DXA-based Fat Mass With Risk of Worsening Insulin Resistance in Adolescents: A 9-Year Temporal and Mediation Study
Authors' conclusion
Mid-adolescence may be an optimal time for interrupting the worsening fat mass-insulin resistance pathologic cycle and attenuating the risk of progressively worsening metabolic dysfunction before young adulthood.
Study context
- Population
- Adolescents from Avon Longitudinal Study of Parents and Children (ALSPAC) with complete DXA and fasting blood samples at age 15 years and repeated measures at ages 17 and 24 years; 51% female
- Participants
- 3,160 adolescents
- Exposure
- Per 1-kg cumulative increase in total and trunk fat mass
- Outcome
- High insulin resistance (HOMA-IR ≥75th percentile), hyperglycemia (fasting glucose >6.1 mmol/L) and hyperinsulinemia (insulin >11.78 mU/L)
- Follow-up
- Ages 15 to 24 years
Methodological detailsUK birth cohort (ALSPAC), longitudinal, mediation and temporal path analysis, adjusted for cardiometabolic and lifestyle factors
- UK birth cohort (ALSPAC)
- Longitudinal
- Mediation and temporal path analysis
- Adjusted for cardiometabolic and lifestyle factors
Main finding
As reported in the abstract
High insulin resistance · ages 15 through 24 years
OR per 1-kg cumulative increase in total fat mass
1.12
95% CI 1.11–1.13
OR per 1-kg cumulative increase in trunk fat mass
1.21
1.19–1.23
Observational data: associations, not effects.
Further findings
Mediation of total fat mass–insulin resistance association
- Partly mediated by TG
- 9% mediation
Temporal path analysis
- Higher total fat mass at age 15 associated with higher insulin resistance at age 17, but not vice versa
- Total fat mass at age 17 bidirectionally associated with higher insulin resistance at 24
Trajectories · age 15 through 24 years
- Fat mass and lean mass increased linearly in males and females; glucose, insulin and homeostatic model assessment for insulin resistance (HOMA-IR) had a U-shaped course
Original publication
DXA-based Fat Mass With Risk of Worsening Insulin Resistance in Adolescents: A 9-Year Temporal and Mediation Study. J Clin Endocrinol Metab. Published 4 January 2024. doi:10.
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