Insulin resistance and associated factors in healthy volunteers in South-west Nigeria

  • EN Adejumo
  • OA Adejumo Department of Community Medicine,LASUTH,Ikeja
  • OA Ogundahunsi
Keywords: Associated factors, Diabetes mellitus, HOMA IR, Insulin Resistance, Metabolic syndrome, Nigeria


Background: Insulin resistance (IR) is linked with the pathophysiology of some non-communicable diseases including Type 2 Diabetes mellitus and metabolic syndrome.

Objective: To determine the factors associated with IR among apparently healthy individuals in South-west Nigeria.

Methods: A cross-sectional study of a cohort of apparently healthy volunteers aged 18 years and above consecutively recruited from two communities was conducted. IR was determined using the homeostasis model assessment for IR (HOMA-IR) based on the cut off values of ≥ 2. Bivariate and multivariate analyses were used to determine the crude and adjusted odds ratio of IR associated factors.

Results: A total of 520 participants aged 18–89 years were recruited for the study. Their mean age was 46.7±14.6 years and the prevalence of IR was 43.5%. Alcohol intake (AOR = 2.1, 95%CI 1.3 – 3.4; p<0.001), lack of physical exercise (AOR = 1.5, 95%CI 1.0 – 2.3), and Body Mass Index (AOR = 1.03, 95%CI 1.0 – 1.1) were the factors associated with IR.

Conclusion: The prevalence of IR among apparently healthy individuals in this study was high. The need for proactive measures to avert the sequelae of IR is of utmost importance.


Laakso M, Kuusisto J. Insulin resistance and hyperglycaemia in cardiovascular disease development. Nat Rev Endocrinol 2014; 10: 293-302.

Chen S, Liu H, Liu X, Li Y, Li M, Liang Y, et al. Central obesity, C-reactive protein and chronic kidney disease: a community-based cross-sectional study in southern China. Kidney Blood Press Res 2013; 37: 392-401.

Krentz AJ. Insulin Resistance: A Clinical Handbook. Oxford, UK: Blackwell Science Limited; 2008.

Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014; 30: 766-781.

Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 2004; 27: 1047–1053.

World Health Organization. The World Health Report 1998: life in the 21st century: a vision for all. Geneva: World Health Organization. Available at (Accessed April 2019).

Johnson AM, Olefsky JM. The origins and drivers of insulin resistance. Cell 2013; 152: 673-684.

Oliveira EP, Souza ML, Lima MD. HOMA (Homeostasis Model Assessment) index in clinical practice: a review. J Bras Pathol Med Lab 2005; 41: 237-243.

Matthews D, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412-419.

Vasques AC, Rosado LE, Alfenas RC, Geloneze B. Critical analysis on the use of the homeostasis model assessment (HOMA) indexes in the evaluation of the insulin resistance and the pancreatic beta cells functional capacity. Arq Bras Endocrinol Metab 2008; 52: 32-39.

Adejumo EN, Ogundahunsi OA, Adejumo AO, Sotunsa J, Jagun O. Prevalence of metabolic syndrome in a rural and urban community in South-West Nigeria using three different definitions. Int J Trop Dis Health 2017; 24: 1e9.

World Health Organization: Body mass index. Available at (Accessed May 2019)

Young EE, Okafor CN, Iroezindu MO, Agbalu IS. Insulin resistance, metabolic syndrome, and lipids in African women. Niger J Clin Pract 2016; 19: 793-798.

Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, Di Angelantonio E, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Emerging Risk Factors Collaboration. Lancet 2010; 26: 2215-2222.

Gast KB, Tjeerdema N, Stijnen T, Smit JWA, Dekkers OM. Insulin Resistance and Risk of Incident Cardiovascular Events in Adults without Diabetes: Meta-Analysis. PLoS ONE 2012; 7: e52036

Ezenwaka CE, Akanji AO, Akanji BO, Unwin NC, Adejuwon CA. The prevalence of insulin resistance and other cardiovascular disease risk factors in healthy elderly south western Nigerians. Artherosclerosis 1997; 128: 201-211.

Akande TO, Adeleye JO, Kadiri S. Insulin resistance in Nigerians with essential hypertension. Afr Health Sci 2013; 13: 655 – 660.

Raimi TH, Odusan OO, Fasanmade OA, Odewabi AO, Ajala MO, Oritogun K et al. Insulin Resistance In Semi-Urban South Western Nigeria and It’s Relationship With Indices Of Obesity. Niger Endocrine Pract 2012; 6: 46-50.

Antuna-Puente B, Disse E, Rabasa-Lhoret R, Laville M, Capeau J, Bastard JP. How can we measure insulin sensitivity/resistance? Diabetes Metab 2011; 37: 179–188.

Moran A, Jacobs DR. Jr, Steinberger J, Steffen LM, Pankow JS, Hong CP, et al. Changes in insulin resistance and cardiovascular risk during adolescence: establishment of differential risk in males and females. Circulation 2008; 117: 2361–2368.

Ferrara CM, Goldberg AP, Nicklas BJ, Sorkin JD, Ryan AS. Sex differences in insulin action and body fat distribution in overweight and obese middle-aged and older men and women. Appl Physiol Nutr Metab 2008; 33: 784–790.

Ferrannini E, Natali A, Bell P, Cavallo-Perin P, Lalic N, Mingrone G. Insulin resistance and hypersecretion in obesity. European Group for the Study of Insulin Resistance (EGIR). J Clin Invest 1997; 100: 1166–1173.

Clausen JO, Borch-Johnsen K, Ibsen H, Bergman RN, Hougaard P, Winther K, et al. Insulin sensitivity index, acute insulin response, and glucose effectiveness in a population-based sample of 380 young healthy Caucasians. Analysis of the impact of gender, body fat, physical fitness, and lifestyle factors. J Clin Invest 1996; 98: 1195–1209.

Reaven GM.Banting Lecture 1988. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595-1607.

Colberg SR, Albright AL, Blissmer BJ, Braun B, Chasan-Taber L, Fernhall B, et al. Exercise and Type 2 Diabetes: American College of Sports Medicine and the American Diabetes Association: joint position statement. Exercise and Type 2 Diabetes. Med Sci Sports Exerc 2010; 42: 2282–2303.

Balkau B, Mhamdi L, Oppert JM, Nolan J, Golay A, Porcellati F, et al. Physical Activity and Insulin Sensitivity: The RISC Study. Diabetes 2008; 57: 2613–2618.

Koppes LL, Dekker JM, Hendriks HF, Bouter LM, Heine RJ. Moderate alcohol consumption lowers the risk of Type 2 diabetes: a meta-analysis of prospective observational studies. Diabetes Care 2005; 28: 719-725.

Davies MJ, Baer DJ, Judd JT, Brown ED, Campbell WS, Taylor PR. Effects of moderate alcohol intake on fasting insulin and glucose concentrations and insulin sensitivity in postmenopausal women: a randomized controlled trial. JAMA 2002; 287: 2559-2562.

Schrieks IC, Heil ALJ, Hendriks HFJ, Mukamal KJ, Beulens JWJ. The Effect of Alcohol Consumption on Insulin Sensitivity and Glycemic Status: A Systematic Review and Meta-analysis of Intervention Studies Diabetes Care 2015; 38: 723–732.

Campfield LA, Smith FJ, Guisez Y, Devos R, Burn P. Recombinant mousen OB protein: evidence for a peripheral signal linking adiposity and central neural networks. Science 1995; 269: 546-549.

Joosten MM, Beulens JW, Kersten S, Hendriks HF. Moderate alcohol consumption increases insulin sensitivity and ADIPOQ expression in postmenopausal women: a randomised, crossover trial. Diabetologia 2008; 51: 1375-1381.

Lindtner C, Scherer T, Zielinski E, Filatova N, Fasshauer M, Tonks NK, et al. Binge Drinking Induces Whole-Body Insulin Resistance by impairing Hypothalamic Insulin Action. Sci Transl Med. 2013; 30: 170ra14. doi:10.1126/scitranslmed.3005123.

Original Research