Determinação dos valores de glicemia, insulinemia e índice (HOMA) em escolares e adolescentes eutróficos

Abstract

Objective: To determine fasting glycemia and insulinemia levels and the HOMA index in a group of children and adolescents with normal body mass index (BMI).Methods: This was a cross-sectional study conducted at two public schools in Ribeirão Preto, SP, Brazil. A total of 447 children and adolescents of both sexes, with normal BMI, aged 7 to 17.9 years and of average maturity for their age, underwent anthropometric measurements and provided personal data and a sample of venous blood so that glycemia, insulinemia and HOMA index could be determined. The results obtained for boys and girls were compared for each age range using the Mann-Whitney test. The results within each age band were then compared for boys and girls using the Kruskal-Wallis test.Results: Glycemia results varied from 7 to 8.9 years (p = 0.0005). Fasting insulinemia varied significantly with age in both sexes (p < 0.001), with the highest values observed among children aged 13 to 14.9 years. HOMA indices varied significantly with age in both boys and girls (p < 0.001), with values that increased progressively up to the age band of 13 and 14.9 years.Conclusions: These data demonstrate the necessity of establishing reference curves for these three indicators.J Pediatr (Rio J). 2008;84(2):136-140: Obesity, hyperinsulinism, insulin, metabolic syndrome X.

Isolated Premature Pubarche: Report of Anthropometric and Metabolic Profile of a Brazilian Cohort of Girls

“…The prevalence of insulin resistance was very low, being estimated in 10.4% when the glucose/insulin ratio was used and 10.2% when fasting insulin or HOMA-IR were considered (table 3). In our cohort, fasting insulin levels and HOMA-IR were statistically similar to normal girls studied in Brazil (p > 0.05, Student’st test) [16]. …”

“…Fasting insulin was compared to normative pediatric data according to age and gender, obtained from a Brazilian cohort of schoolchildren and adolescents with normal pubertal development and BMI [16]. The ratio glucose/insulin was used as a marker of insulin resistance and was considered altered if <7 [17].…”

High Prevalence of Dyslipidemia and Insulin Resistance in HIV-infected Prepubertal African Children on Antiretroviral Therapy

“…The following thresholds were considered abnormal: total cholesterol >200mg/dL (>5.18mmol/L) 6 ; LDL cholesterol >130mg/dL (>3.37mmol/L) 6-7 ; HDL cholesterol <35mg/dL (<0.91mmol/L) 7 ; triglycerides >150mg/dL (>1.7mmol/L) 6-7 ; fasting glucose >100mg/dL (>5.6mmol/L) 8 . HOMA values were evaluated against norms presented by de Almeida et al 9 , which are the most appropriate norms available in current literature for children in a developing country, since norms for African children are not available. Lipoatrophy was formally graded by consensus between two HIV pediatricians who were experienced in identifying lipoatrophy using a standardized visual grading scale similar to that described by Carr and others 10-12 : Grade 0 – No fat changes; Grade 1 – Possible minor changes, noticeable only on close inspection; Grade 2 – Moderate changes, unequivocably noticeable only to an experienced clinician or a close relative who knows the child well; Grade 3 – Major changes, readily noticeable to an uninformed observer.…”

“… IQR = Interquartile range; SD = Standard deviation; LDL = low-density lipoprotein; HDL = high-density lipoprotein; HOMA = homeostatic model assessment insulin resistance index. § Defined as current exposure or exposure within the previous six months. * Age- and gender-related norms taken from de Almeida et al 2008 9 …”

Low prevalence of glucose intolerance in racially mixed children with cystic fibrosis

“…Insulin resistance was evaluated by the HOMA (Homeostasis Model Assessment) index, using the following formula: HOMA‐IR = [fasting serum insulin (µU/mL) × fasting glycemia (mmol/L)/22.5]. The reference values for HOMA‐IR for Brazilian children over the age of 7 was established by Almeida et al (14). For the three children below this age, the same reference values as those for children from 7 to 9 yr old were used.…”