Insulin level and insulin sensitivity indices among healthy children and adolescents

Abstract

Introduction. Information on insulin reference values and insulin sensitivity indices in the field of pediatrics is scarce. Objective. To describe insulin range and insulin sensitivity surrogate indices during childhood. Population and methods. Fasting insulin level range and surrogate indices, such as the homeostasis model assessment of insulin resistance (HOMA-IR), among healthy children and adolescents by age, body mass index, pubertal stage (PS), insulin-like growth factor-1 (IGF-1), total cholesterol, and triglycerides. Results. Two hundred and twenty-six healthy children and adolescents (1-18 years old) were included. Insulin increased with age, body mass index, pubertal stage, IGF-1 and triglyceride levels (r 2 = 0.38, p < 0.0001). Prepubertal children > 7.5 years old had higher insulin levels [median (P3 and P97) µIU/mL: 5.0 (1.7-9.6)] than prepubertal children ≤ 7.5 years old [2.9 µIU/ mL (1.3-10.9), p < 0.01]. During puberty (from PS II to PS V), insulin was higher in girls than in boys [7.4 (1.8-16.9) versus 5.8 (1.8-12.9), p < 0.01]. The HOMA-IR index increased in the group of prepubertal children > 7.5 years old: 1.1 (0.3-2.0) versus children ≤ 7.5 years old: 0.6 (0.3-1.4, p < 0.01). The insulin level and HOMA-IR results were higher in pubertal children compared to the prepubertal group (p < 0.001). Conclusions. Known physiological changes were observed in both insulin levels and the HOMA-IR index among children and adolescents. A fasting blood insulin level of 10 µIU/mL in prepubertal children and of 17 µIU/mL and 13 µIU/mL in pubertal girls and boys, respectively, may be considered as an acceptable cut-off value in healthy children. A HOMA-IR value > 2.0 and > 2.6 in prepubertal and pubertal children, respectively, may be considered a warning sign for pediatricians to further investigate insulin resistance.

The incidence of insulin resistance based on indices calculated using the HOMA and Belfiore methods and its impact on the occurrence of metabolic complications in prepubertal children born small for gestational age

“…IRI HOMA was calculated according to the following formula [14]: (fasting glucose [mmol/l] × fasting insulin [uIU/ml])/22.5). IRI HOMA >2.5 was considered to be IR [23,24].…”

Glucokinase maturity-onset diabetes of the young as a mimicker of stress hyperglycemia: a case report

“…Considering the insulin secretory capacity, hyperglycemia in GCK-MODY can be attributed to inappropriate insulin secretion rather than insulin resistance through upregulated catecholamine, cortisol, and inflammatory cytokines and downregulation of post-receptor insulin signaling, the underlying cause of hyperglycemia-associated FS ( 12 , 13 ). Compared with the healthy prepubertal group, the present patient exhibited a relatively high glycemia/insulin ratio (204 vs. 24 [10–50]) and low HOMA-IR (0.1 vs. 0.7 [0.3–1.9]) during high fever ( 14 ). Although the patient did not present with a severe hyperglycemic state on examining IRI, it provided us an opportunity to suspect a decreased insulin secretory capacity.…”

Relationship between inflammatory biomarkers and insulin resistance in excess-weight Latin children

“…These results were reported by other authors. Ballerini et al studied the relationship among HOMA values, BMI and Tanner stage in children and adolescents, finding that the increase in BMI and pubertal development increase the cases of IR [ 17 ].…”