Blood was drawn from the antecubital vein, after a fasting period of 12 h. Serum glucose was determined by enzymatic photometric tests (Glucose GOD FS, DiaSys Diagnostic Systems GmbH) in an automated analyzer (Vitalab Selectra E, Vitalab Scientific). Serum insulin levels were determined by an immunoassay method (Adaltis Diagnostics) using an Eclectica analyzer (Adaltis Diagnostics). The cut-off point of 14.38 was considered for abnormal insulin levels since it has been proven to have an adequate performance to diagnose metabolic syndrome for a similar population to our sample [27 (link)].
The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated using the formula [28 (link)]: [fasting insulin (µU/mL)*fasting glucose (mg/dL)]/405. Two validated cut-off points were used to diagnose insulin resistance: HOMA-IR > 3.16 as proposed by Keskin et al. in 2005, which has been widely used in epidemiological studies [29 (link)], and HOMA-IR > 2.97 proposed by Piña-Aguero et al. in 2018 as a valid cut-off for insulin resistance in Mexican adolescents [27 (link)].
The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated using the formula [28 (link)]: [fasting insulin (µU/mL)*fasting glucose (mg/dL)]/405. Two validated cut-off points were used to diagnose insulin resistance: HOMA-IR > 3.16 as proposed by Keskin et al. in 2005, which has been widely used in epidemiological studies [29 (link)], and HOMA-IR > 2.97 proposed by Piña-Aguero et al. in 2018 as a valid cut-off for insulin resistance in Mexican adolescents [27 (link)].
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