Is the Single Point Insulin Sensitivity Estimator (SPISE) index a reliable tool for children and adolescents with overweight/obesity?

Giacomo Tantari; Marta Bassi; Angela Pistorio; Nicola Minuto; Flavia Napoli; Gianluca Piccolo; Giordano Spacco; Giuseppe d'Annunzio; Mohamad Maghnie

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ESPE Abstracts (2024) 98 RFC11.2

ESPE2024 Rapid Free Communications Fat, Metabolism and Obesity 2 (6 abstracts)

Is the Single Point Insulin Sensitivity Estimator (SPISE) index a reliable tool for children and adolescents with overweight/obesity?

Giacomo Tantari ¹ , Marta Bassi ¹ , Angela Pistorio ² , Nicola Minuto ¹ , Flavia Napoli ¹ , Gianluca Piccolo ³ , Giordano Spacco ⁴ , Giuseppe d'Annunzio ¹ & Mohamad Maghnie ⁴

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¹Pediatric Clinic and Endocrinology Unit IRCCS Istituto Giannina Gaslini, Genoa, Italy. ²Scientific Directorate, Epidemiology and Biostatistic Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy. ³Neuro-Oncology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy. ⁴DINOGMI (Department of Neurosciences, Rehabilitation, Opthalmology, Genetics, Maternal and Child Health, University of Genoa and Pediatric Clinic and Endocrinology Unit IRCCS IStituto Giannina Gaslini, Genoa, Italy

Introduction: Pediatric obesity is is increasing worldwide. Children and adolescents affected are at increased risk of Type 2 Diabetes Mellitus and its cardiovascular complications, starting in young adulthood and linked to insulin resistance and its inflammatory milieu. The SPISE index, calculated using baseline triglycerides, HDL cholesterol, and BMI, shows promise in predicting insulin resistance in this population. It is not affected by insulin secretion pulsatility, as for Homeostatic Model of Insulin Resistance (HOMA-IR) index.

Objectives: The primary aim was aim was to identify the values of SPISE index in children and adolescents with obesity. Secondary aims were to establish the relationship between SPISE index and glycometabolic profile and its predictive value as compared to other known insulin reisitance indexes t

Methods: The study included 232 children and adolescents (median age 13.2 years) with overweight/obesity (48 with overweight and 184 with obesity), according to WHO criteria. Participants were categorized by Tanner stages (Group 1: Tanner I, Group 2: Tanner II-III-IV, Group 3: Tanner V) and assessed for insulin resistance using HOMA-IR and sum of insulin during OGTT. SPISE index was calculated with the formula: 600 × HDL Cholesterol^0,185/triglycerides^0,2x BMI^1,338. Oral Glucose Tolerance Test (OGTT) and lipid, liver and kidney function were performed in all cases. Total Insulin Sum (TIS) > 535 microU/Ml was considered a marker of insulin resistance

Results: SPISE cutoffs of ≤ 6.92 and ≤ 6.13 were identified for Tanner stages I and II, respectively, showing good sensitivity and specificity for detecting individuals at higher risk of insulin resistance. SPISE index significantly decreased with the progression of pubertal development (Tanner 1 to Tanner5) and obesity severity (P < 0.0001). No significant differences were observed between patients with normal and abnormal OGTT within any pubertal stage. SPISE values were significantly lower in patients with confirmed insulin resistance (TIS > 535 microU/ml) in all three pubertal development groups (G1: P = 0.008, G2: P = 0.0008, G3: P = 0.002, respectively).

Conclusion: In children and adolescents with obesity the SPISE index seems to be a useful alternative measure for evaluating insulin resistance as comapred to OGTT and other insulin-based methods. The main advantage is due to its simplicity, and the use of readily available and inexpensive laboratoty test. This makes it suitable for large-scale baseline and follow-up studies among different pediatric populations characterized by simple or secondary obesity.