ESPE Abstracts

Introduction: Obese children with normal glucose tolerance (NGT) but with 1-hour post-load plasma glucose (1hPG) ≥ 132.5 mg/dl are at higher risk of developing type 2 diabetes (T2D) and cardiometabolic complications. In addition, new markers of systemic inflammation derived from blood cell count could be used as indicators of insulin resistance, thus predicting worse metabolic profile.

Objective: The aim of our study was to assess whether metabolic abnormalities documented in overweight and obese children with 1hPG ≥ 132.5 mg/dl are related to unfavourable blood cell count indexes.

Methods: Data from medical records of 247 overweight/obese children and adolescents (110/122 M/F; age: 11.1 ± 2.7 years), who had undergone an oral glucose tolerance test (OGTT), were analyzed. In the analysis only NGT children were included, thus the study population was divided into two groups according to 1hPG (low NGT Group: 1hPG < 132.5 mg/dl; high NGT Group: 1hPG ≥ 132.5 mg/dl). Anthropometric, biochemical and haematological measurements including blood cell count data were collected from the hard copy archive. Particularly, leukocyte (WBC) and platelet counts (PLT), the neutrophil-to-lymphocyte (NLR) and the monocytes-to-lymphocyte ratio (MLR) have been considered as markers of inflammation. Fasting and 2h-blood glucose and insulin values were evaluated and the indexes of insulin sensitivity (WBISI) and insulin secretion and beta-cell function (Insulinogenic Index-IGI, Disposition Index) were calculated during the OGTT.

Results: Of the 247 records analyzed, 232 fulfilled criteria for NGT and had complete biochemical data. Among NGT patients, 66 (28.4%) showed 1hPG ≥ 132.5 mg/dL (high-NGT), while 166 (71,6%) had 1hPG < 132.5 mg/dL (low-NGT). The two groups were similar for gender, pubertal stage and age. No significant difference for anthropometric parameters (weight SDS, Heigth SDS, BMI SDS, SBP SDS, DBP SDS) was documented. The group of high-NGT showed a WBC, PLT and NLR values significantly higher compared with the low-NGT group (P<0.001, P=0.03 and P=0.03, respectively). The high-NGT group also showed a significant lower WBISI, IGI and DI as well as increased glucose excursions during OGTT compared with the low-NGT group. On the other hand, no significant differences in terms of fasting insulin were documented between the two groups. In addition, DI correlated significantly with WBC and PLT values in the entire population.

Conclusion: Increased WBC and PLT values and a higher NLR are documented in overweight and obese NGT youth with a 1hPG ≥ 132.5 mg/dL are related to impaired glucose metabolism and insulin sensitivity.