Diabetes
Temporal Trends in Hyperinsulinemia and Insulin Resistance Prevalence among Nondiabetic Adults in the U.S., NHANES, from 1999 to 2018 Chuyue Wu* Chuyue Wu Yixun Ke Roch A. Nianogo
Background:
Hyperinsulinemia and insulin resistance are strong predictors for future cardiometabolic diseases.
Objective:
Our aim is to estimate and test the temporal trends in hyperinsulinemia and insulin resistance prevalence by race/ethnicity and poverty level, among non-diabetic adults in the United States from 1999 to 2018.
Methods:
We used data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Hyperinsulinemia was defined as people with serum fasting insulin levels ≥ 10 U/ml (the median). Insulin resistance was defined by using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index ≥ 2.6 (the 66th percentile). We assessed nonlinearity by evaluating cubic terms in polynomial logistic regression models. Logistic regression models were fitted to test the sample weighted and age-standardized time trends.
Results:
We included 17,310 men and nonpregnant women, aged 20 years or older, and free of diagnosed diabetes. The prevalence of hyperinsulinemia and insulin resistance rose by about 40% from 1999 to 2018 (Figure 1). Non-Hispanic (NH) White people and those with higher family income (i.e., higher ratio of family income to poverty level) were more likely to have lower prevalence of hyperinsulinemia and insulin resistance. The prevalence of hyperinsulinemia and insulin resistance among NH Black and Hispanic individuals was consistently higher compared to NH White people. NH Asian people had a rapid increase in hyperinsulinemia and insulin resistance prevalence since 2013. We found the presence of temporal trends for each subgroup defined by race/ethnicity and poverty level (P for trend < 0.01).
Conclusions:
There was an increased time trend in the prevalence of hyperinsulinemia and insulin resistance among nondiabetic adults in the US from 1999 to 2018. This underscores the need for targeted interventions, particularly addressing disparities across racial and income subgroups.
