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Insulin sensitivity from preschool to school age in patients with severe obesity

Melania Manco1, Maria Rita Spreghini, Rosa Luciano

  • 1Scientific Directorate, Research Unit for Multifactorial Disease, Bambino Gesù Children Hospital, Rome, Italy. melania.manco@opbg.net

Plos One
|August 13, 2013
PubMed

Insights

Insulin sensitivity declines in severely obese children before puberty. This decrease in whole-body insulin sensitivity index (WBISI) is linked to rising BMI z-scores and other metabolic markers.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Health
  • Obesity Research

Background:

  • Insulin sensitivity typically declines during puberty.
  • Limited data exists on insulin sensitivity changes in younger obese children.
  • Understanding early changes is crucial for timely intervention.

Purpose of the Study:

  • To describe the longitudinal changes in insulin sensitivity.
  • To investigate the time-course of insulin sensitivity from preschool to school age in severely obese children.
  • To identify predictors of these metabolic changes.

Main Methods:

  • Retrospective cohort study of 47 severely obese children (BMI ≥99th percentile).
  • Evaluations conducted between 2-6 years and before 8 years of age.
  • Longitudinal assessment of glucose tolerance, Whole Body Insulin Sensitivity Index (WBISI), and other metabolic indices via oral glucose tolerance test.

Main Results:

  • A significant decrease in WBISI and increase in fasting and 2-hour glucose levels were observed.
  • Changes in BMI z-score and ISSI-2 were significant predictors of WBISI and 2-hour glucose.
  • BMI z-score also predicted beta-cell demand index (BCDI).

Conclusions:

  • Insulin sensitivity appears to decrease in severely obese children even before pubertal onset.
  • Changes in total adiposity partially explain the observed variations in insulin sensitivity.
  • Early metabolic decline in obese children warrants further investigation.
Abstract

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