Trends in HOMA-IR values among South Korean adolescents from 2007–2010 to 2019–2020: a sex-, age-, and weight status-specific analysis

BACKGROUND/OBJECTIVES: An increase in obesity prevalence may lead to an increase in the HOMA-IR value. This study aimed to investigate changes in age- and sex-specific homeostasis model assessment of insulin resistance (HOMA-IR) values among South Korean adolescents, using data from the Korean National Health and Nutrition Examination Survey (KNHANES) IV, V, and VIII conducted between 2007–2010 and 2019–2020. SUBJECTS/METHODS: Overall, 4621 adolescents aged 10–18 years were evaluated, including 3473 from the 2007–2010 dataset and 1148 from the 2019–2020 dataset. The mean HOMA-IR values and percentile curves were evaluated by age, sex, and weight status. RESULTS: The mean HOMA-IR values peaked at puberty in both sexes and further increased during puberty in the 2019–2020 dataset (boys 5.21, 95% confidence interval [CI] 4.16–6.26; girls 5.21, 95% CI 3.09–7.33) compared with the 2007–2010 dataset (boys 3.25, 95% CI 3.04–3.47; girls 3.58, 95% CI 3.31–3.85). Both groups (with normal-weight and overweight/obesity) exhibited a peak HOMA-IR value during puberty in both sexes and both datasets, although the group with overweight/obesity had a higher and wider peak age range. While the mean HOMA-IR values did not change in adolescents with normal-weight, they increased during puberty and post-puberty in boys with overweight/obesity. CONCLUSIONS: HOMA-IR values should be interpreted considering sex, weight status, and pubertal stages. In particular, during the pubertal period, insulin resistance (IR) can coexist not only due to weight-related factors but also as a result of the distinct hormonal changes characteristic of puberty. Over the 10-year period, the mean HOMA-IR values increased in the group with overweight/obesity during puberty and post-puberty, highlighting the need for active intervention to prevent metabolic complications in adolescents with overweight/obesity.