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Glucose tolerance status in 510 children and adolescents attending an obesity clinic in Central Italy.
Pediatr Diabetes. 2010 Feb; 11(1):47-54.PD

Abstract

Childhood obesity is epidemic in developed countries and is accompanied by an increase in the prevalence of type 2 diabetes (T2DM).

AIMS

Establish prevalence of glucose metabolism alterations in a large sample of overweight/obese children and adolescents from Central Italy.

METHODS

The study group included 510 overweight/obese subjects (3-18 yr). Oral glucose tolerance test (OGTT) was performed with glucose and insulin determination. Homeostatic model assessment of insulin resistance (HOMA-IR) and insulin sensitivity index (ISI) were derived from fasting and OGTT measurements. Beta-cell function was estimated by insulinogenic index. Fat mass was measured by dual-energy x-ray absorptiometry.

RESULTS

Glucose metabolism alterations were detected in 12.4% of patients. Impaired glucose tolerance (IGT) was the most frequent alteration (11.2%), with a higher prevalence in adolescents than in children (14.8 vs. 4.1%, p < 0.001); silent T2DM was identified in two adolescents (0.4%). HOMA-IR and glucose-stimulated insulin levels were higher in patients with IGT than individuals with normal glucose tolerance (HOMA-IR = 4.4 +/- 2.5 vs. 3.4 +/- 2.3, p = 0.001). Fat mass percentage and insulinogenic index were not different between the two groups. In multivariate analysis, age, fasting glucose, and insulin resistance influenced independently plasma glucose at 120 min of OGTT. Individuals with combined impaired fasting glucose/IGT (IFG/IGT) and T2DM were older and had reduced plasma insulin values at OGTT when compared to patients with simple IGT.

CONCLUSIONS

Glucose metabolism alterations are frequently found among children and adolescents with overweight/obesity from Central Italy. Age, fasting glucose, and insulin resistance are main predictors of IGT. We suggest the use of OGTT as a screening tool in obese European adolescents.

Authors+Show Affiliations

Endocrinology and Diabetes Unit, Department of Paediatric Medicine, Bambino Gesù Children's Hospital IRCCS, Rome, Italy. cbrufani@libero.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19460122

Citation

Brufani, Claudia, et al. "Glucose Tolerance Status in 510 Children and Adolescents Attending an Obesity Clinic in Central Italy." Pediatric Diabetes, vol. 11, no. 1, 2010, pp. 47-54.
Brufani C, Ciampalini P, Grossi A, et al. Glucose tolerance status in 510 children and adolescents attending an obesity clinic in Central Italy. Pediatr Diabetes. 2010;11(1):47-54.
Brufani, C., Ciampalini, P., Grossi, A., Fiori, R., Fintini, D., Tozzi, A., Cappa, M., & Barbetti, F. (2010). Glucose tolerance status in 510 children and adolescents attending an obesity clinic in Central Italy. Pediatric Diabetes, 11(1), 47-54. https://doi.org/10.1111/j.1399-5448.2009.00527.x
Brufani C, et al. Glucose Tolerance Status in 510 Children and Adolescents Attending an Obesity Clinic in Central Italy. Pediatr Diabetes. 2010;11(1):47-54. PubMed PMID: 19460122.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glucose tolerance status in 510 children and adolescents attending an obesity clinic in Central Italy. AU - Brufani,Claudia, AU - Ciampalini,Paolo, AU - Grossi,Armando, AU - Fiori,Rossana, AU - Fintini,Danilo, AU - Tozzi,Alberto, AU - Cappa,Marco, AU - Barbetti,Fabrizio, Y1 - 2009/04/30/ PY - 2009/5/23/entrez PY - 2009/5/23/pubmed PY - 2010/7/21/medline SP - 47 EP - 54 JF - Pediatric diabetes JO - Pediatr Diabetes VL - 11 IS - 1 N2 - UNLABELLED: Childhood obesity is epidemic in developed countries and is accompanied by an increase in the prevalence of type 2 diabetes (T2DM). AIMS: Establish prevalence of glucose metabolism alterations in a large sample of overweight/obese children and adolescents from Central Italy. METHODS: The study group included 510 overweight/obese subjects (3-18 yr). Oral glucose tolerance test (OGTT) was performed with glucose and insulin determination. Homeostatic model assessment of insulin resistance (HOMA-IR) and insulin sensitivity index (ISI) were derived from fasting and OGTT measurements. Beta-cell function was estimated by insulinogenic index. Fat mass was measured by dual-energy x-ray absorptiometry. RESULTS: Glucose metabolism alterations were detected in 12.4% of patients. Impaired glucose tolerance (IGT) was the most frequent alteration (11.2%), with a higher prevalence in adolescents than in children (14.8 vs. 4.1%, p < 0.001); silent T2DM was identified in two adolescents (0.4%). HOMA-IR and glucose-stimulated insulin levels were higher in patients with IGT than individuals with normal glucose tolerance (HOMA-IR = 4.4 +/- 2.5 vs. 3.4 +/- 2.3, p = 0.001). Fat mass percentage and insulinogenic index were not different between the two groups. In multivariate analysis, age, fasting glucose, and insulin resistance influenced independently plasma glucose at 120 min of OGTT. Individuals with combined impaired fasting glucose/IGT (IFG/IGT) and T2DM were older and had reduced plasma insulin values at OGTT when compared to patients with simple IGT. CONCLUSIONS: Glucose metabolism alterations are frequently found among children and adolescents with overweight/obesity from Central Italy. Age, fasting glucose, and insulin resistance are main predictors of IGT. We suggest the use of OGTT as a screening tool in obese European adolescents. SN - 1399-5448 UR - https://www.unboundmedicine.com/medline/citation/19460122/Glucose_tolerance_status_in_510_children_and_adolescents_attending_an_obesity_clinic_in_Central_Italy_ L2 - https://doi.org/10.1111/j.1399-5448.2009.00527.x DB - PRIME DP - Unbound Medicine ER -