Trends in Hyperinsulinemia Among Nondiabetic Adults in the U.S.

  1. Chaoyang Li, MD, PHD1,
  2. Earl S. Ford, MD, MPH1,
  3. Lisa C. McGuire, PHD1,
  4. Ali H. Mokdad, PHD1,
  5. Randie R. Little, PHD2 and
  6. Gerald M. Reaven, MD3
  1. 1Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
  2. 2Departments of Pathology & Anatomical Sciences and Child Health, University of Missouri School of Medicine, Columbia, Missouri
  3. 3Department of Medicine, Stanford University School of Medicine, Stanford, California
  1. Address correspondence and reprint requests to Chaoyang Li, MD, PhD, Centers for Disease Control and Prevention, 4770 Buford Hwy., MS K66, Atlanta, GA 30341. E-mail: cli{at}


OBJECTIVE—Insulin resistance and compensatory hyperinsulinemia have been proposed as increasing risk for a variety of abnormalities and clinical syndromes, including type 2 diabetes and cardiovascular disease. Our aim was to assess the trends in the mean concentrations of fasting serum insulin and the prevalence of hyperinsulinemia among nondiabetic adults during the periods of 1988–1994 and 1999–2002 in the U.S.

RESEARCH DESIGN AND METHODS—We conducted analyses of data among men and nonpregnant women without diabetes aged ≥20 years from the Third National Health and Nutrition Examination Survey (NHANES III; 1988–1994; n = 7,926) and NHANES 1999–2002 (n = 2,993). Both surveys were designed to represent the noninstitutionalized civilian U.S. population. We calculated age-adjusted mean concentrations of fasting insulin and the prevalence of hyperinsulinemia defined using the 75th percentile of fasting insulin among nondiabetic individuals as the cutoff value.

RESULTS—The geometric mean concentrations of fasting insulin increased by ∼5% from 1988–1994 to 1999–2002 among nondiabetic adults aged ≥20 years in the U.S. Mexican-American men, men and women aged 20–39 years, and non-Hispanic white women had a greater relative increase in the mean concentrations of fasting insulin than their counterparts. The prevalence of hyperinsulinemia increased by 35.1% overall (38.3% among men and 32.1% among women).

CONCLUSIONS—In parallel with the obesity epidemic, concentrations of fasting insulin and prevalence of hyperinsulinemia have increased remarkably among nondiabetic U.S. adults.


  • The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

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

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted August 9, 2006.
    • Received February 3, 2006.
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