Insulin resistance and type 2 diabetes in children

Castorani, Valeria; Polidori, Nella; Giannini, Cosimo; Blasetti, Annalisa; Chiarelli, Francesco

doi:10.6065/apem.2040090.045

Cited by 46 publications

(45 citation statements)

References 96 publications

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“…In this study, sex-specific differences were also observed in the correlation between IR surrogates and associated cardiometabolic risk factors, such as total cholesterol, HDLcholesterol, and DBP. These data support the idea that additional genetic and lifestyle factors including dietary patterns and exercise, may also influence IR and the dysmetabolic profile [1,5,49].…”

Section: Discussionsupporting

confidence: 80%

“…Childhood obesity is a multisystem condition associated with several metabolic diseases [39]. IR is an early manifestation of dysmetabolism in pediatric patients, and is also considered a precursor and risk factor for other cardiovascular diseases [1][2][3][4][5]. IR is characterized by an inappropriate compensatory insulin secretory response, which leads to hyperinsulinemia [40].…”

Section: Discussionmentioning

confidence: 99%

“…Insulin resistance (IR) is a crucial factor contributing to the pathogenetic mechanism of several disorders, including type 2 diabetes mellitus (DMT2), hypertension, dyslipidemia, cardiovascular disease, and metabolic syndrome [1][2][3]. IR represents the earliest manifestation of dysmetabolism in children [4,5].…”

Section: Introductionmentioning

confidence: 99%

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Sex-Specific Differences in the Relationship between Insulin Resistance and Adiposity Indexes in Children and Adolescents with Obesity

et al. 2021

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New indexes of adiposity have been introduced to evaluate body-fat distribution and cardiometabolic risk. However, data on the correlation between Insulin Resistance (IR) and these new indexes are limited. We therefore evaluated the relationship between IR and adiposity indexes in children and adolescents with obesity, focusing on gender differences. We retrospectively enrolled 586 patients with obesity (10.80 ± 2.63; 306F/279M). As adiposity indexes we considered body mass index (BMI), BMI-z score, WC, waist-to-height ratio (WHtR), a body shape index (ABSI), triponderal mass index (TMI), visceral adiposity index (VAI) and conicity index (ConI). The homeostasis model assessment for insulin resistance (HOMA-IR), HOMA of percentage β-cell function (HOMA-β), quantitative insulin sensitivity check index (QUICKI), and triglyceride and glucose index (TyG-index) were measured and recorded as IR surrogates. In both sexes, WC and VAI significantly correlated with all IR measurements (p < 0.001). BMI significantly correlated (p < 0.001) with all IR parameters except for the TyG-index in females. Fat mass and TMI correlated with IR parameters only in females, BMI-z score with IR markers except for HOMA-β in males, WHtR with HOMA-β in both sexes (p < 0.05), free fat mass with HOMA-IR and QUICKI only in females (p < 0.01), ConI correlated with the TyG index in females (p = 0.01). Tryglicerides and SBP were correlated with all IR measurements (p < 0.001), in both sexes. Correlations between different sex parameters were significantly more evident in middle puberty. The relationship between IR surrogates and obesity indexes is influenced by gender in pediatrics. Sex-specific differences in obesity-related complications should be considered in preventive intervention decision-making.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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Sex-Specific Differences in the Relationship between Insulin Resistance and Adiposity Indexes in Children and Adolescents with Obesity

et al. 2021

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“…Obesity-induced in ammation contributes to development of insulin resistance and T2DM (4,10), and these conditions are important contributing factors to MS (11). In ammatory markers, including Creactive protein, ferritin, and cytokine, are elevated in obesity (11,12).…”

Section: Introductionmentioning

confidence: 99%

Positive Association Between Body Mass Index and Hematologic Parameters, Including RBC, WBC and Platelet Count, in Korean Children and Adolescent

Jeong

Shim

2021

Preprint

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Objective: To investigate the associations between hematologic parameters and obesity in children and adolescents.Methods: A total of 7,997 subjects (4,259 boys, 3,738 girls) aged 10–18 years was enrolled and hematologic parameters, including WBC, RBC, Hb, Hct, and platelet levels, were recorded and compared against body mass index (BMI) classified into normal-weight, overweight, and obesity groups.Results : The obesity group had significantly higher mean levels of WBC (7.16 vs. 6.16 (x103/mm3), p<0.001), RBC (4.90 vs. 4.82 (x106/mm3), p<0.001), Hb (14.07 vs. 13.99 (g/dL), p<0.05), Hct (42.31 vs. 41.91 (%), p<0.001) and platelets (311.87 vs. 282.66 (x103/mm3), p<0.001) than the normal-weight group after adjusting for obesity and sex. BMI SDS was significantly positively associated with WBC (β=0.275, p<0.001), RBC (β=0.028, p<0.001), Hb (β=0.034, p<0.001), Hct (β=0.152, p<0.001), and platelets (β=8.372, p<0.001) after adjusting for age, sex, and possible socioeconomic confounders in a multiple linear regression analysis.Conclusion: Higher BMI is associated with elevated WBC, RBC, Hb, Hct and platelet counts in children and adolescents. Because higher hematologic parameters are potential risk factors for obesity-related morbidity, more attention should be paid to evaluating and interpreting hematologic parameters in children and adolescents with obesity

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“…Combination of multiple risk factors such as genetics, the mother's gestational diabetes, poor diet and lifestyle are considered as the cause of this rise (Castorani, et al. [1]). While there are no possible actions can be done to change the genetics of the person, adopting an appropriate personalized diet and lifestyle represents the sole option for the prevention of the disease pathogenesis and management.…”

Section: Introductionmentioning

confidence: 99%

Recovery of a Vietnamese Child from Impaired Fasting Glucose and Hyperinsulinemia After one Year of Implementation of an Appropriate Diet Plan: A Case Report

La¹,

Van

2021

BJSTR

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Background: Increasing type 2 diabetes mellitus (T2D) in children and adolescents has bypassed the living standard barrier among countries to become a global epidemics. The diagnosis of T2D often focuses on overweight or obese individuals which leaves behind the normal Body Mass Index (BMI) ones whose late diagnosis causes grave complications and consequences. Changing diet and lifestyle are affective means for the management of the disease.Method: A 9-year-old normal weight Vietnamese male with a BMI of 23.3 kg/m2 was diagnosed with impaired fasting glucose (IFG) and hyperinsulinemia a in December 2019 after intensive treatments for severe hair loss progression (Alopecia areata). The patient was under both topical and oral cortisol (4mg of Methylprednisolone and 0.1% Mometasone furoate, daily), fasting blood glucose was 6.6 mmol/L, HbA1C was 5.1%, fasting insulin was 123.048 μU/mL, C-peptide was 4.7 nmol/L and a complete hair loss. His white blood count showed an increase in % Lymphocytes associated with a decrease in: % Neutrophils, number of Eosinophils and number of Basophils. He was born 4.1 kg and his mother did not have gestational diabetes. He adopted an anti-inflammatory diet protocol for the first 6 months which was then extended to high fat low carb diet.Result: After about one year of changing his diet, from May 2020 to April 2021, the patient was off all his medications, his blood test was back to normal (glucose, HbA1C, insulin and C-peptide are 4.22 mmol/L, 4.94%, 3.9 μU/mL, 0.72 nmol/L respectively) and his complete blood count has completely recovered. However, there have been no signs of recovery for his hair loss. Conclusion:The adoption of an appropriate diet is an effective tool for the prevention of T2D progression as well as the management of the disease. Thanks to changes in his diet, the patient has recovered from not only IFG and hyperinsulinemia but also the severe inflammation which, if left advanced, could have led to other complications including the development of polygranular autoimmune disease. Routine screening and early diagnosis of T2D, impaired fasting glucose and hyperinsulinemia are recommended to help patients to avoid serious consequences from the disease complications. Children and adults with normal BMI should be paid as much attention as to those whose BMI is high.

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Insulin resistance and type 2 diabetes in children

Cited by 46 publications

References 96 publications

Sex-Specific Differences in the Relationship between Insulin Resistance and Adiposity Indexes in Children and Adolescents with Obesity

Sex-Specific Differences in the Relationship between Insulin Resistance and Adiposity Indexes in Children and Adolescents with Obesity

Positive Association Between Body Mass Index and Hematologic Parameters, Including RBC, WBC and Platelet Count, in Korean Children and Adolescent

Recovery of a Vietnamese Child from Impaired Fasting Glucose and Hyperinsulinemia After one Year of Implementation of an Appropriate Diet Plan: A Case Report

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