ESPE Abstracts (2015) 84 P-3-861

Decreased Insulin Sensitivity and Secretion in Obese Youth with High OGTT Derived 1 h Blood Glucose

M Loredana M Loredana, Elsa Marisi, Ilaria Di Giovanni, Chiara De Leonibus, Francesco Chiarelli & Angelika Mohn

University of Chieti, Chieti, Italy

Background: Obese adults with normal glucose tolerance (NGT) but 1-h post load glucose (1 hPG)≧155 mg/dl have an increased cardiometabolic risk. In children, preliminary data suggest that 1hPG≧132.5 mg/dl might identify those at higher risk of type 2 diabetes.

Objective and hypotheses: To assess whether NGT obese youth with 1hPG ≧132.5 mg/dl (High-NGT) have worse insulin sensitivity and secretion compared to obese youth with 1hPG <132.5 mg/dl (low-NGT).

Method: Oral glucose tolerance tests (OGTTs) were performed in 202 obese children (83 males, 82 prepubertal, mean age (S.D.): 11.1±2.8 years, BMI-SDS: 2.23±0.52). Indexes of insulin sensitivity (HOMA-IR, WBISI) and secretion (insulinogenic index), and the area under the curve (AUC) for glucose and insulin during the OGTT were calculated.

Results: Ten (5%) youth had impaired glucose tolerance. Among those with NGT, 38 (19.8%) were classified as high-NGT (age: 10.9±2.7 years) and 154 as low-NGT (age: 11.2±2.9 years). High-NGT youth showed higher fasting glucose and AUC glucose and insulin, lower insulin sensitivity (WBSI) and insulin secretion.

Table 1 (for abstract P3-861)
Whole study groupLow-NGTHigh-NGTP
Fasting glucose (mg/dl)92.9±9.491.9±9.895.9±7.20.02
Fasting insulin (μU/ml)15.6 (10.3–22.6)15.6 (10.0–22.7)15.1 (10.3–21.4)0.99
AUC glucose (mg/dl)111.5±15.8105.9±11.2125.9±11.5<0.001
AUC insulin (μU/ml)70.4 (100.5–120.4)65.2 (41.3–99.0)106.4 (55.9–127.1)0.007
HOMA-IR3.5 (2.4–5.1)3.4 (2.3–5.1)3.7 (2.5–5.2)0.66
WBISI0.32 (0.20–0.48)0.34 (2.37–4.99)0.26 (0.18–0.38)0.016
Insulinogenic Index2.5 (1.4–5.3)2.7 (1.5–6.5)1.7 (1.2–2.9)0.009

Conclusions: These data suggest that 1hPG ≧132.5 mg/dl may identify NGT youth with impaired insulin secretion and insulin sensitivity, at increased risk for type 2 diabetes and other cardiometabolic complications.

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