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Indexes of insulin resistance and secretion in obese children and adolescents: a validation study.
Diabetes Care 2004; 27(2):314-9DC

Abstract

OBJECTIVE

To assess the concurrent validity of fasting indexes of insulin sensitivity and secretion in obese prepubertal (Tanner stage 1) children and pubertal (Tanner stages 2-5) adolescents using estimates from the modified minimal model frequently sampled intravenous glucose tolerance test (FSIVGTT) as a criterion measure.

RESEARCH DESIGN AND METHODS

Eighteen obese children and adolescents (11 girls and 7 boys, mean age 12.2 +/- 2.4 years, mean BMI 35.4 +/- 6.2 kg/m(2), mean BMI-SDS 3.5 +/- 0.5, 7 prepubertal and 11 pubertal) participated in the study. All participants underwent an insulin-modified FSIVGTT on two occasions, and 15 repeated this test a third time (mean 12.9 and 12.0 weeks apart). S(i) measured by the FSIVGTT was compared with homeostasis model assessment (HOMA) of insulin resistance (HOMA-IR), quantitative insulin-sensitivity check index (QUICKI), fasting glucose-to-insulin ratio (FGIR), and fasting insulin (estimates of insulin sensitivity derived from fasting samples). The acute insulin response (AIR) measured by the FSIVGTT was compared with HOMA of percent beta-cell function (HOMA-beta%), FGIR, and fasting insulin (estimates of insulin secretion derived from fasting samples).

RESULTS

There was a significant negative correlation between HOMA-IR and S(i) (r = -0.89, r = -0.90, and r = -0.81, P < 0.01) and a significant positive correlation between QUICKI and S(i) (r = 0.89, r = 0.90, and r = 0.81, P < 0.01) at each time point. There was a significant positive correlation between FGIR and S(i) (r = 0.91, r = 0.91, and r = 0.82, P < 0.01) and a significant negative correlation between fasting insulin and S(i) (r = -90, r = -0.90, and r = -0.88, P < 0.01). HOMA-beta% was not as strongly correlated with AIR (r = 0.60, r = 0.54, and r = 0.61, P < 0.05).

CONCLUSIONS

HOMA-IR, QUICKI, FGIR, and fasting insulin correlate strongly with S(i) assessed by the FSIVGTT in obese children and adolescents. Correlations between HOMA-beta%, FGIR and fasting insulin, and AIR were not as strong. Indexes derived from fasting samples are a valid tool for assessing insulin sensitivity in prepubertal and pubertal obese children.

Authors+Show Affiliations

Department of Endocrinology and Diabetes, Royal Children's Hospital, Herston, Brisbane, Queensland, Australia. louise_conwell@health.qld.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14747206

Citation

Conwell, Louise S., et al. "Indexes of Insulin Resistance and Secretion in Obese Children and Adolescents: a Validation Study." Diabetes Care, vol. 27, no. 2, 2004, pp. 314-9.
Conwell LS, Trost SG, Brown WJ, et al. Indexes of insulin resistance and secretion in obese children and adolescents: a validation study. Diabetes Care. 2004;27(2):314-9.
Conwell, L. S., Trost, S. G., Brown, W. J., & Batch, J. A. (2004). Indexes of insulin resistance and secretion in obese children and adolescents: a validation study. Diabetes Care, 27(2), pp. 314-9.
Conwell LS, et al. Indexes of Insulin Resistance and Secretion in Obese Children and Adolescents: a Validation Study. Diabetes Care. 2004;27(2):314-9. PubMed PMID: 14747206.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Indexes of insulin resistance and secretion in obese children and adolescents: a validation study. AU - Conwell,Louise S, AU - Trost,Stewart G, AU - Brown,Wendy J, AU - Batch,Jennifer A, PY - 2004/1/30/pubmed PY - 2004/9/3/medline PY - 2004/1/30/entrez SP - 314 EP - 9 JF - Diabetes care JO - Diabetes Care VL - 27 IS - 2 N2 - OBJECTIVE: To assess the concurrent validity of fasting indexes of insulin sensitivity and secretion in obese prepubertal (Tanner stage 1) children and pubertal (Tanner stages 2-5) adolescents using estimates from the modified minimal model frequently sampled intravenous glucose tolerance test (FSIVGTT) as a criterion measure. RESEARCH DESIGN AND METHODS: Eighteen obese children and adolescents (11 girls and 7 boys, mean age 12.2 +/- 2.4 years, mean BMI 35.4 +/- 6.2 kg/m(2), mean BMI-SDS 3.5 +/- 0.5, 7 prepubertal and 11 pubertal) participated in the study. All participants underwent an insulin-modified FSIVGTT on two occasions, and 15 repeated this test a third time (mean 12.9 and 12.0 weeks apart). S(i) measured by the FSIVGTT was compared with homeostasis model assessment (HOMA) of insulin resistance (HOMA-IR), quantitative insulin-sensitivity check index (QUICKI), fasting glucose-to-insulin ratio (FGIR), and fasting insulin (estimates of insulin sensitivity derived from fasting samples). The acute insulin response (AIR) measured by the FSIVGTT was compared with HOMA of percent beta-cell function (HOMA-beta%), FGIR, and fasting insulin (estimates of insulin secretion derived from fasting samples). RESULTS: There was a significant negative correlation between HOMA-IR and S(i) (r = -0.89, r = -0.90, and r = -0.81, P < 0.01) and a significant positive correlation between QUICKI and S(i) (r = 0.89, r = 0.90, and r = 0.81, P < 0.01) at each time point. There was a significant positive correlation between FGIR and S(i) (r = 0.91, r = 0.91, and r = 0.82, P < 0.01) and a significant negative correlation between fasting insulin and S(i) (r = -90, r = -0.90, and r = -0.88, P < 0.01). HOMA-beta% was not as strongly correlated with AIR (r = 0.60, r = 0.54, and r = 0.61, P < 0.05). CONCLUSIONS: HOMA-IR, QUICKI, FGIR, and fasting insulin correlate strongly with S(i) assessed by the FSIVGTT in obese children and adolescents. Correlations between HOMA-beta%, FGIR and fasting insulin, and AIR were not as strong. Indexes derived from fasting samples are a valid tool for assessing insulin sensitivity in prepubertal and pubertal obese children. SN - 0149-5992 UR - https://www.unboundmedicine.com/medline/citation/14747206/Indexes_of_insulin_resistance_and_secretion_in_obese_children_and_adolescents:_a_validation_study_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=14747206 DB - PRIME DP - Unbound Medicine ER -