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Diabetes Care Publish Ahead of Print published online ahead of print January 17, 2008
DOI: 10.2337/dc07-1655
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Original Research

Alternative Methods of Insulin Sensitivity Assessment in Obese Children and Adolescents

Sophia M Rössner, MD1, Martin Neovius, PhD2, Scott M Montgomery, PhD3,,4,,5, Claude Marcus, MD, PhD6 and Svante Norgren, MD, PhD1

1 Division of Pediatrics, Department of Woman and Child Health, Karolinska Institute, Stockholm, Sweden
2 Department of Medicine, Karolinska Institute, Stockholm, Sweden
3 principal research fellow, Clinical Epidemiology Unit, Karolinska Institute, Stockholm Sweden
4 Clinical Research Centre, Örebro University Hospital, Sweden
5 Department of Primary Care and Social Medicine, Charing Cross Hospital, Imperial College, London, UK
6 National Childhood Obesity Centre, Department for Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska Institute, Stockholm, Sweden

sophia.rossner{at}karolinska.se

ABSTRACT

Objective: To validate fasting indices against minimal model analysis of the frequently sampled intravenous glucose tolerance test (FSIVGTT-MMOD) in an obese pediatric population.

Research Design and Methods: FSIVGTT-MMOD results were compared to HOMA-IR and fasting insulin with sample stratified by sex, puberty and Si median in 191 children (82 males; 13.9±2.9y, BMI 36.9±6.2 kg/m2, BMI-SDS 6.1±1.6).

Results: Across pubertal groups correlation coefficients between Si 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.

Conclusions: The validity of fasting indices in explaining Si was sex dependent, varied with pubertal stage, and in females influenced by degree of insulin sensitivity. In obese pediatric populations we generally discourage the use of fasting indices, although the validity varies within subgroups.


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Copyright © 2008 by the American Diabetes Association.