HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) All Versions of this Article: dc07-1376v1 31/4/783    most recent Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Schwartz, B. Articles by Sinaiko, A. R. Search for Related Content PubMed PubMed Citation Articles by Schwartz, B. Articles by Sinaiko, A. R. Social Bookmarking                What's this?

Measurement of Insulin Sensitivity in Children: Comparison Between the Euglycemic Hyperinsulinemic Clamp and Surrogate Measures

Betsy Schwartz, M.D.^*, David R. Jacobs, Jr., Ph.D., Antoinette Moran, M.D.^*, Julia Steinberger, M.D., M.S.^*, Ching-Ping Hong, M.S. and Alan R. Sinaiko, M.D.^*,

*Department of Pediatrics, School of Medicine
Division of Epidemiology, School of Public Health, University of Minnesota

sinai001{at}umn.edu

ABSTRACT

Objective: This study compared fasting insulin and measures of insulin sensitivity based on fasting insulin and glucose (i.e., HOMA, QUICKI, FGIR) or triglycerides to the insulin clamp in a cohort of children/adolescents.

Research Design and Methods: The subjects were Minneapolis 5^th-8^th grade students. Euglycemic hyperinsulinemic clamps were performed on 323 at mean age 13 and repeated on 300 at mean age 15. Insulin sensitivity (M) was determined by glucose uptake (mg/kg/min) adjusted for lean body mass (M_LBM) and steady state insulin (M_LBM/ln SSI). Comparisons were made for the whole cohort and by body size (BMI <85%ile vs. BMI 85%ile). ROC curves tested whether specific fasting insulin cut-points separated true positive from false positive approximations of insulin resistance.

Results: Fasting insulin was significantly correlated with HOMA (r=0.99), QUICKI (r=0.79), FGIR (r=-0.62) and [ln fasting insulin + ln triglycerides] (0.88). Correlations of the surrogates with M_LBM were significantly lower than M for the total cohort and 85%ile group. In general, correlations in the 85%ile group were higher than the <85%ile group. Correlations with M_LBM and M_LBM/ln SSI decreased in the total cohort and 85%ile group from age 13 to 15. ROC curves showed only a modest capability to separate true from false positive.

Conclusions: Surrogate measures are only modestly correlated with the clamp measures of insulin sensitivity and do not offer any advantage over fasting insulin. In general, lower correlations are seen with M_LBM than M and with heavier than thin individuals.

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?