Asian Adolescents with Excess Weight are at Higher Risk for Insulin Resistance than their Non-Asian Peers

OBJECTIVE: Evaluate whether Asian-American adolescents have higher metabolic risk from excess weight than non-Asians. METHODS: 733 students, 14- to 19-years old, completed a school-based health screening. The 427 Asian and 306 non-Asian students were overall equivalent on age, sex, and family income. Height, weight, waist circumference, percent body fat, and blood pressure were measured. Fasting bloods measured triglycerides, high- and low-density lipoproteins, glucose, and insulin levels. Asian and non-Asians in lean or overweight/obese groups were contrasted on the 5 factors that make up the Metabolic Syndrome. RESULTS: Asian adolescents carrying excess weight had significantly higher insulin resistance (IR), triglyceride levels, and waist to height ratios (W/H), despite a significantly lower overall body mass index (BMI) than corresponding non-Asian. Similarly, Asians had a stronger relationship between W/H and the degree of IR than non-Asian counterparts; 35% and 18% of the variance were explained (R(2)=0.35, R(2)=0.18) respectively, resulting in a significant W/H by racial group interaction (F(change)(1,236) = 11.56, p<0.01). CONCLUSIONS: Despite lower overall BMIs, Asians have higher IR and triglyceride levels from excess weight than their non-Asian counterparts. One-size-fits-all public health policies targeting youth should be reconsidered and attention paid to Asian adolescents, including those with mild degrees of excess weight.