[Insulinsensitivity and beta-cell function in children with idiopathic nephrotic syndrome]

Area of Science:

• Pediatric Endocrinology
• Nephrology
• Metabolic Disorders

Background:

• Idiopathic nephrotic syndrome (INS) is often associated with glucose intolerance, a potential cardiovascular risk factor.
• Proteinuria and steroid therapy are suspected to independently influence insulin sensitivity in INS patients.

Purpose of the Study:

• To evaluate insulin resistance and beta-cell function in children with INS across different disease stages.
• To investigate the impact of disease activity, steroid treatment, and proteinuria on metabolic parameters.

Main Methods:

• Studied 66 children with INS (relapse, remission with steroids, remission without steroids) and 20 healthy controls.
• Assessed insulin resistance (HOMA-IR) and beta-cell function (HOMA-beta) using Homeostatic Model Assessment.
• Performed multivariate analysis to identify factors correlating with insulin resistance.

Main Results:

• Insulin resistance (HOMA-IR) was significantly elevated in children with INS during relapse and remission with steroids compared to controls.
• Beta-cell function (HOMA-beta) was also significantly higher in these groups, indicating compensatory insulin secretion.
• Multivariate analysis revealed correlations between HOMA-IR and proteinuria, steroid dose, and BMI.

Conclusions:

• Children with INS, particularly those on steroid treatment, exhibit increased insulin resistance with compensatory beta-cell hypersecretion.
• Proteinuria emerges as an independent risk factor contributing to decreased insulin sensitivity in pediatric INS.