SPISE is more strongly correlated with cardiometabolic factors in adolescents with obesity than HOMA-IR, and is related to the amount of body weight reduction under lifestyle intervention

Giacomo Tantari; Stephanie Brandt-Heunemann; Mohamad Maghnie; Wolfgang Siegfried; Christian Denzer; Martin Wabitsch

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ESPE Abstracts (2024) 98 FC6.3

ESPE2024 Free Communications Fat, Metabolism and Obesity 1 (6 abstracts)

SPISE is more strongly correlated with cardiometabolic factors in adolescents with obesity than HOMA-IR, and is related to the amount of body weight reduction under lifestyle intervention

Giacomo Tantari ¹ , Stephanie Brandt-Heunemann ² , Mohamad Maghnie ^1,3 , Wolfgang Siegfried ⁴ , Christian Denzer ² & Martin Wabitsch ²

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¹Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy. ²Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University, Ulm, Germany. ³DINOGMI (Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health), University of Genoa, Genoa, Italy. ⁴Obesity Rehabilitation Centre INSULA, Berchtesgaden, Germany

Introduction: Impaired insulin sensitivity (IS) is a hallmark of increased cardiometabolic risk in adolescents with obesity. Surrogate markers of IS based on fasting insulin have important limitations. The Single-Point Insulin Sensitivity Estimator-Index (SPISE), obtained using the mathematical formula 600 × HDL-C^0.185/Triglycerides^0.2 × BMI^1.338, has been shown to be a predictor for detecting both insulin resistance and the risk of developing glucose intolerance or type 2 diabetes mellitus (PMID: 34142364, 36677025). Here, we compared the correlations between baseline SPISE index and the well known HOMA-IR and cardiometabolic risk factors in adolescents with extreme obesity (AwEO) as well as changes in SPISE index and HOMA-IR and changes in cardiovascular risk factors after extensive weight loss by long term lifestyle intervention. Furthermore, we studied whether SPISE index can serve as predictor for weight loss achieved.

Methods: SPISE index and HOMA-IR were calculated in n = 107 AwEO (age: 15.2±2.3yrs; females n = 59; BMI SDS: 3.3±0.6) at the start and at the end of a long-term inpatient lifestyle intervention program (5.70±2.32 months). Correlations between SPISE index, HOMA-IR and waist circumference (WC), CRP, IL-6, AST, ALT, GGT, at baseline and under intervention were analysed. Furthermore, weight loss in n = 10 AwEO with high SPISE index (indicating high IS) and n = 10 AwEO with low SPISE index (indicating low IS) matched for age, sex, and BMI was compared.

Results: At baseline, SPISE index correlated better with WC (r =-0.82, P <0.0001) than HOMA-IR (r =0.26, P <0.05). SPISE index was strongly correlated with AST levels (r =-0.55, P <0.05), and with IL-6 levels (r =-0.47, P <0.0001), whereas both parameters did not correlate with HOMA-IR (AST: r =0.03, P >0.05; IL-6: r =0.16, P >0.05). The change in SPISE (ΔSPISE) during the intervention correlated better with the observed change in WC (r =-0.63, P <0.0001) than ΔHOMA-IR (r =0.31, P <0.05). Changes in levels of AST were significantly correlated with ΔSPISE (r =-0.21, P <0.05), but not with ΔHOMA-IR (P >0.05). Changes in cardiometabolic risk, as calculated by MetS severity score (PMID:26783022), were strongly correlated with ΔSPISE (r =-0.56, P <0.001), but not with ΔHOMA-IR (r =0.15, P >0.05). We found that adolescents with a high SPISE index at baseline showed a significantly greater reduction in %BMI per month (-3.9±1.2%) than those with a low SPISE index (-2.9±0.7%; P <0.05).

Discussion: SPISE index correlated more strongly with cardiometabolic risk factors than HOMA-IR in AwEO. The SPISE index appears to be a useful marker of cardiovascular risk in AwEO and may serve as a predictor of weight loss during lifestyle intervention.