Neighborhood Characteristics and Components of the Insulin Resistance Syndrome in Young Adults

The Coronary Artery Risk Development in Young Adults (CARDIA) Study

  1. Ana V. Diez Roux, MD, PHD1,
  2. David R. Jacobs, PHD2 and
  3. Catarina I. Kiefe, MD, PHD3
  1. 1Division of General Medicine, Columbia College of Physicians and Surgeons and Division of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
  2. 2Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis, Minnesota, and the Institute for Nutrition Research, University of Oslo, Oslo, Norway
  3. 3Center for Outcomes and Effectiveness Research and Education, University of Alabama at Birmingham, and the Birmingham Veterans Administration Medical Center, Birmingham, Alabama


    OBJECTIVE—To examine associations of neighborhood characteristics with six components of the insulin resistance syndrome (IRS) in young adults.

    RESEARCH DESIGN AND METHODS—Cross-sectional data from the Coronary Artery Risk Development in Young Adults (CARDIA) Study were used to examine associations of neighborhood characteristics with the IRS in 3,093 nondiabetic adults aged 28–40 years. Measures of BMI, fasting HDL cholesterol, triglycerides, insulin, glucose, and systolic blood pressure were combined into an IRS score. U.S. Census-derived neighborhood characteristics were summarized into a neighborhood socioeconomic score, with an increasing score signifying increasing socioeconomic advantage.

    RESULTS—Among white men and women, the IRS score was inversely related to neighborhood socioeconomic score. Neighborhood characteristics remained associated with the IRS score after controlling for personal income and education (adjusted mean differences for 95th vs. 5th percentile of neighborhood score: −0.24 standard deviation units [SE = 0.12] in men and −0.56 standard deviation units [SE = 0.10] in women). Among black participants, neighborhood score was inversely associated with IRS score in persons of high income and education (mean differences 95th vs. 5th percentile −0.54 [SE 0.26] in men and −0.52 [SE 0.26] in women) but positively associated or not associated with IRS score in persons of low income and education (mean differences 0.60 [SE 0.21] in men and 0.00 [SE 0.16] in women).

    CONCLUSIONS—The IRS score is associated with neighborhood characteristics as early as young adulthood. Features of residential environments may be related to the development of insulin resistance.


    • Address correspondence and reprint requests to Ana V. Diez Roux, Division of General Medicine, 622 W. 168th St., PH9 East Rm. 105, New York, NY 10032. E-mail: ad290{at}

      Received for publication 15 March 2002 and accepted in revised form 31 July 2002.

      A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

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