ESPE Abstracts

Background: Increased glycaemic variability (GV) (short-term fluctuations in blood glucose level) is associated with increased oxidative stress, vascular complications and mortality in diabetic and prediabetic patients.

Objective and hypotheses: To investigate the relationship between GV and inflammatory markers in obese children with metabolic syndrome (MS) and insulin resistance (IR).

Method: Fifty obese adolescents with insulin resistance were included in the study. Insulin resistance was diagnosed according to the results of oral glucose tolerance test (OGTT). All patients underwent anthropometric measurements, body fat analysis and subcutaneous continuous glucose monitoring (SCGM) for 24 h. Serum lipid, adiponectin and interleukin-6 (IL-6) levels were measured. Glycaemic variability coefficient (GVC) was calculated using the standard deviation and the average glucose value obtained by SCGM. MS was diagnosed according to the modified World Health Organization and the International Diabetes Federation criteria.

Results: Twenty-seven of the patients had MS and the remaining had only IR. Body fat mass, HbA1c and peak insulin levels in the OGTT were significantly higher in patients with MS than the group without MS. IL-6 levels were significantly higher in the group with MS, but there was no difference in adiponectin levels. There was a significant positive correlation between GVC and HOMA-IR; fasting, peak and total insulin levels. When ROC analysis was used to determine the best sensitivity and specificity value for IL-6 and adiponectin in the diagnosis of MS, the best sensitive (70.4%) and specific (82.6%) value for IL-6 was 1.41 (pg/ml×2) but there were no significant expression of adiponectin values.

Conclusion: This study suggests that there may be a relationship between GV and insulin resistance parameters such as HOMA-IR, fasting insulin, peak and total insulin values in OGTT. IL-6 levels are higher in obese children with MS than without MS.