consent of parents/subjects. Various Anthropometric measurements were taken. 1. Weight: weight was recorded using the electronic weighing machine to nearest 1000 gram. Subjects were made to stand barefoot without touching anything else. 2. Height: it was measured to the nearest 1 cm using stadiometer. Subjects were made to stand barefoot on the foot board heel, buttocks, shoulders and occipit touching against the vertical plank, looking straight ahead with the head held in a way that it lies in the Frankfurt plane (i.e. lower border of orbital fossa on the same horizontal plane as the upper border of external auditory meatus in parallel to the ground). Height was measured to the nearest 1 cm using the scale mounted on vertical plank. 3.Body mass index (BMI): following formula was used to compute the BMI- BMI (kg/m2) = weight (kg)/height (m)2 Each BMI value was converted into corresponding BMI percentile (age & sex specific). Than subjects were classified into 3 categories as follow i. <85th centile – normal ii. 85 – 95th centile – overweight iii. >95th centile -obese[1] Beyond 18 years i. 18.5 – 22.9 kg/m2 – normal ii. 23.0 – 26.9 - overweight iii. > 27 - obese[2] 4.Waist circumference: measured using a non stretchable tape at the mid-point of the lowest rib-cage and the iliac crest to the nearest 1 cm in the standing position during end tidal expiration. It was measured twice and if the difference between the two readings was 0.4 cm a 3rd reading was taken and mean was calculated using the two closet values. Waist circumference percentiles were generated using age and sex specific Kuriyan chart of waist measurements for Indian children and based these percentiles subjects were categorized into three groups 1. <75th centile – normal 2. 75 – 90th centile – overweight 3. >90th centile – obese[3] Beyond 16 years, based on sex following values were taken as cut off[4] Girls <80cm – normal >80 cm – obese Boys <90 cm – normal >90 cm – obese. 5. Hip circumference: recorded to the nearest 0.1 cm at the level of greater trochanter in the standing position. It was measured twice and if the agreement between 2 repeats was >0.4 cm, than a 3rd measurement was taken and the mean was calculated using the 2 closet values. 6. Waist/Hip ratio: it signifies the ratio of the truncal and extremity fat distribution. In male >0.9 and in female >0.8 were taken off as cut off.[5] 7. Neck circumference: measured in the standing position, head held erect at the level of thyroid cartilage. In the absence of data on the cut off values for neck circumference in Indian children we adopted the corresponding values from the US counterpart[6] Result-total 30 subjects participated in the study. 17(57%) were male and 13(43%) were female. 6(20%) subjects were in 6-<10 year age group, 15(50%) were in 10-<15 year, and 09(30%) were in 15-19 year age group. Total 25 subjects had abnormal neck circumference. Out of 17% had normal neck circumference and 83% had higher neck circumference. it was found tha no significant correlation between neck circumference and insulin resistance (p value = 0.24) Conclusion: Insulin resistence is significantly associated with marker of adiposity like neck circumference.it association was significant.nc on application chi square trends the association between the bmi and homa-ir was found to be not significant.Our study show that the insulin resistence of adult disease erupt in childhood itself and therefore control of weight should be aim from early childhood so as to prevent complication of obesity in future.

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