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Utility of early insulin response and proinsulin to assess insulin resistance

Amy M Jean1, Abeer Hassoun, Jennifer Hughes

  • 1Department of Pediatrics, Division of Pediatric Endocrinology, Columbia University, New York, NY 10032, USA.

The Journal of Pediatrics
|August 1, 2009
PubMed

Insights

Obese children with premature adrenarche exhibit higher early insulin response (EIR) and proinsulin (PI) levels, indicating an increased risk for prediabetes and type 2 diabetes. This highlights the additive impact of obesity and premature adrenarche on metabolic health.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Health
  • Diabetes Research

Background:

  • Premature adrenarche and obesity are independently associated with metabolic dysfunction.
  • Understanding their combined effects is crucial for early risk assessment in children.

Purpose of the Study:

  • To investigate if obesity and premature adrenarche act additively to increase the risk of insulin resistance and beta-cell dysfunction.
  • To utilize early insulin response (EIR) and proinsulin (PI) as key markers.

Main Methods:

  • Prospective case-control study of 81 prepubertal children.
  • Categorization into lean controls, obese controls, lean premature adrenarche, and obese premature adrenarche groups.
  • Assessment of fasting glucose, insulin, proinsulin, and oral glucose tolerance tests to calculate EIR.

Main Results:

  • Obese children, with or without premature adrenarche, showed significantly higher EIR.
  • The obese premature adrenarche group exhibited the highest EIR and elevated fasting PI levels compared to lean counterparts.
  • No significant difference was found in the fasting PI/I ratio across groups.

Conclusions:

  • Obese children with premature adrenarche demonstrate a heightened risk for developing prediabetes and type 2 diabetes mellitus.
  • EIR and PI serve as valuable indicators for assessing metabolic risk in this pediatric population.
  • Early identification and intervention are critical for mitigating long-term metabolic complications.
Abstract

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