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Association Between Insulin Sensitivity and Post-Glucose Challenge Plasma Insulin Values in Overweight Latino Youth

¹ Department of Physiology and Biophysics, University of Southern California, Los Angeles, California
² Department of Pediatrics, University of Southern California, Los Angeles, California
³ Department of Preventive Medicine, University of Southern California, Los Angeles, California

Address correspondence and reprint requests to Michael I. Goran, Professor of Preventive Medicine, Physiology and Biophysics, University of Southern California, 1540 Alcazar St., CHP Room 208-D, Los Angeles, CA 90089. E-mail: goran{at}hsc.edu.

OBJECTIVE—To determine associations between directly measured insulin sensitivity (SI) and oral glucose tolerance test (OGTT)-derived plasma insulin values, or calculated SI indices, in overweight peripubertal Latino children at risk for type 2 diabetes.

RESEARCH DESIGN AND METHODS—Thirty overweight Latino children with a family history of type 2 diabetes, aged 8–13 years, Tanner stages 1–2, underwent an OGTT. Fasting and 2-h plasma insulin values and OGTT-derived SI indices were compared with SI derived from a frequently sampled intravenous glucose tolerance test (FSIGTT) with minimal model analysis, before and after adjustment for total body fat and lean tissue mass, or BMI.

RESULTS—FSIGTT-derived SI for all subjects was 1.62 ± 0.78 x 10^-4 min ^-1 · (µU/ml), with no sex differences. SI correlated (all P values < 0.001) with fasting (r = -0.57) and 2-h (r = -0.58) plasma insulin and all SI indices (r = -0.57 to 0.67). After adjusting for total body fat and lean tissue mass, or BMI, the associations between SI and either fasting insulin or fasting SI indices were no longer significant. However, the 2-h insulin and post-glucose challenge SI indices maintained significant independent associations with SI, even after adjustment for body composition.

CONCLUSIONS—In overweight, peripubertal Latino children at risk for type 2 diabetes, the 2-h plasma insulin value and postchallenge SI indices are better independent correlates of SI than fasting values, after accounting for body composition. The 2-h insulin may therefore be superior to fasting insulin as a single blood sample value for clinical or epidemiological estimates of SI, especially when combined with assessment of body composition.

Abbreviations: AUC-insulin, area under the insulin curve • CDC, Centers for Disease Control and Prevention • FSIGTT, frequently sampled intravenous glucose tolerance test • GCRC, USC General Clinical Research Center • HOMA-IRI, homeostasis model assessment for insulin resistance index • IGT, impaired glucose tolerant • NGT, normal glucose tolerant • OGTT, oral glucose tolerance test • SI, insulin sensitivity • WBISI, whole-body SI index

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