***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background This study investigates prospect i ve associations of anthropometrical and lifestyle indices with  insulin resistance ( IR ) in European children from the IDEFICS cohort . Insulin resistance ( IR ) is a growing concern in childhood obesity and a central aspect of the metabolic syndrome ( MS ) . It most likely represents the link between obesity and type 2 diabetes . Methods This longitudinal study included 3348 preadolescent children aged 3 to 10.9 years from 8 European countries who were observed from 2007/2008 to 2009/2010 . The main outcome measure in the present analysis is HOMA-IR ( homeostasis model assessment as a common proxy indicator to quantify IR ) at follow-up and in its longitudinal development .  Anthropometrical measures and lifestyle indices  , including objective ly determined physical activity  , were considered , among others factors , as determinants of IR . Prospect i ve associations between IR at follow-up and anthropometrical and lifestyle indices were estimated by logistic regression models . Results Country-specific prevalence rates of IR in the IDEFICS cohort of European children showed a positive trend with weight category . Prospect i ve multivariate analyses showed the strongest positive associations of IR with BMI z-score ( OR = 2.6 for unit change from the mean , 95 % CI 2.1–3.1 ) and z-score of waist circumference ( OR = 2.2 for unit change from the mean , 95 % CI 1.9–2.6 ) , which were analysed in separate models , but also for sex ( OR = 2.2 for girls vs. boys , 95 % CI 1.5–3.1 up to OR 2.5 , 95 % CI 1.8–3.6 depending on the model ) , audio-visual media time ( OR = 1.2 for an additional hour per day , 95 % CI 1.0–1.4 in both models ) and an inverse association of objective ly determined physical activity ( OR = 0.5 for 3rd compared to 1st quartile , 95 % CI 0.3–0.9 in both models ) . A longitudinal reduction of HOMA-IR was accompanied with a parallel decline in BMI . Conclusions This study is , to our knowledge , the first prospect i ve study on IR in a preadolescent children ’s population . It supports the common hypothesis that overweight and obesity are the main determinants of IR . Our data also indicate that physical inactivity and a sedentary lifestyle are likewise associated with the development of IR , independent of weight status . The promotion of physical activity should thus be considered as an equal option to dietary intervention for the treatment of IR in the paediatric practice In this study of 4525 children , a 1-hour-longer sleep duration was associated with lower levels of adiposity , insulin resistance , and fasting glucose . BACKGROUND : Associations between sleep duration and type 2 diabetes  ( T2D ) risk markers in childhood have been little studied . We examined associations between self-reported  sleep duration  and T2D risk markers in children . METHODS : Cross-sectional study of 4525 multiethnic UK children aged 9 to 10 years .  Sleep time  was calculated from self-reported usual time of going to bed and getting up on a school day , vali date d in a subset using accelerometers . Fasting blood sample s provided levels of serum lipids and insulin , plasma glucose , and HbA1c . Physical measures included height , weight , bioimpedance , and blood pressure . Multilevel linear regression models of anthropometric , T2D , and cardiovascular risk markers with sleep duration were adjusted for sex , age , month , ethnicity , socioeconomic position , observer ( physical measures only ) , and r and om effect of school . RESULTS : On average , children slept 10.5 hours per night ( 95 % range 8.0–12.0 hours ) . There were strong inverse grade d relationships between sleep duration , adiposity , and diabetes risk markers . In adjusted models , a 1-hour-longer sleep duration was associated with 0.19 lower BMI ( 95 % confidence interval [ CI ] 0.09 to 0.28 ) , 0.03 kg/m5 lower fat mass index ( 95 % CI 0.00 to 0.05 kg/m5 ) , 2.9 % lower homeostasis model assessment insulin resistance ( 95 % CI 1.2 % to 4.4 % ) , and 0.24 % lower fasting glucose ( 95 % CI 0.03 % to 0.44 % ) ; there was no association with HbA1c or cardiovascular risk . Associations with insulin and glucose remained after an additional adjustment for adiposity markers . CONCLUSIONS : The finding of an inverse association between sleep duration and T2D risk markers in childhood is novel . Intervention studies are needed to establish the causality of these associations , which could provide a simple strategy for early T2D prevention 
    Output:
    
The strongest evidence of an association with sleep is with obesity , hypertension , and insulin sensitivity .