(P13-017-24) Identification of Modifiable Risk Factors and a HOMA-IR Cut-Off Point to Measure Cardiometabolic Risk in Peruvian Adolescents

Objectives: Identify a cut-off point to detect insulin resistance (IR) using the HOMA-IR and identify its risk factors in Peruvian adolescents.

Methods: This is a secondary analysis of a longitudinal study of 329 Peruvian adolescents follow up from infancy (6 to 11 months of age) to 14 years of age. Infants were part of a trial to evaluate the efficacy of complementary feeding with bovine milk fat globule membranes (bMFGM). ROC curve analysis was used to identify the specific cut-off point to classify IR using the sensitivity and specificity values in comparison with the MS (metabolic syndrome). Multiple logistic regression analysis including diet, physical activity and body composition from adolescence, excess weight during infancy, family history of non-chronic disease (FHNCD) and participation in infant trial with bMFGM was included to identify risk factors associated with IR.

Results: Mean HOMA-IR was 3.3 (95% CI 3.1; 3.5) with no differences by sex. Prevalence of obesity and overweight in the adolescents was 14.6% (95% CI 11.3; 18.5%) and 27.5% (95% CI 23.2; 32.3%), respectively. Prevalence of MS according to the IDF criteria was 7.8% (95% CI 5.5; 11.0). We identified 3.9 for HOMA-IR as the cut-off point with high sensitivity (72.4%) and specificity (75.4%) for predicting MS. IR was present in 28.6% (95% CI 24.2;33.4%); 84% had at least one cardiometabolic risk factor and low high-density lipoprotein and abdominal obesity were the most prevalent (62 and 35%, respectively). Adolescents with higher fat mass index (OR 16.03, 95% CI 6.79 to 37.86), and those physically inactive (OR 2.08 95% CI 1.06 to 4.07) were more likely to have IR. No association was found with diet, excess weight at infancy, FHCD and whether received the (bMFGM) at infancy.

Conclusions: A cut-offs point of 3.9 for HOMA-IR allows to identify adolescents with high metabolic risk early in life. Strategies to promote lower FMI and improve the physical activity levels could reduce the risk of IR in adolescents. This strategies could be implemented in Food environments that have been recognize as potential spaces for this.

Funding Sources: Research direction of the “Universidad Peruana de Ciencias Aplicadas”, Lima-Peru. The original  study was funded by Mead Johnson & Company, and Arla Foods Ingredients Group. The funders had no role in the research question of this paper, analyses, interpretation of data and decision to publish.