ESPE2015 Poster Category 3 Fat (88 abstracts)
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.
| Whole study group | Low-NGT | High-NGT | P | |
| Fasting glucose (mg/dl) | 92.9±9.4 | 91.9±9.8 | 95.9±7.2 | 0.02 |
| 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±15.8 | 105.9±11.2 | 125.9±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-IR | 3.5 (2.4–5.1) | 3.4 (2.3–5.1) | 3.7 (2.5–5.2) | 0.66 |
| WBISI | 0.32 (0.20–0.48) | 0.34 (2.37–4.99) | 0.26 (0.18–0.38) | 0.016 |
| Insulinogenic Index | 2.5 (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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