Alternative methods of insulin sensitivity assessment in obese children and adolescents

Diabetes Care
Sophia M RössnerSvante Norgren

Abstract

To validate fasting indexes against minimal model analysis (MMOD) of the frequently sampled intravenous glucose tolerance test (FSIVGTT) in an obese pediatric population. FSIVGTT-MMOD results were compared with homeostasis model assessment of insulin resistance (HOMA-IR) and fasting insulin with the sample stratified by sex, puberty, and sensitivity index (S(i)) median in 191 children (82 males and 109 females, 13.9 +/- 2.9 years of age, BMI 36.9 +/- 6.2 kg/m(2), BMI SD score 6.1 +/- 1.6). Across pubertal groups, correlation coefficients between S(i) and HOMA-IR ranged from -0.43 to -0.78 in males and from -0.53 to -0.57 in females (age and BMI adjusted, P < 0.05 in all instances). Similar results were seen for fasting insulin. In females, the relationship was significantly weaker in more-insulin-resistant subjects. The validity of fasting indexes in explaining S(i) was sex dependent, varied with pubertal stage, and in females was influenced by degree of insulin sensitivity. In obese pediatric populations, we generally discourage the use of fasting indexes, although the validity varies within subgroups.

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Citations

Sep 16, 2009·International Journal of Obesity : Journal of the International Association for the Study of Obesity·M Westerståhl, C Marcus
Apr 22, 2011·The Journal of Clinical Endocrinology and Metabolism·Lindsey GeorgeSilva Arslanian
Apr 25, 2009·PloS One·Lovisa E JohanssonMartin Ridderstråle
Oct 2, 2009·Journal of Endocrinological Investigation·S PiliaS Loche
Jun 16, 2010·Acta Paediatrica·Sophia M RössnerSvante Norgren
Sep 16, 2010·Annals of the New York Academy of Sciences·Vincenzina BruniDaniela Nuvolone
Apr 24, 2014·Pediatric Diabetes·Rebecca J Brown, Jack A Yanovski
Jul 26, 2014·Acta Paediatrica·Emilia HagmanClaude Marcus
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Feb 18, 2012·The Journal of Pediatrics·Alan R Sinaiko, Sonia Caprio
Aug 10, 2019·Autism Research : Official Journal of the International Society for Autism Research·Evelyn HerbrechtRené Spiegel

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