Background: Obesity-related insulin resistance is present in obese children and Matsuda index is a method proposed to evaluate insulin resistance, using data obtained from the oral glucose tolerance test (OGTT).
Objective and hypotheses: To investigate whether the clinical indicators of family history of obesity and/or Type II diabetes, acanthosis nigricans, and increased waist circumference are associated with insulin resistance, as calculated by the Matsuda index and if they could be used as selection markers for patients to undergo OGTT. Moreover, the correlation of insulin resistance with the coexistence of metabolic syndrome.
Methods: Data from 95 overweight and obese children (47 boys and 48 girls) with mean age 10.7±2.2 years were analyzed. Students t-tests were used for the comparison of means and Pearson correlation coefficients were used to explore the association of two continuous variables.
Results: Insulin resistance was found in 39.1% of the children. The mean MATSUDA index was 3.4 (S.D.=1.9). The mean AUC for glucose was 14211.3 (S.D.=2016.5) and for insulin 13484.2 (S.D.=11985.3). Matsuda index was significantly lower in cases with acanthosis nigricans (P=0.007), in those with metabolic syndrome and in puberty. Additionally, Matsuda index was significantly correlated with waist circumference (r=−0.40, P=0.006). The proportion of those with insulin resistance was similar in boys and girls and greater in puberty. AUC for insulin was significantly greater in cases with acanthosis nigricans (P=0.007) or metabolic syndrome (P=0.006). Waist circumference was also predictive for AUC for insulin (r=0.30, P=0.044).
Conclusion: Family history of obesity and diabetes, acanthosis nigricans and increased waist circumference are associated with insulin resistance and can be used as clinical markers to indicate that a patient should undergo OGTT. In addition, increased insulin sensitivity is associated with better metabolic profile as reflected by lower levels of triglycerides, LDL and higher HDL.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology