Assessment of disturbed glucose metabolism and surrogate measures of insulin sensitivity in obese children and adolescents.

ABSTRACT: BACKGROUNDWith the rising prevalence of obesity and type 2 diabetes (T2D) in obese children, it is becoming imperative to detect disturbed glucose metabolism as early as possible in order to prevent T2D development.SUBJECTS/METHODSCross-sectional study of 92 obese children (median age 11.7 years, 51% female) and 7 lean children (median age 11.4 years, 57% female) who underwent an oral glucose tolerance test (OGTT) in a tertiary pediatric care center. Glucose tolerance was assessed and different indices for ?-cell function, insulin sensitivity and insulin secretion were calculated.RESULTSNineteen obese children were identified with prediabetes (PD, 12 impaired glucose tolerance, 4 increased fasting glucose and 3 combined). Compared with the 73 obese children with normal glucose tolerance (nGT), subjects with PD had higher insulin resistance, but lower insulin sensitivity and ?-cell function, although their glycated hemoglobin (HbA1c) levels were comparable. The Whole Body Insulin Sensitivity Index (WBISI) and ?-cell function by Insulin Secretion-Sensitivity Index-2 (ISSI-2) strongly correlated with the OGTT glucose area under the curve 0-120?min (r?=?0.392, p?CONCLUSIONSChildren with identified PD had changes of several markers for ?-cell function, insulin sensitivity and resistance before changes in HbA1c occurred. The lower disposition index indicates that these children have already inadequate ?-cell compensation for the degree of insulin resistance.

SUBMITTER: Roth CL 

PROVIDER: S-EPMC5865547 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature