Trends in Hyperinsulinemia and Insulin Resistance Among Nondiabetic US Adults, NHANES, 1999-2018.
Level 4 - case-series / case-control
Serial cross-sectional population survey (NHANES).
PubMed 40364246 · doi:10.3390/jcm14093215
What was done
Analyzed data from 17,310 nondiabetic men and nonpregnant women aged 20 years or older from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018. The authors fitted linear and joinpoint logistic regression models to evaluate sample-weighted, age-standardized temporal trends in the prevalence of hyperinsulinemia and insulin resistance across sociodemographic groups.
What was found
The age-standardized prevalence of hyperinsulinemia rose from 28.2% in 1999-2000 to 41.4% in 2017-2018. Insulin resistance prevalence similarly increased from 24.8% in 1999-2000 to 38.4% in 2017-2018. Across the entire study period, prevalence was consistently higher among males, non-Hispanic Black adults, Hispanic adults, and individuals with lower educational attainment or lower family income. Increasing temporal trends were observed across all sociodemographic subgroups in at least some intervals.
Why it matters
Highlights a substantial two-decade increase in early cardiometabolic disease risk among US adults without diagnosed diabetes, indicating widening exposure and persistent sociodemographic disparities.
Limits
The serial cross-sectional design cannot assess individual longitudinal trajectories or establish causality. The abstract does not specify the laboratory assays, diagnostic thresholds, or fasting criteria used to define hyperinsulinemia and insulin resistance. The methods used to exclude individuals with diabetes were not detailed in the abstract, and potential unmeasured confounders like dietary changes or medication use were not described.
Cited by
- supports One in three people in the United States have insulin resistance.