Prevalence of insulin resistance and impaired glucose tolerance in a sample of obese spanish children and adolescents

Abstract

The prevalence of obesity in children has increased in developed countries in the last decades. It is associated with alterations in glucose metabolism that may be present in childhood. To assess the frequency of glucose metabolism alterations and insulin resistance and their possible determinants in a sample of obese children from Valladolid (Spain), we retrospectively studied 100 obese children and adolescents (11.59 ± 2.73 years). Anthropometric measures, biochemical parameters, and oral glucose tolerance test (OGTT) were performed. Insulin resistance was evaluated with fasting insulin, HOMA index, and insulin values in OGTT. Impaired glucose tolerance was found in 15% of the sample, and was the most frequent of glucose metabolism alterations. Impaired fasting glucose was found in 2%. No case of type 2 diabetes was found. Acanthosis nigricans was present in 22%, with predominance in females, but not all presented insulin resistance. The prevalence of insulin resistance was 29% when HOMA index was used, and 50% when the insulin response in OGTT was used. Not all patients with impaired glucose tolerance had a pathological HOMA index, and not all with pathological HOMA index presented insulin resistance when insulin values in OGTT were used. Higher 2-h post-OGTT insulin levels were found in children with impaired glucose tolerance. It is paramount to identify young people with glucose regulation alterations for early, intensive intervention to prevent or at least postpone the onset of type 2 diabetes. OGTT is a screening tool necessary to fulfill this objective.

Lower Frequency of HLA-DRB1 Type 1 Diabetes Risk Alleles in Pediatric Patients with MODY

“…Thus, we could consider a limitation in our study not having included a group of patients with type 2 diabetes in the analysis. However, the current prevalence of type 2 diabetes in our Caucasian youth population is very low [24, 25]. Therefore, it is unlikely that MODY may be misdiagnosed as type 2 diabetes in this pediatric population.…”

Association of the Apolipoprotein B/Apolipoprotein A-I Ratio, Metabolic Syndrome Components, Total Cholesterol, and Low-Density Lipoprotein Cholesterol with Insulin Resistance in the Population of Georgia

“…The prevalence of IR is increasing worldwide [28–31]. Studies have indicated that IR was significantly associated with ApoB/ApoA-I ratio, metabolic syndrome (MetS), and lipid indices.…”

Insulin resistance in type 2 diabetic youth

“…It remains unclear whether the same cutoffs should apply to youth, and whether mild elevations during the increased insulin resistance of puberty will persist [41 ▪ ,52,53 ▪ ,54,55 ▪ ]. Both fasting and OGTT-based measures can be problematic for early diagnosis [17 ▪▪ ,26,56 ▪ ,57 ▪ ,58,59], HbA1c and OGTT values are poorly correlated [41 ▪ ], repeated OGTT’s have poor reproducibility in youth [60] and HbA1 can vary substantially depending on method, making diagnosis of prediabetes and early T2DM difficult. One recent proposal was to conduct OGTTs in children with a HbA1c more than 5.5% [61], whereas others recently proposed an algorithm including glucose, triglycerides and BMI; HbA1c did not add to the predictive value of this method [62 ▪▪ ].…”